[Microecosystem of ostiomeatal complex and its changes via functional endoscopic sinus surgery]

Area of Science:

• Microbiology
• Otolaryngology
• Sinusitis Research

Context:

• The ostiomeatal complex (OMC) functions as a unified microecosystem in healthy adults.
• Chronic sinusitis leads to inflammation that disrupts the OMC's microecosystem, causing separation between its anatomical parts.
• Understanding the microbial composition of the OMC is crucial for diagnosing and treating sinusitis.

Purpose:

• To investigate the microbial composition of the ostiomeatal complex (OMC) in adults.
• To analyze how functional endoscopic sinus surgery (FESS) alters the OMC microecosystem in patients with sinusitis.

Summary:

• This study analyzed the microecosystem of the ostiomeatal complex (OMC) in 200 adults, comparing pre- and post-functional endoscopic sinus surgery (FESS) groups. Aerobes, anaerobes, and fungi were cultured from three OMC sites. Preoperatively, significant differences in aerobic bacteria and the rate of same aerobic culture from three sites (RSAC) were observed compared to controls. Postoperatively, aerobic culture rates decreased, and RSAC differences became non-significant. Fungi showed no significant differences across groups, and anaerobes were rare.
• Results indicated that chronic inflammation separates the OMC microecosystem, leading to multimicrobial existence. FESS was found to reverse this separation, reintegrating the OMC into a whole space and promoting recovery.

Impact:

• Findings suggest FESS plays a role in restoring the structural and microbial integrity of the OMC microecosystem.
• This research provides insights into the microbial dynamics of the OMC and the therapeutic effects of FESS in sinusitis patients.
• The study highlights the importance of considering the OMC as a unified microecosystem when managing chronic sinusitis.