A Comparison between Endoscopically Middle Meatal Aspiration Culture Using Modified Aspiration Instrument and Direct Maxillary Antral Tap Culture in Chronic Rhinosinusitis
Virat Kirtsreesakul MD*, Yanin Chatwiwat MD*, Varaporn Laohaprertthisan BSc**
Affiliation : * Division of Allergy and Rhinology, Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Songkhla ** Division of Microbiology, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla
Objectives : To evaluate the accuracy of endoscopically guided middle meatal aspiration culture by comparing
the culture results between middle meatal aspiration using the modified aspiration instrument and direct
maxillary antral tap.
Materials and Methods : Sixteen patients with chronic rhinosinusitis underwent functional endoscopic sinus
surgery (FESS) were enrolled. Both endoscopically middle meatal aspiration culture (EMAC) using modified
aspiration instrument and direct antral tap culture (ATC) were performed before FESS. Microbiologic data
were compared and analyzed for any statistical differences between EMAC and ATC.
Results : The positive culture rates were 93.75% in both EMAC and ATC groups. Aerobic and facultative
anaerobic bacteria were found in 87.5% of EMAC group and 81.25% of ATC group. The two most common
bacteria in both groups were coagulase-negative Staphylococcus and Staphylococcus aureus. The association
between EMAC and ATC was strong to moderate (13/16) 81.25%.
Conclusion : EMAC appears to be a valuable alternative to ATC for guiding bacterial-specific therapy in
chronic rhinosinusitis. This modified aspiration instrument should be useful in clinical practice and serve as
a cost effective procedure.
Keywords : Chronic rhinosinusitis, Culture, Aspiration instrument, Middle meatal aspiration, Antral tap
