Modern Pediatrics. Ukraine. (2026).2(154): 29-34. doi: 10.15574/SP.2026.2(154).2934
Khaitovych M. V., Didkovskiy V. L.
Bogomolets National Medical University, Kyiv, Ukraine

For citation: Khaitovych MV, Didkovskiy VL. (2026). Acute rhinosinusitis: the role of mucociliary clearance support (literature review). Modern Pediatrics. Ukraine. 2(154): 29-34. doi: 10.15574/SP.2026.2(154).2934.
Article received: Jan 05, 2026. Accepted for publication: Mar 16, 2026.

Acute rhinosinusitis (ARS) is one of the most common upper respiratory tract diseases and significantly affects patients’ quality of life. Impairment of mucociliary clearance is a key pathogenic mechanism contributing to pathogen persistence, progression of inflammation, and development of bacterial complications.
Aim – to summarize current evidence on the role of mucociliary clearance in the pathogenesis of ARS and to analyze available approaches for its pharmacological support.
A narrative review of current scientific publications, international guidelines, and consensus documents addressing the etiology, pathogenesis, and treatment of ARS, with particular attention to factors affecting mucociliary transport, was performed. The efficiency of mucociliary clearance depends on the integrity of the ciliated epithelium, ciliary beat frequency, and rheological properties of mucus. Viral and bacterial pathogens may directly damage ciliated cells, alter mucus characteristics, and promote biofilm formation, leading to impaired mucociliary transport. Some intranasal medications, including topical decongestants and corticosteroids, may negatively influence ciliary activity. Current therapeutic strategies focus on restoring mucociliary function through saline irrigation, mucoactive agents, anti-inflammatory therapy, and symptomatic treatment. Oral combination products containing a decongestant and an antihistamine may reduce nasal obstruction without direct contact with the nasal mucosa, improving mucociliary clearance.
Conclusions. Impaired mucociliary clearance plays a crucial role in the development and progression of ARS. Restoration of mucociliary transport promotes pathogen elimination, reduces inflammation, and improves clinical outcomes. Treatment selection should be based on current evidence and consider the effects of medications on mucociliary function.
No conflict of interest was declared by the author.
Keywords: acute rhinosinusitis, mucociliary clearance, ciliated epithelium, nasal obstruction, decongestants, antihistamines.

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