Pub Date : 2018-12-01DOI: 10.25121/newmed.2018.22.4.129
Iwona Łapińska, L. Zawadzka-Głos
Introduction. Hypertrophy of the pharyngeal and/or palatine tonsils as well as otitis media with effusion are the most prevalent childhood diseases leading to the referral of children to the ENT specialist. Adenoidectomy is the most commonly performed surgical procedure among paediatric patients. The main indications to adenoidectomy include sleep apnoea, frequent infections of the upper respiratory tract, and otitis media with effusion (OME). OME is defined as the presence of fluid in the middle ear without coexisting symptoms of ear infection. Aim. The aims of the study were to perform a clinical analysis of patients undergoing surgery on tonsils, and to evaluate the effect of tonsillar hypertrophy on speech disorders. Material and methods. The prospective study involved a group of 92 patients subjected to surgical procedures including adenoidectomy, adenotonsillotomy and adenotonsillectomy. Results. The study was carried out in a group of 92 patients aged 4.5-18 years who underwent tonsil surgery in two of Poland’s specialist medical centres. A total of 63 patients treated in the Warsaw centre, and 29 patients receiving treatment in the Elbląg centre, were included. The vast majority of the study group comprised children aged 5 to 9 years. Hearing impairment and the need to turn up the volume of the TV before the procedure were reported by 42 (45.7%) of the respondents. A total of 37 (40.2%) patients reported having to ask about the same thing several times. Among the patients who presented with hearing problems, 28 (30.4%) reported speech disorders, and 4 (4.3%) had slurred speech. Conclusions. Correct and early diagnosis and appropriate treatment of OME in children is necessary. An improvement of hearing in children contributes to an improvement in pronunciation.
{"title":"Does tonsillar hypertrophy contribute to speech disorders in children?","authors":"Iwona Łapińska, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.4.129","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.4.129","url":null,"abstract":"Introduction. Hypertrophy of the pharyngeal and/or palatine tonsils as well as otitis media with effusion are the most prevalent childhood diseases leading to the referral of children to the ENT specialist. Adenoidectomy is the most commonly performed surgical procedure among paediatric patients. The main indications to adenoidectomy include sleep apnoea, frequent infections of the upper respiratory tract, and otitis media with effusion (OME). OME is defined as the presence of fluid in the middle ear without coexisting symptoms of ear infection. Aim. The aims of the study were to perform a clinical analysis of patients undergoing surgery on tonsils, and to evaluate the effect of tonsillar hypertrophy on speech disorders. Material and methods. The prospective study involved a group of 92 patients subjected to surgical procedures including adenoidectomy, adenotonsillotomy and adenotonsillectomy. Results. The study was carried out in a group of 92 patients aged 4.5-18 years who underwent tonsil surgery in two of Poland’s specialist medical centres. A total of 63 patients treated in the Warsaw centre, and 29 patients receiving treatment in the Elbląg centre, were included. The vast majority of the study group comprised children aged 5 to 9 years. Hearing impairment and the need to turn up the volume of the TV before the procedure were reported by 42 (45.7%) of the respondents. A total of 37 (40.2%) patients reported having to ask about the same thing several times. Among the patients who presented with hearing problems, 28 (30.4%) reported speech disorders, and 4 (4.3%) had slurred speech. Conclusions. Correct and early diagnosis and appropriate treatment of OME in children is necessary. An improvement of hearing in children contributes to an improvement in pronunciation.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44804883","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 : 2018-09-01DOI: 10.25121/newmed.2018.22.3.79
A. Wasilewska, L. Zawadzka-Głos
Introduction. Diffuse otitis externa is one of the causes of ear pain, especially in school-age children. Risk factors for the disease include skin damage during cleaning audito ry canal, moisture exposure, anatomical factors, and dermatological comorbidities. Aim. The aim of the study was to present clinical picture, differential diagnosis and method of treatment of diffuse otitis externa based on cases of patients hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw. Material and Methods. A retrospective analysis of the clinical presentation and diagnostic tests of 12 cases of children with diffuse otitis externa hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw from 1st March 2017 to 1st March 2018 was conducted. Results. The most common etiological factor of diffuse otitis externa was Pseudomonas aeruginosa. Over half of the patients presented an involvement of retroauricular region during otitis externa. All the patients were treated with local and intravenous antibiotics. Conclusions. Atypical course associated with the spread of inflammation to the retroauricular region may lead to an erroneous diagnosis of otitis externa as a complication of otitis media. Treatment is difficult due to severe pain and resistance of P. aeruginosa to most antibiotics.
