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.

AIDS was reported in the pediatric population for the first time in 1982 in the USA by pediatricians who hardly managed to convince those responsible for childcare, because it can also occur in this population segment. Thanks to efforts for disease recognition in the pediatric population, scientists have been able to provide support and children infected with human immunodeficiency virus (HIV) receive the same treatment protocol as adults. Early detection of HIV infection in pregnant women leads to the possibility for starting a treatment to prevent HIV transmission from mother to child. The ELISA test has a high sensitivity and is indicated for HIV screening and Western Blot test has highly specificity and confirming the HIV infection.