Joanna Szaleniec

Artificial neural network modelling of the results of tympanoplasty in chronic suppurative otitis media patients

The application of computer modelling for medical purposes, although challenging, is a promising pathway for further development in the medical sciences. We present predictive neural and k-nearest neighbour (k-NN) models for hearing improvements after middle ear surgery for chronic otitis media. The studied data set comprised 150 patients characterised by the set of input variables: age, gender, preoperative audiometric results, ear pathology and details of the surgical procedure. The predicted (output) variable was the postoperative hearing threshold. The best neural models developed in this study achieved 84% correct predictions for the test data set while the k-NN model produced only 75.8% correct predictions.

Can phage therapy solve the problem of recalcitrant chronic rhinosinusitis

Chronic rhinosinusitis (CRS) affects 5-15% of the global population. In some patients, the infectious exacerbations of the disease are recalcitrant to medical treatment and surgery. These cases are probably associated with the presence of bacterial biofilms. Bacteriophage (phage) therapy seems to be a promising antibiofilm strategy. The efficacy of phage therapy in sinonasal infections has been demonstrated both in vitro and in animal models. In the past, phage preparations were also administered to humans with CRS with favorable outcomes and no significant side effects. Very recently, the safety and efficacy of phage therapy in otolaryngological infections has been demonstrated in pioneer Phase I/II clinical trials. This review addresses the potential of phage therapy to treat CRS. We also discuss issues that require further research.

Endoskopowe leczenie olbrzymich kostniaków podstawy czaszki

Summary Introduction Osteomas are relatively common, benign, slow-growing neoplasms. Mainly occurring in frontal and ethmoid sinuses. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim We discuss our experiences in endoscopic treatment of giant osteomas. Results In giant osteomas Draf III or Lothrop approaches are prefered. Periostium of the orbit was intact in all cases. Discharge of cerebrospinal liquid was not observed. Conclusions Size of tumor determines type of surgical aprroach. Endoscopic surgery is more and more popular way in surgical treatment of giant osteomas.

Choroba kociego pazura – lekceważone schorzenie

Summary Introduction Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellular bacilli Bartonella, transmitted by domestic animals. Aim We present a case report of a patient treated in the Department of Otolaryngology UJ CM in Krakow. The patient presented with a neck tumor. Due to unclear clinical manifestation he underwent surgical treatment. The postoperative histopathological examination suggested cat scratch disease. In detailed anamnesis the patient admitted contact with cats and dogs in his household. No posoperative complications were observed. Conclusions In every case of neck tumor it is advisable to consider cat scratch disease, remembering that exclusion of a neoplastic process remains a priority.

Endoskopowe resekcje guzów złośliwych nosa i zatok przynosowych

Summary Malignant neoplasms of the nose and paranasal sinuses constitute about 3% of head and neck tumors. They are more often observed in males. We discuss clinical appearance and treatment performed in 6 individuals with malignant tumors in the nose and paranasal sinuses that were removed with endoscopic surgery. Successful result in endoscopic treatment patients with malignant tumors in the nose and paranasal sinuses depends on right indications of individuals to this procedure. In some situations it could be alternative to surgery with external approach.

Tonsillektomia z zastosowaniem skalpela harmonicznego – doświadczenie własne i przegląd literatury

Summary Introduction The harmonic scalpel has been used in tonsil surgery for several years. The comparison of harmonic scalpel tonsillectomy with other tonsillectomy techniques has been the subject of many studies. The research results proved to be contradictory, particularly concerning postoperative complications and complaints. Most authors observed reduced intraoperative bleeding during harmonic scalpel tonsillectomy. Objective Analysis of harmonic scalpel tonsillectomy results and review of literature. Material and methods The harmonic scalpel was used for 71 tonsillectomies in the Department of Otolaryngology UJ CM between 2002–2007. The surgical procedure and postoperative results were analyzed retrospectively and compared with other tonsillectomy techniques. Results The harmonic scalpel provided sufficient intraoperative hemostasis in 67% of cases. 33% of patients required electrocautery, vessel ligation in the operation field or suturing of the marginal tissue to control bleeding. Postoperative hemorrhage requiring surgical intervention occurred in 3 patients. No other severe postoperative complications were observed in either group. Conclusions Harmonic scalpel tonsillectomy is an effective and safe alternative technique in tonsil surgery. In some cases however other hemostasis techniques may be necessary to control intense bleeding.INTRODUCTION The harmonic scalpel has been used in tonsil surgery for several years. The comparison of harmonic scalpel tonsillectomy with other tonsillectomy techniques has been the subject of many studies. The research results proved to be contradictory, particularly concerning postoperative complications and complaints. Most authors observed reduced intraoperative bleeding during harmonic scalpel tonsillectomy. OBJECTIVE Analysis of harmonic scalpel tonsillectomy results and review of literature. Material and methods. The harmonic scalpel was used for 71 tonsillectomies in the Department of Otolaryngology UJ CM between 2002-2007. The surgical procedure and postoperative results were analyzed retrospectively and compared with other tonsillectomy techniques. RESULTS The harmonic scalpel provided sufficient intraoperative hemostasis in 67% of cases. 33% of patients required electrocautery, vessel ligation in the operation field or suturing of the marginal tissue to control bleeding. Postoperative hemorrhage requiring surgical intervention occurred in 3 patients. No other severe postoperative complications were observed in either group. CONCLUSIONS Harmonic scalpel tonsillectomy is an effective and safe alternative technique in tonsil surgery. In some cases however other hemostasis techniques may be necessary to control intense bleeding.

