[The effectiveness comparison of various conservative treatment options of nasopharyngeal inflammation in children]. / Sravnenie effektivnosti razlichnykh variantov konservativnogo lecheniya vospaleniya glotochnoi mindaliny u detei.

The problem of hyperplasia/inflammation of the structures of the Pirogov-Waldeyer lymphoid-pharyngeal ring and related complications is one of the most frequently discussed in pediatric practice, in particular in matters of methods and expediency of conservative treatment. The article describes the effectiveness of various regiment of conservative treatment of pediatric patients with inflammation of the pharyngeal tonsil (adenoiditis) based on the results of an open comparative observational study. OBJECTIVE: To compare the effectiveness of various schemes of conservative therapy of adenoiditis in children. MATERIAL AND METHODS: 154 patients were divided into three groups: group I - standard therapy; group II - standard therapy + a specially developed homeopathic protocol; group III - a specially developed homeopathic protocol. At each of the visits (day 0th, 7th, 30th, and 90th), ENT-organs endoscopy and a 10-point visual assessment of symptoms were performed by analog score. The effectiveness of treatment (day 7th, 30th, and 90th) was evaluated by both doctors and patients. RESULTS: Analysis of the results showed that the symptoms of adenoiditis were stopped most quickly (day 7th) in patients of group I, but more pronounced and prolonged positive dynamics was noted in comparison groups II and III (only in these groups parents/legal representatives of patients rated the effectiveness as recovery in 25% and 35%, respectively). CONCLUSION: Conservative treatment of adenoiditis: has a positive effect (the severity and duration depends on the therapy regimen); avoids adenotomy, especially in patients who have taken homeopathic medications as a part of combined therapy. The use of a standardized homeopathic protocol is possible, both in combination with the use of other medications, and as monotherapy. Against the background of taking homeopathic medications, undesirable side effects may occur, which the parents of patients should be informed about in advance.

[The role of group A ß-hemolytic streptococcus in the etiology of acute inflammatory pathology of the pharynx in children and adolescents]. / Rol' ß-gemoliticheskogo streptokokka gruppy A v étiologii ostroi vospalitel'noi patologii glotki u detei i podrostkov.

Group A ß-hemolytic streptococcus (GABHS) is the most important bacterial agent in the genesis of acute inflammatory conditions of the pharynx due to the possible development of local and systemic complications. During the seasonal increase of incidence of respiratory viral infections, the possibility of viral-bacterial co-infection is often not taken into account. AIM: Determine the incidence of GABHS in children with catarrhal symptoms (rhinorrhea, cough) and without them. MATERIAL AND METHODS: 69 children with signs of acute tonsillopharyngitis (ATP) in the first 2 days of the disease were examined. Patients were divided into 2 groups depending on the presence or absence of rhinorrhea and cough. All patients underwent a comprehensive otorhinolaryngological examination and bacteriological examination of smears from the surface of the posterior pharyngeal wall and lacunae of the tonsils. Obtained data was processed by basic statistical methods. RESULTS: Incidence of GABHS in children with ATP without catarrhal symptoms was 9.5%, with rhinorrhea and cough - 3.7%. Median age for the detection of GABHS in patients with ATP was 5.6 years. A statistically significant symptom of GABHS-positive patients in our study was the enlargement of the anterior cervical lymph nodes; plaques on the tonsils were found only in 20% of cases. CONCLUSION: GABHS is predominant in patients with ATP without catarrhal phenomena, however, the presence of rhinorrhea and coughing in a patient does not exclude the possibility of the presence of GABHS infection, therefore, patients with ATP should undergo an objective examination for GABHS.

[Paracentez]. / Paratsentez.

In this article, we present the analysis of the data of the specialized literature and the results of our own observations on the use of paracentesis in the treatment of acute suppurative otitis media. We highlight a method for diagnosing acute otitis media, which makes it possible to determine the rational algorithm of treating this disease - digital videootoscopy. Common methods of procedures aimed at draining the tympanum in acute purulent otitis media, such as tympanic membrane puncture, myringotomy, tympanostomy, tympanocentesis, and the differential approach to these methods of surgical treatment of the disease are discussed. The very concept of paracentesis is specified, the history of this surgical intervention is presented. Authors described the technique and features of paracentesis, a number of indications for its implementation, possible complications of surgical intervention and their causes. The risk of developing a chronic pathological process after the use of paracentesis or, conversely, due to the rejection of this manipulation during acute inflammation in the middle ear is assessed.

[The specific features of the clinical course and the treatment strategy in the children presenting with viral sinusitis]. / Osobennosti klinicheskogo techeniia i taktiki vedeniia detei s virusnym sinusitom.

The objective of the present study was to elucidate the peculiar features of acute viral and bacterial sinusitis in the children and to elaborate the algorithm for their treatment based on the results of the primary clinical and laboratory examination. As many as 224 children at the age varying from 1-17 years suffering from acute sinusitis were enrolled in the study. The following methods were employed for the purpose of the study; the analysis of the medical histories of the patients, general examination by an otorhinolaryngologist, diagnostic endoscopy of the nasal cavity and nasopharynx, radiological studies and computed tomography of the paranasal sinuses, echosinusoscopy, the comprehensive microbiological and virological investigation, and evaluation of the peripheral blood characteristics. The study allowed to elucidate the main clinical specific features of acute sinusitis of different etiology including the virological one. The scoring system for the estimation of the risk of development of acute bacterial sinusitis was proposed and the algorithm was developed for the treatment of the children suffering from acute sinusitis to be used in the practical work by general practitioners and otorhinolaryngologists.

