The influence of nasal and oropharyngeal mucosal dysbiosis on the condition of the middle ear in children with congenital cleft palate

Abstract

Disturbance of the microbiocenosis of the nasal cavity and oropharynx in children with congenital cleft palate presents serious therapeutic difficulties. Pathobionts colonizing the upper respiratory tract and chronic adenoiditis pose a threat of acute purulent otitis media and chronic otitis media with effusion. The authors studied nasal and oropharyngeal mucosal dysbiosis in patients before elective uranoplasty and the effect of dysbiotic manifestations on the condition of the middle ear in the postoperative period. The results of microbiological examination of 80 swabs from the nasal cavity and oropharynx in patients with congenital cleft palate were analyzed. Among the culture-positive results in patients in clinical and laboratory remission of ENT-infections dysbiosis of 2–3 degrees prevails, the presence of bacterial-bacterial and bacterial-fungal associations is often noted, the predominance of gram-negative microflora is noted. There was an increase in the frequency of perforations of the tympanic membrane in the presence of bacterial and fungal associations, the appearance of retraction pockets in the presence of gram-negative microflora, the relationship between grade 3 dysbiosis and the appearance of purulent otitis media after uranoplasty were revealed.Conclusion. Disturbance of microbiocenosis in patients with congenital cleft palate before uranoplasty requires the inclusion of a microbiological study in the preoperative preparation schedule and a personalized approach to perioperative antibiotic prophylaxis.