Understanding the role of bacteria in chronic airway inflammation has become a cornerstone of our pediatric ENT research. Our group led the first study characterizing the adenoid microbiome in children undergoing adenoidectomy for chronic rhinosinusitis. We found that the adenoid surface harbors distinct microbial communities in children with sinus disease, suggesting a target role for microbiota in upper airway inflammation (PMID: 32348024). This study is just one of many that reflects our long-term vision to define how microbial environments shape ENT pathology in early life.