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Laryngitis is one of the commonest causes of dysphonia in the subjects engaged in the voice and speech professions. This condition can be either associated with the professional activities or related to voice fatigue. It is a common practice to distinguish between acute and chronic forms of occupational laryngitis. The main factors responsible for development of both conditions include the non-observance of directions concerning the protection and hygiene of the speaking and singing voice. The present study included 478 (100%) subjects engaged in the voice and speech professions presenting with the diagnosis of acute or chronic occupational laryngitis who applied for medical assistance to our Phoniatric Care Department. The clinical state of their larynx was evaluated with the use of the videoendostroboscopic technique. Acute laryngitis was diagnosed in 103 (21.5%) of the examined subjects while the remaining 375 (78.5%) ones presented with chronic laryngitis. A characteristic feature of acute occupational laryngitis documented in 38 (36.9%) examined professional voice users with this condition (practically healthy in all other respects) was the development of this disorder as a result of overloading the speech organs. On the contrary, viral and/or bacterial laryngitis revealed in 65 (63.1%) of the patients was preceded by acute respiratory symptoms. A total of 62 (16.5%) patients suffered from chronic occupational laryngitis attributable to overloading of the organs of speech during protracted periods. The remaining 313 examined professional voice users were found to present with various forms of chronic laryngitis including catarrhal laryngitis in 175 (46.7%) of them, edematous-polypoid and atrophic forms in 32 (8.5%) and 19 (5.1%) subjects respectively. The main etiological factors underlying the development of all the tree forms of chronic laryngitis were smoking, chronic tonsillitis, gastroesophageal reflux disease, bronchial asthma, and diabetes mellitus.

Stenosing laryngotracheitis (SLT) affecting the children is considered to be an emergency pediatric condition associated with ENT pathology. Its treatment presents a serious challenge for otolaryngologists, pediatricians, specialists in communicable diseases, allergologists, etc. We have undertaken a retrospective analysis of the available data with a view to summarizing the tendencies in the evolution of SLT morbidity. The results of the 35 year-long experience with the use of the currently available therapeutic strategies for the treatment of the children suffering from stenosing laryngotracheitis are presented. Special emphasis is laid on the advantages of the combined treatment of the patients presenting with this condition based at a specialized infectious department with the participation of an otorhinolaryngologist.

Unlabelled: The objective of the present study was to develop a method for the, Aim: comprehensive and uniform evaluation of the results of the treatment of vocal professionals experiencing exacerbations of chronic laryngitis under effect of physical factors. We propose the system of quantitative gradation of the main clinical and functional characteristics that should be taken into consideration for the assessment of the health status of the patients presenting with exacerbations of chronic laryngitis. In addition, the aggregate health index was calculated the dynamics of which can be used to estimate the results of the treatment. The quantitative criteria were developed for the expert evaluation of the temporary incapacity for work in the vocal professionals experiencing exacerbations of chronic laryngitis. It is concluded that the proposed approach can be employed by otorhinolaryngologists, phoniatrists, physiatrists, and developers of new technologies for the treatment of exacerbations of chronic laryngitis. Moreover, it is recommended for the application in out-patient and in-patient healthcare facilities, centresof restorative and rehabilitative medicine, medical research and development institutions.

The objective of the present work was to estimate the clinical, prophylactic, and microbiological effectiveness of fusafungine applied for the treatment of acute rhinosinusitis (ARS) in the children that develops as a consequence of acute stenosing laryngotracheitis. The study included 61 children presenting with ARS and concomitant acute stenosing laryngotracheitis (ASLT) that were treated with fusafungine (Bioparox). Both tolerance and safety of this preparation were evaluated. Fusaferine was prescribed after reduction of pharyngeal stenosis. The children were divided into two groups. Group 1 was comprised of the patients with the respiratory symptoms and rhinosinusitis (n = 36), group 2 consisted of the children with the respiratory symptoms in the absence of rhinosinusitis (n = 25). Subgroups of the children treated with fusafungine and without it were distinguished to estimate the clinical, prophylactic, and microbiological effectiveness of fusafungide. Within the first days after hospitalization, 59% of the children with diagnosis ASLT developed bilateral rhinosinusitis, in all probability of viral etiology. Fusafungine produced the clinically apparent effect in the patients with ASLT regardless of the presence of ARS. Specifically, this preparation decreased the degree of hypertrophy of pharyngeal tonsils three times faster than standard therapy; moreover, it reduced the requirement for systemic antibiotics by 1.9 times. The treatment with fusaferine prevented the development of acute bilateral rhinosinusitis in the children with ASLT and promoted compete decontamination of the nasopharynx from M. catarrhalis, Str. pneumonia, Str. pyogenes, H. influenza, Cor. s the nasopharynx pecies, E. faecalis, and C. albicans. The frequency of adverse reactions of organoleptic character was estimated at 16.6%.

Otalgia and/or impairment of hearing is one of the earliest, if not the first, symptom of certain pharyngeal and laryngeal disorders. Underestimation of these conditions or incorrect interpretation of their origin frequently lead to erroneous diagnosis and the wrong choice of treatment strategy. A total of 1074 patients with pharyngeal and laryngeal problems were available for examination that revealed pathologies in which otalgia and/or impairment of hearing is the first or an earlier symptom of the disease. Otalgia proved to be an early manifestation of serious inflammatory diseases affecting the middle part of the pharynx or of metastasis of malignant pharyngeal and laryngeal tumours into deep cervical lymph nodes. Juvenile angiofibroma, hemangiouma, malignant nasopharyngeal tumour are known to disturb functional automatism of pharyngeal openings of Eustachian tubes and cause impairment of hearing long before clinical manifestations of neoplastic growth. Results of diagnostic studies are usually interpreted as middle ear pathology (tubootitis, exudative otitis, middle ear inflammation). Correct diagnosis is possible within 1-12 months (or more) after the appearance of the first symptoms. An error is possible to avoid by thorough examination of the pharynx using endoscopic optics. Target biopsy is indicated as soon as neoplastic microlesions are identified excepting cases of branched arterial-type hemangiomas.

