Pub Date : 2023-01-25DOI: 10.5604/01.3001.0016.2304
Agnieszka Jasińska-Nowacka, Katarzyna Pierchała, Emil Wnuk, K. Niemczyk
Wstęp: Choroba Ménière’a charakteryzuje się występowaniem napadowych zawrotów głowy z towarzyszącym szumem usznym i uczuciem pełności w uchu oraz fluktuacyjnym niedosłuchem odbiorczym. Stanowi istotną przyczynę zawrotów głowy, spotykaną w gabinetach lekarzy otolaryngologów, neurologów i lekarzy podstawowej opieki zdrowotnej. Rozwój technik diagnostyki obrazowej, w tym badanie rezonansu magnetycznego (MRI) ucha wewnętrznego, pozwala obecnie na przyżyciowe stwierdzenie wodniaka endolimfatycznego, uważanego za podłoże choroby. Z uwagi na nieznaną etiologię leczenie choroby Ménière’a jest przede wszystkim objawowe. Aktualne międzynarodowe wytyczne ds. diagnostyki i leczenia choroby Meniere’a, zalecają terapię eskalacyjną, rozpoczynającą się od leczenia zachowawczego, a zwieńczoną metodami chirurgicznymi proponowanymi pacjentom z agresywnym przebiegu choroby. Miarą skuteczności leczenia jest redukcja liczby ataków wirowych zawrotów głowy, uważanych za najbardziej uciążliwy aspekt schorzenia. Opis przypadkuPrzedstawiono przypadek pacjenta z jednostronną zdefiniowaną chorobą Ménière’a o zaawansowanym przebiegu klinicznym, u którego w badaniu MRI nie stwierdzono obecności wodniaka endolimfatycznego, a jedynie wzrost wysycenia kontrastowego ślimaka po stronie występowania objawów. Pacjent został zakwalifikowany do operacji neurektomii przedsionkowej z dostępu przez środkowy dół czaszki. Leczenie operacyjne skutkowało całkowitym ustąpieniem zawrotów głowy. W kontrolnym badaniu, wykonanym osiem miesięcy po operacji przecięcia nerwu przedsionkowego z dostępu przez środkowy dół czaszki, stwierdzono istotne zmniejszenie zakontrastowania ucha operowanego. PodsumowanieBadanie rezonansu magnetycznego stwarza możliwość monitorowania przebiegu choroby w uchu wewnętrznym po zastosowanym leczeniu. Omówiony przypadek oraz przegląd literatury pozwalają sądzić, iż asymetryczne wzmocnienie objawowego ucha jest wczesnym radiologicznym objawem u pacjentów z chorobą Ménière’a, a wcześnie postawiona diagnoza oraz odpowiednio wdrożona terapia dają szansę na poprawę komfortu życia pacjenta, a być może także zatrzymanie patologicznych procesów zachodzących w uchu wewnętrznym.
