Bacteriology of the maxillary sinus

The bacteriologic findings in the maxillary sinus of 20 patients who underwent surgical repositioning of the maxilla are presented. Using an open sterile surgical technique, three samples from each patient were collected prior to the planned osteotomy. The specimens included a section of the anterior bony sinus wall, an aspirate of the irrigated sinus, and a swab of the sinus membrane procured through an antral window. All specimens were cultured for aerobic and anaerobic organisms. In addition to bacterial culture samples, a portion of the sinus membrane was resected and examined microscopically for the presence of an inflammatory cell infiltrate. Eighty per cent (16/20) of the patients studied showed no bacterial growth from any sinus specimen. The remaining 20% (four of 20) had some bacterial growth, but in negligible numbers. Microscopically, all mucosal specimens showed some degree of inflammatory cell infiltrate, but the specimens where bacteria were present showed a more acute inflammatory response. It was concluded that the asymptomatic adult maxillary sinus is usually sterile, but that a few transient bacteria may exist in a clinically silent antrum. When bacteria are present, they are recognized as foreign and elicit the appropriate inflammatory responses.