Sinusitis pathophysiology

Role of biofilms
Biofilms are complex aggregates of extracellular matrix and inter-dependant microorganisms from multiple species, many of which may be difficult or impossible to isolate using standard clinical laboratory techniques. Bacteria found in biofilms may show increased antibiotic resistance when compared to free-living bacteria of the same species. It has been hypothesized that biofilm-type infections may account for many cases of antibiotic-refractory chronic sinusitis. A recent study found that biofilms were present on the mucosa of 3/4 of patients undergoing surgery for chronic sinusitis.