Chronic hyperplastic sinusitis in allergic patients: A bacteriologic study of two hundred operative cases

Abstract

This study consisted of the bacteriologic examination of: (1) 365 washings obtained from the maxillary and sphenoidal sinuses, (2) 130 polyps and membranes removed from the ethmoidal and sphenoidal sinuses, and (3) 108 membranes removed from the maxillary sinuses. One hundred and sixty-five of our patients had asthma, 25 had hay fever, 12 vasomotor rhinitis, and 7 urticaria and angioneurotic edema. There were two or more manifestations of allergy in one-fourth of the patients. In order to obtain these membranes, 48 unilateral and 87 bilateral ethmoidectomies and sphenoidectomies, and 47 unilateral and 53 bilateral Caldwell-Luc operations were performed. The technique of securing the washings and the cultural methods are described. Eighty-eight per cent of all washings, 80 per cent of the ethmoidal and sphenoidal membranes, and 96 per cent of the antral membranes showed bacterial growth. The frequency with which the organisms were obtained from the cultures is given. The staphylococci predominate in cultures of both washings and membranes. The hemolytic streptococci are found twice as often in the antral membranes as they are in the washings or in the ethmoidal and sphenoidal membranes. The importance of these bacteriologic findings in 200 cases of hyperplastic sinusitis is discussed.