{"title":"Rola asymetrycznego wzmocnienia kontrastowego ucha wewnętrznego w badaniu MRI w diagnostyce choroby Ménière’a - opis przypadku","authors":"Agnieszka Jasińska-Nowacka, Katarzyna Pierchała, Emil Wnuk, K. Niemczyk","doi":"10.5604/01.3001.0016.2304","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2304","url":null,"abstract":"Wstęp: Choroba Ménière’a charakteryzuje się występowaniem napadowych zawrotów głowy z towarzyszącym szumem usznym i uczuciem pełności w uchu oraz fluktuacyjnym niedosłuchem odbiorczym. Stanowi istotną przyczynę zawrotów głowy, spotykaną w gabinetach lekarzy otolaryngologów, neurologów i lekarzy podstawowej opieki zdrowotnej. Rozwój technik diagnostyki obrazowej, w tym badanie rezonansu magnetycznego (MRI) ucha wewnętrznego, pozwala obecnie na przyżyciowe stwierdzenie wodniaka endolimfatycznego, uważanego za podłoże choroby. Z uwagi na nieznaną etiologię leczenie choroby Ménière’a jest przede wszystkim objawowe. Aktualne międzynarodowe wytyczne ds. diagnostyki i leczenia choroby Meniere’a, zalecają terapię eskalacyjną, rozpoczynającą się od leczenia zachowawczego, a zwieńczoną metodami chirurgicznymi proponowanymi pacjentom z agresywnym przebiegu choroby. Miarą skuteczności leczenia jest redukcja liczby ataków wirowych zawrotów głowy, uważanych za najbardziej uciążliwy aspekt schorzenia. Opis przypadkuPrzedstawiono przypadek pacjenta z jednostronną zdefiniowaną chorobą Ménière’a o zaawansowanym przebiegu klinicznym, u którego w badaniu MRI nie stwierdzono obecności wodniaka endolimfatycznego, a jedynie wzrost wysycenia kontrastowego ślimaka po stronie występowania objawów. Pacjent został zakwalifikowany do operacji neurektomii przedsionkowej z dostępu przez środkowy dół czaszki. Leczenie operacyjne skutkowało całkowitym ustąpieniem zawrotów głowy. W kontrolnym badaniu, wykonanym osiem miesięcy po operacji przecięcia nerwu przedsionkowego z dostępu przez środkowy dół czaszki, stwierdzono istotne zmniejszenie zakontrastowania ucha operowanego. PodsumowanieBadanie rezonansu magnetycznego stwarza możliwość monitorowania przebiegu choroby w uchu wewnętrznym po zastosowanym leczeniu. Omówiony przypadek oraz przegląd literatury pozwalają sądzić, iż asymetryczne wzmocnienie objawowego ucha jest wczesnym radiologicznym objawem u pacjentów z chorobą Ménière’a, a wcześnie postawiona diagnoza oraz odpowiednio wdrożona terapia dają szansę na poprawę komfortu życia pacjenta, a być może także zatrzymanie patologicznych procesów zachodzących w uchu wewnętrznym.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-23DOI: 10.5604/01.3001.0016.1566
Anna Waśniewska-Włodarczyk, W. Konopka, Małgorzata Śmiechura-Gańczarczyk
Objective: To assess the treatment of hearing loss in children with severe heart defects after cardiac surgeries in their early life. The evaluation included the preparation to the surgery, the safety and effectiveness of cochlear implantation. The study design: It was a retrospective study. In our database there are 7 children (age: 2.5-5.5) with congenital heart defect who have had cardiac surgery. All of them were implanted with a Cochlear CI512 device. Late implantation was a result of a necessity to perform life-saving cardiac surgeries. The children are still under the observation of audiologists and speech therapists.Results: Assessment of the four-frequency average of indicative free field audiometry shows that there is an increase of hearing ability within a given time period: without sound processor (SP) the threshold of hearing had been 112.75 dB, with SP (three month after surgery) it was 67.5 dB, 6 months after surgery was 49 dB. After the cochlear implantation, speech development of implanted children was faster than observed prior to cochlear implant (CI) surgery. Conclusion: Pre-operation planning reduces the risk during cochlear implantation. Cochlear implantation is safe for children with heart defects, if they are early diagnosed and treated.
