[Surgical treatment of postintubation stenosis of the larynx in children]. / Khirurgicheskoe lechenie postintubatsionnykh stenozov gortani u detei.

Post-intubation laryngeal stenosis is the most common cause of upper respiratory obstruction in children. According to published data, the incidence of post-intubation stenosis ranges from 0.1 to 20%. Treatment of children with chronic laryngeal stenosis is a special branch of respiratory surgery. It remains one of the most complex and urgent problems in pediatrics, pediatric otorhinolaryngology, and pediatric surgery. Although numerous studies have described various methods for treating stenosis of the infraglottic space, there is no standard management approach. Currently, there are two main treatment methods: endoscopic interventions and open reconstructive surgery. Each method has its benefits and drawbacks. Despite the use of various techniques, the effectiveness of cicatricial laryngeal stenosis repair and decannulation in children is 63-64%, according to published data. With combined lesions of infraglottic and vocal cord parts of the larynx, especially with their cicatricial obliteration, reconstructive surgery is successful only in 50% of cases. Thus, treating children with post-intubation respiratory stenosis remains a complex problem and is a relevant direction for further research.

[Features of sleependoscopy in children]. / Osobennosti slipendoskopii v detskom vozraste.

OBJECTIVE: To describe the technique and determine the indications for sleep endoscopy in children. MATERIAL AND METHODS: This study included 35 children, the average age of 5 years 1 month ± 3 years 4 months (from 1 year 6 months to 14 years 5 months). All children underwent standard polysomnography and sleep endoscopy. RESULTS: According to polysomnography, severe obstructive sleep apnea (OSA) was diagnosed in 21 children, moderate - in 8 children and mild - in 6 children. Sleep endoscopy revealed that in most cases in unoperated children (about 70%), adenoids and palatine tonsils were the cause of obstruction. In the group of children, who previously underwent surgery for OSA, the causes of residual apnea more often were soft palate and palatine tonsils. In 5 of 8 children, tonsils pharyngoscopy size did not exceed the 1st degree. In 1 child after adenotonsillectomy, the hypertrophic tori tubarii were the cause of obstruction. Another rare cause of upper airway obstruction, lingual tonsil hypertrophy, was found in 2 primary patients. CONCLUSION: Sleep endoscopy is a safe and useful method that makes it possible to determine the level of obstruction in children and to plan the optimal amount of surgical treatment.

[The immunological consequences and risks of adenoidectomy]. / Immunologicheskie posledstviia i riski adenotomii.

The objective of the present review article was the analysis of the potential risks and negative consequences associated with the surgical treatment of adenoids and the comparison of the potential harm to health and effectiveness of adenoidectomy for the children. It is concluded, based on the currently available information, that adenoidectomy provides an efficient surgical method for the management of the problems associated with adenoid pathology. The application of this technique based on the proper medical indications has no adverse effects on the children's health conditions and the mechanisms of immune protection. Moreover, it contributes to the improvement of the quality of life of the patients, fosters their physical and mental development.

[The state of the stirrup prosthesis estimated from the results of functional multispiral computed tomography].

The objective of the present study was to estimate the state of the stirrup prosthesis based on the results of functional multispiral computed tomography (fMSCT). A total of 30 patients suffering otosclerosis and treated by stapedoplasty were examined using the modified fMSCT technique developed by the authors. The data obtained were compared with the results of the audiologic study. It was shown that modified fMSCT makes it possible to objectively and visually estimate the state of the stirrup prosthesis, elucidate the causes of poor outcome of the surgical treatment and identify the indications for the second operation. The study has demonstrated that a more pronounced decrease of the air-bone gap (ABG) is associated with a rise in the amplitude of prosthesis movements whereas the degree of reduction of bone conduction does not significantly correlate with the depth to which the prosthesis reaches into the vestibulim.

[The use of functional multispiral computed tomography for differential diagnostics of otosclerosis and congenital malformation of the internal and middle ear (a case report)].

This paper reports a rare clinical observation of congenital malformation of the internal and middle ear diagnosed with the help of functional multispiral computed tomography (fMSCT). The patient presenting with conductive hearing loss was suspected to have otosclerosis. However, the use of fMSCT made it possible to arrive at a more precise diagnosis, that is congenital malformation of the internal and middle ear that clinically manifested itself as the conductive loss of hearing. It was decided to refrain from the surgical intervention: first, because its efficacy in this case was considered to be doubtful and second, it was fraught with the high risk of development of postoperative complications.