Polish Journal of Otolaryngology最新文献

Objective: The purpose of this report to determine sudden death following operation, radiotherapy (RT) or chemoradiotherapy (CRT) for head and neck cancer.

Study design: Retrospective, observational, single-center.

Methods: Data from 729 consecutive patients diagnosed with head and neck cancer (confirmed using multiple modalities) who underwent operation, RT or CRT at Kagoshima University Hospital between April 2011, and March 2020 were analyzed. A total of 199 patients underwent operation, 223 patients underwent RT and 307 underwent CRT. 175 patients who received operation, 118 patients who received RT and 190 who received CRT had a complete response.

Results: There were 13 cases of sudden death reported in 10 years. 12 were male and one was female.Sudden death occurred in 3/175 patients (1.7%) who received operation, in 4/118 patients (3.4%) who had received RT and in 6/190 (3.1%) who had received CRT.

Conclusions: We present the first report on cases of sudden death after operation, RT and CRT for head and neck cancer. Otolaryngologists should still follow these patients carefully after such treatment given that sudden death does occur in some patients.

Introduction: The aim of the study was to analyze the causes of the occurrence and treatment results of sudden hearing loss / deafness in own material.

Material and methods: The tests were performed in 64 women aged 10-89 years and 70 men aged 18-85 years, who were treated in the Department of Otolaryngology due to sudden hearing loss / deafness in 2011-2020. A retrospective analysis was carried out on the basis of the data contained in the medical documentation, taking into account: gender, age of patients, type of symptoms, establishing the circumstances and possible causes of the appearance of symptoms, audiological and imaging tests, the cause of the sudden hearing loss / deafness and applied treatment.

Results: In the conducted research it was found that sudden hearing loss / deafness was the most common in women and men in the age range of 51-60 years and 61-70 years. Sudden hearing loss/ deafness was accompanied by the following symptoms in both women and men: tinnitus in 48,4% and 74,3%, tinnitus and vertigo in 28,1% and 14,3%, and vertigo in 6,3% and in 1,4%. In own research, the most common cause of sudden hearing loss/deafness in women and men was respectively: idiopathic cause in 43,8% and 40,0%, infectious in 18,8%, vascular in 12,4% and 12,9%, and neurovascular conflict (included separately) in 12,4% and 12,9%, while in men the acoustic trauma should also be mentioned in 18,5%. The best results in the treatment of sudden hearing loss / deafness on a three-point scale, which depends on the treatment method used, both in women and men, i.e. complete relief of symptoms obtained after the use of vascular drugs with steroid therapy and hyperbaric oxygen therapy - in 25,0% and 22,9%, partial relief of symptoms occurred after vascular treatment with steroid therapy - in 28,1% and 37,2%.

Conclusions: Sudden hearing loss / deafness in both women and men was accompanied by tinnitus, tinnitus and vertigo and vertigo at the same time. In own research the most common cause of sudden hearing loss / deafness in both women and men was: idiopathic, infectious, vascular and neurovascular conflict. The best emergency treatment outcomes of sudden hearing loss / deafness according to a three-level scale, depending on the applied method of treatment, both in women and men, i.e. complete relief of symptoms was obtained after the use of vascular drugs with steroid therapy and hyperbaric oxygen therapyKey words: causes, occurrence, treatment results, sudden hearing loss / deafnes.

Recently, there has been a significant increase in the number of patients hospitalized and undergoing surgery due to parotid gland tumors. We have observed an increase in the total number of salivary gland tumors, and hence an increased number of malignant tumors. Etiological factors of salivary gland tumors are still unknown. Oxidative stress (OS) has been suggested to be an important indicator of carcinogenesis in some tumors. Therefore, the aim of our study was to assess the state of OS in patients with selected benign and malignant parotid gland tumors. After final postoperative histological diagnosis of the tumor, patients were divided into the following groups i.e. pleomorphic adenoma 35 patients, Warthins tumor (WT) - 17 patients, mucoepidermoid carcinoma - 9 patients and 45 controls. The final study group included 106 patients. We found an increase in plasma lipofuscin levels in patients with all investigated parotid gland tumors. Furthermore, the activity of Cu/Zn-SOD in Warthins tumor patients was statistically lower compared to the controls, pleomorphic adenoma or mucoepidermoid carcinoma.In conclusion, we sustain the hypothesis on the presence of a low intensity whole-body OS in patients with parotid gland tumors. Furthermore, LPS may be a useful marker of OS in patients with benign and malignant tumors. Moreover, pathological mechanisms connected with WT seem to be different compared to malignant neoplasms and other benign tumors. It seems that Cu/Zn-SOD, as an antioxidative enzyme, may play an important role in those mechanisms taking part in WT.

