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1
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Microbiota and antibiotic therapy in rhinosinusitis

100%
Zawadzka-Głos L.
Polish Journal of Otolaryngology
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2023
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vol. 77
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issue 5
36-42
EN
Rhinosinusitis is one of the most frequently diagnosed diseases in patients seeking medical consultation. Sinusitis is a heterogeneous group of diseases and can be acute or chronic. The current state of knowledge on rhinosinusitis is presented in the recommendations of the European Position Paper on Rhinosynusitis and Nasal Polyps 2020 (EPOS 2020). More and more attention is paid to the condition of the microbiota in the context of inflammatory changes in the sinuses. There is also a negative effect of excessively prescribed antibiotics on the increase in bacterial resistance to drugs and significant changes in the disturbance in the composition of the microbiota during antibiotic therapy. Since the most common etiology of acute sinusitis is viral, the use of antibiotics in uncomplicated sinusitis is unjustified. New therapeutic solutions are sought, including the use of herbal medicines. The EPOS 2020 document recommends the use of BNO 1016 in uncomplicated acute rhinosinusitis. New models of treatment also take into account the use of biological drugs, especially in the treatment of chronic rhinosinusitis.
2
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Cryptotia – a case report and literature review

63%
Niemczyk-Cieślak E., Zawadzka-Głos L.
Polski Przegląd Otorynolaryngologiczny
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2023
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vol. 12
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issue 2
61-65
EN
Cryptotia is a congenital defect that affects the upper third of the auricular cartilage which is being buried underneath temporal skin; underdevelopment of temporoauricular sulcus is also observed. The problem predominantly affects Asians and is relatively rare among Europeans. In addition to aesthetic flaws, cryptotia impairs the auricular function by preventing wearing glasses, face masks, or hearing aids. The defect is caused by abnormal attachment or function of the intrinsic auricular muscles which are primarily responsible for the formation of the antihelix. Consequently, two subtypes of the deformity are distinguished: subtype I, being the most prevalent and associated with abnormalities within the transverse and superior auricular muscles; and subtype II, associated with abnormalities within the oblique auricular muscles, and leading to minor cartilage deformities. Cryptotia can be treated conservatively in infants of up to six months of age. The treatment consists in external corrective braces being applied to achieve excellent aesthetic outcomes. In older children and adults, surgical procedures are the most effective treatment option. Otoplasty as performed in cryptotia reconstruction involves the formation of temporoauricular sulcus, the coverage of the resulting skin defect on the medial surface of the auricle, and surgical correction of the deformed cartilage.
3
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Paediatric Otogenic Cerebral Venous Thrombosis: Diagnostic Approach and Therapeutic Management – A Five-Year Single-Centre Experience

63%
Wolniewicz M., Zawadzka-Głos L.
Polish Journal of Otolaryngology
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2024
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vol. 79
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issue 1
26-31
EN
Introduction: Central venous thrombosis (CVT) represents a well-documented complication of acute otitis media (AOM) and acute mastoiditis (AM). Despite widespread antibiotic utilization, which has significantly reduced the incidence of severe AOM/AM complications, recent years have witnessed an increasing frequency of thrombotic complications in pediatric patients, not invariably presenting with classical neurological manifestations. Aim: This study aimed to investigate the potential correlation between COVID-19 infection and increased CVT incidence, while sharing therapeutic experiences, given the absence of standardized treatment protocols for otogenic CVT in pediatric populations. Materials and methods:A retrospective observational analysis was conducted on patients admitted to the Department of Pediatric Otolaryngology at the Medical University of Warsaw for otogenic CVT between 2018 and 2023, with treatment completion by January 2024. The investigation encompassed the extent of thrombotic changes, concurrent complications, anticoagulation therapy modalities and duration, and therapeutic monitoring protocols. Results: The study cohort comprised 13 patients, with complete follow-up data available for 11 subjects. Low-molecular-weight heparin (LMWH) monotherapy achieved a 60% success rate (defined as complete recanalization), while combination anticoagulation therapy demonstrated a 16.67% success rate. Notably, all cases exhibited regression of active thrombosis, constituting a satisfactory therapeutic outcome. Conclusions: Anticoagulation therapy demonstrated both efficacy and safety, with no significant hemorrhagic complications observed. These findings underscore the necessity for multicenter analysis to establish evidence-based clinical guidelines.
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Kryptotia – opis przypadku i przegląd literatury

