[Ethmoid sinus mucocele penetrating to the orbit and anterior cranial fossa - case report]. / Sluzowiak zatok sitowych penetrujacy do oczodolu i przedniego dolu czaszki - opis przypadku.

Paranasal sinus mucocele is the cystic formation lined by inflammatory changed mucoperiosteum. This is slow-growing pathology with a tendency to bone erosion. The symptoms are dependent on the direction of the penetration, and are as follows: increasing headaches, deformations of frontal or orbital region, ophthalmic manifestations such as lacrimation, decreased visual acuity, exophthalmos, ocular movement limitation, diplopia. The most common location of the mucocele is fronto-ethmoid region. The most useful diagnostic tests are a magnetic resonance imaging (MRI) and a computed tomography (CT) which show the progress of the disease and bone destructions. Surgery is the only method of treatment (external approach or FESS). This paper reports the case of a 74-year-old woman with ethmoid mucocele penetrating into the orbit, frontal sinus and anterior cranial fossa with compression of frontal lobe of the brain. The patient underwent CT and MRI and was treated with endoscopic intranasal marsupialization of the cyst. There are no clinical signs of disease recurrence 7 months after surgery. The endoscopic surgical management in treatment of sinus mucocele is a good alternative to the operation from external approach because of its low invasiveness, low complication risk, rapid healing and good therapeutic effects.

[Acute ear trauma caused by failure of mobile phone/cellular phone]. / Ostry uraz akustyczny i termiczny ucha spowodowany awaria telefonu komórkowego.

The case of acute acoustic and burn ear trauma caused by mobile phone failure is presented. A woman aged 24 after dialling a phone number and putting a phone into the ear heard a sound of high frequency and intensity. At the same time she felt a pain and heat and there was also a smoke from the phone. With otoscopic examination a burn of external acoustic duct (I0) and sensitive hearing loss (examination made with tuning forks) were stated. The patient did not agree to stay in hospital and she was administered prednizone, trimetazidin and xantylol nicotinate. Audiometric examination, which was made on another day, showed hearing loss of 30 dB for frequency 4000Hz. After 2 days she started to hear a sound like a sea noise in her right ear. In the control examination, made 2 weeks after injury, no abnormalities in audiogram were stated but the patient steal heard ear noise. She continued to take trimetazidin and betahistin and after one month all symptoms of ear injury relieved. Patient is still under control of otolaryngologist. Unfortunately our efforts to explain the cause of such accident from phone producer were ineffective. Described case proves that mobile phone failure can be a cause of acute ear injury.

[Perceptiv-acoustic characteristic after supracricoid laryngectomy with cricohyopexy or cricohyoepiglottopexy]. / Charakterystyka percepcyjno-akustyczna glosu i mowy po laryngektomiach nadpierscieniowych z CHP lub CHEP.

INTRODUCTION: Supracricoid laryngectomy with cricohyopexy (CHP) and cricoepiglottopexy (CHEP) are the one of functional laryngectomy. AIM: The aim of the study is phonation assessment of the reconstruction larynx. Material and methods. The examined group consisted of 58 patients (49 males and 9 female). An average age 54. 32 patients underwent CHP and 26-CHEP CHP was performed in following modes: a) 1 arytenoid cartilage left in 17 cases, b) 2 arytenoid cartilages left in 14 cases and c) 1 arytenoid cartilage left and second was resected with subsequent reconstruction in 1 case. The arytenoid cartilage was reconstructed in 19 cases (8 after CHP and 11 after CHEP). The vascularized thyroid lobe was used to the reconstruction of arytenoid cartilage in 8 cases (6 after CHP and 2 after CHEP), cuneiform or corniculate cartilage was used in 4 patients (1 CHP and 3 CHEP) and mucous membrane in 7 cases (1 CHP and 6 CHEP). RESULT: Socially efficient speech was found in 74% patients and the results were better after CHEP. CONCLUSION: The phonetic-acoustic structure of voice and resonant speech was considerably different from the phonetic-acoustic structure of voice and speech under physiologic conditions. These differences applied to segmental (formant structure, frequencies, noise range), as well as suprasegmental voice features.

