A total of 22 patients with extensive chronic sinusitis were examined before and 7.2 +/- 1.1 months after microscopic endonasal sinus surgery. Pre- and postoperative nasal mucociliary transport was measured using a modified saccharine test and ciliary beat frequency of nasal respiratory cells using video interference contrast microscopy. In patients suffering from chronic sinusitis, nasal ciliary beat frequency was significantly lower (8.0 +/- 1.8 Hz) than in normals (9.5 +/- 1.7 Hz p < 0.02). Following endonasal sinus surgery, ciliary beat frequency in patients with chronic sinusitis remained reduced (8.3 +/- 1.2 Hz). Nasal mucociliary transport time was significantly (p < 0.05) longer (20.9 +/- 9.4 minutes) in patients with chronic sinusitis than in normals (14.9 +/- 8.4 minutes). Nasal mucociliary transport improved significantly (p < 0.05) to 13.8 +/- 8.4 minutes in 17 of 22 patients without recurrent sinusitis and remained prolonged (20.6 +/- 7.7 minutes) in 5 of 22 patients with recurrent disease. These data suggest that ciliary beat frequency of nasal respiratory cells and nasal mucus transport are impaired in patients suffering from chronic sinusitis. After microscopic endonasal sinus surgery, impaired mucociliary transport is improved, and ciliary beat frequency remains lower than in normals.