Hsin Chung-Han, Tsao Chien-Han, Su Mao-Chang, Chou Ming-Chih, Liu Chia-Ming
Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Eur Arch Otorhinolaryngol. 2007 Oct;264(10):1157-62. doi: 10.1007/s00405-007-0334-9. Epub 2007 May 22.
Rhinosinusitis is a common complication in patients with nasopharyngeal carcinoma (NPC) who receive radiotherapy. An impaired mucociliary clearance due to this treatment may be the major cause of rhinosinusitis in these irradiated patients. The relative frequency with which various pathogens cause rhinosinusitis in these patients is unknown. This study investigates the bacteriology of acute rhinosinusitis in irradiated NPC patients by maxillary sinus puncture. From October 2001 through July 2006, 20 irradiated NPC patients with radiograph-proven acute maxillary sinusitis received maxillary sinus punctures. Aspirate contents of the sinuses were collected for aerobic and anaerobic cultivation. A total sampling of 26 sides was performed in the 20 patients. The culture rate was 85%. Frequently identified aerobes and facultative anaerobes included alpha-hemolytic streptococcus (n = 8), Staphylococcus aureus (n = 5) and Pseudomonas aeruginosa (n = 3). Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, however, are far less common. This may provide important information about the antibiotic therapy in irradiated NPC patients with acute rhinosinusitis.
鼻窦炎是接受放疗的鼻咽癌(NPC)患者的常见并发症。这种治疗导致的黏液纤毛清除功能受损可能是这些接受放疗患者发生鼻窦炎的主要原因。各种病原体导致这些患者发生鼻窦炎的相对频率尚不清楚。本研究通过上颌窦穿刺调查接受放疗的NPC患者急性鼻窦炎的细菌学情况。从2001年10月至2006年7月,20例经X线片证实为急性上颌窦炎的接受放疗的NPC患者接受了上颌窦穿刺。收集鼻窦吸出物进行需氧和厌氧培养。20例患者共进行了26侧的采样。培养率为85%。常见的需氧菌和兼性厌氧菌包括α-溶血性链球菌(n = 8)、金黄色葡萄球菌(n = 5)和铜绿假单胞菌(n = 3)。然而,肺炎链球菌、流感嗜血杆菌和卡他莫拉菌则远没有那么常见。这可能为接受放疗的急性鼻窦炎NPC患者的抗生素治疗提供重要信息。