scholarly journals Challenging the gold standard: methods of sampling for microbial culture in patients with chronic rhinosinusitis

2021 ◽  
Author(s):  
Joanna Szaleniec ◽  
Agnieszka Gibała ◽  
Patryk Hartwich ◽  
Karolina Hydzik-Sobocińska ◽  
Marcin Konior ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Frontal Sinus ◽  
Sampling Site ◽  
Microbial Culture ◽  
Representative Sampling ◽  
Additional Information ◽  
Inadequate Information ◽  
Sinus Cavity ◽  
Inadequate Antibiotic Therapy

Abstract Purpose Chronic rhinosinusitis (CRS) is a highly prevalent multifactorial disorder. Culture-directed antibiotics are frequently prescribed to patients with CRS and the middle nasal meatus (MM) is traditionally believed to be a representative sampling site of the sinuses as a whole. The purpose of our study was to reevaluate the reliability of the MM as a sampling site in patients with CRS who suffer from impaired drainage from the sinuses to the MM. Methods Swabs and tissue biopsies were collected from the MM, maxillary sinus and frontal sinus from 50 patients with CRS. The results of bacterial culture were compared between sampling methods and sites in relation to the patency of the sinus ostia. Results 782 bacterial isolates were cultured from the samples. Concordant results between the MM and the sinus cavity were noted in 80% of patients for the maxillary sinus, but only 66% for the frontal sinus and 76% for the sinuses a whole. The differences were similarly prevalent in patients with open and occluded sinus ostia. Notably, swabs from all three sites provided representative information in 92% of patients and tissue biopsies did not provide additional information compared to multiple swabs. Conclusion The traditional method of sampling from the middle meatus provides inadequate information in 24% of patients with CRS, which may result in inadequate antibiotic therapy and contribute to increasing antibiotic resistance. Additional sampling from the sinuses should be recommended whenever possible, while invasive sampling is not necessary.

scholarly journals Comparison of the Frequency of Detection of Some Radiological Signs in Chronic Maxillary Sinusіtis of Fungal and Non-Fungal Origin

2020 ◽  
Vol 5 (6) ◽  
pp. 202-207
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Biologically Active ◽  
Differential Diagnostics ◽  
Diagnostic Significance ◽  
Fungal Ball ◽  
The One

The one of the most informative method of preoperative diagnosis of fungal paranasal sinuses is computed tomography. The radiological marker that allows to identify chronic sinusitis of fungal origin is an eclipse with hyperintensive inclusions. The sensitivity of this criterion for fungal ball is about 80%. In addition, a sign of recalcitrant chronic sinusitis is the presence of reactive changes in the bone wall of the sinus – "osteitis". The purpose of the work was to study the frequency of radiological signs of osteitis and areas of increased radiological density in the maxillary sinuses of the patients with chronic sinusitis of fungal and non-fungal etiology, to clarify the diagnostic significance of these symptoms in the differential diagnostics. Material and methods. The results of a retrospective study of computer tomography data of 60 people with chronic rhinosinusitis (intraoperative was verified fungal ball in the maxillary sinus space of 30 patients, other 30 patient had no signs of fungal etiology). Results and discussion. In patients with chronic rhinosinusitis of non-fungal nature, hyperintensive inclusions in the sinus were found in 13.3%, and signs of osteitis were detected in 36.7%, which was significantly less common than in patients with fungal processes, 83.3% and 80,0% respectively (p <0,05). The presence of both of the radiological symptoms was observed in 63.3% of patients from the group of chronic rhinosinusitis in the presence of a fungal body in the space of the sinus and in 6.7% of cases the chronic rhinosinusitis of non-fungal etiology. The severity of osteitis according to KOS, in patients with a fungal body in the sinus was 0.71 ± 0.15 points, and 0.55 ± 0.2 points in patients without a fungus. The pathogenesis of osteitis in the cases of sinusitis with fungal origin is a violation of bone trophism, which develops due to periostitis after the influence of biologically active substances secreted by the fungus. The increase of radiation density in areas of osteitis indicates the predominance of osteogenesis over osteolysis in the inflammatory focus of the bone wall of the maxillary sinus. Conclusion. The frequency of detecting radiological signs of osteitis in patients with chronic rhinosinusitis of the maxillary sinus with fungal bodies was 80%, that was comparable to the frequency of detecting hyperintense inclusions in the lumen of the sinus in these patients (83.3%), and was significantly more than in patients with chronic sinusitis nonfungal etiology. The presence of radiological signs of osteitis of the bone wall of the maxillary sinus in computed tomography should be regarded as an additional symptom in the differential diagnosis of maxillary sinusitis of fungal origin

scholarly journals Morphofunctional State of the Maxillary Sinus Mucosa in Patients After Endoscopic Infundibulotomy

