慢性鼻-鼻窦炎纤毛上皮细菌生物膜超微形态学观察

目的:观察慢性鼻-鼻窦炎(CRS)纤毛上皮细菌生物膜的超微形态学特点。方法:取4例行鼻内镜鼻窦手术的CRS患者中鼻甲黏膜,每个标本约4mm×4mm大小。经4%多聚甲醛固定24h、1%四氧化锇固定2h、乙醇梯度脱水、二氧化碳干燥、表面喷金镀膜后,用扫描电子显微镜观察标本超微形态。结果:4例标本均发现细菌生物膜的存在,生物膜主要形成于纤毛表面,细菌的鞭毛与纤毛缠绕;可见由多种细菌或细菌和真菌构成的混合感染。结论:细菌生物膜可以形成于CRS纤毛上皮上。     

细菌生物膜的电镜下特征及其与慢性鼻-鼻窦炎的关系

目的 观察慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者鼻内镜下所取钩突、筛窦黏膜标本是否存在细菌生物膜(bacterial biofilms,BF)及其形态学特征,探讨细菌生物膜在CRS发病机制中的作用.方法 对15例CRS伴有鼻息肉患者(试验组)和11例无CRS的鼻骨骨折患者(对照组),在鼻内镜下取钩突、筛窦黏膜(患者均知情同意),扫描电镜电镜下观察,判断标本中是否存在细菌生物膜,并描述其形态学特征.分析试验组与对照组之间的差异,对细菌生物膜的存在与部分临床指标进行相关分析.所有患者均行鼻窦CT检查并行CT评分.计量资料实验数据采用t检验,计数资料采用卡方检验,小样本计数资料用Fisher精确检验.结果 试验组15例患者中发现9例有细菌生物膜;对照组11例患者中发现1例有细菌生物膜,两者比较差异有统计学意义(χ~2=6.949,P<0.01).扫描电镜下,试验组9例患者标本中发现具有水通道、三维结构、基质包被的球形和椭圆形小体等典型特征的细菌生物膜.5例(包括1例对照组)标本发现除具有典型细菌生物膜特征外,还可见到与普通炎症导致的纤毛排列紊乱、缺失不同的纤毛黏聚.试验组细菌生物膜阳性患者的鼻窦CT评分(15.89±6.30)高于细菌生物膜阴性的患者(9.50±5.79),两者比较差异有统计学意义(t=2.14,P<0.05).结论 扫描电镜下可观察到CRS患者鼻黏膜中存在水通道、三维结构、基质包被的球形和椭圓形小体的典型形态特征的细菌生物膜.纤毛黏聚可能是细菌生物膜形成过程中的一种特有表现,是否也可以作为判断细菌生物膜存在的标志,有待于今后进一步研究.细菌生物膜的存在与CRS的发病密切相关,与疾病的严重程度相关,也可能是CRS难治的原因之一.     

难治性慢性鼻窦炎的相关因素探讨

目的 慢性鼻窦炎的难治性在于发病因素的复杂性,本研究拟探讨细菌生物膜、变态反应、主要炎性细胞因子与难治性慢性鼻窦炎的相关性.方法 采用视觉模拟量表评分和鼻内镜检查评分的方法 ,从340例首次接受内镜鼻窦手术和规范药物治疗1年以上的慢性鼻窦炎患者中,选择19例治疗无效者、6例临床治愈者分别作为实验组和对照组,通过电镜扫描、酶联免疫吸附法分别检测两组病例筛窦黏膜表面细菌生物膜的形成和筛窦黏膜组织中特异性IgE、白细胞介素(interleukin,IL)-4、IL-5、IL-6、IL-8的含量,统计分析比较组间差异.数据分析用SPSS13.0统计软件处理.结果 ①筛窦黏膜表而细菌生物膜:实验组有19例除上皮细胞结构破坏、纤毛脱落等病变以外,全部发现细菌生物膜形成,而对照组6例上皮细胞结构完整,纤毛整齐,未发现细菌生物膜形成,组间细菌生物膜检出率差异具有统计学意义(P<0.01).②特异性IgE:实验组有9例筛窦黏膜组织检测到特异性IgE,而对照组6例均未检测到特异性IgE,组间差异有统计学意义(P<0.05).③IL:实验组仪有2例标本中检测到IL-8含量升高,实验组和对照组其他病例4种IL含量均在王常参考值以下而无法检出.实验组检测到IL的病例数分别为:IL-4 7例、IL-5 14例、IL-6 15例、IL-8 12例,对照组检测到的病例数分别为:IL-4 1例、IL-5 5例、IL-6 5例、IL-8 5例,组间检出率差异无统计学意义(P值均>0.05).结论 细菌生物膜、变应性炎性反应是导致难治性慢性鼻窦炎的重要相关因素之一.     

