CORRELATION OF MIDDLE MEATAL AND MAXILLARY SINUS CULTURES IN ACUTE MAXILLARY SINUSITIS

Cultures obtained from the middle meatus have been used frequently in the past to direct therapy in patients with acute maxillary sinusitis. However, no convincing data have been published to indicate that midd le meatal cultures accurately represent the bacterial flora within the maxillary sinus. The hypothesis of this experiment is that bacteria o btained by directed middle meatal cultures qualitatively and quantitat ively correlate with cultures taken by maxillary sinus puncture. Acute sinusitis was induced by injecting 10(8) colony-forming units of bact eria directly into the maxillary sinuses of rabbits in which the ostia were occluded with cotton packs. Eight animals were injected with Sta phylococcus aureus, eight with Haemophilus influenzae, and eight with Streptococcus pneumoniae. The packs were removed after 3 days, and spe cimens were obtained from the middle meatus in the region of the maxil lary sinus ostium, and from the maxillary sinus, 1 day later. The cont ralateral maxillary sinuses of six of the animals were injected with n ormal saline and sewed as controls. There was a 100% correlation rate between cultures of specimens obtained from the maxillary sinus and fr om the middle meatus in all 24 animals. In addition, the quantitative counts from the middle meatus and the maxillary sinus correlated. Cont rol animals showed no bacterial growth from either the middle meatus o r the maxillary sinus. These results show that, in an animal model of acute sinusitis, cultures of specimens from the middle meatus reflect the contents of the maxillary sinus.