Microbiology and antibiotic resistance of chronic rhinosinusitis in patients undergoing primary vs. revision endoscopic sinus surgery.

INTRODUCTION Chronic Rhinosinusitis (CRS) is an inflammatory process associated with several different pathogenic aerobic and anaerobic organisms. The microbiology of CRS has been studied extensively. As a result, probability guided antibiotics have been used. Endoscopic cultures of the middle meatus and sinuses have assisted in directing the choice of antibiotics and overall treatment. Reports of cultured organisms in medically treated patients as well those treated surgically by functional endoscopic sinus surgery (FESS) have demonstrated differences in the isolates. (1-6) Many patients that undergo FESS, however, often have recurrent and persistent CRS that requires additional surgical intervention after appropriate medical treatment. Studying the endoscopically guided cultures intraoperatively may demonstrate those microorganisms that persist in the nasal cavity and sinuses despite aggressive treatment. In this article, we describe the microbiology of patients undergoing primary FESS and those requiring revision FESS.