The role of bacterial biofilms in the pathogenesis of chronic rhinosinusitis

Patients with chronic rhinosinusitis have decreased quality of life. The prevalence of this disease is estimated at above ten percent in some studies. This poses a major socioeconomic challenge. The pathogenesis is still poorly understood. Bacteria in colony form (biofilms) are implicated in many chronic infectious diseases. We wanted to investigate the occurrence of biofilms in patients with sinusitis undergoing surgery compared to controls. Perioperative biopsies where harvested and underwent confocal laser scanning microscopy to determine the presence of biofilms. This microscope allows 3-dimensional examination of the biopsies and is considered the gold standard for determining biofilms. Biofilms occurred significantly more frequent in patients with sinusitis compared to controls, and also within the sinuses (ethmoid bulla) compared to the outside (front of the middle turbinate). This correlation must be investigated with further prospective studies to determine if biofilms have a causal role in the pathogenesis of chronic rhinosinusitis