Comparative evaluation of the diagnostic value of the VHIT and Dix-Hallpike test in patients with balance system disorders in out-patient healthcare practice and expertise preparation.

INTRODUCTION: The aim of the paper was the comparative analysis of the diagnostic value of the Video Head Impulse Testing (VHIT) Ulmer I and Dix-Hallpike Test in patients with balance system disorders in out-patient practice and expertise preparation. MATERIAL AND METHODS: The examination was performed in 63 patients aged 20-79, including 28 women aged 20-72 and 35 men aged 23-79, divided into two groups: Group I (study group) - 33 patients with mixed cause vertigo (on the basis of the Fitzgerald-Hallpike caloric test during the VNG examination), and Group II (reference group) - 30 healthy patients. After the ENT interview and physical examination, exclusion of pathological lesions in the external acoustic meatus and middle ear, each patient was subjected to a Fitzgerald-Hallpike caloric test during VNG examination, as well as a VHIT test and Dix-Hallpike test, with the evaluation of eyeball reaction during head rotation. RESULTS: In the group of patients with mixed-cause vertigo (Group I), the Fitzgerald-Hallpike caloric test showed unilateral labyrinth deficiencies in 90.9% of the patients (with the average value of 41.8%) and relative directional preponderance with the average value of 19.0%, while in 9.1% of the patients, the detected values of labyrinth excitability were normal. In the examination of patients with vertigo, benign paroxysmal positional vertigo was diagnosed in 9.1% of cases. This diagnosis was based on the positive response to the Dix-Hallpike manoeuvre and indicative of damage to the posterior semicircular canal in the VHIT test (without signs of deficiency in the VNG examination). CONCLUSION: The VHIT test and Dix-Hallpike test enable quick and precise detection of benign paroxysmal positional vertigo in out-patient practice and expertise preparation.

The influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives.

INTRODUCTION: The objective of the paper is to evaluate the influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives. MATERIAL AND METHODS: 105 young women participated in the study who were divided into 2 groups. Group I: 52 women disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 20-49; Group II: 53 women with no disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 18-40. Patients entering the study underwent full otoneurological examination, detailed laryngological assessment and the examination of selected parameters of the hemostasis system, including the evaluation of fibrinogen and D-dimer levels, APTT and PT, estradiol and progesterone concentrations in the blood serum and evaluation of the body mass index (BMI). RESULTS: Central vertigo was the most common type of vertigo in the study group (59,6% of cases). Other vertigo types in this group included compensated vertigo of mixed origin (36,6% of cases) and peripheral vertigo (only 3,8% of cases), which indicates that 40.4% of the cases suffer from damage to the labyrinth. The analysis of the concentration of estradiol in the blood serum revealed, after consideration of a menstrual cycle phase, that estradiol concentration exceeded normative values significantly more often in the study group than in the control group and that estradiol concentration was significantly less frequently below the norm in the study group; the difference was statistically significant (p=0,048). The body mass index (BMI) of women participating in the study significantly correlated with the concentration of D-dimers only in the study group (p=0,35 vs p=0,012). CONCLUSIONS: Evaluating the body mass index before administering hormonal contraception can be useful to eliminate other risk factors for thromboembolism. In order to prevent potential thromboembolism episodes, administering hormonal contraception only after lowering the body mass index may also be worth considering.

The influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives.

INTRODUCTION: The objective of the paper is to evaluate the influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives. MATERIAL AND METHODS: 105 young women participated in the study who were divided into 2 groups. Group I: 52 women disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 20-49; Group II: 53 women with no disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 18-40. Patients entering the study underwent full otoneurological examination, detailed laryngological assessment and the examination of selected parameters of the hemostasis system, including the evaluation of fibrinogen and D-dimer levels, APTT and PT, estradiol and progesterone concentrations in the blood serum and evaluation of the body mass index (BMI). RESULTS: Central vertigo was the most common type of vertigo in the study group (59,6% of cases). Other vertigo types in this group included compensated vertigo of mixed origin (36,6% of cases) and peripheral vertigo (only 3,8% of cases), which indicates that 40.4% of the cases suffer from damage to the labyrinth. The analysis of the concentration of estradiol in the blood serum revealed, after consideration of a menstrual cycle phase, that estradiol concentration exceeded normative values significantly more often in the study group than in the control group and that estradiol concentration was significantly less frequently below the norm in the study group; the difference was statistically significant (p=0,048). The body mass index (BMI) of women participating in the study significantly correlated with the concentration of D-dimers only in the study group (p=0,35 vs p=0,012). CONCLUSIONS: Evaluating the body mass index before administering hormonal contraception can be useful to eliminate other risk factors for thromboembolism. In order to prevent potential thromboembolism episodes, administering hormonal contraception only after lowering the body mass index may also be worth considering.