{"title":"Treatment of deafness with the use of cochlear implants in children with severe heart defects","authors":"Anna Waśniewska-Włodarczyk, W. Konopka, Małgorzata Śmiechura-Gańczarczyk","doi":"10.5604/01.3001.0016.1566","DOIUrl":"https://doi.org/10.5604/01.3001.0016.1566","url":null,"abstract":"Objective: To assess the treatment of hearing loss in children with severe heart defects after cardiac surgeries in their early life. The evaluation included the preparation to the surgery, the safety and effectiveness of cochlear implantation. The study design: It was a retrospective study. In our database there are 7 children (age: 2.5-5.5) with congenital heart defect who have had cardiac surgery. All of them were implanted with a Cochlear CI512 device. Late implantation was a result of a necessity to perform life-saving cardiac surgeries. The children are still under the observation of audiologists and speech therapists.Results: Assessment of the four-frequency average of indicative free field audiometry shows that there is an increase of hearing ability within a given time period: without sound processor (SP) the threshold of hearing had been 112.75 dB, with SP (three month after surgery) it was 67.5 dB, 6 months after surgery was 49 dB. After the cochlear implantation, speech development of implanted children was faster than observed prior to cochlear implant (CI) surgery. Conclusion: Pre-operation planning reduces the risk during cochlear implantation. Cochlear implantation is safe for children with heart defects, if they are early diagnosed and treated.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-23DOI: 10.5604/01.3001.0016.1567
Azzam Abbas *, Mustafa Hamed **, Ahmed Ahmed ***
AbstractBackground: Cochlear Implantation has proven beneficial in patients with profound congenital hearing impairments. Performing cochlear implantation in patients with inner ear malformation has always been a matter of dispute as congenital deaf ears may have anatomical malformations and difficulties during operation, it is important to focus on problems and complications that may face the surgeon who is performing this operation.Objective: Evaluate the problems and surgical difficulties encountered in patients with congenital inner ear malformation, who underwent cochlear implantation.Patients and methods: A series of 21 pediatric cochlear implant (CI) patients with known inner ear malformations determined on computed tomography (CT) of the temporal bone who underwent cochlear implantation in the department of otolaryngology in Hospital Martyr Ghazi Al-Hariri and AL-Yarmouk Teaching Hospital, Baghdad, Iraq, during the period from January 2018 to January 2021 were the subjects of the study to determine intraoperative adverse effects of these anomalies regarding electrode array insertion depths, predisposition to cerebrospinal fluid (CSF) leak through the cochleostomy, and associated facial nerve anomalies that can create access problems for scala tympani.Results: The most common inner ear anomalies were wide vestibular aqueduct (15) patients with percentage of (71.4%), incomplete partitions (5) patients with percentage of (23.8%), and common cavity (1) patient with percentage of (4.8%). CSF leak, the most common was CSF ooze (11) patients with percentage of (52.4%), CSF gusher seen in (6) patients (28.6%), and no CSF leak in (4) patients (19%). Facial nerve anomalies, only one case has abnormal position (more superficial and not injured) with a percentage of (4.8%), while in 20 patients (95.2%) no anomaly was detected. Electrode insertion depth, full insertion was achieved in (17) patients with percentage of (81%), while incomplete insertion was occurred in (4) patients (19%).Conclusion: Cochlear implant can be successfully and safely done in patients with selected congenital inner ear anomalies. Surgery can be challenging in certain cases of gusher and facial nerve abnormalities, but proper radiology and good surgical technique will help avoid complications. Keywords: Cochlear Implantation, Congenital inner ear malformation, facial nerve anomalies.
{"title":"Cochlear Implantation in Children with Congenital Inner Ear Malformations","authors":"Azzam Abbas *, Mustafa Hamed **, Ahmed Ahmed ***","doi":"10.5604/01.3001.0016.1567","DOIUrl":"https://doi.org/10.5604/01.3001.0016.1567","url":null,"abstract":"AbstractBackground: Cochlear Implantation has proven beneficial in patients with profound congenital hearing impairments. Performing cochlear implantation in patients with inner ear malformation has always been a matter of dispute as congenital deaf ears may have anatomical malformations and difficulties during operation, it is important to focus on problems and complications that may face the surgeon who is performing this operation.Objective: Evaluate the problems and surgical difficulties encountered in patients with congenital inner ear malformation, who underwent cochlear implantation.Patients and methods: A series of 21 pediatric cochlear implant (CI) patients with known inner ear malformations determined on computed tomography (CT) of the temporal bone who underwent cochlear implantation in the department of otolaryngology in Hospital