{"title":"Retroauricular region involvement during otitis externa caused by P. aeruginosa","authors":"A. Wasilewska, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.3.79","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.3.79","url":null,"abstract":"Introduction. Diffuse otitis externa is one of the causes of ear pain, especially in school-age children. Risk factors for the disease include skin damage during cleaning audito ry canal, moisture exposure, anatomical factors, and dermatological comorbidities. Aim. The aim of the study was to present clinical picture, differential diagnosis and method of treatment of diffuse otitis externa based on cases of patients hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw. Material and Methods. A retrospective analysis of the clinical presentation and diagnostic tests of 12 cases of children with diffuse otitis externa hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw from 1st March 2017 to 1st March 2018 was conducted. Results. The most common etiological factor of diffuse otitis externa was Pseudomonas aeruginosa. Over half of the patients presented an involvement of retroauricular region during otitis externa. All the patients were treated with local and intravenous antibiotics. Conclusions. Atypical course associated with the spread of inflammation to the retroauricular region may lead to an erroneous diagnosis of otitis externa as a complication of otitis media. Treatment is difficult due to severe pain and resistance of P. aeruginosa to most antibiotics.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44812076","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 : 2018-09-01DOI: 10.25121/newmed.2018.22.3.87
Iryna Drohobycka, L. Zawadzka-Głos
Introduction. One of the most commonly diagnosed upper respiratory diseases is sinusitis. A particular form of sinusitis in children is ethmoiditis. Due to the location of ethmoidal cells, their inflammation is associated with higher risk of complications compared with inflammation of other sinuses. Aim. The aim of the study was to assess the prevalence, severity and management of ocular complications of ethmoiditis in the retrospective material of the reference laryngological academic center. Material and Methods. The retrospective analysis included 41 patients with ocular complications of ethmoid sinusitis who were hospitalized in the Department of Pediatric Otolaryngology in the years 2012–2017. The analysis included the severity of complications on Chandler’s scale, management and results of culture of the material obtained during surgery. Results. The study included 25 boys (60%) and 16 girls (40%) aged from 3 months to 16 years. Mean age of the patients was 5.34 years (SD = 3.98). According to Chandler’s scale, retroseptal complications were diagnosed in 12 patients (29.27%), and anteroseptal complications – in 29 patients (70.73%). Surgical treatment was performed in 12 patients (29.27%), 8 of whom (66.7%) underwent external ethmoidectomy with orbital drainage, and 4 of whom (33.3%) underwent functional endoscopic sinus surgery (FESS). Consistent findings of CT scan with lesions found during surgical intervention were found in 10 patients (83.3%). Fifteen different pathogens were isolated from the material collected during the procedures. In more than half of the patients (53.3%), the pathogen was a staphylococcus. Al the patients with retroseptal ocular complications underwent combination therapy consisting of surgical management and two intravenous antibiotics targeted for the etiological factor. The most frequently used antibiotics included 3rd generation cephalosporins and clindamycin. Conclusions. In children with ethmoiditis treated in a reference laryngological academic center, anteroseptal complications occurred twice as often as retroseptal complications. Most cases did not require surgical intervention.
