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We are pleased to respond to the letter by Gaynor. Our study reported on a selected group of patients who failed to respond to conventional therapy, and who finally required surgical intervention. It does not advocate surgery as a primary approach. However, because surgery was performed on these patients, it provided us with good bacteriologic information, which was correlated with the therapy given to these patients. The majority of patients in our hospital today, as they did in the years of the study, respond to conventional forms of therapy, and do not require surgical drainage. Obviously, nowadays, other antimicrobials as well as endoscopic sinus surgery are also available. We believe, however, that the lessons gained from our retrospective evaluation are still applicable today — that even after drainage adequate antimicrobial therapy effective against both aerobic and anaerobic bacteria is of great importance. As Gaynor noted, this principle may be even
Brook I. Current Concepts in the Treatment of Sinusitis-Reply. Arch Otolaryngol Head Neck Surg. 1995;121(6):702. doi:10.1001/archotol.1995.01890060100022
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