Nasal Cavity In Children Research Articles

Characterization of the upper respiratory tract microbiota in Chilean asthmatic children reveals compositional, functional, and structural differences.

Around 155 million people worldwide suffer from asthma. In Chile, the prevalence of this disease in children is around 15% and has a high impact in the health system. Studies suggest that asthma is caused by multiple factors, including host genetics, antibiotic use, and the development of the airway microbiota. Here, we used 16S rRNA high-throughput sequencing to characterize the nasal and oral mucosae of 63 asthmatic and 89 healthy children (152 samples) from Santiago, Chile. We found that the nasal mucosa was dominated by a high abundance of Moraxella, Dolosigranulum, Haemophilus, Corynebacterium, Streptococcus, and Staphylococcus. In turn, the oral mucosa was characterized by a high abundance of Streptococcus, Haemophilus, Gemella, Veillonella, Neisseria, and Porphyromonas. Our results showed significantly (P < 0.001) lower alpha diversity and an over-abundance of Streptococcus (P < 0.01) in nasal samples from asthmatics compared to samples from healthy subjects. Community structure, as revealed by co-occurrence networks, showed different microbial interactions in asthmatic and healthy subjects, particularly in the nasal microbiota. The networks revealed keystone genera in each body site, including Prevotella, Leptotrichia, and Porphyromonas in the nasal microbiota, and Streptococcus, Granulicatella, and Veillonella in the oral microbiota. We also detected 51 functional pathways differentially abundant on the nasal mucosa of asthmatic subjects, although only 13 pathways were overrepresented in the asthmatic subjects (P < 0.05). We did not find any significant differences in microbial taxonomic (composition and structure) and functional diversity between the oral mucosa of asthmatic and healthy subjects. This study explores for the first time the relationships between the upper respiratory airways bacteriome and asthma in Chile. It demonstrates that the nasal cavity of children from Santiago harbors unique bacterial communities and identifies potential taxonomic and functional biomarkers of pediatric asthma.

Oral fluid immunological characteristics in children with congenital cleft palate and a postoperative defect

Relevance. The lack of anatomical differentiation between the oral cavity and the nasal cavity in children with congenital cleft palate leads to the deterioration of saliva characteristics affecting dental and periodontal disease progression. The oral fluid immunological profile may provide information about the nature of the inflammatory processes and changes in the reaction to the ongoing therapy.Material and methods. The article presents the results of the oral fluid enzyme immunoassay in 109 children aged 6-12 years with congenital cleft palate and a postoperative defect and in 50 practically healthy children of the same age. The study determined the levels of pro-inflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) cytokines and secretory immunoglobulin sIgA in the oral fluid by enzyme-linked immunosorbent assay.Results. The study of children aged 6-12 years with congenital cleft palate and a postoperative defect revealed hyperstimulation of oral fluid pro-inflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) cytokines and a decrease in secretory immunoglobulin sIgA mean level.Conclusion. The oral fluid immunological complexes imbalance in children with congenital cleft palate and a postoperative residual defect is a progressive factor for the development and chronicity of oral inflammatory diseases.The received data evidence the local inflammatory process and a decrease in the oral fluid local protective factors, which one must consider to develop methods for improving the condition of organs and tissues of the oral cavity in children with congenital cleft palate during preparation for surgery to eliminate the residual defect.

Rapid Maxillary Expansion Has a Beneficial Effect on the Ventilation in Children With Nasal Septal Deviation: A Computational Fluid Dynamics Study.

Nasal septal deviation (NSD) is one of the most common nasal diseases. Different from common clinical examination methods, computational fluid dynamics (CFD) can provide visual flow information of the nasal cavity. The dimension and volume of the nasal cavity are easily affected by rapid maxillary expansion (RME). The purpose of this study was to use CFD to evaluate the effect of RME on the aerodynamics of the nasal cavity in children with maxillary transverse deficiency and NSD. Computational fluid dynamics was implemented after 3D reconstruction based on the CBCT of 15 children who have completed RME treatment. After treatment, the volume increases in the nasal cavity, nasopharynx, oropharynx, and pharynx were not statistically significant. The wall shear stress of the nasal cavity after RME, 1.749 ± 0.673 Pa, was significantly lower than that before RME, 2.684 ± 0.919 Pa. Meanwhile, the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (−31.058 Pa) than before (−48.204 Pa). This study suggests that RME has a beneficial effect on nasal ventilation. The nasal airflow became more symmetrical in the bilateral nasal cavity after RME. Pharyngeal resistance decreased with the reduction in nasal resistance and the increase in the volume of oropharynx after RME.

