Objectives. To determine bacterial and fungal organisms that are present in
patients undergoing surgery for chronic frontal sinusitis. Study Design: R
etrospective, nonrandomized study. Methods. Retrospective, nonrandomized ba
cterial and fungal cultures were performed on 46 sinus aspirates obtained b
y frontal sinus trephination performed on 30 consecutive patients with chro
nic frontal sinusitis. Results. Six patients were having sinus surgery for
the first time, 19 patients had undergone prior functional endoscopic sinus
surgery without instrumentation of the frontal sinus/recess, and the third
group included 5 patients who had undergone prior frontal sinus/recess sur
gery. Preoperative computed tomography scan of the frontal sinuses revealed
complete opacification in 63% (29/46 frontal sinuses) and partial opacific
ation in 22% (10/46), and no data were available for 15% (7/46). Aerobic cu
ltures revealed that 38% (13/35 cultures) had no growth, 21% (7/35) grew St
aphylococcus aureus, 21% (7/35) grew coagulase-negative Staphylococcus, 9%
(3/35) grew Haemophilus influenzae, and 26% (9/35) grew a variety of other
organisms. Anaerobic cultures were positive in 3% (1/32) of sinuses, and fu
ngal cultures were positive in 4% (1/24). Haemophilus influenzae was most c
ommon in primary cases, whereas coagulase-negative Staphylococcus was most
common in patients undergoing revision frontal sinus surgery. There were no
other significant differences between cultures from patients undergoing re
vision frontal sinus surgery, revision functional endoscopic sinus surgery
without prior frontal surgery, and primary surgery. Conclusions: This study
suggests that organisms involved in chronic inflammatory disease of the fr
ontal sinus may change after previous sinus surgery. The study failed to su
pport a significant role for anaerobes. The role for coagulase-negative Sta
phylococcus as a potential pathogen or a contaminating agent remains unclea
r.