title: Investigation of the presence of biofilms in chronic suppurative otitis media, nonsuppurative otitis media, and chronic otitis media with cholesteatoma by scanning electron microscopy.
abstract: OBJECTIVE
  Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma. Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.
  
  
  METHODS
  The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).
  
  
  RESULTS
  Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.
  
  
  CONCLUSIONS
  In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.
authors.affiliation: Department of Otorhinolaryngology, Medical Faculty, Eskisehir Osmangazi University, School of Medicine, 26480 Eskisehir, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Kaya
authors.forename: Ilknur
authors.initials: I
authors.lastname: Dag
authors.forename: Armagan
authors.initials: A
authors.lastname: Incesulu
authors.forename: Melek Kezban
authors.initials: MK
authors.lastname: Gurbuz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Acar
authors.forename: Leman
authors.initials: L
authors.lastname: Birdane
mesh_terms: D018441:Biofilms; D018424:Cholesteatoma, Middle Ear / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009831:Olfactory Mucosa / Q000382:microbiology / Q000648:ultrastructure*; D010035:Otitis Media, Suppurative / Q000382:microbiology* / Q000473:pathology