Martyr Ghazi Al-Hariri and AL-Yarmouk Teaching Hospital, Baghdad, Iraq, during the period from January 2018 to January 2021 were the subjects of the study to determine intraoperative adverse effects of these anomalies regarding electrode array insertion depths, predisposition to cerebrospinal fluid (CSF) leak through the cochleostomy, and associated facial nerve anomalies that can create access problems for scala tympani.Results: The most common inner ear anomalies were wide vestibular aqueduct (15) patients with percentage of (71.4%), incomplete partitions (5) patients with percentage of (23.8%), and common cavity (1) patient with percentage of (4.8%). CSF leak, the most common was CSF ooze (11) patients with percentage of (52.4%), CSF gusher seen in (6) patients (28.6%), and no CSF leak in (4) patients (19%). Facial nerve anomalies, only one case has abnormal position (more superficial and not injured) with a percentage of (4.8%), while in 20 patients (95.2%) no anomaly was detected. Electrode insertion depth, full insertion was achieved in (17) patients with percentage of (81%), while incomplete insertion was occurred in (4) patients (19%).Conclusion: Cochlear implant can be successfully and safely done in patients with selected congenital inner ear anomalies. Surgery can be challenging in certain cases of gusher and facial nerve abnormalities, but proper radiology and good surgical technique will help avoid complications. Keywords: Cochlear Implantation, Congenital inner ear malformation, facial nerve anomalies.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-23DOI: 10.5604/01.3001.0016.2237
M. Litwiniuk, Aleksandra Piechuta, Barbara Jamróz
Introduction: Exercise-induced laryngeal obstruction (EILO) is a transient and reversible narrowing of the larynx in response to intense physical effort. The clinical picture of EILO often resembles those of asthma or exercise induced bronchospasm. The gold standard in EILO diagnostics is nasofiberoscopic examination during intense exercise (CLE).Case Description: We present two clinical cases of athletes initially treated for asthma who were diagnosed with EILO after CLE. This allowed the initiation of phoniatric rehabilitation and initial improvement of exercise tolerance.
{"title":"Exercise-induced laryngeal obstruction: a rarely recognized cause of exercise-induced dyspnea. Two case reports","authors":"M. Litwiniuk, Aleksandra Piechuta, Barbara Jamróz","doi":"10.5604/01.3001.0016.2237","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2237","url":null,"abstract":"Introduction: Exercise-induced laryngeal obstruction (EILO) is a transient and reversible narrowing of the larynx in response to intense physical effort. The clinical picture of EILO often resembles those of asthma or exercise induced bronchospasm. The gold standard in EILO diagnostics is nasofiberoscopic examination during intense exercise (CLE).Case Description: We present two clinical cases of athletes initially treated for asthma who were diagnosed with EILO after CLE. This allowed the initiation of phoniatric rehabilitation and initial improvement of exercise tolerance.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47378367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-23DOI: 10.5604/01.3001.0016.2235
M. Król, Kacper Dykas, Patryk Hartwich, J. Szaleniec
Introduction: Pyocele is a rare complication of sinusitis that is usually associated with stenosis of the ostium of the sinus caused by inflammation, trauma.Case report: A 68-year-old woman was admitted to the Otolaryngology Clinical Department of the University Hospital in Krakow, Poland because of a tumor of the right frontal bone which was painful during palpation. In anamnesis there were the histories of previous laryngological surgeries associated with the treatment of chronic sinusitis. The conducted medical imaging presented the destruction of the walls of both the right and left frontal sinuses caused by pathological changes penetrating to the orbit and adhering to the dura mater. The clinical and radiological picture suggested the diagnosis of empyema of the paranasal sinus (pyocele). The patient was scheduled for bilateral endoscopic frontoethmoidectomy and the surgery ended without complications. Nowadays, the patient remains under follow-up in the outpatient otolaryngology clinic.Discussion: The main disease entity, which should be included in the differential diagnosis of pyocele is the retention cyst of the sinus. The vast majority of pyocele cases are caused by superinfection of a mucocele by bacteria (in the described case the bacterial culture of the lesion content revealed the presence of Citrobacter koseri). An efficient and sufficient method of treatment of pyocele of paranasal sinuses is their endoscopic drainage.Conclusion: In the diagnosis of pyocele, the most important are data from anamnesis, physical examination and results from computed tomography and magnetic resonance imaging. Treatment is mainly based on properly performed surgery, pharmacotherapy and consecutive rehabilitation. Endoscopic surgery is an effective procedure and its early use often prevents serious complications resulting from the expansion of the lesion.
