ABSTRACT
Children's and adults' rhinosinusitis are two diseases that have both similarities and differences in anatomy, epidemiology, causes, pathogenesis, diagnosis and treatment. At the same rhinosinusitis is one of the most common in otorhinolaryngology's practice, both in children and adults. The of adults paranasal sinuses (PNS) anatomy differs from children's PNS anatomy. Although ostiomeatal complex occlusion is recognized as a major cause of poor ventilation and drainage of the adult paranasal sinuses, it does not have a strong effect on pediatric rhinosinusitis, but adenoids play a key role. Adenoids are bacteria and biofilms reservoirs that cause chronic refractory rhinosinusitis regardless of pharyngeal tonsil size. The prevalence of chronic rhinosinusitis (CRS) is lower in children than in adults. Diagnosis of children's rhinosinusitis is more difficult because nasal cavity endoscopic examination is performed rarely due to the occasional need of general anesthesia during the procedure. Moreover, it's necessary to take into account prevailing etiological role of viruses in ARS at children's age and chronic adenoiditis often accompanies pediatric CRS, which requires attention prescribing medical therapy as the basis of rhinosinusitis treatment. The DysheLORz based on Pelargonium sidoides roots is highly effective and safe for children's and adults ARS and CRS treatment, both as monotherapy and in combination with topical steroids and antibiotics. This herbal medicine immunomodulatory effect is mediated mainly by stimulating the production of TNF-α, IL-1, IL-12 and IFN-γ. It activates macrophages and improves their phagocytic activity. IL-12, together with TNF-α, enhances NK and cytotoxic CD8+ lymphocytes' activity against infected cells. IL-12 effect on Th1 lymphocytes maturation provides a link between innate and adaptive immunity. This is also increasing MCP-1, IP-10 and MIP-1ß chemokines synthesis and decreasing MIP-1α, ENA-78, GROα and IL-8 production in PNS and nasal mucosa. This leads to decrease of neutrophils chemotaxis to the inflammation site, and decline of serine proteases concentration (neutrophils main enzymes), that increases mucous membrane epithelial barrier permeability, reducing bacterial infections risk. Additionally, Pelargonium sidoides increases epithelial cells beating cilia frequency and inhibits hemagglutinin and neuraminidase present on influenza virus surface. The drug increases antimicrobial peptides production as defensins, human neutrophil peptides (HNP) and bactericidal permeability-increasing protein (BPI), which is also important for rapid inflammation regression in rhinosinusitis. It causes bacterial adhesion to epithelial cells inhibition, phagocytosis stimulation, nitric oxide (NO) release and oxidative burst. The medicine had a direct effect on Streptococcus pneumoniae, Staphylococcus aureus, Neisseria, Moraxella catarrhalis and Haemophilus influenza. Based on these data, it is possible to explain the high effectiveness and safety of the drugs based on Pelargonium sidoides in ENT organs inflammation treatment, for both adults and children over 1 year old.
Subject(s)
Rhinitis , Rhinosinusitis , Sinusitis , Adult , Humans , Child , Infant , Rhinitis/therapy , Rhinitis/drug therapy , Tumor Necrosis Factor-alpha , Sinusitis/therapy , Sinusitis/drug therapy , Nasal Mucosa , Inflammation , Interleukin-12/therapeutic use , Chronic DiseaseABSTRACT
Presented a clinical case of a rare localization amyloidosis of the larynx, simulating a tumor. Considered the features of diagnosis and treatment of this disease.
Subject(s)
Amyloidosis , Laryngeal Diseases , Larynx , Humans , Laryngeal NeoplasmsABSTRACT
In this article describe the clinical case of treatment of melanoma of the larynx mucous membrane.Presented the clinic, immunohistochemistrydiagnostics and methods of surgical treatment.
Subject(s)
Laryngeal Neoplasms , Melanoma , Humans , Laryngeal Mucosa , Laryngeal Neoplasms/diagnosis , Melanoma/diagnosis , Mucous MembraneABSTRACT
This article describes the observation of a clinical case of a vascular branched tumour (hemangioma) of the external ear with special reference to the clinical features and diagnostics of this condition and the methods for its surgical treatment.
Subject(s)
Blood Loss, Surgical , Ear Neoplasms , Ear, External , Hemangioma , Hemostasis, Surgical/methods , Sclerotherapy/methods , Vascular Surgical Procedures , Adolescent , Dissection/methods , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Ear, External/pathology , Ear, External/surgery , Female , Hemangioma/pathology , Hemangioma/surgery , Humans , Recurrence , Reoperation/methods , Treatment Outcome , Vascular Surgical Procedures/adverse effects , Vascular Surgical Procedures/methodsABSTRACT
The objective of the present study was to elucidate etiology and clinical picture of the tumours of the external ear as well as to evaluate the effectiveness of their radiowave surgery. We sought to optimize the surgical strategy for the treatment of tumour-like masses, benign and malignant neoplasms of the external ear with the use of the Surgitron radiowave scalpel.
Subject(s)
Blood Loss, Surgical/prevention & control , Ear Neoplasms , Ear, External , Otologic Surgical Procedures , Radiofrequency Therapy , Adult , Aged , Ear Neoplasms/diagnosis , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Ear, External/pathology , Ear, External/surgery , Female , Humans , Male , Middle Aged , Operative Time , Otologic Surgical Procedures/adverse effects , Otologic Surgical Procedures/instrumentation , Otologic Surgical Procedures/methods , Radiosurgery/adverse effects , Radiosurgery/instrumentation , Radiosurgery/methods , Treatment OutcomeSubject(s)
Ear Canal , Ear Neoplasms , Neoplasms, Second Primary , Otologic Surgical Procedures , Radiotherapy, Adjuvant , Aged , Combined Modality Therapy/methods , Ear Canal/pathology , Ear Canal/surgery , Ear Neoplasms/pathology , Ear Neoplasms/physiopathology , Ear Neoplasms/radiotherapy , Ear Neoplasms/surgery , Humans , Male , Neoplasms, Second Primary/pathology , Neoplasms, Second Primary/physiopathology , Neoplasms, Second Primary/radiotherapy , Neoplasms, Second Primary/surgery , Otologic Surgical Procedures/adverse effects , Otologic Surgical Procedures/methods , Radiotherapy, Adjuvant/adverse effects , Radiotherapy, Adjuvant/methods , Reoperation/methods , Treatment FailureABSTRACT
The addition of nebulizer therapy with antiedematous, steroid and mucolytic drugs to antibacterial therapy in patients with different forms of acute laryngitis was assessed. Basing on the main symptoms of the disease, three variants of nebulizer therapy were proposed. As shown by the results of treatment of 48 patients with catarrhal laryngitis, 19 patients with laryngeal angina and 27 patients with phlegmonous laryngitis, nebulizer therapy is highly effective in different forms of laryngeal diseases including purulent process with stenosis.