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Biofilm surface area in the pediatric nasopharynx: Chronic rhinosinusitis vs obstructive sleep apnea

James Coticchia1, Giancarlo Zuliani, Crystal Coleman

  • 1Division of Pediatric Otolaryngology, Department of Otolaryngology, Wayne State University, Children's Hospital of Michigan, Detroit 48201, USA. jcoticch@med.wayne.edu

Archives of Otolaryngology--Head & Neck Surgery
|February 21, 2007
PubMed

Insights

Children with chronic rhinosinusitis (CRS) have significantly more adenoid biofilm coverage than those with obstructive sleep apnea (OSA). This finding suggests biofilms may harbor antibiotic-resistant bacteria in CRS, potentially explaining adenoidectomy benefits.

Area of Science:

  • Otorhinolaryngology
  • Microbiology
  • Pediatric Surgery

Background:

  • Biofilms on adenoids are implicated in pediatric upper airway conditions.
  • Chronic rhinosinusitis (CRS) and obstructive sleep apnea (OSA) are common pediatric conditions affecting the nasopharynx.

Purpose of the Study:

  • To compare the adenoid mucosal surface area covered by biofilms in children with CRS versus those with OSA.

Main Methods:

  • A comparative microanatomical investigation using scanning electron microscopy was performed on adenoid tissues.
  • Adenoid mucosa samples were obtained from pediatric patients diagnosed with CRS or OSA.
  • The primary outcome measure was the percentage of adenoidal surface area covered by biofilms.

Main Results:

  • Adenoids from children with CRS exhibited extensive mature biofilm coverage, averaging 94.9% of the mucosal surface.
  • Adenoids from children with OSA showed minimal biofilm coverage, averaging 1.9% of the mucosal surface.
  • The difference in biofilm coverage between the two groups was statistically significant (P < .001).

Conclusions:

  • Children with CRS have near-complete adenoid mucosal surface coverage by biofilms, contrasting sharply with minimal coverage in children with OSA.
  • Nasopharyngeal biofilms in pediatric CRS may serve as a reservoir for antibiotic-resistant bacteria.
  • Adenoidectomy may provide clinical benefits in pediatric CRS by mechanically removing these biofilms.
Abstract

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