63%
Niemczyk-Cieślak E., Zawadzka-Głos L.
Polski Przegląd Otorynolaryngologiczny
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2023
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vol. 12
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issue 2
61-65
PL
Kryptotia jest wrodzoną deformacją małżowiny usznej. W wadzie tej górna 1/3 chrząstki małżowiny jest schowana pod skórą okolicy skroniowej, a bruzda skroniowo-małżowinowa jest niewykształcona. Problem ten dotyczy przede wszystkim Azjatów i wyjątkowo rzadko występuje w populacji europejskiej. Powoduje defekty estetyczne oraz zaburza funkcjonalność małżowiny poprzez utrudnienie korzystania z okularów, maseczek czy aparatów słuchowych. Wada ta jest związana z nieprawidłowym przyczepem czy funkcjonowaniem mięśni własnych małżowiny, mających wpływ przede wszystkim na deformację grobelki. W związku z tym wyróżnia się dwa podtypy wady. Podtyp I występuje częściej i jest związany z nieprawidłowościami mięśnia poprzecznego małżowiny i mięśnia usznego górnego. Podtyp II wiąże się z anomaliami mięśnia skośnego małżowiny i powoduje mniejsze zniekształcenia chrząstki. Kryptotię można leczyć zachowawczo u niemowląt do ukończenia 6. miesiąca życia. Stosuje się wówczas zewnętrze aparaty korygujące, uzyskując dobre efekty estetyczne. U dzieci starszych lub u osób dorosłych najbardziej skuteczne są metody chirurgiczne. Założenia otoplastyki w kryptotii są następujące: wytworzenie bruzdy skroniowo-małżowinowej, pokrycie ubytku skóry powstałego na przyśrodkowej powierzchni małżowiny i chirurgiczna korekta zdeformowanej chrząstki. W tym celu wykorzystuje się plastykę wolnymi płatami skórnymi czy lokalnymi płatami skórno-powięziowymi i skórno-powięziowo-mięśniowymi (płaty przesuwane, płaty rotacyjne, płaty transponowane, uszypułowane płaty wyspowe). Bywa, że leczenie chirurgiczne powoduje niezadowalające efekty estetyczne. Dlatego w literaturze można znaleźć mnogość autorskich metod chirurgicznych, doskonalących wcześniej opisywane rozwiązania.
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Polish National Guidelines for the diagnosis and treatment of chronic otitis media with effusion in children

39%
Mierzwiński J., Tyra J., Szydłowski J., Bielecki I., Zawadzka-Głos L., Konopka W.
Polish Journal of Otolaryngology
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2023
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vol. 77
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issue 6
1-11
EN
Otitis media with effusion (OME) is a common childhood disease characterized by long-term retention of fluid within the middle ear cavities with no symptoms of acute infection. Surgical treatment, i.e. the drainage of the middle ear, is one of the most frequently performed pediatric ENT procedures worldwide. In February 2022, updated guidelines of the American Academy of Otolaryngology – Head and Neck Surgery on tympanostomy in infants between 6 and 12 months of age were published in Otolaryngology – Head and Neck Surgery. The guidelines are addressed to ENT specialists, pediatricians, and other medical staff directly involved in the management of patients subjected to or qualified for ventilation drainage. The previous version of the guidelines had been published in 2013. During the 7th International Conference OTOLOGY 2022 as held on 15–17 September, 2022 in Toruń, an Experts’ Board chaired by the National Consultant in Pediatric Otorhinolaryngology, Prof. Wiesław Konopka MD PhD, analyzed the hitherto published recommendations and consensus positions from other European as well as non-European countries, and resolved to undertake the task of developing new national guidelines for the diagnostics and treatment of OME.
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