Rinossinusite crónica: papel dos biofilmes

Chronic rhinosinusitis is a very prevalent disorder with significant societal impact and economic burden1,2. It is defined by a number of symptoms which last for more than 12 weeks and by inflammatory signs which are observed through anterior rhinoscopy and nasal endoscopy. Computed tomography imaging may also be used to document the disease1. The pathogenesis of chronic rhinosinusitis remains largely unknown3. One of the possible etiological factors is the involvement of bacterial biofilms which has received much attention by many authors in the past few years4,5. Infections associated with these biofilms have proven refractory to prolonged treatment with antibiotics4,6. Biofilms have been implicated in several head and neck infections such as dental and periodontal disease, otitis media with cholesteatoma, typanoplasty tube otorrhea and chronic tonsillitis7. Recently, various authors have confirmed the involvement of biofilms in chronic rhinosinusitis2-7. Furthermore, in patients with chronic rhinosinusitis associated with biofilms, structural alterations of the sinonasal mucosa are observed by electronic microscopy3,6. Various stages of severity have been detected from ciliar disorganization to total absence of cilia and goblet cells6. This paper presents a systematic review of the published medical literature in the Portuguese and English language. Current concepts of chronic rhinosinusitis and the role of biofilms in this pathology are discussed.