Oral flora in head and neck cancer patients

In this study, we examined the oral flora in the saliva of head and neck cancer patients. We identified both the bacteria and its quantity in the flora as well as opportunistic pathogens in the saliva of 65 head and neck cancer patients. First, we counted the total number of bacteria in the saliva. Patients before the treatment had 1×107∼1×108cfu/ml of bacteria in their saliva. Second, we identified four bacilli in the oral flora. Streptococcus spp. was most prevalent in the saliva of head and neck cancer patients. The distribution of oral flora was not correlated with the primary site of the head and neck cancer. This data suggest that the primary site of cancer has no impact on the oral flora. On the other hand, the number of bacteria in patients with microvascular free flap was lower than in other patients. Next, we detected opportunistic pathogens in saliva. Oral cancer and oropharyngeal cancer patients had more opportunistic pathogens in their saliva than other head and neck cancer patients. The incidence of detection of opportunistic pathogens in patients who were scheduled for reconstruction with microvascular free flap was higher than the in other patients before the treatment. Moreover, opportunistic pathogens were detected with almost equal incidence in the patients who were scheduled for reconstruction with microvascular free flap and patients who had microvascular free flap. These findings indicate that cases with microvascular free flap can become highly complicated because of opportunistic infection. In conclusion, opportunistic pathogens have the potential to induce postoperative infection and pneumonia after reconstruction with micrvascular free flap, and oral care seems to be one possibility to prevent it.