[The morphology of vocal fold polyps and mucosa in Reinke's edema].

OBJECTIVE: To investigate the morphogenesis of vocal fold polyps and Reinke's edema on the basis of clinical and morphological analyses of the histological and immunohistochemical data characterizing the state of the local microcirculatory bed and the mechanisms of its permeability impairment. SUBJECTS AND METHODS: Polyps of the vocal folds and their mucosal tissue samples in Reinke's edema mucosa, which had been obtained after microsurgical treatment of 31 patients (13 men and 18 women) aged 23 to 75 years, were studied using a wide panel of peroxidase-labeled monoclonal and polyclonal antibodies (DAB chromogen), including T and B cell differentiation markers, Toll-like receptors (TLR2, TLR4, and TLR9), the costimulatory molecule CD80 (B7- 1), and markers for angiogenesis (CD34), vascular and tissue permeability (matrix metalloproteinases (MMP-1 and MMP-9)), and vascular cell adhesion molecule-1 (VCAM-1). Results. All types of the examined polypoid hyperplasia were ascertained to realize through the impaired permeability of the wall of microcirculatory vessels in the membranous vocal fold portion called Reinke's space. The expression of molecules, such as CD34, VCAM-1, MMP-1 and MMP-9, as well as TLR4 and TLR9 was revealed on the endothelial cells of microcirculatory vessels. The epithelial lining cells simultaneously expressed the above-mentioned Toll-like receptors and the costimulatory molecule CD80 (B7-1) that modulated T cell lymphocyte activity (through CD28) or attenuation (through CTLA-4), ensuring the interaction of structures of innate and adaptive immunity. CONCLUSION: The morphogenesis of polypoid hyperplasia of the vocal folds is a result of an epithelial stromal interaction under poor etiological factors, such as high vocal loads, exogenic intoxications, and viral infections. The integumentary lining cells carrying Toll-like receptors initiate reactive alterations in Reinke's space.

[Chlamydial laryngitis: clinical picture and amixine treatment]. / Klinika i lechenie khlamidioznogo laringita s primeneniem amiksina.

Chlamydia trachomatis DNA was detected by PCR in 12 patients with continuously recurrent catarrhal pharyngolaryngitis. These included 9 males and 3 females whose age ranged 16 to 72 years. All the patients were found to have degrees II-III alpha- and g-INF deficiencies. The interferon inducer amixine in combination with sumamed was used in the treatment of patients with chlamydial laryngitis. After treatment, there was a significant improvement in two thirds of patients. The pain syndrome was relieved, hoarseness diminished, and the laryngoscopic and microlaryngostroboscopic picture and interferon status became normal. Control studies showed no Ch. trachomatis in this group of patients. Despite positive changes in the course of the disease, the control study again detected Ch. trachomatis in 4 patients, which required repeated treatment courses.

[The treatment of laryngeal papillomatosis with interferon inducers]. / Lechenie papillomatoza gortani induktorami interferona.

Seventy three patients aged 16 to 88 years who had laryngeal papillomatosis (LP) were followed up. Microsurgical endolaryngeal removal of laryngeal papillomas was made in all the patients. The interferon inducers amixine and cycloferon as antirecurrent drugs were used in 45 patients by the regime the authors developed by taking into account the interferon status and cellular immunity of patients. The criteria for the efficiency of treatment were their improved interferon status and longer remission. The efficiency of treatment with amixine and cycloferon was 72 and 80%, respectively. Thus, the use of a sparing microsurgical intervention in combination with interferon inducers may be regarded as the method of choice in the LP treatment.

[Microsurgical rehabilitation of patients with scar-induced deformities of the larynx]. / Mikrokhirurgicheskaia reabilitatsiia bol'nykh s rubtsovymi deformatsiiami gortani.

Having analyzed 58 cases of laryngeal scars (patients aged from 17 to 67 years), the authors divided them into 3 groups by depth of the lesion. Group 1 patients had adhesive process of the laryngeal mucosa, group 2 had scars and partial motility of the cricoarytenoid articulation, involvement of the laryngeal cartilaginous skeleton was registered in group 3 patients. 2-staged rehabilitation was performed: phonosurgery and orthophonic correction. Collagen injections were given according to the original technique. The orthophonic correction employs the effects of the biological feedback. The proposed policy is recommended for clinical practice.

[Implantation microsurgery in the phoniatric practice]. / Primenenie implantatsionnoi mikrokhirurgii v foniatricheskoi praktike.

The paper reports the results of teflon paste implantation into the vocal folds of 368 patients with laryngeal unilateral paralysis and scar deformities, atrophy of vocal muscles. Implantation of teflon paste polytef produces a high functional effect in unilateral laryngeal paralysis. 38 patients underwent implantation with collagen. The response of the adjacent tissues to collagen injection is minimal positively comparing to teflon. However, 10 patients needed more injections of liquid collagen 6-18 months following the initial administration because of collagen metabolism.

[Persistent dysphonia. Clinical and morphologic evaluation of marginal thickening of the vocal cords]. / Stoikaia disfoniia. Kliniko-morfologicheskaia otsenka kraevykh utolshchenii golosovykh skladok.

Microlaryngoscopic, video- and microlaryngostroboscopic findings were obtained for 160 patients with persistent functional dysphonia. A histological examination of the vocal cords with consideration of the disease history, clinical and stroboscopic picture has been conducted for 27 patients. A relationship has been revealed between the affection of the vocal cords mucosa and the disease duration.

[Videolaryngoscopy and videolaryngostroboscopy in phoniatrics]. / Primenenie videolaringoskopii i videolaringostroboskopii v foniatricheskoi.

Clinical applications of videolaryngoscopy (VLS) and videolaryngostroboscopy (VLSS) in phoniatrics were investigated. Altogether 150 patients with functional and organic lesions of the larynx and 50 normal subjects representing "voice" specialties were examined. Measurements of vibration, amplitude, frequency and oscillation asynchronicity of vocal cords yielded objective information about vibration in the norm and at pathology. VLS and VLSS can help identify functional and organic diseases of the larynx, document various pathological processes, evaluate the condition of the vocal apparatus, and compare pre- and postoperative laryngoscopic pictures. These methods can find application in training and therapeutic procedures for biofeedback purposes.

[Results of implantation of teflon paste into the vocal cord according to the data of light and electron microscopy]. / Rezul'taty implantatsii teflonovoi pasty v golosovye skladki po dannym svetovoi i élektronnoi mikroskopii.

Light and electron microscopy was used to study 5 observations of the tissue response to the teflon paste implanted into the vocal cords to modulate the vocal function. The study showed that teflon was not an absolutely inert substance, it produced inflammation as giant cell granuloma of foreign bodies. Giant cells of foreign bodies (GCFB) enclosing and resorbing the particles of teflon were found to have all the ultrastructural signs of actively phagocytizing cells presenting with various differentiation. The ultrastructure of GCFB provides support for the fact that the cells making up polykaryons belong to the system of mononuclear phagocytes.