Investigation of biofilm formation in the middle ear mucosa of patients who have chronic middle ear infection

Chronic suppurative otitis media (CSOM) is a disease which is seen especially in low socioeconomical and developing countries. Although detalied researches have been done, etiopathogenesis and epidemiology has not been revealed even in developed countries. In spite of reduced mortalitiy rates due to new antibiotics and treatment modalities, hearing loss, language and speaking retardation is still a problem and this causes decrease of life quality. Eustachian disfunction, acute otitis media episodes and biofilm formation are some of the etiologic factors.Biofilms can be defined as the organisms that they become together to form water, nutrient and waste channels. Bacteria which lives in biofilms are more resistant to antibiotics, environmental effects and to the host immune system. Thus biofilm plays an important role in the etiology of chronic and difficult treating disesaes. Medical treatment of CSOM is very difficult. Because of this difficult treatment and chronicity it causes functional losses and mortal complications.In our study, CSOM patient?s middle ear mucosa were investigated with transmission electron microscope to reveal whether biofilm plays a role or not. 12 of 19 (%63,15) mucosa were found biofilm positive. The control group consisted of cochlear implantation candidates. The healthy middle ear mucosa of the control group was investigated with TEM. İn the control group none of the patients have biofilm in their middle ear mucosa. These findings were statistically significant (p<0,05).As a result CSOM is a mortal and morbid disease which biofilm formation plays an important role in the etiology. Because of this, surgical therapy and new treatment modalities which are described to treat biofilms have to be considered in the managment of this chronic disease.