Comparison of the efficacy and tolerability of amoxycillin/clavulanic acid 875 mg b.i.d. with cefuroxime 500 mg b.i.d. in the treatment of chronic and acute exacerbation of chronic sinusitis in adults.

The efficacy and safety of amoxycillin/clavulanic acid (AMX/CA) (875/125 mg b.i.d. for 14 days) were compared with that of cefuroxime axetil (500 mg b.i.d. for 14 days) in a multicenter, open, parallel-group, randomized clinical trial in 206 adults with chronic or acute exacerbation of chronic sinusitis. Clinical response was similar, with 95% of AMX/CA-, and 88% of cefuroxime-treated, clinically evaluable patients cured (95% confidence interval; -0.6% to +15%). In bacteriologically evaluable patients, cure rates, defined as eradication of the original pathogen with or without re-colonization with non-pathogenic flora, were also similar, with 65% of AMX/CA- and 68% of cefuroxime-treated patients cured (95% confidence interval; -18% to +15%). However, clinical relapse was significantly higher in the cefuroxime group: 7% (7/89) of clinically evaluable patients, compared with 0% (0/98) in the AMX/CA (p=0.0049) group. A similar incidence of possible or definite adverse events related to the study drug was reported for both treatments (AMX/CA 4.4%, cefuroxime 4.3%), the most frequent being diarrhea. Four adverse events were recorded as serious or life-threatening with only one considered related to the study drug (urticaria, cefuroxime). AMX/CA 875/125 mg b.i.d. for 14 days is as effective and well tolerated as cefuroxime axetil 500 mg b.i.d. for 14 days in the treatment of chronic, or acute exacerbation of chronic sinusitis, but is associated with a significantly lower clinical relapse rate.

[Reconstructive methods in the surgery of defects of the floor of the mouth and the tongue due to carcinoma]. / Sposoby rekonstrukcji ubytków dna jamy ustnej i jezyka po operacjach z powodu raka.

A retrospective analysis of patients with tongue, floor of the mouth and tonsil carcinoma treated in II ENT Department University School of Medicine in Zabrze between 1994 and 1996 was undertaken. 32 male and 10 female underwent operation of the oropharynx. The visor flap, mandibulotomy or peroral approach was used. In 32 cases mandibulotomy, in 2 cases visor flap and in 3 cases peroral approach was performed. The usefulness of bone grafts from iliac ala, skin flaps and part of the tongue applied to replace the defect after extensive operation of the oropharynx was analysed and presented. In 2 patients partial mandibulectomy was performed. In 2 patients defect was replaced with iliac crest. Good graft's vitality, availability and function were emphasized.

[The management in chronic otitis media complicated by labyrinthine fistula]. / Postepowanie w przewleklym zapaleniu ucha srodkowego powiklanym przetoka blednikowa.

12 cases of the labyrinthine fistulae from 88 patients operated due to chronic otitis media with cholesteatoma were presented. All patients underwent canal wall dawn technique. In 3 cases the radical ear operation was performed. Other 9 patients were operated by modified radical ear operation with simultaneous tympanoplasty. The frequency and location of labyrinthine fistulae were estimated in chronic otitis media based on own material and literature. The different operating methods were analysed and their influence on the inner ear function was emphasised.

[Clinical analysis of indications to ventilation tube removal in otitis media with effusion]. / Kliniczna analiza wskazan do usuniecia drenów wentylacyjnych w przebiegu wysiekowego surowiczo- uzowego zapalenia ucha srodkowego.

The indications to ventilations tube removal in otitis media with effusion based on the own material and other authors suggestions were defined. The necessity of the tube removal in the case when it hasn't extruded itself after recovery was pointed out. Special conditions were defined in such cases. The necessity of the ventilations tube removal in otitis media with effusion during developing complications, such as tube displacement into middle ear, granulation tissue around the tube, otorrhea, blocked lumen of a tube that cannot be opened by alternative means, was also emphasized.

[The evaluation of the wound healing failure in patients after total laryngectomy]. / Ocena niepowodzen w gojeniu sie ran po calkowitym usunieciu krtani.

The authors presented own results concerning complications in wound healing after total laryngectomies. 59 total laryngectomies and 4 pharyngo-laryngectomies were performed. In 18 cases local and systemic complications were observed. Pharyngo-cutaneous fistulas developed in 15 patients. Therapeutic management was successful in all cases.

[Otogenic sigmoid sinus thrombosis in the course of chronic otitis media]. / Zakrzepowe zapalenie zatoki esowatej w przebiegu przewleklego zaostrzonego zapalenia ucha srodkowego.

A four cases of sigmoid sinus thrombosis due to chronic exacerbated otitis media were presented. In all patients surgical intervention involved a radical mastoidectomy and exposure of the sinus. In two cases sigmoid sinus was incised and the internal jugular vein ligated. In the two others, sinus was only needled. A high dosages of antibiotics were administered parenterally. All patients were discharged in good state of heals.