Bcateriology Of Postradiotherapy Chronic Rhinosinusitis

Objective:To investigate and compare the bacteriology of postradiotherapy chronic rhinosinusitis(postRT-CRS)and chronic rhinosinusitis(CRS)by evaluating aspiration materials of maxillary sinus from patients with postRT-CRS and patients with CRS.Methods:The postRT-CRS group consisted of 24 men and 6 women, whose mean age was 42.7 years and duration of sinus symptoms mean 2.92±2.20 years.The CRS group comprised 23 men and 7 women,whose mean age was 33.8 years and the duration of sinus symptoms mean 4.97±4.38 years. By maxillary sinus puncture,37 specimens were obtained from the 30 nasopharyngeal carcinoma(NPC)survivors with postRT-CRS and 37 specimens were obtained from 30 patients with CRS,respectively.All specimens were sent for aerobe/facultative anaerobe bacteria culture,and the antimicrobial susceptibility of these specimens were evaluated.Secretion specimens obtaining from middle nasal meatus of 15 the healthy adults were sent for aerobe bacteria culture.In addition,we measured mucociliary transport rate(MTR)of all subjects by saccharin test.Results:Isolated gram-positive coccus rate in postRT-CRS patients was significantly higher than in CRS patients(62.5%compared with 30%, respectively;p＜0.05),and isolated gram-negative bacilli rate in postRT-CRS patients was significant lower than in CRS patients(31.25%compared with 70.0%,respectively;p＜0.05).The most common isolate in postRT-CRS group was Streptococcus viridians,while that in CRS group was Hemophilies influenzae.In 8 positive specimens(53%)obtaining from the middle nasal meatus of 15 healthy adults,4 yielded Staphylococcus epidermidis.The resistance rates of Erythromycin,Clindamycin,SMZ and Penicilin were relatively higher than those of other antibiotics in this study.The mean mucociliary transport rate(MTR)in patients of the postRT-CRS group,in the CRS patients without nasal polyp,in the CRS patients with nasal polyp and in control subjects was 4.50±1.63mm/min,8.23±2.78mm/min,5.59±2.98 mm/min, and 8.45±2.02 mm/min,respectively.The mean MTR in patients of the postRT-CRS group and in the CRS patients with nasal polyp were all significant lower than in control subjects(p＜0.05).Conclusion:Gram-positive coccus and gram-negative bacilli were the predominant aerobic/facultative anaerobe pathogenic bacteria in patients with postRT-CRS and in patients CRS,respectively.But we didn't found any significant differences in distribution of aerobic/facultative anaerobe bacteria between postRT-CRS and CRS in our study.The mean MTR in the patients with postRT-CRS and in the CRS patients with nasal polyp were all lower than in healthy adults,whereas there was not difference between in the CRS patients without polyp and in healthy adults.Probably bacteria infection was merely a secondary event following chronic disease process.