2021 ◽  
Vol 1 (3) ◽  
pp. 6-10
Author(s):  
Djuraev Jamolbek Abdukakharovich ◽  
◽  
Makhsitaliev Mukhammadbobur Ibrokhimovich, Ibrokhimovich ◽  
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Mucous Membrane ◽  
Paranasal Sinuses ◽  
Pathological Process ◽  
Fundamental Factor ◽  
Sinus Mucosa ◽  
Morphological State

The work carried out made it possible to substantiate the need to apply a method for studying the frequency of beating of cilia of the mucous membrane of the nasal cavity and paranasal sinuses in patients with chronic rhinosinusitis when choosing treatment tactics in an ENT hospital. Analysis of the study of data on the functional and morphological state of the mucous membrane of the nasal cavity and maxillary sinus allows us to judge the severity of the pathological process before surgery, which is the fundamental factor in the algorithm for the treatment of chronic rhinosinusitis.

Necessity of Clinical Information in Surgical Pathology

1999 ◽  
Vol 123 (7) ◽  
pp. 615-619 ◽  
Author(s):  
Raouf E. Nakhleh ◽  
Gordon Gephardt ◽  
Richard J. Zarbo
Keyword(s):  
Clinical Data ◽  
Clinical Information ◽  
The United States ◽  
Surgical Pathology ◽  
Lower Percentage ◽  
Malignant Neoplasms ◽  
Anatomic Site ◽  
Improvement Program ◽  
Additional Information ◽  
Inadequate Information

Abstract Objectives.—To examine the frequency and nature of problems caused by inadequate clinical data provided on surgical pathology requisition forms. Design.—Participants in the 1996 Q-Probes voluntary quality improvement program of the College of American Pathologists were asked to document prospectively all surgical pathology cases with inadequate information. Inadequate clinical information was defined as the pathologist's need for additional clinical information before a diagnosis could be rendered, regardless of the amount of information already present on the requisition slip. Cases that had no clinical information on a requisition slip were not counted if the lack of history did not hinder diagnosis. The study concluded when 3 months had elapsed or 40 surgical pathology cases were documented. The following data were recorded for each case: anatomic site, type of procedure, nature of disease, method of obtaining additional information, importance of obtained information, and the length of delay in the final diagnosis. Participants.—Three hundred forty-one laboratories, 322 of which were from the United States. Results.—A total of 5594 cases (0.73%) required additional clinical information for diagnosis (10th through 90th percentile range, 3.01% to 0.08%). Institutions with greater average occupied bedsize, a greater number of cases accessioned per year, and a greater number of pathologists had a lower percentage of cases with inadequate clinical data (P &lt; .05). Sixty-eight percent of these cases had no delay in completion of a case, 16.2% had a delay of 1 day or less, and 15.1% of cases were delayed more than 1 day. In 59.4% of cases, the additional clinical information obtained confirmed the initial diagnostic impression. In 25.1%, the information was not relevant to the pathologic diagnosis. In 6.1% there was a substantial change in the diagnosis or a revised report was issued, and in 2.2% no additional information could be obtained. Specific anatomic sites that correlated with a higher rate of changed diagnoses or revised reports in cases with inadequate information included the small bowel, the bronchus/lung, and the ovary. Resection specimens were also significantly associated with a higher rate of changed diagnoses or revised reports when additional information was obtained, as were malignant neoplasms and therapy-induced changes. Conclusions.—This study establishes an aggregate rate of cases with inadequate clinical information for diagnosis (0.73%) and documents the extent of problems caused by inadequate clinical information. The criticality of appropriate clinical information provided to the pathologist is identified for specific anatomic sites and disease processes and is reflected in changed diagnoses or revised reports.

A Sinus Floor Reaugmentation Technique Around an Apically Exposed Implant Into the Maxillary Sinus

2019 ◽  
Vol 45 (3) ◽  
pp. 213-217
Author(s):  
Daisuke Ueno ◽  
Noriko Banba ◽  
Akira Hasuike ◽  
Kazuhiko Ueda ◽  
Toshiro Kodama
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Treatment Option ◽  
Prolonged Treatment ◽  
Sinus Cavity ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Recovery Approach

Sinus floor augmentation (SFA) is the most predictable treatment option in the atrophic posterior maxilla. However, exposure of the apical implant body into the maxillary sinus cavity is an occasionally observed phenomenon after SFA. Although most penetrating dental implants remain completely asymptomatic, they may induce recurrent rhinosinusitis or implant loss. Removal of the implant should be considered if there is significant implant exposure that results in prolonged treatment and increased costs. This case report demonstrates a recovery approach using sinus floor reaugmentation without implant removal in a patient with an apically exposed implant into the maxillary sinus cavity.

