Serum and Mucosal Nitric Oxide Levels and Efficacy of Sodium Nitroprussid in Experimentally Induced Acute Sinusitis

Experimental acute sinusitis was induced in 21 New Zealand hybrid rabbits by occluding the ostium and inoculating them with Streptococcus pneumonia. While a group of rabbits with sinusitis was left untreated, two other groups were administered parenteral sodium nitroprussid (SNP) and oral levofloxacin for ten days. While staphylococci species, non-hemolytic streptococcus and contaminated flora were isolated from the sinuses of controls, Streptococcus pneumonia was re-isolated in two of six untreated rabbits, in one of six SNP administered rabbits and none of the levofloxacin treated rabbits. Serum and maxillary sinus mucosal nitric oxide (NO) levels were correlated. While the mean maxillary sinus NO level of controls was significantly higher than that of untreated rabbits, the mean maxillary sinus and serum NO levels were significantly higher in SNP administered rabbits than in the others. Although goblet cell hyperplasia and squamous cell metaplasia were detected in some slides, edema and neutrophil infiltration were the prominent findings. The most severe inflammatory changes were found in the untreated sinusitis group on the third and fifth days. The earliest improvement was observed in the levofloxacin treated rabbits. It was concluded that NO level is decreased during acute sinusitis and that SNP administration hastens the bacteriological and histological recovery.

Diagnostic and Therapeutic Significance of Sinoscopy in Maxillary Sinusitis

Sinoscopy as an endoscopic investigative method of examining the maxillary sinus offers the advantage of a direct local interpretation in contrast to the usual indirect methods. The beginning of sinoscopy dates back to Hirschmann (1903) and Spielberg (1922). During the last 20 years, this method has been reintroduced and refined. In spite of a large number of articles about sinoscopy from Europe, there have been no articles about sinoscopy from Korea. In the present study, 182 maxillary sinuses were examined by sinoscopy and PNS Xpray for diagnostic reasons. The failure rate in sinoscopy was 3.8% and the rate of incomplete sinoscopy was inferior to X-ray. The detection rate of antral secretion by sinoscopy was higher than by Xpray. In the bacteriological study of antral secretions the percentage of no-growth specimens was 75.7%. In all approximately ten strains of bacteria were isolated from the secretions. Among them, streptococcus was the most common organism found. Therapeutic sinoscopy was performed in 16 patients who suffered from subacute or chronic maxillary sinusitis. In 8 of these patients, local treatment during therapeutic sinoscopy improved the mucosal appearance.