Adaptation and validation of the Singing Voice Handicap Index into Polish.

OBJECTIVE: To translate and adapt the original Singing Voice Handicap Index (SVHI) for the Polish population and to evaluate the psychometric properties of the Polish SVHI version, such as internal consistency, reliability and construct validity in different groups of dysphonic singers. STUDY DESIGN: Prospective case-control study. SETTING: Patients treated at a single institute. PARTICIPANTS: Sixty singers with voice disorders and 57 healthy singers completed the SVHI and the Voice Handicap Index (VHI). Thirty singers completed the SVHI twice within a 2- to 4-week interval. MAIN OUTCOME MEASURES: Internal consistency, test-retest reliability, discriminant validity, criterion-related validity RESULTS: A strong Cronbach's alpha coefficient (0.96) indicates that the SVHI items are measuring the same construct. Evaluating the test-retest reliability, the r-Spearman correlation coefficient was r = 0.797 for the total score of SVHI, which shows a good level of reproducibility. There were significant differences between the control group (CG) and patients with benign vocal fold lesions (P < 0.001), CG and singers with muscle tension dysphonia (P < 0.001), CG and coexistence of muscle tension dysphonia and chronic laryngitis (P < 0.001). There was a positive statistically significant correlation between SVHI and VHI (r = 0.753, P = 0.000*). CONCLUSIONS: The Polish version of SVHI serves as a valid health status instrument, as well as discriminating between singers with voice disorders and singers without voice problems. The SVHI is easy to perform in clinical practice.

[A case of maxillary neurosarcoma]. / Przypadek nerwiakomiesaka (neurosarcoma) szczeki.

A case of neurosarcoma located in maxillary sinus is presented. The patient was 62 years old women who complained of nasal obstruction, epistaxis and headache. Results of physical examination showed a giant mass filling the nasal cavity and maxillary sinus. The lesion was completely resected by lateral rhinotomy way. After the operation histopathological diagnosis was difficult, one pathologist recognised schwannoma benignum other one sarcoma. Finally postoperative diagnosis was schwannoma benignum, it was misdiagnosis. Two years later the patient was surgically treated again because of tumor recurrence. These time pathological diagnosis was neurosarcoma. Radiotherapy was done as well. The patient died 18 months after treatment, tumor regrowth and generalization metastases was reason of the death.

[Tumors of the parotid glands in the material of the Department of otolaryngology of the Medical Academy in Warsaw in 1986-1995]. / Guzy slinianek przyusznych w materiale Kliniki Otolaryngologii AM w Warszawie w latach 1986-1995.

In the Department of Otolaryngology, Medical Academy in Warsaw, 332 patients were surgically treated between 1986 and 1995 because of parotid gland tumors. In 275 cases benign tumors, in 57 cases--malignant tumors were observed. The majority of benign tumors were pleomorphic adenoma (61.45%) and lymphadenoma (22.54%); the majority of malignant tumors were adenocarcinoma (28%), adenoid cystic carcinoma (21%), mucoepidermoid carcinoma (15.78%). All patients with benign tumors were surgically treated, patients with malignant tumors were operated on and irradiated. The surgical procedure used superficial parotidectomy and total parotidectomy with preservation of facial nerve where possible. Ten patients required total parotidectomy with facial nerve resection because of malignant tumors, six patients had neck dissection performed. Of the 57 patients treated on account of malignant tumors 43 survived; 14 patients died of a local recurrence or generalization neoplasm disease.

[Metastasis of the cutis malignant melanoma of the parotid gland]. / Przerzut czerniaka skóry do slinianki przyusznej.

The authors presented a rare case of metastases of the cutis malignant melanoma to the parotid nodes. The attention was directed towards clinical aspects and diagnostic difficulties. Basing on data from the literature frequency and possibilities of cutis malignant melanoma metastases were analysed.

[Surgical management of the advanced orbit malignancies]. / Postepowanie chirurgiczne w przypadkach zaawansowanych guzów zlosliwych oczodolu.

Twenty one patients with advanced malignant tumors of the orbit have been treated in the Department of Otolaryngology, Medical Academy in Warsaw, between 1980 and 1995. There were two groups of patients: five with primary orbital tumors and sixteen with secondary tumors that penetrated from sinuses. In all cases surgical treatment with orbital exenteration has been performed, as well as postoperative radiotherapy. The local cutaneus flaps and temporalis muscle flap have been used for reconstruction of the orbitomaxillary defects. The authors suggest that one-stage reconstruction of maxillo-facial region after surgery decreases facial deformation and allows to apply ocular prothesis guickly.

