Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Am J Rhinol Allergy. 2010 May-Jun;24(3):205-9. doi: 10.2500/ajra.2010.24.3461.
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.
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.
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.
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.
Aspiration technique can significantly enhance the reliability of endoscopy cultures in children with rhinosinusitis, probably by increasing the amount of specimen obtained.
大多数研究表明，内镜下中鼻道培养（EDMMC）的结果与成人鼻窦炎上颌窦穿刺培养的结果相当。然而，比较儿科鼻窦炎内镜下中鼻道培养和经上颌窦窦腔穿刺培养结果的研究显示，相关性降低。抽吸取样被认为可以提高培养的可靠性。
本研究旨在比较使用拭子或抽吸取样的内镜下中鼻道培养（EDMMC）与儿科鼻窦炎上颌窦穿刺培养的微生物学结果。
共纳入 31 例慢性鼻窦炎患儿。2007 年入组的患者（A 组）行 EDMMC 时使用拭子，2008 年入组的患者（B 组）行 EDMMC 时使用抽吸。比较 EDMMC 结果与上颌窦穿刺结果。
A 组 15 例患者共获得 29 对培养物，B 组 16 例患者共获得 30 对培养物。A 组中，拭子法 EDMMC 的敏感性为 52%，特异性为 100%，相关性为 66%。B 组中，抽吸法 EDMMC 的敏感性为 86%，特异性为 100%，相关性为 87%。拭子法与上颌窦穿刺培养物的生长密度差异无统计学意义，但抽吸法与上颌窦穿刺培养物的生长密度差异有统计学意义。
抽吸技术可以显著提高鼻窦炎患儿内镜培养的可靠性，可能是通过增加获得的标本量来实现的。
