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Optical coherence tomography for biofilm detection in chronic rhinosinusitis with nasal polyposis

  • Rhinology
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Abstract

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a multifactorial disease that seems to be associated with the presence of microbial biofilms and corresponding subepithelial inflammatory reactions. Optical coherence tomography (OCT) might be applied to detect bacterial and fungal biofilms in patients with CRSwNP. A total of 27 patients with CRSwNP undergoing endoscopic sinus surgery (ESS) were analyzed. The negative control group consisted of six patients undergoing septoplasty for nasal obstruction without CRSwNP. The nasal polyps and inferior turbinate mucosa specimens applied as negative controls were processed to OCT analysis and H.E. and Gram staining. Biofilm was detected in 22 of 27 patients (81.5 %) with CRSwNP and in none of six negative controls. In our series, OCT scan showed an obvious association with the findings of H.E. and Gram staining and was allocated to be a good predictor of biofilm existence. On OCT images, biofilms were displayed as distinct superficial layers with high optical density. It was found that microscopic architecture of biofilms was strongly associated with the integrity of nasal mucosa and to the cellular pattern of subepithelial inflammatory reaction. This study confirmed the presence of microbial biofilms in patients with CRSwNP according to OCT scans and histological analysis. Since biofilms may affect the severity and recurrence rate of CRS treated by ESS they should be detected preoperatively. In conclusion, single application of OCT analysis or combination with conventional histological protocols provides a robust and reliable method for the detection of bacterial and fungal biofilms in CRSwNP. Level of evidence 3b, individual case–control study.

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Acknowledgments

This work was supported by the grant of Hungarian Scientific Research Fund (OTKA PD75371, K81480).

Conflict of interest

All authors state that they have no conflicts of interest. Authors declare that Tamás Karosi MD PhD and István Sziklai MD DSc are both considered as last authors of the manuscript.

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Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, Medical and Health Science Center, University of Debrecen, Nagyerdei Krt. 98., 4032, Debrecen, Hungary

    László Tóth, Péter Csomor, István Sziklai & Tamás Karosi

  2. Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary

    Attila Vajas & András Berta

Authors
  1. László Tóth
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  2. Attila Vajas
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  3. Péter Csomor
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  5. István Sziklai
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  6. Tamás Karosi
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Correspondence to Tamás Karosi.

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Tóth, L., Vajas, A., Csomor, P. et al. Optical coherence tomography for biofilm detection in chronic rhinosinusitis with nasal polyposis. Eur Arch Otorhinolaryngol 270, 555–563 (2013). https://doi.org/10.1007/s00405-012-2051-2

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  • DOI: https://doi.org/10.1007/s00405-012-2051-2

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