Biofilm Presence vs Postoperative Outcomes in Chronic Rhinosinusitis with Polyps

Objective Evaluate the role of biofilms on sinus surgery outcomes of patients with chronic rhinosinusitis with nasal polyps (CRSwP). Method Prospective study conducted in a tertiary care center among 2008‐10. Patients underwent sinus surgery for CRSwNP, and mucosal samples were harvested for scanning electron microscopic. Preoperative and postoperative (followed up to 12 months) data were recorded. Data were considered nonparametric. Mann‐Whitney test and Spearman rank correlation were used. Results This was the first report to analyze the effect of biofilms only in patients with CRSwNP. Biofilms were present in 67.9 % (19/28) of the CRSwNP patients. Both groups had similar age median (Interquartile‐Range = 45.0[15.0] vs 46.5[27.0]). Patients with biofilms had better Lund‐Kennedy outcome (‐3[5] vs ‐1[2], U = 46.0, P =. 036). These patients had worst outcomes in SNOT‐20 (‐0.75[1.15] vs ‐1.30[1.32], U = 69.0, P =. 21) and similar outcomes in NOSE (‐55.0[50.0] vs ‐60.0[50.0], U = 81.0, P =. 67) and Lund‐Mackay (‐4[5] vs ‐4[4], U = 75.5, P =. 49). There was a correlation among QoL outcome scores in both groups, and between NOSE and Lund‐Mackay outcomes scores in the biofilms group. (Spearman’s rank). Conclusion This study showed that biofilms were present in most patients with CRSwNP, and these patients have less improvement of QoL. Moreover, the best endoscopic improvement may reflect a worse clinical preoperative status. Although CRSwNP is not caused by biofilms, it could act as an aggravating factor to the clinical picture of these patients.