A Comparison of the Bacterial Culture Results of Maxillary Sinus Mucosa and Pus Collections for Chronic Maxillary Rhinosinusitis

Objective: Although maxillary antral taps are the standard for collecting pus for culture, they sometimes reveal no growth. Intraoperative mucosal cultures are another method to collect pathogen samples. This study compared aerobic bacterial cultures from mucosa and pus from chronic maxillary rhinosinusitis patients. Methods: A prospective study of 22 chronic maxillary rhinosinusitis patients was conducted. Antral pus and mucosa collected during endoscopic sinus surgery were immediately sent to a microbiological laboratory. The degree of concordance between maxillary sinus mucosa aerobic bacterial cultures and pus cultures was then analyzed. Results: Twenty-seven specimens were obtained for the cultures. The proportions of positive mucosal and pus cultures were 40.74% and 51.85%, respectively. The common aerobic pathogens from the two culture techniques were Pseudomonas aeruginosa and Staphylococcus aureus. A concordance between the pus and mucosal cultures was demonstrated by 19 out of 27 specimens (70.37%). Compared with the pus cultures, the mucosal cultures had a specificity of 84.62% (95% CI, 54.55%-98.08%), a sensitivity of 57.14% (95% CI, 28.86%-82.34%), a predictive value of a positive result of 80% (95% CI, 50.83%-93.93%), and a predictive value of a negative result of 64.71% (95% CI, 48.96%-77.80%). Conclusion: Similar pathogenic bacteria were recovered from the mucosa and pus. Given the high degree of similarity of the bacteria found, the good concordance rate, and the high specificity and positive predictive value of the mucosal cultures compared with the pus cultures, mucosal cultures should be a reference standard and an option when pus is unavailable, especially with immunocompromised patients

Radiofrequency Inferior Turbinate Reduction Improves Smell Ability of Patients with Chronic Rhinitis and Inferior Turbinate Hypertrophy

Radiofrequency inferior turbinate reduction (RFITR) of inferior turbinate hypertrophy (ITH) is an effective way to treat patients with intractable nasal mucosal obstruction. The objective of this study was to assess smell ability, nasal symptoms, inferior turbinate grading (ITG), peak nasal inspiratory flow (PNIF) of patients with chronic rhinitis (CR), and ITH before and after RFITR. Patients with CR and ITH, aged 18–60 years, who underwent RFITR, were prospectively recruited. Smell ability (measured by smell detection threshold [SDT]), visual analog scale (VAS) of nasal symptoms, ITG, and PNIF before and 6–10 weeks after RFITR were compared. Forty-eight subjects were included. All nasal symptoms were significantly decreased after RFITR. After surgery, SDT (tested by phenyl ethyl alcohol) was worsened in 7 patients (14.6%), improved in 8 patients (16.7%), and did not change in 33 patients (68.7%). SDT after RFITR of six patients in the worsened SDT group were still within normal range (> −6.5). There was only one patient whose SDT changed from normosmia to mild hyposmia (–7.25 to −5.38). In the improved SDT group, two of eight patients had obviously better SDT after RFITR, which changed from moderate hyposmia to normosmia (–3.65 to −10; −3.73 to −10), whereas six of eight patients had little better SDT after RFITR. RFITR also significantly reduced ITG and improved PNIF. In conclusion, the treatment of patients with CR and ITH with RFITR significantly improved PNIF, ITG, and nasal symptoms assessed by VAS, although SDT after RFITR could be the same or improved or worsened