A stepwise protocol for neural network modeling of persistent postoperative facial pain in chronic rhinosinusitis

Abstract In the artificial neural network field, no universal algorithm of modeling ensures obtaining the best possible model for a given task. Researchers frequently regard artificial neural networks with suspicion caused by the lack of repeatability of single experiments. We propose a systematic approach that may increase the probability of finding the optimal network architecture. In the experiments, the average effectiveness in groups of networks rather than single networks should be compared. Such an approach facilitates the analysis of the results caused by changes in the network parameters, while the influence of chance effects becomes negligible. As an example of this protocol, we present optimization of a neural network applied for prediction of persistent facial pain in patients operated for chronic rhinosinusitis. In the stepwise approach, the percentage of correct predictions was gradually increased from 54% to 75% for the external validation set.

Smell impairment in chronic rhinosinusitis – evaluation of endoscopic sinus surgery results and review of literature concerning olfactory function predictors.

INTRODUCTION Endoscopic sinus surgery (ESS) is the treatment of choice for patients with chronic rhinosinusitis (CRS) refractory to medical therapy. ESS successfully reduces most symptoms of CRS, but its effect on olfaction is always uncertain. AIM OF THE STUDY The aim of this study was to assess the influence of sinus surgery on olfaction and to analyze the predictors of olfactory function before and after ESS in the context of a literature review. MATERIAL AND METHODS The study group comprised of 153 patients with CRS refractory to medical treatment. The patients evaluated their olfactory function before ESS, 3-6 months after ESS (121 individuals) and 12 months after ESS (58 individuals). Statistical analysis concerned the postoperative olfactory improvement as well as the influence of various predictors on the impairment of smell before and after surgery. RESULTS AND CONCLUSIONS Olfactory dysfunction was significantly reduced after ESS. The smell impairment before and after surgery depended on different predictors. Patients with severe preoperative olfactory dysfunction and extensive pathological changes in the nose and sinuses, including nasal polyps, reported most pronounced improvement after ESS. However, severely hyposmic subjects with nasal polyposis, asthma or aspirin intolerance as well as older patients reported worse postoperative smell scores.

Research on the changes in voice quality caused by tonsillectomy

Abstract The article presents the results of the research on the changes in voice quality caused by tonsillectomy. It was carried out in a group of 20 patients (12 male and 8 female). The voice was recorded on a E-MU 0404 USB sound card with a 24-bit A/C AK5385A convertor. Having analyzed the pronunciation of prolonged Polish vowels: /a/, /e/, /i/ and /u/, the researchers defined a set of parameters which differentiate the pronunciation before and after tonsillectomy. The results show that the differences in pronunciation might be observed due to dynamic properties of the articulatory track. Additional researches emphasize the usefulness of such recordings applying external E-MU 0404 USB sound card in the clinical environment.

Prognostic factors in patients operated on eardrum perforation with intact ossicular chain

Summary Background Ear drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. Aim This paper is intended to evaluate effectiveness of tympanic membrane reconstruction and indicate factors which have an influence on hearing improvement after myringoplasty. Material and methods Analysis involves ca. 500 individuals operated on ear in Department of Otolaryngology at the Jagiellonian University between 2004 and 2009. Results 120 individuals were operated on for the first time due to chronic otitis media with intact ossicular chain. Statistically significant heating improvement was observed in patients with discharge, without discharge and in group with scars. Conclusions The presence of granulation changes is an unfavorable prognostic condition in the patients with ear drum perforation. In clinical practice, the criterion which often determines the application of either of the materials in myringoplasty are operators preferences, as well as the availability of given material for transplanting.BACKGROUND Ear drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. AIM This paper is intended to evaluate effectiveness of tympanic membrane reconstruction and indicate factors which have an influence on hearing improvement after myringoplasty. MATERIAL AND METHODS Analysis involves ca. 500 individuals operated on ear in Department of Otolaryngology at the Jagiellonian University between 2004 and 2009. RESULTS 120 individuals were operated on for the first time due to chronic otitis media with intact ossicular chain. Statistically significant heating improvement was observed in patients with discharge, without discharge and in group with scars. CONCLUSIONS The presence of granulation changes is an unfavorable prognostic condition in the patients with ear drum perforation. In clinical practice, the criterion which often determines the application of either of the materials in myringoplasty are operators preferences, as well as the availability of given material for transplanting.