[Management of nasal trauma in children]. / Procedura postepowania w urazach nosa u dzieci.

In this study we investigated the optimal treatment of nasal fractures and nasal deformations in children. An algorithm for the management of nasal fractures by children is publicated.

[The influence of neck-dissection operations on cervical and cerebral blood circulation]. / Wplyw operacji wezlowej szyi na hemodynamike krazenia szyjnego i mózgowego.

The authors conducted examination of blood flow velocity in medial cerebral artery using Trans Cranial Doppler method and calculated pulsatility index (PI) in 35 patients after neck dissection operation. Similarly 35 patients after neck dissection had duplex Doppler examination of common and internal carotid arteries performed. Pulsatility and resistance indexes and blood flow capacity were estimated. We compared the results with the control group consisted of 15 patients operated on because of chronic otitis. We confirmed a neck dissection operation influence into cranial and cervical blood flow disturbances as well as relationship between postoperative soft tissue oedema and hemodynamical changes. We didn't found connections between cervical and cerebral blood flow and postoperative complications.

[Osteochondroma of the larynx]. / Kostniakochrzestniak krtani.

Benign cartilaginous tumours of the larynx and trachea are rare. The most common is chondroma, and only 6 cases of osteochondroma of the larynx have been reported in the world literature. We present a case of 74 year's old woman with osteochondroma of the right arytenoid cartilage. This is followed by a review of the literature, diagnostic evaluation and surgical management.

Rhinospirography in evaluation of respiratory disorders in patients with central nervous system tumors.

The aim of the study was to define respiratory disorders caused by central nervous system tumors. We investigated 51 patients (31 men, 20 women, mean age 58). They were divided into the following groups: patients with supra-, infratentorial and cranio-vertebral junction lesions. We analyzed: the localization of tumors based on CT and MRI examinations and intraoperative observation, the status of consciousness by GCS scale, neurological status and histological findings. For the estimation of dynamics of the respiratory changes, rhinospirography examination was repeated several times in the course of observation. The alterations of respiration were clearly visible in many cases. We have confirmed that respiratory disorders found by rhinospirography provide a source of important clinical information on the effect of the treatment and prognosis. We have also confirmed that changes in respiration are observed earlier than changes of consciousness.

[Physiology and surgery of the nose]. / Fizjologia nosa a leczenie chirurgiczne.

Understanding the physiology of the normal nasal functions should prevent unnecessary surgery to the septum and turbinates. The most important function of the nose is the respiratory one. Respiration provides oxygen for metabolism and removes carbon dioxide from the body, and it is nose that modifies air so that it is ideal for this purpose. The nose performs three functions: humidification, heat transfer, and filtration. Because of its ability to transfer heat, the nose is very important not only in temperature regulation of the inspired air, but also for the thermal homeostasis of central nervous system. The air flow pattern and the dynamic changes in nasal resistance are significant for heat exchange, for reflexes initiated in the nose and for nasal neurovascular reflexes, therefore all the factors must be taken into account while performing surgery of the nose.

[The use of CO2 laser in the treatment of leukoplakia of the oral cavity]. / Zastosowanie lasera CO2 w leczeniu leukoplakii jamy ustnej.

During the period from 1992 to 1996 in the Otolaryngological Clinic of the Medical Academy in Bydgoszcz 20 patients with leucoplakia of the oral cavity were hospitalized. The treatment with the CO2 laser was used. Depending on the kind of lesion single or continuous ray of the power 6-15 W were applied. The patients were divided into 3 groups according to the kind of leucoplakia: patients with simple leucoplakia, patients with nodular leucoplakia, Patients with verrucous leucoplakia. According to the size of the leucoplakia area: lesions of 1 cm diameter, lesions of 2 cm diameter, lesions of over 2 cm diameter were differentiated. In the case of simple leucoplakia the laser ray of 5-6 W power was applied, in nodular leucoplakia 6-10 W, and in verrucous leucoplakia the power was 10-15 W. In this work the results of the 5 years observation are presented.

[Functional voice evaluation after Reinke's edema treated with CO2 laser and Kleinsasser's microsurgery]. / Ocena czynnosciowa glosu po leczeniu obrzeków reinkego w mikrochirurgii laserowej CO2 oraz w mikrolaryngoskopii metoda wg Kleinsassera.

