Cicatricial stenosis of the nasopharynx. A comprehensive review.
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Respiratory scleroma is a chronic, progressive granulomatous disease of the respiratory tract. The causal organism is the Klebsiella rhinoscleromatis. The disease has three stages: the initial catarrhal stage, granulomatous stage, and sclerotic stage. The object of this report was to determine the clinical behaviour of the laryngeal scleroma. The study included 17 patients with this manifestation characterized by airway obstruction and dysphonia. The report revealed that respiratory scleroma affected the larynx in 40%, and the principal findings were glottic/subglottic stenosis.
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Nineteen patients with scleroma respiratorium treated surgically were studied retrospectively. The results suggested that the surgical operation combined with antibiotic therapy were beneficial to the curtive effect of the patients in the granulomatous stage with nasal or pharyngeal obstruction or nasal sinuses involvement due to the serious proliferation of the lesions; tracheotomy should be considered in the patients with laryngeal obstruction up to the second degree or above; plastic operations were necessary for the patients with cicatrical stenosis or imperforation remained of the nasal cavity, pharynx, larynx or trachea.
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Presence of influence of Bacillus subtilis during peroral and parenteral administration upon the laboratory animals' immune system has been studied. Absence of immuno-depressing action of the bacillus culture under study has been presented with the help of assessment tests on the humoral response to the thymus-dependent antigen: creation of the antibodies, and the delayed-onset hypersensitivity reaction. An insignificant stimulating effect has been revealed under execution of the reaction of the delayed-onset hypersensitivity as a result of B. subtilis application. The obtained data confirm the prospects of application of the B. subtilis strain as a basis of the anti-scleroma probiotics.