{"title":"A pyocele of a frontal sinus as a complication of a chronic sinusitis - a case report","authors":"M. Król, Kacper Dykas, Patryk Hartwich, J. Szaleniec","doi":"10.5604/01.3001.0016.2235","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2235","url":null,"abstract":"Introduction: Pyocele is a rare complication of sinusitis that is usually associated with stenosis of the ostium of the sinus caused by inflammation, trauma.Case report: A 68-year-old woman was admitted to the Otolaryngology Clinical Department of the University Hospital in Krakow, Poland because of a tumor of the right frontal bone which was painful during palpation. In anamnesis there were the histories of previous laryngological surgeries associated with the treatment of chronic sinusitis. The conducted medical imaging presented the destruction of the walls of both the right and left frontal sinuses caused by pathological changes penetrating to the orbit and adhering to the dura mater. The clinical and radiological picture suggested the diagnosis of empyema of the paranasal sinus (pyocele). The patient was scheduled for bilateral endoscopic frontoethmoidectomy and the surgery ended without complications. Nowadays, the patient remains under follow-up in the outpatient otolaryngology clinic.Discussion: The main disease entity, which should be included in the differential diagnosis of pyocele is the retention cyst of the sinus. The vast majority of pyocele cases are caused by superinfection of a mucocele by bacteria (in the described case the bacterial culture of the lesion content revealed the presence of Citrobacter koseri). An efficient and sufficient method of treatment of pyocele of paranasal sinuses is their endoscopic drainage.Conclusion: In the diagnosis of pyocele, the most important are data from anamnesis, physical examination and results from computed tomography and magnetic resonance imaging. Treatment is mainly based on properly performed surgery, pharmacotherapy and consecutive rehabilitation. Endoscopic surgery is an effective procedure and its early use often prevents serious complications resulting from the expansion of the lesion.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-23DOI: 10.5604/01.3001.0016.2236
T. Wojciechowski
The development of imaging methods in the last twenty years and the increased availability of high-resolution CT of temporal bones make it possible to analyze the complex anatomy of the insides of the temporal bone in detail with greater accuracy than before. At the same time, advances in middle ear surgery require the surgeon to be familiar with the interpretation of imaging examinations. This approach makes it possible to select the treatment method individually for each patient. It may also contribute to reducing the risk of complications.The article presents a description of the CT examination technique along with a historical outline, as well as the interpretation of the CT examination of temporal bones together with the description of anatomical structures, Particular interest was brought on the middle ear structures and those visible in the CT examination. In addition, anatomical variants are presented that a person viewing the images obtained with this method may encounter.