{"title":"Ocular compications in ethmoiditis in children treated in a reference laryngological academic center","authors":"Iryna Drohobycka, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.3.87","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.3.87","url":null,"abstract":"Introduction. One of the most commonly diagnosed upper respiratory diseases is sinusitis. A particular form of sinusitis in children is ethmoiditis. Due to the location of ethmoidal cells, their inflammation is associated with higher risk of complications compared with inflammation of other sinuses. Aim. The aim of the study was to assess the prevalence, severity and management of ocular complications of ethmoiditis in the retrospective material of the reference laryngological academic center. Material and Methods. The retrospective analysis included 41 patients with ocular complications of ethmoid sinusitis who were hospitalized in the Department of Pediatric Otolaryngology in the years 2012–2017. The analysis included the severity of complications on Chandler’s scale, management and results of culture of the material obtained during surgery. Results. The study included 25 boys (60%) and 16 girls (40%) aged from 3 months to 16 years. Mean age of the patients was 5.34 years (SD = 3.98). According to Chandler’s scale, retroseptal complications were diagnosed in 12 patients (29.27%), and anteroseptal complications – in 29 patients (70.73%). Surgical treatment was performed in 12 patients (29.27%), 8 of whom (66.7%) underwent external ethmoidectomy with orbital drainage, and 4 of whom (33.3%) underwent functional endoscopic sinus surgery (FESS). Consistent findings of CT scan with lesions found during surgical intervention were found in 10 patients (83.3%). Fifteen different pathogens were isolated from the material collected during the procedures. In more than half of the patients (53.3%), the pathogen was a staphylococcus. Al the patients with retroseptal ocular complications underwent combination therapy consisting of surgical management and two intravenous antibiotics targeted for the etiological factor. The most frequently used antibiotics included 3rd generation cephalosporins and clindamycin. Conclusions. In children with ethmoiditis treated in a reference laryngological academic center, anteroseptal complications occurred twice as often as retroseptal complications. Most cases did not require surgical intervention.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45303811","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 : 2018-09-01DOI: 10.25121/newmed.2018.22.3.95
M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska
Perforation is a defect of nasal septum manifested by the disruption of mucosa in the cartillaginous or bone part of nasal septum or in both of the parts at the same time.As a result, disruption of air transport through the nose and impaired nasal physiology occur. Crusting, epistaxis, and wheezing arise. Perforations are classified according to their size, type, and localization. There are many causes for nasal septum perforation: trauma, surgery, tumors, coexistence of inflammatory, infectious, degenerative, and autoimmune diseases, and cocaine abuse. The assessment of a patient with nasal septum perforation includes detailed medical history, physical examination, diagnostic and laboratory tests. Treating the underlying disease is of primary importance. The second step involves closing the perforation. Perforations can be treated conservatively (pharmacologically) or surgically. The choice of approach depends on the etiology, size, and location of the perforation. Surgical approach is the most effective. Surgical closure of nasal septal perforation is a difficult procedure associated with many complications. All surgical approaches are based on two main principles: creating mucosal, mucoperichondrial, and/or mucoperiosteal flaps or transplant. Prosthetic treatment is another solution. Literature data shows that highest success rate is achieved after surgical procedures with the use of mucosal flaps and temporal fascia transplants, as well as acellular human dermal allografts.
{"title":"Nasal septum perforation – new treatment methods","authors":"M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska","doi":"10.25121/newmed.2018.22.3.95","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.3.95","url":null,"abstract":"Perforation is a defect of nasal septum manifested by the disruption of mucosa in the cartillaginous or bone part of nasal septum or in both of the parts at the same time.As a result, disruption of air transport through the nose and impaired nasal physiology occur. Crusting, epistaxis, and wheezing arise. Perforations are classified according to their size, type, and localization. There are many causes for nasal septum perforation: trauma, surgery, tumors, coexistence of inflammatory, infectious, degenerative, and autoimmune diseases, and cocaine abuse. The assessment of a patient with nasal septum perforation includes detailed medical history, physical examination, diagnostic and laboratory tests. Treating the underlying disease is of primary importance. The second step involves closing the perforation. Perforations can be treated conservatively (pharmacologically) or surgically. The choice of approach depends on the etiology, size, and location of the perforation. Surgical approach is the most effective. Surgical closure of nasal septal perforation is a difficult procedure associated with many complications. All surgical approaches are based on two main principles: creating mucosal, mucoperichondrial, and/or mucoperiosteal flaps or transplant. Prosthetic treatment is another solution. Literature data shows that highest success rate is achieved after surgical procedures with the use of mucosal flaps and temporal fascia transplants, as well as acellular human dermal allografts.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44181043","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 : 2018-06-01DOI: 10.25121/newmed.2018.22.2.35