慢性鼻窦炎保留钩突功能性鼻内镜手术30例临床观察

目的探讨保留钩突在鼻内镜手术中的意义,保留钩突的FESS更能维护鼻腔鼻窦的正常生理功能。方法30例单纯慢性鼻窦炎患者为实验组,实验组施行经鼻内镜下保留钩突的功能性鼻内镜手术,30例单纯慢性鼻窦炎为对照组,对照组采取经典钩突切除术。结果随访6个月,实验组治愈26例,好转2例,无效2例,有效率93.3％。对照组治愈22例,好转2例,无效6例,总有效率80.0％,两组总有效率比较P<0.05。实验组术后并发症较对照组明显减少。结论鼻窦开放术中保留或部分保留钩突维持了鼻腔的正常解剖学形态,同时避免吸人性气流对鼻窦的直接冲击,预防鼻腔粘连,使手术更加适应鼻腔鼻窦的气流特征,减少了鼻窦黏膜炎症的复发机会。     

鼻窦手术后联合应用桉柠蒎治疗鼻窦炎的疗效观察

目的 观察鼻内镜鼻窦手术后联合应用桉柠蒎治疗慢性鼻-鼻窦炎的临床疗效.方法 对慢性鼻-鼻窦炎Ⅱ型2期患者120例,随机分为治疗组和对照组,治疗组术后联合应用桉柠蒎治疗,而对照组应用常规综合治疗方法,对比两组病例疗效情况.结果 治疗组有效率为90.0％,对照组为75.0％,两组比较差异有统计学意义(P＜0.05).结论 鼻内镜鼻窦手术后应用桉柠蒎联合治疗,能有效促进鼻腔鼻窦黏膜黏液纤毛清除系统功能恢复,显著改善鼻腔鼻窦通气,缩短干鼻时间,提高手术疗效.     

中药鼻腔冲洗对术后鼻窦炎康复的促进作用

目的 观察中药溶液鼻腔冲洗对慢性鼻窦炎术后康复过程的影响.方法 常规鼻内镜手术治疗的Ⅱ型3期慢性鼻窦炎鼻息肉患者56例,随机分为两组,每组28例,均同法予以围手术期综合治疗.术后第3天开始,实验组应用中药溶液进行鼻腔冲洗,对照组则用生理盐水同法冲洗,1次/d,连续1周.分别于术后2、4周观察术腔黏膜恢复情况,并测试鼻黏膜纤毛传输速率.术后随访6个月,比较两组疗效.结果 术后2周时,2组动物均见术腔黏膜肿胀,有少量结痂和少量分泌物,鼻腔纤毛传输速率无明显组间差异;术后4周时,实验组术腔病变明显减轻,鼻黏膜纤毛传输速率加快.随访结束时,实验组治疗有效率明显高于对照组.结论 中药溶液鼻腔冲洗能够有效促进鼻内镜手术后的术腔康复过程.     

细菌生物膜与慢性鼻及鼻窦炎

细菌生物膜(bacteral biofilm,BBF)与慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)的关系是目前鼻科学研究的热点之一.细菌牛物膜可能是慢性鼻及鼻窦炎的一个重要致病因素.本文就细菌生物膜与慢性鼻及鼻窦炎关系的最新研究做一综述.     

慢性鼻及鼻窦炎细菌生物膜的研究现状

细菌生物膜被认为是多种慢性感染性疾病持续存在和不易治愈的重要原因.目前的研究证明慢性鼻及鼻窦炎患者的鼻窦黏膜中存在细菌生物膜,细菌生物膜与慢性鼻及鼻窦炎的发病相关.细菌生物膜在微生物学领域是研究热点,现阶段对其形成过程及调控机制、致病机制、耐药机制已有r初步了解,但很少涉及其与慢性鼻及鼻窦炎的相关性.本文对细菌生物膜的研究现状及其在慢性鼻及鼻窦炎的发病机制中的作用做一综述.     

