This study aims to understand better the relationship between culturable bacteria and histopathology in chronic rhinosinusitis.

A structured histopathology report was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery in a group of patients with chronic rhinosinusitis refractory to medical therapy. Patients with cystic fibrosis or ciliary dysfunction were excluded. Histology variables included eosinophil count per high-power field, neutrophil infiltrate, basement membrane thickening, subepithelial edema, hyperplastic/papillary changes, mucosal ulceration, squamous metaplasia, fibrosis, fungal elements, Charcot-Leyden crystals, and eosinophil aggregates. Researchers also collected baseline Lund-Mackay score and Sinonasal Outcome Test 22 score. The researchers assessed the association of culture data with the variables mentioned above.

Fifty-nine chronic rhinosinusitis patients who underwent functional endoscopic sinus surgery were included. Chronic rhinosinusitis patients with Pseudomonas aeruginosa had significantly increased neutrophil infiltrate, subepithelial edema, and a trend toward increased fungal elements. Chronic rhinosinusitis patients with Staphylococcus aureus had significantly more hyperplastic changes and a trend toward increased squamous metaplasia.

The study concluded that researchers noted the distinct histopathologic changes based on sinus culture data for S. aureus and P. aeruginosa. These findings may have important implications on the extent of surgical management and prognosis after surgery.