Grażyna Niedzielska

Acoustic analysis in the diagnosis of voice disorders in children

The main aim of this study was to describe the changes in acoustic analysis in diagnosing voice disorders in children. The secondary goal was the attempt at differentiation of organic and functional disorders by means of acoustic analysis. The study included 112 children in treated due to laryngeal papilloma, gastro-esophageal reflux, atopic disease and noduli vocales. The following values have been determined: basic frequency F(o), jitter, shimmer, F(o) tremor and the harmonics to noise ratio (HNR). The study results confirmed that the HNR value was the most sensitive indicator of changes in the voice organ.

Acoustic analysis of voice in children with noduli vocales

The acoustic tests of voice were carried out on 46 children with noduli vocales before the treatment and after its completion. Acoustic parameters of voice were compared with the control group of children without voice pathology. The results of the investigation were analysed acoustically. It has been proved that jitter, shimmer, Fo tremor and HNR values significantly differentiate the children with noduli vocales from the children without pathological changes in the larynx. These parameters during treatment tend to approach normal values. Therefore, the acoustic analysis of voice may be used in treatment monitoring.

Esophageal Foreign Bodies in Pediatric Patients: A Thirteen-Year Retrospective Study

We discuss clinical symptoms and radiological findings of variable esophageal foreign bodies as well as therapeutic procedures in Caucasian pediatric patients. A retrospective study of 192 cases of suspected esophageal foreign bodies between 1998 and 2010 was conducted. Data were statistically analyzed by chi-square test. A foreign body was removed from a digestive tract of 163 children aged 6 months to 15 years (mean age 4.9). Most objects were located within cricopharyngeal sphincter. Dysphagia occurred in 43%, followed by vomiting (29%) and drooling (28%). The most common objects were coins. Plain chest X-rays demonstrated aberrations in 132 cases, and in doubtful situations an esophagram test was ordered. In the group of thirty-seven patients whose radiograms were normal, esophagoscopy revealed fifteen more objects, which were eventually successfully removed. No major complications occurred. Esophagram should be a second X-ray examination if an object is not detected in plain chest X-ray. We recommend a rigid esophagoscopy under general anesthesia in doubtful cases as a safe treatment for pediatric patients.

ABR disturbances in children with insulin dependent diabetes mellitus

A number of papers present the research on hearing disturbances in the course of diabetes mellitus. Some authors report the damage of inner ear cells, whereas others maintain that it is located in the retrocochlear part of the hearing pathway. The objective of the paper was to find the location of the auditory pathway disturbances in children suffering from diabetes mellitus. The analysis concerns 37 insulin treated children aged 6-18 years. The following audiometric methods were applied: pure-tone audiometry, impedance audiometry as well as auditory brainstem response (ABR). We observed conduction disturbances within the stem in ABR, in the children without hearing loss in pure-tone audiometry.

The phenotypic and genetic biofilm formation characteristics of coagulase-negative staphylococci isolates in children with otitis media

OBJECTIVE Medical biofilms are involved in a number of chronic infections including otitis media with effusion and chronic rhinosinusitis, which are common pediatric infectious diseases. The purpose of the study was to analyze the phenotypic and genotypic indicators of biofilm formation of coagulase negative staphylococci isolates in children with otitis media with effusion, and in children with chronic rhinosinusitis as a comparison group by using three different detection methods. METHODS Forty nine children aged from 2 to 6 years old, diagnosed with otitis media with effusion were enrolled to the study. The comparative group consisted of twenty three strains of coagulase-negative staphylococci from the strains collection isolated from nose swabs from children 3 to 7 years old suffering from rhinosinusitis for longer than 12 weeks. Cultured strains were tested for biofilm formation ability with three tests: Congo red agar, tissue culture plate methods and detection of ica operon. RESULTS Out of 97 ear effusion specimens, obtained from 49 children suffering from OME, 38 were found positive in conventional culture resulting in isolation of 50 different bacterial species. Nested-PCR method confirmed bacterial presence in 95 (97.9%) cases. Among 50 different bacterial species isolated, 30 (30.9%) CNS and 20 (20.6%) other than CNS species. Detection of slime producing phenotype of CNS was performed with CRA plate test. Among OME isolates, 11 (36.7%) were CRA plate test positive. In case of isolates from CRS, 8 (34.8%) strains revealed black coloration on CRA. Using TCP method, strong adherence to microtiter plate was observed in two Staphylococcus epidermidis strains from OME and two S. epidermidis from CRS. By using the ica operon test, the genotypic ability to form biofilm was identified in 7 (23.3%) S. epidermidis strains cultured from ears effusion and in 3 (13%) strains from nose swabs. CONCLUSIONS CNS strains revealed genotypic and phenotypic features responsible for the ability to form the biofilm in vivo. The presence of ica genes and phenotypic ability to form a biofilm by CNS strains emphasizes the pathogenic character of these strains in some cases of otitis media with effusion.