Foreign bodies in the nasal cavity in children

Foreign bodies in the nasal cavity in children are a fairly common reason for contacting an otorhinolaryngologist. Most foreign bodies can be removed quite easily. However, some cases are associated with significant difficulties in their searching and removing and require the use of special technical methods and general anesthesia. We present two cases of unusual foreign bodies in the nasal cavity in children.

КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ ИЗМЕНЕНИЙ МИКРОБИОМА ПОЛОСТИ НОСА У ДЕТЕЙ СО ЗЛОКАЧЕСТВЕННЫМИ ОПУХОЛЯМИ ПАРАМЕНИНГЕАЛЬНОЙ ЛОКАЛИЗАЦИИ ВО ВРЕМЯ ХИМИОЛУЧЕВОЙ ТЕРАПИИ

Malignant tumors of parameningeal localization are various morphological neoplasms located in the nasal cavity, nasopharynx, paranasal sinuses and middle ear. As a result of tumor growth, conditions are created for the development of chronic inflammation. Studies of the microbiome of the upper respiratory tract in children with malignant tumors were practically not conducted. Objective of the research: to identify changes in the microbiome of the nasal cavity in children with malignant tumors of parameningeal localization during chemoradiotherapy. Materials and methods: the study included 29 patients with parameningeal tumors, 2–17 years old. Among the included in the study there were 18 boys (62%) and 11 girls (37%). Morphologically, the following were verified: embryonic rhabdomyosarcoma (ERMS) – 17 (58%), alveolar rhabdomyosarcoma (arms) – 3 (10%), other sarcomas – 4 (13%), nasopharyngeal cancer – 5 (17%). All patients received induction chemotherapy. Simultaneous radiotherapy (LT) and chemotherapy (CT) – in 24 (82%) cases. After completing the chemoradiotherapy stage, consolidation therapy continued in 20 (70%) patients. Results: before the start of LT (after the induction stage of chemotherapy), a variety of microflora was observed in the nasal secretions, gram-positive and gram-negative bacteria were isolated in an equal ratio. The absence of growth of microorganisms was determined in 4 (13%) cases before the start of LT. Methicillin-resistant Staphylococcus epidermidis and Staphylococcus haemolyticus were more frequently detected after LT. Colonization of the nasal cavity of Candida albicans occurred before the start of LT in 4 (13%) and persisted after irradiation in 5 (17%) patients. In the delayed period, there was an increase in the percentage of patients who ridiculed gram-negative microorganisms – Pseudomonas aeruginosa in 4 (13%) cases. After 12 months, 3 (10%) patients showed a return of nosocomial flora (S. epidermidis MRSE and S. haemolyticus MRS), a decrease in colonization of P. aeruginosa and the preservation of C. albicans. Conclusion: at different stages of chemoradiotherapy, the nasal mucosa is colonized by various microorganisms that differ in their properties and pathogenicity. The continuation of this study will clarify the clinical significance of certain types of opportunistic microorganisms in the pathogenesis of inflammatory diseases of the upper respiratory tract in children with malignant tumors.