嗅觉障碍与慢性鼻-鼻窦炎患者鼻腔鼻窦形态的相关性研究

目的:观察伴有嗅觉障碍的慢性鼻-鼻窦炎患者鼻腔鼻窦形态及其影像学表现,探讨嗅觉障碍与鼻腔鼻窦形态和影像改变的相关性。方法:对176例慢性鼻-鼻窦炎患者测试嗅觉功能,同时行鼻窦CT和鼻内镜检查,进行Lund-Mackey鼻窦CT评分及Kennedy鼻内镜评分,并观察嗅裂区阻塞情况,对检查及评分结果进行统计学分析。结果:①30例患者嗅觉正常(17.1%),109例患者有不同程度的嗅觉减退(61.9%),37例患者嗅觉丧失(21%);②Lund-Mackey鼻窦CT评分与嗅觉障碍的程度存在正相关(P<0.01);③Kennedy鼻内镜评分的变化与嗅觉障碍程度正相关(P<0.05)。结论:①嗅觉功能障碍与慢性鼻-鼻窦炎相关;②Lund-Mackey鼻窦CT评分系统对于嗅觉障碍的初步判断有一定临床意义;③Kennedy鼻内镜评分系统更侧重于评价鼻腔总体形态的改变。     

鼻内镜术后两种处理方式的疗效比较

目的 探讨理想的鼻内镜手术后处理方式.方法 对200例慢性鼻窦炎行鼻内镜手术,术后处理随机分成观察组和对照组,分别采用纳吸绵材料填塞(100例)结合鼻腔冲洗,及Merocel膨胀海绵(100例)填塞结合鼻腔冲洗两种处理方式,观察两组术后鼻腔及鼻窦黏膜形态和鼻部舒适度.结果 观察组术后不同时段黏膜形态评分和鼻腔舒适度显著优于对照组(均P ＜0.05).结论 鼻内镜术后采用纳吸绵填塞结合鼻腔冲洗的处理方式简单有效,可以明显提高患者鼻部舒适度、改善术后生活质量、减少鼻腔黏膜损伤、促进鼻腔黏膜愈合,是一种值得临床推广的理想方法.     

Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis

OBJECTIVES: Biofilms are bacterial pathogens that organize in several chronic and recalcitrant infectious processes. We hypothesize that biofilms play a role in chronic rhinosinusitis (CRS). Our goal is to demonstrate biofilms in mucosal specimens of patients undergoing surgery for CRS. STUDY DESIGN: A prospective study of the presence of biofilms in patients undergoing endoscopic sinus surgery for CRS compared with control patients without CRS. METHODS: There were a total of 30 subjects and 4 controls enrolled. The samples of 24 subjects and 4 controls were cultured and then prepared using standard methods for scanning electron microscopy (SEM). The remaining six subjects' samples were treated using advanced cryofixation methods as preparation to preserve structure for SEM and transmission electron microscopy (TEM). RESULTS: Using strict SEM morphologic criteria, 24 (80%) of the 30 patients were found to have micrographic evidence of biofilms. All controls had healthy appearing cilia and goblet cells without biofilms. The six cryofixation samples showed biofilm structures on SEM micrographs that were correlated with bacterial structures seen at the mucosal surface on the corresponding TEM cross sections. Bacterial cultures were positive on all patients. CONCLUSIONS: Biofilms were demonstrated to be present in patients undergoing surgery for CRS; none of the patients without CRS had any evidence of biofilms. Although SEM is capable of demonstrating the biofilms' three-dimensional structure, glycocalyx, and water channels, it cannot clearly demonstrate the presence of bacteria within the biofilm. We were able to demonstrate evidence of bacteria in the biofilms on the subjects tested using TEM.     