ntroductionIn all otologic surgeries, the facial nerve can be considered the most important structure that must be protected. The surgical damage risk of the facial nerve will be increased in presence of facial canal dehiscence (FCD).AimIn this study, we aimed to evaluate the FCD and its associated situations in patients with chronic otitis media undergoing mastoidectomy.Materials and Methods850 patients who performed ear surgery were reviewed. Patients who did not perform mastoidectomy were excluded. In patients, the ratios, localization of FCD, and association of facial canal dehiscence with cholesteatoma were researched. Association between FCD and closed-cavity tympanomastoidectomy, open-cavity tympanomastoidectomy, and radical mastoidectomy procedures, and also an association between FCD and primary or revision surgery was evaluated. ResultsFacial canal dehiscence was found in 8.4% of patients. The relationship between dehiscence and cholesteatoma was found significant (p<0.001). In the comparison of radical mastoidectomy and closed-cavity tympanomastoidectomy, dehiscence was higher in the radical mastoidectomy group (p<0.03). In revision cases, dehiscence was seen more frequently (p<0.003). FCD incidence was higher in adult patients than in pediatric patients (p<0.001). Twenty of 468 patients who were operated on for cholesteatoma had congenital cholesteatoma. ConclusionFacial canal dehiscence can be seen especially in cases with cholesteatoma and when performing radical mastoidectomy and revision surgeries. Therefore, a detailed evaluation of the status of facial nerve and determination of situations in which occurrence of FCD is more likely both preoperatively and intraoperatively will minimalize potential complications.Keywords: Cholesteatoma, tympanic, radical mastoidectomy, oval window, tympanomastoidectomy.

SummaryPurpose. The aim of the study was to evaluate serum concentrations of total sialic acids (TSA) in patients with squamous cell carcinoma of the larynx preoperatively and 4 years postoperatively and to compare the results with the serum concentration of sialic acids in patients with non-neoplastic laryngeal lesions.

Methods: The study comprised 52 patients with squamous cell carcinoma of the larynx and 25 patients with non-neoplastic laryngeal lesions. Serum TSA concentrations were assessed in all patients preoperatively. Four years after surgery, serum TSA concentrations were assessed again in 21 patients from the study group in whom recurrence was not detected.

Results: Significantly higher serum concentrations of TSA were found in patients with laryngeal cancer compared to the control group (p< 0.0000001). Changes in TSA concentrations in the study group depended only on cancer grade (G). Significantly higher TSA concentrations were found in G3 patients. Such a relationship was not found for other parameters assessed. Alcohol consumption was the only important factor that affected TSA concentration in the control group. Significantly higher TSA concentrations were found in patients who admitted alcohol abuse. Significantly lower TSA concentrations were observed in patients with laryngeal cancer who were assessed 4 years postoperatively (p < 0.000106).

Conclusion: Serum concentration of TSA was increased significantly in laryngeal cancer and decreased significantly after several years of successful treatment. Further studies are warranted to assess the possibility of using sialic acids as a marker or target for immunotherapy.

Key words: sialic acids, squamous cell carcinoma of the larynx, markers in laryngeal cancer, N-acetyl-5-neuraminic acid.

Background: Acute rhinosinusitis (ARS) is a common and well-defined disorder, primarily of viral aetiology, with rhinovirus and coronavirus accounting for more than 50% of viral ARS. The fight with COVID-19 pandemic resulted in an increased availability viral testing, which in turn allowed testing for presence of SARS-Cov-2 in all patients presenting common cold (or ARS) symptoms. The aim of this study was to assess the clinical characteristics of acute rhinosinusitis in patients diagnosed with COVID-19.

