title: Biofilms in chronic rhinosinusitis with nasal polyps.
abstract: OBJECTIVE
  (1) Evaluate the presence of biofilms in patients with chronic sinusitis with nasal polyps (CRSwNP) and (2) investigate the association of biofilm presence and CRSwNP.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University-based tertiary care center.
  
  
  METHODS
  The study group consisted of 33 consecutive patients undergoing functional endoscopic sinus surgery for CRSwNP. The control group consisted of 27 control patients undergoing septoplasty for nasal obstruction without diagnosis of chronic sinusitis. Mucosal samples were harvested intraoperatively for scanning electron microscopic examination to determine biofilm presence. Statistical analysis was performed. For all statistical tests, P = .05 was considered significant.
  
  
  RESULTS
  Biofilms were found in 24 (72.7%) of the 33 patients with CRSwNP and in 13 (48.1%) of the 27 septoplasty patients (odds ratio = 2.87; 95% confidence interval, 0.98-8.42; P = .051).
  
  
  CONCLUSIONS
  (1) Biofilms were present in patients undergoing functional endoscopic sinus surgery for CRSwNP and also in controls without chronic sinusitis. This suggests that biofilms may not be sufficient to cause chronic sinusitis without other cofactors. Host factors could be the responsible for the pathogenesis of biofilms. (2) Although the prevalence of biofilms in patients with CRSwNP was not significantly different from that in the controls, the extremely wide 95% confidence interval, which is just below unity, suggests that a meaningful clinical difference may have been missed because of low statistical power. Further studies are necessary.
authors.affiliation: Department of Otorhinolaryngology and Ophthalmology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil. bezerratfp@gmail.com
authors.forename: Thiago Freire Pinto
authors.initials: TF
authors.lastname: Bezerra
authors.forename: Francini Grecco de Melo
authors.initials: FG
authors.lastname: Padua
authors.forename: Eloisa Maria Mello Santiago
authors.initials: EM
authors.lastname: Gebrim
authors.forename: Paulo Hilário Nascimento
authors.initials: PH
authors.lastname: Saldiva
authors.forename: Richard Louis
authors.initials: RL
authors.lastname: Voegels
mesh_terms: D000328:Adult; D018441:Biofilms; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D009297:Nasal Mucosa / Q000382:microbiology; D009298:Nasal Polyps / Q000150:complications*; D012220:Rhinitis / Q000150:complications / Q000382:microbiology*; D012852:Sinusitis / Q000150:complications / Q000382:microbiology*