Age-related description of the posterior structures of the nasal cavity in children

The aim of the study was to describe morphometric characteristics of the posterior parts of the nasal cavity in different periods of childhood and to specify the age-related norm for improving surgical treatment options of choanal atresia and providing an optimal access to the anterior part of the skull base. Material and methods. The study included 87 children aged 1-21 who were exposed to craniometry of the nasal cavity structures. Results. The age-related variability of the linear dimensions and shape of the choanae, their relationship with the dimensions of the pyriform aperture and the height of the nasal cavity in the posterior part were defined in the study. The increase in the height of the choanae and the height of the nasal cavity at the back starts from 2– 3 years of age, and the width – from 8–12 years of age. The height and width of the pyriform aperture are equal to the age of 8–12; these parameters increase in older children's groups with a predominance of the height over the width. The height of the nasal cavity at the back increases in all age periods. The growth of the studied structures of the nasal cavity is completed by adolescence. In infancy, the height of the choanae is less than the height of the nasal cavity at the back by 45%, and less than the height of the pyriform aperture by 20%; in adolescence, these ratios are 42% and 23%, respectively. In infancy the choanal width is less than the width of the pyriform aperture by 49%, and in adolescence – by 40%. In infancy and early childhood, the choanae are typically small in height and width. Their shape is round in 25% of cases, however, ovoid shape is also found. The height and width of the pyriform-shaped aperture at these age periods are similar and do not exceed 17–18 mm; the height of the nasal cavity at the back is 25–27 mm. Conclusion. The authors have described age-related morphometric features of the posterior structures of the nasal cavity. These features should be taken into account by otorhinolaryngologists and neurosurgeons when planning endoscopic intranasal surgical access in children. The younger the child is, the more difficult it is to perform a surgery due to the significant restriction of the access resulted from the small size of the piriform opening and the nasal cavity, and the obstinacy of the nasal septum. When performing choanotomy for atresia, it is necessary to form the choana comparing it in shape and size with the age-related norm

The use of decongestants for the treatment of runny nose symptom in children: the clinical and pharmaceutical analysis of the pharmaceutical market of Ukraine

The rational treatment of acute rhinosinusitis of infectious or allergic origin is an urgent task of both therapeutic and pediatric practice. This problem is of particular importance in connection with its prevalence in children, with a large list of drugs for the symptomatic treatment, the presence of significant side effects in active pharmaceutical ingredients, the peculiarities of the use of dosage forms, as well as a wide range of OTC drugs, including those approved for use in children.Aim. To develop recommendations for introducing changes or additions to the peculiarities of using decongestants for topical use in diseases of the nasal cavity (sympathomimetics, corticosteroids, antihistamines, etc.) in children (under 15 years of age) in the Protocol of the Pharmacist “Symptomatic treatment of rhinitis”.Materials and methods. To achieve the goal, the clinical and pharmaceutical analysis of decongestants for local use in diseases of the nasal cavity (sympathomimetics, corticosteroids, antihistamines, etc.), registered and marketed inUkraine was performed.Results. As a result of the study it has been found that in February 2020 there are 146 decongestants for local use in diseases of the nasal cavity registered at the Ukrainian market. 87.7 % of the drugs are OTC and can be used by patients/patient representatives independently. 12.3 % of the drugs (18 items, mainly from the group of corticosteroids) are dispensed by prescription. The analysis of the composition of decongestants has been performed; it has been found that agents based on oxymetazoline (21.2 %) and xylometazoline and its combinations (39 %) prevail. When studying the prescribing information it has been found that 136 of 146 trade names can be used in the case of a cold in children under the age of15. In addition, depending on the age, the ranking of their active pharmaceutical ingredients (APIs) can be presented by the following sequence: sodium chloride (0.65 %), phenylephrine hydrochloride (0.125 %), oxymetazoline hydrochloride (0.01 %). Clinical and pharmacological evaluation of undesirable effects of APIs and the ways of their prevention have been performed.Conclusions. The range and presence of undesirable effects of APIs of modern decongestants requires a cautious approach to responsible self-medication and a careful selection of the drug for the symptomatic treatment of acute rhinosinusitis in children. It is recommended to clarify the Protocol of the Pharmacist “Symptomatic treatment of rhinitis” on the possibility of using decongestants for topical use in diseases of the nasal cavity in children of different ages.