[The surgical treatment of malignant tumors of the maxillo-ethmoid complex]. / Leczenie nowotworów zlosliwych masywu szczekowo-sitowego.

Forty-seven patients were treated in the Department of Laryngology, Medical Academy in Warsaw between 1980 and 1989. Twenty-seven patients had squamous cell carcinoma. All cases were advanced. The patients were treated by combination of surgery and postoperative radiotherapy. Nineteen patients (40.4%) survived five years.

[The results of surgical treatment of patients with laryngeal carcinoma in years 1988-1989 in four departments of otorhinolaryngology]. / Wyniki operacyjnego leczenia chorych na raka krtani w latach 1988-1989 w czterech osrodkach klinicznych.

In a group of 579 patients with laryngeal carcinoma treated surgically in years 1988-1989 in four departments of otorhinolaryngology of the Medical Academies in Poznan, Warsaw, Cracow and Lublin, 72% survived 3 years without recurrence and 59% survived 5 years. Similar results were obtained in years 1986-1987. The authors discuss in detail the reasons for failures of the surgical treatment, i.e.: supraglottic localization of the cancer, its extensiveness in the larynx, the stage of clinical development, general condition of the patient, effectiveness of the operation, regularity of postsurgical examination, the degree of histological malignancy, blood transfusion during the operation, distant metastases, little efficiency of medical service in early diagnosis of laryngeal cancer, avoiding postsurgical radiation, subjective factors of the patients and the choice of the optimal method of the treatment. Few patients can be cured if the initial treatment fails.

[The maxillary artery embolization in the management of recurrent epistaxis]. / Embolizacja tetnic szczekowych w leczeniu nawracajacych krwawien z nosa.

The management of recurrent epistaxis, especially posterior epistaxis, is difficult. Anterior and posterior nasal packing constitutes the initial treatment. Ligation of the ethmoid arteries and maxillary artery is the next step if the previous methods fails. We have described three cases with recurrent epistaxis; all underwent successful diagnostic angiography and therapeutic embolization of the maxillary artery. The role of embolization in the management of persistent epistaxis has been discussed.

[Efficiency of surgical treatment in patients with laryngeal cancer depending on age]. / Wydolnosc operacyjnego leczenia chorych na raka krtani w zaleznosci od wieku.

In the group of 578 patients with larynx cancer that underwent surgical treatment in four clinics of Medical Academies between 1986-87 a comparable analysis of the efficiency of surgical treatment depending on age of the operated patients was carried out. It was found that the difference between age average and the general state of patients was statistically highly important: Statistically significant was also the dependence between the patients' age and the postoperative complications; close to importance was also the dependence between the age and the survival period of patients. 68% of operated patients up to 65 year of age had five-year survival period without any symptoms; but in the group of patients over 65 years of age the analogical survival value was 51%.

[Multiple primaries in head and neck malignant neoplasms]. / Mnogie pierwotne nowotwory zlosliwe glowy i szyi.

Multiple primary neoplasm has developed in 70 patients with head and neck cancer who were treated in Otorhinolaryngology Department Medical Academy in Warsaw. Two primary neoplasm has been recognised in 63 patients, three independent tumors in 7 patients. The most common site for a first tumor was laryngeal carcinoma, for a second - lung, skin and tongue. The squamous cell carcinoma was the most common in the first as well as in the second malignancies.

[Head and neck tuberculosis: a still urgent problem]. / Gruzlica glowy i szyi--problem wciaz aktualny.

The upper respiratory tract is an unusual site for tuberculous infection. Most of the cases are secondary to active pulmonary tuberculosis. We present thirty five cases of tuberculosis localize in the head and neck region. There were twelve patients with lymphonodular tuberculosis, eleven patients with laryngeal tuberculosis, six patients with oral and pharyngeal tuberculosis, three patients with partoid gland tuberculosis, two patients with nose and paranasal sinuses tuberculosis and one patient with middle ear tuberculosis. This cases exemplifies the difficulty in diagnosis of tuberculosis in such an unusual sites.

[Efficiency of surgical treatment in patients with laryngeal cancer in four clinical centers]. / Wydolnosc operacyjnego leczenia chorych na raka krtani w czterech osrodkach klinicznych.

A group of 578 patients with larynx cancer underwent surgical treatment in four Otolaryngological Clinics of Medical Universities in Poznan, Warsaw, Cracow and Lublin between 1986-1987. Within this group, 75% of operated patients had a three--year survival rate without symptoms, and 58% of patients had a five-year survival rate. A detailed evaluation of causes of failures in surgical treatment dealt with e.g. the initial placement of the cancer including entrance margins of larynx in a rich net of lymphatic vessels, extensiveness of organs, the degree of clinical progressions, general physical condition of a patient, radicality of treatment, regularity of check-ups after the operation, high degree of histological malignancy unfavourable configuration of TNM feature blood transfusions, the appearance of remote metastases low efficiency in the early diagnostics of larynx cancer, subjective conditions of patients, discontinuation of complementary irradiation.