慢性鼻-鼻窦炎鼻息肉患者细菌生物膜的观察

目的 观察慢性鼻-鼻窦炎鼻息肉患者手术黏膜组织中细菌生物膜的形态特征,并分析其与临床因素、术后疗效的关系.方法 试验组获取72例慢性鼻-鼻窦炎鼻息肉患者手术中筛窦黏膜组织,对照组获取15例鼻中隔偏曲患者、10例鼻骨骨折患者钩突黏膜组织(患者均知情同意),所有组织标本均行扫描电镜检查.对两组患者进行术后随访,分别应用Lund-Kennedy鼻内镜检查、慢性鼻窦炎疗效评定标准(1997年,海口)评估患者病情改善程度.采用t检验分析细菌生物膜对术后Lund-Kennedy评分的影响;采用卡方检验分析细菌生物膜与内镜手术疗效的相关性,以P＜0.05为差异有统计学意义.结果 试验组72例慢性鼻-鼻窦炎鼻息肉患者中有3例患者失访,失访率为4.2%.69例慢性鼻-鼻窦炎鼻息肉患者的细菌生物膜阳性率71.0%(49/69),并且可以观察到黏膜组织纤毛不同程度的损伤.对照组未发现细菌生物膜,可以观察到黏膜纤毛较浓密,排列整齐.卡方检验结果显示,性别、慢性鼻-鼻窦炎鼻息肉类型、病程等因素在试验组细菌生物膜阴性组与阳性组间差异无统计学意义(P值均＞0.05).细菌生物膜阳性组患者术后6个月和12个月的Lund-Kennedy 评分(4.78 ±1.67;4.55 ±1.61)分别高于细菌生物膜阴性组患者(3.65 ±1.39;3.65 ±1.18),差异均有统计学意义(t=-2.654,P＜0.01;t=-2.264,P＜0.05);细菌生物膜阴性组术后6个月和12个月的疗效明显优于细菌生物膜阳性组,差异有统计学意义(x2值分别为18.014、22.063,P值均＜0.001).结论 慢性鼻.鼻窦炎鼻息肉患者手术黏膜组织中存在细菌生物膜的生命周期不同形态,细菌生物膜的存在与否,与慢性鼻-鼻窦炎鼻息肉的类型、性别、病程无明显相关.细菌生物膜可能对患者术后疗效产生不良的影响.

Abstract：

Objective To explore the presence of bacterial biofilms(BF) in patients with CRS and the effect of BF on clinical symptoms and postoperative outcomes.Methods Seventy-two patients with chronic sinusitis were enrolled in this study.The control group included 15 patients with deviation of the nasal septum and 10 patients had a fracture of the nasal bone.Mucosa of the uncinate process or ethmoid near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery.The specimens were subjected to scanning electron microscopy.Patients were followed for 1 year and observed by the LundKennedy endoscopy,and the Haikou standard classification (ESS-1997).Statistical analysis was performed by t-test or chi-square test Results Three patients were lost to follow-up.The scanning electron microscopy analysis showed bacterial biofilms in 49 of the 69 patients with chronic sinusitis.A marked destruction of the epithelium and cilia was observed in samples positive for bacterial biofilms.No bacterial biofilms were detected in the control group,and scanning electron microscopy showed normal epithelium and cilia in those specimens.There was no significant difference in gender,classification or duration of disease between the BF(-) and BF( + ) groups.At six months and one year postoperative,the Lund-Kennedy endoscopy scores for CRS patients with BF(4.78 ± 1.67 ;4.55 ± 1.61) were significantly higher than those without BF(3.65 ±1.39;3.65 ±1.18) (t =-2.654,P＜0.01;l =-2.264,P＜0.05).Based on the Haikou standard classification,there was a significantly difference between patients with BF and those without BF( x2 = 18.014,22.063 ,P ＜ 0.001,respectively).Conclusions Different life stages of bacterial biofilms were demonstrated to be present in CRS.Gender,classification or duration of disease did not affect the presence of bacterial biofilms in patients with CRS.There is a correlation between bacterial biofilms and an unfavorable outcome in patients with CRS after ESS.     

Confocal scanning laser microscopy evidence of biofilms in patients with chronic rhinosinusitis

