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Orlandi et al.

Adappa 610 2016 4 Presence of biofilms in CRSsNP subjects and vs T2R38 taste 59 CRS Subjects Invitro biofilm formation Linear association between invitro biofilm 51CRS SNOT-20 score, receptor phenotype

67% of CRSsNP subjects had biofilm present, while 0% of control patients had biofilm present. All patients with presence of intracellular S. aureus had presence of biofilm.

significantly worse 6 months post-surgery in subjects with biofilm-forming bacteria. formation and T2R38 taste receptor phenotype. This association was

exclusively driven by CRSsNP subjects. 71% of patients had biofilms present at the time of surgery. Patients with biofilms had

Biofilms identified in 9/15 postoperative samples 6 months later. Presence of biofilms correlated with objective

Lund-Kennedy and Lund-Mackay scores. Biofilm-forming capacity of cultured bacteria during ESS correlated with

TABLE IX-4 Evidence for biofilms as a contributing factor for CRSsNP Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Glowacki 587 2014 3 Presence of biofilms during ESS and post-surgical outcomes 33CRSwith biofilms 33 CRS without biofilm (Control) SNOT-20 score, Lund-Kennedy score, Lund-Mackay score CRS subjects with biofilms had greater subjective and objective severity of disease preoperatively. CRS subjects with biofilms have more persistent and severe disease post-ESS. Tan 581 2012 3 Prospective study of biofilms in CRS 15CRSsNP 5 control Surface biofilm presence Zhang 583 2015 4 Retrospective cohort Study of biofilm

156CRS SNOT-22 score 15% of CRS patients had biofilm-forming bacteria present. Patients with

biofilm-forming bacteria had significantly worse postoperative SNOT-22 scores than those without biofilm-forming bacteria. QoL improvements after ESS are

significantly worse preoperative objective severity scores. Patients with biofilms had significantly worse postoperative SNOT-20 and Lund-Kennedy Scores.

unfavorable clinical evolution following ESS.

27CRS Surface biofilm presence

Lund-Kennedy

score, Lund-Mackay score

unfavorable

post-ESS evolution (objective and subjective)

19CRS Favorable vs

presence and QoL

Singhal 585 2010 4 Prospective study of QoL post-ESS in

patients with and

without biofilms

Zhang 582 2009 4 Prospective Study of Intraoperative

biofilm formation

Bendouah 586 2006 4 Biofilm capacity of cultured bacteria

from ESS patients

and post-surgical outcomes