[The influence of an isotonic solution containing benzalkonium chloride and a hypertonic seawater solution on the function of ciliary epithelium from the nasal cavity in vitro].

The objective of the present study was to evaluate the influence of an isotonic saline solution containing benzalconium chloride and of a hypertonic seawater solution on the function of ciliary epithelium in the nasal cavity in vitro. To this effect, we investigated the cytological material obtained from 35 children presenting with adenoid tissue hypertrophy. The tissue samples were taken from the nasal cavity by the standard method. A cellular biopsy obtained from each patient was distributed between three tubes that contained isotonic saline solution supplemented by benzalconium chloride (0.1 mg/ml), a hypertonic seawater solution, and a standard physiological saline solution. It was shown that the number of the viable cells in both isotonic solutions was statistically comparable and significantly higher than in the hypertonic solution (p<0.05). The ciliary beat frequency of the cells embedded in the two isotonic solutions was not significantly different but considerably exceeded that in the hypertonic seawater solution (p<0.05). Thus, the present study has demonstrated the absence of the ciliotoxic influence of isotonic saline solution containing benzalconium chloride at a concentration of 0.1 mg/ml and the strong ciliotoxic effect of the hypertonic seawater solution. This finding gives reason to recommend isotonic solutions for the regular application whereas hypertonic solutions can be prescribed only during infectious and/or inflammatory ENT diseases.

[Hoarseness patterns in children].

The objective of the present work was to study the structure of voice disorders in children depending on the methods chosen to diagnose dysphonia. Medical histories of 1,451 children at the age varying from 2 months to 16 years were analysed. All of them were patients hospitalized for the first time between 1997 and 2007 to treat hoarseness caused by vocal cord nodules, functional or mutational dysphonia, chronic laryngitis, vocal cord paresis/palsy, recurring respiratory papillomatosis, vocal cord cystitis, and cicatrical laryngeal stenosis. It was shown that vocal cord nodules and functional dysphonia diagnosed in 53.1% and 12.2% of the children were the main causes of voice disturbances. The former condition was especially common in boys aged from 7 to 12 years engaged in intense sports activities while the latter prevailed in 5 to 12 year-old girls studying singing. It is concluded that measures are needed to increase awareness of both parents and teachers of psycho-emotionally labile children about causes of hoarseness and methods of its diagnosis. The use of the fibrolaryngoscopic technique makes it possible to elucidate the cause of dysphonia in children of any age starting from the first days of postnatal life.

[Recurrent respiratory papillomatosis: update review].

This paper updates information on epidemiology, etiology, clinical features, surgical and anti-relapse treatment of recurrent respiratory papillomatosis in children.

[Infection of the upper respiratory tract with human papilloma virus in children without clinical signs of respiratory papillomatosis].

The objective of this study was to evaluate the frequency of infection of pharyngeal mucosa, palatal and pharyngeal tonsils with types 6, 11, 16, 18, 31, and 33 human papilloma virus (HPV). A total of 57 children (30 boys and 27 girls) aged from 2 yr 10 mo to 14 yr 5 mo (mean 82+/-28.9 months) were examined. The patients were hospitalized for preplanned adenotomy, tonsillotomy or tonsillectomy. None of them exhibited clinical signs of recurrent respiratory papillomatosis. DNA of HPV was detected by means of the polymerase chain reaction (PCR assay) in mucosal cells obtained by scraping from the posterior pharyngeal wall (57 samples) and in biopsies from palatal (8 samples) and pharyngeal (52 samples) tonsils. The presence of HPV DNA was documented in 24 of the 57 (42.1%) children. In was found in ten (17.5%) samples from mucosal cells of the posterior pharyngeal wall, in pharyngeal tonsil biopsies from 16 of the 52 (30.8%) children, and in palatal tonsil biopsies from one of the 8 (12.5%) patients. Type 6 HPV was identified in 8 (14%) children, type 11 HPV in 1 (1.7%), type 16 HPV in 5 (8.8%), type 31 in 4 (7%), and type 33 in 12 (21%) patients. None of the samples contained type 18 HPV. Two types of HPV were simultaneously found in 4 (7%) children and three types in one patient. The frequency of HPV infection was comparable in children of preschool and school age.

[Gastroesophageal reflux disease and pharyngolaryngeal reflux in children with chronic laryngeal pathology].

A prospective non-randomized trial was made to evaluate incidence of gastroesophageal reflux disease (GERD) and pharyngolaryngeal reflux (PLR) in children with chronic laryngeal pathology. A total of 46 children aged 6 to 15 years were examined including 16 patients with recurrent respiratory papillomatosis, 15 patients with acquired laryngotracheal scarry stenosis and 15 patients with vocal nodules and functional dysphonia. Combination of GERD with PLR is a factor of risk for scarry laryngostenosis in a child with recurrent respiratory papillomatosis. If it is impossible to perform 24-h pH-monitoring of the esophagus for detection of GERD or PLR in patients with chronic laryngeal pathology, antireflux therapy is prescribed empirically. It is necessary to establish significant diagnostic criteria of PLR.

[Efficacy of indinol in antirecurrence therapy of juvenile respiratory papillomatosis].

The study of indinol efficacy in antirecurrence therapy of respiratory papillomatosis was performed in 46 children aged 2-14 years. The treatment lasted at least 12 weeks. Duration of a recurrence-free period before and after indinol administration was analysed. The response was observed in 30 (65.2%) patients. In 5 (10.9%) patients the remission continued from 2 to 3 years 10 months. In 25 (54.3%) patients recurrence-free period increased 1,5-6-fold. Side effects were not registered. Simple in use, cheap, well tolerated, usable with other treatments, indinol is recommended as a method of choice in antirecurrence treatment of recurrent respiratory papillomatosis.

[Papillomatosis of the lower respiratory tracts in children].

Papillomatosis of the trachea, bronchi and lungs was investigated in 40 children with papillomatosis of the lower airways in comparison with 408 children with laryngeal papullomatosis. All the patients were operated in 1988-2003 with histological verification of the diagnosis. Papillomas involved the lower airways because of tracheotomy (92.5%) or tracheal intubation (7.5%). Papillomatosis of the lower airways runs a more aggressive course than laryngeal papillomatosis, its treatment efficacy is worse. All the patients suffering from laryngeal papillomatosis with a history of tracheotomy need a regular endoscopic and x-ray control as papillomatosis of the trachea and/or lungs may develop in them several years after decanulation. Pulmonary papillomatosis has an invariably poor prognosis.