{"title":"Radiologic anatomy of the middleear and inner ear in computed tomography images","authors":"T. Wojciechowski","doi":"10.5604/01.3001.0016.2236","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2236","url":null,"abstract":"The development of imaging methods in the last twenty years and the increased availability of high-resolution CT of temporal bones make it possible to analyze the complex anatomy of the insides of the temporal bone in detail with greater accuracy than before. At the same time, advances in middle ear surgery require the surgeon to be familiar with the interpretation of imaging examinations. This approach makes it possible to select the treatment method individually for each patient. It may also contribute to reducing the risk of complications.The article presents a description of the CT examination technique along with a historical outline, as well as the interpretation of the CT examination of temporal bones together with the description of anatomical structures, Particular interest was brought on the middle ear structures and those visible in the CT examination. In addition, anatomical variants are presented that a person viewing the images obtained with this method may encounter.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-23DOI: 10.5604/01.3001.0016.2238
Agata Szleper, Magdalena Lachowska, A. Pastuszka, Zuzanna Łukaszewicz-Moszyńska, T. Wojciechowski, K. Niemczyk
Cochlear hypoplasia is a congenital inner ear malformation (IEM) characterized by a reduced external cochlear dimension, usually accompanied by an abnormal internal architecture. Type IV cochlear hypoplasia is a cochlea with hypoplastic middle and apical turns. It may occur along with dislocation of the facial nerve, associated with semicircular abnormalities, less clearly marked promontory, or stapedial fixation. Such patients can present a broad spectrum of audiological test results, from sensorineural or mixed mild or profound hearing loss. The above anatomical changes may be responsible for intraoperative difficulties during cochlear implantation. In the studied case, a 6-month-old patient was diagnosed with an inner ear malformation - cochlear hypoplasia type IV on both sides. Computed tomography with multiplanar and 3D reconstruction was performed to analyze the middle and inner ear anatomy in detail. Both types of imaging reconstruction helped decide which cochlear implant electrode to choose. Perimodiolar-positioned cochlear implant electrode was found to be the most suitable choice. The patient underwent sequential bilateral cochlear implantation with expected incomplete electrode array insertion on both sides. First repeatable auditory responses were observed two months after the second implant activation. Good parental cooperation with therapists and adequately defined developmental goals in the presented patient allowed the multidisciplinary team to take advantage of the child's intellectual abilities and choose the suitable communication method; however, the patient's auditory responses were obtained slowly. The final auditory results cannot be predicted in inner ear malformations due to abnormal anatomical structure and, thus, heterogeneous innervation within the deformed cochlea. The programming of the sound processor must be individual in each case, based on the child's behavior observation and, if possible, objective test results. Patients with cochlear malformations usually require higher stimulation intensities to obtain sound sensations than patients with a typical cochlear structure.
{"title":"Anatomical and clinical aspects and outcomes of bilateral cochlear implantation in cochlear hypoplasia type IV - a case report","authors":"Agata Szleper, Magdalena Lachowska, A. Pastuszka, Zuzanna Łukaszewicz-Moszyńska, T. Wojciechowski, K. Niemczyk","doi":"10.5604/01.3001.0016.2238","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2238","url":null,"abstract":"Cochlear hypoplasia is a congenital inner ear malformation (IEM) characterized by a reduced external cochlear dimension, usually accompanied by an abnormal internal architecture. Type IV cochlear hypoplasia is a cochlea with hypoplastic middle and apical turns. It may occur along with dislocation of the facial nerve, associated with semicircular abnormalities, less clearly marked promontory, or stapedial fixation. Such patients can present a broad spectrum of audiological test results, from sensorineural or mixed mild or profound hearing loss. The above anatomical changes may be responsible for intraoperative difficulties during cochlear implantation. In the studied case, a 6-month-old patient was diagnosed with an inner ear malformation - cochlear hypoplasia type IV on both sides. Computed tomography with multiplanar and 3D reconstruction was performed to analyze the middle and inner ear anatomy in detail. Both types of imaging reconstruction helped decide which cochlear implant electrode to choose. Perimodiolar-positioned cochlear implant electrode was found to be the most suitable choice. The patient underwent sequential bilateral cochlear implantation with expected incomplete electrode array insertion on both sides. First repeatable auditory responses were observed two months after the second implant activation. Good parental cooperation with therapists and adequately defined developmental goals in the presented patient allowed the multidisciplinary team to take advantage of the child's intellectual abilities and choose the suitable communication method; however, the patient's auditory responses were obtained slowly. The final auditory results cannot be predicted in inner ear malformations due to abnormal anatomical structure and, thus, heterogeneous innervation within the deformed cochlea. The programming of the sound processor must be individual in each case, based on the child's behavior observation and, if possible, objective test results. Patients with cochlear malformations usually require higher stimulation intensities to obtain sound sensations than patients with a typical cochlear structure.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48841337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Snoring is a common form of breathing disturbances during sleep. Snoring is the most frequent an isolated symptom (called then primary snoring) but sometimes it is one of OSA or UARS symptoms. Primary snoring is not only a social but also a health problem. That is why we should diagnose and treat all the patients complaining of snoring. For many years, methods have been sought that would, on the one hand, ensure adequate effectiveness and, on the other hand, minimize the invasiveness of therapy.Aim: The aim of this study is to review the methods of snoring treatment paying attention to its invasiveness and effectiveness. Material and methods: The scientific publications on the Pubmed between 2005 and 2022 were reviewed using the key words.Results: A large variety of surgical procedures offered to patients who snore is an evidence to the lack of an optimal method of treatment. Methods of therapy are still being sought, which, on the one hand, would give a chance for a significant reduction of snoring and maintain this result for a longer period of time, and on the other hand, would be characterized by low invasiveness. One of the techniques that is characterized by low invasiveness and, at the same time, high efficiency in a selected group of patients snoring with the soft palate hypertrophy is the Er:YAG laser treatment.
