Assessment of quality of life, pain level and disability outcomes after lumbar discectomy.

This study aimed to assess the quality of life of 113 Caucasian patients with intervertebral disc (IVD) degeneration of the lumbosacral (L/S) spine who qualified for microdiscectomy during a 12-month period after surgery. Based on magnetic resonance imaging before the surgery, the degree of radiological advancement of the degenerative changes was determined according to the Pfirrmann grading scale from 1 to 5. To assess pain intensity, the Visual Analog Scale (VAS) was used; the Satisfaction with Life Scale (SWLS) was used to evaluate quality of life; and to assess the degree of ability, the Oswestry Low Back Pain Disability Questionnaire (ODI) was employed. The level of pain, assessed using the VAS, significantly changed in the months following the surgery, with the highest values noted before surgery and the lowest a year after. In turn, the results of the SWLS questionnaire revealed a significant increase in satisfaction with life in the subsequent stages of the study. The conducted correlation analysis revealed significant dependencies in terms of quality of life in regard to pain as well as degree of disability. The level of pain and degree of disability were closely related to the degree of radiological advancement of degenerative changes according to the Pfirrmann grading scale.

Paragangliomas of head and neck - A surgical challenge.

Paragangliomas of the head and neck region are rare and predominantly asymptomatic tumors. These neoplasms arise from widely distributed paraganglionic cells, which originate from both mesodermal elements of third branchial arch and the neural crest residues. Despite the rare occurrence of paragangliomas, problems encountered in their diagnosis, unclear malignancy and treatment ensure that they still remain in the focus of head and neck surgeons. This is a retrospective study of the medical records of patients treated in the ENT Department of the 5th Military Hospital in Krakow during the period 2010-2014. All the preoperative, intraoperative and postoperative data were carefully analyzed for each patient. Thirteen patients (16 tumors) were treated during the study period. All the patients with a pre-operative suspicion of paraganglioma underwent computed tomography angiography. The whole cohort of patients was treated surgically. Paraganglioma should be always considered in the differential diagnosis for painless neck masses. These tumors require thorough radiological pre-operative evaluation and skilled operative technique. Surgical treatment occurs to provide good cure rates with minimal recurrence and morbidity rates.

[Severe sepsis after dog bite caused by Capnocytophaga canimorsus]. / Ciezka sepsa wywolana przez Capnocytophaga canimorsus po pogryzieniu przez psa.

We describe a case of a life-threatening septicemia resulting from a previous dog bite wound. The isolated bacterium was Capnocytophaga canimorsus, a slow-growing Gram-negative bacillus commonly found in dog saliva. Known risk factors for invasive C. canimorsus infections are alcohol abuse, cigarette smoking, splenectomy or other forms of immunosuppression. Any clinician seeing patients with a history of a dog bite should consider this pathogen as a causative agent and take detailed history regarding exposure to animals.

[Epidemiological and demographic analysis of indications for Baha® surgery in Poland--multicenter study]. / Analiza epidemiologiczna i demograficzna wskazan do implantacji systemu Baha® w Polsce--badanie wieloosrodkowe.

AIM OF THE STUDY: To collect and analyze epidemiological and demographical data of patients qualified for and implanted with the Baha® system in Poland. MATERIAL AND METHOD: 17 out of 28 otolaryngology departments performing Baha® implantation in Poland participated in the study. Up to date there were 286 patients registered in database. Data were obtained from the preoperative questionnaires including information such as age and gender, indications for the implantation, previous hearing aid use as well as data regarding the surgical technique. RESULTS: The most frequent indication for the Baha® system was bilateral mixed hearing loss (51%), followed by SSD (18%), bilateral conductive hearing loss (17%), unilateral mixed (8%) and conductive (6%) hearing loss. In 11% of subjects hearing impairment was congenital versus 89% cases of acquired. The mean age was 44 years with the slight prevalence of women (52%). 63% of patients did not have previous experience with hearing aids. The most frequent surgical technique was classic dermatome single stage procedure performed under general anesthesia (65%). CONCLUSIONS: Data gather in this multicentre research serve as a valuable source of information on qualifications for the Baha®, shows demographic spectrum of adult recipients in Poland. It also presents the preferences of surgical procedures. Outcomes of the study may constitute a reference for each centre participating in this research as well as for new centers starting the Baha® procedure.

