Assessment of Predictive Factors for Biofilms Presence in Chronic Rhinosinusitis with Polyps

Abstract

Objective: Evaluate predictive factors for the presence of biofilms during sinus surgery for chronic sinusitis with nasal polyps (CRSwP). Method: Prospective study conducted in a tertiary care center in 2008 to 2009. Patients underwent sinus surgery for CRSwP, and mucosal samples were harvested for scanning electron microscopic. Preoperative data were recorded. Data were considered nonparametric. Mann-Whitney test and Spearman rank correlation were used. Results: Biofilms were present in 66.6 % (22/33) of the CRSwNP patients. Both groups had similar age median [Interquartile Range] = 45.0 [15.0] (38-56) vs 46.5 [27.0] (22-78) and the same sex distribution (male:female ratio = 1.75). Patients with biofilms had worst Lund-Kennedy score (6.0[3.0] (3-10) vs 8.0[3.0] (3-11), U = 69.5, P = .44). Although patients with biofilms had worst NOSE and Lund-Mackay scores and best SNOT-20 and SNOT-20(5+) scores, those were not statistically different between groups. There was a strong correlation between preoperative NOSE and SNOT-20 scores in both groups. Conclusion: This study showed that biofilms were present in most patients with CRSwNP. Despite the fact that NOSE and Lund-Mackay scores were worse in patients with biofilms, only Lund-Kennedy scores shown a significant predictive value to find biofilms intraoperatively.