The development of paranasal sinuses in patients with cystic fibrosis: sinuses volume analysis.

BACKGROUND: Cystic fibrosis (CF) is a severe systemic disease that affects many aspects of patients' lives. It is known that the progression of the disease adversely affects lower and upper airways including the paranasal sinuses. However, its impact on sinus development in the pediatric population is not fully examined. The purpose of this study was to evaluate the development of the paranasal sinuses in a pediatric population with CF and compare it to a control group consisting of healthy children. METHODS: The results of computed tomography (CT) scans of children with the disease and the control group were evaluated. The study included 114 CT images of children in the study group and 126 images of healthy children aged 0-18 years. The volumes of maxillary, frontal, and sphenoid sinuses were analyzed. The obtained results were compared with those of the control group and analyzed statistically. RESULTS: The volume and the development of the paranasal sinuses in both groups increased with age, but statistically significant differences were found between the study and the control group. CONCLUSIONS: The obtained results provide valuable knowledge regarding the impact of the CF on sinuses development. Also, they may be important in understanding the progression of the disease and its influence on the quality and length of life of patients. The results may contribute to enhanced diagnostics and have implications for improving therapy for patients with chronic sinusitis associated with CF.

Speech Understanding in Manic and Depressive Episodes of Mood Disorders.

OBJECTIVE: The aim of this study was to assess the perception of speech in adverse acoustic conditions during manic and depressive episodes of mood disorders. METHODS: Forty-three patients with bipolar disorder (mania, N=20; depression, N=23) and 32 patients with unipolar depression were included for analyses. Thirty-five participants served as the control group. The study of speech understanding was carried out using the Polish Sentence Matrix Test, allowing for the determination of the speech reception threshold (SRT). The test was performed in the clinical groups both during an acute episode and remission; during remission, patients underwent audiometric evaluation. RESULTS: Compared with control subjects, patients with mood disorders had worse speech understanding (higher SRT), regardless of the episode or remission. A manic episode in the course of bipolar disorder was not associated with worse speech understanding compared with remission of mania. However, an episode of depression in the course of both bipolar disorder and unipolar depression was associated with worse speech understanding compared with remission of depression. In bipolar depression, this correlated with age, duration of the disorder, number of episodes, and number of hospitalizations, as well as in remission with age and duration of illness. In unipolar depression, poor speech understanding was more severe in individuals with hearing impairment. CONCLUSIONS: These findings revealed that patients with mood disorders had impaired speech understanding, even while in remission, and manic episodes in the course of bipolar disorder were not associated with impaired speech understanding compared with mania remission.

Decreased miRNA-320e correlates with allergy in children with otitis media with effusion.

OBJECTIVE: Otitis media with effusion (OME) is a common childhood disease and the main cause of conductive hearing loss in this age group. Many factors predispose to OME but allergy is still widely disputed. The answer may lay in the molecular mechanisms of ear exudate formation and the recent studies showed miRNAs might take part in it. MiRNAs are also potent regulators of allergic response. As miRNAs are present in the middle ear, we hypothesized their expression differs between allergic and non-allergic patients and reflects the difference in pathomechanism of effusion formation between these two groups. MATERIALS AND METHODS: This study aimed to establish the expression of 5 different miRNAs (miR-223-3p, miR-451a, miR-16-5p, miR-320e, miR-25-3p) in ear exudates in children diagnosed with OME. The allergy group consisted of 18 patients whereas the non-allergic group had 36 patients. MicroRNA was isolated from the middle ear fluid collected during myringotomy and transcribed into cDNA. MiRNA expression was measured with TaqMan™ MicroRNA Assays and analyzed with DataAssist software. The comparative CT method was used for calculating the relative quantification of gene expression based on the endogenous control gene expression (U6 snRNA-001973). RESULTS: MiR-320e expression was significantly decreased in allergic children with OME. Other studied miRNAs also showed reduced expression in allergic children, but the decrease was not significant. CONCLUSIONS: MiRNA expression differs between children with and without allergy in the course of OME, but further studies are needed to explain the exact role of miR-320e and its target genes in OME pathology in allergic patients.

The Acute Phase Proteins Reaction in Children Suffering from Pseudocroup.