Karolina Raczkowska-Łabuda, Anna Gorzelnik, Jolanta Jadczyszyn, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos
Introduction. Parapharyngeal abscesses are invariably a diagnostic and therapeutic challenge for pediatric otolaryngologists. The lack of consistency in the Polish nomenclature in relation to the English terms additionally complicates the problem. The wide spectrum of signs and symptoms, as well as an extremely heterogenous clinical presentation of the disease, also delay the implementation of appropriate treatment. Aim. The aim of the study was to analyze selected epidemiological and clinical characteristics of the parapharyngeal abscesses in children, such as the seasonality in the incidence, diagnostic difficulties, and available treatment methods. Material and Methods. A retrospective analysis was conducted on data obtained from medical histories of patients treated for deep neck space infections in the years 2013–2018 in the Department of Pediatric Otolaryngology of the Medical University of Warsaw. The study analyzed the age and sex of the children, as well as diagnostic methods and bacterial culture tests of the abscess. Particular attention was drawn to the seasonality in the incidence of the parapharyngeal abscesses in children. A statistical analysis was performed and seasonality index for the data was calculated, and a simulation of the prognosis of the occurrence of the factor for a moving average with a reference period of 2 months was performed. Next, the thesis on the discrete uniform data distribution was adopted, and Monte Carlo method was used for testing of the hypothesis. The significance level was α = 1%. The probability of 9 cases in one month was calculated based on the binomial distribution. Results. In the years 2013–2018, 23 children with parapharyngeal and retropharyngeal abscesses were admitted to the Department, 9 of which were admitted in December. In the analyzed group, a slight advantage in the number of boys was observed, with the male to female ratio being M:F = 1.3:1. Mean age of the patients was 3 years and 5 months. All the children had undergone an upper respiratory tract infection before being diagnosed with a deep neck space infection. All the patients had enlarged neck lymph nodes. The seasonality index for December was over 3 times higher than for March and accounted 4.696. The hypothesis on the discrete uniform data distribution was adopted (H0). The significance level was α = 1%. Based on monomial distribution, the probability of the occurrence of 9 cases in one month was calculated and amounted P(9) = 0.000141. Hence, the rejection of H0 occurs with an error of 0.17% < 1%. Conclusions. In Poland, the admission of a child diagnosed with a retropharyngeal or parapharyngeal abscess is most likely in late autumn – in November and December. Purulent deep neck space infections in children are a complication of upper respiratory tract infections. Deep neck space infections are difficult to diagnose due to the lack of pathognomonic signs and symptoms. The conservative treatment is an alternative to the surgica
{"title":"Seasonality in the incidence of deep neck space infections in children hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw","authors":"Karolina Raczkowska-Łabuda, Anna Gorzelnik, Jolanta Jadczyszyn, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.2.35","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.2.35","url":null,"abstract":"Introduction. Parapharyngeal abscesses are invariably a diagnostic and therapeutic challenge for pediatric otolaryngologists. The lack of consistency in the Polish nomenclature in relation to the English terms additionally complicates the problem. The wide spectrum of signs and symptoms, as well as an extremely heterogenous clinical presentation of the disease, also delay the implementation of appropriate treatment. Aim. The aim of the study was to analyze selected epidemiological and clinical characteristics of the parapharyngeal abscesses in children, such as the seasonality in the incidence, diagnostic difficulties, and available treatment methods. Material and Methods. A retrospective analysis was conducted on data obtained from medical histories of patients treated for deep neck space infections in the years 2013–2018 in the Department of Pediatric Otolaryngology of the Medical University of Warsaw. The study analyzed the age and sex of the children, as well as diagnostic methods and bacterial culture tests of the abscess. Particular attention was drawn to the seasonality in the incidence of the parapharyngeal abscesses in children. A statistical analysis was performed and seasonality index for the data was calculated, and a simulation of the prognosis of the occurrence of the factor for a moving average with a reference period of 2 months was performed. Next, the thesis on the discrete uniform data distribution was adopted, and Monte Carlo method was used for testing of the hypothesis. The significance level was α = 1%. The probability of 9 cases in one month was calculated based on the binomial distribution. Results. In the years 2013–2018, 23 children with parapharyngeal and retropharyngeal abscesses were admitted to the Department, 9 of which were admitted in December. In the analyzed group, a slight advantage in the number of boys was observed, with the male to female ratio being M:F = 1.3:1. Mean age of the patients was 3 years and 5 months. All the children had undergone an upper respiratory tract infection before being diagnosed with a deep neck space infection. All the patients had enlarged neck lymph nodes. The seasonality index for December was over 3 times higher than for March and accounted 4.696. The hypothesis on the discrete uniform data distribution was adopted (H0). The significance level was α = 1%. Based on monomial distribution, the probability of the occurrence of 9 cases in one month was calculated and amounted P(9) = 0.000141. Hence, the rejection of H0 occurs with an error of 0.17% < 1%. Conclusions. In Poland, the admission of a child diagnosed with a retropharyngeal or parapharyngeal abscess is most likely in late autumn – in November and December. Purulent deep neck space infections in children are a complication of upper respiratory tract infections. Deep neck space infections are difficult to diagnose due to the lack of pathognomonic signs and symptoms. The conservative treatment is an alternative to the surgica","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45082543","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 : 2018-06-01DOI: 10.25121/newmed.2018.22.2.46
