The Journal of Laryngology & Otology

Review Articles

Biofilms and their role in otorhinolaryngological disease

E Macasseya1 c1 and P Dawesa1

a1 Department of Otorhinolaryngology, Dunedin Public Hospital, New Zealand


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.

(Accepted January 22 2008)

(Online publication April 11 2008)


c1 Address for correspondence: Dr Emily Macassey, Department of Otorhinolaryngology, Dunedin Public Hospital, Great King Street, Dunedin, New Zealand. Fax: 006434747956 E-mail:


Dr E Macassey takes responsibility for the integrity of the content of the paper.

Competing interests: None declared