Abstract
Chronic adenoiditis occurs frequently in children, and it is complicated by the subsequent development of recurrent or chronic middle ear diseases, such as recurrent acute otitis media, persistent otitis media with effusion and chronic otitis media, which may predispose a child to long-term functional sequalae and auditory impairment. Children with chronic adenoidal disease who fail to respond to traditional antibiotic therapy are usually candidates for surgery under general anaesthesia. It has been suggested that the ineffectiveness of antibiotic therapy in children with chronic adenoiditis is partially related to nasopharyngeal bacterial biofilms, which play a role in the development of chronic nasopharyngeal inflammation due to chronic adenoiditis, which is possibly associated with chronic or recurrent middle ear disease. This paper reviews the current evidence concerning the involvement of bacterial biofilms in the development of chronic adenoiditis and related middle ear infections in children.
Highlights
Chronic adenoiditis is frequent in children, mainly affecting those aged 3–7 years [1]
Bacterial biofilms may be involved in the pathogenesis of chronic adenoiditis, as they may be present throughout the nasopharyngeal mucosa, and in the lateral portion of adenoidal pads extending towards the orifice of the Eustachian tube
Given the close anatomical and functional relationship between the nasopharynx and the middle ear, chronic adenoiditis is often complicated by the development of chronic or recurrent middle ear disease [3,4,5], which may manifest itself as persistent serous or mucous fluid in the middle ear, repeated acute middle ear infections, or long-lasting middle ear suppuration through chronic perforation of the tympanic membrane [3,4,5]
Summary
Chronic adenoiditis is frequent in children, mainly affecting those aged 3–7 years [1]. Chronic OME is defined as documented as middle ear effusion without any sign of concomitant acute middle ear inflammation persisting for at least three months [4]; RAOM is defined as at least three episodes of acute otitis media within a period of six months, or more than four episodes in a period of 12 months [3]; and CSOM is defined as the presence of a long-lasting purulent ear discharge through a persistent perforation of the tympanic membrane [5] Each of these conditions may significantly affect a patient’s quality of life and possibly predispose them to long-term functional sequelae and serious complications such as mastoiditis, meningitis, cerebral abscess, and lateral sinus thrombosis and auditory impairment [5]. Ex vivo and animal studies, reviews and papers that did not clearly report the prevalence of bacterial biofilm involvement in their case series were excluded
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