Browsing by Author "Baljošević, Ivan (56247329700)"

Introduction. Etiopathogenetically, there are two types of chollesteatomas: congenital, and acquired. Numerous theories in the literature try to explain the nature of the disease, however, the question about cholesteatomas remain still unanswered. The aim of the study was to present a case of external ear canal cholesteatoma (EEC) developed following microsurgery (ventilation tube insertion and mastoidectomy), as well as to point ant possible mechanisms if its development. Case report. A 16-yearold boy presented a 4-month sense of fullness in the ear and otalgia on the left side. A year before, mastoidectomy and posterior atticotomy were performed with ventilation tube placement due to acute purulent mastoiditis. Diagnosis was based on otoscopy examination, audiology and computed tomography (CT) findings. CT showed an obliterative soft-tissue mass completely filled the external ear canal with associated erosion of subjacent the bone. There were squamous epithelial links between the canal cholesteatoma and lateral tympanic membrane surface. They originated from the margins of tympanic membrane incision made for a ventilation tube (VT) insertion. The position of VT was good as well as the aeration of the middle ear cavity. The tympanic membrane was intact and of normal appearance without middle ear extension or mastoid involvement of cholesteatoma. Cholesteatoma and ventilation tube were both removed. The patient recovered without complications and shortly audiology revealed hearing improving. Follow-up 2 years later, however, showed no signs of the disease. Conclusion. There could be more than one potential delicate mechanism of developing EEC in the ear with VT insertion and mastoidectomy. It is necessary to perform routine otologic surveillance in all patients with tubes. Affected ear CT scan is very helpful in showing the extent of cholesteatoma and bony defects, which could not be assessed by otoscopic examination alone.

Background/Aim. Otitis media with effusion (OME) is a common disease among the children aged from 6 months to 4 years, but recurrences are common after the extraction of ventilation tubes. The aim of the study was to determine the risk factors for recurrent OME after extraction of ventilation tubes. Methods. The research was a prospective study with 305 children aged 0 to 10 years with OME. Forty three (14%) of them had recurrent OME. We analyzed the factors that could lead to the redevelopment of the disease after extrusion of the tubes. Results. It was found that the majority of children with recurrent disease was between the ages of 5 to 7 years (56%) and had allergy in significantly higher rate than children without recurrence. In most cases (37.7%), the retention time of ventilating tube was above 10 months and the recurrent disease was diagnosed in 46.5% cases within a period of 10 to 12 months after extrusion of tubes. Conclusion. Children with OME and after ventilation tube extrusion need to be followed up for 1 year after the removal of tubes. It is necessary to inform the parents that the disease can recur. Children in the kindergarten, in preschool age and with a respiratory allergy had higher possibility for recurrent OME. © 2017, Inst. Sci. inf., Univ. Defence in Belgrade. All Rights Reserved.

Background and Objectives: Tonsillitis is common in children and is predominantly caused by viruses and, less frequently, by bacteria such as group A beta-hemolytic streptococcus. The treatment primarily involves supportive care; however, the overuse of antibiotics remains a concern due to rising antibiotic resistance. Probiotics, particularly Lactobacillus strains, have been shown to modulate immune responses, offering a potential alternative treatment. Materials and Methods: Our prospective single-arm, open-label study included 98 pediatric patients aged 5–15 years with recurrent throat and tonsil infections, from October 2022 to January 2023. Patients received lozenges containing heat-killed Lactobacillus helveticus MIMLh5. Monthly follow-ups involved a comprehensive ear, nose, and throat examination, throat cultures, and recording the frequency of infections and antibiotic use. Data were analyzed using SPSS 29.0, with statistical significance set at p < 0.05. Results: After three months, significant reductions were observed in the occurrences of nose and throat infections (p < 0.001), enlarged submandibular glands (p < 0.001), and positive throat cultures (p < 0.001). Antibiotic and corticosteroid prescriptions also significantly decreased (p < 0.001). Among children aged 5–10 years, significant improvements were noted in throat and tonsil infections (p < 0.001) and positive throat cultures (p = 0.012). Overall, there was a substantial reduction in school days missed (p < 0.001). Conclusions: The use of paraprobiotic Lactobacillus helveticus MIMLh5 lozenges significantly reduced the incidence of recurrent throat and tonsil infections in children, decreased the need for antibiotics and corticosteroids, and improved overall clinical outcomes without adverse effects. These findings support the use of paraprobiotic supplements as a safe and effective preventive measure for pediatric throat and tonsil infections. © 2024 by the authors.

Background/Aim. Prolonged ventilation is the most common indication for pediatric tracheostomy. The aim of the study was to determine the indications, possible com-plications, and outcomes of tracheostomy in infants, as well as the association of patient phenotype with compli-cations following tracheostomy. Methods. This retrospec-tive study highlights the main indications, complications, and decannulation rates in tracheostomy pediatric patients treated at the Institute of Mother and Child Health Care of Serbia "Dr. Vukan Čupić", Belgrade, for three years. Results. A total of 38 infants were included in our retro-spective study, 31 (81%) of whom underwent elective tra-cheostomy, and 7 (19%) underwent urgent tracheostomy due to acute respiratory distress and difficult intubation. The mean age was 5.4 ± 3.5 months, and the youngest participant was 36 hrs old. The primary indication for elec-tive tracheostomy was prolonged mechanical ventilation in 13 (42%) patients, neuromuscular disorders in 5 (16%), airway obstruction in 10 (32%), craniofacial anomalies in 2 (5%), and pulmonary disease in 1 (3%) patient. Early complications (occurring within the first seven days after tracheostomy) were present in 4 (10.5%) patients, three of whom had air leaks (due to inappropriate cannula selec-tion), whereas wound dehiscence was reported in one pa-tient. Late complications (those occurring more than seven days after tracheostomy) were reported in 4 (10.5%) pa-tients and they were peristomal granulations in three pa-tients and tube obstruction in one patient. There were no deaths associated with tracheostomy, although overall mortality was 21% (8 patents). All of these patients died as a result of their primary diseases. Seventeen (44%) patients were successfully decannulated. Conclusion. Most pa-tients required long-term treatment and tracheostomy re-tention due to the nature of their primary diseases, which coincided with low decannulation rates. Therefore, trache-ostomies should preferentially be carried out in specialized pediatric centers with trained medical personnel ensuring adequate health care. © 2024 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Congenital laryngeal cysts are rare lesions that may occur in newborns, characterized by symptoms of respiratory obstruction and severe dyspnea. The aim of this study was to indicate optimal surgical treatment of congenital laryngeal cysts in newborns. We present a case series of five neonates treated for congenital laryngeal cysts during the 2011-2017 period at our pediatric tertiary care hospital. Patient age ranged from one day to 14 days. All patients had unilateral cysts. After surgical excision, burning of the walls of the cysts was performed by a CO2 laser. In one case, after four months, a recurrent cyst appeared, and re-operation was performed. Our relatively small case series indicates that symptoms such as stridor and labored breathing can occur already during the first days of life and potentially en-danger the patient’s life. Complete excision of the cyst and burning of its walls with CO2 laser leads to complete cure and prevent recurrence of the lesion. © 2023, Dr. Mladen Stojanovic University Hospital. All rights reserved.