[The specific features of the clinical course of acute suppurative otitis media of viral and mixed viral-bacterial etiology in the children of the preschool age]. / Klinicheskie osobennosti techeniia ostrogo srednego gnoinogo otita virusnoi i virusno-bakterial'noi étiologii u detei doshkol'nogo vozrasta.

The objective of the present study was to elucidate the spectrum of the pathogenic agents responsible for the development of acute suppurative otitis media in the children of the preschool age and to reveal the specific clinical features of this disease depending on its etiological factors. The study involved 138 patients (186 ears) of either sex at the age from 1 year to 84 months who presented with acute suppurative otitis media. The following methods were employed for the purpose of the study: analysis of the patients' complaints and the past medical histories, examination of the ENT organs, microbiological (bacteriological and virological) studies of secretion from the tympanic cavity, diagnostic endoscopy of the nasal cavity and nasopharynx, laboratory investigations. The study allowed to reveal the characteristic clinical manifestations of the pathology of interest depending on its etiology.

[Polypous pansinusitis with the deformation of the external nose in a 8 year-old child presenting with the primary ciliary dyskinesia syndrome]. / Polipoznyi pansinusit s deformatsiei naruzhnogo nosa u rebenka 8 let s sindromom pervichnoi tsiliarnoi diskinezii.

This article reports a rare observation of the development of chronic polypous pansinusitis with deformation of the external nose in a 8 year-old child presenting with primary ciliary dyskinesia syndrome. The patient underwent multiple surgical interventions in the preceding period. The key argument in favour of the definitive diagnosis was the results of investigation of ciliated epithelium biopsy taken from the nasal cavity and bronchi in combination with the data obtained by diagnostic endoscopy of the nasal cavity and nasopharynx supplemented by computed tomography. The proposed treatment strategy including endoscopic endonasal pansinusotomy, antibacterial therapy taking into consideration the sensitivity of the seeded microorganism, and hormonal therapy proved optimal for the management of the given patient.

[The size of the vocal folds in the children during the first years of life].

The objective of the present study was to determine the size of the vocal folds in the children during the first several years of life. The study included 137 children at the age from the birth up to 3 years who were referred to our clinic for the pre-planned surgical intervention with the use of endotracheal intubation. The length and the width of the vocal folds from the muscle tubercle to the anterior commissure in abduction were measured using a probe specially designed and adapted for this purpose. In all the cases, the endoscope was positioned at the same distance from the vocal folds. The fold length (ab) and width (cd) were expressed in millimeters. These parameters were measured in the following age groups of the patients: from the birth to 1 month 29 days (group 1), from 12 mo to 23 mo 29 d (group 2), from 24 mo to 35 mo 29 d (group 3), and above 36 months (group 4). The length and the width of the vocal folds varied from 2.6 mm to 7.8 mm and from 1.3 mm to 3.2 mm respectively. The length of the vocal folds increased at a rate of 1.025 mm per year showing marked variations within each age group, from the maximum value of 1.79 mm during the second year of life to the minimum of 0.48 mm during the fourth year. The authors conclude that these data may be of use for the improvement of the quality of the surgical treatment and subsequent rehabilitation of the respiratory and voice-generating functions of the larynx.

[The state of the nasal cavity and paranasal sinuses in the children presenting with congenital cleft of upper lip and palate].

The objective of the present study was to evaluate the state of the nasal cavity and paranasal sinuses in the children presenting with congenital cleft of upper lip and palate (CLP). A total of 23 children at the age from 9 to 16 years who had undergone the surgical treatment of the above malformations during the first year of life were examined. The comprehensive study including routine ENT examination, endoscopic examination of the nasal cavity and nasopharynx, and computed tomography has demonstrated that 50% of the patients with congenital cleft of upper lift and palate suffered the deflection of the nasal septum associated with hyperplasia of inferior turbinal bones. The children with congenital cleft of upper lip and palate were characterized by enhanced pneumatization of the anterior end of the middle turbinate despite the absence of well apparent differences between their paranasal sinuses and those of the healthy children, with the degree of pneumatization being consistent with the patient's age in both groups.

[The application of digital video-otoscopy for diagnostics of various forms of otitis in the children]. / Tsifrovaia videootoskopiia v diagnostike razlichnykh form otita u deteĭ.

Digital video-otoscopy (DVO) is one of the modern high-tech methods for otiatric diagnostics that allows to enlarge the image of the area being examined, i.e. the otoscopic picture. DVO has been shown to facilitate the objective dynamic observation of the clinical course of the disease by means of photo- and videodocumentation of he changes in the tympanic membrane and other otoscopicstructures. The DVO technique makes it possible to substantially improve the quality of diagnostics, detect the middle ear conditions at the early stagesof their alteration, and choose the optimal strategy for the continued conservative and/or surgical treatment.

[Ciliary epithelium and topical decongestants: how to minimize the undesirable events?].

The objective of the present study was to evaluate the influence of the combination of 0.1% xylometazoline with seawater (Rinomaris, "Jadran", Croatia) on the state and functional activity of the ciliary epithelium of the nasal cavity. The results of the study confirm the safety of this treatment and the possibility of its application in routine clinical practice.

[Potentialities of conservative therapy of vocal disorders in children].

The article concerns problems of classification and treatment of various vocal problems in children, presents treatment outcomes in patients with functional and organic dysphonia using complex homeopathic drugs.

[Infantile cerebral paralysis: modern approach to diagnosis and correction of hearing problems].

The article describes clinical forms of infantile cerebral paralysis, provides the results of examination of the acoustic function in infants with introduction of modern techniques (otoacoustic emission, acoustic impedance technique, acoustic evolved potentials).