Comparison of maxillary sinus puncture with endoscopic middle meatal culture in pediatric rhinosinusitis.
BACKGROUND
Although maxillary sinus puncture is considered the gold standard for obtaining bacterial cultures, there is an increasing field of evidence indicating that results of endoscopic middle meatal culture correlate well with those of maxillary sinus punctures. However, the subjects of these studies were adults and there was no prior study comparing endoscopic middle meatal culture with maxillary sinus punctures in children with rhinosinusitis. The aims of this study were to compare the results obtained by endoscopic middle meatal culture and maxillary sinus punctures in children with rhinosinusitis.


METHODS
A prospective study of children with community-acquired rhinosinusitis was conducted. Results obtained by endoscopic culture were compared with those of maxillary sinus puncture, and the correlation of these 2 techniques was investigated.


RESULTS
There were 41 specimen sets sent for aerobic cultivation. Correlation obtained from the middle meatus with those from the maxillary sinus puncture was demonstrated in 32 of 41 specimens (78.0%). When looking at the diagnostic usefulness of endoscopic middle meatus sampling versus maxillary sinus puncture, endoscopic sampling provided a sensitivity of 75.0%, a specificity of 88.9%, a predictive value of a positive result of 96.0%, a predictive value of a negative result of 50.0%, and an accuracy of 78.0%.


CONCLUSIONS
We demonstrated that, when performed in pediatric patients, the correlation between endoscopic middle meatal culture and maxillary sinus puncture was not as favorable as in the case of adult patients.
Hsin
Chung-Han
CH
Department of Otolaryngology, School of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Tsao
Chien-Han
CH
Su
Mao-Chang
MC
Chou
Ming-Chih
MC
Liu
Chia-Ming
CM
D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000382:microbiology* / Q000601:surgery; D015523:Maxillary Sinusitis / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D009666:Nose / Q000382:microbiology* / Q000601:surgery; D011446:Prospective Studies; D011677:Punctures / Q000379:methods*; D012220:Rhinitis / Q000150:complications / Q000382:microbiology / Q000601:surgery*