Biofilms are organized bacterial communities that may be homogeneous or heterogeneous. They play a significant role in the pathogenesis of chronic nasal
sinusitis, chronic
tonsillitis,
cholesteatomas, and device-related
infections. Despite this, few studies have been done that examine the presence of bacterial biofilms in tissues from patients with different types of COM or
middle ear cholesteatomas. In the current study, we examined the presence of biofilms in surgical tissue specimens from humans with chronic
ear infections using scanning electron microscopy (SEM). We hypothesize that bacterial biofilms present differently in patients with different types of chronic
otitis media. Our results provide new insights regarding treatment of chronic
otitis media. A prospective study was conducted in which middle ear tissues were obtained from 38 patients who underwent
tympanoplasty and/or tympanomastoid surgery due to chronic
ear infections. A total of 50 middle and mastoid tissue samples were processed for SEM analysis. In addition, 38 middle ear secretion specimens were obtained for routine bacterial culture analysis. Bacterial biofilms were present in 85 % (11 of 13) of patients with
middle ear cholesteatoma, 92 % (12/13) of patients with chronic
otitis suppurative media (CSOM), and 16 % of patients (2/12) with
tympanic membrane perforation (
TMP). Fungal biofilms were found in two cases of
cholesteatoma. The positive coincidence rate between bacterial biofilms visualized by SEM and bacteria detected by culture was 82 %. Our findings suggest that bacterial biofilms are very common in CSOM and
middle ear cholesteatomas. Positive bacterial cultures imply the presence of biofilm formation in CSOM and
cholesteatomas. As such, our results provide new insights regarding treatment of chronic
otitis media.