Effects of oral contraceptives on selected parameters of the homeostatic control system in young women having a sudden disorder of the auditory and/or balance system.

The purpose of the paper was to assess the effects of oral contraceptives on selected parameters of the homeostatic control system in women having a sudden disorder of the auditory and/or balance system. The study included 105 young women divided into two groups: Group I--52 women with the disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 20-49; and Group II--53 women without any disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 18-40. The patients included in the study underwent a full otoneurological evaluation, detailed laryngological diagnostics and an evaluation of selected parameters of the homeostatic control system--fibrinogen level, D-dimer level, evaluation of APTT and PT indicator, plasma estradiol and progesterone with the Roche Cobas analyser by means of chemiluminescence. The vertigo occurring in the study group was most often central (59.6% of cases), mixed with compensation in 36.6% of cases, and peripheral only in 3.8% of cases, indicating labyrinth damage in 40.4% of cases. An analysis of the progesterone level, considering the menstrual cycle phase in the group, showed that its value was abnormal in 51.0% of women in the study group and 47.1% in the control group. In their own studies, the authors observed that the estradiol level in the plasma, considering the menstrual cycle phase in the study group, was abnormal in 41.2% of women and that the differences in its concentration were statistically significant in the study and control groups (p = 0.005), which may have a negative impact on the possibility of a thromboembolic episode.

[Neoplastic tumors in patients with unilateral inflammations qualified for endoscopic surgery]. / Guzy nowotworowe u chorych z jednostronnymi zmianami zapalnymi zakwalifikowanymi do operacji endoskopowych.

INTRODUCTION: The aim of this work was to analyze the occurrence and type of neoplasm in unilateral pathological lesions within the nose and paranasal sinuses in patients who underwent endoscopic surgery, in own material. MATERIAL AND METHODS: Between 2006 and 2012 2295 patients, including 1006 women aged 15-84 and 1289 men aged 17-87, were operated on due to diseases of paranasal sinuses in the Department of Otolaryngology and Laryngological Oncology. The patients underwent surgery after a medical interview, physical examination, 3D CT of paranasal sinuses and laboratory tests. The removed lesions were histopathologically investigated. The studied group included the patients with only unilateral lesions and histopathologically recognized neoplastic lesion. RESULTS: In the studied material, neoplastic lesions occurred in 9.8% cases, out of which 5.4% were inverted papillomas, 3.1% osteomas, and 1.5% malignant tumors. However, in the patients who were operated due to hypertrophic changes within paranasal sinuses, neoplasm was found in 1.3% cases, while inverted papilloma in 0.7%, osteoma in 0.4% and malignant tumors in 0.1%, which altogether amounts to 8 times higher occurrence of neoplastic lesions in unilateral changes. RESULTS: Unilateral changes within paranasal sinuses require highly inquisitive pre-operative diagnostics, peri-operative analysis and histopathological evaluation.

[Internal and external chordectomy via laryngofissure with the use of CO2 laser]. / Chordektomia wewnetrzna i zewnetrzna poprzez rozszczepienie krtani i zastosowaniem lasera CO2.