Experimental Results of Autogenous Cancellous Bone Chips Transplanted into the Canine Frontal Sinus Cavity

1974 ◽  
Vol 83 (17_suppl) ◽  
pp. 1-15 ◽  
Author(s):  
Allan L. Abramson ◽  
Robert L. Eason ◽  
William H. Pryor ◽  
Eugene J. Messer
Keyword(s):  
Cancellous Bone ◽  
Frontal Sinus ◽  
Experimental Results ◽  
Variable Amount ◽  
Cystic Formation ◽  
Partial Filling ◽  
Sinus Cavity ◽  
Sinus Mucosa

Autogenous marrow-cancellous bone chips were transplanted into 36 canine frontal sinus cavities and studied over variable postoperative periods by radiographic and histologic methods. Cysts lined with frontal sinus mucosa were noted to enlarge progressively between three and 26 weeks. Cysts which originated from the ectoturbinate scroll frequently went on to communicate with the nasofrontal duct (neocavitation). If no cystic formation developed, this loosely packed autograft eventually was transformed into organized cancellous bone, thus obliterating the sinus cavity. When external frontal contour was evaluated, good results were obtained when the cavity was completely filled with cancellous autograft. If partial filling of the sinus cavity was performed, a variable amount of depression was noted.

Osteomyelitis of frontal sinus, zygomatic bone and maxilla

2020 ◽  
Vol 13 (9) ◽  
pp. e236163
Author(s):  
Anshul Rai ◽  
Anuj Jain ◽  
Rishi Thukral
Keyword(s):  
Maxillary Sinus ◽  
Frontal Sinus ◽  
Systemic Disease ◽  
Lateral Nasal Wall ◽  
Maxillary Bone ◽  
Zygomatic Bone ◽  
3D Ct Scan ◽  
Orbital Wall ◽  
Patient Reported

A 52-year male patient reported with loosening of right upper jaw. He has no pain or discharge, or any acute symptoms and systemic disease. Intraoral examination reveals necrosed maxillary bone. He also has no sickle cell disease, hepatitis, HIV or tuberculosis. 3D CT scan reveals destruction of maxilla, maxillary sinus, lateral nasal wall, superior and inferior orbital wall, zygoma and frontal bone(outer table). The clinical diagnosis of osteomyelitis was made. Under general anaesthesia, sequestrectomy was done with the help of Weber-Ferguson incision with infraorbital extension for maxilla, maxillary sinus, zygomatic bone, lateral nasal wall and infraorbital and medial wall of orbit. Frontal sinus region sequestrectomy was done via bicoronal flap. The patient was completely diseased free after 4 years follow-up.

Comparison of bacterial maxillary sinus cultures between odontogenic sinusitis and chronic rhinosinusitis

2020 ◽  
Author(s):  
Abdulkader Yassin‐Kassab ◽  
Pallavi Bhargava ◽  
Robert J. Tibbetts ◽  
Zachary H. Griggs ◽  
Edward I. Peterson ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Odontogenic Sinusitis

Regeneration of Maxillary Sinus Mucosa following Surgical Removal

1993 ◽  
Vol 102 (6) ◽  
pp. 459-466 ◽  
Author(s):  
Karin Forsgren ◽  
Jan Kumlien ◽  
Pontus Stierna ◽  
Bengt Carlsöö
Keyword(s):  
Maxillary Sinus ◽  
Lamina Propria ◽  
Surgical Removal ◽  
Fibroblast Proliferation ◽  
Cellular Processes ◽  
Operative Removal ◽  
Normal Sinus ◽  
Bone Degradation ◽  
Sinus Cavity ◽  
Sinus Mucosa

A rapid regeneration of the epithelium takes place in the maxillary sinus in rabbits after experimental operative removal of the mucosa. Two weeks postoperatively the previously denuded areas have reepithelialized. The subepithelial glands, however, do not seem to regenerate. The normal sinus mucosa contains numerous serous glands in the lamina propria, but in the regenerated mucosa these glands are replaced by dense connective tissue. Atypical glands and polyp formations are sometimes encountered, but goblet cells are sparse. Furthermore, the sinus cavity on the operated side is reduced in size compared with the nonoperated side because of fibrosis and periosteal reactions including bone degradation and neogenesis. This study indicates that although the mucosa is reepithelialized within 2 weeks, the regeneration of the lamina propria is incomplete, and reactive cellular processes such as bone remodeling, fibroblast proliferation, and formation of polyps and “atypical glands” are characteristic of regenerating mucosa.

Sign in / Sign up

Export Citation Format

Share Document