The aim of the study was to evaluate the inflammatory reaction in children with pseudocroup and compare it with other laryngological diseases according to the available literature data. The study group included 51 children hospitalized because of pseudocroup. The measurements of the acute phase proteins (APP), such as C-reactive protein (CRP), alpha-1-antitrypsin (AT), alpha-1-antichymotrypsin (ACT), alpha-1-acid glycoprotein (AGP), ceruloplasmin (Cp), transferrin (Tf), alpha-2-macroglobulin (A2M), and haptoglobin (Hp) were obtained at 3 time points. The glycosylation profiles of AGP, ACT, and Tf were completed. An increased AGP level was observed in girls. The AGP glycosylation revealed the advantage of the W0 variant over the W1 variant. W1 and W2 were decreased in boys. W3 emerged in boys. The Tf concentration and T4 variant were lower compared to the control group. The A2M level was lower after treatment. The Hp and AT levels were decreased a few weeks later. The ACT glycosylation revealed a decrease of the A4 variant in boys. In conclusion, the inflammatory reaction during pseudocroup was of low intensity. The APP glycosylation suggested a chronic process. In a follow-up investigation, no normalization of the parameters was noted, but signs of persistent inflammation were observed.

The awareness of caregivers about their children's exposure to ionizing radiation accompanying medical procedures: the assessment study.

OBJECTIVES: The aim of the study was a survey-based assessment concerning parents of children undergoing CT examinations and their knowledge of detailed information about procedures involved in imaging diagnostics. MATERIAL AND METHODS: A statistical analysis of 108 surveys of parents of children undergoing CT studies in the Department of Pediatric Radiology in Poznan, Poland was done, with the use of Statistica software. RESULTS: In result of the evaluation of all subsections of the substantive question number, the majority of answers were incorrect (68-98%). No correlation between the number of CT examinations conducted for a child and the number of correct answers to substantive questions was observed. No correlation between the number of CT examinations conducted for a child and the fact of noting the examination with the use of ionizing radiation down in a child's health certificate was stated. The statistical analysis showed that children of parents who declared that the aim of the CT examination had been explained to them better underwent more of them. CONCLUSIONS: Parents are poorly informed about a radiation dose and risk related to a CT examination procedure. Int J Occup Med Environ Health. 2019;32(1):65-73.

The Central Neck Dissection or the Modified Sistrunk Procedure in the Treatment of the Thyroglossal Duct Cysts in Children: Our Experience.

BACKGROUND: The aim of the study was to present the surgical techniques providing the lowest recurrence rate in treatment of the primary and recurrent thyroglossal duct cyst (TGDC) in children. METHODS: The study included 73 patients operated on because of TGDC in years 2011-2016. Ultrasound was performed in all patients preoperatively. In 8 patients with the recurrence of the disease, the CT or MR was carried out before the surgery. Children with the primary disease underwent the modified Sistrunk procedure. In the revision cases the central neck dissection was a method of choice. RESULTS: In 45 children, the modified Sistrunk procedure was performed and 28 underwent the central neck dissection. In 2 patients, hematoma occurred after the modified Sistrunk procedure with the need of the surgical revision in one. No complications were observed after the central neck dissection. CONCLUSIONS: A modified Sistrunk procedure is method of choice in the treatment of the uncomplicated TGDC. In selected cases of the TGDC with a history of infected cyst or incision of an abscess or in revision cases the central neck dissection should be considered in order to avoid the risk of the further recurrences.

Multiple, delayed post-tonsillectomy bleedings in 11-year-old girl as a result of vascular abnormality and anastomosis. Case report.

Tonsillectomy and adenoidectomy are the most common surgical procedures in pediatric otolaryngology. The incidence of primary hemorrhage after tonsillectomy in children ranges from 0.38 to 6%. The prevalence of secondary bleeding occurs in 0.5%-9.3% cases [1]. Authors present a case of an 11-year-old girl who experienced 6 delayed, massive post-tonsillectomy bleedings as a result of presence of vascular malformation and the activation of collateral circulation as a result of the left ECA ligature.

Prevalence of human papillomavirus (HPV) in upper respiratory tract mucosa in a group of pre-school children.