INTRODUCTION: The aim of this work was to evaluate the therapy results of patients with glottic carcinoma in the T1NoMo advanced clinical stage on internal or external chordectomy via the thyroid cartilage with the use of CO2 laser. MATERIAL AND METHODS: The study was conducted in 110 patients, including 7 women aged 52-68 and 103 men aged 52-73, who were treated in the Department of Otolaryngology and Laryngological Oncology, Military Medical Academy Teaching Hospital in Lodz, during the years 2010-2012, due to laryngeal carcinoma (T1N0M0). RESULTS: The studied material was subjected to external chordectomy via laryngofissure in 51 men (46.4%), and internal chordectomy with the use of CO2 laser in 52 men (47.2%) and 7 women (6.4%). In the patients operated via laryngofissure, the following types of external chordectomy were performed: IV - in 25 cases (49.0%), Vc - in 12 cases (23.6%), and Vb and Vd - in 7 cases each (13.7% each). Internal chordectomy was conducted with the use of the following types: III - in 31 cases (52.5%), IV - in 15 cases (25.4%) and Vd - in 13 cases (22.1%). During the post-operative follow-up of 1-3 years, no recurrence of carcinoma was observed. CONCLUSIONS: The place and size of carcinoma are often dependent on the type of internal and external chordectomy, which is preceded by tracheotomy and is usually dependent on a patient's consent. Too short post-operative follow-up does not allow for the comparison of effective therapies of the two surgical methods.

Inflammation of the frontal intersinus septal air cell as a cause of headaches.

INTRODUCTION: The aim of this paper is to present a rare case of frontal intersinus septal air cell inflammation as a cause of headaches. PRESENTATION OF CASE: A 23-year-old patient was admitted to the Department of Otolaryngology and Laryngological Oncology for severe headaches during an upper respiratory tract infection. After neurological consultation including brain MRI and CT scanning of the paranasal sinuses, the inflammation of the frontal intersinus septal air cell was diagnosed. After examination, the patient was qualified for external osteoplasty. Under general endotracheal anaesthesia, the frontal intersinus septal air cell was intraoperatively opened from the side of the right frontal sinus, the mucoid content was aspirated and a plate of bone was removed. The patient reported complete relief from headaches on the second day after surgery. DISCUSSION: According to the previous studies, the frontal intersinus septal cell is more frequent in patients with frontal sinus inflammation than in the patients without inflammatory changes. Further, the conducted research indicates that its occurrence does not result in significant disorders in the drainage and ventilation of the frontal sinuses, and as such is not likely to be the cause of inflammation. CONCLUSION: In the case of inflammatory changes in the frontal intersinus septal air cell without concomitant frontal or ethmoid sinusitis, surgery via the external approach appears to be an effective method for the radical removal of pathological changes.

[Inverted papilloma of the nose and paranasal sinuses in own material]. / Brodawczaki odwrócone nosa i zatok przynosowych w materiale wlasnym.

INTRODUCTION: The aim of this work was to analyze the occurrence of inverted papilloma within the nose and paranasal sinuses, the extent of lesions and the clinical course in the patients who underwent endoscopic surgery. MATERIALS AND METHODS: Between the years of 2006-2012, at the Department of Otolaryngology and Laryngological Oncology, 2295 patients were subjected to surgery due to paranasal sinus diseases. The material was based on their past medical histories. The analysis includes the age and gender of the patients, the type of surgery, and results of histopathological examinations. A surgical procedure covered the paranasal sinuses with lesions diagnosed in CT. The qualified patients had inverted papilloma in histopathological results. RESULTS: Among 2295 patients who were operated because of chronic inflammatory changes, inverted papilloma was histopathologically diagnosed in 49 cases. In 16 patients with inverted papilloma, inflammatory changes were present on one side only, while in 33 cases inverted papilloma was confirmed histopathologically on one side. The analysis of age and gender of the study group showed that the highest occurrence of inverted papilloma was in patients over 50 years of age. In the majority of the studied cases, inverted papilloma spread in the middle nasal concha and the maxillary or ethmoid sinus. CONCLUSIONS: In surgery, the endoscopic technique allows for an effective removal of inverted papilloma from the nose and paranasal sinuses. According to the authors, endoscopy is the most valuable method for post-operative monitoring of recurrent inverted papilloma.

The use of videonystagmography head impulse test (VHIT) in the diagnostics of semicircular canal injuries in patients with vertigo.

