The aim of this study is to analyze the impact of various parameters on the course and treatment outcome in patients with laryngotracheal stenosis and recurrent stenosis. Two groups of patients were compared: Group I included 29 patients with primary stenosis, and Group II included 22 patients with recurrent stenosis. The most frequent etiological factor for the development of stenosis was prolonged endotracheal intubation (79.3:77.3%), with subglottic-tracheal (44.8:45.5%) and tracheal (48.3:36.4%) localization being the most affected. Subglottic-tracheal stenosis was more common in men. There were no significant differences between the groups in regard to the grade of lumen obstruction and the length of the resected segment. In male patients, the length of the resected stenotic segment was significantly longer. Subglottic-tracheal stenoses were longer than tracheal ones. Various surgical procedures were performed, with additional management of recurrent laryngeal nerve paralysis, if necessary. Laryngotracheal reconstruction (LTR) with costal cartilage grafting (CCG) was statistically significantly more often performed in Group II, while cricotracheal resection (CTR) was more common in Group I. The incidence of complications in Group I was 24.1%, and in Group II it was 31.8%. Satisfactory airway lumen with undisturbed breathing was achieved in 93.1% of patients in Group I, and in 95.3% in Group II. Since the success rate was similar in both groups of the patients, it could be concluded that treatment outcome depends less on the factors associated with the stenosis, and more on adequate choice of surgical procedure and surgical team know-how.

Clin. Otolaryngol. 2012, 37, 362–368 Objectives:  To compare the prevalence of laryngopharyngeal reflux in choristers, teachers and control subjects without vocal load at work and to determine the risk factors for laryngopharyngeal reflux. Design:  A prospective, multicentre, multivariate comparative study. Participants:  One hundred and nineteen singers from four professional choirs, seventy teachers from four schools and 111 control subjects with an occupation without vocal load. Main outcome measures:  All participants completed a questionnaire about their dietary habits, height and weight, presence of stress, smoking and allergies, including the nine‐item Reflux Symptom Index. The groups of choristers, teachers and the controls were compared with each other with regard to their sex, age, dietary habits, body‐mass index, Reflux Symptom Index score and other factors affecting voice quality. The subjects from all three groups with suspected laryngopharyngeal reflux were compared with the subjects without it. The relationship between the Reflux Symptom Index score and the possible risk factors for reflux was estimated. Results:  The results showed significantly higher Reflux Symptom Index scores in the choristers than in the teachers and the controls (mean scores, 7.86 versus 6.33, P = 0.044; 7.86 versus 4.80, P = 0.000, respectively), but the number of subjects with suspected laryngopharyngeal reflux (Reflux Symptom Index score >13) did not differ significantly between the groups. The choristers were significantly more often treated for laryngopharyngeal reflux than the teachers and the controls (41%, 17% and 28%, respectively). The occupation chorister and frequently experiencing stress were the only factors that influenced the total Reflux Symptom Index score. Conclusions:  Laryngopharyngeal reflux affects the choristers more often than the teachers or the control subjects without vocal load at work. These results suggest that singing as the main professional activity can notably contribute to the development of the reflux. Vocal load without singing is probably not an important aetiological factor for laryngopharyngeal reflux. The extraoesophageal symptoms affecting voice require treatment for laryngopharyngeal reflux and proper dietary habits especially in the group with high voice quality demands.

The effectiveness of teaching esophageal speech depends significantly on the motivatidn of the patients. It was found that the patients who mastered esophageal speech successfully had'been learning it longer than those who did not master it. The success in mastering esophageal speech did not depend on whether the patients were trained individually or collectively, whereas neither method of training was successful in group 2.

Studies assessing the efficiency of different methods of vocal therapy are scarce bearing in mind the importance of vocal therapy and the fact that many patients refuse surgical treatment. Research on the efficiency of assistive techniques in phoniatric rehabilitation of patients with unilateral vocal cord paresis yields conflicting results. However, assistive techniques are useful practical methods in vocal rehabilitation of these patients.

The paper describes a patient who ingested a piece of bone during his meal. A Jbreign body was suspected and admission to the hospital was recommended as well as esophagoscopy, which he refused. Approximately 48 hours after the meal, the patient was admitted to the hospital for increased temperature, neck pain, and swollen right side of neck. Assuming that the condition was a result of hypopharyngeal perforation cased by a foreign body, computed tomography was performed A collection oJ'pus was found in the lateral and anterior neck compartments with subcutaneous tissue edema, and a foreign body was found in the projection of the hypopharynx. A wide incision was made under general anesthesia and drainage was performed using surgical drains and nasogastric tube. Antibacterial therapy was also applied. The patient was dismissed from the hospital in good general condition. Complications involving a foreign body in the hypopharynx and/or esophagus require urgent attention and adequate diagnosis and therapy. A correct indication, good choice of surgical procedure and intensive antibacterial therapy increase the chance of cure in such patients.