[The effectiveness of rinorin introduced in the combined treatment of chronic adenoiditis in the children].

This study was designed to analyse the effectiveness of combined treatment of chronic adenoiditis in the children with the use of rinorin (Orion, Finland) in comparison with the traditional methods for the management of this condition either combined with irrigation therapy or without it. The results of the study indicate that the application of rinorin enhance the effectiveness of the treatment due to the substantial reduction of the manifestation of clinical symptoms and the frequency of relapses. The patients describe rinorin as a modern convenient-to-use preparation superior to the traditional medicines for the treatment of adenoiditis which improved medication compliance.

[Laryngeal ultrasound studies: potential, prospects, limitations].

In the last years, laryngeal ultrasound has been finding increasingly wide application due to the growing availability of relevant up-to-date equipment, apparent technical simplicity and non-invasive character of the study. However, poor knowledge of the physical basis of this method coupled to ungrounded self-confidence of the operators and uncritical treatment of the obtained findings may lead to the overestimation of the diagnostic potential of this sonographic technique. This paper is focused on disadvantages of ultrasound examination of the larynx and associated acoustic artefacts that can be taken for true abnormal structures. Attempts at qualitative and quantitative interpretation of such images are fraught with wrong conclusions.

[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.

[Prevalence of human papilloma virus types and their influence on the course of the disease in children suffering from recurrent respiratory papillomatosis]. / Rasprostranennost' tipov virusa papillomy cheloveka i ikh vliianiia na techenie zabolevaniia u detei, stradaiushchikh retsidiviruiushchim respiratornym papillomatozom.

The type of human papilloma virus (HPV) was determined in 26 children aged between 1 year 10 months to 15 years 5 months suffering from recurrent respiratory papillomatosis (RRP). Polymerase chain reaction identified DNA of HPV type 6, 11, 16 and 18. HPV DNA was detected in all the patients including fifteen patients infected with HPV type 11; seven patients infected with HPV type 6; four children infected with HPV type 6 and 11. Types 16 and 18 of HPV were not detected. The analysis of RRP course has found that laryngeal papillomatosis runs a more aggressive course in cases with HPV type 11 infection than in those with HPV type 6.

[Immunity in children with aquired cicatricial stenoses of the larynx and cervical trachea. Communication 3. Condition of phagocyting immune system]. / Pokazateli immuniteta u detei s priobretennym rubtsovym stenozom gortani i sheinogo otdela trakhei. Soobshchenie 3. Sostoianie fagotsitiruiushchei sistemy immuniteta.

Macrophagal-phagocyting immunity was studied in 59 children with cicatricial acquired stenosis of the larynx and cervical trachea aged 1 year 9 months to 14 years 8 months. It was found that children with acquired cicatricial stenosis had a sharp depression of all functions of the cells of the macrophagal-phagocyting system (chemotaxis, absorptive, digestive, oxidation-reduction) as well as reduction of their number. This is, on the one hand, a defense reaction of the organism to continuous antigenic stimulation; on the other hand, this marks feasibility of progressive immunocomplex and/or autoimmune processes. The most prominent alterations were seen in patients with concurrent affection of the CNS.

[Immunity in children with acquired scarry stenosis of the larynx and cervical trachea. Communication 2. The status of T-cell immunity]. / Pokazateli immuniteta u detei s priobretennym rubtsovym stenozom gortani i sheinogo otdela trakhei. Soobshchenie 2. Sostoianie T-kletochnogo zvena immuniteta.

T-cell immunity was studied in 59 children (39 boys-66.1% and 20 girls-33.9%) with acquired stenosis of the larynx and cervical trachea at the age of 1 year 9 months to 14 years 8 months. Compromised T-cell immunity was revealed in the examinees, especially in those who had acute infectious-inflammatory diseases or CNS damage before critical care responsible for development of the stenosis. These changes in T-cell immunity should be considered as a factor of risk to develop immune and autoimmune diseases.

[Immunity in children with acquired scarred stenosis of the larynx and cervical trachea]. / Pokazateli immuniteta u detei s priobretennym rubtsovym stenozom gortani i sheinogo otdela trakhei.

Humoral immunity was studied in 63 children with acquired laryngotracheal stenosis 1 year 9 months to 14 years 8 months of age. The study discovered humoral immunity dysfunction which was most pronounced in patients who developed scary stenosis after critical care for acute stenotic laryngotracheobronchitis. It was found that if a child has allergy (atopy) in conduction of critical care requiring long-term nasotracheal intubation, he/she is at risk to develop scary stenosis.

[Characteristics of psychoemotional sphere in children with chronic laryngeal obstruction]. / Osobennosti psikhoémotsional'noi sfery u detei s khronicheskoi obstruktsiei gortani.

45 children from 10 to 14 years of age with chronic laryngeal obstruction were examined psychologically. 29 of them had recurrent respiratory papillomatosis, 16 ones had cicatrical laryngostenosis. The majority of the examinees (65%) showed symptoms of posttraumatic stress syndrome (PTSS). The children develop PTSS one-two years after onset of laryngeal obstruction. Later, the children underwent persistent specific maladaptation personality disorders. Thus, children with recurrent laryngeal papillomatosis, especially with cicatrical laryngostenosis, should undergo psychological correction.