up to 50% of sinus surgery patients have biofilms

[Guest guest]

....and, not surprisingly, the presence of biofilms is associated with a poor

surgery

outcome.

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The effect of bacterial biofilms on post-sinus surgical outcomes

Authors: Psaltis, Alkis J.1; Weitzel, K.1; Ha, Kien R.1; Wormald,

-1

Source: American Journal of Rhinology, Volume 22, Number 1, January-February

2008 ,

pp. 1-6(6)

Abstract:Background: Although the existence of biofilms on the sinus mucosa of

patients

with chronic rhinosinusitis (CRS) is now well established, the role that these

structures play

remains unclear. It is thought that biofilms may contribute to the recalcitrant

and

persistent nature that characterizes CRS, but little research exists documenting

the effect

that they have on postoperative mucosal outcomes. This article presents a

retrospective

analysis of sinus surgical patients and correlates the presence of biofilms with

mucosal

outcomes. This study was performed to evaluate the role that bacterial biofilms

have on

post-sinus surgical outcomes.

Methods: A retrospective analysis of prospectively collected data was performed

on 40

patients undergoing endoscopic sinus surgery (ESS) for CRS. Preoperative

demographic,

clinical, and radiologic data were recorded from each patient and,

intraoperatively, sinus

culture specimens and mucosal samples were obtained for microbiological and

microscopic examination. Biofilm determination was performed using confocal

scanning

laser microscopy. Postoperatively, patients were followed up for a minimum of 8

months

with endoscopic evaluation of their sinonasal mucosa. The presence of ongoing

symptoms

was recorded also.

Results: Bacterial biofilms were found in 20 (50%) of the 40 CRS patients.

Patients with

biofilms had significantly worse preoperative radiological scores and,

postoperatively, had

statistically worse postoperative symptoms and mucosal outcomes.

The only other factor that was statistically related to an unfavorable outcome

was the

presence of fungus at the time of surgery. In this study the presence of polyps,

eosinophilic mucin, or pus was not related to poor outcomes.

Conclusion: This retrospective study showed that bacterial biofilms and fungus

were

correlated with the persistence of postoperative symptoms and mucosal

inflammation

after sinus surgery for CRS. This provides evidence that biofilms indeed may

play an active

role in perpetuating inflammation in CRS patients and may explain the recurrent

and

resistant nature of this disease. Therapies targeted at removing biofilms may be

important

in the management of recalcitrant CRS.