The importance of mucosal biofilm on the treatment of chronic tonsillitis

Chronic tonsillitis is one of common infectious diseases of childhood and adults. Tonsillectomy is often performed when antibiotic therapy fails to ameliorate this disease. The role of biofilms in the persistence of chronic mucosal-based ear nose and throat(ENT) related infections was recognized in chronic tonsillitis. Biofilms have been shown to play a role in otitis media, sinusitis, cholesteatoma, adenoiditis and surgery device infections. Biofilm cells are resistant to host defenses, since the increased biomass prevents phagocytosis and the exopolysaccharide(EPS) provides a physical barrier to complement, antibody and immune cells. Biofilms are aggregates of bacteria encased in a structured polysaccharide matrix that they synthesize and that attaches the community to a surface. Biofilms are organized, heterogeneous bacterial communities. Biofilm bacteria are embedded in a rich matrix of polysaccharides, nucleic acids, and proteins known as the extracellular polymeric substance (EPS). In this study, we want to evaluate the tonsil tissues removed during tonsillectomy operation with chronic tonsillit patients, for histological and ultrastructural evidence of bacterial mucosal biofilm on the surface of tonsil tissues after invitro local applied n-acetyl-cysteine (NAC) and acetylsalicylic acid(ASA) on tonsils surface areas. The objective of this study was, in general, to provide to a better understanding of how NAC ve ASA influences biofilm processes and however we observed variable biofilm morphological features with light microscopic (LM) and transmission electron microscope(TEM) .