M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska
Introduction. The patency of the lower part of the upper respiratory tract depends on the muscle tone of pharynx, soft palate and tongue muscles. The consequence of the lowered tone of these muscles is recurrent total or partial narrowing of the airways. In this case, the turbulent airflow causes soft tissue vibration, which is heard as snoring. Material and Methods. The study included 34 patients: 27 men and 7 women. Carbon dioxide diode laser-assisted uvulopalatoplasty was employed. The diode laser with a wavelength of 810 mm, power of 5 W, and pulse length of 4 seconds was used. Before the procedure, all the patients underwent laryngological assessment. Medical history of the patients was also collected. In addition, the patients completed 2 questionnaires: a sleep disorder screening questionnaire and Ephworth Sleepiness Scale. Moreover, a 3D CT scan and acoustic rhinometry were performed. All the tests were repeated 3 months after the procedure. Results. The procedure was performed in 34 patients. Complete clinical response was observed in 21 cases, and a partial response was seen in 13 cases. There were no patients in the study group who had not experienced at least a partial improvement of symptoms. None of the patients reported any complications. Conclusions. Good clinical outcome was obtained in all the patients after obtaining palatal stiffening, which contributed to the resolution of symptoms. The advantages of diode laser-assisted uvulopalatoplasty using palisade technique include the safety of the procedure, minimal invasiveness, short healing time, and a low risk of complications. The procedure is performed on an out-patient basis under local anesthesia.
{"title":"Diode laser-assisted uvulopalatoplasty using palisade technique","authors":"M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska","doi":"10.25121/newmed.2018.22.2.46","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.2.46","url":null,"abstract":"Introduction. The patency of the lower part of the upper respiratory tract depends on the muscle tone of pharynx, soft palate and tongue muscles. The consequence of the lowered tone of these muscles is recurrent total or partial narrowing of the airways. In this case, the turbulent airflow causes soft tissue vibration, which is heard as snoring. Material and Methods. The study included 34 patients: 27 men and 7 women. Carbon dioxide diode laser-assisted uvulopalatoplasty was employed. The diode laser with a wavelength of 810 mm, power of 5 W, and pulse length of 4 seconds was used. Before the procedure, all the patients underwent laryngological assessment. Medical history of the patients was also collected. In addition, the patients completed 2 questionnaires: a sleep disorder screening questionnaire and Ephworth Sleepiness Scale. Moreover, a 3D CT scan and acoustic rhinometry were performed. All the tests were repeated 3 months after the procedure. Results. The procedure was performed in 34 patients. Complete clinical response was observed in 21 cases, and a partial response was seen in 13 cases. There were no patients in the study group who had not experienced at least a partial improvement of symptoms. None of the patients reported any complications. Conclusions. Good clinical outcome was obtained in all the patients after obtaining palatal stiffening, which contributed to the resolution of symptoms. The advantages of diode laser-assisted uvulopalatoplasty using palisade technique include the safety of the procedure, minimal invasiveness, short healing time, and a low risk of complications. The procedure is performed on an out-patient basis under local anesthesia.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47420328","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 : 2018-05-21DOI: 10.25121/newmed.2018.22.2.65
Piotr Kwast, Maja Waszak, J. Rafałowska, L. Zawadzka-Głos
Introduction. Acute rhinosinusitis is a very common disease in children, however, its complications occur much less frequently. The most common complication of rhinosinusitis is periorbital cellulitis, and its manifestations include subperiosteal abscess of the orbit. Case report. We present a case of a 3-year-old boy with a preexisting bilateral exophtalmia, who was treated twice for periorbital cellulitis in the course of acute rhinosinusitis. During the first episode, an orbital abscess occurred and was subsequently treated with external ethmoidectomy. The second episode was treated conservatively. In computed tomography, a potential dehiscence of lamina papyracea was identified as the reason for recurrent periorbital complications. The patient underwent planned adenoidectomy and endoscopic sinus surgery. He currently remains under the care of the Department. No recurrence of complicated rhinosinusitis have been diagnosed. Conclusions. Periorbital complications, which are considered an emergency in otorhinolaryngology, should be immediately treated in hospital conditions. Dehiscence of lamina papyracea may predispose to periorbital complications in children with acute rhinosinusitis. Special caution should be exercised when diagnosing patients with preexisting exophtalmia reporting with orbital complications of rhinosinusitis.
