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EN
Orbital abscess in the course of sinusitis are rare condition, but due to severe need urgent Orbital abscess in the course of sinusitis are rare condition, but due to the severe need urgent diagnosis and implementation of effective treatment. This complication due to the high variability of clinical symptoms qualifies this disease to a group of emergencies, mainly due to the risk of vision loss. We present a case report a patient with orbital subperiosteal abscess in chronic sinusitis, in which in the age of admission to an experienced significant disorders of the ocular. The patient was performed orbital abscess drainage by intranasal, complicated by the occurrence of orbital hematoma and the need to re-perform the surgery.
EN
Introduction: Endoscopic surgery of the paranasal sinuses is a surgical technique that has revolutionized the surgical treatment of patients with chronic sinusitis. Application of this method now goes far beyond the conditions of the nasal cavity. Aim: It allows among other operations within the eye socket, acting alternative technique for the operation of the external appproauch. Material and Methods: This work is devoted to the analysis of the effectiveness of endoscopic surgery in the treatment of patients with orbital complications in the course of sinusitis in the Department of Otolaryngology SU in Cracow in the years 2004-–2016, aim of this study is to search for optimal treatment of patients with the above disorders. Results: In the group of patients operated on because of orbital abscess from reaching the outside in all patients had symptoms of revocation on the part of the orbit and ocular, and postoperative complications were not observed. Among patients undergoing endoscopic trocar in one patient there was no improvement in the function of the eye. It could lead to a too long period of time from the first appearance of symptoms (over 48 hours), and sometimes surgical intervention, as well as the occurrence of orbital hematoma in the second postoperative day and the necessity of re-operation of the external handle.
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
Introduction: CRS is a complex systemic disease affecting more than 10% of the population. There are two main types of CRS phenotypes: CRSwNP and CRSsNP. In the Caucasian population, the prevalence of inflammation markers typical of the Th1 profile is observed in CRSsNP, whereas Th2 and Th17 in CRSwNP. Th2 inflammation is observed in the CRSwNP phenotype with concomitant allergies, asthma or hypersensitivity to NSAIDs. Objectives: The aim of the study was to evaluate, based on the authors’ own material, whether allergies, asthma or hypersensitivity to NSAIDs were a risk factor for the development of a specific CRS phenotype. An attempt was also made to investigate the influence of comorbidities on the extent of sinus endoscopic procedures, which depended on the severity of inflammation. Methods: In the years 2006–2015, ESS was performed on 2217 patients with different CRS phenotypes. Patients with an allergy, bronchial asthma and hypersensitivity to NSAIDs were subjected to analysis. Results: Based on logistic regression, it was found that among the mentioned comorbidities, only asthma (P < 0.0001) and hypersensitivity to NSAIDs (P = 0.0007) significantly affect the occurrence of the phenotype with polyps, whereas the impact of allergies is statistically insignificant (P = 0.1909). The relationship between the type of ESS and CRS phenotypes is statistically significant (P < 0.0001). Conclusions: Bronchial asthma and hypersensitivity to NSAIDs have a statistically significant effect on the occurrence of the CRSwNP phenotype. This effect was not observed in allergies. The impact of allergies, asthma and hypersensitivity on the phenotype was observed in the group of patients subjected to the most extensive surgery (ESS 4).
EN
Introduction: CRS is a complex systemic disease affecting more than 10% of the population. There are two main types of CRS phenotypes: CRSwNP and CRSsNP. In the Caucasian population, the prevalence of inflammation markers typical of the Th1 profile is observed in CRSsNP, whereas Th2 and Th17 in CRSwNP. Th2 inflammation is observed in the CRSwNP phenotype with concomitant allergies, asthma or hypersensitivity to NSAIDs. Objectives: The aim of the study was to evaluate, based on the authors’ own material, whether allergies, asthma or hypersensitivity to NSAIDs were a risk factor for the development of a specific CRS phenotype. An attempt was also made to investigate the influence of comorbidities on the extent of sinus endoscopic procedures, which depended on the severity of inflammation. Methods: In the years 2006–2015, ESS was performed on 2217 patients with different CRS phenotypes. Patients with an allergy, bronchial asthma and hypersensitivity to NSAIDs were subjected to analysis. Results: Based on logistic regression, it was found that among the mentioned comorbidities, only asthma (P < 0.0001) and hypersensitivity to NSAIDs (P = 0.0007) significantly affect the occurrence of the phenotype with polyps, whereas the impact of allergies is statistically insignificant (P = 0.1909). The relationship between the type of ESS and CRS phenotypes is statistically significant (P < 0.0001). Conclusions: Bronchial asthma and hypersensitivity to NSAIDs have a statistically significant effect on the occurrence of the CRSwNP phenotype. This effect was not observed in allergies. The impact of allergies, asthma and hypersensitivity on the phenotype was observed in the group of patients subjected to the most extensive surgery (ESS 4).
