Recurrent tonsillitis and tonsillectomy in juvenile idiopathic arthritis.

OBJECTIVES: To compare the clinical and bacteriological features of recurrent tonsillitis between patients with and without juvenile idiopathic arthritis (JIA). METHODS: A total of 122 participants, aged 2-18 years, were consecutively recruited into four groups: (i) JIA and recurrent tonsillitis; (ii) JIA; (iii) recurrent tonsillitis; and (iv) healthy. All the patients with recurrent tonsillitis underwent tonsillectomy. Swabs from tonsillar surface crypts of all children and samples from tonsillar core tissue in case of tonsillectomy were processed for culturing. Mycoplasma pneumoniae was determined by polymerase chain reaction (PCR). RESULTS: Significantly lower rates of recurrences but more frequent tonsillar detritus, paratonsillar scars, and more intensive bleeding during tonsillectomy were found in patients with JIA and recurrent tonsillitis, versus patients with recurrent tonsillitis without arthritis. In JIA patients with recurrent tonsillitis, Staphylococcus aureus was cultured from the tonsillar surface in 36%, and from the core tissue in 92% of cases (p = 0.0000). In patients suffering from recurrent tonsillitis alone, this pathogen was cultured from the core in 55.9% of cases (p = 0.0066 compared to JIA patients with recurrent tonsillitis). No M. pneumoniae was revealed by PCR in samples from the tonsillar surface and the core tissue. CONCLUSIONS: The increased rate of S. aureus in the core tissue of tonsils, the higher frequency of tonsillar detritus, the more pronounced paratonsillar scarring, and more intensive bleeding during tonsillectomy, associated with the lower frequency of tonsillitis recurrences, are characteristic for recurrent tonsillitis in JIA as compared to recurrent tonsillitis without arthritis.

Clinical otosclerosis and auditory exostoses in ancient Europeans (investigation of Lithuanian paleoosteological samples).

The purpose of this investigation was to establish the incidence of clinical otosclerosis and auditory exostoses in Lithuanian paleopopulations. The total sample consists of 4080 skulls, dating from the Neolithic to the C17th-C18th A.D., investigated visually, under magnification and radiologically. Eight cases of clinical otosclerosis and 22 of auditory exostoses were identified. The general epidemiology of otosclerosis (0.19 +/- 0.08 per cent) was established to be similar to contemporary populations. This suggests that there are no new aetiological factors attributable to our modern society. Clear diminution of the incidence of auditory exostoses from the 1st to the 2nd millenium A.D. (3.46 +/- 0.76 per cent, against 0.06 +/- 0.04 per cent, p < 0.001) and definite sexual differences (males: 1.21 +/- 0.28 per cent; females: 0.17 +/- 0.10 per cent, p < 0.001) were also noted. In general, auditory exostoses were found much more frequently than in recent populations.

[Early detection of the neurosensory component of hearing loss in patients with adhesive otitis media]. / Rannee vyiavlenie neirosensornogo komponenta tugoukhosti u bol'nykh adgezivnym srednim otitom.

Thirty patients with adhesive otitis media and 10 otologically normal subjects were examined audiometrically in a wide frequency range according to Sagalovich. It was found that this kind of audiometry may help detect early symptoms of hearing impairment on a neurosensory basis which remain unobservable in conventional audiography. It was demonstrated that hearing threshold increments in a wide frequency range correlated with the shape of the curve of bone conductivity in conventional audiography. The hearing changes in a wide frequency range were dependent on the primary disease duration and were independent of the bone-air interval value in conventional audiography. Our investigations allow the conclusion that measurement of hearing sensitivity in a wide frequency range under the conditions of bone conductivity enlarges the capabilities of current tonal audiometry and opens up new perspectives for assessing the hearing level of patients with adhesive otitis media.