The relationship of biofilms to chronic rhinosinusitis.
OBJECTIVE
To provide an update on the state of biofilm research in otolaryngology.


RESULTS
Chronic rhinosinusitis is a polymicrobial infection, which includes planktonic and biofilm infections with bacterial and fungal elements. The importance of genetic shift in microbes, when converting into a biofilm state, as well as the multiple phenotypes in each bacterial colony cannot be overemphasized. This creates a very sophisticated community of pathogens, some of which will likely survive a simple chemical treatment. Sinus cultures cannot be expected to provide a complete knowledge of the cause of chronic sinusitis. A new diagnostic method and innovative treatment plans will be necessary to provide a lasting treatment of chronic rhinosinusitis. Surgery combined with postoperative treatment is the most effective mean of controlling the majority of chronic rhinosinusitis infections. The challenges associated with the treatment of chronic rhinosinusitis patients may be met by focusing more on the community of microorganism present in the sinuses.


CONCLUSIONS
The understanding of the implication of chronic biofilm infections is growing rapidly but will require an enormous effort to completely control chronic rhinosinusitis.
Hunsaker
Darrell H
DH
Otolaryngology-Head and Neck Surgery, Naval Medical Center, San Diego, California, USA. darrell.hunsaker@med.navy.mil
Leid
Jeff G
JG
D001424:Bacterial Infections / Q000150:complications*; D018441:Biofilms; D002908:Chronic Disease; D006801:Humans; D009181:Mycoses / Q000150:complications*; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*