INTRODUCTION: Human Papillomavirus (HPV) is a group of DNA viruses which is an etiological factor of many benign and malignant diseases of the upper respiratory tract mucosa, female genital tract and the skin. HPV infection is considered a sexually-transmitted infection, but can also be transmitted by non-sexual routes, including perinatal vertical transmission, physical contact, iatrogenic infection and autoinoculation. Recurrent Respiratory Papillomatosis (RRP) in children is connected with HPV infection transmitted vertically from mother to child during the passage of the foetus through an infected birth canal. OBJECTIVE: The aim of this study was to establish the level of Human Papillomaviruses carrier state in upper respiratory tract mucosa in healthy pre-school children, and to identify potential risk factors for HPV infection. MATERIALS AND METHOD: After obtaining consent from their parents, 97 pre-school children were examined--51 girls and 46 boys between the ages of 3-5 years; average age--4 years and 5 months. 68 children were urban dwellers and 29 came from a rural environment. A questionnaire with detailed history was taken including parents' and child`s personal data, as well as perinatal risk factors in pregnancy. Socio-demographic information was also obtained, including the standard of living, and chosen environmental factors. Routine ENT examination was performed. Exfoliated oral squamous cells were collected from swabs and analysed for the presence of DNA papillomaviruses by polymerase chain reaction. RESULTS: The presence of HPV in the respiratory tract in children was detected in 19.6% cases. 'High oncogenic potential' HPVs, such as HPV-16 and HPV-18, were not observed in squamous cell mucosa of the respiratory tract in the children. No significant differences were observed between the HPV carrier state in urban and rural inhabitants.

Environmental pollution and parental smoking influence on the appearance of pseudocroup in children.

OBJECTIVE: The aim of the study was to assess the effect of environmental pollution and parental tobacco smoking on the occurrence of pseudocroup in children. MATERIAL AND METHODS: A questionnaire-study was performed in 345 children with pseudocroup admitted to the ENT Dept between 1997-2007. 116 children had smoking and 229 had non-smoking parents. Both groups were compared with respect to environmental pollution (urban, rural), parents' level of education, household crowding and breast feeding period. The prevalence of upper and lower respiratory tract infections and the presence of allergy were also anlaysed. The results were compared to those performed in the ENT Dept in 1977-1986. RESULTS: In the group of rural children, 21 were children with pseudocroup from smoking parents and 36 children of non-smoking parents. Among children living in the urban areas there were 95 from smoking parents and 193 from non-smoking parents. Both non-smoking parents presented a large group of people with a higher level of education, and in the smoking families both parents presented a lower level of education. Analysis of the breast feeding period revealed that it was the longest (up to 9 months) in non-smoking mothers--21% of the group, and only in 4.3% of smoking mothers.

["Starplasty" tracheotomy in children of Pediatric ENT Department of Poznan University of Medical Sciences]. / Tracheotomia metoda "starplasty" u dzieci, w materiale Kliniki Otolaryngologii Dzieciecej Katedry Otolaryngologii w Poznaniu.

INTRODUCTION: Obvious anatomical differences between larynx and trachea of the adult and the child necessitate different surgical techniques. The "starplasty" technique of pediatric tracheotomy was introduced in 1998 as an alternative pediatric tracheotomy technique associated with several advantages such as easy recannulation in case of accidental decannulation, isolation of trachea secretions from the tracheotomy wound and the absence of stenosis and anterior wall collapse. AIM OF THE STUDY: The aim of this study was to compare the new technique of tracheotomy with the traditional one in pediatric patients. MATERIAL AND METHODS: 26 "starplasty" tracheotomies were performed in the Pediatric ENT Dept. from 2006-2010. There were two control groups. The first one consisted of 25 patients and their observation period was 3 years. In the second one there were 14 patients and the observation time was 7 years. In both, the tracheotomy was performed with use of traditional technique. RESULTS: The comparison of these groups of patients revealed significant differences in long-term complications such as presence of granuloma tissue (0 after "starplasty", 8% to 14,3% after traditional technique) and suprastomal collapse (0% after "starplasty", 8% to 78,6% after traditional tracheotomy). CONCLUSIONS: "Starplasty" is a safe and easy to perform pediatric tracheotomy technique. It decreases the incidence of short and long-term complications. But the persistence of postoperative tracheocutaneous fistula should limit the indications to perform it only in children in whom the tracheotomy will be permanent.

[Tracheotomy in children of the Pediatric ENT Department in years 1995-2005]. / Tracheotomia u dzieci--na podstawie materialu Kliniki Otolaryngologii Dzieciecej w Poznaniu w latach 1995-2005.

