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Adenotonsillar microbiome: an update
  1. James Jordan Johnston,
  2. Richard Douglas
  1. Department of Surgery, University of Auckland, Auckland, New Zealand
  1. Correspondence to Professor Richard Douglas, Department of Surgery, The University of Auckland, Auckland 1149, New Zealand; richard.douglas{at}


Pathogenic bacteria associated with the adenoids and tonsils cause much morbidity in the paediatric population. Hyperplasia of the adenoids is associated with otitis media with effusion and hyperplasia of the palatine tonsils is associated with both recurrent tonsillitis and obstructive sleep apnoea. Most current knowledge of the microbiology of the upper airways has been derived from culture-based studies, which usually reflect only a small fraction of the bacteria present on the mucosal surface. Culture-independent molecular surveys based on 16S ribosomal RNA sequencing are now being employed to determine the microbiota on the surface and within the tissue of adenoids and palatine tonsils. This review describes the new techniques applied in determining the microbiome and summarises the results of studies employing these techniques.

  • microbiome
  • adenoid
  • tonsil
  • paediatric otolaryngology

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  • Contributors JJJ and RD planned the study. JJJ performed the literature search. JJJ selected relevant papers for review. JJJ wrote the first draft manuscript. RD edited manuscript. JJJ submitted the manuscript. JJJ and RD are responsible for overall content as guarantors.

  • Funding This work was supported by the Garnett Passe and Rodney Williams Memorial Foundation Surgeon Scientist Scholarship awarded to Dr James Johnston for work towards a Doctor of Philosophy at the University of Auckland.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors confirm that there is no additional unpublished data from this study that is available. All work detailed in this submission is from published sources and referenced accordingly.