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Wyniki czynnościowe operacji tympanoplastycznych

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Matuszewska I., Burduk P., Kaźmierczak W., Janiak-Kiszka J.
Polish Journal of Otolaryngology
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2016
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vol. 70
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issue 6
12-19
PL
Wstęp Tympanoplastyki stanowią obecnie podstawową metodę leczenia przewlekłego zapalenia ucha środkowego, ze względu na oszczędzający charakter i nacisk na rekonstrukcję, co przekłada się na dobre wyniki czynnościowe słuchu. Materiał i metoda Materiał zebrano wśród pacjentów leczonych z powodu przewlekłego zapalenia ucha środkowego w Klinice Otolaryngologii i Laryngologii Onkologicznej Collegium Medicum Uniwersytetu Mikołaja Kopernika w Bydgoszczy w latach 2004-2010. Dokonano analizy wyników audiometrii tonalnej w zależności od typu operacji tympanoplastycznej oraz czasu, jaki upłynął od jej przeprowadzenia. Wyniki Analizując wyniki średniej rezerwy ślimakowej odnotowano poprawę słuchu po operacji w każdym punkcie czasu dla wszystkich typów tympanoplastyk. Istotność statystyczną stwierdzono w grupach 1, 2 oraz 3. W ocenie wyników odległych (po trzech latach od zabiegu) stwierdzono istotne statystycznie pogorszenie wyników jedynie dla tympanoplastyki typu 2. W pozostałych grupach z upływem czasu wyniki nieco pogarszały się, ale nie odnotowano między nimi istotności statystycznej. Wnioski Najlepsze rezultaty funkcjonalne oparte o pomiar rezerwy ślimakowej uzyskujemy po tympanoplastyce typ 1, a najgorsze po tympanoplastyce typ 4. Średnia rezerwa ślimakowa po 3 latach od zabiegu (w obserwacji odległej) notowana po tympanoplastyce typ 2 i tympanoplastyce typ 3 jest podobna, natomiast w obserwacji krótkoterminowej (3 miesiące i 1 rok po zabiegu) jest mniejsza w przypadku tympanoplastyki typu 2. Biorąc po uwagę aspekt upływu czasu poprawa słuchu z użyciem materiału autogennego jest bardziej trwała w przypadku tympanoplastyki typ 3 niż tympanoplastyki typ 2.
2
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Functional outcomes of tympanoplasty surgery

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Matuszewska I., Burduk P., Kaźmierczak W., Janiak-Kiszka J.
Polish Journal of Otolaryngology
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2016
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vol. 70
|
issue 6
12-19
EN
Objective: We reviewed functional outcomes of tympanoplasty. Study design: The results of tympanoplastic surgery are changing in time. We present late treatment outcomes among different types of tympanoplasty. Methods: Eighty-six patients who underwent tympanoplasty were enrolled in the study. The results of pure tone audiometry performed 7 days before, then at 3 months, 1 year, and 3 years after the surgery were assessed. Type II tympanoplasty involved implantation of a partial ossicular replacement prosthesis and type III tympanoplasty involved reconstruction with a total ossicular replacement prosthesis and the use of autogenous homogenous material. Statistical analysis was performed. Results: With all four types of tympanoplasty, hearing improvement was achieved at 3 months and 1 year after surgery based on the magnitude of the mean ABG reduction (p<0.001). In patients who underwent type I, type III, and type IV tympanoplasty, the ABG reduction at 3 years after surgery was maintained at the level reported at 3 months and 1 year after surgery (p<0.001). In patients who underwent type II tympanoplasty, however, the mean ABG value was increased at all tested frequencies (p<0.05). The mean ABG values reported 3 years after type II and type III tympanoplasty were similar. Conclusions: Based on the results over time, hearing improvement seems to be less durable after reconstruction with the partial ossicular replacement prosthesis procedure compared to the total ossicular replacement prosthesis procedure.
3
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Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic for outpatient and hospital practices

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Wierzbicka M., Niemczyk K., Jaworowska E., Burduk P., Składzień J., Szyfter W., Markowski J.
Polish Journal of Otolaryngology
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2020
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vol. 74
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issue 3
1-5
EN
Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.
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Rekomendacje Zarządu Głównego Polskiego Towarzystwa Otorynolaryngologów, Chirurgów Głowy i Szyi na czas pandemii COVID-19 dla Otolaryngologów w praktyce ambulatoryjnej i szpitalnej

