PENICILLIN ADMINISTERED LOCALLY IN TREATMENT OF DISEASE OF NASAL ACCESSORY SINUS: Evaluation of Bacterial Sensitivity

Cardwell, Edgar P.

doi:10.1001/archotol.1946.00680060306005

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…Multiple reports have demonstrated that sinus lavages decreased the need for sinus surgeries. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] The importance of sinus lavage in nonresponders was considered obvious as most reports from that period did not describe its benefits empirically but rather focused on its role in various contexts or comparing the different techniques of sinus puncturing. 15,[30][31][32][33][34][35][36] However, patient selection and quantification of data were poor, which limited further data analysis.…”

Section: Discussionmentioning

confidence: 99%

Safety of a New Sinus Irrigation Device in Rhinosinusitis: A Pilot Study

et al. 2021

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Background: Puncture and lavage of the paranasal sinuses, previously the primary treatment for unresponsive acute bacterial rhinosinusitis before surgery, has been abandoned due to procedural discomfort and advancements in antibiotic efficacy and endoscopic surgery. The rise in antibiotic-resistant bacteria has renewed the interest in minimally invasive sinus lavage to both avoid aggressive surgical interventions and identify appropriate antibiotic therapy. In this article, we describe the safety and feasibility of a new device in human patients and evaluate its efficacy as a treatment before the traditional sinus surgery in acute rhinosinusitis. Methods: The device with its seeker-shaped guiding tube and rotating wire can enter the sinus cavity through the natural ostium, pulverize the inspissated mucus, and enable lavage and culture sampling without the need for sinus puncturing. It was tested in 6 patients with chronic sinusitis under general anesthesia during endoscopic sinus surgery and in additional 10 patients with maxillary acute bacterial rhinosinusitis in outpatient settings under local anesthesia. Results: The device enabled rapid, efficient, and atraumatic insertion of the wire into the occluded sinuses. The rotating wire permitted pulverization of the thick mucus, which enabled irrigation without mucosal damage or adverse events. Overall, 9 of 10 patients with acute bacterial rhinosinusitis demonstrated remarkable improvements and were discharged the following day with no acute symptoms. The visual analog scale score for pain dropped from 8.9 to 0.4. The remaining one patient underwent endoscopic sinus surgery subsequently. None of the patients treated during endoscopic sinus surgery developed any adverse events.

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