Swabs from 93 chronically inflamed maxillary sinuses in children were taken from aerobic and anaerobic bacteria during endoscopy. Bacterial growth was present in 87/93 specimens (93%). Anaerobic bacteria were isolated in 81/87 culture-positive specimens (93%) and were recovered alone in 61 cases (70%) and mixed with aerobic or faculative bacteria in 20 (23%). Aerobic or facultative bacteria were present alone in six cases (7%). A total of 261 isolates (3/specimen), 19 (2.4/specimen) anaerobes and 69 (2.6/specimen) aerobes or facultatives, were isolated. The predominant anaerobic organisms were Bacteroides sp. and anaerobic cocci; the predominant aerobes or facultatives were Streptococcus sp. and Staphylococcus aureus. These findings indicate the important role of anaerobic organisms in chronic sinusitis.

We conclude that BCS helps to dilate the sinus ostia properly and effectively in the management of chronic rhinosinusitis. It can also be performed in the ethmoidal air cell area.

Patients were aged 32-69 years (mean 57.4). There were 22 female and 13 male patients. Revision mastoidectomies were applied to 14 previous ICW and 21 prior CWD mastoidectomies. Of the 35 patients, 24 patients had cholesteatoma and 11 of them did not. Of the patients who had revision surgery, 10 had ICW mastoidectomy and 25 had CWD mastoidectomy. After revision mastoidectomy, at 3-25 months follow-up (mean 16.7 months), 29 patients had been successfully treated; they had dry well epithelialized cavity, with no findings of persistent, recurrent discharge or granulation tissue and cholesteatoma. In 21 patients in whom revision CWD mastoidectomy was performed, causes of failure of previous ear surgery in order of frequency were recurrent or persistent cholesteatoma and narrow meatoplasty (80.9%), persistent sinodural angle air cells and close supratubal recess (71.4%), high facial ridge and inadequate canalplasty (66.7%), persistent tegmental air cells and tympanic membrane remnant (57.1%), persistent mastoid apex air cells and open eustachian orifice (52.4%). Causes of failure after our revision ICW mastoidectomy in order of frequency were persistent or recurrent cholesteatoma (78.6%), closed supratubal recess (64.3%), persistent sinodural angle air cells, inadequate canalplasty and persistent mastoid apex air cells (57.1%), persistent tegmental air cells (42.9%).

The results suggest that a prothrombotic condition might play a role in the pathophysiology of tinnitus.

The purpose of this study was to determine the effect of uncinectomy without sinusotomy and natural ostial dilatation on maxillary sinus ventilation in chronic rhinosinusitis. Twenty patients with chronic rhinosinusitis were included in this study. The patients were randomly divided into two groups. Group 1 consisted of patients with uncinectomy (n = 10), while group 2 was made up of patients treated with natural ostial dilatation (n = 10). The CO(2) tension and pressure levels of the maxillary sinus during inspiration and expiration phases were obtained and compared before and after the procedures within and between the groups. The mean CO(2) tension levels in both groups were significantly decreased after the procedures. The mean maxillary sinus pressure during inspiration was significantly decreased to a negative value after uncinectomy; however, no significant change was observed during expiration. There were no significant changes in maxillary sinus pressures after natural ostial dilatation procedure. Both uncinectomy and natural ostial dilatation seem to be equally effective in decreasing maxillary sinus pCO(2) levels. The effects of decreased maxillary sinus pressure during inspiration after uncinectomy on mucociliary clearance and development mechanisms of chronic rhinosinusitis seem to be worth investigating.