An upper lip tumour as the presenting symptom of metastatic renal cancer.

INTRODUCTION: Renal cell carcinoma (RCC) constitutes about 3% of solid tumours in adults. Unfortunately, in spite of continuous development of more and more efficient diagnostic methods, in about 30% of patients with RCC metastatic spread is found at presentation. Only in 1% of patients with advanced RCC metastases are limited exclusively to the head-and-neck region. We present a case of a male patient in whom a tumour of the upper lip was the first symptom of advanced renal cancer. CASE REPORT: A 59-year-old male was admitted to the Urology Department due to a large tumour of the right kidney. About two months earlier the patient noted a nodule located within the upper lip. In the same period painless hematuria occurred twice, which was disregarded by the patient. A CT scan of the chest and abdomen showed a large tumour of the kidney, multiple lung and bone metastases. The patient underwent local surgical excision of the lip tumour and palliative renal artery embolization. CONCLUSIONS: In natural history of renal cancer there is a risk of metastatic spread to the head-and-neck region. Contrast enhanced computed tomography of the abdomen should be considered if a tumour of unknown origin is found within the head-and-neck region. Prognosis in case of confirmed metastatic renal cancer is unfavourable and patient's treatment should be conducted in specialist centres.

[Endoscopic surgery in treatment of inverted papilloma nose et paranasal sinuses in the older patient]. / Brodawczak odwrócony nosa i zatok przynosowych leczony chirurgia endoskopowa u chorej w wieku podeszlym.

Inverted papilloma is a benign neoplasm of uncertain ethiology. The tumour is considered locally aggressive, its tendency to invade adjacent paranasal structures and high recurrence rate causes. In this work was described one case of 102 year's old patient with unilateral nasal obstruction since 5 month and headache. Endoscopy surgery was applied. Histological examination revealed inverted papilloma.

[Bacterial flora in paranasal sinuses of the chronic inflammation]. / Flora bakteryjna w przewleklym zapaleniu zatok przynosowych.

OBJECTIVE: To investigate the bacteriological profile in patients with chronic rhinosinusitis. MATERIALS AND METHODS: We enrolled to this trial 100 patients (56 females and 44 males) aged from 18 to 62 (mean 41.3), with chronic rhinosinusitis. Control group were 20 patients (9 females and 11 males) aged from 19 to 44 (mean 29.4). RESULTS: In collected material from 87 patients (87%) growth of bacteria on 89 blood agar were received. In two cases mixed flora was observed. In 13 specimens there was no growth of any bacteria. Comparing results of studied cultures: in 78 patients pathological flora were discovered whereas in 8 patients saprophytic bacteria. In the group of pathological flora 71.57% cultured bacteria was aerobe, among it the commonest were: Staphylococcus aureus (13.73%), Streptococcus pneumoniae (10.78%), Haemophilus influenzae (9.8%), Staphylococcus coagulase negative (9.8%). In anaerobe group most frequently bacteria isolated was Prevotelle sp. (6.86%). CONCLUSIONS: In our trial 15 different bacterial types were identified. In 72% cases aerobic bacteria were cultured. The most commonest pathogens were: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus coagulase negative.

[Bacterial flora of the tonsillar surface versus tonsillar core in chronic tonsillitis]. / Flora bakteryjna wystepujaca na powierzchni i w miazszu migdalków w przewleklym zapaleniu migdalków podniebiennych.

The purpose of the work was to present the frequency of isolation of particular bacterial species from smear samples obtained from the surface of the palatal tonsils and from aspirates of tonsillar core. The material involved 100 patients, 49 women and 51 men among them, who were qualified to tonsillectomy based on their history, otolaryngological examination and selected laboratory parameters and in whom bacteriological examination of smears taken from the right and left palatal tonsil were performed. The material obtained from superficial tonsillar smears and from tonsillar core aspirates was subject to bacteriological analysis. Frequency of isolation of particular bacterial species was performed. Higher detectability of beta-haemolytic streptococci was found in tonsillar core aspirates, as compared to superficial smears. Bacteriological analysis of palatal tonsil core aspirate was shown to be a good method of isolation of pathogenic microbial strains.

[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.

[Assessment of the correlation between taste and smell functioning]. / Ocena zaleznosci miedzy funkcjonowaniem zmyslu smaku i powonienia.

UNLABELLED: There are few studies examining relationship between taste and smell. However their clinical unity is more often indicated. Smell perception abnormalities cause modification in taste of food intensity, disabling perception of taste as a consequence of taste's sniffing failure. Thus disturbances of these senses, which often commonly coexist could cause great discomfort in patients, however taste sense is estimated as less important comparing to smell sense. The aim of that study was to compare the taste perception in patients with normal smell function and patients with hyposmia and anosmia. There was analyzed correlation between the patients' subjective estimation of smell and taste senses and results of gustometry and olfactometry examinations. MATERIAL AND METHOD: there were indicated three groups of patients based on smell examination with usage of Elsberga--Levy'ego olfactometr in Pruszewicz modification. The first group included patients with normosmia, the second--patients with hyposmia or anosmia related to every smell, the third--patients with hyposmia on few smells and normal smell feeling of others. The Bornstein's method gustometry modified by us was performed for all groups. Moreover patients presented their subjective estimation of smell and taste senses. All results were statistically analyzed, taking into consideration results with alpha < or = 0.05. RESULTS: All (100%) patients with normosmia correctly identified sour, bitter and salty tastes, while only 53% of patients with hyposmia and anosmia got similar results. However 76.5% of patients from the second group subjectively estimated their sense of taste as a normal perception. CONCLUSIONS: Patients with smell disturbances significantly more often have abnormalities in taste perception than patients with normosmia and their subjective estimation of taste and smell senses is much more different than gustometry and olfactometry results.

[New method of biopsy of palatine tonsils and its role in the indication for tonsillectomy (preliminary report)]. / Nowa metoda oligobiopsji migdalków podniebiennych i jej znaczenie w kwalifikacji do tonsillektomii (doniesienie wstepne)

In our work we presented a new method of chronic tonsillitis diagnosis and evaluated its usefulness in qualification to tonsillectomy. Oligobiopsies were obtained from right and left palatine tonsils of 36 patients who were qualified to tonsillectomy on the basis of past medical history, otolaryngological examination and laboratory tests findings. Following gauge of biopsy instruments were used: 2 mm, 3 mm, 4 mm. The material obtained at biopsies and tonsillectomies was histopathologically evaluated. Histopathological findings of specimens obtained at oligobiopsies and post tonsillectomies were compared. The presence of interstitial fibrosis, neutrophils infiltrates, hyperplastic changes of lymphoid follicles of palatine tonsils were evaluated in oligobiopsy specimens in comparison to the results of postoperative specimen findings. Full concordance of histopathological findings obtained at oligobiopsy and post tonsillectomy was noted with the use of biopsy instruments of 3 mm and 4 mm gauge. Specimens obtained at oligobiopsies had a great diagnostic value. It was proved that the biopsy performed according to our method has a great diagnostic value and helps surgeon to qualify patient to tonsillectomy.