Sinusitis of the maxillary antrum

Area of Science:

• Otolaryngology
• Infectious Diseases
• Diagnostic Imaging

Background:

• Sinusitis diagnosis often relies on clinical symptoms.
• Accurate differentiation between acute and chronic sinusitis is crucial for treatment.
• Microbiological confirmation of sinusitis can be challenging.

Purpose of the Study:

• To evaluate the diagnostic accuracy of maxillary sinus transillumination and radiological findings.
• To correlate direct sinus aspirate analysis with clinical presentation and imaging.
• To assess the utility of antibiotic therapy based on in vitro sensitivity.

Main Methods:

• Sixty-five needle punctures of the maxillary antrum were performed in 24 adults with sinusitis.
• Sinus aspirates were analyzed for leukocytes and microbial cultures.
• Transillumination and Water's view radiography were used to assess sinus status.
• Correlation of clinical findings, aspirate results, and imaging was performed.

Main Results:

• Opaque sinuses and marked mucosal thickening strongly correlated with abnormal aspirates (P < 0.001).
• High leukocyte counts in aspirates indicated infection (bacterial titers > 10^5/mL or virus/fungus isolation).
• Anterior nasal swab cultures showed poor correlation with direct sinus aspirates.
• Commonly isolated organisms included Haemophilus influenzae, Streptococcus pneumoniae, and anaerobes.

Conclusions:

• Maxillary sinus transillumination and radiography are valuable adjuncts in diagnosing sinusitis.
• Direct sinus aspiration provides reliable microbiological data for guiding treatment.
• Antibiotic therapy is effective in acute sinusitis when guided by in vitro organism sensitivity (P < 0.001).