{"title":"Striking a balance between invasiveness and effectiveness of snoring treatment","authors":"Pawel Scierski, Ścierski Wojciech, Iwona Sybis, Mateusz Frelich","doi":"10.5604/01.3001.0016.2346","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2346","url":null,"abstract":"Introduction: Snoring is a common form of breathing disturbances during sleep. Snoring is the most frequent an isolated symptom (called then primary snoring) but sometimes it is one of OSA or UARS symptoms. Primary snoring is not only a social but also a health problem. That is why we should diagnose and treat all the patients complaining of snoring. For many years, methods have been sought that would, on the one hand, ensure adequate effectiveness and, on the other hand, minimize the invasiveness of therapy.Aim: The aim of this study is to review the methods of snoring treatment paying attention to its invasiveness and effectiveness. Material and methods: The scientific publications on the Pubmed between 2005 and 2022 were reviewed using the key words.Results: A large variety of surgical procedures offered to patients who snore is an evidence to the lack of an optimal method of treatment. Methods of therapy are still being sought, which, on the one hand, would give a chance for a significant reduction of snoring and maintain this result for a longer period of time, and on the other hand, would be characterized by low invasiveness. One of the techniques that is characterized by low invasiveness and, at the same time, high efficiency in a selected group of patients snoring with the soft palate hypertrophy is the Er:YAG laser treatment.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47530773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.5604/01.3001.0016.2345
Nataliya Vasilenok, N. Olszewska, E. Olszewska
Obstructive Sleep Apnea Syndrome (OSAS) is a common sleep-related breathing disorder. Untreated OSAS leads to significant health consequences, disturbed functioning in society, decreased efficiency in a workplace and increased risk of accidents at work and while driving. The main patomechanisms of OSAS development are hypoxia, oxidative stress and inflammatory process. Intermittent hypoxia in OSAS patients is associated with subsequent episodes of reoxygenation with simultaneous increase of reactive oxygen species and reactive nitrogen species that stimulate secretion of extracellular metalloproteinases (MMPs). These compounds belong to a group of endogenous proteolytic enzymes produced by structural cells of extracellular matrix (ECM) and by cells of inflammatory response as well. ECMs are made of collagen proteins and glycoproteins. They form a scaffold for tissues of the soft palate. MMPs break down collagen molecules, which results in flaccidity of tissues, including tissues of the soft palate. The results of scientific studies have shown that expression, secretion, and activeness of MMPs increase during hypoxia. Thus metalloproteinases may be involved in the process of upper airway tissue damage during the intermittent hypoxia in OSAS.
