title: Nasal and Tracheal Microbial Colonization in Laryngectomized Patients.
abstract: OBJECTIVE
  Complete separation of upper and lower respiratory tract after total laryngectomy results in loss of physiological nasal functions and presence of "unconditioned" inspired air in lower airways. Aim of this study is evaluating the presence of a microbial colonization of nasal cavities and trachea in laryngectomized long-term survivors.
  
  
  METHODS
  Twenty-five laryngectomized patients underwent symptoms' anamnestic evaluation, endoscopic fiber optic nasal and tracheal examination, specimen collection for microbiological exam, and culture. Enrolled patients had at least a 2-year follow-up period in order to evaluate long-term microflora.
  
  
  RESULTS
  Gram positive polimicrobic flora represented the main finding in nasal cavities and trachea (92% and 48% of patients, respectively). Other bacteria were non-fermenters Gram negative bacteria, Enterobacteriaceae and Staphylococcus aureus. The same microflora was demonstrated in nasal cavity and trachea in 5 patients (20%), while sterile nasal cavity and trachea were seen in 3 (12%) and 4 (16%) cases, respectively. No fungi were observed in nasal cavity and trachea.
  
  
  CONCLUSIONS
  Nasal cavities and trachea of laryngectomized patients are colonized by nonpathogenic and/or potentially pathogenic bacteria, in absence of signs and symptoms of infection. Colonizer microflora should be kept in mind when a culture from nasal or tracheal swabs is needed in daily practice.
authors.affiliation: 1st ENT Division, Surgical Sciences Department, University of Turin, Italy giuseppe.riva84@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Riva
authors.affiliation: 1st ENT Division, Surgical Sciences Department, University of Turin, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Garzaro
authors.affiliation: Microbiology and Virology, Laboratory Diagnostics Department, University of Turin, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Zaccaria
authors.affiliation: 1st ENT Division, Surgical Sciences Department, University of Turin, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Peruzzetto
authors.affiliation: Microbiology and Virology, Laboratory Diagnostics Department, University of Turin, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cipriani
authors.affiliation: 1st ENT Division, Surgical Sciences Department, University of Turin, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Salonia
authors.affiliation: 1st ENT Division, Surgical Sciences Department, University of Turin, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Raimondo
authors.affiliation: Allergology and Clinical Immunology, Medical Science Department, University of Turin, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Boita
authors.affiliation: 1st ENT Division, Surgical Sciences Department, University of Turin, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pecorari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002353:Carrier State / Q000382:microbiology*; D003352:Corynebacterium / Q000302:isolation & purification; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D000077195:Squamous Cell Carcinoma of Head and Neck; D013211:Staphylococcus aureus / Q000302:isolation & purification; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification; D014132:Trachea / Q000382:microbiology*
keywords: bacterial colonization; laryngectomy; microbial colonization; nasal microflora; tracheal microflora