title: Relationship between positive bacterial culture in maxillary sinus and surgical outcomes in chronic rhinosinusitis with nasal polyps.
abstract: OBJECTIVE
  There are many studies on clinical prognosis following endoscopic sinus surgery (ESS) for the treatment of chronic rhinosinusitis with nasal polyp (CRSwNP). However, there are no independent reports on bacterial infection as a factor that influences surgical outcomes. We investigated the association between bacterial infection and surgical outcomes following ESS.
  
  
  METHODS
  This retrospective review of medical records was performed on 71 patients with CRSwNP that was refractory to medical treatment and who were diagnosed between July 2007 and June 2012. The extent of the polyps and the Lund-Mackay CT score (L-M score) were preoperatively evaluated in all the patients. For this analysis, patients were classified into three groups (normal flora, culture-positive, and culture-negative) according to their intraoperative bacterial culture results. We compared the objective endoscopic findings between these groups at 6-months postsurgery.
  
  
  RESULTS
  Bacteria were cultured in 55 of the 71 patients (77%). Of these, 43 patients (61%) demonstrated endoscopic improvement at the 6-month follow-up examination. The preoperative L-M score and polyp grade demonstrated no significant statistical differences in terms of surgical outcome, but the cure rate was statistically higher in culture-negative patients in comparison with normal flora and culture-positive patients (87.5% vs. 46.2% vs. 54.8, respectively).
  
  
  CONCLUSIONS
  Intraoperative culture results can be a prognostic factor for the clinical outcomes of ESS in CRSwNP patients. Hence, the intraoperative culturing of pathologic secretions and the postoperative administration of susceptible antibiotics could improve surgical results.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Bong-Jae
authors.initials: BJ
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin-Hyuk
authors.initials: SH
authors.lastname: Yoo
authors.affiliation: Department of Otolaryngology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea. Electronic address: jjongmari@nate.com.
authors.forename: Jong Sook
authors.initials: JS
authors.lastname: Yi
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D046508:Culture Techniques; D004724:Endoscopy; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications*; D016908:Gram-Positive Bacterial Infections / Q000150:complications*; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012220:Rhinitis / Q000601:surgery*; D013203:Staphylococcal Infections / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chronic rhinosinusitis; Culture; Nasal polyp; Prognosis