{"title":"Periorbital complications as a result of rhinosinusitis in a pediatric patient. Case report.","authors":"Piotr Kwast, Maja Waszak, J. Rafałowska, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.2.65","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.2.65","url":null,"abstract":"Introduction. Acute rhinosinusitis is a very common disease in children, however, its complications occur much less frequently. The most common complication of rhinosinusitis is periorbital cellulitis, and its manifestations include subperiosteal abscess of the orbit. Case report. We present a case of a 3-year-old boy with a preexisting bilateral exophtalmia, who was treated twice for periorbital cellulitis in the course of acute rhinosinusitis. During the first episode, an orbital abscess occurred and was subsequently treated with external ethmoidectomy. The second episode was treated conservatively. In computed tomography, a potential dehiscence of lamina papyracea was identified as the reason for recurrent periorbital complications. The patient underwent planned adenoidectomy and endoscopic sinus surgery. He currently remains under the care of the Department. No recurrence of complicated rhinosinusitis have been diagnosed. Conclusions. Periorbital complications, which are considered an emergency in otorhinolaryngology, should be immediately treated in hospital conditions. Dehiscence of lamina papyracea may predispose to periorbital complications in children with acute rhinosinusitis. Special caution should be exercised when diagnosing patients with preexisting exophtalmia reporting with orbital complications of rhinosinusitis.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42003433","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 : 2017-11-30DOI: 10.25121/NEWMED.2017.21.4.115
A. Dmowska-Koroblewska, M. Michalik, Adrianna Podbielska-Kubera, Włodzimierz Jakub Siemianowski
Introduction. Obstructive sleep apnea is a disorder of breathing during sleep. Lack of clinical improvement after previously performed laryngological procedures is an indication for endoscopic examination during drug – induced sleep. Drug-induced sleep endoscopy (DISE) provides important information about functional upper airways patency. Material and methods. The study was performed in patients in whom other treatment methods had not been effective. DISE was performed in these patients. Continuous intravenous propofol infusion was given as general anesthetic to ensure the safety of the procedure. Results. From 2007 to 2017, 2897 procedures for snoring and sleep apnea were performed at the MML Medical Center. At this time, 176 DISE examinations were performed. Causative treatment methods were determined by the means of questionnaire, CBCT, laryngological examination, and DISE examination. Subjective improvement of apnea symptoms was achieved in 80% of patients. In 70% of cases, snoring decreased. The rest of the patients are required to look for systemic causes of cardiological, neurological gastrological, or endocrine origin. Conclusions. In our patients, the use of the DISE examination enabled to precisely determine the location of the vibration and of the collapse of the respiratory tract. DISE enables to effectively diagnose the cause of sleep disorders when other methods, such as cone beam computed tomography (CBCT) or cephalometry are not sufficient. Keywords
{"title":"Drug-induced sleep endoscopy in assessing airway patency – own experiences","authors":"A. Dmowska-Koroblewska, M. Michalik, Adrianna Podbielska-Kubera, Włodzimierz Jakub Siemianowski","doi":"10.25121/NEWMED.2017.21.4.115","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.4.115","url":null,"abstract":"Introduction. Obstructive sleep apnea is a disorder of breathing during sleep. Lack of clinical improvement after previously performed laryngological procedures is an indication for endoscopic examination during drug – induced sleep. Drug-induced sleep endoscopy (DISE) provides important information about functional upper airways patency. Material and methods. The study was performed in patients in whom other treatment methods had not been effective. DISE was performed in these patients. Continuous intravenous propofol infusion was given as general anesthetic to ensure the safety of the procedure. Results. From 2007 to 2017, 2897 procedures for snoring and sleep apnea were performed at the MML Medical Center. At this time, 176 DISE examinations were performed. Causative treatment methods were determined by the means of questionnaire, CBCT, laryngological examination, and DISE examination. Subjective improvement of apnea symptoms was achieved in 80% of patients. In 70% of cases, snoring decreased. The rest of the patients are required to look for systemic causes of cardiological, neurological gastrological, or endocrine origin. Conclusions. In our patients, the use of the DISE examination enabled to precisely determine the location of the vibration and of the collapse of the respiratory tract. DISE enables to effectively diagnose the cause of sleep disorders when other methods, such as cone beam computed tomography (CBCT) or cephalometry are not sufficient. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43417134","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 : 2017-11-23DOI: 10.25121/newmed.2017.21.4.99
