The hallmark of gastroesophageal reflux disease (GERD) is an increased exposure of esophageal and laryngeal mucosa to gastric juice. This exposure can cause complications such as chronic laryngitis or chronic respiratory diseases. We report our experience in managing three pediatric patients with severe recurrent juvenile laryngeal papillomatosis (JLP) associated with GERD. All patients showed a high rate of recurrence requiring multiple laser surgeries. Systemic alpha interferon therapy over a period of more than 1 year and photodynamic therapy with dihematoporphyrin produced no improvement. However, after therapy for GERD, the rate of recurrence of JLP decreased significantly. Although the course of respiratory papillomatosis is known to fluctuate, our findings suggest that gastroesophageal reflux may have a role in aggravating papillomatosis.

In order to study a possible role of Helicobacter pylori infection in chronic laryngitis, we performed endoscopic and histological assessments in addition to a urease test for the bacterium in 35 patients with chronic hoarseness. Six of the patients investigated (17.1%) revealed a positive urease test of the laryngeal biopsy (four male and two female patients). These H. pylori-positive patients were treated with omeprazole and an antibiotic regimen using clarithromycin and metronidazole. This led to an eradication of the H. pylori and resolution of clinical signs and symptoms. These findings show a possible role of H. pylori infection in the etiology of chronic laryngitis in certain patients and can be important for clinical diagnosis and treatment.

We present a case of massive epistaxis caused by an internal carotid artery aneurysm. The initial treatment with endovascular balloon embolization failed as a result of balloon displacement. After rebleeding, the intracavernous aneurysm was treated with an endovascular detachable balloon embolization technique, which resulted in cessation of epistaxis. The different treatment options for interventional radiology and management of ruptured carotid artery aneurysms are discussed.

The chronic secretory otitis media (CSOM) is a common disease in children. Its cardinal symptoms are recurrent middle ear effusions and conductive hearing loss. Until today, the pathophysiological mechanism of this disease remains unknown. The correlation with adenoids and tubal dysfunction during childhood seems to be obvious, but the origin of middle ear effusions still has to be clarified. It is known that the CSOM affects the mucociliary system in several ways. In order to find out more about these correlations, the ciliary beat frequency was examined in 123 samples of infantile middle ear mucosa suffering from CSOM. Samples were surveyed using a stroboscopic microscopy method. The results of this study showed a significant decrease of ciliary beat frequency (CBF) to an average of 7.4 s(-1) in children with a CSOM. The healthy group of control showed a frequency of 10.1 s(-1). The measured CBF dataset was correlated with microbiological findings. We found a typical bacterial profile in nearly all the cases that were examined but were unable to find a specific bacterium decreasing CBF. This study provides evidence for the diminution of CBF in cases of CSOM in comparison to a healthy control group. Our findings emphasize the importance of stopping the vicious circle of recurrent effusions by paracentesis or grommet insertion.