INTRODUCTION: In the nineteenth century tracheotomy was performed in case of diphtheria. In 1869 Trousseau presented data on 215 cases of this disease treated this way and it became an operation that was reserved for life threatening conditions. In 1907 Jackson presented his experience with tracheotomy and provided information on equipment and techniques that are still used nowadays. MATERIAL AND METHODS: A retrospective analysis was performed on 79 patients undergoing tracheotomy at Pediatric ENT Dept in Poznañ from 1995-2005. Charts were reviewed with respect to primary diagnosis and indication for tracheotomy. RESULTS: Approximately 56% of the tracheotomies were performed in infants, 18%--in neonates and 26% in children over 1 years old. The most common indication for this procedure in neonates was prolonged intubation--43% in neonates and 25% in infants. Congenital laryngotracheal anomalies were the second group of indications in neonates--28.5% cases and congenital heart anomalies in infants--22.7%. In children over 1 year of age the most common indication were respiratory failure--52.,4% and prolonged intubation in 14.3%. CONCLUSIONS: Obvious anatomical differences between the larynx and trachea of the adult and the child necessitate different surgical techniques. It is important to perform tracheotomy over a bronchoscope or endotracheal tube when possible because of the malleability of the trachea in the child. After the tracheotomy tube is placed it is necessary to check its position and level with flexible bronchoscope.

[Case reports of congenital laryngeal cysts in children]. / Opisy przypadków wrodzonych torbieli krtani u dzieci.

INTRODUCTION: Congenital laryngeal cysts occur as a result of embryological development anomalies. They are usually situated on the lateral wall of the larynx, in the supraglottic region or on the epiglottis. They are mostly diagnosed in childhood. They are present in 2.4% of population and represent only 7% of all benign laryngeal lesions. Needle aspiration or marsupialization does not give long term results. The most effective and minimally invasive way of treatment is complete excision of the cyst. MATERIALS AND METHODS: Authors present 2 cases of congenital laryngeal cysts in children. Diagnosis was made during direct laryngoscopy. CT and MR confirmed the cystic nature of the lesions. Endoscopic excision with suspension microlaryngoscopy was performed in both children. RESULTS AND CONCLUSIONS: In both cases microlaryngeal surgery after diagnostic aspiration was an effective and permanent treatment of congenital laryngeal cyst. It enabled total excision of the lesion and provided the correct function of larynx.

[Surgical treatment of laryngomalacia in children]. / Leczenie operacyjne wiotkosci krtani u dzieci.

INTRODUCTION: Laryngomalacia is the most common congenital malformation of the larynx which causes stridor in newborns and infants. The stridor is inspiratory and it is first noted at birth but sometimes may not develop until 2 weeks of age. It increases in severity during crying, nursing, agitation, excitement and is made worse with head flexion or supination. Other symptoms such as supraclavicular, intraclavicular, intercostal and abdominal retractions may be associated. Boys are affected over twice as often as girls. Diagnosis of laryngomalacia is made by rigid or flexible laryngoscopy. Although this disorder is usually self-limited, in some cases the symptoms are so severe that operative intervention cannot be avoided. MATERIAL AND METHODS: Between 2002 and 2005, 13 infants were operated for severe form of laryngomalacia in the Pediatric ENT Dept in Poznan. In all patients the rigid or flexible laryngoscopy was performed to confirm the diagnosis. Then aryepiglottoplasty or epiglottoplasty were performed in all cases. It involved excision of the redundant mucosa over the arytenoid cartilages, the offending parts of he aryepiglottic folds, and trimming the lateral edges of the epiglottis, using microlaryngeal scissors and forceps. RESULTS: In all children symptoms such as: laryngeal stridor, feeding difficulties and dyspnea improved or completely resolved. In one case post-operative ventilation for several hours was required. All patients except one demonstrated significant airway improvement in the immediate postoperative period. CONCLUSIONS: Direct laryngoscopy must be performed prior to the aryepiglottoplasty to decide what amount of tissue to resect. Endoscopic aryepiglottoplasty with use of microlaryngeal instruments is an effective and safe method of the treatment of severe form of laryngomalacia. It is better to perform this procedure in general anesthesia without intubation.

[Examination of acute phase proteins concentrations in children with allergic rhinitis]. / Badanie stezen bialek ostrej fazy u dzieci z alergicznym niezytem nosa.

