title: [Observation of bacterial biofilms in patients with chronic rhinosinusitis].
abstract: OBJECTIVE
  To explore the presence of bacterial biofilms (BF) in patients with CRS and the effect of BF on clinical symptoms and postoperative outcomes.
  
  
  METHODS
  Seventy-two patients with chronic sinusitis were enrolled in this study. The control group included 15 patients with deviation of the nasal septum and 10 patients had a fracture of the nasal bone. Mucosa of the uncinate process or ethmoid near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery. The specimens were subjected to scanning electron microscopy. Patients were followed for 1 year and observed by the Lund-Kennedy endoscopy, and the Haikou standard classification (ESS-1997). Statistical analysis was performed by t-test or chi-square test.
  
  
  RESULTS
  Three patients were lost to follow-up. The scanning electron microscopy analysis showed bacterial biofilms in 49 of the 69 patients with chronic sinusitis. A marked destruction of the epithelium and cilia was observed in samples positive for bacterial biofilms. No bacterial biofilms were detected in the control group, and scanning electron microscopy showed normal epithelium and cilia in those specimens. There was no significant difference in gender, classification or duration of disease between the BF(-) and BF(+) groups. At six months and one year postoperative, the Lund-Kennedy endoscopy scores for CRS patients with BF (4.78 +/- 1.67; 4.55 +/- 1.61) were significantly higher than those without BF (3.65 +/- 1.39; 3.65 +/- 1.18) (t = -2.654, P < 0.01; t = -2.264, P < 0.05). Based on the Haikou standard classification, there was a significantly difference between patients with BF and those without BF (chi2 = 18.014, 22.063, P < 0.001, respectively).
  
  
  CONCLUSIONS
  Different life stages of bacterial biofilms were demonstrated to be present in CRS. Gender, classification or duration of disease did not affect the presence of bacterial biofilms in patients with CRS. There is a correlation between bacterial biofilms and an unfavorable outcome in patients with CRS after ESS.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Jinhua Central Hospital, Jinhua 321000, China.
authors.forename: Hui-hua
authors.initials: HH
authors.lastname: You
authors.forename: Pan
authors.initials: P
authors.lastname: Zhuge
authors.forename: Hai-ming
authors.initials: HM
authors.lastname: Shi
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: Huan-le
authors.initials: HL
authors.lastname: Du
mesh_terms: D000328:Adult; D018441:Biofilms; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology*; D009298:Nasal Polyps / Q000382:microbiology*; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*; D055815:Young Adult