The Efficacy of Paraprobiotic Lozenges (Lactobacillus helveticus MIMLh5) for the Prevention of Acute and Chronic Nose and Throat Infections in Children.

Background and Objectives: Tonsillitis is common in children and is predominantly caused by viruses and, less frequently, by bacteria such as group A beta-hemolytic streptococcus. The treatment primarily involves supportive care; however, the overuse of antibiotics remains a concern due to rising antibiotic resistance. Probiotics, particularly Lactobacillus strains, have been shown to modulate immune responses, offering a potential alternative treatment. Materials and Methods: Our prospective single-arm, open-label study included 98 pediatric patients aged 5-15 years with recurrent throat and tonsil infections, from October 2022 to January 2023. Patients received lozenges containing heat-killed Lactobacillus helveticus MIMLh5. Monthly follow-ups involved a comprehensive ear, nose, and throat examination, throat cultures, and recording the frequency of infections and antibiotic use. Data were analyzed using SPSS 29.0, with statistical significance set at p < 0.05. Results: After three months, significant reductions were observed in the occurrences of nose and throat infections (p < 0.001), enlarged submandibular glands (p < 0.001), and positive throat cultures (p < 0.001). Antibiotic and corticosteroid prescriptions also significantly decreased (p < 0.001). Among children aged 5-10 years, significant improvements were noted in throat and tonsil infections (p < 0.001) and positive throat cultures (p = 0.012). Overall, there was a substantial reduction in school days missed (p < 0.001). Conclusions: The use of paraprobiotic Lactobacillus helveticus MIMLh5 lozenges significantly reduced the incidence of recurrent throat and tonsil infections in children, decreased the need for antibiotics and corticosteroids, and improved overall clinical outcomes without adverse effects. These findings support the use of paraprobiotic supplements as a safe and effective preventive measure for pediatric throat and tonsil infections.

[Application of fascia of the temporal muscle and cartilage of the auricular tragus in myringoplasty in children].

INTRODUCTION: Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infection and loss of hearing. OBJECTIVE: The aim of this study was to analyze the application of different reconstructive materials in surgical technique myringoplasty. METHODS: We performed 88 myringoplasties due to auricular tragus perforation in 76 children (aged 4 to 16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and the site of perforation, status of the contra lateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels and postoperative complications were recorded and analyzed. In performing myringoplasty we used fascia of the temporal muscle and cartilage of the auricular tragus. RESULTS: In 43 (48%) patients we used fascia of the temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft success was defined as an intact eardrum at 12 months postoperatively and improvement in the perception of air-bone gap of 10 dB, which we recorded in 73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases with the temporal fascia. CONCLUSION: Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, exept for young age, differences between the two groups did not reach the level of statistical significance.

[Surgical treatment of nasal septal deviation (septoplasty) in children].

The aim of this study was to indicate the importance of surgical treatment of nasal septal deviation in children as early correction of functional and cosmetic nose deformities. In this study, we presented 76 children, from age of 7 to 15, who were surgical treated for the reason of nasal septal deviation starting from January 2001. to December 2009. There were 48 (63%) male and 28 (37%) female patients. The lowest number of patients were between 7 and 9 years old--5 (6.5%), between 10 and 12 years--28 (37%) and 43--(56.5%) between 13 and 15 years. Only 7 (9%) patients indicated genetics inheritance, and 11 of them (14%) could not determine the exact cause of deviation origin. References taken from the parents showed that nasal septal deviation developed like consequence of injury in 58 (76%) cases. We used closed technique of septoplasty with hemitransfictional incision and sub mucosal resection. Deviated portion of septum was completely removed. Patients felt improvement in nose breathing in 65 (85%) cases. The most often complication was nasal obstruction in 6 (8%) cases which occurred due to the insufficient removal of deviated portion. We also had a septal perforation in one and abscess of nasal septum in another case. There were no esthetic deformities.Surgical treatment of nasal septal deviation in children must to be conservative and limited on injured part of septum. After the operation nose breathing significantly improved, without consequences on esthetic appearance or the growth of central part of a face.