The Demonstration of Bacterial Biofilm and It's Impact on Postoperative Course in Patients with Chronic Rhinosinusitis / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Bacterial biofilm is thought to contribute to the progression and persistence of chronic rhinosinusitis. There are many studies which demonstrate these structures on chronic rhinosinusitis (CRS), but the majority of the studies just focus on the documentation of their presence and the method for identification. There are also a few researches that show the impact of biofilm on postoperative surgical outcomes. In this study, we demonstrated bacterial biofilm in CRS patients and determined whether they affect clinical courses and outcomes after surgery. SUBJECTS AND METHOD: The mucosa of ethmoid bulla was obtained during endoscopic sinus surgery from 21 CRS patients. Fluorescent microscope and scanning electron microscopy (SEM) were used for the determination of biofilm. The outcomes of the surgery were evaluated by endoscope every two weeks for 6 months. Preoperative symptom scores, CT scores, and the post operative results were compared between patients with biofilm and patients without biofilm. RESULTS: Bacterial biofilm were seen in 13 (62%) of the 21 CRS patients. A statistical association existed between the presence of biofilm and the worsened preoperative symptom scores, but the preoperative CT scores were not related to the presence of biofilm. Patients with biofilm had long-lasting postoperative mucosal inflammation and a prolonged healing time, and these differences have statistical significance. CONCLUSION: This study showed that the presence of bacterial biofilm were significantly correlated with worsening preoperative symptom scores and the prolonged postoperative recovery time. Therefore, bacterial biofilm may play an important role in the recalcitrant and resistant nature of CRS.