الفهرس 
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Abstract
it has been observed that ear, nose, and throat (ENT) infections encountered in clinical practice are becoming more resistant to common treatment. Moreover, the chronic nature of some of them (i.e., chronic rhinosinusitis [CRS], chronic otitis media [COM], otitis media with effusion [OME]) makes the situation more difficult with regard to diagnosis and management. The latter often fails, and long-term antibiotic administration is often inadequate to eradicate disease that gradually affects patients’ quality of life. Even though one can argue that these situations could merely represent an increase in antibiotic resistance, because of the overuse of antibiotics in current clinical practice, the challenging concept of biofilms can be considered as an etiologic factor, among others.
Bacterial biofilms are three-dimensional aggregates of bacteria that have been shown recently to play a major role in many chronic infections. Biofilm formation is an ancient and integral component of the prokaryotic life cycle and is a key factor for survival in diverse environments.
In the human host, biofilms exist as a community of sessile bacteria embedded in a matrix of extracellular polymeric substances (EPS) they have produced, which adhere to a foreign body or a mucosal surface with impaired host defense or ample roughness.