Analysis of the Bacterial Flora in the Nasal Cavity and the Sphenoid Sinus Mucosa in Patients Operated on with an Endoscopic Endonasal Transsphenoidal Approach

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  • SHIBAO Shunsuke
    Department of Neurosurgery, Keio University Graduate School of Medicine
  • TODA Masahiro
    Department of Neurosurgery, Keio University Graduate School of Medicine
  • TOMITA Toshiki
    Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Graduate School of Medicine
  • OGAWA Kaoru
    Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Graduate School of Medicine
  • YOSHIDA Kazunari
    Department of Neurosurgery, Keio University Graduate School of Medicine

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The aim of this study was to analyze the bacterial flora in the nasal cavity and sphenoid sinus and evaluate the sensitivity of these bacteria to antibiotics that can be used to prevent postoperative meningitis. Bacteria of the preoperative nasal cavity and intraoperative sphenoid sinus mucosa were cultured and analyzed in 40 patients (20 men and 20 women; mean age, 52.2 years) who underwent endoscopic transsphenoidal surgery. The sensitivity of these bacteria to cephalosporin, a representative prophylactic antibiotic, was examined. Staphylococcus epidermidis was the most frequently detected species in both spaces; 24 (38.7%) of 62 isolates in the nasal cavity and 26 (37.1%) of 70 isolates in the sphenoid sinus. In contrast, Corynebacterium species were found mainly in the nasal cavity, and anaerobic bacteria were found only in the sphenoid sinus. Bacteria that were resistant to cephalosporin were found in the nasal cavity in 3.2% of patients and in the sphenoid sinus in 20% of patients. In conclusion, the composition of bacterial flora, including bacteria that are resistant to prophylactic antibiotics, differs between the nasal cavity and the sphenoid sinus.

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