Introduction. Adenoid hypertrophy (pharyngeal tonsil hypertrophy) is considered as one of the most common diseases of the ENT organs.Aim. To study the polymorphism of the IL-10 gene (interleukin 10) and infections caused by human herpesvirus 6 (HHV6), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in children with AH.Materials and methods. The study included 106 children with adenoid hypertrophy and 38 healthy children aged 2 to 11 years. All children with adenoid hypertrophy were divided into three subgroups depending on the size of the pharyngeal tonsil. Viruses were determined by real-time quantitative polymerase chain reaction (PCR).Results. In patients with AH, HHV6 was detected more often than in CMV and EBV. Among the three subgroups of children with HGM, HHV6 and EBV infections prevailed in children with the maximum degree of pharyngeal tonsil hypertrophy. The frequency of the GG genotype was higher in the control group of children. Significantly higher frequencies of the G allele and GG and GA genotypes for IL-10 rs1800896 were found in the subgroup of children with the smallest size of the pharyngeal tonsil compared to other subgroups.Discussions. The frequencies of HHV-6 and CMV in the control group are significantly different. HHV-6 was the most frequently detected virus in patients with HGM compared with CMV and EBV. The frequency of the GG genotype was in the control group of children. A significantly higher frequency of the G allele and GG genotypes was found in the first subgroup of children compared to the second and exclusive subgroups. We found a lower frequency of the G allele and GG and GA genotypes in a significant subgroup of children compared to the second subgroup. Previous studies show a significant increase in the frequency of the A allele and the AA and IL-10 genotypes (rs1800896-1082G/A) in patients resistant to HHV-6 and CMV infections compared to those infected.Conclusions. The presence of HHV-6 and CMV infections contributes to the development of pharyngeal tonsil hypertrophy, and HHV-6 and EBV may contribute to the size of the pharyngeal tonsil.

The study objective – to present a unique clinical observation of the successful treatment of tracheoesophageal fistula using laser exposure.Case report. Patient H., 51 years old, applied to the Moscow City Oncology Hospital No 62, Moscow Healthсare Department on January 22, 2018, with a diagnosis of thyroid cancer (multicentric growth), T3N0M0 (hospital No. 1974 / 43). Thyroidectomy was performed on 03.08.2009, removal of a recurrent tumor with resection of the esophageal wall and trachea – 03.02.2021. Histological examination No. 5589 / 56662–56668 dated 09.02.2021: papillary cancer with invasion of the wall of the esophagus and trachea. Resection within unaltered tissues. A mobilized sternocleidomastoid muscle was used to separate the esophagus and trachea. A nasogastric tube was used for 14 days. The wound on the neck healed by primary intention. The patient began to eat through the mouth. A day after the removal of the probe, facial emphysema began to grow intensively, which was accompanied by a cough. The nasogastric tube is reinserted. With fluoroscopy of the esophagus and with pharyngogastroduodenoscopy, a tracheoesophageal fistula was revealed along the right lateral wall of the trachea, about 0.5 cm in size, 1.5–2 cm below the level of the vocal folds. On endoscopic examination a week later, the fistula was already 1.0 cm in size. Conservative therapy and surgical treatment were carried out. Due to the flexible laser fiber, a phased effect on the fistula wall was carried out, both from the esophagus and from the trachea. Within a week after the first session, the fistulous opening decreased by 2 times. Then 2 more sessions were carried out with an interval of 10 days. During endoscopic examination from 05.05.2021 the fistula between the trachea and the esophagus is not defined. The mucous membrane is epithelized, smooth. Swallowing is free.Conclusion. Thus, the problem of treating patients with tracheoesophageal fistulas is extremely complex and versatile. The localization of the fistula, its size, and the clinic’s capabilities for treating a patient are of great importance.

This article describes the observation of a clinical case of a vascular branched tumour (hemangioma) of the external ear with special reference to the clinical features and diagnostics of this condition and the methods for its surgical treatment.

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