Allergic rhinitis in children: from diagnosis to therapy

Allergic rhinitis, according to modern data, affects up to a quarter of the population of developed countries. The disease affects not only the nasal mucosa, but also affects the receptors and mediators of inflammation in the bone marrow. A significant decrease in the quality of life of patients against the background of exacerbation of allergic rhinitis makes us look for new approaches to both the treatment of attacks and their prevention. Correction, including surgical, of concomitant pathology of the nasal cavity and paranasal sinuses significantly improves the quality of life of patients with allergic rhinitis. For a long time, surgical treatment of concomitant pathology of the nasal cavity in children was extremely limited due to the risk of damage to the growth zones and, as a consequence, a high probability of recurrence of deformation of the structures of the nose and paranasal sinuses. With the development of endoscopic methods of surgical treatment of the nasal cavity and paranasal sinuses, operations with minimal invasiveness and, as a consequence, safe at any age were introduced into practice. Surgical intervention on the structures of the lymphoid pharyngeal ring in children with allergic rhinitis is causing heated debate in the pediatric community to date. The article considers modern approaches to the diagnosis and treatment of allergic rhinitis in children. Topical problems of conservative and surgical treatment are discussed. Special attention is paid to the safety of various treatment regimens. The discussed practical issues of tactics of treatment of allergic rhinitis are relevant for both pediatric allergists and ENT pediatricians.

Rapid and direct molecular detection of Streptococcus pneumoniae and Haemophilus influenzae isolated in oropharynx and nasal cavity of children.

There is a direct correlation between asymptomatic oropharyngeal colonization by pathogenic bacteria and the prevalence of paediatric respiratory infections. Streptococcus pneumoniae and Haemophilus influenzae are common cause of serious bacterial infections such as meningitis in children. This study aimed to monitor healthy children to detect asymptomatic carriers of S. pneumoniae and H. influenzae. In the present cross-sectional study, real-time PCR assay was developed and evaluated in comparison with culture for direct detection of S. pneumoniae and H. influenzae in 123 oropharynx and nasal cavity specimens from healthy children in Ilam, Iran. In addition, virulence factor (ply and hpd) and iron uptake (tbpA and piuA) genes were evaluated by PCR. Our results demonstrated that among all isolates only 14 S. pneumoniae and eight H. influenzae were identified by phenotypic methods, whereas 37 and 21 S. pneumoniae and H. influenzae were identified, respectively, by real-time PCR assay. All S. pneumoniae and H. influenzae isolates possessed tbpA and piuA genes. Also, 81% (30/37) of S. pneumoniae isolates were positive for ply gene, which encoded pneumolysin, as well as 90% (19/21) of H. influenzae isolates were positive for hpd gene. Simultaneous colonization of S. pneumoniae and H. influenzae could indicate the importance of monitoring of healthy children to identification of carriers.

Инородные тела в полости носа у детей: современный взгляд на эпидемиологию, профилактику и лечение осложнений

Инородные тела в полости носа у детей: современный взгляд на эпидемиологию, профилактику и лечение осложнений

How does nonsyndromic craniosynostosis affect on bone width of nasal cavity in children? - Computed tomography study.

Craniosynostosis is caused by premature fusion of one or more cranial sutures, restricting skull, brain and face growth. Nonsyndromic craniosynostosis could disturb the proportions of face. Although morphometric diameters of nasal cavity in healthy children are already known, they have not been established yet in children with nonsyndromic craniosynostosis. The aim our study was to check whether diameters of bone structures of nasal cavity in children with nonsyndromic craniosynostosis measured in CT are within normal range. 249 children aged 0–36 months (96 with clinical diagnosis of nonsyndromic craniosynostosis and 153 in control group) were included into the study. The following diameters were measured on head CT scans: anterior bony width (ABW), bony choanal aperture width (BCAW), right and left posterior bony width (between bone sidewall and nasal cavity septum—RPBW and LPBW). The study group has been divided into 4 categories, depending on child’s age. The dimensions measured between bone structures of nasal cavity were statistically significantly lower in comparison to the control group. They did not depend on the sex for ABW, nor on age in groups 7–12 months and < 2 years for BCAW, RPBW and LPBW. The measured dimensions increased with age. In children with nonsyndromic craniosynostosis the diameter of pyriform aperture and bony choanal aperture were lower than in controls, what may be described as fronto-orbital anomalies. Morphometric measurements of anthropometric indicators on CT scans could be used as standards in the clinical identification of craniosynostosis type and may help in planning surgical procedures, particularly in the facial skeleton in children.

