Katarzyna Amernik

Association between early-onset breast and laryngeal cancers

SummaryRecent studies suggest that there are groups of genes that predispose simultaneously to both early-onset breast and laryngeal cancer. Studies were performed on a large series of unselected patients with laryngeal cancer diagnosed in Szczecin, Poland. Pedigrees of 683 laryngeal cancer patients were analysed for the frequency of early-onset and late-onset breast cancer among first degree relatives. The observed frequencies of breast cancer in these families were compared to those expected. In addition, common mutations/variants in the 3 genes BRCA1, NOD2 and CYP1B1, known to be associated with early-onset breast cancer, were assessed to determine their frequency in 348 unselected laryngeal cancers. The average age at diagnosis of LC among patients, who had relatives affected by BC diagnosed under the age of 50xa0years was 57.62. In comparison LC patients reporting a first degree relative affected by BC diagnosed above 50xa0years of age, had an average age of diagnosis of 66.00xa0years, which was significantly different (p=0.0064). Similarly, the average age of diagnosis of BC among patients with LC diagnosed under age of 50xa0years was 46.7xa0years and whereas LC patients with tumors diagnosed above 50xa0years had relatives diagnosed with breast cancer at an average age of 53.37xa0years, which was significantly different (p=0.02).From the 348 consecutive ascertained laryngeal cancer patients who had molecular studies undertaken, breast cancers among first degree relatives were found in 18 families including 8 with breast cancers diagnosed less than 50xa0years of age. A molecular basis was identified (the CYP1B1 355T/T genotype) in only 2 of the 8 early cases suggestive of there being additional, as yet unknown genes that are associated with an early-onset laryngeal-breast cancer phenotype.

Articulation disorders and duration, severity and L-dopa dosage in idiopathic Parkinson's disease.

BACKGROUNDnParkinsons disease (PD) is one of the most common diseases of the central nervous system (CNS). It is frequently heralded by speech disturbances, which are one of its first symptoms.nnnAIMnThe aim of this paper is to share our own experience concerning the correlation between the severity of speech disorders and the PD duration, its severity and the intake of L-dopa.nnnMATERIAL AND METHODSnThe research included 93 patients with idiopathic PD, aged 26-86 years (mean age 65.1 years). Participants were examined neurologically according to the Unified Parkinsons Disease Rating Scale (UPDRS) and the Hoehn and Yahr Scale. They were also assessed by Frenchay Dysarthria Assessment.nnnRESULTSnConsiderable and severe disorders were concurrent with impairments in the mobility of the tongue, lips, the jaw as well as the pitch and loudness of the voice. The strongest correlation but at a moderate level was found to exist between the severity of labial impairment, voice loudness and the length of the disease. There was also a positive correlation between lip movement while the motions were being diversified, lip arrangement while speaking and the intake of L-dopa.nnnCONCLUSIONSnAs PD progresses a significant decline in vocal articulation can be observed, which is due to reduced mobility within the lips and the jaw. Exacerbation of articulation disorders resulting from progression of the disease does not materially influence the UPDRSS scores. L-dopa has been found to positively affect the mobility of the lips while the patient is speaking and their arrangement at rest.

Ostry uraz akustyczny i termiczny ucha spowodowany awarią telefonu komórkowego

Summary The case of acute acoustic and burn ear trauma caused by mobile phone failure is presented. A woman aged 24 after dialling a phone number and putting a phone into the ear heard a sound of high frequency and intensity. At the same time she felt a pain and heat and there was also a smoke from the phone. With otoscopic examination a burn of external acoustic duct (I0) and sensitive hearing loss (examination made with tuning forks) were stated. The patient did not agree to stay in hospital and she was administered prednizone, trimetazidin and xantylol nicotinate. Audiometric examination, which was made on another day, showed hearing loss of 30 dB for frequency 4000 Hz. After 2 days she started to hear a sound like a sea noise in her right ear. In the control examination, made 2 weeks after injury, no abnormalities in audiogram were stated but the patient steal heard ear noise. She continued to take trimetazidin and betahistin and after one month all symptoms of ear injury relieved. Patient is still under control of otolaryngologist. Unfortunately our efforts to explain the cause of such accident from phone producer were ineffective. Described case proves that mobile phone failure can be a cause of acute ear injury.The case of acute acoustic and burn ear trauma caused by mobile phone failure is presented. A woman aged 24 after dialling a phone number and putting a phone into the ear heard a sound of high frequency and intensity. At the same time she felt a pain and heat and there was also a smoke from the phone. With otoscopic examination a burn of external acoustic duct (I0) and sensitive hearing loss (examination made with tuning forks) were stated. The patient did not agree to stay in hospital and she was administered prednizone, trimetazidin and xantylol nicotinate. Audiometric examination, which was made on another day, showed hearing loss of 30 dB for frequency 4000Hz. After 2 days she started to hear a sound like a sea noise in her right ear. In the control examination, made 2 weeks after injury, no abnormalities in audiogram were stated but the patient steal heard ear noise. She continued to take trimetazidin and betahistin and after one month all symptoms of ear injury relieved. Patient is still under control of otolaryngologist. Unfortunately our efforts to explain the cause of such accident from phone producer were ineffective. Described case proves that mobile phone failure can be a cause of acute ear injury.

