Cysts of the infant larynx.

We report the largest single-centre series in the literature of laryngeal cysts in infants. Most of these children presented with stridor within the first two weeks of life, and were found to have a supraglottic or vallecular cyst. Early endoscopic de-roofing of the cyst is the recommended form of treatment.

Incidence of cytomegalovirus disease in cyclosporine-treated renal transplant recipients based on donor/recipient pretransplant immunity.

We retrospectively reviewed the clinical data of all renal transplant patients treated with cyclosporine as their main chronic immunosuppressive agent between 12/83 and 11/85 to identify cytomegalovirus-negative patients at our institutions who received cytomegalovirus (CMV)-positive kidneys. Using a latex agglutination test, twenty-two such patients were identified, of whom 2 were excluded due to early death and lack of posttransplant follow-up serology. Of the remaining 20 patients, 12 developed CMV antibody in the first 4 months posttransplant, and of these, 11 were hospitalized with complications related to primary CMV disease. Two of these seroconverting patients eventually died, and one lost her kidney. Of the 8 persistantly CMV-negative patients, 1 lost his kidney soon after transplantation, and one had a febrile illness 4 months posttransplant caused by a bacterial pneumonia. Concomitantly, 145 renal transplants (CMV-negative recipient receiving a CMV-negative kidney or CMV-positive recipient receiving either positive or negative kidneys) given to 142 patients functioned for at least 4 weeks. Only 3 cases of CMV reactivation disease occurred in previously antibody-positive patients. We conclude that the transplantation of a cytomegalovirus-positive kidney into a CMV-negative recipient carries a high risk of mortality/morbidity from primary cytomegalovirus disease. On the other hand, reactivation of CMV disease was uncommon early in the posttransplant course of cyclosporine-treated patients.

Juvenile laryngeal papillomatosis.

From the records of 23 patients with juvenile laryngeal papillomatosis, various aspects of the aetiology, natural history and treatment of the condition have been presented. The lesions are thought to be viral in origin, they are notoriously unpredictable in their behaviour, and treatment can often be prolonged and frustrating. Tracheostomy should be avoided, if possible, owing to the risk of further dissemination down the trachea and bronchi. The CO2 laser now seems to be the surgical treatment of choice, and early reports of adjuvant interferon therapy are encouraging. However, the laser is only available in certain centres, and interferon supplies are limited at present.

Treatment of respiratory papillomatosis with adenine arabinoside.

Nine children with respiratory papillomatosis have been treated with adenine arabinoside with limited success. No long term benefit was obtained in six, and although resolution was achieved in one and probably two others, this could not be attributed confidently to treatment.

A comparative study of benzydamine hydrochloride 0.15% w/v ('Difflam' Oral Rinse) and acetyl salicylic acid as analgesics following tonsillectomy.

The efficacy of 'Difflam' Oral Rinse and soluble aspirin in the post-operative management of tonsillectomy in adult patients has been compared. Whilst aspirin proved slightly more effective in relieving pain and discomfort of swallowing, 'Difflam' Oral Rinse was superior in the relief of earache, in promoting the healing of the tonsil bed and in the duration of necessity of treatment. It is therefore suggested that the two preparations might be taken concomitantly to provide quick, as well as long-lasting, pain relief.