[Etiopathogenetic factors of wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea]. / Etiopatogeneticheskie faktory zazhivleniya rany pri khronicheskikh postintubatsionnykh rubtsovykh stenozakh gortani i trakhei.

Despite the existing modern high-tech methods of examination and a variety of surgical treatment methods, the problem of diagnosis, treatment and rehabilitation of patients with chronic post-intubation cicatricial stenosis of the larynx and trachea still requires further study. Improving the understanding and correction of cellular, molecular genetic and biochemical disorders in a chronic wound is a key condition for increasing the efficiency of diagnosis, individual prognosis of the clinical course and the conduct of adequate therapeutic and preventive measures for post-intubation cicatricial laryngotracheal stenoses. In this regard, it seemed appropriate to analyze the existing etiopathogenetic factors of pathological wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea. Our attempt to summarize the available literature data demonstrated that laryngotracheal scars are a fibro-proliferative disease caused by aberrant wound healing after a damaging effect on the tissues of the larynx and trachea. The article describes the most pathogenetically significant healing, repair, and scarring factors in post-intubation laryngotracheal stenoses, including transforming growth factor ß1, vascular growth factor A, type I and III collagen, and matrix metalloproteinases. An assessment of the features of the diagnostic and prognostic significance of these markers will increase the effectiveness of the treatment of patients with chronic cicatricial stenosis of the larynx and trachea, and will also serve as a prerequisite for the development of strategies for diagnostic, treatment, prophylactic and rehabilitation measures that will improve the quality of medical care and the quality of life of patients with chronic cicatricial stenosis of the larynx and trachea.

[Features of microsurgery of the vestibular larynx using CO and a diode laser]. / Osobennosti mikrokhirurgii vestibuliarnogo otdela gortani s ispol'zovaniem SO2-lazera i diodnogo lazera.

The purpose of the study was to evaluate the possibility of using and the effectiveness of CO2 and diode lasers in the microsurgery of the vestibular larynx. 85 surgical interventions were performed (using CO2 laser - 45, diode - 40) on the vestibular larynx of 52 patients (papillomatosis, cicatricial stenosis, cysts, hyperplastic laryngitis, initial stage of laryngeal cancer). The complications, duration of the intervention and inflammatory changes after the operation were assessed. In 3 (3.5%) cases, the use of CO2 laser was complicated by bleeding. The duration of the intervention with the use of a CO2 laser averaged 24±5.6 minutes, with a diode laser 30±5.4 minutes (p<0.05). In patients with a diode laser, edema, mucosal congestion, fibrin and pain were significantly longer than patients after using a CO2 laser (p<0.05). Thus, the use of CO2 laser in the surgical treatment of the vestibular laryngeal region occurs with less time, a less prolonged inflammatory response, but in some cases requires additional methods of hemostasis.