Monika Jabłońska-Jesionowska, Małgorzata Dębska-Rutkowska, Piotr Kwast, L. Zawadzka-Głos
Introduction. Parotitis can be divided into chronic and acute parotitis. Acute parotitis is caused by a viral or bacterial infection. Chronic parotitis includes chronic recurrent parotitis, parotitis due to sialolithiasis, parotitis related to angiomas, as well as parotitis as a symptom of autoimmune diseases. Aim. The aim of the study was to analyze the inflammatory changes in parotid salivary glands in children. Material and Methods. Between 2010 and 2017, 30 children were hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw due to the swelling and pain of a parotid gland . Age, gender, etiology of the disease, location, laboratory findings, and comorbidities were assessed. Results. The cause of hospitalization was swelling and pain of a parotid salivary gland. The age of children ranged from 1 month to 15 years of age (mean age was 4.2 years). In 11 children, bilateral parotitis was diagnosed, in 19 children, the lesions were unilateral. In 7 children, acute parotitis was diagnosed. In these patients, elevated inflammatory markers, enlarged lymph nodes, or an abscess of the gland in the ultrasonographic examination was observed. In 20 children, chronic recurrent parotitis was diagnosed. In these patients, no elevated inflammatory markers were observed during exacerbations. In ultrasound, hypoechogenic foci were observed. Eleven children were diagnosed with autoimmune diseases. Three children were diagnosed with lymphangioma or hemangioma. None of the patients suffered from sialolithiasis nor pneumoparotitis. Conclusions. Parotitis that have its onset between 3 and 4 years of age may be recurrent parotitis. The diagnosis of chronic recurrent parotitis is based on clinical symptoms, ultrasound signs, and lack of elevated inflammatory markers. Bilateral chronic recurrent parotitis is related to an increased risk of autoimmunological diseases; chronic parotitis precedes their onset. Children with bilateral chronic recurrent parotitis require further testing for autoimmune diseases. Keywords
{"title":"Parotitis in children hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw in the years 2010-2017","authors":"Monika Jabłońska-Jesionowska, Małgorzata Dębska-Rutkowska, Piotr Kwast, L. Zawadzka-Głos","doi":"10.25121/newmed.2017.21.4.99","DOIUrl":"https://doi.org/10.25121/newmed.2017.21.4.99","url":null,"abstract":"Introduction. Parotitis can be divided into chronic and acute parotitis. Acute parotitis is caused by a viral or bacterial infection. Chronic parotitis includes chronic recurrent parotitis, parotitis due to sialolithiasis, parotitis related to angiomas, as well as parotitis as a symptom of autoimmune diseases. Aim. The aim of the study was to analyze the inflammatory changes in parotid salivary glands in children. Material and Methods. Between 2010 and 2017, 30 children were hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw due to the swelling and pain of a parotid gland . Age, gender, etiology of the disease, location, laboratory findings, and comorbidities were assessed. Results. The cause of hospitalization was swelling and pain of a parotid salivary gland. The age of children ranged from 1 month to 15 years of age (mean age was 4.2 years). In 11 children, bilateral parotitis was diagnosed, in 19 children, the lesions were unilateral. In 7 children, acute parotitis was diagnosed. In these patients, elevated inflammatory markers, enlarged lymph nodes, or an abscess of the gland in the ultrasonographic examination was observed. In 20 children, chronic recurrent parotitis was diagnosed. In these patients, no elevated inflammatory markers were observed during exacerbations. In ultrasound, hypoechogenic foci were observed. Eleven children were diagnosed with autoimmune diseases. Three children were diagnosed with lymphangioma or hemangioma. None of the patients suffered from sialolithiasis nor pneumoparotitis. Conclusions. Parotitis that have its onset between 3 and 4 years of age may be recurrent parotitis. The diagnosis of chronic recurrent parotitis is based on clinical symptoms, ultrasound signs, and lack of elevated inflammatory markers. Bilateral chronic recurrent parotitis is related to an increased risk of autoimmunological diseases; chronic parotitis precedes their onset. Children with bilateral chronic recurrent parotitis require further testing for autoimmune diseases. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42087470","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 : 2017-11-20DOI: 10.25121/newmed.2017.21.4.108
