No abstract

Objectives/Hypothesis: Stenosis of the middle meatus antrostomy (MMA) represents a major cause of recurrent disease following endoscopic sinus surgery (ESS). Various strategies have been developed to prevent the occurrence of MMA stenosis. The aim of the present study was to evaluate the effects of spray cryotherapy (SC) on nasal wound healing following ESS. Methods: This is a prospective within-subject, randomized, and controlled trial. Twenty-six patients submitted to bilateral ESS with chronic rhinosinusitis without polyps were included. Following surgery, patients were randomized to receive SC on one side and saline contralaterally. Outcomes were represented by MMA diameter and area, histology of nasal mucosa, and nasal symptoms. Variables were assessed at 3 and 12 months postoperatively. Results: The MMA size in the SC group at 3 and 12 months (area-0.578 ± 0.1025 cm 2 , diameter-0.645 ± 0.1024 cm; 0.605 ± 0.1891 cm 2 , 0.624 ± 0.0961 cm, respectively) was significantly larger (p = 0.000) than in the control group. Histology established that cell infiltration, goblet cells, edema, and epithelial hyperplasia were prominent and persistent in the control side compared to the SC side. Nasal obstruction and discharge were significantly improved in the SC group compared to the control group. Conclusion: SC is a promising therapy following ESS, since it precludes MMA stenosis and decreases inflammation, edema, and goblet cell hyperplasia.

Obstructive sleep apnea is characterized by recurrent episodes of partial or complete obstruction of upper respiratory airways which appear during sleep and lead to the decrease of oxygen saturation and numerous awakenings. The symptomatology in pediatric obstructive sleep apnea is very different from the adult type in many aspects. The gold standard examination for diagnosis and evaluation of severity is polysomnography. The authors present their experience in the surgical tratament of children with obstructive sleep apnea. It is outlined a group of patient enrolled during a period of 5 years (2010-2014) who had their tonsils reduced through coblation and radiofrequency techniques.

The tonsill represents a natural barrier against various infectious pathogens. Around the tonsillar crypts, the tissues produce an area of mechanical defence barrier formed of granulation tissue, neoformation vascularization and leukocytes. In this region a series of complex immunological processes take place, the central role being occupied by immunoglobulin A. Tonsillar outbreak infection is a particular feature of immune response, generating numerous imunopathologic reactions.

Tonsillar outbreak infection is an non-discharging inflammatory disease of the connective tissue, with multiple organ manifestations, with a self-timing nature, being chronologically and etiopathogenically linked to the infection with beta-hemolytic streptococcus group A. An important role for the emergence and persistence of the outbreak infection is assigned to the poor local immunity, which is translated, among others, by low levels of serum and secretory IgA in upper respiratory mucosa. Tonsil immune pathology is at the origin of various diseases, mainly cardiac and renal. We present some data regarding the concept of tonsillar infection, hoping to help the physicians in making better decisions for the amigdalectomy indication.

The ingress of foreign bodies in the esophagus is relatively easy and, at the same time, frequently, especially during the childhood. Children usually carry to their mouth within easy reach, different objects: seeds, pits/kernels, coins, buttons, food pieces, toys’ pieces, tiny toys, pins, drawing pins, rings, earrings, etc. We present a case of a multiple esophageal foreign body, at which, only the attention and accuracy with which the esophagoscopy was proceeded, has allowed the extraction of the foreign body.

Most foreign bodies ingested or impacted food boluses in the esophagus pass spontaneously to the stomach without requiring an intervention of extracting them. However, in 10-20% of cases, it is necessary to intervene endoscopic to extract the foreign body and, in very rare cases, about 1% surgical intervention for the extraction of the esophageal body is demanded. Sensitive categories for the foreign esophageal bodies are firstly children and rarely the adults. Foreign esophageal bodies are more common in children than in adults, and it is one of the pediatric otorhinolaryngology emergencies. The authors present the case of a 14 years old patient, at whom the esophagoscopy under general anesthesia, which was imperious, has detected a rare vegetal esophageal foreign body.

Headache is part of an alarm system announcing that somewhere in the body of the person who has this accuse something peculiar happens in the pathological or physiological point of view. Patients have various forms of headache and, therefore, each case must be correctly diagnosed, being necessary a very thorough medical history, in order to characterize each type of headache. Although most patients with headache have a normal physical exam, it is extremely important to continue the investigation plan with functional testing, that will guide both the diagnosis and treatment. Approach to the patient with headache starts with the usual paraclinical tests. In this paper, the authors bring into question electrophysiological and neuroimaging paraclinical testing of patients with headache.