Zakażenia ropne głębokich przestrzeni szyi w Klinice Otolaryngologii PUM w okresie ostatnich 5 lat

Summary Purulent infections of deep neck spaces, due to the potential spread and generalization of inflammatory process requires the urgent antibioticotherapy and surgery. The aim of the study is the overview of the symptoms, diagnosis and treatment of neck abscesses and phlegmon in the group of patients of the Department of Otolaryngology of PUM. Over the last 5 years 18 patients (9 M and 9 F) aged 17–68 were treated. The patients revealed painful neck swelling (nxa0=xa012), sore throat (nxa0=xa012), dysphagia (nxa0=xa011), trismus (nxa0=xa010), fever (nxa0=xa07), elevated CRP (nxa0=xa018). The neck abscess (nxa0=xa03), neck phlegmon (nxa0=xa010) or parapharyngeal space phlegmon (nxa0=xa05) were diagnosed. The largest group were post-tonsillitis (nxa0=xa07) and odontogenic (nxa0=xa04) complications. Intravenous antibiotic therapy was administered. All the patients underwent surgery. The incision and drainage of the spaces of the neck was done in 11 cases, in 5 cases – tonsillectomy with the opening of parapharyngeal space, in 1 case – removal of suppurative cyst. In 1 patient the cavity of spontaneously ruptured abscess was drained. 2 patients required temporary tracheostomy. The regression of inflammation was obtained in all cases. Mean hospital stay was 11.6 day (3–25). The early diagnosis and urgent surgical treatment is essential to control infection of deep neck structures.

Hot or Immediate Tonsillectomy: A Safe and Effective Method for Treatment of Acute Tonsillitis’ Complications

Aim: The aim of this study was retrospective analysis of indications to hot tonsillectomy, its effectiveness and safety. Peritonsillar abscess (PTA) is one of the most common complications of acute tonsillitis and the cause of emergency laryngological counselling. In some cases, it is necessary to perform hot tonsillectomy. Material and Methods: In between 2009-2015, 21 patients (aged between 4 to 43 years old) with an initial diagnosis of peritonsillar abscess were admitted. Among them, 11 were women and 10 were men. All underwent hot tonsillectomy. Results: Most of the patients were between 20-40 years old. The most common symptoms were pain in the throat, trismus and dysphagia. In all cases incision of an abscess was made, in 9 patients purulent discharge was present. In all patients there was no relief of symptoms after incision and antibiotic therapy. In 12 cases without drainage after initial incision, pus was drained after tonsillectomy. In the remaining 9 cases there were additional reservoirs of pus, which were drained after surgery in 6 patients. In 8 patients there was more than one localization of an abscess. There were no problems with intubation and no complications in the early and late post-operative periods occurred. The average time of stay in hospital was 8 days (5-12 days). Conclusion: Lack of improvement after initial treatment of PTA is an indication to hot tonsillectomy. This procedure is not connected with an increased risk of complications. Evacuation of purulent content does not exclude presence of another abscess, unusual localization or parapharyngeal space abscess.

Rzadki przypadek chłoniaka złośliwego zatoki czołowej objawiający się w postaci pyocele

Summary Lymphoma (mostly NHL) accounts for 3–5% of all malignant tumors. Only 0.17–2% of lymphoma localizes in the sinonasal tract. Lymphoma of the frontal sinus is extremely rare. The symptoms are often nonspecific and differentiating between inflammatory and neoplastic changes of the frontal sinus is very difficult. The aim of this study was to present a case of a patient operated on because of the left frontal sinus pyocele with orbital complication, in which histopathological examination revealed the presence of malignant lymphoma. The complication of sinusitis was suspected because of the rapid development of symptoms in the formerly healthy patient. The CT and MRI revealed erosion of the anterior and posterior table of the frontal bone and the roof of the orbit and the pathological mass of the frontal sinus penetrating into the orbit. The infected mucocele was initially diagnosed. Histopathologic analysis of the mass removed by the external approach revealed diffuse large B-cell lymphoma. The differential diagnosis of the sinus pathology with bone destruction should include malignant tumors, including lymphomas, despite their rarity in this area. The external approach to the frontal sinus affords good visualization and taking the appropriate material for histopathology, which is crucial for the final diagnosis. In the case of malignant lymphoma of the frontal sinus ENT role is limited to the collection of material and treatment of potential inflammatory complications.

