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PubMed1995

Chronic sinusitis.

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Aspergillosis↗
PubMed1984

Chronic sinus disease with associated reactive airway disease in children.

Sinus disease has been described as one of several aggravating factors for chronic adult-onset asthma. Forty-eight children whose reactive airway disease (asthma) was significantly improved with treatment of their sinusitis have been observed. All of the subjects were seen in the office with chronic (more than 3 months) respiratory symptoms; all had daytime and nighttime cough and/or wheeze. The 48 children (32 male and 16 female) had a mean age of 8.2 +/- 1.2 (SD) years (range 4 to 13 years). Fourteen (35%) were nonatopic as determined by family history, personal history, and skin test reactivity to inhalant and pollen antigens. Eighteen of the patients were receiving or had recently received oral corticosteroids. All had been taking bronchodilators daily for at least 3 months without adequate control of the asthma. Sinus radiographs (Waters view) revealed the following abnormalities of the maxillary sinuses: greater than 6 mm of mucosal thickening (ten children [21%]), one opacified (12 children [25%]), bilateral opacification (18 children [38%]) and air fluid level(s) (eight children [17%]). All children were treated with antimicrobial agents for 2 to 5 weeks. Thirty-nine responded both clinically and radiologically. Antral lavage was performed in nine children. Of the 48 subjects, 38 (79%) were able to discontinue taking the bronchodilators with resolution of their sinusitis. It is concluded that sinus disease in children may be an aggravating factor for chronic reactive airway disease and that proper, aggressive treatment of the former will notably improve the latter.

Adolescent↗
PubMed1982

[Aerodynamic aspects in the concept of treatment in chronic sinusitis maxillaris (author's transl)].

Hitherto the conditions of air flow had been neglected in the concept of treatment of chronic inflammation of the maxillary sinus. Our experimental and clinical studies with measurement of airflow and temperature yielded several aspects of clinical importance as follows: The maximum size of the operated opening in the antral wall should be more than 10 X 10 mm. to achieve optimal ventilation. If there are two meatal open windows, the operated fenestration in the inferior meatus, for example, and the ostium maxillaris in the middle meatus, an "aerodynamic short circuit" arises. This results in insufficient ventilation. Large fenestrations have the same effect.

Biophysical Phenomena↗
PubMed2003

Molecular analysis of bacterial flora associated with chronically inflamed maxillary sinuses.

Chronic maxillary sinusitis is a chronic inflammatory condition in which the role of microbial infection remains undefined. Bacteria have been isolated from chronically inflamed sinuses; however, their role in the chronicity of inflammation is unknown. The objective of this study was to determine whether bacteria are present in clinical samples from chronic maxillary sinusitis and to assess the diversity of the flora present. Washes and/or tissue samples from endoscopic sinus surgery on 11 patients with chronic maxillary sinusitis were subjected to PCR amplification of bacterial 16S rDNA using three universal primer pairs, followed by cloning and sequencing. The samples were also assessed for the presence of bacteria and fungi by conventional culture methods. Viable bacteria and/or bacterial 16S rDNA were detected from maxillary sinus samples of five of the 11 patients examined (45 %). Three sinus samples were positive by both PCR and culture methods, one was positive only by PCR, and one only by culture. Thirteen bacterial species were identified: Abiotrophia defectiva, Enterococcus avium, Eubacterium sp., Granulicatella elegans, Neisseria sp., Prevotella sp., Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, Stenotrophomonas maltophilia, Streptococcus gordonii, Streptococcus mitis/Streptococcus oralis and Streptococcus sp. Fungi were not detected. In one patient Streptococcus mitis/Streptococcus oralis, and in another patient Pseudomonas aeruginosa, were detected from both the sinus and the oral cavity using species-specific PCR primers. These results suggest that both aerobic and anaerobic bacteria can be detected in nearly half of chronic maxillary sinusitis cases.

Bacteria↗