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Pediatric Otolaryngology

Middle Meatus, Tonsil, and Adenoid Microbiome in Pediatric Chronic Rhinosinusitis

Monday, October 2, 2023
1:51 PM - 1:57 PM East Coast USA Time
Location: 207CD
Disclosure(s):
Katie Liu, BA: No relevant relationships to disclose.
Aaron N. Pearlman, MD: No relevant relationships to disclose.
Alison M. Maresh, MD: No relevant relationships to disclose.
Introduction: Pediatric chronic rhinosinusitis (PCRS) is a common condition with a significant impact on quality of life. This study aims to compare the microbiome of PCRS patients with controls.

Methods: This was a single-center, prospective, qualitative case-control study conducted from April 2021 to August 2022 in a large metropolitan area. Patients undergoing adenoidectomy for PCRS (n=20) or obstructive sleep apnea (n=20) were recruited. 16s rRNA sequencing was performed on right middle meatus (MM), adenoid, and palatine tonsil samples from each patient. Statistical analysis included t-tests and regression models to compare alpha diversity as measured by the Simpson’s Diversity Index (SDI), permutational multivariate analysis of variance of the Bray-Curtis dissimilarity index to assess microbiome composition, and Analysis of Composition of Microbiomes to assess differential abundance of bacteria genera.

Results: There were 40 adenoid, 40 tonsil, and 37 middle meatus samples analyzed. There was no significant difference in alpha diversity between controls and PCRS patients (p=0.56). The tonsils (SDI 0.86 ± 0.10) were significantly more diverse than the adenoids (SDI 0.75 ± 0.20), which were more diverse than the MM (SDI 0.48 ± 0.21) (p < 0.001). Alpha diversity of the MM significantly increased with age (p=0.023). There was no significant difference based on other demographic variables including sex or antibiotic use. There was no difference in bacterial composition between controls and PCRS patients, but the composition of the three sites were significantly different (p < 0.001). The dissimilarity between the adenoid and MM sites was larger in the control group than the PCRS group (pseudoF 7.23 vs 2.28).

Conclusions: There were significant differences in alpha diversity and bacterial composition between the anatomic three sites, however there was no difference between the control and PCRS groups. The larger dissimilarity between adenoid and MM sites in controls compared to PCRS suggest there may be colonization of the MM by the adenoid in PCRS patients. Future longitudinal cohort studies of the microbiome are needed.