[Reconstructive surgery in an advanced laryngeal neoplasm]. / Chirurgia rekonstrukcyjna w zaawansowanym raku krtani.

The case of the extensive laryngeal cancer recurrence after radiotherapy was described. The authors were discussed treatment surgery it with reconstruction of the tissue defect. The skin defect was reconstructed with the pectoralis mayor myocutaneous island flap, the pharyngeal secondary fistula was reconstructed with the Trapezius myocutaneous flap.

[Advanced nasopharyngeal tumor]. / Rozlegly guz nosogardla.

Nasopharyngeal cancer is a rare neoplasm in most parts of the world, it is the most common cancer the Chinese. Nasopharyngeal cancer is often misdiagnosed because of the variety of subtle signs and symptoms and the difficulty of examining this region. The most common neoplasms of the nasopharynx are epithelial malignancies originates from epithelial cells in the nasopharynx. The authors has presented a rare case of advanced nasopharyngeal adenocarcinoma.

[A case of maxillary tumor--difficulties with diagnosis and treatment]. / Przypadek guza szczeki--trudnosci diagnostyczne i lecznicze.

Atypical fibroxanthoma is an uncommon mesenchymal neoplasm. It is cytologically malignant but usually clinically being tumor which typically arises in sundamaged skin of the head and neck region. The principal differential diagnoses are spindle cell squamous carcinoma, melanoma and leiomyosarcoma. Immunohistochemistry plays a key role in diagnosis. We report a patient with atypical fibroxanthoma of the maxilla and the neck.

[The head and neck metastases from clear cell carcinoma of the kidney]. / Przerzut raka jasnokomórkowego nerki do glowy i szyi.

The kidney carcinoma is the commonest tumour to metastasize to the head and neck. The majority of renal metastases occur in the nose and paranasal sinuses. This paper presents four cases of metastatic tumour in the nasal cavities, paranasal sinuses, frontal bone and piriform fossa. The difficulties in diagnosis and management was also presented.

[Lateral rhinotomy is still a useful surgical approach]. / Rynotomia boczna wciaz uzyteczna.

Experience with 130 patients requiring a lateral rhinotomy is reported. It is concluded that excellent surgical exposure is assured by this approach and that minimal postoperative complications are attributable to the incision. An understanding of the advantages and disabilities associated with each of several extensions may help to the surgeon to tailor the approach to individual case. The lateral rhinotomy approach allows wide access to the nose, some elements of skull base, the nasopharynx and the paranasal sinuses for removal of benign and malignant lesions.

[Malignant melanomas of the head and neck]. / Czerniaki zlisliwe glowy i szyi.

During 1980-1992 twelve patients with malignant melanoma of the head and neck were treated in the Department of Otolaryngology of Medical Academy in Warsaw. The largest group (eight patients) consisted of the cases with melanoma localized on the nasal mucosa. In next four patients the tumor localized on the skin of the head. The clinical course of the melanoma was discussed and its methods of cure in dependence on the degree of progression.

[Neuroendocrine carcinomas of the larynx]. / Neuroendokrynne raki krtani.

Neuroendocrine carcinomas of the larynx are uncommon tumors. They include typical carcinoid tumors, atypical carcinoid tumors and small cell neuroendocrine carcinomas. The diagnosis is based on light microscopy which demonstrate evidence of neurosecretory granules, and on histochemical and immunohistochemical investigations. The histogenesis, treatment and prognosis factors are discussed.

[Inverted papilloma of the nose and paranasal sinuses]. / Brodawczak odwrócony (inverted papilloma) jam nosa i zatok przynosowych.

Inverted papilloma of the nose and paranasal sinuses is an unusual benign neoplasm that has the propensity for local tissue destruction and an association with malignant degeneration. The tumor represents an inverted growth of epithelium rather than outward proliferation. Surgical excision is the recommended treatment though the aggressiveness of the approach has varied. Transkanal local excision has been associated with a high recurrence rate. Lateral rhinotomy with removal of the lateral nasal wall and wide local excision has a low recurrence rate and has been recommended treatment by most authors since 1975. We present series of 18 patients treated over eleven years period. All patients underwent lateral rhinotomy. The recurrence rate in our group is 0% with a mean 4, 2 years follow-up.