Biofilms and their role in otorhinolaryngological disease.

Objective: To describe the pathophysiology of biofilm communities and their role in otorhinolaryngological disease, with reference to the published literature. Design: Review of relevant literature, using Medline and the combined search terms 'biofilms' and 'otorhinolaryngology', and also various related keywords such as 'tonsil' and 'adenoid'. Results: Description of biofilm pathophysiology and of published reports of biofilms in otorhinolaryngological disease. Conclusion: Virtually all microbes live in biofilm communities. Within these communities, the microbes assume differing specialised roles which confer survival advantages on the community. These communities cause chronic and device-associated infections. Within the specialist field of otorhinolaryngology, biofilms have been shown to play a role in many infections, including: chronic otitis media, cholesteatoma, chronic tonsillitis, chronic sinusitis, and infections of tracheostomies, endotracheal tubes and cochlear implants.