2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

B. Microbiome of the upper aerodigestive tract Gelbard A, Katsantonis NG, Mizuta M, et al. Molecular analysis of idiopathic subglottic stenosis for Mycobacterium species. Laryngoscope . 2017; 127(1):179-185. EBM level N/A...................................................................................................................226-232 Summary : This article aims to use non-culture–dependent techniques to describe the tracheal microbiome composition in normal and diseased (idiopathic subglottis stenosis and intubation-related laryngotracheal stenosis) states. Furthermore, it seeks to identify specific pathogens associated with these particular disease states through a variety of biochemical and histological techniques in order to consider differences in the pathogenesis of different airway stenosis. Mycobacterium species predominate in idiopathic subglottic stenosis, and peripheral serum samples from test cases demonstrate a specific immune response to Mycobacterium antigen. This suggests a potential role for Mycobacterium infection or the host response to it in the development of idiopathic subglottic stenosis. Summary : The authors of this study used fecal samples to measure the microbiomes using RNA techniques to determine changes in microbiome populations which they believe are attributable to proton pump inhibitor (PPI) use. The authors used both historic data for control as well as isolating 70 twin pairs with discordant PPI use. Ortega O, Sakwinska O, Combremont S, et al. High prevalence of colonization of oral cavity by respiratory pathogens in frail older patients with oropharyngeal dysphagia. Neurogastroenterol Motil . 2015; 27(12):1804-1816. EBM level 4.......................241-253 Summary : The authors aim to further characterize the relationship of swallowing function, bacterial burden, and host immunity in frail, elderly adults who are susceptible to aspiration pneumonia. A number of variables among dysphagic elderly subjects with and without pneumonia as well as elderly subjects without dysphagia are compared. Those subjects with pneumonia have evidence of less swallowing safety. All subjects have similar oral health, and no significant differences among commensurate or pathologic organisms exist. Jackson MA, Goodrich JK, Maxan ME, et al. Proton pump inhibitors alter the composition of the gut microbiota. Gut . 2016; 65(5):749-756. EBM level 4.......233-240

Turan M, Ekin S, Ucler R, et al. Effect of inhaled steroids on laryngeal microflora. Acta Otolaryngol . 2016; 136(7):699-702. EBM level 2.................................................254-257

Summary : Using standard microbiology evaluation (Gram staining and catalase tests), the authors sought to understand the effect of inhaled corticosteroids on the laryngeal (epiglottis) microbiome as well as in adjacent pharyngeal areas (oropharynx, vallecula). An abundance of specific organisms (coagulase-negative Staphylococcus , Streptococcus viridans , Candida ) was observed in inhaled steroid users across all sampled sites.