For the first time in 1975 ultrastructural defects of the sperm tail and the cilia of the respiratory tract were recognized as causing male sterility and chronic bronchitis. A spectrum of ultrastructural defects leading to a restricted mucociliary clearance and chronic bronchitis was found by further investigations. Whereas genetically determined primary structural defects appear generally, secondary ciliary changes caused by chronic infections are found sporadically and not bound to a fixed pattern. Congenital and acquired specific ciliary alterations in the tubulin-dynein-system should be distinguished from nonspecific acquired alterations. A summary of the presently known ultrastructural changes is illustrated by findings of the authors.

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