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EN
Introduction: The aim of the study was to present selected cases with Eagle’s syndrome diagnosed and treated at the Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, in the years 2016–2020. Material and method: Five selected clinical cases with Eagle’s syndrome are presented, including three male patients and two female patients, aged 28 to 42 years. Results: The prevalence of Eagle’s syndrome was similar for both female and male patients. The carotid artery syndrome, which is characterized by: visual disturbances, unilateral pain located along cervical vessels, headache and migraine, was more common. Lack of proper diagnosis of Eagle’s syndrome often significantly delays the implementation of proper treatment and thus exposes patients to long-term struggle with pain. Our observations have shown that the time between the onset of symptoms and correct diagnosis in patients averaged about five years. 3D-CT scan is the gold standard for detecting Eagle’s syndrome. An intraoral approach was used in surgical treatment. Although this approach offers shorter treatment time and better cosmetic effect, there is also a greater risk of complications associated with limited visibility of the surgical field and infection. Conclusions: Although styloid syndrome usually occurs bilaterally, these patients reported unilateral symptoms. No correlations were found between the prevalence of Eagle’s syndrome and sex, the length of the styloid process or age, nor side of the body. The best healing effect is obtained by surgical correction/reduction of the elongated styloid process.
EN
Breast cancer is the most frequently diagnosed female cancer in Poland (over 17,500 women). Anthracyclines have become one of the most important drugs in breast cancer systemic treatment. In the treatment of metastatic disease combination chemotherapy with doxorubicin provides the objective response rate of 60–85%, and the median time of progression-free survival is about 12 months. Non-pegylated liposomal doxorubicin (NPLD) in combination with cyclophosphamide is associated with a lower risk of cardiotoxicity, higher efficacy and more favourable toxicity profile as compared with conventional anthracycline regimes. Two cases of females patients treated with NPLD described in this article demonstrate the importance of the choice of chemotherapy, professional monitoring, early detection and treatment of adverse effects. Non-pegylated liposomal doxorubicin ordained in systemic treatment of stage IV breast cancer prolongs survival and enhances the quality of life. It is a reasonable option for palliative therapy.
EN
The article draws attention to the need to maintain oncological vigilance in the daily practice of a family doctor. Diagnosis and effective treatment of hypercalcemia and plasma cell myeloma are presented.
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Rare facial clefts

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EN
In 1976 Dr. Paul Tessier described numeric classification for rare craniofacial clefts. He first emphasized that a fissure of the soft tissue corresponds, as a general rule, to a cleft of the bony structure. The classification, easy to understand, became widely accepted because the recording of the malformations was simple and facilitated communication between observers. The aim of this study was to present our own experience with treatment of patients with rare facial clefts. Material and methods. Our Department has 11 patients with rare craniofacial clefts under its care. This group includes 8 boys and 3 girls. The patients aged from 2 months to 18 years at the time of the first consultation. Results. In two patients the cleft was median, in seven patients it was one-sided and in two – bilateral. The most common type of cleft was number 6, and the rarest were 2, 3, and 7. All patients underwent surgical treatment. Conclusions. Atypical facial clefts are rare congenital anomalies, however because of functional and aesthetic disturbances they constitute a serious medical and therapeutic problem. Facial clefts are characterized by variable clinical presentation and require individualized treatment plan.
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Aim: Aim of the study was retrospective analysis of the patients documentation treated for acute mastoiditis (AM) in Department of Pediatric Otolaryngology in Bialystok and available literature on this subject to determine the optimal rules of treatment in AM. Material and methods: A retrospective analysis of 40 patients treated for AM in 2001-2017. We have adopted Anthonsen et al. [15] AM diagnosis criteria to include patients to this study. Results: The mean age of the respondents was 46 months, 37% of children were less than 2 years old. 2/3 of the cases were not preceded by previous acute otitis media(AOM) episodes. 69% of patients received antibiotics before admission to the hospital. In laboratory studies, 95% of patients had elevated indices of inflammation (CRP, leukocytosis), and their value was higher among patients qualified for surgery. The indications for computed tomography (CT) were the lack of improvement after conservative treatment for 48 hours or symptoms of the presence of subperiosteal abscess. CT was performed in 35% of patients. 24 patients (60%) were treated only conservatively: myringotomy without / with the insertion of a ventilation tubes and intravenous antibiotic therapy. The most commonly used antibiotic was ceftriaxone - 75% of patients. 16 patients required mastoidectomy. The most common indication (30%) for mastoidectomy was the presence of subperiosteal abscess. Conclusion: In uncomplicated AM cases CT does not have to be routinely performed, a myringotomy should be performed with or without drains insertion and an empiric intravenous antibiotic therapy should be started. In presence of a subperiosteal abscess, it is recommended to perform CT with contrast and mastoidectomy. Deterioration of the patient's condition or lack of improvement after 48 hours of conservative treatment obliges us to make a CT and on the basis of the decision on mastoidectomy.