OBJECTIVES: The recent detection of bacterial biofilms on the sinus mucosa of patients with chronic rhinosinusitis (CRS) has implicated biofilms in the pathogenesis of this condition. Electron microscopy has been the main modality used to document the presence of biofilms on sinus tissue, however, it has inherent problems associated with tissue preparation and sampling. Recently, Confocal Scanning Laser Micrsocopy (CSLM) has emerged as a noninvasive, nondestructive technique for the analysis of biofilms. This study used CSLM as the means of investigating biofilm presence in CRS patients. STUDY DESIGN AND METHODS: A prospective study comparing the presence of bacterial biofilms on the sinus mucosa of CRS and control patients was conducted using CSLM. Thirty eight CRS patients undergoing endoscopic sinus surgery and nine control patients were enrolled in this study. Demographic and clinical information was recorded from each patient and intraoperatively, sinus culture specimens and mucosal samples were obtained for microbiologic and microscopic examination. RESULTS: Using previously documented CSLM criteria, bacterial biofilms were found in 17 (44%) of the 38 CRS patients. No biofilm structures were evident in any of the controls. Patients having undergone previous sinus surgery seemed to have a higher incidence of biofilms compared with the incidence for those undergoing their first procedure. The difference however was not statistically significant. No correlation between positive bacterial cultures and biofilm presence was observed. CONCLUSIONS: The CSLM detection of biofilms in CRS patients and their absence in controls further supports the hypothesis that biofilms may play a role in the pathogenesis of CRS. This study's lower reported incidence of biofilms compared with that of previous studies might reflect the increased accuracy of biofilm detection with CSLM.     

The effect of bacterial biofilms on post-sinus surgical outcomes

BACKGROUND: Although the existence of biofilms on the sinus mucosa of patients with chronic rhinosinusitis (CRS) is now well established, the role that these structures play remains unclear. It is thought that biofilms may contribute to the recalcitrant and persistent nature that characterizes CRS, but little research exists documenting the effect that they have on postoperative mucosal outcomes. This article presents a retrospective analysis of sinus surgical patients and correlates the presence of biofilms with mucosal outcomes. This study was performed to evaluate the role that bacterial biofilms have on post-sinus surgical outcomes. METHODS: A retrospective analysis of prospectively collected data was performed on 40 patients undergoing endoscopic sinus surgery (ESS) for CRS. Preoperative demographic, clinical, and radiologic data were recorded from each patient and, intraoperatively, sinus culture specimens and mucosal samples were obtained for microbiological and microscopic examination. Biofilm determination was performed using confocal scanning laser microscopy. Postoperatively, patients were followed up for a minimum of 8 months with endoscopic evaluation of their sinonasal mucosa. The presence of ongoing symptoms was recorded also. RESULTS: Bacterial biofilms were found in 20 (50%) of the 40 CRS patients. Patients with biofilms had significantly worse preoperative radiological scores and, postoperatively, had statistically worse postoperative symptoms and mucosal outcomes. The only other factor that was statistically related to an unfavorable outcome was the presence of fungus at the time of surgery. In this study the presence of polyps, eosinophilic mucin, or pus was not related to poor outcomes. CONCLUSION: This retrospective study showed that bacterial biofilms and fungus were correlated with the persistence of postoperative symptoms and mucosal inflammation after sinus surgery for CRS. This provides evidence that biofilms indeed may play an active role in perpetuating inflammation in CRS patients and may explain the recurrent and resistant nature of this disease. Therapies targeted at removing biofilms may be important in the management of recalcitrant CRS.     

The influence of bacterial biofilm on the clinical outcome of chronic rhinosinusitis: a prospective,double-blind,scanning electron microscopy study

The aim of this study was to assess the influence of bacterial biofilms in chronic rhinosinusitis (CRS) patients on the clinical outcomes following endoscopic sinus surgery (ESS). This was a prospective, double-blind study. Patients undergoing ESS, because of CRS, were recruited. Overall 80 patients were qualified. For each of these demographic, clinical and radiologic characteristics were recorded. During surgery each patient had at least 7 mucosal specimens taken to assess, using scanning electron microscopy, the possible presence of bacterial biofilms. Prior to mucosa specimen excision, swabs for bacteriological and fungal analyses were taken. Each patient underwent perioperative and follow-up assessment at 3 and 6 months post-ESS. Biofilms were found in 33 (41.3 %) patients (study group). From among the 47 patients without the presence of biofilms, 33 (control group) were taken to match the study group in age, gender and clinical characteristics. The intensity of subjective and objective CRS symptoms, as well as patient quality-of-life, did not correlate with the Lund and Mackay score (p > 0.05). Analysis of variance showed that, in the control group or the group as a whole, the intensity of subjective and objective symptoms decreased (p < 0.05), and the quality-of-life increased with time (p < 0.05). In conclusion, biofilm-positive patients tend to have a greater severity of disease preoperatively and continue to have persistent and more severe symptoms post-ESS. This study supports the role of biofilms in maintaining the chronic and recalcitrant nature of CRS. The lack of planktonic bacteria in post-operative sinus swabs does not rule out the presence of bacterial biofilms.     

