Bacterial Profile Stability of Middle Meatus Following Endoscopic Sinus Surgery: A Prospective Pilot Study

PurposeThe aim of this study was to explore longitudinal changes in the middle meatal microbiome following endoscopic sinus surgery (ESS), accounting for relevant clinical variables in a group of patients with chronic rhinosinusitis (CRS).MethodsParticipants with CRS without nasal polyps and CRS with nasal polyps admitted for ESS were prospectively recruited. Endoscopically guided swabs were collected from 40 CRS patients at the time of surgery and during the postoperative visit, approximately 6 weeks after the surgery, from the region of the middle meatus. Bacterial communities were characterized using the 16S rRNA gene sequencing. Paired samples from 22 patients with CRS were included in the final analysis.ResultsThe overall microbial community composition, as reflected in alpha- and beta-diversity metrics and relative taxon abundances, remained generally stable after surgery. However, using advanced statistical methods, we identified subtle alterations in the microbiome. Postoperative beta diversity differed by occupational exposure and vitamin D status, whereas the Linear Model for Differential Abundance extended to a linear mixed-effect model detected modest taxonomic variation associated with age, allergy, body mass index, 25(OH)D, and extent of surgery.ConclusionDespite various factors known to modulate CRS and anatomical changes resulting from ESS, this pilot study found that the baseline microbiome structure of the middle meatus remained largely stable postoperatively. While ESS did not result in pronounced alterations of the overall bacterial landscape, selected covariates appeared to be associated with postsurgical microbiome shifts, highlighting the need for further investigation in larger cohorts.