Epidemiology of foreign objects of the nasal cavity in a large megalopolis

The article presents a retrospective analysis of the prevalence of nose pathology, in particular, foreign objects of the nasal cavity in children’s hospitals in Moscow at the period of 2012 through 2016. The prevailing nose pathology is the nasal injure (23.4%), the 2nd position is occupied by inflammatory diseases of nose and paranasal sinuses (17%), and the 3rd one – by the foreign objects of the nasal cavity (6.6%). Particular attention is paid to foreign objects of the nasal cavity causing complications in children.

Limited Approach in Endoscopic Dacryocystorhinostomy of Pediatrics.

Background:Limited spatial nasal cavity in children, make pediatric dacryocystorhinostomy (DCR) a difficult surgical procedure. We apply a limited approach to pediatric DCR and follow them for their consequences.Materials and Methods:An experimental study was done in pediatric DCR with limited approach (age < 14-year-old). After written consent, with general anesthesia, with nasal endoscopic surgery, lacrimal bone is exposed and extruded. In contrast with routine procedure, ascending process of maxillary sinus reserve; and marsupialization and wide exposure to lacrimal sac was done only by lacrimal bone defect; and cannulation preserve with temporary silicone tube.Results:Between 2006 and 2012, 16 pediatric DCR was done by a unique surgeon in 2 otorhinolaryngologic centers. Before surgery 14 (87.5%) had epiphora, 3 (18.8%) had eye discharge, and 3 (18.8%) had eye sticky eye. Two (12.5%) had history of facial trauma, and 10 (62.5%) had congenital nasolacrimal duct insufficiency. Five (31.3%) had history of dacryocystitis. Patients were followed for 17 ± 9 months. Silicone tube stayed for 4 ± 2.5 months. We could follow 7 patients and minimal improvement or need to revision surgery considered as technical failure. After surgery, 3 patients had no epiphora with complete improvement; 2 had very good improvement with confidence of the patients and parents; 2 cases had unsuccessful surgery in our patients, who needs to another surgery. One of them had several probing and surgery before our endoscopic DCR.Conclusions:Limited approach in endoscopic DCR of pediatrics can be done in noncomplicated patients, with minimal manipulation, more confidence, and acceptable results.

Correlations between selected parameters of nasal cavity in neonates and young infants - computed tomography study.

Correlations between selected metric parameters of the nasal cavity and nasopharynx in children without atresia may be useful for anticipating probable dimensions of this region in living subjects, in terms of changes with age. One hundred and eighty children, age range 0-3 years, were divided into five age groups, and measurements of 18 distances between structures of nasal cavity and nosopharynx were performed on computed tomography scans. Correlation coefficients and relations between parameters have been determined. Our study confirmed the existence of statistically significant correlations between linear dimensions within nasal cavity in children. The analysis demon-strated that for the values of following indexes: nasal septum length/piriform aperture width, and maximum length of the nasal septum/posterior nares width no statistically significant differences have been noted between age groups of children. All correlations have been positive. No statistically significant differences have been noted between the maximum width of the vomer and osseous parameters measured, both in the anterior and posterior part of the nasal cavity, and nasal septum length. The size of posterior nares changed with age in children by a constant value. So far, no such an analysis has been carried out assessing potential correlations between linear dimensions for the entire nasal cavity, nasopharynx, length of the nasal septum in children, as well as proportions of individual linear dimensions of the anatomical structures analysed, in various age groups.

Foreign bodies in the nasal cavity of children

The article provides material on foreign bodies in the nasal cavity in the period between 2004 and 2014 in children aged 0 through 12 years. The authors described epidemiological features, clinical manifestations depending on the type of foreign body and the duration of its stay in the nasal cavity.

