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Aspiration technique improves reliability of endoscopically directed middle meatal cultures in pediatric
Chung-Han Hsin1, Tsai-Hsin Chen, Mao-Chang Su
1Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Background:
Most studies demonstrated that the results of endoscopically directed middle meatal cultures (EDMMC) compare favorable with those of maxillary sinus taps in adults rhinosinusitis. Studies comparing results of EDMMC and antral puncture cultures in pediatric rhinosinusitis, however, revealed a decreased correlation. Sampling by suction aspiration was considered likely to improve the reliability of culture.
Objective:
The aim of this study was to compare the microbiology results obtained by EDMMC using swabs or suction aspiration with the results of maxillary sinus taps in pediatric rhinosinusitis.
Methods:
Thirty-one children with chronic rhinosinusitis were enrolled. Patients enrolled in 2007 (group A), underwent EDMMC using a swab, whereas those enrolled in 2008 (group B) underwent EDMMC using suction aspiration. Results obtained by EDMMC were compared with those of maxillary sinus taps.
Results:
In group A, 29 paired cultures were obtained from 15 patients. In group B, 30 paired cultures were obtained from 16 patients. In group A, EDMMC by swab demonstrated a sensitivity of 52%, a specificity of 100%, and a correlation of 66%. In group B, EDMMC by suction aspiration provided a sensitivity of 86%, a specificity of 100%, and a correlation of 87%. The difference in density of growth between EDMMC with swab and maxillary sinus tap was not significant, but the difference between EDMMC with aspiration and maxillary sinus tap was significant.
Conclusion:
Aspiration technique can significantly enhance the reliability of endoscopy cultures in children with rhinosinusitis, probably by increasing the amount of specimen obtained.
Insights
Suction aspiration for middle meatal cultures in pediatric rhinosinusitis significantly improves diagnostic accuracy compared to swabs. This enhanced technique increases the reliability of endoscopic cultures in children.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Endoscopically directed middle meatal cultures (EDMMC) show favorable comparison with maxillary sinus taps in adult rhinosinusitis.
- Correlation between EDMMC and antral puncture cultures is decreased in pediatric rhinosinusitis.
- Suction aspiration sampling is hypothesized to improve culture reliability.
Purpose of the Study:
- To compare microbiology results of EDMMC using swabs versus suction aspiration.
- To compare EDMMC results with maxillary sinus taps in pediatric rhinosinusitis.
Main Methods:
- Thirty-one children with chronic rhinosinusitis were enrolled.
- Group A (2007) underwent EDMMC using a swab.
- Group B (2008) underwent EDMMC using suction aspiration.
- EDMMC results were compared with maxillary sinus taps.
Main Results:
- Group A (swab): 52% sensitivity, 100% specificity, 66% correlation with maxillary sinus taps.
- Group B (suction aspiration): 86% sensitivity, 100% specificity, 87% correlation with maxillary sinus taps.
- Significant difference in culture results between EDMMC with aspiration and maxillary sinus tap.
Conclusions:
- Aspiration technique significantly enhances the reliability of endoscopic cultures in pediatric rhinosinusitis.
- Increased specimen quantity via aspiration likely improves diagnostic accuracy.
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