Is there any interplay between human gut microbiota and upper airway susceptibility to recurrent respiratory papillomatosis exacerbations?

INTRODUCTION: Recurrent respiratory papillomatosis is a long-term disease caused by HPV 6 and 11, but there is still noconsensus on the factors that may influence its course. AIM: The aim of the study is the analysis of the recurrent activity of respiratory papillomatosis measured by the number ofsurgeries and recent disease activity, as well as an interview regarding intestinal symptoms. MATERIAL AND METHODS: Our study involved 73 patients with confirmed papillomatosis (39 men, 34 women). The mainvariables of crucial importance for the severity of papilloma disease were: age of onset, number of operations, and currentdisease activity. Variables important for the analysis of the impact of intestinal dysbiosis on the course of papillomatosis wereas follows: intestinal symptoms and the number of antibiotic courses in the last year. The main outcome measure in this studywas the relationship between papilloma activity and indicators of intestinal microflora status. RESULTS: Our results showed that diet had a statistically significant effect on the last disease activity measured by the intervalrecurrence of RRP (P = 0.005). The remaining variables did not affect the number of surgeries performed during the patient'slifetime or the current RRP status. CONCLUSIONS: The acquired knowledge may contribute to further work on the discovery of the relationship between the stateof the intestinal microbiota and the course of recurrence of respiratory papillomatosis infection in patients with recurrentrespiratory papillomatosis.

The importance of the gut microbiota in the promotion, development, and treatment outcomes of cancer with special regard to the gut-respiratory axis.

The role of oral and pharyngeal microbiota is important in the promotion and development of head and neck cancers, as discussed in detail in this publication. The object of this work is to gather scientific information on the importance of the gut- respiratory axis in the promotion, development, and treatment outcome of head and neck cancer (HNSCC). Scientific knowledge about the interaction of head and neck cancer tumor cells and gut microbiota is residual, so examples of the relationship between the gut microbiota and the promotion of development in cases of other malignancies are also discussed. The subject of this work is also to present the importance of the gut-respiratory axis in promotion, development, and its impact on treatment outcomes of head and neck cancers.

Thyroplasty in unilateral vocal fold paresis with coexisting hereditary hemorrhagic telenagiectasia: A case report.

RATIONALE: The coincidence of an idiopathic unilateral vocal fold paresis and hereditary hemorrhagic telenagiectasia (HHT) is extremely rare and has not been described in the available literature yet. PATIENTS CONCERNS: A 55-year-old female was admitted to hospital due to acute onset of hoarseness, voice fatigue, and effort dyspnea. In the past, the patient was diagnosed with HHT and on admission presented characteristic vascular lesions in the oral cavity. She reported also experiencing a moderate epistaxis at least once per month. DIAGNOSES: The otolaryngological examination (fiberolaryngoscopy, phoniatric examination) revealed unchanged mobility and morphology of the right vocal fold and paresis of the left vocal fold in intermediate position. Computed tomography and magnetic resonance imaging of head, neck, and chest were inconclusive and showed no pathologic findings. INTERVENTIONS: The unilateral paresis was treated for 12 months as idiopathic, with extensive rehabilitation. However, no improvement was observed. As a patient suffering from HHT is a challenge for anesthesiologists in terms of general anesthesia, the decision to perform type I thyroplasty (medialization) in local anesthesia was made. OUTCOMES: There were no complications intraoperatively or in postoperative period. The implemented treatment was successful, as the voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shimmer, NHR). LESSONS: A routine surgical treatment in patients with HHT is a challenge. However, in this case, it was uneventful and successful, thus it can be recommended in other patients with similar background.