Pathological Role of Biofilm in Fungal Rhinosinusitis

Abstract

Abstract Background The first case of fungal sinusitis was reported in 1885. This fungal disease occurred rarely until the past decade, when a worldwide increase in its incidence occurred. Till one decade back bacteria was implicated as pathogen in most form of chronic rhinosinusitis (CRS). Fungi were thought to be responsible for few specific forms, sine 1999, when ponikau and associates claimed that fungi were responsible for nearly all cases of CRS. Their study demonstrated the presence of fungi & eosinophils from nose & paranasal sinuses from ∼96 % cases of CRS. Aim of the Work The aim of the work was to detect the presence of fungal biofilm, in patients with fungal sinusitis trying to find its role in recurrence of fungal sinus infection, resistance to medical treatment and occurrence of intra orbital and intracranial complications. Patients and Methods The study consisted of 20 different cases of fungal sinusitis controlled by 10 cases of non fungal sinusitis. Control cases were divided into 5 cases of chronic sinusitis with nasal polyposis and 5 cases of deviated septum with no evidence of sinusitis undergoing nasal surgery. Results Using statistical analysis, there was evidence of pressure of fungal biofilm in different cases of fungal sinusitis whether primary or recurrent, also whether invasive or non invasive. Comparing cases with controls, There was statistically significant difference between them as regard Biofilm (p-value: < 0.001) with incidence reaching (70 %) in cases while (0%) in controls. By applying risk analysis for biofilm, we used relative risk (p value = 0.0001) which is statistically significant indicating higher risk of positive biofilm in cases of fungal sinusitis, also by Using odds ratio (p value= 0.0002) which is statistically significant indicating higher risk of positive biofilm in cases of fungal sinusitis. Conclusion The study showed the presence of fungal biofilm in different cases of fungal siunsitis whether primary or recurrent, also whether invasive or non invasive.