EN
Introduction: Warthin’s tumor is a non-malignant tumor that occurs in major salivary glands. Diagnostics include an interview and physical examination as well as additional tests – ultrasonography, magnetic resonance tomography, fine-needle aspiration biopsy. Surgical tumor resection remains the method of treatment, the scope of which includes techniques from extracapsular tumor resection to a full range of parotidectomy. Material and methods: A retrospective analysis was conducted for available medical records of 53 patients treated surgically at the Department of Otolaryngology and Laryngological Oncology at the Collegium Medicum of the Nicolaus Copernicus University in Toruń in 2009–2016. Each patient underwent an interview, physical examination and a routine ultrasound examination. Results of treatment of 57 tumors were analyzed. Results: The study showed that in the case of extracapsular tumor excision in 57 patients in the treatment of Warthin’s tumors of the lower pole of the parotid lobe, there were no complications in the form of: permanent paralysis or facial nerve palsy, mucocele, symptoms of Frey’s syndrome or cosmetic facial defect. Ultrasound examination performed in 8 (14%) patients revealed lesions requiring further diagnostics or periodic ultrasound monitoring. Conclusions: 1. Extracapsular tumor excision appears to be an accurate surgical technique in Warthin’s tumor of the lower pole of the parotid gland’s superficial lobe. 2. After removal of a cancerous lesion of the parotid gland, every patient requires periodic laryngological monitoring.
EN
Travel to developing countries is associated with possibility to acquire different, also parasitic, diseases which have become a diagnostic and therapeutic problem. The ENT specialist is one of the medical officers who may make initial contact with a patient with a suspected parasitic disease. One of them is leishmaniosis: a parasitic disease classified as Neglected Tropical Diseases (NTD), which occurs in the tropics, subtropics and southern Europe. While asymptomatic invasion is observed in some cases, three forms of symptomatic leishmaniosis can be distinguished: cutaneous leishmaniosis (CL), visceral leishmaniosis (VL), and mucosal leishmaniosis (ML). Signs and symptoms of these forms, as well as the differential diagnosis, diagnostic procedures and treatment are presented in the paper.
EN
Introduction: The aim of the study was to present selected cases with Eagle’s syndrome diagnosed and treated at the Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, in the years 2016–2020. Material and method: Five selected clinical cases with Eagle’s syndrome are presented, including three male patients and two female patients, aged 28 to 42 years. Results: The prevalence of Eagle’s syndrome was similar for both female and male patients. The carotid artery syndrome, which is characterized by: visual disturbances, unilateral pain located along cervical vessels, headache and migraine, was more common. Lack of proper diagnosis of Eagle’s syndrome often significantly delays the implementation of proper treatment and thus exposes patients to long-term struggle with pain. Our observations have shown that the time between the onset of symptoms and correct diagnosis in patients averaged about five years. 3D-CT scan is the gold standard for detecting Eagle’s syndrome. An intraoral approach was used in surgical treatment. Although this approach offers shorter treatment time and better cosmetic effect, there is also a greater risk of complications associated with limited visibility of the surgical field and infection. Conclusions: Although styloid syndrome usually occurs bilaterally, these patients reported unilateral symptoms. No correlations were found between the prevalence of Eagle’s syndrome and sex, the length of the styloid process or age, nor side of the body. The best healing effect is obtained by surgical correction/reduction of the elongated styloid process.
