Evaluating the reproducibility of sinus lavages with a saline solution administered directly in the maxillary sinus of patients after endoscopic sinus surgery.
BACKGROUND
Chronic sinusitis is recognized as having a strong inflammatory component, and failures of endoscopic sinus surgery (ESS) are frequently attributed to persistent inflammation. A test that would allow rhinologists to evaluate the inflammatory state of a patient's sinuses would be helpful to evaluate cases refractory to therapy, determine appropriate medical therapy, and monitor the response to therapy.


OBJECTIVE
The goal of this preliminary research is to assess the optimal method of collection and the reproducibility and specificity of sinus lavages.


METHODS
Twelve patients who had undergone ESS were recruited. They were divided into two groups according to the persistence of their symptoms and the recurrence of acute sinusitis after ESS. The subjects were seen twice. Three successive lavages were collected from each maxillary sinus and were analyzed by cell count.


RESULTS
Intrasession cell counts were most reproducible (Spearman rank correlation .7 for eosinophils and .6 for neutrophils) for the second lavage. Intersession cell counts were highly reproducible for eosinophils (r = .7) for the second lavage. The two-tailed t-test did not reveal any statistically significant differences between the good and the poor outcome groups.


CONCLUSIONS
Assessment of eosinophil cell counts on sinus lavage is a feasible and reproducible method to evaluate the inflammatory state of a patient's sinuses in patients who have undergone ESS.
Cloutier
Jean-François
JF
Service d'otorhino-laryngologie, Centre Hospitalier de l'Université de Montreal, pavilion Hôtel-Dieu, Université de Montreal, Montreal, Quebec.
Desrosiers
Martin Y
MY
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002452:Cell Count; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D007962:Leukocytes / Q000378:metabolism; D015523:Maxillary Sinusitis / Q000097:blood* / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000382:microbiology*; D011182:Postoperative Care; D015203:Reproducibility of Results; D012965:Sodium Chloride / Q000627:therapeutic use*; D007507:Therapeutic Irrigation / Q000379:methods
D012965:Sodium Chloride