The authors performed functional evaluation of voice in 124 patients treated with microsurgery due to oedema Reincke in the years 1991-1994. In 90 patients surgery was performed with CO2 laser microsurgery and in 34 patients with microlaryngoscopy according to Kleinsasser. The picture of larynx was registered and evaluated with help of laryngovideostroboscopy. The voice status was evaluated in phoniatric examination, registered on tape and submitted to acoustic analysis. No correlation between method of surgical treatment and quality of voice was observed. However, significantly worse quality of voice was noted in those smoking after surgery.

[The use of the CO2 laser in the treatment of laryngostenosis and tracheostenosis]. / Zastosowanie lasera CO2 w leczeniu zwezen krtani i tchawicy.

The authors show the possibilities of using the laser CO2 in treatment of both laryngostenosis and tracheostenosis in 54 patients. In the article various forms of treatment of laryngostenosis and tracheostenosis as well as the results of the therapy have been presented. On the basis of the cases treated so far, the prospects of using the laser CO2 in this form of treatment have been found limited. The best results have been attained in treating the narrowings on a small surface. In case of complex laryngostenosis and tracheostenosis, the most effective treatment has been obtained by using the combination of the laser microsurgery performed on the larynx area along with the surgical resection of the narrowed segment of the trachea and the fusion "end to end". In some cases good results have been achieved by using the laser CO2 to remove postoperative scars of the larynx after partial laryngectomies.

[A case of mucous cyst of the nasopharynx]. / Przypadek torbieli sluzowej czesci nosowej gardla.

We presented a rare case mucocele cyst of the nasopharynx in a 41 year old man. The cyst was located at the higher level between the roof and right lateral band of nasopharynx, and was removed by the transpalatal approach.

[Rhinitis medicamentosa: an increasing therapeutical problem]. / Rhinitis medicamentosa--narastajacy problem leczniczy.

The most common upper respiratory illness is rhinitis. The majority of ENT specialists and general practitioners prescribe topical decongestants as first line therapy in rhinitis, independently of causes and kind of rhinitis. Long term use of topical vasoconstrictors for the nose may result in rhinitis medicamentosa, the rebound swelling of the nasal mucosa. The swelling probably is due to vasodilatation, but it may be also due to interstitial oedema. The prolonged use of decongestants may destroy the nasal cilia and mitochondria of epithelial cells, disturbing their function. Rhinitis medicamentosa from topical vasoconstrictor abuse results in nasal obstruction which can be life-threatening in neonates. Rhinitis medicamentosa is a increasing therapeutical problem that is best managed by prevention.

[Transcranial Doppler sonography in radical and function neck dissection]. / Badania ultrasonograficzne (TCD) przeplywów mózgowych po rozleglych operacjach wezlowych szyi.

To evaluate the influence of radical or functional neck dissection on cerebral hemodynamics, pre- and postoperatively TCD sonographic examinations were performed in a group of patients following unilateral radical or bilateral radical/functional neck dissection. Cerebral blood flow velocities (cm/s) and pulsatility index (PI) were studied preoperatively and postoperatively 4, 24 and 48 hours after the operation, using a 2 MHz-pulsed transcranial ultrasonographical system (TCD) with a transtemporal approach to the middle cerebral artery. To exclude the influence of general anaesthesia on cerebral circulation TDC was also performed in a group of patients, following operations under general anaesthesia but not radical nor functional neck dissection. The results of both groups were compared with the data obtained in a control group of healthy persons the same age. The reductions in blood flow velocities and concomitant increases in PI observed during the first postoperative insonation in patients after radical/functional neck dissection reflect a heightened resistance to flow in the arterial cerebral vasculature.

[CO2 laser in treatment of laryngeal carcinoma]. / Laser CO2 w leczeniu raka krtani.

The authors performed functional evaluation of voice in 64 patients, who due to limited carcinoma of larynx were submitted unilateral CO2 laser cordectomy. The appearance and mobility of larynx were registered and evaluated in particular periods post surgery, the patients voices were registered and acoustic analysis submitted. Gradual voice improvement following the wound healing were observed in subjective patients evaluation as in objective one. In some cases very good functional results were obtained, which made possible for patients after CO2 laser cordectomy to continue work requiring good function of larynx.

[The effect of laryngectomy on the fibrinolysis process in the blood of patients with laryngeal neoplasms]. / Wplyw laryngektomii na proces fibrynolizy we krwi chorych na raka krtani.