EN
Background: Esophageal perforation is a life-threatening condition of a complex etiology. No clear guidelines are available regarding the management of this condition. In this study, we review publications related to esophageal perforation, and analyze patients treated for this condition at our Department of Thoracic, General and Oncological Surgery. Objective: The objective of the study was to retrospectively assess and analyze management methods for esophageal perforations of different etiologies. All patients were treated in the Department of Thoracic, General and Oncological Surgery in years 2009-2015. Patients with perforations resulting from post-operational leaks within surgical anastomoses were excluded from the study. Material, methods, results: The analysis involved a total of 16 cases of esophageal ruptures. All cases were treated in years 2009-2015. Patients with perforations resulting from postoperative leaks within surgical anastomoses following elective surgeries for either oncological or non-oncological causes were excluded. The most common reason for esophageal rupture was iatrogenic injury (7 cases, 44%). Other causes included Boerhaave syndrome (5 cases, 31.2%), blunt trauma (2 cases, 12.5%), abscess perforation (1 case, 6.2%), and ulcer perforation (1 case, 6.2%). Ten patients underwent surgery, and the rest underwent esophageal prosthesis placement, of whom 2 cases required drainage of the mediastinum and pleural cavity. The mortality rate in the study group was 9/16 cases (56.2%). Conclusions: Esophageal perforation poses a significant interdisciplinary challenge regarding diagnostic workup, selection of treatment methods, and management of potential postoperative complications. This retrospective study was conducted in a single center. Although the analyzed period was long, we found only 16 cases. In spite of a variety of etiologies present, we found several statistically significant results of potential clinical value. 1. Most perforations that are not diagnosed within 48 hours affected the lower part of the esophagus and presented with unclear symptoms and imaging findings 2. Delaying diagnosis and treatment beyond 24 hours was associated with a higher mortality rate.
EN
Introduction. Surgical treatment of OSAS is focused on removal of narrowing that increase airway resistance in upper respiratory tract. Nd:YAG laser beam penetrates deeper into tissue than CO2 laser followed by superior scarification ability. In this study we investigate efficacy of surgery with Nd:YAG laser assisted uvuloplasty (LAUP). Material and methods. The subject was 51 patients with OSAS treated in Department of Otolaryngology, Medical University of Gdansk during the 2004–2005 period. All patients underwent all-night PSG and the ESS (Epworth Sleepiness Scale) score was used to assess the daytime sleepiness. Surgery treatment was performed and all patients underwent LAUP and additionally lingual base laser vaporization, tonsillectomy and nasal surgery where needed. The postoperative control ENT examination including ESS and all-night PSG was performed after 6 months. Results. Success was found in 29 patients, they achieved AHI<10 and ESS<12. In another 22 patients improvement at PSG parameters and ESS score were evaluated but they were still beyond normal range. Success was obtained in 14/16 patients with preoperative AHI I degree, 10/19 AHI II, and 4/16 AHI III. Nasal surgery for enlargement of airway passage was performed more frequently (25/32) in the group with success then in the group with partial improvement (9/19). Preoperative PSG parameters were better in patients with nasal obstruction. Patients with BMI≥30 succeeded rarely (10/22) in compare with patients with BMI<30 (success in 24/29). Preoperative PSG parameters were better in patients with BMI<30. Conclusion. LAUP with Nd:YAG laser wit additional tonsillectomy, lingual base surgery and nasal surgery were needed is successful method for surgery at light and medium stage of OSAS in nonobese patients.
EN
Renal artery pseudoaneurysms and arteriovenous fistulae most often occur as an iatrogenic complication. The article discusses a case of a patient diagnosed with an arteriovenous fistula and a pseudoaneurysm. A 64-year-old woman was admitted to the hospital due to nonspecific pain in the lumbar region. Imaging showed a typical picture of clear cell renal carcinoma. The patient was qualified for surgical treatment. After tumor resection, the patient developed microhematuria. Arteriovenous fistula and renal pseudoaneurysm were diagnosed using Doppler and computed tomography scans. The patient was qualified for arteriography with simultaneous embolization of the lesion. A follow-up evaluation confirmed the exclusion of aneurysm and fistula. Treatment outcomes were monitored using Doppler ultrasound. Doppler ultrasonography is the first method of choice in detecting and monitoring renal artery irregularities. Safety, non-invasiveness and easy access to this tool make it play a key role in the diagnosis of renal artery fistulas and pseudoaneurysms.