PL
Cel. Przewlekłe zapalenie zatok (CRS) stanowi narastający problem zdrowotny na świecie. Skargi chorych na ściekanie wydzieliny, ograniczenie drożności nosa, zaburzenia węchu nie zawsze znajdują odzwierciedlenie w przeprowadzanych badaniach obiektywnych, co może utrudniać podjęcie decyzji o leczeniu operacyjnym Celem badania było porównanie wyników badań obiektywnych oceniających nasilenie zmian w obrębie błony śluzowej nosa i zatok czyli endoskopii i badania TK z wynikami testów subiektywnych oraz próba znalezienia innych czynników wpływających na wyniki badań subiektywnych i obiektywnych. Materiał i metody. Badaniem objęto 130 chorych z przewlekłym zapaleniam zatok w wieku 46.9 ± 14.5, przyjętych do Oddziału Laryngologii I Onkologii Laryngologicznej pomiędzy 1.07 a 31. 10.2019r zakwalifikowanych do zabiegu ESS zgodnie z wytycznymi EPOS 2012 (zaktualizowanymi z EPOS 2020). U wszystkich chorych wykonano badania subiektywne (SinoNasal Outcomes Test, Visual Analogue Scale , Brief Smell Identification Test ) oraz obiektywne badanie endoskopowe (Lund-Kenne-dy) i tomograficzne (Lund-Mackay) oraz uzyskano dane dotyczące palenia, atopii, chorób współistniejących i poprzednich operacji. Wyniki. Stwierdzono istotną korelację pomiędzy wynikami badań subiektywnych a rozległością zmian zapalnych widocznych w badaniu tomograficznym zatok i endoscopowym jamy nosa. Wykształcenie, nikotynizm, atopia, nadciśnienie tętnicze, cukrzyca nie miały wpływu na subiektywne wyniki ocen. Pacjenci z cukrzycą mieli znacząco wyższy stopień nasilenia zmian w skali Lund-Mackay. Wyniki SNOT-22, SNOT-12 i VAS były statystycznie wyższe u kobiet. Stwierdzono znaczące statystycznie różnice między podgrupami pacjentów z różną punktacją BSIT a skalą Lund-Mackay oraz Lund-Kennedy
EN
Objective. Chronic rhinosinusitis (CRS) is a growing health problem in the world. Patients’ complaints are not always reflected in objective tests, which may hinder the decision about surgical treatment. The aim of the study was to compare the results of objective tests assessing the severity of lesions i.e. endoscopy and CT, with the results of subjective tests. Methods. The study comprised 130 patients with CRS aged 46.9 ± 14.5 (range 19-82 years), admitted to the Department of Laryngology and Laryngological Oncology between July 1 and October 31, 2019 and qualified for ESS in accordance with EPOS 2012 guidelines (update to EPOS 2020). Subjective Sino-Nasal Outcomes Test (SNOT), Visual Analogue Scale (VAS), Brief Smell Identification Test (BSIT) and objective, endoscopic (Lund-Kenne-dy) and tomographic (Lund-Mackay), tests were performed in all the patients. The data on smoking, atopy, co-morbidities and previous operations were obtained. Results. A significant correlation was found between the results of subjective tests and the extent of inflammatory lesions in the sinus CT and nasal endoscopy. Education, smoking, atopy, arterial hypertension, diabetes mellitus did not influence the subjective assessment results. Patients with diabetes mellitus had a significantly higher Lund-Mackay score. SNOT-22, SNOT-12 and VAS scores were significantly higher in female patients. Significant differences were found among subgroups of patients with different BSIT scores and both the Lund-Mackay score and the Lund-Kennedy score. Conclusion. Subjective assessment of CRS-related complaints is a good indicator for making further therapeutic decisions.
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