Conflicting Evidence on Tobacco’s Effect on ESS Outcomes

“Otolaryngologists can tell patients that smoking is associated with the need for more surgery, but providing them with a descriptive example of these coral reef-type structures in their sinuses may help persuade them to stop,” he said.

In a study published last year (PLoS One 2011;6(1):e15700), Dr. Palmer and his team demonstrated that tobacco smoke exposure induces biofilm formation in respiratory bacteria and that smoking cessation should revert bacteria back to a smoke-naïve phenotype.

Telling patients about biofilms and how they decrease outcome after surgery “is something patients like,” he said. “It tells them they will do worse because smoking increases biofilm formation in their sinuses.”