PL
Pseudotętniaki tętnic nerkowych i przetoki tętniczo-żylne nerek pojawiają się najczęściej jako powikłania jatrogenne. W pracy omówiono przypadek chorej, u której w badaniu ultrasonograficznym i tomografii komputerowej rozpoznano przetokę tętniczo-żylną i tętniaka rzekomego, zlokalizowane w nerce prawej, a następnie leczonej metodami wewnątrznaczyniowymi. Sześćdziesięcioczteroletnia kobieta została przyjęta do szpitala z powodu niespecyficznych dolegliwości bólowych w okolicy lędźwiowej. Badania obrazowe wykazały typowy obraz dla jasnokomórkowego raka nerki. Chorą zakwalifikowano do leczenia chirurgicznego. Po resekcji klinowej u pacjentki obserwowano okresowy krwinkomocz. Za pomocą badania dopplerowskiego i tomografii komputerowej zdiagnozowano przetokę tętniczo-żylną i tętniaka rzekomego nerki prawej. Chorą zakwalifikowano do arteriografii z równoczasową embolizacją. Po zabiegu embolizacji badania kontrolne potwierdziły wyłączenie tętniaka i przetoki z krążenia. Wyniki leczenia monitorowano za pomocą badań dopplerowskich. Ultrasonografia dopplerowska jest metodą z wyboru w wykrywaniu i monitorowaniu nieprawidłowości tętnic nerkowych. Bezpieczeństwo, nieinwazyjność i dostępność badania sprawiają, że odgrywa ono kluczową rolę w diagnozowaniu przetok tętnic nerkowych i pseudotętniaków.
EN
The main objective of the study was to determine the validity of intraoperative antiseptic treatment during endoscopic sinus surgery and the impact of such a treatment on the postoperative outcomes. Fifty-five patients with chronic sinusitis, qualified for surgical treatment were enrolled into the trial. It was designed as a prospective, randomized, blinded study. The surgical procedures were performed on both sides, in the same scope. In the next stage, after opening, one side was flushed with saline solution, and the other side with octenidine solution. The analysis showed a statistically significant reduction in postoperative crusting measured using the Lund-Kennedy scale between the test and the control group. Intraoperative lavage of the paranasal sinuses in both control and study group showed an effect on decreasing the total number of positive postoperative cultures relative to preoperative ones. Study showed a beneficial effect of the intervention consisting in rinsing with Octenisept on the reduction of crusting in the postoperative assessment.
EN
Computational Fluid Dynamics (CFD) is a fluid mechanics department that uses numerical methods to solve fluid flow issues. A review of the literature was done as well to summarize the usage of the CFD method in the assessment of airflow through the upper respiratory tract (GDO), especially in the larynx. CFD is now becoming a very useful tool not only for analyzing airflow patterns and mechanism of particle deposition in the larynx, but also for obtaining information on temperature, pressure and shear stress changes in GDO. It is a tool with which one can safely plan surgical treatment as well as predict its potential effects.
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EN
CRS symptoms in children can be mild and uncharacteristic. The disease is multifactorial, and therefore requires a multifaceted, multidisciplinary approach. Treatment of CRS in children is difficult, infections often recur, and treatment methods are often ineffective. In children, surgery is performed infrequently, only when other therapies have failed. The first stage of surgery is adenoidectomy. Functional endoscopic surgery of the paranasal sinuses may be considered if no improvement of the patient after exhausting all possibilities of conservative treatment.
EN
Increasing number of malignant neoplasms of the oral cavity and facial region as well as lower age of the patients hospitalized were the interest of the authors. Material and methods. Clinical data from the years 2002–2004 were analysed in this paper. In this study the factors as: sex and age of patients, tumor localization, histological examinations, surgical treatment of the tumor and lymph nodes are reported. Results. During the 3 years period there were 346 tumors of the oral cavity treated in Clinic of Maxillofacial Surgery in Poznaƒ. Epidemiologic studies have revealed a increased number of squamous cell carcinomas and other malignant tumors as lymphomas, adenoid cystic carcinomas and sarcomas of the oro-facial region. The staging of the tumors is similar as in previous years. Conclusions. The study shows better knowledge about oral malignancies in dentists and general praticioners. The tumor patients are surgically treated earlyer as in previous years.
