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Postoperative autologous peripheral blood mononuclear cell therapy in the rehabilitation of children with chronic hypertrophic rhinitis: a prospective comparative study

Thu, 01 Jan 2026 00:00:00 GMT

Title: Postoperative autologous peripheral blood mononuclear cell therapy in the rehabilitation of children with chronic hypertrophic rhinitis: a prospective comparative study Authors: Furculița, Daniel; Maniuc, Mihail; Danilov, Lucian; Ababii, Polina Abstract: Chronic hypertrophic rhinitis in children is a common pathology associated with inferior turbinate hypertrophy, persistent nasal obstruction, and impaired quality of life. Surgical interventions to reduce turbinate volume, such as diode laser and bipolar cautery, are widely used, but postoperative inflammation and mucosal regeneration can be prolonged. Autologous cell therapy represents a promising regenerative approach to accelerate tissue healing. Objective – to evaluate the effectiveness of postoperative autologous mononuclear cell therapy in the rehabilitation of children with chronic hypertrophic rhinitis following surgical treatment. Methods. The study was prospective, interventional, and comparative, conducted on a group of 40 children aged 7 to 17 years diagnosed with chronic hypertrophic rhinitis. Patients were divided into four groups (n = 10/group): diode laser (DL), diode laser + cell therapy (DL+CT), bipolar cautery (BC), and bipolar cautery + cell therapy (BC+CT). Cell therapy consisted of the postoperative local administration of a suspension of autologous mononuclear cells obtained from peripheral blood. The evaluation included the NOSE symptom score, rhinomanometry, acoustic rhinometry and endoscopic examination. The follow-up period was 24 months. Results. All groups showed postoperative clinical improvement. The cell therapy groups demonstrated a significantly faster and more stable reduction in symptoms, with a decrease in the NOSE score to 14.0 ± 4.0 in the DL+CT group at 24 months, compared to 30.0 ± 6.0 in DL and 36.0 ± 7.0 in BC. Nasal resistance decreased more sharply in the cell therapy groups, and the incidence of persistent edema, crusting and relapses was lower. Conclusions. Autologous cell therapy applied postoperatively accelerates the regeneration of the nasal mucosa and improves functional outcomes in children with chronic hypertrophic rhinitis, with maximum efficiency in combination with diode laser.

Immunohistochemical assessment of proliferation, angiogenesis, and viral markers in recurrent laryngeal papillomatosis

Thu, 01 Jan 2026 00:00:00 GMT

Title: Immunohistochemical assessment of proliferation, angiogenesis, and viral markers in recurrent laryngeal papillomatosis Authors: Cernev, Daniela; Saptefrați, Lilian; David, Valeriu; Cabac, Vasile Abstract: Recurrent laryngeal papillomatosis (RLP) is a benign but clinically aggressive condition, characterized by frequent recurrences and significant morbidity. Although infection with the human papillomavirus (HPV) represents the main etiological factor, the biological mechanisms underlying the persistence and recurrence of lesions remain incompletely understood. This study aimed to perform a comprehensive histopathological and immunohistochemical evaluation of recurrent laryngeal papillomatosis, focusing on epithelial proliferat ion, angiogenesis, the inflammatory microenvironment, and HPV expression. A retrospective tissue-based study was conducted on a cohort of 32 surgically excised laryngeal papilloma specimens obtained from adult patients. Conventional histopathological examination was performed using hematoxylin–eosin staining. Immunohistochemical analysis included HPV markers, Ki-67, VEGF-A, CD31, and CD68. Proliferative activity, angiogenesis, and inflammatory infiltrates were assessed using semi-quantitat ive and quantitative methods. Statistical analysis was performed using standard comparative tests, with a p-value < 0.05 considered statistically significant. Histopathological evaluation revealed a typical papillary architecture, with fibrovascular stromal cores, epithelial acanthosis, koilocytic changes, and chronic inflammatory infiltrates. HPV immunopositivity was detected in 21.9% of cases, predominantly in the suprabasal epithelial layers, displaying a mosaic pattern. All lesions showed positivity for Ki-67, with heterogeneous proliferative indices. CD68-positive macrophages were variably distributed within the subepithelial stroma. CD31 immunostaining demonstrated a dense and mature microvascular network in all cases. VEGF-A expression was present in the majority of lesions and showed a moderate positive correlation with microvascular density, indicating active angiogenesis. Recurrent laryngeal papillomatosis is characterized by a complex interaction between epithelial proliferation, angiogenesis, chronic inflammation, and HPV-associated changes. VEGF-A-mediated angiogenesis appears to play a significant role in sustaining lesion growth. Comprehensive immunohistochemical profiling provides valuable insights into the biological behavior of RLP and may contribute to improved risk stratification and the development of targeted therapeutic strategies.

