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. 2023 Nov;62(3):406-414.
doi: 10.20471/acc.2023.62.03.2.

BIOFILM AND HISTOPATHOLOGICAL GRADING OF MAXILLARY SINUS MUCOSA IN PATIENTS WITH ANTROCHOANAL POLYPS

Gorazd Poje  1 , Mario Bilić  1 , Krsto Dawidowsky  1 , Lana Kovač Bilić  1
Affiliations

BIOFILM AND HISTOPATHOLOGICAL GRADING OF MAXILLARY SINUS MUCOSA IN PATIENTS WITH ANTROCHOANAL POLYPS

Gorazd Poje et al. Acta Clin Croat. 2023 Nov.

Abstract

The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. Mucosal samples from maxillary sinus in 40 ACP patients who underwent endoscopic sinus surgery were analyzed histopathologically and by scanning electron microscopy. Results were compared with maxillary mucosa samples of 40 patients without endoscopic and radiological signs of sinus disease. The existence of biofilm and its relation to the degree of histopathological changes according to Terrier classification of chronic mucosal inflammation of maxillary sinus were statistically analyzed. Biofilm was detected in 23 of 40 (57.5%) ACP patients; the incidence was significantly lower in the control group (2/40, 5%). Biofilm was not found in type 1 mucosa according to Terrier classification. In conclusion, biofilm showed a significant incidence in the maxillary sinus mucosa of ACP patients (57.5%). Occasionally, biofilm can be found in patients with no signs of sinus disease, but not on histologically normal mucosa. Results of this study support the theory that biofilm formation does not represent the initial stage of the inflammatory process.

Keywords: Antrochoanal polyp; Biofilm; Maxillary sinus.

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Figures

Fig. 1
Fig. 1
Biofilm on the maxillary sinus mucosa in a patient with antrochoanal polyp: water channels (white arrow) and pila (black arrow) visible on the surface (SEM X33000).
Fig. 2
Fig. 2
Biofilm with spherical bodies that resemble cocci bacteria within the matrix in a control group patient (SEM X3000).
Fig. 3
Fig. 3
Three-dimensional structure of the biofilm: channels and pockets free of bacteria on the surface of the extracellular matrix (SEM X3500).
Fig. 4
Fig. 4
Disoriented ciliary epithelium with well represented cilia without evidence of biofilm (A-SEM X10000). Destroyed ciliary epithelium, aggregates of bacteria – beginning of biofilm formation (B-SEM X15000).
See this image and copyright information in PMC

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