The effect of endoscopic sinus surgery on bacterial biofilms in chronic rhinosinusitis.

OBJECTIVE: To determine whether or not endoscopic sinus surgery (ESS) alters bacterial biofilms in patients with chronic rhinosinusitis (CRS) after three months of follow-up.

STUDY DESIGN: Prospective study.

SETTING: Department of Otorhinolaryngology-Head and Neck Surgery, University of Queensland.

SUBJECTS AND METHODS: Participants with CRS from the Princess Alexandra Hospital Department of Otorhinolaryngology-Head and Neck Surgery and from Logan Hospital were enrolled in the study (2008-2009). The total number of patients was 28, and the age range was 18 to 65 years. All patients underwent pre- and post-ESS questionnaires, endoscopic scoring, and nasal swabs for bacterial culture. Crystal violet staining was used to assess biofilm formation on a 96-well culture plaque.

RESULTS: ESS resulted in a statistically significant improvement in quality-of-life, subjective, and objective outcome measures after three months. A significant reduction was observed in biofilm density before and after ESS (2.63 versus 1.3, P = 0.043). No correlations between the reduction of bacterial biofilms with any of the subjective, objective, and quality-of-life outcomes were seen in our study.

CONCLUSION: ESS was shown to be capable of reducing the prevalence of bacterial biofilms but did not eliminate them entirely. There was no correlation between altered biofilm formation and improved outcome measures in individual patients.