title: Concordance of middle meatal swab and maxillary sinus aspirate in acute and chronic sinusitis: a meta-analysis.
abstract: BACKGROUND
  The medical management of acute and chronic sinusitis is a therapeutic challenge. The use of endoscopic middle meatal cultures as a noninvasive method to determine the bacteriology of the maxillary sinus has not accurately been established. The aim of this study was to review the literature that compares cultures obtained by endoscopic middle meatal swabs with those obtained from maxillary sinus aspirates (MSAs).
  
  
  METHODS
  We reviewed studies published between January 1966 and October 2003 that were identified from searches of multiple databases, bibliographies, and original articles. Studies were included for analysis if they compared the results of endoscopic middle meatal cultures to aspirate cultures. All clinical variables and test performances were independently extracted by two reviewers.
  
  
  RESULTS
  Middle meatal culture had a per isolate accuracy of 82% (95% confidence interval, 0.64, 0.92) compared with MSA (excluding coagulase negative staphylococcus and fungal cultures).
  
  
  CONCLUSIONS
  Endoscopic middle meatal cultures have a high concordance with MSAs.
authors.affiliation: Department of Otolaryngology, Johns Hopkins University, Johns Hopkins University, 6210 JHOC, 601 N. Caroline St., Baltimore, MD 21287, USA.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Dubin
authors.forename: Charles S
authors.initials: CS
authors.lastname: Ebert
authors.forename: Charles S
authors.initials: CS
authors.lastname: Coffey
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Melroy
authors.forename: Robert E
authors.initials: RE
authors.lastname: Sonnenburg
authors.forename: Brent A
authors.initials: BA
authors.lastname: Senior
mesh_terms: D000208:Acute Disease; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002908:Chronic Disease; D004724:Endoscopy; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D008443:Maxillary Sinus / Q000382:microbiology*; D015523:Maxillary Sinusitis / Q000382:microbiology*; D009296:Nasal Cavity / Q000382:microbiology*; D012680:Sensitivity and Specificity