Microecosystem of ostiomeatal complex and the changes via functional endoscopic sinus surgery

摘要

Objective: To study the composition of microecosystem in ostiomeatal complex (OMC) of adults and the changes via functional endoscopic sinus surgery. Methods: 220 adults with chronic sinusitis(20 as control) were classified into pre- and post-operative groups, and categorised according to its type of sinusitis. Swab specimens were taken from three different sites of ostiomeatal complex in each individual, and cultivations and identifications of aerobes, anaerobes and fungi were performed simultaneously. The microecosystem was analysed. Results: Cultured aerobes belonged to 30 species from 13 genera, anaerobes species, and fungi 3 major species, most of which have none or less virulence. The difference of mi-croecological status between type Ⅰ and Ⅱ was not significant ( P > 0.05) . Aerobic culture rates between preoperative group and control group had significance( P < 0.01 ) ; culture rate descended in postoperative group while the difference was not significant compared to preoperative group ( P > 0. 05) ; difference of rate of same aerobic culture from three sites (RSAC) , which reflects the microecological integrity of OMC, between preoperative and control group was significant ( P < 0.01) , while was not between postoperative group and control one( P > 0. 05) . Taking fungi into account, differences among all groups had no significance ( P > 0.05) ; anaerobes were rare in all groups. Conclusion: Being a microecosystem under normal condition, ostiomeatal complex is relatively clean and exists as a whole space. Chronic inflammations separate different parts of which from each other with multimicrobial existence . FESS reverses separation of the microecosystem and rebuild it as a whole again, thus promote the recovery.