Voice after radiotherapy of the larynx carcinoma

BACKGROUND The study presents the evaluation of the phonatory function of the larynx after radiotherapy. The research covered the patients from the rural areas of Poland who revealed neoplastic changes in the glottis area. MATERIAL AND METHODS The test group consisted of 45 men aged 41-78 years with the carcinoma of the larynx with T1 and T2 progression types of cancer, according to the TNM classification. The analysis of laryngeal tone was performed with the digital analyzer Kay Elemetrics Model CSL 4300 and Multi Dimensional Voice Program (MDVP). A stroboscopic test in all the patients with T1 progression revealed the reduction of vibrations. RESULTS The acoustic analysis of the voice in the pre-treatment group as compared with the control group allowed for differentiation of the following parameters of a definitely pathologic character: Jita, Jitter, RAP, PPQ, vFo, Shimmer, APQ, vAm, NHR, VTI, SPI, and DUV. CONCLUSIONS In the acoustic analysis of voice in the post-radiotherapy group, the following parameters reached values close to the norm: JITA, JITT, RAP, PPQ, vF0, vAM, DUV, and Schimmer dB.

Dendritic cells and lymphocyte subpopulations of the adenoid in the pathogenesis of otitis media with effusion

OBJECTIVE To assess dendritic cells and lymphocyte subpopulations of adenoid and peripheral blood in patients with adenoid hypertrophy and otitis media with effusion (OME). To explain the influence of immunological status of adenoid on the development of OME. METHODS The examined group covered 123 surgically treated patients due to adenoid hypertrophy (39 children with coexisting OME). Preoperative clinical examination included anamnesis and otorhinolaryngological examination with nasofiberoscopy, videootoscopy and assessment of the hearing organ. The material of the study were surgically removed adenoids and peripheral blood samples prepared and then analyzed by the means of tri-colour flow cytometry. The obtained results were statistically analyzed. RESULTS Significant differences between patients with adenoid hypertrophy with coexisting OME and children without OME concerning CD19+CD69+, CD3+CD69+, CD4+CD69+CD8+CD69+ and CD19+CD25+ cells were observed. No statistical differences were revealed in the blood of patients with and without OME. Several statistical differences were noted between the adenoid and peripheral blood in patients with otitis media with effusion concerning BDCA-2+/CD123+ cells, CD3+ and CD19+ lymphocytes with the markers of their activation. CONCLUSIONS The adenoid is involved in local immune response regardless of constitutional immunological mechanisms in patients with OME coexisting with adenoid hypertrophy. Significantly lower percentage of CD3+CD69+, CD4+CD69+, CD8+CD69+ and CD19+CD69+ cells of adenoid in patients with OME attests to reduced T-cells activation of the adenoid in relation to patients without OME.

Risk factors for otolaryngological foreign bodies in Eastern Poland.

Objective To identify the sociodemographic characteristics and risk factors associated with suspected foreign bodies in the ear, nose, throat, airway, and esophagus among Polish children. Study Design Case series with chart review. Setting Tertiary care medical center. Subjects and Methods A retrospective analysis of the medical records of patients hospitalized for a suspected foreign body (FB) between 1998 and 2008 was conducted. Data regarding place of residence, presence of siblings, parents’ educational status, seasonality, psychomotor development, age, and sex were collected and statistically analyzed. Results Of the 1011 patients with suspected foreign body insertion, 849 (84%) had a positive diagnosis. Of the confirmed foreign bodies, 96 were found in the tracheobronchial tree, 142 were found in the esophagus, and 611 were located in the external auditory canals, nasopharyngeal passage, tonsils, auricles, or lips. Sociodemographically, 596 of the children came from urban areas, with a preponderance of males (55%). Objects were removed more frequently in summer and autumn (60%). Children with siblings (53%) predominated. The majority of patients (52%) had parents with an elementary education. Food was the most frequent foreign body in children under 3 years of age. Patients with delayed psychomotor development constituted 1.6% of the analyzed population. Conclusions Being male, 1 to 3 years of age, belonging to an urban family with siblings, and having parents with an elementary education increased the risk of foreign body insertion. Training caregivers about proper nutrition and safety rules when playing with children can reduce the risk of accidents related to foreign body insertion.

Hearing defects in children born of mothers suffering from rubella in the first trimester of pregnancy

The investigations concerned women that had suffered from symptomatic rubella in the first trimester of pregnancy. The presence of immunoglobulin G and immunoglobulin M antibodies in mothers and their children was detected, and the hearing organ was examined. In early childhood (up to 3 years of age), hearing loss was confirmed in 50% of the children born of mothers with rubella.

Bacterial etiology of recalcitrant acute otitis media in sixty two children – high risk of pathogen colonization after treatment

Acute otitis media (AOM), common childhood infection that is one of leading cause of antibiotic prescriptions for children, is diagnosed at least once in approximately 80% of preschool children and 30-40% of them have recurrent episodes. Antibiotic treatment of AOM is usually empiric, without isolation of otopathogens from middle ear fluid and their antibiotic susceptibility testing. Due to the improper antibiotic use, the infection can persist in some cases, termed AOM treatment failure. This article is protected by copyright. All rights reserved.