Evaluation of ultrastructural changes in paranasal sinus mucosa after functional endoscopic sinus surgery in patients with chronic rhinosinusitis

The purpose of this study was to compare the preoperative and postoperative ultrastructural changes of paranasal sinus mucosa in patients treated with functional endoscopic sinus surgery for chronic rhinosinusitis. Twelve patients undergoing functional endoscopic sinus surgery for the treatment of chronic rhinosinusitis were involved. The ethmoid sinus mucosa was sampled during the operation and approximately 6 months after the operation. The ciliated epithelium of sinus mucosa was evaluated with transmission electron microscopy. The samples were taken at the Otolaryngology Department of Istanbul University School of Medicine. Electron microscopic study was performed at the Histology and Embryology Department of the same University. Preoperatively, ciliated epithelial cells of the sinus mucosa of the patients showed degenerated ultrastructure with decreased number of cilia, cytoplasmic protrusions, cisternal dilatations of endoplasmic reticulum, and mitochondrial swellings. Remnants of degenerated cells and cellular separations at cell junctions were evident in the diseased epithelium. Goblet cells were frequent along the epithelial lining. Postoperatively, normal architecture and ultrastructure of the ciliated epithelium was restored. These observations showed that unlike other surgical operations, paranasal sinus mucosa can regenerate and the ciliated epithelium can return to normal after functional endoscopic sinus surgergy.     

Biofilm detection in chronic rhinosinusitis by combined application of hematoxylin-eosin and gram staining

The pathomechanism of chronic rhinosinusitis with nasal polyposis (CRS/NP) seems to be unclear. Bacterial-, fungal- and combined biofilms might play a potential role in the pathogenesis of various inflammatory diseases and recently in CRS/NP. A prospective, blinded observational study was performed to confirm that the combination of conventional hematoxylin–eosin (HE) and Gram staining protocols could be used to detect bacterial and fungal biofilms in patients with CRS/NP. A total of 50 patients with CRS/NP undergoing endoscopic sinus surgery (ESS) were analyzed. The negative control group consisted of 12 patients undergoing septoplasty for nasal obstruction without CRS/NP. The nasal polyps and inferior turbinate mucosa specimens applied as negative controls were processed to HE and Gram staining. Biofilm was detected in 44 of 50 patients with CRS/NP and in none of 12 negative controls. In our series, HE method showed an obvious correlation with the results of Gram staining and was allocated to be a good predictor of biofilm existence. It was found that the microscopic structure and thickness of biofilms were strongly associated with the integrity of nasal mucosa and with the characteristics of subepithelial cellular infiltration. This study confirmed the presence of bacterial and fungal biofilms on the surface of NPs obtained from patients with CRS. Since biofilms may affect the severity and recurrence rate of CRS treated by ESS they should be detected histologically. In conclusion, HE staining combined with Gram protocol is a robust and reliable method for the detection of bacterial and fungal biofilms in CRS/NP.     

Clinical value of bacteriological examinations of nasal and paranasal mucosa in patients with chronic rhinosinusitis

Introduction. In the literature, contradictory statements regarding the physiological flora of the nose and paranasal sinuses, the role of aerobic and anaerobic ‘pathogenic’ bacteria, and the influence of the sample technique and location can be found. The aim of this study was to examine the reliability of bacteriological examinations of the nasal and paranasal mucosa in patients with chronic rhinosinusitis. Methods. Patients with and without chronic rhinosinusitis undergoing a functional endoscopic sinus surgery (FESS) or a septoplasty were examined. Nasal brushes of the inferior turbinate and mucosal biopsies of the middle turbinate were taken in both groups. Mucosal biopsies of the ethmoidal bulla and maxillary sinus were taken in only the chronic rhinosinusitis group. Results. In both groups, coagulase‐negative Staphylococci were found in all samples. Staphylococcus aureus was found in 22% (middle turbinate) and 33% (inferior turbinate) of all samples in the control group and in 33% (maxillary sinus) and 50% (inferior turbinate) in the patient group. Other aerobic bacteria were found in low percentages in both groups. No strictly anaerobic bacteria and no significant differences between both groups and the different samples were found. Conclusions. A differentiation between patients with and without chronic sinusitis was not possible.