INTRODUCTION: Allergic rhinitis is an inflammatory disorder of upper respiratory tract (about 15 per cent of the population in industrialized countries suffer from this condition), characterized by frequent sneezing and a runny or stuffy nose sometimes accompanied by watery eyes. As the most common allergic condition, allergic rhinitis affects people of all ages. Boys are twice as likely to get allergic rhinitis than girls. The median age of onset of the condition is 10 years old, meaning that equal numbers of children develop the condition before and after age 10. Symptoms usually appear in childhood first and then lessen by the age of 30 or 40. Seasonal allergic rhinitis usually results from tree, grass or weed pollen. With this type of rhinitis, symptoms will decrease with the arrival of cold weather. Perennial allergic rhinitis can cause year-round symptoms. This allergic reaction is the result of indoor irritants such as feathers, mold spores, animal dander (hair and skin shed by pets) or dust mites. It is often aggravated by a food allergy, the most common being an allergy to milk. Acute phase proteins (APP) belong to the most ancient part of the unspecific immunity and contribute markedly to the keeping of homeostasis. As much as 30 various proteins are for the moment regarded as APP. Being multifunctional regulators and effectors APP stay in multiple relations to practically all types of cells and molecules. Among APP following functional groups may be described: transport proteins (transferrin, ceruloplasmin and haptoglobin), clotting factors (fibrinogen), antiproteases (alpha1-antitrypsin, alpha1-antichymotrypsin, alpha2-macroglobulin), complement components (C3, C4) and several proteins of hardly known function, like C-reactive protein (CRP), serum amyloid A, acid alpha1-glycoprotein (AGP) and others. MATERIAL AND METHODS: From a group of 32 children, aged from 5 to 14 years, with symptoms of seasonal allergic rhinitis, and from a control group of 10 healthy children sex and age matched, blood sample was taken after written parents' consent. In all children skin tests (Stallergens) were performed at the beginning of the year. Any reaction was present in the control group. Following proteins were analyzed: CRP, AGP, alpha1-antichymotrypsin (ACT), transferrin, ceruloplasmin (Cp), alpha1-antitrypsin, haptoglobin and alpha2-macroglobulin (A2M). RESULTS: C-reactive protein level was very low, what allowed us to exclude all acute conditions. As expected, AGP and ACT concentrations were not elevated, either, and even non significantly lower values were observed in allergic children in comparison to controls. It is worth noticing that transferrin concentration was statistically lower in allergic children, as well as A2M and Cp concentrations. All this suggest an on-going disturbance in cytokine network that may directly affect both the iron metabolism and the non-specific immunity. CONCLUSIONS: It may be stated that allergic rhinitis causes impairment of acute phase proteins synthesis, which may affect natural defense or homeostasis in the immune system of a child.

[Glycosylation profile of selected acute phase proteins in children with chronic tonsillitis and allergic symptoms]. / Glikozylacja bialek ostrej fazy u dzieci z zapaleniem migdalków podniebiennych i objawami alergii.

INTRODUCTION: Acute phase proteins may be regarded as laboratory markers of inflammatory processes of various origin, but they also play several important biological roles. As majority of them are glycoproteins alterations in glycosylations profiles form additional sign of disturbances in the cytokines network during inflammation and allow to distinguish between acute and chronic inflammatory conditions. MATERIAL AND METHODS: A group of 25 children, aged from 6 to 13 years, admitted due to tonsillectomy was examined using skin tests towards specific allergens. Fifteen children out of the whole group showed reaction to pollens, whereas in ten children no allergen was detected despite clear allergic symptoms. In sera samples from every child concentrations of C-reactive protein, alpha1-acid glycoprotein (AGP) and alpha1-antichymotrypsin (ACT) were measured using rocket immunoelectrophoresis acc. to Laurell, and glycosylations profiles of AGP and ACT were determined, using crossed affino-immunoelectrophoresis acc. to Bøg-Hansen. RESULTS: Lower concentration of AGP and higher of ACT was shown for children allergic to pollens. Glycosylation profile of both proteins was altered towards higher reactivity with ConA for children allergic to pollens, whereas rather chronic image was observed in children allergic to unknown allergen. The latter image was similar to previously described in children with food allergies. CONCLUSIONS: The presence of allergic reaction may alter the cytokine network activity in children, thus affecting also the immune status, independently from chronic inflammatory process in tonsillitis.

