Bacterial flora of the nasal cavity in laryngectomized patients.

In laryngectomized patients, the nose does not function. The absence of a physiological airflow stimulus leads to clinical, cytologic and histologic changes of the nasal mucosa. The aim of this study was to identify the nasal cavity bacterial flora in these patients and to determine whether or not it undergoes changes with time. In a group of 25 patients, the nasal mucosa swabs were taken before, and 8 days and 1 month after the surgery. In a group of 15 patients, the nasal mucosa swabs were taken 1 to 2 years postoperatively.

Bacteriological nasal flora in newborns indicating health and/or development of infection.

During delivery, a fetus otherwise sterile during the intrauterine life, comes in contact with bacterial flora of the mother's birth canal, and then also with the ward personnel's skin and respiratory system flora. Due to the absence of competitive bacteriological flora, the nasal cavity is gradually colonized by microorganisms, especially those with a capacity of adhesion to epithelial cells of respiratory nasal mucosa. Bacteriological flora of the newborn's nasal flora was observed on days 1 and 3 postpartum, in an attempt to determine whether a finding of pathogenic bacterial flora in newborn's nasal mucosa indicates a localized infection only or points to the possible development of generalized infection. Bacteriological nasal flora was monitored in infants born by spontaneous delivery and in those born by cesarean section. In mothers of infants born by spontaneous delivery, bacteriological flora from the cervix uteri was investigated. Results of the study performed by usual methods revealed Escherichia coli and Staphylococcus aureus to prevail in the pathogenic flora. Gram-negative microorganisms were found to be good indicators of local infection of newborn's nasal mucosa, regardless of the absence of clinical symptoms.

[Pathophysiologic mechanisms of functional disorders of the cardiorespiratory system in snoring]. / Patofizioloski mehanizam poremecaja funkcije kardiorespiratornog sistema pri fenomenu hrkanja.

Disturbances in the function of cardio-respiratory system due to nasal obstruction, accompanied by snoring, are described. Obstructions to other levels, oropharynx, pharynx and larynx, also inducing such disturbances are mentioned, with particular reference to snoring which may lead to the development of apnea during sleep. The need of a multidisciplinary approach to such patients is underlined, with a very specific role of the otorhinolaryngologist, especially when obstruction of the nose has caused such a disturbance. The act of snoring can be eliminated or diminished, and the development of obstructive apnea during sleep prevented or interrupted by accurate indications for and properly performed reconstructive surgery of the nose.

[Intubation lesions of the oropharynx, larynx and trachea]. / Intubacijske lezije orofarinksa, larinksa i traheje.

The authors examined and followed 104 patients who had undergone surgery under endotracheal anesthesia in order to recognize the lesions of the oropharynx and the larynx resulting from intubation and other manipulations within the oral cavity and the pharynx. Laryngoscopic examination disclosed: a hematoma of true vocal cords in 5 patients, hematoma of the aditus ad laryngem and soft palate in 1 patient, edema in 4 patients, and in 8 patients hematoma of the oropharyngeal mucosa. The patients reported the following post-extubation discomforts: sore throat, hoarseness, dysphagia, a feeling of burning, clenching or foreign body in the throat, rough throat, irritation to hacking cough, and pains in the cervical musculature. Laryngitis was singled out as a disorder found in an increased percentage in the study group, as compared to the literature data, for which an explanation is given.

Clinical and cytomorphological alterations of nasal mucosa in laryngectomized patients.

A group of laryngectomized patients were rhinoscopically examined. The nasal mucosa was found to become thinner and change its colour over time. The nasal mucosa swabs from the same patients were cytologically examined at various time intervals following laryngectomy, revealing degenerative alterations of the multi-layered epithelium that occurred as a consequence of the nose exclusion from its function due to laryngectomy. Our experience has shown these degenerative changes to be completed within a two-year post operative period, as indicated by the fact that both the clinical and cytological findings obtained after that time point remained practically unchanged.

Cytological and histological alterations in the nasal mucous membrane during experimental obstruction of nasal openings.

In an attempt to determine the respiratory nasal mucous membrane response, a complete surgical obstruction of both nasal openings was experimentally done in four dogs. The fifth animal served as a control. After a 5 month period, the mucous membrane was cytologically and histologically examined. The findings obtained pointed to the development of degenerative alterations involving all the mucous membrane layers. The authors have thus concluded that stimulation of the respiratory mucous membrane by air stream is the most important factor associated with its multiple functioning. The results obtained in the experiment have been related to the daily clinical routine.

Temporary artificial obstruction of the nose and changes in gas exchange in the blood.

A group of 31 subjects were subjected to complete artificial obstruction of the nose for a period of one hour. Their ages ranged from 14 to 16 years. Prior to the experiment the subjects were found to be healthy. During the nasal obstruction there was a fall in pO2 and an increase in pCO2 due to the hindered ventilation.