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Background and Objectives:The pathogenesis of paranasal sinusitis has not been fully understood. The role of staphylococcal enterotoxins in the development of the paranasal sinusitis has recently been identified. The aim of the study is to investigate the in vitro effects of enterotoxin of Staphylococcus aureus on ciliary activity of the nasal mucosa and its in vivo activity on histology of sinus mucosa. Materials and Method:Maxillary sinus mucosa of the rabbit is harvested and prepared. Ciliary beat frequency (CBF) of the mucosa is observed in the culture media containing staphylococcal enterotoxin A (SEA). After direct instillation of SEA into the maxillary sinus, CBF and the histological finding of the maxillary sinus mucosa are examined. Results:After exposure to low dose enterotoxin (0.03 or 0.3 ng/ml of SEA), CBF did not decrease. But, after exposure to high dose enterotoxin (1.5, 3, 30 ng/ml of SEA), CBF decreased significantly as a function of time. Twenty four hours after instillation of high dose (30 ng/ml) SEA, CBF decreased. Seven days after instillation of high dose SEA, sinusitis is observed. After instillation of low dose (0.3 ng/ml) SEA, CBF and epithelial integrity is not affected. But, subepithelial edema and the infiltration of inflammatory cells are observed. Conclusion:The induction of sinusitis with high dose SEA may be related to the ciliostatic effect of staphylococcal enterotoxin. But, low dose staphylococcal enterotoxin can induce sinus inflammation without ciliostatic effect.

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