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Wierzbicka M., Niemczyk K., Jaworowska E., Burduk P., Składzień J., Szyfter W., Markowski J.
Polish Journal of Otolaryngology
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2020
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vol. 74
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issue 3
1-5
PL
Zalecenia Zarządu Głównego Polskiego Towarzystwa Otorynolaryngologów, Chirurgów Głowy i Szyi dotyczące świadczenia usług podczas pandemii COVID-19 stanowią wytyczne dla ambulatoryjnych i szpitalnych praktyk we wszystkich przypadkach kontaktu z pacjentem, którego status COVID-19 jest nieznany. Zostały one utworzone w oparciu o światowe publikacje i rekomendacje ze względu na obecny stan pandemii COVID-19. Przedstawiono uzasadnienie zawieszenia planowanego świadczenia usług w pierwszej fazie pandemii. Omówiono wskazanie najlepszych praktyk medycznych na czas stabilizacji, ale z utrzymaniem się ryzyka zakażenia COVID-19 w populacji. Ważna jest możliwość świadczenia usług w następnych miesiącach pandemii. Wskazano na obiektywne przesłanki uzasadniające wznowienia zabiegów medycznych, tym samym przedstawiając optymalne procedury i zachowania do czasu zatwierdzenia procedur, wytycznych i zasad postępowania w zakresie związanym z SARS-COV2.
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Tissue remodelling in chronic rhinosinusitis – review of literature

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Radajewski K., Wierzchowska M., Grzanka D., Antosik P., Zdrenka M., Burduk P.
Polish Journal of Otolaryngology
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2019
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vol. 73
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issue 5
1-4
EN
CRS is a process involving a number of adverse changes in the mucosa of the paranasal sinuses and nasal polyps, e.g. increased fibroblast proliferation, angiogenesis, increased formation of fibrous tissue (subepithelial fibrosis) and tissue destruction. There are biomarkers whose levels can be increased in chronic inflammation of the paranasal sinuses: peripheral blood eosinophilia, IgE immunoglobulin, cytokines – IL-4, IL-5, IL-13, IL-25, IL-33, periostin, P-glycoprotein, CXCL-12, CXCL-13, INF-Υ, TNFα, TGFβ1, albumins, eotaxin. These biomarkers are not pathognomonic for CRS. The concentration of biomarkers is also increased in bronchial asthma and atopic dermatitis. The TGFβ, in particular the β1 subunit, was identified as the main factor involved in the remodelling of tissue stroma. In conjunction with continuous improvement of tissue testing methods, it is advisable to search for new factors that will more accurately allow the assessment of tissue remodelling in the chronic processes of paranasal sinuses.
6
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Benign paroxysmal vertigo of childhood

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Mierzwiński J., Polak M., Dalke K., Burduk P., Kaźmierczak H., Modrzyński M.
Polish Journal of Otolaryngology
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2007
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vol. 61
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issue 3
307-310
EN
Objective. To relate the authors’ experience to the diagnosis and follow-up of patients with benign paroxysmal vertigo of childhood (BPV) who were followed-up at the Children’s Hospital of Bydgoszcz between 1999 and 2004, and to review and discuss controversial issues regarding the disease. Methods. Among 124 children suffering from vertigo 14 were classified as having BPV. All the children were submitted to differential diagnosis protocol which consisted of meticulous history, otolaryngological, ophthalmological, psychological, neurological examination, biochemical tests and standard neurootological examination including caloric tests. The children were followed-up and the tests were repeated if no improvement was observed. Results. All the children suffered from episodic vertigo of variable intensity and frequency. All of them were neurologically intact. In 8 patients pathologic ENG results were found, only 1 patient with canal paresis could be considered as having peripheral lesion, 7 patients had central/mixed pathology. The follow-up was favorable in majority of patients. Six of them recovered completely, in 6 an improvement was noted and in 2 no improvement was observed. Three patients after remission of BPV attacks developed migraine. One child before development of BPV attacks suffered from paroxysmal torticollis of infancy. Conclusions. Childhood BPV is a disorder of vestibular system with the onset occurring mainly in preschoolers aged 1–7. Older children with the onset of BPV - like symptoms should be suspected for functional background of the disease. There are no typical ENG features for BPV. The only objective evidence of vestibular dysfunction is the presence of nystagmus during the attack. The disease is probably of vascular origin and there is strong evidence for close relationship between spasmodic torticollis, BPV and migraine.
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