Some data in the literature indicate on the influence of different kind of surgery on the fibrinolytic process. Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1)--play important role in regulation of fibrinolysis. The aim of our work was to evaluate the influence of laryngectomy on fibrinolytic potential in the blood of operated patients with larynx carcinoma. Study group consisted of 20 men aged 42-75 years old with larynx carcinoma subjected to total laryngectomy. In the blood of patients we measured the concentration of t-PA:Ag, fibrinogen and FDP levels, PAI-1 activity, and ELT. The increase of t-PA and FDP concentrations, decrease of PAI-1 activity and fibrinogen level with simultaneous ELT shortening indicate on the fibrinolysis activation during the laryngectomy.

[Epidemiology of malignant neoplasms of the upper respiratory tract and oral cavity in the Bydgoszcz region]. / Epidemiologia nowotworów zlosliwych górnych dróg oddechowych i jamy ustnej w województwie bydgoskim.

The authors performed epidemiological analysis of malignant neoplasms of the nose, paranasal sinuses, throat, tongue, larynx and salivary glands in Bydgoszcz area. All the patients were treated in the Otolaryngological Clinic of Medical Academy in Bydgoszcz. Patient's sex, age, profession, living and environmental conditions as well as histopathological diagnosis were taken into analysis. The data were referred to various regions of Bydgoszcz province, which were elucidated on the basis of microclimate conditions, industry, soil conditions, density of the forest area, and cultivated agriculture plants. Correlations between occurrence of oral cavity and the upper respiratory tract malignant neoplasms and living conditions as well as kind of profession in different parts of Bydgoszcz province were estimated.

[Parotid neoplasms from material in the Bydgoszcz otolaryngologic clinics in the years 1980-1994]. / Guzy nowotworowe slinianek przyusznych w materiale bydgoskiej Kliniki Otolaryngologii w latach 1980-1994.

During the years 1980-1994 159 patients with parotid tumors were treated in ENT Clinic in Bydgoszcz. 26.4% (42 patients) of tumors were malignant. The main surgical procedures were the removal of tumor, partial parotidectomy, total conservative parotidectomy and total radical parotidectomy. In malignant tumor cases the radiotherapy followed the surgery.

[Tissue and urokinase plasminogen activators (t-PA, u-PA) and their inhibitor PAI-1 in blood of patients with laryngeal neoplasms]. / Tkankowy i urokinazowy aktywator plazminogenu (t-PA, u-PA) oraz ich inhibitor PAI-1 we krwi chorych na raka krtani.

Plasminogen activators and inhibitors regulate a variety of physiological and pathological processes involved in tissue morphogenesis, cell differentiation, migration, cancer cell invasion and metastasis. Several reports have shown the decrease of fibrinolytic activity in the blood of cancer patients. In this study we measured the concentrations of tissue plasminogen activator (t-PA), urokinase plasminogen activator (u-PA), activity of plasminogen activator inhibitor type 1 (PAI-1) and euglobulin lysis time (ELT) in the blood of 20 men aged 42-75 years old with planoepitheliale larynx carcinoma, and 10 healthy persons in similar age. In this study the mean values of t-PA, u-PA concentrations, PAI-1 activity and ELT in the blood of patients with larynx carcinoma were similar to the examination results of healthy persons, but 40% of our cancer patients have increased activity of PAI-1.

[Osteosarcoma of the sphenoid bone -- the cause of hemorrhage from the cavernous sinus]. / Osteosarcoma kosci klinowej jako przyczyna krwotoku z zatoki jamistej.

A very rare of the osteosarcoma osteolythicum teleangiectaticum of the paranasal sinuses, treated surgically, is reported. The infiltration and destruction of the sphenoid bone caused a haemorrhage from the cavernous sinus. The difficulties in the preoperative evaluation of the extent of the osteosarcoma in the craniofacial bone structures are discussed.

[Stellectomy in the treatment of patients with long QT syndrome]. / Stelektomia w leczeniu chorych z zespolem wydluzonego QT.

The authors present the surgical technique of stellate ganglion excision as a therapeutic method in patients with the long QT syndrome. The operations were performed through an anterior supraclavicular approach. Discussing the anatomic considerations, the possibilities of complications and side effects, both temporary and permanent, including Horner's syndrome are reviewed. On the base of the review of present literature and the postoperative results in patients treated in the Otolaryngological Department of the Medical Academy in Bydgoszcz, the authors confirm that the results of stellate ganglion excision in patients with the long QT syndrome are encouraging, but the possibilities of complications, including sudden death after stellectomy, must be taken into consideration.