OBJECTIVES: The aim of the study was to assess the function of semicircular canal in videonystagmography head impulse test (VHIT) in the patients with vertigo and balance disorders. MATERIAL AND METHODS: The study was performed in 135 patients (86 women and 49 men) aged 22-79 years, who were divided into 2 groups: I (study group) - 73 patients with vertigo of peripheral, central or mixed origin, II (control group) - 62 patients without vertigo (healthy individuals). The function of canal was determined on the basis of GAIN and expressed as DG/RH×100% (where DG is deviation of gaze and RH is rotation of head). RESULTS: In the study group the semicircular canal injuries were found in 37 (50.69%) patients, including 24 (32.87%) patients with 1 injury and 13 (17.8%) patients with 2 or more injuries in semicircular canal. The injured anterior semicircular canal was reported 13 times; the lateral - 9 times and the posterior - 31 times. CONCLUSIONS: In the study group, in the VHIT, injuries in semicircular canals were reported in peripheral vertigo, mixed vertigo with non-compensated and compensated function of the labyrinth in 50.68% cases, whereas in the caloric test dysfunction of the labyrinth was found in 58.49% cases.

[Anatomical anomalies of the vertebral and carotid arteries in patients with vertigo and hearing disorders]. / Anomalie anatomiczne tetnic doczaszkowych u chorych z zawrotami glowy i zaburzeniami sluchu.

INTRODUCTION: The aim of this work was the analysis of the frequency and type of anatomical anomalies of the arteries to the cranium such as vertebral arteries and carotid arteries in patients with vertigo and hearing disorders. MATERIAL AND METHODS: Between 2007 and 2011, in the Department of Otolaryngology and Laryngological Oncology, the number of the patients diagnosed due to vertigo and hearing disorders amounted to 2,167. In CT-angiogram anatomical anomalies were confirmed in 29 of these patients. The studied group included 22 women aged 22-68 and 7 men aged 21-53. Each patient underwent a subjective and objective structured laryngological interview, audiological and otoneurological examinations, laboratory tests, USG and angio-CT of the arteries to the cranium. RESULTS: The most common anatomical anomaly of the arteries to the cranium was hypoplasia of the right vertebral artery in 58.7% of the cases, out of which 51.7% in women and 6.9% in men. Hypoplasia of the left vertebral artery was diagnosed in 24.7% of the studied group, 13.8% of women and 10.3% of men. Hypoplasia of the right internal carotid artery was found in 3.4% of the female patients while hypoplasia of the left internal carotid artery was identified in 6.8% of the studied cases, 3.4% of women and 3.4% of men. Hypoplasia of the right common carotid artery was confirmed in 3.4% of the male patients whereas critical stenosis of the left subclavian artery with the subclavian steal syndrome was found in 3.4% of the studied female patients. Tinnitus was reported in 88.2% of the patients with diagnosed right vertebral artery hypoplasia, and in 58.8% vertigo and in 52.9% hearing disorders were confirmed. Tinnitus was the most common complaint in the studied group, both in men and women. Less frequent complaints referred to vertigo (65.5% altogether) and hearing impairment (55.2% altogether). CONCLUSIONS: In the analyzed group, diagnosed anatomical anomalies were not indications for vascular surgery nor neurosurgery, therefore, the applied treatment was strictly conservative.

[Early complications of Griggs percutaneous tracheotomy in own material]. / Wczesne powiklania tracheotomii przezskórnej metoda Griggsa w materiale wlasnym.

INTRODUCTION: The aim of the work was to assess early complications of Griggs percutaneous tracheotomy in the own material. MATERIAL AND METHODS: The study covered 155 patients aged 17-88, including 36 women and 119 men. The patients were treated at the Department of Anaesthesiology and Intensive Therapy between 2006-2010. They underwent Griggs percutaneous tracheostomy by a laryngologist or a trained anaesthesiologist. Each surgical procedure was conducted with the use of Portex Blue Line Ultra Percutaneous Tracheotomy Kit (Smiths Medical Co., USA), the trachea was intubated while the patient was under general anaesthesia with propofol, fentanyl and relaxation with atracurium. RESULTS: The studied material revealed Griggs percutaneous tracheotomy complications in 26 patients (16.8%), in which 11 patients (7.1%) presented complications within the perioperative period while 15 patients (9.7%) reported early complications. Haemorrhage, usually not very profuse, occurred 7 times (4.6%), mainly in tracheopunction, and was the most often perioperative complication. Moreover, in the perioperative period, 3 patients (1.9%) had trachea identifications difficulties, which required tracheopunction many a time, and 1 patient (0.65%) encountered sudden circulatory arrest with asystolia and effective CPR. In the early postoperative period after Griggs percutaneous tracheotomy, the most common complication was haemorrhage in the operative twenty-four hours, which was noted in 10 patients (6.5%). Among other adverse complications were found: infection of the tissues near the tracheostomal region in 3 patients (1.9%), subcutaneous oedema in 1 patient (0.65%), accidental removing the tube from an unformed tracheostoma in 1 patient (0.65%). CONCLUSIONS: In the studied material, complications after Griggs percutaneous tracheotomy amounted to 16.8%, of which 7.1% occurred in the perioperative period while 9.7% were early complications, mainly light bleeding. This may prove good preparation of the surgical team for the surgical procedures.

