“Despite a decade of research on biofilm and sinusitis, we still don’t know when a biofilm becomes pathogenic,” he said, adding that the basic science supports the fact that biofilm in chronic rhinosinusitis (CRS) can cause mucosal injury when the bacteria in the biofilm bind to the epithelium and destroy it through local inflammation.
Whether or not this injury is caused by the amount of biofilm or by the type of organism found on the biofilm is not known. “My personal thought is that the organism and the quantity of the organism allows the biofilm to become pathogenic,” he said.
Dr. Han also addressed the issue of treatment, including the use of topical antibiotics, mechanical disruption and topical surfactant to treat the bacteria on the biofilms directly. Other treatment options may involve treatment of the inflammation, which would not eradicate the biofilm but would decrease the inflammation. He emphasized that a single modal therapy will most likely not be effective to treat biofilms in patients with CRS and that most will need multi-modality treatment that includes high-dose topical antibiotics with a surfactant after mechanical disruption such as endoscopic sinus surgery or hydrodynamic shearing of the biofilm in the sinuses. | ← Previous | | | Next → | Single Page