Multimodality Treatment of Pediatric Esthesioneuroblastoma.

Esthesioneuroblastoma (ENB) is a rare cancer of the nasal cavity in children. Radical surgery followed by postoperative radiation is considered the standard of care in adults. A similar approach in children can lead to significant long-term morbidity. A retrospective multi-institutional review of patients less than 21 years of age diagnosed with ENB between 1990 and 2014 was performed. Clinical features, treatment, and outcome were obtained from the medical records. Twenty-four patients were identified with a median age of 14 years (range 0.6-20 years) at diagnosis. The majority (75%) were females. Headache was the most common presenting symptom, followed by nasal obstruction and epistaxis. Eight patients had Kadish stage B tumors and 16 had Kadish stage C tumors. Nine patients had metastatic disease. Gross total resection was achieved at diagnosis in eight patients and after neoadjuvant chemotherapy in four patients. Twenty-one patients received radiation therapy (45-68.4 Gy). Thirteen patients received neoadjuvant chemotherapy with 84% objective response rate. Seven patients experienced disease progression or relapse-five in central nervous system, one local, and one in cervical lymph node. Fifteen patients were alive at the last follow-up. The 5-year disease-free survival and overall survival were 74% and 73%, respectively. Late effects were observed in 78% of long-term survivors. Four patients developed subsequent malignant neoplasms. Pediatric ENB is a chemosensitive disease. Preoperative chemotherapy-based multimodal approach should be used in patients with advanced stage disease. Radiation therapy is effective for local control, but lower doses should be considered in children.

Уход за полостью носа у детей с аллергическим ринитом в осенне-зимний период

Уход за полостью носа у детей с аллергическим ринитом в осенне-зимний период

Molecular detection of adhesins genes and biofilm formation in methicillin resistant Staphylococcus aureus

Staphylococcus aureus has been identified as a major cause of nosocomial infections in hospitals. In this study, 41 S. aureus have been isolated from the nasal cavity of children in Libya. Congo red agar assay (CRA), semi quantitative adherence assay and microbial adhesion to solvent (MATS) test were used to study qualitative and quantitative biofilm formation of the isolated strains. Molecular detection of adhesion (icaA, icaD, fnbA, cna andclfA) genes was detected by polymerase chain reaction. Our results showed that 21 strains (51.2%) were slime producers on CRA plates. In a parallel way, 19 strains were slime producer on polystyrene plates. The MATS assay showed that all the studied strains have hydrophilic character. Molecular detection of adhesion genes revealed that 56.1% strains were icaA and icaD positives, 34.1% were cna positives, and 56.1% were fnbA positives. Moreover clfA gene was not detected in all the tested strains. This study confirms the adhesion ability and the presence of adhesion genes in the majority of the strains isolated from the nasal cavity of Libyan children. Key words: Staphylococcus aureus, nasal carriage, biofilm, hydrophobicity, adhesin genes.

A huge true fibroma of nasal cavity in children: a case report

患儿男，6岁，进行性右侧鼻腔阻塞3年，间断性少量鼻出血，伴右眼球渐突出，视力下降。于2005年9月20日以“鼻腔肿物”收入院。查体：颈部淋巴结无肿大，右面颊部隆起，右眼球向前外方突出，眼睑肿胀，睑裂变小，复视，右眼视力0.6，右鼻腔有淡灰白色肿物，质硬，基底广，不易出血，对血管收缩剂不敏感。CT影像示右侧鼻腔巨大占位性病变，鼻中隔受压移位。门诊取活组织检查，病理报告为“鼻腔纤维瘤”。2005年9月28日在全身麻醉下，采用鼻侧切开术式行鼻腔肿瘤切除术。术中见肿瘤质韧，有不完全包膜，血管不丰富，肿瘤突入右侧眶内及筛窦内，大部分眶纸样板及上颌窦内侧壁骨质压迫吸收，鼻中隔受挤压突向左侧鼻腔。

Mucociliary function in the nasal cavity of children and adolescents with cholesteatoma

Mucociliary function in the nasal cavity of children and adolescents with cholesteatoma