Aspiration technique improves reliability of endoscopically directed middle meatal cultures in pediatric rhinosinusitis.

BACKGROUND

Most studies demonstrated that the results of endoscopically directed middle meatal cultures (EDMMC) compare favorable with those of maxillary sinus taps in adults rhinosinusitis. Studies comparing results of EDMMC and antral puncture cultures in pediatric rhinosinusitis, however, revealed a decreased correlation. Sampling by suction aspiration was considered likely to improve the reliability of culture.

OBJECTIVE

The aim of this study was to compare the microbiology results obtained by EDMMC using swabs or suction aspiration with the results of maxillary sinus taps in pediatric rhinosinusitis.

METHODS

Thirty-one children with chronic rhinosinusitis were enrolled. Patients enrolled in 2007 (group A), underwent EDMMC using a swab, whereas those enrolled in 2008 (group B) underwent EDMMC using suction aspiration. Results obtained by EDMMC were compared with those of maxillary sinus taps.

RESULTS

In group A, 29 paired cultures were obtained from 15 patients. In group B, 30 paired cultures were obtained from 16 patients. In group A, EDMMC by swab demonstrated a sensitivity of 52%, a specificity of 100%, and a correlation of 66%. In group B, EDMMC by suction aspiration provided a sensitivity of 86%, a specificity of 100%, and a correlation of 87%. The difference in density of growth between EDMMC with swab and maxillary sinus tap was not significant, but the difference between EDMMC with aspiration and maxillary sinus tap was significant.

CONCLUSION

Aspiration technique can significantly enhance the reliability of endoscopy cultures in children with rhinosinusitis, probably by increasing the amount of specimen obtained.