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The aspiration-irrigation maneuver
1Semo Otolaryngology Head & Neck Surgery, Inc., Cape Girardeau, Missouri, USA.
Objectives/Hypothesis:
To compare cultures obtained from the aspiration-irrigation maneuver (AIM) with other reports and compare diagnostic and therapeutic value after AIM versus the Proetz maneuver and needle aspiration-irrigation.
Study Design:
Patients with radiographic evidence (mucous membrane thickness greater than 6 mm, air-fluid levels, or complete opacification) and symptoms (nocturnal cough, fever, postnasal drainage [PND], otitis, mucopurulent discharge from the nose) of sinus disease who were referred from pediatrician and/or family physician and who otherwise would be candidates for surgery were selected to receive treatment with AIM. The study was divided into three separate groups (54 patients who were age 8 years and younger, 54 patients who were age 9 years and older, and 32 adult patients who were treated with both needle aspiration and AIM.
Methods:
Using Bernoulli's principle and the Venturi effect, saline and a vacuum apparatus were used to capture the contents of the sinuses for culture, and results were compared with results of needle aspirate cultures.
Results:
Children's cultures from group 1 compared favorably with the literature (Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae or a combination of these); cultures in patients age 9 years and older revealed a greater variety of bacteria, depending on chronicity of infection, and a high incidence of Staphylococcus aureus (beta-lactamase positive). There was a 66% correlation of AIM with needle aspiration.
Conclusions:
AIM was found to be a safe, simple, painless, and inexpensive adjunct to the diagnosis and treatment of sinus disease.
Insights
The aspiration-irrigation maneuver (AIM) is a safe and effective method for diagnosing and treating sinus disease in children and adults. AIM cultures showed good correlation with needle aspiration, identifying common pediatric sinus pathogens.
Area of Science:
- Otolaryngology
- Microbiology
Background:
- Sinus disease diagnosis often relies on clinical presentation and imaging.
- Microbiological confirmation of sinus pathogens is crucial for effective treatment.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic utility of the aspiration-irrigation maneuver (AIM) for sinus disease.
- To compare AIM cultures with needle aspiration and existing literature.
- To assess AIM in pediatric and adult populations.
Main Methods:
- Patients with symptomatic sinus disease underwent AIM using saline and vacuum.
- Sinus contents were cultured and compared with needle aspirate cultures.
- Study included pediatric groups (≤8 years, 9+ years) and an adult group.
Main Results:
- Pediatric AIM cultures aligned with known pathogens (H. influenzae, M. catarrhalis, S. pneumoniae).
- Older patients showed diverse bacteria, including Staphylococcus aureus.
- AIM correlated with needle aspiration in 66% of cases.
Conclusions:
- AIM is a safe, simple, painless, and cost-effective tool for sinus disease diagnosis and treatment.
- AIM provides valuable microbiological data for guiding therapy.