Immunohistochemical detection of pepsin in recurrent laryngeal papillomatosis: findings consistent with laryngopharyngeal reflux exposure

Thu, 01 Jan 2026 00:00:00 GMT

Title: Immunohistochemical detection of pepsin in recurrent laryngeal papillomatosis: findings consistent with laryngopharyngeal reflux exposure Authors: Cernev, Daniela; Saptefrați, Lilian; David, Valeriu; Cabac, Vasile Abstract: Background. Recurrent laryngeal papillomatosis (RLP) is a benign epithelial disease with a relapsing course that often requires repeated interventions and imposes a substantial clinical burden. While human papillomavirus infection is the primary etiologic factor, the marked variability in recurrence suggests that additional cofactors may contribute. Laryngopharyngeal reflux has been proposed as one such cofactor through chronic irritation of the laryngeal mucosa. Objective. To assess pepsin immunoreactivity in RLP specimens and interpret the findings as tissue markers consistent with laryngopharyngeal reflux exposure. Materials and methods. We conducted a retrospective, tissue-based analysis of 32 surgically excised laryngeal papilloma specimens from adult patients with RLP, without a control group. Pepsin immunohistochemistry was performed using a standardized protocol with an anti-pepsinogen C (PGC) antibody. Staining was evaluated semi-quantitatively (score 0–3) and characterized by epithelial and stromal localization. Statistical analysis was descriptive. Results. Pepsin immunoreactivity (score ≥1) was detected in 24/32 cases (75.0%; 95% CI: 57.9–86.7). Positivity was typically granular and cytoplasmic within the epithelium, with stratified involvement and a focal/mosaic distribution. Occasional weak staining was also observed in stromal inflammatory cells and vascular endothelium. Score 0 cases showed no epithelial or stromal staining. Conclusions. In this series, pepsin immunoreactivity was frequently detected in RLP tissue, a pattern consistent with laryngopharyngeal reflux exposure. These findings suggest that reflux-related mucosal injury may be a cofactor in disease persistence and recurrence.

Laryngeal granuloma – experience of the ENT clinic of ”Timofei Mosneaga” Republican Clinical Hospital

Thu, 01 Jan 2026 00:00:00 GMT

Title: Laryngeal granuloma – experience of the ENT clinic of ”Timofei Mosneaga” Republican Clinical Hospital Authors: Osman, Victor; Vetricean, Sergiu; Sencu, Eusebiu; Noroc, Iurie; Chiriac, Ana-Maria; Vita, Andrian; Zveaghintev, Piotr Abstract: Vocal fold granuloma is a benign laryngeal lesion located at the vocal processes of the arytenoid cartilages and characterized by the formation of granulation tissue as a response to chronic mucosal irritation. Material and methods. A retrospective analysis of data from 12 patients diagnosed with laryngeal granuloma and treated between 2019 and 2024 at the ENT Clinic of the “Timofei Moșneaga” Republican Clinical Hospital. Results. In the examined series, males predominated (58.33%). Age distribution showed a bimodal pattern: 16–30 years (33.3%) and 41–50 years (33.3%). The clinical presentation was dominated by dysphonia (58.3%), foreign body sensation (41.66%), and irritative cough (50%). Most patients sought medical care more than one month after symptom onset (41.66% of cases). Constant vocal abuse was associated with 41.66% of cases, gastroesophageal reflux disease (GERD) with 33.3%, intubation with 16.6%, and 1 case (8.35%) was idiopathic. Morphologically, medium-sized granulomas predominated (66.6%), followed by microgranulomas (25%) and large granulomas (8.35%). Conservative therapy proved effective in the vast majority of cases, 9 of 12 patients (75%). A favorable outcome after CO₂ laser ablation assisted by jet ventilation was observed in 66.6% of the patients undergoing the procedure (1 recurrence among 3 operated cases). Conclusions. Conservative treatment (proton pump inhibitors, corticosteroids—3 days intramuscularly followed by 7 days inhalation, proteolytic enzymes, NSAIDs, antihistamines, and phoniatric therapy) represents the initial treatment option for laryngeal granulomas. Surgery is reserved for symptomatic, treatment-refractory, or recurrent cases. Late presentation, likely associated with the gradual increase in granuloma size, combined with gastroesophageal reflux disease, increases the probability of conservative treatment failure and the need for surgical intervention.