[The comparative effectiveness of framycetin included in combined therapy of adenoiditis in the children].

The objective of the present study was to evaluate the effectiveness of framycetin included in combined therapy of adenoiditis in the children. The study involved 67 children at the mean age of 6.9±2.7 years. Group 1 was comprised of 35 children given framycetin as topical therapy, the patients of group 2 were treated by the endonasal administration of a 2% silver proteinate solution. It was shown that the use of framycetin as a component of combined therapy of adenoiditis enhances the effectiveness of the treatment and compliance to therapy in comparison with the same parameters in the case of the application of traditional topical antibacterial preparations.

[Foreign bodies (disk batteries) in the nose].

This paper reports the results of analysis of the treatment of 8 children after the removal a disk battery from the nasal cavity. It was shown that the restoration of all the structures of the nasal cavity is possible if the foreign body remains in it during a short (up to 5 hours) time. The longer presence of such a body in the nasal cavity gives rise to post-traumatic defects, in the first place septal perforations and injuries to the inferior turbinated bone. In such cases, the foreign body must be immediately removed from the nasal cavity, and the child should be placed under thorough medical observation taking into consideration the long process of rejection of necrotic tissues and healing of the resulting defects.

[The effectiveness of propranolol therapy of subfold hemangioma in the children during the first year of life].

The objective of the present study was to estimate the effectiveness and tolerance of propranolol therapy prescribed to the children presenting with vascular hyperplasia of the larynx. The experience with propranolol therapy of 12 patients suffering vascular hyperplasia of the larynx (subfold hemangioma) is analysed. Nine of these children had been given systemic glucocorticoid therapy prior to the present study that failed to produce a clinically significant effect. On the contrary, the treatment with propranolol resulted in a well apparent clinical effect in the form of the marked decrease in the size of subfold hemangioma and the reduction in the degree of laryngeal stenosis from grade 2-3 to 0-1 as early as 10-14 days after the onset of propranolol therapy at a daily dose of 2 mg/kg. None of the patients developed adverse reactions related to the treatment with propranolol. The results of the study indicate that the treatment of vascular hyperplasia, such as subfold hemangioma with the non-selective beta-blocker propranolol is both efficacious and safe for the patients. This gives reason to recommend this therapeutic modality as the first-line treatment of the children starting from the first weeks of life.

[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.

[Epidemiological aspects of congenital stridor].

The objective of the present work was to study epidemiology of congenital stridor as a leading symptom of laryngeal malformation. The continuous sampling method was employed to perform the retrospective analysis of the growth charts of the patients attending three children's polyclinics in Moscow (9.625 patients born between 2005 and 2009). In addition, the medical histories of 4.623 newborn and breast-fed babies under the age of 1 year admitted to the Department of Newborn and Neonatal Pathology, Saint Vladimir City Children's Clinical Hospital, and 347 patients of the Department of Reconstructive Laryngeal Surgery were analysed. The children with the history of tracheal intubation in the preceding period were excluded from the study. The frequency of congenital stridor annually diagnosed in the aforementioned polyclinics varied from 0.17 to 5.8% compared with 1.5% in the general population. It was 2.21 to 3.14% (mean 2.47%) among the children treated at the Clinical Hospital. In the children under the age of 1 year, congenital malformations accounted for 90.8% of all laryngeal diseases. The principal cause of stridor was shown to be laryngomalacia. This pathology was diagnosed in 91.9% of the cases included in this study. In 11.2% of the patients, this condition occurred in combination with other congenital pathologies. It is concluded that the diagnosis of congenital stridor is an indication for laryngeal endoscopy regardless of the children's age starting from the first day of life. Meeting this recommendation allows the cause of stridor to be established and the treatment strategy to be developed on an individual basis.

[On the classification of vascular structures in children].

Vascular structures are a common childhood pathology that may cause not only the development of extensive cosmetic defects but also functional disorders of respiration, swallowing, vision, and hearing. These conditions not infrequently lead to severe disability and sometimes have a fatal outcome. The choice of the treatment modality depends on the type of the so-called "hemangiomas", the classification of these tumours remaining poorly developed. Our experience with the treatment of the children with these vascular structures (including those of "critical" localization) enabled us to propose a classification of vascular lesions according to which all vascular structures are subdivided into vascular hyperplasias, vascular malformations, and vascular tumour-like structures (both benign and malignant). It is believed that the rational use of this classification may be helpful for the choice of the adequate treatment strategies.

[The results of adjuvant therapy of juvenile recurring respiratory papillomatosis with the use of indole-3-carbinol].

The authors analyse the efficacy of anti-relapse therapy of juvenile recurring respiratory papillomatosis in 87 children aged from 2 to 15 years with the use of indole-3-carbinol. Prior to inclusion into this study, the patients underwent from 2 to 86 (mean 12 +/- 14) surgical interventions for the ablation of papillomas. The average interval between successive relapses of papillomas ranged between 2 weeks and 12 months (mean 4.9 +/- 2.33 months). The patients remained under observation in the clinic during 2 years--6 years 5 months (mean 44.8 +/- 15.93 months). The duration of therapy with indole-3-carbinol varied from 12 weeks to 2 years (mean 8.9 +/- 4.72 months). The stable remission of pathology was documented in 28.7% of the patients within the 2 to 6 year follow-up period. A significant (1.5-10-fold) increase in the duration of interval between successive relapses occurred in 41.1% of the children. In 29.9% of the patients, therapy produced no apparent clinical effect; 18.4% of them showed an insignificant shortening of the interval between relapses that remained unaltered in the remaining 11.5%. No adverse effects of the treatment were recorded. It is concluded that treatment with indole-3-carbinol can be recommended as a starting therapeutic modality for the management of juvenile recurring respiratory papillomatosis and the reduction of the intervals between relapses of the disease.