[Posterior cranial fossa tumours as a cause of sudden hearing deterioration and/or vertigo]. / Guzy tylnego dolu czaszki jako przyczyna naglego pogorszenia sluchu i/lub wystapienia zawrotów glowy.

INTRODUCTION: The aim of the work was to analyse sudden deterioration of hearing and/or vertigo occurrence as an early symptom of posterior cranial fossa tumours. MATERIAL AND METHODS: Among 1.394 people who reported vertigo and hearing impairment and were hospitalised at the Department of Otolaryngology and Laryngological Oncology Military Teaching Hospital in Lodz within the years of 2007-2010 twenty-seven patients were analysed. This group included 19 women aged 20-80 (mean age 45.7 years) and 8 men aged 25-73 (mean age 54.0 years) who had posterior cranial fossa tumours diagnosed on the basis of MRI. Each patient underwent a detailed interview, otorhinolaryngological and otoneurological examinations, pure tone, speech and impedance audiometry, suprathreshold tests (SISI, TDT), tinnitus pitch and frequency evaluation, auditory brainstem response (ABR), complete videonystagmography. RESULTS: The studied material revealed: acoustic neuroma in 15 patients, cerebellar meningioma in 5 patients, cerebellar cyst in 4 patients and cerebellar angioma in 3 patients. Sudden vertigo was present in 27 patients, including mixed-type vertigo in 15 cases and central vertigo in 12 cases. In 19 patients dizziness was accompanied by tinnitus. In 22 patients hearing disorders were diagnosed in a form of: sensorineural hearing loss in 14 subjects, bilateral in 7 subjects, left-lateral in 5 subjects and right-lateral in 2 subjects respectively, as well as deafness in 8 patients, including left ear deafness in 5 cases, right ear deafness in 1 case and bilateral deafness in 2 cases (7.4%). CONCLUSIONS: The early phase diagnosis of a posterior cranial fossa tumour as a cause of sudden hearing deterioration and/or vertigo is very seldom and often accidental because GPs, also otolaryngologists, who follow routine and economy, are not used to referring given patients for complete and objective audiological, otoneurological and imaging diagnostics.

DNA damage and repair of head and neck cancer cells after radio- and chemotherapy.

DNA repair is critical for successful chemo- and radiotherapy of human tumours, because their genotoxic sensitivity may vary in different types of cancer cells. In this study we have compared DNA damage and the efficiency of its repair after genotoxic treatment with hydrogen peroxide, cisplatin and gamma-radiation of head and neck squamous cell carcinoma (HNSCC). Lymphocytes and tissue cells from biopsies of 37 cancer patients and 35 healthy donors as well as the HTB-43 larynx cancer cell line were employed. The cell sensitivity to genotoxic treatment was estimated by the MTT survival assay. The extent of DNA damage and efficiency of its repair was examined by the alkaline comet assay. Among the examined treatments, we found that HNSCC cells were the most sensitive to gamma-radiation and displayed impaired DNA repair. In particular, DNA damage was repaired less effectively in cells from HNSCC metastasis than healthy controls. In conclusion, our results suggest that the different genotoxic sensitivity of HNSCC cells may depend on their DNA repair capacity what in turn may be connected with the effectiveness of head and neck cancer therapy.

[The rare case of the multiple primary planoepithelial laryngeal cancer and clarocellular renal cancer]. / Rzadki przypadek pierwotnego mnogiego raka plaskonablonkowego krtani i jasnokomórkowego nerki.

