Abstract
and sensitivity); subjects also performed daily nasal nebulization of mometasone and the antibiotic, along with saline pressure hydrotherapy, for a period of 6 weeks. Clinical outcome was assessed using the Lund-Kennedy symptom and endoscopic appearance scores. Biofilm disruption was assessed ex-vivo using the traditional Colony Forming Units (CFUs) bacterial assay technique and semi-quantitative real-time PCR (rt-PCR). Mucosal epithelial barrier changes were evaluated histologically. RESULTS: There was a statistically significant difference in the patients’ Lund-Kennedy symptom and endoscopic appearance scores after 6 weeks of rhinotopic therapy. There was also statistically significant difference in CFUs mucosal bacterial count and in microbial and organisms virulence genes presence, indicating mucosal biofilm disruption. Changes indicating mucosal barrier remodeling were observed by H&E histology. Nasoendoscopic-guided cultures performed one month following rhinotopic therapy, showed resolution of the pathogenic organism(s) in 14/23 patients (60.8%). No significant clinical adverse effects were experienced. CONCLUSION: Gel rhinotopic therapy is a promising treatment strategy for refractory chronic rhinosinusitis, and has the potential to cause mucosal biofilm disruption.
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