[Evaluation of chosen parameters of acute-phase reaction in children during pseudocroup according to their age]. / Analiza wybranych parametrów reakcji ostrej fazy w przebiegu podglosniowego zapalenia krtani w zaleznosci od wieku dziecka.

INTRODUCTION: Acute subglottic laryngitis (pseudocroup) usually occurs in infants and small children between 1 and 3 years of age. Due to the viral etiology there are autumn-winter and winter-spring peaks of frequency of this disease observed. Acute-phase proteins are a group of proteins whose concentration in the serum changes following variety of injuries such as bacterial, viral or parasitic infection. These changes are one of the features of an early, non-specific and highly complex reaction of the organism called acute-phase response. The purpose of this reaction is to restore homeostasis. Almost all acute-phase proteins are glycoproteins and changes in their microheterogeneity (glycosylation profile: structure of side suger chains) were also reported during different inflammatory conditions. MATERIAL AND METHODS: 51 children admitted to the Pediatric ENT Dept in Poznan because of an incident of pseudocroup were divided into 3 groups according to their age: I (0-3 years of age), II (between 3 and 5 years old) and III (over 5 years old). In all children levels of selected acute-phase proteins such as a1-antitrypsin [AT], al-antichymotrypsin [ACT], al-acid glycoprotein [AGP], ceruloplasmin [Cp], transferrin [Tf] and haptoglobin [Hp] were measured in three time points: at the beginning of the disease, after treatment and 3 weeks later during control examination. In all sera samples also glycosylation profile of AGP, ACT and Tf was performed. RESULTS: Analysis of AGP glycosylation profile revealed the highest levels of microheterogeneity variants: W2 and W3 in the group of children over 5 years old. Also AGP-RC was significantly increased in this group. The Tf variant T4 reached the highest level in children between 3 and 5 years of age. In all age groups increased level of Hp was observed during treatment and decreased 3 weeks later during control examination. CONCLUSIONS: Acute-phase reaction is the most intensive in the youngest children. Analysis of glycosylation profile revealed acute inflammatory process during episode of pseudocroup in the oldest children (over 5 years old) and chronic inflammation in group of the youngest children.

The results of newborn hearing screening by means of transient evoked otoacoustic emissions.

OBJECTIVE: The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2-4 per 100 in high-risk children. Transient evoked otoacoustic emissions (TEOAEs) represent a method which can be applied to all newborns prior to hospital discharge, enabling early identification of hearing loss. The aim of the study was to evaluate the results of newborn hearing screening by means of TEOAEs. METHODS: Between 01.10.2002 and 30.09.2003, 5601 newborns born in the University Hospital in Poznan, Poland were screened with ERO SCAN (MAICO). Healthy neonates were screened in the second or third day of life and children treated in pathology unit--when their general condition was stable. The risk factors of hearing loss were recorded in a questionnaire. Children who failed the screening test or had risk factors of hearing impairment were referred to the outpatient clinic for further evaluation. RESULTS: Risk factors were identified in 739 newborns. The most often risk factors were: use of ototoxic drugs, low Apgar score and prematurity. Positive test result was obtained in 219 (3.91%) children unilaterally and in 137 (2.45%) bilaterally. In healthy children the prevalence of positive results was 3.56% and in high-risk infants 24.9%. The relative risk of positive test results was the highest in infants with positive family history (RR=7.5), congenital malformations (RR=6.7) and low Apgar score (RR=5). Of the group of 912 children, who were referred to the specialist, only 218 turned up to be assessed during the observation period and had the additional otoacoustic emission test performed. There was not any significant difference in the percentage of children with and without risk factors who turned up for the second test and in whom the result was positive (39.7% versus 40.3%). In 41.9% children with risk factors whose screening test was negative, the second exam gave positive result. CONCLUSIONS: The incidence of positive results in newborn hearing screening is much higher than the prevalence of hearing loss in general population and these results need verification by more precise methods. However, TEOAEs enable to select children who should be referred for audiological evaluation.

[Internal injuries of larynx in children. Case reports]. / Wewnetrzne urazy krtani u dzieci. Opis przypadków.

The authors present larynx injuries among children especially with regard to iatrogenic internal injuries based on personally observed cases: dislocation of arytenoid cartilage in 11 year-old girl and post intubation granuloma in 8 year-old girl.