Biofilms and Mucosal Healing in Postsurgical Patients with Chronic Rhinosinusitis

American Journal of Rhinology and Allergy - Tập 23 Số 5 - Trang 506-511 - 2009
Zhang Zi1, Demin Han1, Shengzhong Zhang1, Yehua Han2, Wei Dai2, Erzhong Fan1, Ying Li1, Yunchuan Li1, De Yun Wang3
1Department of Otolaryngology–Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
2Electron Microscopy Laboratory of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
3Department of Otolaryngology, National University of Singapore, Singapore

Tóm tắt

Background Patients with chronic rhinosinusitis (CRS) often remain symptomatic after technically proficient functional endoscopic sinus surgery. Current hypothesis indicates biofilms may contribute to the persistence of infection. However, few studies showed biofilms in postoperative patients. This study was designed to identify bacterial biofilms on postoperative mucosa, as well as to investigate the healing of sinus mucosa after surgery. Methods After intraoperative mucosa was obtained for assessment of biofilms, 27 patients were followed up for 6 months. Postoperative medications and symptoms were recorded. As indicated by endoscopic evaluation, biopsy specimens of postoperative edema, scar, or adhesion were obtained. Samples were prepared for scanning electron microscopy (SEM) and hematoxylin and eosin (H&E) staining. Results Fifteen postoperative samples were taken from the 20 patients with intraoperative biofilms. Under SEM, postoperative biofilms were identified in 4/6 scar samples and 5/9 edema samples. There was no significant difference in biofilm presence between samples of scar and edema. Microcolonies were also identified on postoperative scar under H&E staining. The presence of intraoperative and postoperative biofilms was correlated with the severity of preoperative Lund-MacKay computed tomography score and postoperative Lund-Kennedy endoscopic score. Compared with intraoperative samples, postoperative samples from the same nine patients significantly recovered from ciliary damage, metaplasia, and basement membrane thickness. Postoperative cultures were positive in samples with and without postoperative biofilms. Conclusion Biofilms persist after treatment, and may cause the unfavorable outcomes of surgery for CRS. The mucosa with biofilms can recover after surgery. Apparent bacterial plaque can be identified by H&E staining.

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Thông tin
Thông tin xuất bản

American Journal of Rhinology and Allergy

Tập 23 Số 5

506-511

Thông tin tác giả