Monika Morawska-Kochman

Ocena epidemiologiczna nowotworów gruczołów ślinowych u pacjentów leczonych w Klinice Otolaryngologii we Wrocławiu w latach 2001–2010

UNLABELLED Salivary gland tumors represents approximately 3% of all head and neck neoplasms. Most of them are benign and located in the parotid gland. AIM Epidemologic analysis of salivary gland neoplasms in the Wrocław ENT Department. MATERIAL AND METHODS 304 patients (170 women, 134 men) with histologically confirmed salivary gland tumors treated in the years 2001-2010 were reviewed retrospectively. RESULTS Benign tumors were diagnosed in 83.9% of patients, malignant lesions constituted 16.1% of cases. The average age of patients were 55 years. Pleomorphic adenoma and Warthins tumor constituted the most common benign tumor (93.3%). Among malignant tumors--adenoid cystic carcinoma (24.5%) and adenocarcinoma (22.5%) were the most frequent. Neoplasms located in submandibular gland and in minor salivary gland in the vast majority of cases were malignat: 35.1% and 38.9%, respectively. Parotid gland tumors were malignant in 11.7%. An increase of salivary gland neoplasms total number, predominantly in men, and in malignant neoplasms percentage: from 13.8% in the years 2001-2005 to 17.7% in the years 2006-2010, was noted. CONCLUSIONS Most of salivary gland neoplasms are benign. Pleomorphic adenoma and Warthins tumor (93.3%) constituted the most common benign tumors, adenoid cystic carcinoma (24.5%) and adenocarcinoma (22.5%) were the most frequent malignant tumors. Malignant tumor patients were avereage 12.5 years older than benign tumors persons. More than 1/3 of submandibular gland and minor salivary glands neoplasms were malignant. An increase of malignant lesions was noted--from 13.8% to 17.7% of the total number of salivary gland neoplasms.

Bilateral Facial Palsy in Rapidly Progressive Course of Wegener's Granulomatosis: A Case Report

Introduction. Wegeners granulomatosis belongs to a group of systemic vasculitis diseases, which is characterized by necrotizing vasculitis and presence of granulomas. In a lot of cases, the first symptoms of the disease are observed in the head and neck region, but the bilateral facial nerve palsy occurs very rarely. Objective. The objective of our report was to describe the unusual course of Wegeners granulomatosis with the bilateral facial nerve paralysis, which subsided after application of steroids and immunosuppressive therapy in combination with surgical treatment. Results and Conclusions. Hearing loss may precede other symptoms in Wegeners granulomatosis. Ear pain and otorrhea may suggest the diagnosis of bacterial purulent otitis media and delay the proper diagnosis. In the presented case, considering the clinical course, it was necessary to apply both pharmacological and surgical treatments.

The presence of bacterial microcolonies on the maxillary sinus ciliary epithelium in healthy young individuals

Objective The aim of this cross-sectional in vitro study was to evaluate the mucosal surfaces of healthy maxillary sinuses, explore different forms of bacterial microorganism colonies present on the mucous membrane, and determine a mucosal surface area they occupy. Methods Samples of the maxillary sinus mucosa were collected from 30 healthy patients (M = 11; F = 19). The material was obtained during the Le Fort I osteotomy performed during corrective jaw surgery. The morphological and morphometric analysis of sinus mucosa and bacterial film that was grown on it was performed using scanning electron microscopy (SEM) as well as imaging software. Results Scanning electron microscopy analysis showed the presence of different bacterium and bacteria-like structures in all the analyzed samples. In most cases, the bacterial film was mostly composed of diplococci-like and streptococci-like structures on the mucosa of the paranasal sinus. In any case, the mucous layer did not cover the whole lining of the evaluated sample. Each colony consists of more than 20 single bacterial cells, which has grown in aggregates. Conclusions Under the conditions of normal homeostasis of the body, the maxillary sinuses present diverse bacterial colonization. The bacteria are dispersed or concentrated in single microcolonies of the biofilm on the border of the mucous covering the ciliary epithelium. There is no uniform layer of the biofilm covering the mucosa of the maxillary sinuses. Because the biofilm is detected on healthy individuals sinus mucosa, the clinical question if it may become pathogenic is unclear and require an explanation.

