Bacteriology of chronic maxillary sinusitis in relation to sinoscopic appearance.

Background: The bacteriology of chronic maxillary sinusitis in relation to different sinoscopic appearances is reported in this study.

Methods: When transantral sinoscopy via an anterior wall puncture was used to examine the maxillary antra in patients with chronic maxillary sinusitis, the sinoscopic appearances were divided into five types. Maxillary antra in which ostia were recognized under the endoscope and no secretion existed were classified as type 1. Maxillary antra in which ostia were not recognized and no secretion existed belonged to type 2. Maxillary antra in which seromucoid secretion existed belonged to type 3. Maxillary antra in which mucopurulent discharge existed belonged to type 4. Maxillary antra in which fungal balls existed belonged to type 5. Swab specimens of these antra were sent for aerobic and anaerobic cultures.

Results: Between 1988 and 1998, 493 sinoscopic appearances of maxillary antra were classified. Among them, 72 were classified as type 1, 59 were type 2, 75 as type3, 227 were type 4, and 60 were type 5. The culture rate of swab specimens from those antra with type 1 sinoscopic appearance was 56.9%. The culture rates were 59.3% for type 2, 48% for type 3, 64.8% for type 4, and 88.3% for type 5. Common cultured bacteria were similar among antra with different types of sinoscopic appearances, except type 5 antra, but less gram-negative aerobes grew from type 1 antra.

Conclusions: This study shows that the bacteriology of noninvasive fungal sinusitis was different from that of ordinary chronic maxillary sinusitis. However, among ordinary chronic maxillary sinusitis, the bacteriology was similar between maxillary antra with different sinoscopic appearances except with mild disease.