Optimal technique to diagnose primary ciliary dyskinesia

Norman R. Friedman, Ravi Pachigolla, Ronald W. Deskin, Hal K. Hawkins

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Objective: To develop a cost-effective protocol for diagnosing primary ciliary dyskinesia (PCD). Study Design: Retrospective chart review in a tertiary care academic medical center. Methods: A review of the electron microscopy logbook identified all patients who had a suspected diagnosis of PCD. Biopsy of respiratory tract mucosa was performed using a cytology brush or a cup forceps in the outpatient clinic or operating room (OR). Outcome measures were to determine the diagnostic adequacy of cytological evaluation compared with tissue biopsy and to determine whether an adequate nasal mucosa sample can be collected in the outpatient clinic setting as compared with the OR and the use of general anesthesia. Results: Twenty-seven patients underwent 31 biopsies. Fifteen specimens were collected with a cup forceps, and 16 with a cytology brush. The sampling sites were nasal mucosa in 28 cases and trachea in the rest. Twelve specimens (39%) were collected in the clinic; the rest were obtained in the OR in conjunction with another procedure. Neither method of specimen collection nor mode of anesthesia made a significant difference in the probability of obtaining an adequate specimen. Ten samples were nondiagnostic: cytological evaluation, 31% (n = 16); tissue biopsy, 27% (n = 15); clinic, 42% (n = 12); and OR, 31% (n = 16). The cost of evaluating ciliary motion at our institution was $150, with an additional charge of $1297 for electron microscopic evaluation. The nonprofessional fee for an outpatient nasal biopsy was $98; in the OR the cost of anesthesia supplies, surgical suite, recovery room, and day-surgery bed was at least $1860. Conclusion: Our results suggest that the optimal method for diagnosis of PCD is in the outpatient clinic with specimen collection by means of either a cup forceps or a cytology brush.

Original languageEnglish (US)
Pages (from-to)1548-1551
Number of pages4
JournalLaryngoscope
Volume110
Issue number9
StatePublished - 2000

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Keywords

  • Cost analysis
  • Cytology
  • Immotile cilia syndrome
  • Primary ciliary dyskinesia

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Friedman, N. R., Pachigolla, R., Deskin, R. W., & Hawkins, H. K. (2000). Optimal technique to diagnose primary ciliary dyskinesia. Laryngoscope, 110(9), 1548-1551.