Technical aspects of nasal cavity surgerythrough the Le Fort I down-fracture approach:An otolaryngologist’s point of viewbased on 90 patients’ experience

BACKGROUND The downfracture access to septoand turbinoplasty during maxillary osteotomy may be recommended in many cases. One or both of these laryngological interventions may be necessary when, after the patients clinical evaluation, either an impaired function of nasal breathing or a deviated septum are present. The main postsurgical risk of the procedure is the destabilization of the cartilaginous septum position and its relation to adjacent anatomical structures, a change in the shape of the nose and the presence of a supratip break. OBJECTIVES In this paper, the authors present their own experience in intranasal procedures, the relevant surgical techniques and possible complications, based on their own clinical findings and on a literature review. MATERIAL AND METHODS The general aim of the study was to describe the key points and differences between septoand turbinoplasty performed classically and during Le Fort I osteotomy based on 90 orthognathic surgery patient cases. The procedures have been evaluated and compared regarding their advantages and disadvantages. RESULTS Intraoperative downfracture of the maxilla facilitates the performance of various subsequent procedures in the regions of the nasal cavities and sinuses. Due to a very convenient access to the nasal cavities, it is possible to perform septoor turbinoplasty in patients with nasal airway breathing problems, a deviated septum, and in others. CONCLUSIONS A combined effort of an otolaryngologist and a maxillofacial team improves the overall nasal breathing with a limited amount of complications. Endoscopy with low-dose computed tomography (CT) is a valuable diagnostic tool for measuring any breathing improvements in nasal capacity. Objective patient nasal breathing problems should be always investigated.

Evaluating the Hearing of Patients with Pseudoexfoliation Syndrome.

BACKGROUND It is estimated that pseudoexfoliation syndrome (PEX) occurs in 10-20% of the general population over 60 years of age, and its morbidity increases with age. Some research indicates that PEX may be a systemic disease. Some experts state that it can also lead to ear dysfunction. OBJECTIVES The aim of the study was to evaluate the incidence and type of hearing disorders in patients with PEX. MATERIAL AND METHODS The study included 51 patients (102 eyes) hospitalized in Wroclaw Medical University Hospitals Department of Ophthalmology and scheduled for cataract surgery in 2012-2014. Among these patients (whose age ranged from 55 to 92), 28 had PEX and 23 served as a control group. Both groups underwent ophtalmic examinations as well as ENT inspection and audiological tests (tonal audiometry, impedance audiometry, distortion product otoacoustic emission tests [DPOAE] and auditory brainstem response tests [ABR]). RESULTS A statistically significant increase in the threshold of hearing in pure-tone audiometry was observed in PEX group for 2 kHz. In impedance audiometry tests, the stapedius reflex was identified in a greater proportion of patients in the PEX group than in the control group in all frequency ranges. There was no difference between the PEX groups and the control group in the results of the DPOAE and ABR tests. CONCLUSIONS PEX can be a systemic disease that affects the functioning of the inner ear causing sensorineural hearing impairment. The increased hearing threshold in pure-tone audiometry of the patients with PEX affects the speech range (mainly the frequency of 2 kHz). Impedance audiometry and pure-tone audiometry appeared useful in audiological diagnostics of patients with PEX.

Sudden Hearing Loss Treated With Hyperbaric Oxygen (HBO) – Case Study

Abstract The article presents a case study of a 32-year-old patient admitted to the Mazowia Hyperbaric Therapy Centre due to a sudden loss of hearing. In an interview the patient reported an abrupt hearing deterioration in his right ear and the feeling of congestion in the left ear with bilateral tinnitus present for over 2 months. The patient was qualified to undergo hyperbaric oxygen therapy (HBO). After 15 treatment sessions in a pressure chamber a noticeable improvement of hearing in his right-ear was noted (proved by pure tone audiometry) and subjective hearing upswing in his left ear. The bibliography includes the articles and references concerning the time limits of HBO therapy and its effectiveness in the treatment of sudden deafness.