[Classification of the formations from blood vessels of maxillofacial region and neck in children].

Multidisciplinary group of investigators basing upon special literature study, analysis of their own observation (1168 cases) including retrospective for 20 years and with the help of several following methods - clinical, roentgenological, pathomorphological,immunohistochemical - picked out from wide group of the so called hemangiomas 3 types of lesions: hyperplasia, malformation, tumour and suggested their clinical biological classification. To each of lesion types characteristic was given.

[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.

[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.

[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.

[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.

[Peculiarities of gastroesophageal reflux disease course in children with diseases of the upper respiratory ways].

UNLABELLED: Data about patogenesis, clinical characteristics, diagnostics, treatment and the forecast of diseases of the upper departments of respiratory ways at children in a combination with gastroesophageal reflux disease (GRD) are presented proceed on the literature and own experience data. The purpose of ours research consisted in revealing of correlation dependence between GRD and chronic diseases of a throat at children. 77 children at the age of 5-16 years with the nonheritable cicatricial stenosis of a throat and cervical department of a trachea (n = 12), with small knots of vocal folds (n = 17), with dysphonia (n = 20) and with anticipate respiratory papillomatosis (n = 28) are surveyed. Reflux disease is diagnosed by means of the developed technique of pH-monitoring at which electrodes were established in hypopharynx, average and bottom departments of a gullet. RESULTS: at definitive rare frequency of clinical GRD signs at children with various variants of reflux disease in 74 cases (96,1%): GRD in a combination with pharyngolaryngeal a reflux (FR)---at 48 children (62,3 %), isolated FR---at 18 children (23,4 %), isolated GRD--in 8 cases (10,4 %). CONCLUSIONS: 1) correlation between chronic diseases of a throat at children and GRD is established; 2) in case of isolated FR often works protective alkalize gullet mechanism; 3) with chronic diseases of a throat it is expedient to include carrying out of daily pH-monitoring in the plan of inspection of children; 4) prospective FR participation in pathogenesis of chronic throat diseases demands carrying out of the further researches.

[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.

[Age-specific and etiological aspects of acquired laryngo-tracheal cicatricial stenosis in children]. / Vozrastnye i étiologicheskie aspekty priobretennogo gortanno-trakheal'nogo rubtsovogo stenoza u detei.

453 case histories of children with acquired laryngo-tracheal stenosis (LTS) have been analysed. Etiological factors of the disease, age at the moment of respiratory lesion, duration of the intubation were examined. LTS developed in the majority of patients (58.3%) within the first 3 years of life. At this age boys suffer from LTS 2.5 times more frequently than girls. The stenosis was caused by tracheal intubation in 86.1% children. The intubation resulted from acute stenosing laryngotracheobronchitis (47.5%), craniocerebral trauma (13.2%), operations (12.8%), acute pathology of CNS (6.8%). LTS in boys develops 3.1 times more frequently in tracheal intubation for acute stenosing laryngotracheobronchitis and 2.9 times more frequently in intubation for acute CNS pathology. In intubation for other reasons the stenosis rate does not depend on the gender. The statistical data obtained by the authors require further clinico-immunological investigations.

[Subglottic hemangioma as the cause of laryngostenosis in young children]. / Podskladkovaia gemangioma kak prichina stenoza gortani u detei rannego vozrasta.

In 1985 to 1996 we observed and treated 22 children (19 girls and 3 boys) with subglottic hemangioma. The children had pronounced clinical symptoms of rough and scraping breathing. Skin hemangiomas were found in 73% of patients. The diagnosis was made using microlaryngoscopy. Laser destruction (11 children) and cryosurgery (9 children) provided cure in the majority of relevant patients.

[Vascular neoplasms of the larynx, pharynx, and mouth cavity in children]. / Sosudistye opukholi gortani, glotki i polosti rta u detei.

41 children with vascular tumors of the larynx, pharynx and mouth cavity were examined in the hospital. Hemangiomas were found in 29, lymphangiomas in 11 cases, lymphemangioma in one child. The tumors had multiple location and in 22 patients were combined with dermal angiomatosis. The chief techniques of removing the above vascular tumors were cryosurgery and CO2-laser coagulation. Radiotherapy was applied in cases of extensive dermal angiomatosis. A good response was achieved in 37 cases, tumor growth persisted in one patient. One child died as a result of the disease progression, and one more child of an intercurrent disease.

[Prolonged nasotracheal intubation in the treatment of respiratory tract scarring stenosis in children]. / Prodlennaia nazotrakheal'naia intubatsiia pri lechenii rybtsovykh stenozov dykhatel'nykh putei u detei.

Prolonged nasotracheal intubation lasting 24-153 days was applied for treatment of 12 children with forming and already established scarry stenosis of the respiratory tracts. The children had not previously undergone tracheotomy. The age of the children varied from 20 months to 7 years. Two thirds of them were admitted at the age under 3. Nine patients have developed stenosis after intubation for acute stenosing laryngotracheobronchitis. The treatment provided rather wide lumen of the respiratory tract in 10 patients. Tracheostoma was established only in 2 children.