Bacterial biofilms and the pathophysiology of chronic rhinosinusitis

Purpose of review To review the evidence for the presence of bacterial biofilms in chronic rhinosinusitis (CRS) and mechanisms by which they may contribute to the chronic inflammation characteristic of this disease. Lastly, to provide an overview of the current and potential future treatments for bacterial biofilms in CRS. Recent findings Advances in the techniques for identifying biofilms have confirmed the presence of bacterial biofilms on the sinonasal mucosa of patients with CRS. The impact on mucosal inflammation of the polymicrobial or multiorganism milieu is not yet well understood. Numerous novel topical therapies for the treatment of bacterial biofilms in CRS have been suggested with some demonstrating clinical efficacy. Blocking of quorum sensing represents a potential future therapy for biofilm treatment in CRS and biofilm infection at large. Summary Biofilms represent an important influence on the pathophysiology of CRS. Further understanding of biofilm interactions and microbial organism behavior will provide us with future treatment modalities for this disease.