Acta Oto-Laryngologica

ISSN: 0001-6489 (Print) 1651-2251 (Online) Journal homepage: http://www.tandfonline.com/loi/ioto20

Maxillary Sinusitis Effects of Treatment on the Local Antibacterial Defence C. Carenfelt To cite this article: C. Carenfelt (1977) Maxillary Sinusitis Effects of Treatment on the Local Antibacterial Defence, Acta Oto-Laryngologica, 84:1-6, 440-445, DOI: 10.3109/00016487709123989 To link to this article: http://dx.doi.org/10.3109/00016487709123989

Published online: 08 Jul 2009.

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Date: 14 March 2016, At: 01:44

Acta Otolaryngol84: 440445, 1977

MAXILLARY SINUSITIS Effects of Treatment on the Local Antibacterial Defence

Downloaded by [University of California, San Diego] at 01:44 14 March 2016

C. Carenfelt From the Department of Otolaryngology, Karolinska sjukhuset, and the Department of Immunology, National Bacteriological Laboratory, Stockholm, Sweden

(Received December 20, 1976)

Abstracts. Low levels of immunoglobulins and complement in purulent antral secretion might jeopardize the local antibacterial defence. To evaluate whether or not antibiotic treatment and antral drainage influence the local content of immunoglobulins and complement, samples of secretion were analysed both prior to drainage and 1-2 days after drainage. In those patients requiring repeated drainage for their recovery, the local concentration of IgA and IgG was significantly lower in the secretion obtained prior to drainage than the local concentration found in patients who recovered after the initial drainage. It was also demonstrated that after drainage, the level of IgA, IgG and the complement factors C3 and C4 increased significantly, whereas the proteolytic activity in the secretion usually decreased.

sinus secretion might result from proteolytic degradation. In the present study, the immunoglobulins IgA, IgG and IgM, the complement factors C3 and C4, and the protease inhibitor a2-macroglobulin were determined in purulent sinus secretion in order to evaluate whether the treatment (including drainage of the purulent secretion) might influence the content of these components in the sinus secretion.

Virulent microorganisms have not only the capacity to replicate in the biochemically complex environment of the host surface, fluid and tissue, but also the ability to resist the host defence, of which immunoglobulins and complement are important components. In a previous study, immunoglobulins were demonstrated in maxillary sinus secretion, the concentration being lower in purulent than in serous secretions (Carenfelt et al., 1976). As pus and certain purulent secretions have a high proteolytic activity (Lieberman & Kurnick, 1962) and as immunoglobulins and complement are susceptible to degradation by proteases, it was surmised that low levels of immunoglobulins and complement in purulent

MATERIAL AND METHODS

This study was supported by grants from Sigurd and Elsa Golje Memorial Foundation. Acta Otoluryngol 84

Patients Twenty-nine patients (21 female and 8 male, age range 22-65 years) with symptoms of maxillary sinusitis for 30 days or less and with a retained purulent secretion in sinus maxillaris were selected for the present study. A sample of sinus secretion (0.5-1 ml) was obtained by aspiration through a Lichtwitz cannula inserted into the antrum through the inferior nasal meatus. The remaining secretion was then evacuated as completely as possible, resulting in volumes varying between 1 and 12 ml. This antral drainage was repeated at intervals of 1-2 days until the patient had recovered, that is until air or a minor volume (

Maxillary sinusitis. Effects of treatment on the local antibacterial defence.

Acta Oto-Laryngologica ISSN: 0001-6489 (Print) 1651-2251 (Online) Journal homepage: http://www.tandfonline.com/loi/ioto20 Maxillary Sinusitis Effect...
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