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Abstract
Chronic rhinosinusitis (CRS) is a prevalent, debilitating condition, poorly controlled by antibiotics and a subpopulation of patients fails to respond to either medical or surgical intervention. Postulated etiologic factors leading to chronic rhinosinusitis include allergy, fungi, functional factors and biofilms. Evidences now suggest that bacterial biofilms may play an important role in chronic rhinosinusitis (Palmer, 2006) and would explain the refractoriness of chronic rhinosinusitis to antibiotic therapy (Ferguson and Stolz, 2005).
Bacterial biofilms are three dimensional aggregates of bacteria that are attached to a surface and encased in a matrix of exopolymeric material (Sanderson et al., 2006). The extracellular polymeric substance include exoplysaccharides, nucleic acids and proteins and it represents about 98% of the volume of the biofilm (Bendouah et al.,2006).
Bacterial biofilms are increasingly implicated in the pathogenesis of chronic diseases and have been established in several chronic ear, nose and throat conditions including chronic rhinosinusitis, chronic otitis media, cholesteatoma, chronic tonsillitis and chronic adenoiditis (Post et al.,2004).