Анализ микробиоты с поверхности небных миндалин у пациентов с ларингофарингеальным рефлюксом

Abstract

Due to the large number of patients with complaints of discomfort and sore throat not associated with infectious tonsillopharyngitis, the question of the role of various microorganisms in the occurrence of these complaints remains open. Objective. Analysis of the species microbial landscape of the pharyngeal surface of the palatine tonsils in patients with laryngopharyngeal reflux. Patients and methods. The study included 120 women and 71 men with a median age of 38.0. Patients with acute tonsillopharyngitis (selection was carried out according to the Centor criteria) and patients with difficulty in nasal breathing were not included. The patients underwent oropharyngoscopy, analysis of the results of cultural inoculation from the mucous membrane of the pharyngeal surface of the palatine tonsils, assessment of complaints from the throat on the VAS (visual analogue scale). Results and discussion. It was found that most of the patients were worried about sore throat, the median quantitative assessment was 4.0, patients rated the feeling of a foreign body or lump at 3.0, difficulty in swallowing food, liquid, or tablets, at 0.0. When collecting an anamnesis, it was possible to find out that pain and discomfort in the throat bothered patients for a long time from 2 weeks to several years. Often, patients associated sore throats with general hypothermia; taking chilled drinks; with a viral infection with a chronic bacterial infection; therefore, numerous studies were carried out to detect pathogenic microflora. Conclusion. On the surface of the palatine tonsils in patients with laryngopharyngeal reflux (LPR), in addition to normal, opportunistic, and pathogenic microflora, representatives of the intestinal flora were found in clinically insignificant amounts of colony-forming units; in 63% of patients with LPR, caseous plugs were found in the lacunae of the palatine tonsils; patients with tonsillolitis (47%) felt bad breath themselves, which others did not notice; patients with LPR are characterized by difficulty in swallowing tablets and sore throat with an empty throat; systemic antibiotic therapy for pain with an empty throat, which was received by 98% of patients, was ineffective.