June 22, 2010 — Adenoid surface biofilm formation appears to be associated with the pathology of chronic otitis media with effusion (COME), the most common chronic ear disorder in pediatric patients, a new study has found.

According to the researchers, biofilms may play an important role in the formation of many chronic or recurrent otorhinolaryngologic diseases, such as “otitis media, sinusitis, cholesteatoma, tonsillitis, adenoiditis, and device infections.” In addition, strong anatomical evidence of bacterial biofilms in chronically diseased tonsils has been reported, the authors note in the June issue of the Archives of Otolaryngology—Head & Neck Surgery.

Güleser Saylam, MD, from the Diskapi Yildirim Beyazit Research and Educational Hospital, in Ankara, Turkey, and colleagues conducted a prospective study of 34 children, aged 4 to 15 years, who underwent adenoidectomy to determine whether COME pathogenesis may also be biofilm related.

Of the participants, 17 had healthy ears but had nasal obstruction with or without apnea, and 17 had COME and adenoid hypertrophy with or without nasal symptoms. During the adenoidectomy for each patient, specimens were obtained from 2 different parts of the nasopharyngeal surface of adenoid tissues. The tissues were examined for biofilm formation with scanning electron microscopy. The 2 groups, with and without COME, were compared with respect to grade of severity of biofilm formation.

Adenoid samples removed from the children with COME had significantly higher-grade biofilm formation than the group undergoing surgery for adenoid obstruction alone (P = .001). No relationship of biofilm formation with either age or duration of symptoms was noted.

“Our results support the role of adenoidectomy in the management of COME resistant to medical therapy to eradicate the reservoir of chronic infection,” Dr. Saylam and colleagues note. They add that adenoids in COME may act as a reservoir of chronic infection rather than causing mechanical eustachian obstruction. “However, with our findings it is not possible to speculate that biofilms spread into the middle ear through the eustachian tube.”

The authors have disclosed no relevant financial relationships.