Blank may damage the ear drum and bones of the middle ear

cholesteatoma

Explanation:

Cholesteatoma is an important and relatively common disease. When left untreated, it can have serious complications and result in partial or total hearing loss. A cholesteatoma is a benign tumor that affects the middle ear and tympanum and can cause hearing problems. The disease consists of an accumulation of skin layers located behind the tympanic membrane. Cholesteatoma usually develops as a cyst, knocking down the layers of old skin.

Step order:

2. The surface (substrate) is preconditioned by environmental molecules.

4.Microbes bind and detach from the preconditioned surface.

1.Quorum detection and extracellular matrix establishment begins as microbes bind more stably.

 3. The mature biofilm and some microorganisms escape the planktonic state.

Explanation:

The biofilm is a highly complex structure where many microorganisms coexist, compete, reproduce, feed, within a micro-system with many ideal conditions for each microorganism that is housed in it.

The biofilm is resistant to non-selective antimicrobials, that is, to disinfectants such as sodium hypochlorite, chlorhexidine, among others.

Evidence was also presented that they are resistant to selective antimicrobials such as antibiotics, that is why they have great virulence factors or potential to trigger pathology.

The solution to destroy a biofilm is mechanical sweeping, with brushing as it happens on our teeth or even with the catheter cleaning brushes that are used (in addition to the sterilization methods).

This biofilm presents separate colonies in its interim with a fluid that it travels transmitting signals, food, toxins, resistant factors between these different types of microorganisms. This fluid and this communication between them is called quorum sensing and not all microorganisms tolerate it.

Many microorganisms compete with each other for the medium, an example is streptococcus mutating in the dental biofilm, which generates an acidic medium by metabolizing carbohydrates within the biofilm, thus generating that those bacteria that live in neutral or alkaline ph cannot reproduce and die.

The biofilm can be contained by bacteria, viruses, fungi and even parasites, but what they all have in common is that they have the ability to reproduce on an inert surface such as catheters, dental surfaces, silicone hoses.