Clinical and histopathological impact of biofilm in chronic rhinosinusitis with nasal polyps
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20205623Keywords:
Biofilm, Nasal polyps, Recalcitrant sinusitis, RhinosinusitisAbstract
Background: Presence of biofilms in sinus mucosa of patients with chronic rhinosinusitis (CRS) remains controversial. Literature shows that biofilms may contribute to the recalcitrant nature of CRS and unfavourable outcome following surgery. This study was performed to evaluate the prevalence of biofilm and its clinical and histopathological impact in patients with chronic rhinosinusitis with nasal polyps (CRSwNP)
Methods: 41 patients of CRSwNP (study group) were included. SNOT-20(sinonasal outcome test-20) score, radiological and endoscopic findings of these patients were evaluated preoperatively. Sinonasal polypoidal tissues removed during surgery were studied for the presence of biofilm and evaluated histopathologically. Postoperatively SNOT-20 score and endoscopic finding were recorded. 41 patients undergoing septoplasty for deviated nasal septum (control group) were also included in the study. Sinonasal mucosal samples of these patients were analysed for the presence of biofilm.
Results: 29 out of 41 (70.73%) samples in study group and 9 out of 41 (21.9%) samples in control group were positive for biofilm. We found a significant impact in preoperative SNOT-20 symptom scores in biofilm positive study group. But there is no significant impact in preoprerative endoscopic scores, radiological scores and postoperative SNOT-20 scores and endoscopic scores in study group patients irrespective of biofilm status.
Conclusions: Prevalence of biofilm in patients with CRSwNP was higher than normal population. Biofilms plays a major role in preoperative symptomatology. But biofilms have no endoscopic, radiological, and histopathological impact in CRSwNP. It was concluded that apart from biofilms, host and other environmental factors plays a major role in the pathogenesis of CRSwNP.
Metrics
References
Rudmik L, Smith TL. Quality of life in patients with chronic rhinosinusitis. Current Allergy and Asthma Report. 2011;11(3):247-52.
Al-Mutairi D, Kitly SJ. Bacterial biofilms and pathophysiology of chronic rhinosinusitis. Current Opinion Allergy Clinical Immun. 2011;11:18-23.
Foreman A, Psaltis AJ, Tan LW, Wormald PJ. Characterization of bacterial and fungal biofilms in chronic rhinosinusitis. Am J Rhinol Allergy. 2009;23(6):556-61.
Meltzer EO, Hamilos DL, Hadley JA, Lanza DC. Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol. 2006;118(5):17-61.
Harvey RJ, Lund VJ. Biofilms and chronic Ramadan HH. Chronic rhinosinusitis and biofilms. Curr Opin Otolaryngol Head Neck Surg. 2006;14:183-6.
Harvey RJ, Lund VJ. Rhinosinusitis: systemic review of evidence, current concepts and directions for research. Rhinology. 2007;45(1):3-13.
Foreman A, Boase S, Psaltis A, Wormald PJ. Role of bacterial and fungal biofilms in chronic rhinosinusitis. Curr Allergy Asthma Rep. 2012;12:127-35.
Post JC, Stooley P, Stoodley H, Elrlich GD. The role of biofilms in otolaryngologic infections. Curr Opin Otolaryngol Head Neck Sug. 2004;12:185-90.
Zuliani G, Carron M, Gurrola J. Identification of adenoid biofilms in chronic rhinosinusitis. Int J Pediatr Otolaryngol. 2006;70:1613-7.
Ferguson BJ, Stolz DB. Demonstration of biofilm in human bacterial chronic rhinosinusitis. Am J Rhinol. 2005;19:452-7.
Meltzer EO, Hamilos DL, Hadley JA. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol. 2004;114(6):155-212.
Piccirillo JF, Merritt MG, Richards ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg. 2002;126(1):41-7.
Lund VJ, MacKay IS. Staging in rhinosinusitis. Rhinology. 1993;107:183-4.
Lund VJ, Kennedy DW. Staging of rhinosinusitis. Otolaryngology Head Neck Surg. 1997;7:535-40.
Stammberger H, Posawetz W. Functional endoscopic sinus surgery: concept, indications and results of the Messerklinger technique. European Arch Otorhino Laryngol. 1990;247:63-76.
Christensen GD, Simpson WA, Younger JA. Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol. 1985;22(6):996-1006.
Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps groups. European position paper on rhinosinusitis and nasal polyps. Rhinol Suppl. 2007;20:136-9.
Zhang Z, Kofonow JM, Finkelman BS. Clinical factors associated with bacterial biofilm formation in chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2011;144(3):457-62.
Sanclement JA, Webster P, Thomas J, Ramandan HH. Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. Laryngoscope. 2005;115:578-82.
Sanderson AR, Leid JG, Hunsaker D. Bacterial biofilms on the sinus mucosa of human subjects with chronic rhinosinusitis. Laryngoscope. 2006;116:1121-6.
Prince AA, Steiger JD, Khalid AN. Prevalence of biofilm-forming bacteria in chronic rhinosinusitis. Am J Rhinol. 2008;22:239-45.
Bezerra TF, Padua FG, Gebrim EM, Saldiva PH, Voegels RL. Biofilms in chronic rhinosinusitis with nasal polyps. Otolaryngol Head Neck Surg. 2011;144(4):612-6.
Zernotti ME, Villegas AN, Revol RM. Evidence of bacterial biofilms in nasal polyposis. J Investig Allergol Clin Immunol. 2010;20(5):380-5.
Sun Y, Zhou B, Wang CS. Clinical and histopathologic features of biofilm-associated chronic rhinosinusitis with nasal polyps in Chinese patients. Chin Med J. 2012;125(6):1104-9.
Dlugaszewska J, Leszczynska M, Lenkowski M, Tartarska A, Pastusiak T. The pathophysiological role of bacterial biofilms in chronic sinusitis. Eur Arch Otorhinolaryngol. 2016;273(8):1989-94.
Sachse F, Becker K, Rudack C. Incidence of staphylococcal colonization and of the 753Q Toll-like receptor 2 variant in nasal polyposis. Am J Rhinol. 2010;24:e10-e13.
Han L, Wang D, Sun X, Hu L, Huapeng Y, Wang J. Relation between bacterial biofilm and clinical features of patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2012;269:155-63.
Hekiert AM, Kofonow JM, Doghramji L. Biofilms correlate with Th1 inflammation in the sinonasal tissue of patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2009;141:448-53.
Foreman A, Holtappels G, Psaltis AJ. Adaptive immune responses in Staphylococcus aureus biofilm-associated chronic rhinosinusitis. Allergy. 2011; 66: 1149-1156.