Is there any association between adenoid biofilm and upper airway infections in pediatric patients?

Aim: To evaluate the association of the presence and extent of adenoid biofilms and the frequency of upper airway infections in children with upper airway obstruction.

Material and Methods: This cross-sectional study was conducted from October 2014 to December 2015 on pediatric patients who were candidates for adenoidectomy due to obstructive sleep apnea. After removal of the adenoid tissue and fixation in 2.5% glutaraldehyde, the samples were sent to the electron microscopy unit. The extent of biofilm formation was examined using environmental scanning electron microscopy. These results were then confirmed using image analysis software.

Results: Fifty-seven children with a mean age of 7.31 (±2.65) years were included in the study. Forty-three (75.4%) were male and 14 (24.6%) were female. The average number of upper airway infections during the last 12 months before adenoidectomy was 10.01 (±5.38). Biofilm structures were detected in all (100%) samples. As the main outcome, the extent of biofilm grading exhibited a statistically significant correlation with the frequency of upper airway infections (p<0.001). There was no significant correlation between sex and adenoid size with the biofilm extent.

Conclusion: The present study showed that the extent of adenoid biofilm had a significant relationship with the frequency of upper airway infection rate. It seems that the presence of a biofilm on the adenoid surface as a reservoir for microorganisms could cause chronic inflammation.