Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, People's Republic of China.
Eur Arch Otorhinolaryngol. 2012 Jan;269(1):155-63. doi: 10.1007/s00405-011-1683-y. Epub 2011 Jul 8.
The purpose of this study was to investigate the incidence of bacterial biofilm (BBF) in patients with chronic rhinosinusitis (CRS) using confocal scanning laser microscopy (CSLM), and to assess the relationship between BBF and clinical features of CRS. This was a prospective observational study of the sinus mucosa of 27 CRS patients and 10 controls undergoing endoscopic sinus surgery (ESS). Clinical information was recorded preoperatively and sinus mucosal specimens were collected intraoperatively. We determined the existence of BBF with BacLight/CSLM detection, and proposed a BBF scoring system based on its morphologic features. Clinical parameters, including symptom score, endoscopy score, CT score and symptom duration, were compared between CRS patients with and without BBF, and among CRS patients with different BBF score. BBF was found in 16/27 (59.26%) CRS patients and none in 10 controls. SNOT-20 symptom score and individual symptoms including need to blow nose, cough and postnasal discharge were significantly more severe in CRS patients with BBF than those without. BBF score was better correlated than BBF existence with SNOT-20 score (r = 0.811, P < 0.001 vs. r = 0.604, P = 0.001), and correlated with both endoscopy score (r = 0.490, P = 0.009) and symptom duration (r = 0.487, P = 0.010), neither was correlated with BBF (P = 0.824; P = 0.263). BBF score is likely to guide anti-BBF therapy in CRS patients.
本研究旨在使用共聚焦扫描激光显微镜（CSLM）检测慢性鼻-鼻窦炎（CRS）患者细菌生物膜（BBF）的发生率，并评估 BBF 与 CRS 临床特征的关系。这是一项对 27 例 CRS 患者和 10 例接受内镜鼻窦手术（ESS）的对照者的鼻窦黏膜进行的前瞻性观察性研究。术前记录临床资料，术中采集鼻窦黏膜标本。我们用 BacLight/CSLM 检测法确定 BBF 的存在，并根据其形态特征提出了一种 BBF 评分系统。比较了有 BBF 和无 BBF 的 CRS 患者以及 BBF 评分不同的 CRS 患者之间的临床参数，包括症状评分、内镜评分、CT 评分和症状持续时间。在 27 例 CRS 患者中，有 16 例（59.26%）发现 BBF，而 10 例对照者中无一例发现 BBF。有 BBF 的 CRS 患者的 SNOT-20 症状评分和包括需要擤鼻、咳嗽和后鼻漏在内的个别症状均显著比无 BBF 的患者严重。BBF 评分与 SNOT-20 评分的相关性优于 BBF 存在（r = 0.811，P < 0.001 比 r = 0.604，P = 0.001），与内镜评分（r = 0.490，P = 0.009）和症状持续时间（r = 0.487，P = 0.010）均相关，与 BBF 均不相关（P = 0.824；P = 0.263）。BBF 评分可能有助于指导 CRS 患者的抗-BBF 治疗。
