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The microbiology of normal non-inflamed sinuses. Objectives: The presence of organisms in the healthy sinus was uncertain for many decades. This review summarizes the studies that have explored the microbiology of normal non-inflamed sinuses using conventional microbiological culture methods and non-culture molecular techniques, and discusses the potential implications of these for the treatment and prevention of sinus inflammation.
Methodology: A literature search of the Cochrane Library, EMBASE, TRIP, and MEDLINE databases was conducted from their inception (1993 for the Cochrane Library, 1980 for EMBASE, 1997 for TRIP, and 1966 for MEDLINE) to 25th June 2016.
Results: Studies that used adequate microbiological methods demonstrated the presence of aerobic and anaerobic bacterial flora in healthy non-inflamed sinuses. These organisms may participate in sinus inflammation if the right circumstances arise. Recent data suggest that the host response or lack of response to normal sinus flora may be central to the development of sinus inflammation.
Conclusions: Healthy non-inflamed sinuses are colonized by rich and diverse populations of aerobic and anaerobic bacterial flora. These organisms may participate in sinus inflammation if the right circumstances arise. The host response or lack of response to the normal sinus flora may be central to the development of sinus inflammation. Corynebacterium tuberculostearicum seems to have a potential pathogenic role, while certain probiotics may have a protective effect. Modulation of the sinus flora by topical antimicrobial and/or probiotic organisms which may interfere with the growth of potential bacterial and fungal pathogens may be used to prevent and treat sinus inflammation.