The role of bacteriotherapy in the prevention of adenoidectomy

Area of Science:

• Otorhinolaryngology
• Microbiology
• Pediatric Surgery

Background:

• Adenoidectomy is a common surgical procedure for adenoidal hypertrophy and otitis media with effusion.
• Potential adverse events associated with adenoidectomy necessitate exploration of effective non-surgical alternatives.
• Reducing surgical interventions can mitigate patient risk and harm.

Purpose of the Study:

• To evaluate the efficacy of bacteriotherapy as a non-surgical treatment to decrease the requirement for adenoidectomy.
• To assess the impact of specific bacterial nasal spray on adenoid size and middle ear effusion.

Main Methods:

• An open experimental study involving 44 children candidates for adenoidectomy.
• The study group received a nasal spray containing Streptococcus salivarius 24SMB and Streptococcus oralis 89a for 3 months.
• The control group received hypertonic saline nasal lavage on the same schedule. Tympanometry and adenoid size were assessed.

Main Results:

• Only 6 out of 22 children in the bacteriotherapy group required surgery, compared to 20 out of 22 in the control group (p<0.0001).
• Bacteriotherapy led to a significant reduction in adenoid size (p<0.0001).
• Significant improvement in middle ear effusion, as measured by tympanometry, was observed in the treated group (p<0.0001).

Conclusions:

• Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray is a viable option to reduce the need for adenoid surgery.
• This nonsurgical treatment effectively reduces adenoid size and improves otitis media with effusion.
• Bacteriotherapy presents a promising, less invasive approach for managing adenoidal hypertrophy and related conditions.