EN
Introduction: Warthin’s tumor is a non-malignant tumor that occurs in major salivary glands. Diagnostics include an interview and physical examination as well as additional tests – ultrasonography, magnetic resonance tomography, fine-needle aspiration biopsy. Surgical tumor resection remains the method of treatment, the scope of which includes techniques from extracapsular tumor resection to a full range of parotidectomy. Material and methods: A retrospective analysis was conducted for available medical records of 53 patients treated surgically at the Department of Otolaryngology and Laryngological Oncology at the Collegium Medicum of the Nicolaus Copernicus University in Toruń in 2009–2016. Each patient underwent an interview, physical examination and a routine ultrasound examination. Results of treatment of 57 tumors were analyzed. Results: The study showed that in the case of extracapsular tumor excision in 57 patients in the treatment of Warthin’s tumors of the lower pole of the parotid lobe, there were no complications in the form of: permanent paralysis or facial nerve palsy, mucocele, symptoms of Frey’s syndrome or cosmetic facial defect. Ultrasound examination performed in 8 (14%) patients revealed lesions requiring further diagnostics or periodic ultrasound monitoring. Conclusions: 1. Extracapsular tumor excision appears to be an accurate surgical technique in Warthin’s tumor of the lower pole of the parotid gland’s superficial lobe. 2. After removal of a cancerous lesion of the parotid gland, every patient requires periodic laryngological monitoring.
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EN
Balneology (from Lat.: balneum - Steam, with gr,: lógos - science) the field of medicine spa known since antiquity that studies the healing properties of groundwater and mud, and using them in therapy. Balneology is especially effective treatment of chronic diseases such as rheumatoid arthritis, osteoarthritis and spine, post-traumatic and post-operative orthopedic osteoarthritis, gout, osteoporosis, coronary heart disease, post myocardial infarction, post alular and vascular diseases, hypertension, diseases of the nervous system and respiratory system. One of the most beautifully situated and rich in water treatment is a spa town in Dlugopole
EN
Solid pseudopapillary tumor (SPT) is a rare pancreatic tumor with low malignancy, constituting 1-2% of exocrine pancreatic tumors, occurring mostly in young women. SPT, despite the achievement of large size gives scant clinical symptoms. The authors present the case of 39-year-old woman with SPT, diagnosed at intraoperative biopsy. The aim of this study is to describe the clinicopathological feature, diagnosis and surgical treatment of SPT.
EN
Multiple endocrine neoplasia type 1 (MEN1) syndrome is an autosomal dominant hereditary disorder characterised by coexistence of pancreatic neuroendocrine tumours (pNETs) with parathyroid and pituitary tumours. PNETs, including mostly non-functioning tumours, gastrinoma and insulinoma, occur in nearly 95% of MEN1 patients and account for over 50% of disorder-related mortality. Therefore, early initiation of screening for pNET using biochemical and imaging tests as well as appropriate surgical and systemic treatment are of particular importance for this group of patients. Currently, there are no clearly defined guidelines which determine the optimal methods for detection and treatment of pNET in MEN1. Caution should be exercised when applying the guidelines designed for patients with sporadic pNET to MEN1 patients as the clinical course of the disorder is slightly different, involving multifocality of lesions and younger age of patients at onset. This paper discusses the distinctive features and challenges in diagnosing and treating pNETs in MEN1 patients.
EN
Non-Hodgkin lymphomas (NHL) comprise a heterogeneous group of B-cell and T-cell neoplasms. Diffuse large B-cell lymphoma (DLBCL), the most common type of NHL, accounts for around 30-40% of NHL cases. However, primary hepatic location of NHLs is rare and constitutes 0.01% of all NHL cases. Due to this rarity and a lack of large randomized trails, it is still unclear what treatment should be used for primary hepatic DLBCLs. In this study, we report of a female patient with primary hepatic DLBCL who was successfully treated with neoadjuvant chemotherapy and surgery. We also shortly review the literature regarding surgical treatments for primary GI tract NHLs. Taking into account our experience and the current literature, surgical treatment with postoperative chemotherapy seems to be a feasible option for patients with focal primary hepatic DLBCLs.
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