Małgorzata Dębska-Rutkowska, Piotr Kwast, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos
Introduction. Tumors of major salivary glands, due to their low incidence and the wide spectrum of possible diagnoses, are a challenge for physicians. Imaging studies are the key elements of the diagnostic process, although their results often do not provide a definitive diagnosis. Aim. The aim of the study was to assess the usefulness of additional tests in the diagnosis of tumors of major salivary glands in children. Material and Methods. A retrospective analysis of medical data of children with tumors of parotid or submandibular salivary gland hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from the years 2012-2017 was performed. Results. In 8 girls and 7 boys aged between 4 months and 17 years, the following diagnoses were established: 6 mixed tumors, 3 hemangiomas, 1 lymphangioma, 1 rhabdomyosarcoma, and 1 mucoepidermoid carcinoma. In all of the patients, ultrasound (US) of salivary gland, computed tomography (CT) and/or magnetic resonance imaging (MRI) of the head were performed. US examination enabled to diagnose the majority (66%) of mixed tumors. US and CT or MRI with contrast enabled to recognize angiomas in all 4 patients with this lesion. In 2 patients, malignant neoplasm was diagnosed based on the histological examination. Conclusions. US remains the primary diagnostic test in patients with tumors of major salivary gland. When necessary, it can be supplemented with CT or MRI. In some cases, imaging studies do not enable to establish a definite diagnosis. The definite diagnosis of salivary gland tumors is established based on the results of the pathological examination (except for angiomas). The most common salivary gland tumor in older children is mixed tumor, and in infants – angioma. It must be remembered that very rare salivary gland tumors, such as sarcomas and carcinomas, may also occur in children. Keywords
{"title":"Diagnostic difficulties in salivary gland tumors in children","authors":"Małgorzata Dębska-Rutkowska, Piotr Kwast, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos","doi":"10.25121/newmed.2017.21.4.108","DOIUrl":"https://doi.org/10.25121/newmed.2017.21.4.108","url":null,"abstract":"Introduction. Tumors of major salivary glands, due to their low incidence and the wide spectrum of possible diagnoses, are a challenge for physicians. Imaging studies are the key elements of the diagnostic process, although their results often do not provide a definitive diagnosis. Aim. The aim of the study was to assess the usefulness of additional tests in the diagnosis of tumors of major salivary glands in children. Material and Methods. A retrospective analysis of medical data of children with tumors of parotid or submandibular salivary gland hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from the years 2012-2017 was performed. Results. In 8 girls and 7 boys aged between 4 months and 17 years, the following diagnoses were established: 6 mixed tumors, 3 hemangiomas, 1 lymphangioma, 1 rhabdomyosarcoma, and 1 mucoepidermoid carcinoma. In all of the patients, ultrasound (US) of salivary gland, computed tomography (CT) and/or magnetic resonance imaging (MRI) of the head were performed. US examination enabled to diagnose the majority (66%) of mixed tumors. US and CT or MRI with contrast enabled to recognize angiomas in all 4 patients with this lesion. In 2 patients, malignant neoplasm was diagnosed based on the histological examination. Conclusions. US remains the primary diagnostic test in patients with tumors of major salivary gland. When necessary, it can be supplemented with CT or MRI. In some cases, imaging studies do not enable to establish a definite diagnosis. The definite diagnosis of salivary gland tumors is established based on the results of the pathological examination (except for angiomas). The most common salivary gland tumor in older children is mixed tumor, and in infants – angioma. It must be remembered that very rare salivary gland tumors, such as sarcomas and carcinomas, may also occur in children. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44461462","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}