In this article :
Nasal and Sinus Cultures
Sinusitis is a very common infection disease that affects many people worldwide affecting both children and adults. Its incidence increases every year and currently, approximately 1 in 8 Indians suffer from Chronic Sinusitis. Sinusitis diagnosis involves many methods, nasal and sinus cultures being one, others being endoscopic examination, X-ray, CT & MRI scan and allergy tests. Nasal and sinus cultures help your sinus specialist establish which microorganism is responsible for your sinusitis.
Sinusitis leads to considerable decrease in the quality of life of these patients and has a strong economic impact on the active population. The importance of proper diagnosis cannot be overemphasized. Identifying the precise microorganisms involved in the development of sinusitis is a challenge for sinus specialists. As a result, in many cases empirical treatment is applied.
In recent years, no significant changes have been observed with respect to microbial agents causing rhinosinusitis. However, there have been considerable variations in the susceptibility of these microorganisms to the antibiotics frequently used to treat this disease.
The nasal and sinus cultures allow determining with precision the microorganism causing this disease and its pattern of antimicrobial sensitivity. Sampling for cultures is usually done using nasal swabs, sinus aspiration through endoscopy, and sinus puncture. These tests are very useful and increase their effectiveness if the microorganisms involved more frequently in this pathology are taken into account.
The determination of the microorganism responsible for sinusitis by nasal and/or sinus culture is particularly important in cases of patients with disseminated infection(infection which spreads from one area of the body to another), alterations in the body’s defense system, or complications such as meningitis. Generally cultures may not be necessary in case of chronic sinusitis but if your condition is not improving with treatment your doctor may go for a culture.
How samples are taken for Nasal and Sinus cultures
There are various procedures for taking culture samples –
It is considered an unreliable method due to the inevitable contamination of the sample by microorganisms that live naturally in the nasal passages. However, its usefulness increases in case of suspected fungal infection.
The procedure consists of introducing a sterile swab through the nostrils and extracting as much pus and / or mucus as possible from the medial and lateral wall of the nasal cavity. The procedure does not require anesthesia since it does not cause pain, the patient just feels discomfort when the doctor introduces the swab through the nostrils. It is a simple procedure and usually lasts less than 5 minutes.
What will the patient feel during Nasal Endoscopy?
First of all, we must know that nasal endoscopy is not a painful procedure. However, in some cases, patients may feel discomfort or pressure as the doctor introduces the endoscope through the nostrils. The anesthetic applied in the nasal cavity can also anesthetize the throat and tongue, so these areas feel numb, but this usually disappears in 20 to 30 minutes.
Sinus Aspiration through Endoscopy
It is currently the technique of choice because it offers accurate results with low risk of complications. The procedure is harmless and easy to perform by the specialist. It is performed through a rigid endoscope that is directed towards the orifice that communicates the paranasal sinuses with the nasal cavity where the outflow of pus can be visualized through said meatus(passage). Once in this position, the sample is taken with the endoscope.
It is a highly reliable technique but very invasive. It consists of the puncture of the paranasal sinuses with the aim of aspirating the cavity content. This procedure can cause some complications such as moderate bleeding. Hence its usage is limited to serious cases.
All clinical samples are sent to the laboratory for processing as soon as possible. A part of the sample must be inoculated in an Anaerobic Transport Medium and the rest must be placed in a sterile container. Biopsies should be transported in a sterile container with saline.