Bacterial Biofilms in Chronic Rhinosinusitis. Clinical Role and Current Therapeutic Strategies

Biofilms, sophisticated microbial communities on both living and inert surfaces or in loose aggregates, present a formidable structure through an intercellular matrix. This configuration not only enables microbes to thrive under harsh conditions but also enhances their resistance against antimicrobial treatments. Emerging research underscores the pivotal role of biofilms in the progression and persistence of chronic infections, notably chronic rhinosinusitis (CRS). Historically, the significance of biofilms in CRS was underappreciated, but recent breakthroughs in detection techniques and molecular science have illuminated their substantial influence on this condition. This revelation has positioned the study of bacterial biofilms at the forefront of otolaryngology, especially in tackling stubborn cases of CRS. This paper delves into the latest insights on the clinical impact of biofilms in CRS, offering a comprehensive review of both existing and innovative treatment approaches aimed at eradicating biofilm-associated complications. Through this exploration, the paper aims to foster further research and development of effective strategies for combating biofilm-associated CRS among the scientific and medical community. In particular, attention is paid to alternative antimicrobial agents, such as bacteriophages, nanomaterials, and antimicrobial peptides. The perspective of applying anti-matrix and anti-adhesive methods is revealed. Also, as one of the promising directions for combating biofilms, methods of influence and disruption of cellular quorum sensing are presented.