Abstract
Maxillary sinusitis, like nasal allergy, is one of the most prevalent nasal illnesses in Japan. The pathogenesis of this disease, however, has not yet been understood fully. This study was undertaken to analyze the local immunity of the antral environment in patients with chronic sinusitis, to evaluate whether this immunological environment might have any implication for the course of this disease and to determine whether lavage or aspiration of sinus secretion could be a useful treatment for this disease. The antral environment was studied by means of 142 specimens of maxillary sinus secretions obtained from 138 patients with this disease.
The mean concentration ratio of IgA/IgG in these secretions was less than 1.0 at the first aspiration, but this ratio came to exceed 1.0 after repeated aspirations. This indicated that there was a bulk of IgG in the maxillary environment of this disease and this IgG derived from circulation could mediate an adverse effect on the mucous membrane. During the course of aspiration therapy, IgA and IgM increased while IgG decreased in the maxillary secretion. In the 30-40% of the sinus secretions, the concentration of secretory components was found to be always less than 0.5mg/dl despite repeated aspirations. These patients should be clearly distinguished from those in whom the concentration of secretory components is always more than 0.5mg/dl. In the latter group, the correlation of the concentrations between IgA and the secretory component had become significant by means of the repeated aspirations.
Aspiration of maxillary sinus secretion in patients with chronic sinusitis was concluded to be useful for improving the immunologically pathologic environment of the maxillary sinus mucosa.