Methodology/principal: This study is a post-hoc analysis. Patients symptoms were evaluated using a structured questionnaire twice: directly after a positive SARS-Cov-2 result and 7-12 days following the first evaluation. Subjects were asked about presence of nasal and systemic symptoms as well as headache.

Results: A total of 130 COVID-19 symptomatic patients were recruited into the study, 58 (45%) patients met EPOS2020 diagnostic criteria for ARS. Of all ARS patients, 72% presented with rhinorrhoea, 69% with pain perceived over paranasal sinuses, 62% with nasal congestion, 52% with cough, 45% with olfactory dysfunction, 38% with fever, 33% with facial pressure and in 22% pain was exacerbated by sinus palpation.

Conclusions: Half of COVID-19 subjects has ARS. The course of SARS-Cov-2 ARS does not seem to differ significantly from ARS of other aetiologies. Since ARS in the course of COVID-19 seems to meet the definition of ARS proposed by EPOS 2020, we hypothesize that substances validated for ARS treatment, such as intranasal corticosteroids could be effective in SARS-Cov-2 ARS.

Introduction: In the Polish population, the most common cause of allergic rhinitis (AR) in the spring is birch pollen.

Aim: The aim of this study was to assess the basic characteristics of the birch pollen season in selected cities in central and northern Poland including Warsaw, Piotrkow Trybunalski, and Bydgoszcz in 2022, considering their clinical implications.

Material and method: Pollen monitoring was conducted using the volumetric method with the Hirst-type continuous volumetric sampler. Measurements were taken in 7-day cycles, and the microscopic analysis was performed for each 24-hour period. Results During the studied period, birch pollen posed a threat in the 2nd and 3rd decades of April and the 1st and 2nd decades of May. The birch pollination intensity was reflected by the very high values of maximum average daily pollen concentration 4102 pollen/m3 in Warsaw, 4389 pollen/m3 in Piotrkow Trybunalski, 3832 pollen/m3 in Bydgoszcz and the sum of the average daily pollen concentrations (i.e. Annual Pollen Integral, APIn) from 32439 in Bydgoszcz to 37638 in Warsaw, and long periods of exposure to high concentrations (2930 days).

Conclusions: The pollen season 2022 is part of an alternating 2-year cycle of the birch pollen season intensity. The variability of parameters describing the dynamics of pollen seasons over years makes it necessary to monitor information on the pollen concentration in the air during the pollen season, both by the patients with inhalant allergy and their physicians.

As interest in AI in medicine grows, so too does the need for education on the topic. Despite the technology itself being so close, our understanding of the essence of how it works remains remote. A greater, more judicious acceptance of AI tools can be fostered in medicine by a broader appreciation of what the technology can and cannot do.

Aim: The aim of the study was to compare the flow disturbances in computational fluid dynamics (CFD) technique based on computed tomography (CT) to the results of active anterior rhinomanometry (RMM), in patients with nasal septum deviation (NSD).

Material and methods: In 24 patients with NSD, RMM and CT of the paranasal sinuses were performed as a part of typical clinical management. For each patient, 3D models of air-filled spaces in the nasal cavity were created, based on CT images, and air flow simulations during inhalation were performed using CFD technique. Correlations between RMM, both before and after anemization, during inspiration, and CFD were tested, independently for the left and right side.

Results: The obtained correlation coefficients for the comparison of flow in RMM during inspiration and in CFD during simulated inspiration were: before anemization 0.46 for the left side and 0.52 for the right side, after anemization 0.65 for the left side and 0.61 for the right side (p < 0.05).

Conclusions: Moderate correlation was found between the results of real and virtual rhinomanometry, with higher correlation coefficients obtained after anemization, compared to the values before anemization.

The Polish Universal Neonatal Hearing Screening Program (PUNHSP) has been carried out in Poland for 20 years. Its main goal is to screen newborns for hearing. This examination is performed on the 2-3 days of a child's life, and in addition, information is collected on the risk factors for the development of hearing loss. In total, 486 centers participate in PPPBSuN at three reference levels. By the end of 2021, 7 million children were registered in the PPPBSuN Central Database. The most common type of hearing loss in children was bilateral sensorineural hearing loss, diagnosed in 2021 in 160 children. The report below presents the most important results and conclusions from the functioning of PPPBSuN in 2021.