[Application of microsurgery in diagnosis and treatment of larynx diseases]. / Zastosowanie mikrochirurgii w diagnostyce i leczeniu chorób krtani.

THE AIM OF THE STUDY: was analyzing cases of laryngeal diseases and their location that required treatment by surgical procedure as well as analyzing complications resulting from microsurgery of the larynx and their location during surgical procedures and treatment performed in the Otolaryngology Clinic at Military Institute of the Health Services Central Military Hospital in Warsaw (years 1994-2003). MATERIAL AND METHODS: We analyzed 713 patients, of which 248 were women (34.8%) and 465 were men (65.2%) aged between 12 and 80 (the average age was 49.4 +/- 11.8), who were diagnosed as requiring microsurgery of the larynx using the Kleinsasser's set together with operating microscope and CO2 laser in selected cases. RESULTS: The total of 713 microsurgical operations was performed in the larynx area. The largest group were the patients who were diagnosed as having polyps (33.0%), chronic laryngitis (19.6%) and an established diagnosis of laryngeal carcinoma. Complications were observed in 416 patients (58.3%). CONCLUSIONS: Microsurgery of the larynx was the most often applied form of treatment of vocal fold polyps, chronic laryngitis and laryngeal carcinoma; pathological changes that require microsurgical treatment are mostly located in the epiglottis and the central part of the glottis whilst the major complications resulting from the microsurgery of the larynx are limited to superficial damage of the mucous membrane, mostly on the lips.

[A case report of fibrous dysplasia in right temporal bone]. / Przypadek zwyrodnienia wlóknistego kosci skroniowej prawej.

The authors describe the rare case of fibrous dysplasia in temporal bone. Dysplasia fibrosa is a benign osseous condition that may involve one or more bones in the cranial and extracranial skeleton. Temporal bone involvement occurs in 18 per cent of craniofacial diseases. Clinical, radiographic and histologic examinations are essential to confirm the diagnosis of fibrous dysplasia. Treatment of illness depends on the associated symptoms.

[Malignant tumors of the nose and paranasal sinuses in the years 1992-2001]. / Nowotwory zlosliwe nosa i zatok przynosowych w latach 1992-2001.

On the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment of basic epidemiological data, including the localization of tumor, and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 10 years the trends to change the mentioned above parameters has been examined. The index of morbidity in this period was constant and compareable with figures published earlier. In the analyzed material there is a predominance of males and the sex ratio was 1.45. The majority of cases were between 50-69 years (55%). The most common histopathological diagnosis was carcinoma (58%). The majority of cases of malignant tumors of the nose and paranasal sinuses was diagnosed in the advanced stage T3-T4 (72.3%) with the highest percentage in the middle region. 90% of all cases were treated surgically, but in about 30% it was the only treatment (also in cases of stage T2-T4). In 56% of all patients the surgical procedure was completed by radiotherapy. This data suggest that indications for additional irradiation should be extended.

[Evaluation of the equilibrium system in patients with multiple sclerosis based on qualitative assessment with videonystagmography]. / Ocena ukladu równowagi u chorych na stwardnienie rozsiane na podstawie jakosciowej oceny badania wideonystagmograiznego.

Multiple sclerosis (SM) is the most frequent inflammatory-demyelinating disease of central nervous system. The character of SM disease provokes that its most frequent symptoms are vertigo, equilibrium disorders and ataxia. Objective method of vertigo estimation is evaluation of the nystagmus via videonystagmography registration (VNG). This examination allows to simultaneously assess the vertical and horizontal component of the nystagmus. It is considered that mainly the vertical nystagmus is characteristic to equilibrium system impairments of the central nervous system, caused also by SM. The study was carried out on 40 patients (28 women, 12 men) with SM diagnosed as a result of neurological examination. 7 patients (17.5%) suffered from sham - movement vertigo, while 33 patients (82.5%) suffered from instability of posture and walking deviation. The videonystagmography examination resulted in the following: deviation of the eye movement was recorded in 26 patients (65%) during either in saccadic test and in smooth pursuit test, optokinetic nystagmus recorded: dissymetric and variable amplitude result in 24 patients (60%), presence of vertical nystagmus component in 30 patients (75%), positional test: directional-changable nystagmus in 8 patients (20%), pendular nystagmus in 4 patients (10%), presence of vertical nystagmus component in 31 patients (77.5%), caloric test: impairments of one of the labyrinth recorded in 12 patients (30%). SM is still the diagnostic and therapeutic problem. During the mentioned tests we have found the quantitative and qualitative changes in VNG recordings. This may be helpful in SM diagnosis, mainly during its early stages.