{"title":"The role of metalloproteinases in the pathogenesis of Obstructive Sleep Apnea Syndrome","authors":"Nataliya Vasilenok, N. Olszewska, E. Olszewska","doi":"10.5604/01.3001.0016.2345","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2345","url":null,"abstract":"Obstructive Sleep Apnea Syndrome (OSAS) is a common sleep-related breathing disorder. Untreated OSAS leads to significant health consequences, disturbed functioning in society, decreased efficiency in a workplace and increased risk of accidents at work and while driving. The main patomechanisms of OSAS development are hypoxia, oxidative stress and inflammatory process. Intermittent hypoxia in OSAS patients is associated with subsequent episodes of reoxygenation with simultaneous increase of reactive oxygen species and reactive nitrogen species that stimulate secretion of extracellular metalloproteinases (MMPs). These compounds belong to a group of endogenous proteolytic enzymes produced by structural cells of extracellular matrix (ECM) and by cells of inflammatory response as well. ECMs are made of collagen proteins and glycoproteins. They form a scaffold for tissues of the soft palate. MMPs break down collagen molecules, which results in flaccidity of tissues, including tissues of the soft palate. The results of scientific studies have shown that expression, secretion, and activeness of MMPs increase during hypoxia. Thus metalloproteinases may be involved in the process of upper airway tissue damage during the intermittent hypoxia in OSAS.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47573006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-15DOI: 10.5604/01.3001.0016.1565
Anna Bąk, W. Smółka, J. Markowski
ABSTRACT INTRODUCTION: Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive cutaneous sarcoma with a low metastasis potential, but a high local recurrence rate. It was first described in 1890 [1]. DFSP grows slowly and may take various forms in clinical trials - it presents both as a firm plaque, subcutaneous fat atrophy and a single or polycyclic tumor. Immunohistochemically DFSP, stains positive for CD34. The gold standard for DFSP treatment is a complete surgical excision with a margin of healthy tissue. Adjuvant therapy includes both radiotherapy and imatinib therapy. CASE REPORT: In June 2022, a 66-year-old patient with a tumor of left temporal area located behind the earlobe was admitted to the medical ward. The skin above the lesion remained unchanged. The imaging examination performed before the procedure showed a well-defined lesion and the results of the FNA biopsy np. BC-73765 were as follows: “numerous neoplastic cells, partially fusiform with atypical features, cytological picture does not allow to determine the malignancy of the tumor”. After performing the necessary examination, the patient underwent surgery. Histopathological biopsy report of the specimen came out as DFSP. Therefore, the patient was referred for adjuvant radiotherapy by the decision of the Medical Council.CONCLUSIONS: Due to high risk of recurrence and incidence of unclear margins after surgical excision, adjuvant radiotherapy is often used in the treatment of DFSP as it reduces the recurrence rate. KEY WORDS: DFSP, radiotherapy, Mohs micrographic surgery, surgical treatment.
{"title":"Dermatofibrosarcoma protuberans of left temporal area with mass effect causing stenosis of EAM in 66-year-old patient - case report.","authors":"Anna Bąk, W. Smółka, J. Markowski","doi":"10.5604/01.3001.0016.1565","DOIUrl":"https://doi.org/10.5604/01.3001.0016.1565","url":null,"abstract":"ABSTRACT INTRODUCTION: Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive cutaneous sarcoma with a low metastasis potential, but a high local recurrence rate. It was first described in 1890 [1]. DFSP grows slowly and may take various forms in clinical trials - it presents both as a firm plaque, subcutaneous fat atrophy and a single or polycyclic tumor. Immunohistochemically DFSP, stains positive for CD34. The gold standard for DFSP treatment is a complete surgical excision with a margin of healthy tissue. Adjuvant therapy includes both radiotherapy and imatinib therapy. CASE REPORT: In June 2022, a 66-year-old patient with a tumor of left temporal area located behind the earlobe was admitted to the medical ward. The skin above the lesion remained unchanged. The imaging examination performed before the procedure showed a well-defined lesion and the results of the FNA biopsy np. BC-73765 were as follows: “numerous neoplastic cells, partially fusiform with atypical features, cytological picture does not allow to determine the malignancy of the tumor”. After performing the necessary examination, the patient underwent surgery. Histopathological biopsy report of the specimen came out as DFSP. Therefore, the patient was referred for adjuvant radiotherapy by the decision of the Medical Council.CONCLUSIONS: Due to high risk of recurrence and incidence of unclear margins after surgical excision, adjuvant radiotherapy is often used in the treatment of DFSP as it reduces the recurrence rate. KEY WORDS: DFSP, radiotherapy, Mohs micrographic surgery, surgical treatment.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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