Staged development of dysbiotic disturbance of the upper airways was revealed in children suffering from stenosing laryngotracheitis in the presence of viral infection. Chronic persistent virus-bacterial inflammation of respiratory tract mucosa and resultant hypersensitivity of the airways produce chronic defects in lung ventilation in patients with recurrent stenosing laryngotracheitis. High sensitivity of the airways to histamine is related to bioelectric activity of the brain characterized by dominant irritation of the mesencephalo-diencephalic structures. Typical features of the curve flow-volume and paradoxic result of the test with broncholytic drugs verified tracheobronchial dyskinesia in patients with stenosing laryngotracheitis. Such dyskinesia promoted the recurrent disease with transformation into bronchial asthma.

The examination of 2000 children and adolescents diagnosed vocal problems in the form of functional and organic dysphonias in 3.5% cases. Mutational, hypotonic dysphonias occurred more frequently among functional diseases; nodules of the vocal cords, acute and chronic laryngitis -- among organic diseases. Causes of their development and therapeutic policy are specified.

Sixty eight patients with laryngeal and pharyngeal complaints have undergone both otorhinolaryngological and gastroenterological examinations. Most of the examinees were diagnosed to have pathological gastroesophageal reflux (PGER). Typical complaints for heartburn and eructation occurred in less than half the patients with PGER. It is proposed to conduct a gastroenterological examination of patients with persistent chronic inflammation of laryngeal and pharyngeal mucosa.

Clinical variants of laryngeal lesions in patients with early syphilis are reviewed. A case of secondary syphilis with a laryngeal lesion is reported in a female who developed aphonia. Basing on laryngoscopic findings, an otorhinolaryngologist made the diagnosis "chronic laryngitis, singer's nodules". The authors infer that painless laryngitis of long duration without signs of inflammation and resistant to standard treatment should be tested for syphilitic etiology. Therefore, the patient's blood should be taken for Wasserman reaction while the patient should be consulted by venereologist.

The treatment of 97 infants aged from 3 months to 2 years included: nasotracheal intubation (56 patients); i. v. injection, drops (77 patients) or aerosol inhalations (20 cases) of trasylol, kontrikal or gordox; inhalations of epsilon aminocaproic acid (12 cases); glucocorticoids (locally, inhalations, laryngeal drop infusions); local and oral bioantioxidants; noradrenaline for local vasoconstriction. The addition of antikinin medication to the complex of pathogenetically differentiated means which are also proteolytic enzyme inhibitors reduced the frequency and duration of tracheal intubation, duration of laryngeal stenosis by half. Systemic and local administration of antikinin drugs is advocated starting on the first post-diagnosis days, except cases of advanced acute inflammation in the presence of infiltrates in the cavum infraglotticum when antikinin, antihistamine and vasoconstrictors proved ineffective.

Herpetic acute stenosing laryngitis (ASL) in 6 infants was compared clinically to catarrhal ASL and latent herpetic infection in 6 infants with acute respiratory disease. Labial, oral and nasal herpes was observed only in 2 patients with herpetic ASC which in the other 4 patients was diagnosed only at laryngoscopy, thus laryngoscopic picture is a key prompting in diagnosis of herpetic ASL.

An allergological examination of 144 patients suffering from acute stenosing laryngotracheitis revealed food, drug, bacterial allergy of exudative diathesis in 62.5% of the cases. Allergic children had laryngostenosis of degree II and more advanced two times more frequently, whereas recurrences (12 cases) occurred primarily in children in premorbid condition. Allergy of shown to contribute to the onset of acute stenosing laryndotracheitis as allergic subjects are more susceptible to respiratory bacterial and viral infection. Local factors are mostly responsible for this. The author offers recommendations on more advanced treatment of acute stenosing laryngotracheitis with consideration of allergic aspects.

To treat acute stenosing laryngotracheitis in acute respiratory viral infection in children an original method has been developed and used for 2 years in a special hospital department. The method implies treatment of children in steam-and-oxygen tents with a universal steam-moistening generator and automatic control system. A controlled study of 50 children with acute laryngeal stenosis degree I-III confirmed high efficacy of this method permitting improvement of blood oxygenation, gas composition, acid-base condition, reduction of acidosis, prevention of exicosis and brain edema. Warm humid atmosphere promoted better discharge of the secretion and better functioning of the ciliated epithelium. Combined treatment incorporating the tents in acute laryngeal stenoses reduced lethality in severe cases, number of intubations and tracheostomies, of complications resultant from parenteral administration of the drugs.

Therapy of acute decompensated forms of laryngotracheitis in children has not been well developed. The mortality rate as a result of asphyxia reaches 10 to 52%. The present authors were able to reduce significantly the number of hazardous complications and lethal outcomes when treating 32 children with acute decompensated forms of laryngotracheitis (only one patient died). This was achieved by using prolonged (from 6 hrs to 19 days) intubation of the trachea, intensive medicine and physical therapy methods. Special attention was given to intubation tubes and drugs used. The postintubation course was smooth and no complications in the trachea were seen after treatment.