[Application of the fusafungine in perioperative period in patients after tonsillectomy]. / Zastosowanie fusafunginy w okresie pooperacyjnym u chorych po tonsillektomii.

The only treatment method in chronic palatine tonsillitis is the removal of tonsils (tonsillectomy). The study aimed at a clinical evaluation of postoperative fusafungine use in patients who underwent tonsillectomy. The study included 200 patients who underwent tonsillectomy for chronic palatine pyotonsillitis in the Otolaryngology Clinic of the Military Institute for the Health Services in Warsaw between 2000 and 2002. The patients were divided into two groups, each group including 100 patients: group I--patients who underwent tonsillectomy, including 67 females and 33 males, aged 16 to 52 (mean age 34.8), in whom fusafungine was used; group II--patients who underwent tonsillectomy, including 58 females and 42 males, aged 17 to 56 (mean age 36.1), who did not receive fusafungine. The subjects were observed during the first 14 days following the operation. The treatment was administered from the first day after the operation, by spraying 4 doses into the throat, 4 times a day, at 8.00 hrs, 12.00 hrs, 16.00 hrs and 20.00 hrs. The two groups were then compared in terms of: symptoms of sore throat, body temperature, swallowing difficulties, the course of healing, appearance of the pharyngeal mucosa, quality of life and general affection. Post-tonsillectomy fusafungine use was found to improve the patients' quality of life, appeases the sore throat and swallowing difficulties, decreases the need for general antibiotic therapy; the above results are statistically significant. Fusafungine was not found to influence body temperature, the appearance of the pharyngeal mucosa or the healing process.

[The case of Wegener's disease of the nose, paranasal sinusses and ears]. / Przypadek choroby Wegenera z lokalizacja w obrebie nosa, zatok przynosowych i uszu.

The Wegener's granulomatosis is an autoimmunologic disease with still unknown etiopathogenesis. A rare case of Wegener's disease in 53-year-old female was described, located in her nose, paranasal sinuses and ears. We have also presented the diagnostic difficulties with this rare disease.

[The case of carcinoma adenoides cysticum of the tongue, the trachea and the thyroid gland]. / Przypadek raka gruczolowo-torbielowatego jezyka, tchawicy i gruczolu tarczowego.

We present a case of a 65-year-old female patient who was for the first time admitted to the clinic in 1997 due to a tuber of the tongue root. The removed tuber turned out to be histopatologically a polymorphic adenoma. The patient was re-admitted to the Clinic in 2001 due to a tuber of the tongue and of the oral cavity bottom. The tuber was removed entirely through a central incision, and an apart hypertrophic change has been found on the posterior pharynx wall and in the scar after the tracheostomy carried out during the previous surgery. In all cases carcinoma adenoides cysticum has been found, as well as metastasis into the thyroid gland and the lungs. The patient was qualified for chemotherapy in the Institute of Oncology, which she has been going through periodically every two weeks until now. In 2002 the patient was operated on a small tuber located hypodermically in the scar after the tracheotomy, which was removed. Carcinoma adenoides cysticum was found. In November 2002, during the surgery a tumorous infiltration of the thyroid gland was found comprehending trachea and reaching the mediastenum. In February 2003 the patient was re-admitted to the Clinic due to dyspnoea caused by a significant contraction of the trachea which occurred as a result of a focus of carcinoma adenoides cysticum and significantly enlarged lymph glands near the trachea. The patient was qualified for stent placement in the Institute of Pulmonary Disease and Tuberculosis (Instytut Chorób Pluc i Gruzlicy). The presented case describes an exceptionally aggressive and polyfocal regrowth and transformation of a polymorphic adenoma into cancer.