Como se comporta a microbiota nasofaríngea de crianças após adenotonsilectomia: uma revisão de escopo
DOI:
https://doi.org/10.34119/bjhrv9n2-072Keywords:
microbioma, tonsilectomia, pediatria, cirurgiaAbstract
Introdução: Adenoides e tonsilas palatinas integram o sistema imune, respondendo a patógenos inalados ou ingeridos. A microbiota nasofaríngea infantil, flexível e dinâmica, pode sofrer alterações após a adenotonsilectomia. Tais variações dependem de fatores como idade, exposição ambiental e hiperplasia tonsilar. As principais indicações cirúrgicas são infecções recorrentes e apneia obstrutiva do sono. Esse ecossistema reflete pressões ecológicas contínuas, evoluindo para estados de resiliência ou disbiose. Metodologia: Revisão sistemática orientada pelo protocolo PRISMA. A busca abrangeu PubMed, EMBASE e SCOPUS, selecionando estudos observacionais e ensaios clínicos randomizados. Resultados: Incluíram-se nove artigos, totalizando 790 pacientes. Os resultados revelaram divergências na composição da microbiota pós-operatória e diferenças entre pacientes com e sem apneia. Alguns estudos apontaram redução de S. aureus e S. pyogenes, enquanto outros registraram predominância de Haemophilus. Conclusão: Verificaram-se alterações nas proporções de patógenos (Staphylococcus aureus, Streptococcus pyogenes e Haemophilus influenzae) após a intervenção, além de uma tendência de restauração de comensais como Streptococcus viridans e Actinomyces. Persistem discordâncias entre os dados, ressaltando a necessidade de mais pesquisas para definir o padrão de mudanças microbióticas no pré e pós-operatório.
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