[Morphology of the glottis after supracricoid laryngectomy with CHP or CHEP and restoration of basic laryngeal function with special attention to quality of phonation]. / Morfologia glosni po laryngektomiach nadpierscieniowych z nastepowa CHP i CHEP a stopien odwzorowania podstawowych funkcji krtani fizjologicznej ze szczególnym uwzglednieniem jakosci fonacji.

PURPOSE: The aim of this work was to describe the morphology of the reconstructed larynx after supracricoid horizontal laryngectomy with simultaneous cricohyopexy (CHP) or cricohyoepiglottopexy (CEHP) preserving one or both arytenoid cartilages, to study the protective and respiratory functions of the larynx, to perform phoniatric evaluation of phonation quality, to analyze voice and speech phonetic-acoustic parameters, and to search for correlations between reconstruction type and phonetic-acoustic characteristics of voice and speech. MATERIAL AND METHODS: The material comprised 58 patients (32 after CHP and 26 after CHEP). CONCLUSION: Oval shape of the neoglottis dominated. Swallowing was normal in 46% of patients and did not depend on reconstruction type. Decannulation was possible in 66% of patients. The results were inferior after CHEP with both arytenoid cartilages intact. Socially efficient speech was found in 74% of patients and the results were better with CHEP. The phonetic-acoustic structure of voice and resonant speech was considerably different from the phonetic-acoustic structure of voice and speech under physiologic conditions. These differences applied to segmental (formant structure frequencies, noise range), as well as suprasegmental voice features.

[Glottis morphology after supracricoid laryngectomy with CHP or CHEP--protetective and respiratory function assessement]. / Morfologia glosni po laryngektomiach nadpierscieniowych z cricohyopexia (CHP) lub cricohyoepiglottopexia (CHEP)--ocena funkcji ochronnej i oddechowej.

The aim of this study was to evaluate morphology and assess of the protective and respiratory function of larynx after cricohyopexis (CHP) and cricohyoepiglottopexis (CHEP). The examined group consisted of 58 patients (49 males and 9 female) operated between 1984-2002. An average age 54 (min. 36, max. 67). 32 patients underwent CHP and 26 had CHEP. CHP was performed in following modes: a) 1 aryteroid cartilage left in 17 (43,75%) cases, b) 2 aryteroid cartilages left in 14 (43,75%) cases and c) 1 aryteroid cartilage left and second resected with subsequent reconstruction in 1 (3,31%) case. In CHEP patients the operations were a) 17 (65,38%), b) 4 (15,38%) and c) 5 (19,23%) respectively. The aryteroid cartilage was reconstructed in 19 cases (8 after CHP and 11 after CHEP). In the reconstruction of aryteroid cartilage vascularized thyroid lobe was used in 8 cases (6 after CHP and 2 after CHEP), cuneiform or corniculate cartilage was used in 4 patients (1 CHP and 3 CHEP) and mucous membrane in 7 cases (1 CHP and 6 CHEP). To determine morphology of larynx, videolaryngoscopy was done. Thus examination distinguished 5 neoglottis shapes: oval (62,1%), longitudinal (13,8), triangle (8,6%), irregular (6,9%). In 8,6% cases the neoglottis was invisible. Decaniulation was possible in 66% patients, 24 (75%) after CHP and 14 (54%) after CHEP. In the group with both aryteroid cartilages left, 16 (89%) patients were decannulated. 31 (54%) patients complained about occasional liquid aspiration. To evaluate dysphagia, subjective complaints between 6-12, 12-18 and >18 months after surgery were analyzed. The swallowing was improving in the course of time. Between 6 and 12 months after surgery 31 (54%) subjects developed dysphagia, but after 18 months only 3 (5,1%) complained about swallowing impairment. Patients without aryteroid cartilage reconstruction or decanulated had more efficient swallowing.