Biofilm Surface Area in the Pediatric Nasopharynx: Chronic Rhinosinusitis vs Obstructive Sleep Apnea | Infectious Diseases | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
February 2007

Biofilm Surface Area in the Pediatric Nasopharynx: Chronic Rhinosinusitis vs Obstructive Sleep Apnea

Author Affiliations

Author Affiliations: Division of Pediatric Otolaryngology, Departments of Otolaryngology (Drs Coticchia, Zuliani, and Carron, Ms Coleman, and Mr Gurrola), and Immunology and Microbiology (Dr Berk), Wayne State University, and Department of Otolaryngology, Children's Hospital of Michigan (Dr Haupert), Detroit.

Arch Otolaryngol Head Neck Surg. 2007;133(2):110-114. doi:10.1001/archotol.133.2.110

Objective  To compare the percentage of mucosal surface area of adenoids infected with biofilms removed from children with chronic rhinosinusitis (CRS) vs children with obstructive sleep apnea (OSA).

Design  Comparative microanatomical investigation of adenoid mucosa from patients with CRS and OSA using scanning electron microscopy.

Setting  University-affiliated hospitals and ambulatory surgery center.

Patients  Four girls and 12 boys ranging in age from 3 months to 10 years.

Main Outcome Measure  Measurements of biofilm coverage of the entire adenoidal surface.

Results  Adenoids removed from patients with CRS had dense mature biofilms covering the mucosal surface; they had a mean of 94.9% of their mucosal surface covered with mature biofilms, compared with a mean of 1.9% coverage on the adenoids removed from patients with OSA. This difference was statistically significant at P<.001.

Conclusions  Adenoids removed from patients with CRS had almost their entire mucosal surface covered with biofilms vs scant coverage for patients with OSA. Biofilms in the nasopharynx of children with CRS may act as a chronic reservoir for bacterial pathogens resistant to standard antibiotics. The mechanical debridement of the nasopharyngeal biofilms may explain the observed clinical benefit associated with adenoidectomy in this subset of pediatric patients.