D. N. Nikitina

Some patients with bronchopulmonary dysplasia (BPD) whose status requires long-term mechanical ventilation (MV), undergo tracheostomy (TS), however, the characteristics of such patients are not presented in domestic studies as yet. The purpose of this research was to calculate the frequency of TS in children with BPD, to assess the clinical features of such patients’ status, the comorbidity and the outcomes in these patients. Materials and methods used: 73 children in their first year of life - aged 2.0 [1.0; 5.0] months old, 45 (62%) boys/28 (38%) girls, with diagnosed BPD participated in a single-center cohort retrospective study and were divided into two groups (with BPD and TS; 14, and with BPD but without TS; 59), who were admitted at the Morozov Children’s City Clinical Hospital (Moscow, Russia) in 2020-2023. The demographic characteristics of patients, their comorbidity and mortality as well as the reasons for TS were assessed. Results: the frequency of TS in infants with BPD was 4.3% [95% CI 2.4%; 7.2%]. In the structure of infant patients with TS, children with BPD accounted for 18.7% [95% CI 10.6%; 29.3%]. In 14 children with BPD, TS was performed at median age of 3.5 [2.0; 6.0] months old with an average age of 4.4±2.7 months old. These patients had severe comorbidities, such as: perinatal CNS damage (all of them), congenital heart defects (6), Edwards syndrome (2), Down syndrome (2) and CHARGE syndrome (2). Patients with BPD and TS, compared with patients with BPD but without TS, had statistically significantly greater gestational age (p=0.005) and birth weight (p=0.046), rather frequently needed the MV (p=0.007) and ware assigned with the palliative patient status (p<0.001). Of the 8 children with BPD with TS with known follow-up, 5 (63%) had died. Conclusion: the need for TS and long-term MV in children with BPD is determined by severe comorbidity.

Objective. To study the efficacy and safety of balloon dilation as the first choice method in the treatment of children of the first year of life with acquired subglottic stenosis. Material and methods. A retrospective analysis of the treatment of 25 patients aged 27 days to 11 months of life (average age 5.3±3.76 months) with subglottic stenosis caused by prolonged intubation, in whom balloon dilation was the first method of treatment. Grade III Cotton-Myer stenosis was preoperatively detected in 22 children, the remaining 3 had grade II stenosis. Results. The success rate of balloon dilation was 100%; tracheotomy was not required in any case, the absence of stenosis during a follow-up examination in the catamnesis was recorded in 14 (56%) children, the remaining 11 (44%) had grade 0-I stenosis and did not cause respiratory disorders. In 1 child (1.5 years old), a subglottic cyst was removed after balloon dilation. One dilation was required in 18 (72%) children, two — in 5 (20%), three and four — respectively for 1 patient. If additional intervention was necessary, the operation was repeated 10 days — 3 months after the previous one. There were no postoperative complications. Conclusion. Balloon dilation is a highly effective and safe alternative to traditional surgical interventions for acquired subglottic stenosis in children of the first year of life and can be recommended as a method of first choice.

Архив медицинского научно-практического журнала «Российская оториноларингология»

The article presents a casuistic clinical observation of the treatment of a child aged 1 year 10 months with a dermoid cyst of the middle ear. The diagnosis was established on the basis of computed tomography and histological examination of the mass. Surgical treatment was performed in the volume of a separate attic-anthromastoidotomy with removal of the formation and one-stage type III tympanoplasty. In the catamnesis, the child's condition is satisfactory, the otoscopic picture shows no signs of inflammation.