Methods: Subjects suffering from a wide spectrum of nasal disorders, after a detailed clinical history and ENT examination, underwent nasal fibroendoscopy, skin prick test, rhinomanometry and nasal cytology.
Results: 1,410 subjects were studied. The infectious spot was present in 107 of them (7.6%) patients; this percentage reached 55.4% in 193 patients who had clear cytologic signs of infectious rhinitis. Biofilms were largely more frequent in patients with adenoid hypertrophy (57.4%), followed by nasal polyposis (24%), chronic rhinosinusitis (9.5%) and non-allergic “cellular” rhinitis (7.6%). Nasal cytology was normal in the remaining patients, with no infectous spot detectable. Statistical analysis showed that nasal resistances were significantly higher in presence of biofilms in patients affected by adenoid hypertrophy (p =0.003), nasal polyposis (p< 0.001), chronic rhinosinusitis (p= 0.018) and septal deviation (p= 0.001).
Conclusions: The results demonstrate that biofilms are not present only in infectious rhinopathies, but also in inflammatory and/or immune-mediateddiseases. Biofilms were more frequent in patients with higher degree of nasal obstruction as assessed by nasal endoscopy (grade III and IV adenoids and stage 3 polyposis) and rhinomanometry. Nasal cytology, by allowing the identification of biofilms represents an useful diagnostic tool with promising research implications.