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Rehabilitation after total laryngectomy – vision and realization

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Betlejewski S., Ossowski R., Sinkiewicz A.
Otolaryngologia Polska
|
2007
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vol. 61(3)
344-348
EN
Universality, early initiation, complexity and continuity – should be the main attributes of rehabilitation in patients after laryngectomy. The authors discuss the problem of universality and accessibility of rehabilitation in Poland. A great role in realization of this attributes played since 20 years the Polish Society of Laryngectomees. Till now the governmental help and the participation of the National Health Fund for the patients after laryngectomy is very limited. The early rehabilitation should be started before the operation and a particular note must be taken to the patient’s changed vital situation after the surgical treatment. The complexity of the rehabilitation must cover the whole spectrum of rehabilitation; it means voice and speech therapy, the improvement of respiratory system function, the problems of respiratory air conditioning and the psychological as well as social psychological aspects. The authors describe a model of such a complex rehabilitation that can be provided in health resorts. In the postoperative period the role of the laryngectomee clubs and associations is very important to assure the continuity of rehabilitation.
2
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Comparative evaluation of the diagnostic value of biopsy and NBI endoscopy in patients with cancer of the hypopharynx and larynx

100%
Wacławek M., Miłoński J., Olszewski J.
Otolaryngologia Polska
|
2019
|
vol. 73(5)
12-17
EN
Introduction: Novel endoscopic technique – Narrow Band Imaging (NBI) seems to be a promising method for an early detection of neoplastic lesions of the upper aerodigestive tract. Compared to white light endoscopy, NBI improves the visualisation of the mucosal and submucosal microvascular patterns of observed pathologies. The aim of the study was to evaluate the diagnostic value of biopsy and NBI in patients with cancer of the larynx and hypopharynx. Material and methods: The study was conducted in 100 adult subjects hospitalized in the Clinic of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics of Military Medical Academy University Teaching Hospital in Lodz, who were planned for surgical procedures for excision or surgical biopsy of pathological lesions of the hypopharynx or larynx. The following examinations were performed: subjective and objective, otorhinolaryngological, NBI endoscopy and histopathological assessment of suspicious lesions. The microvascular pattern of observed lesions was assessed according to the Ni scale criteria. The next stage of the study was to compare the endoscopic examination results (type of vascular pattern according to the Ni scale) with the histopathological result. The obtained results were subjected to statistical analysis. Results: The sensitivity of NBI endoscopy in detection of malignant neoplasms in patients with hypopharynx and larynx lesions is 90.48%, specificity – 91.14%, positive predictive value – 73.08%, negative predictive value – 97.30%. C onclusions: NBI endoscopy is a modern imaging method, increasing the diagnostic potential of endoscopy in the early detection of malignant lesions within the hypopharynx and larynx.
3
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Cancer or syphilis laryngis, politics or diagnostic failure – problems of Emperor Frederick’s III disease

100%
Betlejewski S., Betlejewski A.
Otolaryngologia Polska
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2008
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vol. 62(6)
803-809
EN
The case history of the German emperor Frederick III, who died of laryngeal cancer in 1888, is briefl y reported. In spite of fact, that the German laryngologists the patient’s pathologic changes diagnosed as laryngeal cancer in early stage, the ultimate diagnosis was made too late for surgery to have any effect. This delay was due to the differences in opinions between the attending laryngologists; particularly between that of the English prominent laryngologist Morell Mackenzie and the Germans, prof. Gerhardt and prof. Bergmann. The roles of the British Queen Victoria as well as her daughter, the wife of Prince Frederick, the princess Victoria, in decisions about the treatment of the disease, are discussed. The behavior and the personality of Sir Morell Mackenzie played also a very important role in the course of the disease. Some medical facts and symptoms render it probable that syphilis was the underlying reason for the development of cancer. Crown Prince Frederick was a pipe smoker for at least 30 years before he died at the age of 57 years, so it may be possible, that the Emperor’s laryngeal cancer was induced by tobacco. There are some suggestions, that the premature death of the King of Prussia and German Emperor Frederick III could be a critical turning point in European’s history.
4
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Comparative evaluation of the diagnostic value of biopsy and NBI endoscopy in patients with cancer of the hypopharynx and larynx

100%
Wacławek M., Miłoński J., Olszewski J.
Polish Journal of Otolaryngology
|
2019
|
vol. 73
|
issue 5
12-17
EN
Introduction: Novel endoscopic technique – Narrow Band Imaging (NBI) seems to be a promising method for an early detection of neoplastic lesions of the upper aerodigestive tract. Compared to white light endoscopy, NBI improves the visualisation of the mucosal and submucosal microvascular patterns of observed pathologies. The aim of the study was to evaluate the diagnostic value of biopsy and NBI in patients with cancer of the larynx and hypopharynx. Material and methods: The study was conducted in 100 adult subjects hospitalized in the Clinic of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics of Military Medical Academy University Teaching Hospital in Lodz, who were planned for surgical procedures for excision or surgical biopsy of pathological lesions of the hypopharynx or larynx. The following examinations were performed: subjective and objective, otorhinolaryngological, NBI endoscopy and histopathological assessment of suspicious lesions. The microvascular pattern of observed lesions was assessed according to the Ni scale criteria. The next stage of the study was to compare the endoscopic examination results (type of vascular pattern according to the Ni scale) with the histopathological result. The obtained results were subjected to statistical analysis. Results: The sensitivity of NBI endoscopy in detection of malignant neoplasms in patients with hypopharynx and larynx lesions is 90.48%, specificity – 91.14%, positive predictive value – 73.08%, negative predictive value – 97.30%. C onclusions: NBI endoscopy is a modern imaging method, increasing the diagnostic potential of endoscopy in the early detection of malignant lesions within the hypopharynx and larynx.
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