Bacteriology of nontraumatic maxillary sinus mucoceles versus chronic sinusitis

Objective: To compare the bacteriology of maxillary sinus mucoceles to chro nic sinusitis and understand the pathogenesis of nontraumatic maxillary sin us mucoceles (NTMSM). Study Design: Retrospective review. Methods: Review o f intraoperative bacteriology culture results obtained in patients with NTM SM. Patients with history of facial trauma or previous paranasal sinus surg ery were not included in the study. The results were compared to intraopera tive cultures obtained from patients with chronic sinusitis (CS), Results: The study groups consisted of 16 patients with NTMSM (9 male and 7 female p atients) and 211 patients with CS (86 male and 125 female patients). Cultur es in the NTMSM group were positive in 7 of 16 patients (44%) (four culture s had more than one isolate). There was no growth in cultures of 9 patients (56%). On the other hand, cultures in 176 patients with CS (83%) grew orga nisms (42 cultures had more than one isolate); there was no growth in 36 of 211 patients (17%) (P =.0007), The cultures grew aerobic bacteria in 7 of 16 (44%) and 160 of 211 (76%) patients of the NTMSM and CS groups, respecti vely. Anaerobic bacteria were detected in cultures of 2 of 16 patients (12. 5%) with NTMSM compared with 13 of 211 patients (6.2%) in the CS group (P = .286), The most common pathogenic aerobe in the NTMSM group was a-hemolytic Streptococcus, while Staphylococcus aureus was the most common in the CS g roup. Conclusion: The bacteriology of maxillary sinus mucoceles is differen t from that of CS, The majority of patients with mucoceles have sterile int raoperative cultures, The data do not support infection as the main origin of NTMSM.