Maxillary sinusitis and bronchial asthma: Correlation of roentgenograms, cultures, and thermograms

Abstract

Roentgenographic evidence of sinusitis is found more frequently in patients with bronchial asthma than in normals. Evidence for overt bacterial infection of the maxillary sinuses was sought in a sequential series of adult asthmatic patients. Twenty-one patients with maxillary sinus abnormality noted on roentgenograms were studied by facial thermography and culture of sinus contents. Cultures were obtained from 25 maxillary sinuses by a double-lumen technique that minimized nasal contamination. Twenty sinus cultures, including those from 9 patients in asthmatic relapse at the time of study, yielded no bacteria. Five sinus cultures, including those from 3 patients in asthmatic relapse, yielded aerobic bacteria. Two of the latter were organisms that are commonly thought of as pathogens and were obtained from the only two patients with more than three upper respiratory symptoms. Nasal cultures taken prior to puncture grew aerobic bacteria or fungi from 23 of 25 specimens. There was no correlation between the results of nasal cultures and the results of sinus cultures. Results of facial thermograms did not correlate with culture results. Overt bacterial infection apparently does not account for the abnormality of paranasal sinus roentgenograms found in the majority of adult patients with bronchial asthma.