Rak śluzowo-naskórkowy ślinianki przyusznej u 14-letniej dziewczynki – opis przypadku☆☆☆★★★

Summary Introduction Malignant tumors of salivary glands are rare, especially in children. Material and method We present a case report of 14-years-old girl affected by mucoepidermoid cancer of parotid gland. Results Patient was admitted to our Department in May 2007 due to small, hard, moveable tumor localized in right mandibular angle. The VII nerve function was normal. Fine needle aspiration revealed inflammatory cells without atypical cytologic features. Intraoperative tumor was hard, with irregular surface, surrounded by capsule, connected with the main trunk of facial nerve and cartilaginous part of external auditory meatus. Tumor was excised together with superficial part of parotid gland and surrounding lymph nodes. After operation no signs of facial nerve damage were observed. Postoperative histopathological examination revealed mucoepidermoid cancer, in 2 out of 6 specimens neoplasmatic cells were seen in border of excised tissue. In June 2007 the second operation was performed. Remain part of parotid gland was removed with right facial nerve and conservative lymph node resection. Facial nerve and its branches were reconstructed with sural and great auricular nerve as donor grafts. The symptoms of nerve damage were observed in early postoperative days adequate to 5th degree of House-Brackman scale (HB5). 4 years after operation function of facial nerve is estimated on HB3. The girl is under regular oncological and laryngological control free of neoplasm recurrence. Conclusions Diagnostics and treatment of malignant parotid tumors in children are difficult and clinical picture must be always taken into consideration as the most important factor.

Morfologia głośni i charakterystyka percepcyjno-akustyczna głosu i mowy po laryngektomii fronto-lateralnej poszerzonej z następową epiglotoplastyką

Summary For optimalisation glottis morphology and its phonatory function after frontolateral laryngectomy (FLL) the reconstruction of larynx is made; in Clinic of Otolaryngology the most common is using epiglottis wit or without its vertical incision. Aim of the study the influence of widening laryngeal resection and epiglottis incision on shape of reconstructed glottis, level and degree of phonatory closure and perceptive – acoustic characteristic of voice and speech. Material 39 patients (38 M and 1 F) after FLL widened of false vocal cord (n = 11), false vocal cord and part of cricoid cartilage (n = 22), whole cricoid cartilage (n = 6). Vertical incision of epiglottis was made in 31 cases. Mean age was 52 (min.-39, max.-70) years. Methodics videolaryngoscopic examination, subjective voice estimation using GRBAS scale, objective phonetic – acoustic voice analysis. Results In videolaryngoscopic examination the most common shape of glottis was irregular triangle (n = 24), rhombus (n = 7), half – moon (n = 2), irregular (n = 6). 2 patients were using whisper. In spectrographic recordings (n = 39) only noise character of stimulation source was in 2 patients, noise – periodic with noise component present in whole acoustic spectrum in 37. F0 for single word and sentence vocalized in affirmative and interrogative form had the value of male voices and its changes during speaking were well noted. In subjective and objective estimation, the worse voice quality was after FLL widened of false vocal cord, part or whole cricoid cartilage. Conclusion 1) FLL with subsequent epiglottoplasty in 94% of patients makes satisfactory morphologic and biophysical conditions for production of voice and sociological efficient speech. 2) Widening resection of false vocal cord, part or whole cricoid cartilage has unbeneficial influence on perceptive – acoustic characteristic of voice and speech.

Morfologia głośni i charakterystyka percepcyjno-akustyczna głosu i mowy u chorych na reumatoidalne zapalenie stawów ☆ ☆☆ ◊◊

Introduction: The aim of this study was estimation of glottis morphology and perceptive-acoustic characteristics of voice and speech in patients suffering from rheumatoid arthritis (RA). Material and methods: 77 patients (51 women and 15 men), 19–77 years of age (average 56,7) with recognized RA. The disease duration was from 1 month to 29 (average 9,4) years. Laryngeal, phoniatric examination and phonetic-acoustic analysis of voice and speech (program IRIS). One patient with bilateral vocal folds immobilization had computer tomography of the larynx and electromiography of internal laryngeal muscles. Results: The most frequent complains were: foreign body sensation in the throat 51% (n = 39/76), hoarseness – 47% (n = 36/76), weakness of voice – 29% (n = 22/76). Redness of the mucosal tissue in the area of arytenoids was stated in 41% (32/77) patients and edema in 28% (21/77). Complains and morphological features of inflammation in the larynx were considerably more frequent in patients with active RA. 3 patients had impairment of vocal folds mobility, in 2 of them it was bilateral immobilization requiring emergency tracheotomy. Subjective voice analysis was made according to GRBAS scale. In 35% (26/75) patients there was G2 or G3 stated. The average time of phonation [a] was 7 seconds. Average basic voice frequency was for women 216 Hz and for men 118 Hz. There was statistically important correlation between increasing of some acoustic voice parameters and RA activity and intensity. Conclusions: Patient’s complains for foreign body sensation in the throat and hoarseness, especially when RA is active, can indicate on inflammatory process in the larynx. For these reason it seems to be reliable to stay in close contact for rheumatologist, laryngologist and phoniatrist in every day practice.