Bacteria and inflammatory cells in maxillary sinusitis.

A series of maxillary sinus mucosal specimens and a series of smears of retained maxillary sinus secretions were studied with regard to the relationship between bacteria and inflammatory cells in order to illustrate aspects of the inflammatory process and to investigate the cause of mucosal damage in maxillary sinusitis. The results show that the granulocytes in the retained secretions are actively phagocytizing organisms if conditions are favourable for the granulocytes. Such situations are present in mucopurulent secretions but mostly not in strictly purulent secretions. A correlation was found between the presence of large numbers of inflammatory cells and tissue destruction, whereas bacterial invasion of the mucosa was a rare phenomenon and seen only in areas where the epithelial lining was destroyed. This indicates strongly that the mucosal damage in sinusitis is caused by inflammatory cells and not primarily by bacteria.