[Application of water jet ERBEJET 2 in salivary glands surgery]. / Zastosowanie noza wodnego ERBEJET 2 w chirurgii slinianek.

Anatomical location of salivary glands requires from surgeon high precision during the operation in this site. Waterjet is one of the modern tools which allows to perform "minimal invasive" operating procedure. This tool helps to separate pathological structures from healthy tissue with a stream of high pressure saline pumped to the operating area via special designed applicators. Stream of fluid is generated by double piston pummp under 1 to 80 bar pressure that can be regulated. This allows to precise remove tumors, spare nerves and vessels in glandular tissue and minimize use of electrocoagulation. Waterjet is a modern tool that can help to improve the safety of patients and comfort of surgeon's work.

[Typical surgical reconstruction for nose and paranasal sinuses oncology]. / Typowe zabiegi rekonstrukcyjne w onkologii nosa i zatok przynosowych.

UNLABELLED: The main problem for nose and paranasal sinuses oncology is not the high incidence but the poor oncological and functional results of the treatment. AIM: The aim of the work was presentation the patients and reconstruction methods after oncological ablation of nose and paranasal sinuses area. MATERIAL AND METHOD: The study wa carried out on 14 patients treated in Department of Otolaryngology of The Military Clinical Hospital in Krakow. The patients were divided into groups considering size and localization of the tumor. RESULTS: All the patients are in observation without recurrence untill now. Cosmetic and functional results are satisfed. The main problem is total reconstruction of the nose where the cosmetic results are not satisfied. CONCLUSIONS: The main difficulty is the total and near total reconstruction of the nose especially if it is necessary to reconstruct all nasal structures. From quality of life point of view the cooperation with dental prosthetic doctor is obligated for maxillectomy.

[The infratemporal fossa oncological surgery]. / Chirurgia onkologiczna dolu podskroniowego.

INTRODUCTION: The infratemopral fossa pathology cases are very rare. They grow unnoticed for considerable period until there are some impairments of function of the anatomical structures of the place. Aim. The aim of the paper was to recollect the information about rare cases the pathological state of the area in common laryngological practice. MATERIAL AND MEHOD: The study was carried out on three cases with tumors localizated in the infratemporal fossa, treated in Department of Otolaryngology of Military Clinical Hospital in Krakow (Poland) in the period from 2006 to 2008. The surgical treatment was preceded by precise picture diagnostic. The transzygomatiz approach were used in two cases. The buccal approach to maxilla in one case. Furthermore, in the last case the tumor expanded to parapharyngeal space which was explorated by parotido-cervical approach. The delayed post operative follow-up were carried out.

[An evaluation of the usefulness of impulse-current stimulation in electrogustometry--preliminary report]. / Ocena przydatnosci stymulacji pradowo-impulsowej w elektoustometrii--doniesienie wstepnei.

UNLABELLED: Electrogustometry is a simple and fast method of quantitative taste examination. The direct-current monopolar stimulating equipment was most frequently used until now. Aim of the study was to evaluate usefulness of the new method based on bipolar stimulation with impulse-current Furthermore, the authors wanted to determine taste thresholds using the equipment. MATERIAL AND METHODS: 50 healthy volunteers (25 women and 25 men) in the age of 17-50 were involved. The volunteers had a careful otolaryngological examination. Then the taste thresholds for each quarter of tongue were determined using the new equipment. Additionally, ten of the group of volunteers was examined in accordance to repetition time values. RESULTS: the determined values showed symmetry of taste thresholds, among the range of 4.9-26 microA for anterior 2/3 of the tongue and 41.5-93 microA for the 1/3 posterior. The examination with consideration to repetition time did not show increase of taste threshold after ten minutes stimulation. CONCLUSIONS: in conclusion the new kind of electrogustometry is precision and repeatable taste diagnostic method. Moreover the way of stimulation does not cause the phenomena of fatigue and adaptation.

[Metastasis from a colonic adenocarcinoma to the sphenoid sinus]. / Przerzut raka gruczolowego okreznicy do zatoki klinowej.

The authors present a very rare disease--metastasis of colon adenocarcinoma to the sphenoid sinus based on their own case. The sphenoid sinus was the first place of metastasis. Symptoms were characteristic of sphenoid sinus lesions. Histological examination of sphenoid sinus tissues revealed primary site of the tumour.