The authors present a rare case of the primary multiple planoepithelial laryngeal cancer and clarocellular renal cancer in a patient operated in the Clinic. The patient, called EJ., was admitted to the Clinic of Otolaryngology and Laryngological Oncology due to hoarse voice he had been suffering for 6 months. On the interview with the patient, otolaryngological and videolaryngostroboscopic examinations we diagnosed hypertrophic changes in the whole length of the right vocal fold with the fold mobility preserved. The hypertrophic changes in the right vocal fold were removed by Kleinsasser direct microlaryngoscopy. However, the histopathological examination showed carcinoma planoepitheliale keratodes infiltrans mucosae laryngis G-2. In the further treatment the patient was qualified to the dexter chordectomy by the CO2 laser. The histopathological examination confirmed the total removal of the changes within the healthy cells. After about one year from the completed laryngological treatment the patient visited the urological outpatient clinic due to pain ailments in the right lumbar part. The urographic examination and CT of the abdominal cavity showed a tumour (8 x 9 cm), in the right kidney. The patient was admitted to the 1st Clinic of Urology the Chair of Urology and qualified to the dexter nephrectomy. Following the operation the histopathological examination indicated carcinoma clarocellulare partim cysticum renis dextri. Class, Fuhrman 20, pT2 Nx Mx. The hyperplasia limited to the renal parenchyma. Cut-off lines of the ureter and vessels without neoplastic infiltration. The patient remains under constant catamnesis at the urological and laryngological outpatient clinic, no symptoms of the neoplasm relapse.

[Tinnitus diagnosis and treatment on the basis of our experiences]. / Diagnostyka i leczenie szumów usznych na podstawie wlasnych doswiadczen.

INTRODUCTION: The aim of the study was to analise tinnitus diagnosis and treatment on the basis of our experiences. MATERIAL AND METHODS: 137 patients hospitalizated in Otolaryngology and Laryngological Oncology Clinic because of tinnitus (88 women - 64% and 49 men - 35,8%) were included to the study. The diagnostic procedures were unified that enabled put forward correct diagnosis. After history and otoscopy, detailed audiologic diagnostic procedures (pure tone audiometry, suprathreshold audiometry, speech audiometry, acoustic immittance measures, auditory brainstem responses) were taken. Electronystagmography and videonystagmography, tinnitus loudness match, head and neck radiologic examinations supplemented diagnostic procedures. Alternative tinnitus treatment options were applied. RESULTS: Study confirmed that tinnitus is the most frequent in patients above 50 years old (67,8% of participants). Tinnitus frequently coexist with bilateral sensorineural hearing impairment (69,1% of participants). 40,1% from asalysed group of patients complained of tinnitus of medium frequencies and 30,6% of patients complained of high frequency tinnitus. 42,3% of participants suffered from vertigo. CONCLUSIONS: The risk of tinnitus increases in patients above 55 years old that suffer from metabolic conditions and cervical spondylosis. Tinnitus frequently coexist with bilateral sensorineural hearing impairment and are bilateral or they are noticeable in better hearing ear. The most beneficial to tinnitus is causal and symptomatic treatment with several methods application.

[Comparative assessment of results in cervical vertigo pharmacotherapy vs physiotherapy treatment]. / Porównawcza ocena wyników leczenia zawrotów glowy pochodzenia szyjnego za pomoca farmakoterapii lub fizjoterapii.

INTRODUCTION: The aim of the study was to assess the effectiveness of pharmacotherapy and physiotherapy in cervical vertigo treatment. MATERIAL AND METHODS: 80 patients with cervical vertigo (41 women and 39 men), aged 20 to 85, were treated by pharmacotherapy or physiotherapy. There were two groups: group I was treated by pharmacotherapy and group II was treated by physiotherapy and kinesitherapy. The effects of vertigo treatment were assessed by positional nystagmus testing according to Cawthorne and Rosen; cervical nystagmus testing in neck rotation test; by everyday task self-control cards and vertigo staging system according to Silvoniemi (0-4 points). The effects of treatment were assessed before therapy, 6 and 12 weeks after therapy. Patients from group I were treated by Nootropil and Betaserc; group II received magnetic Fidel, laserotherapy, massage and kinesitherapy exercises. RESULTS: The obtained results showed that the most useful methods of cervical vertigo diagnosis were neck rotation test and Rose method. The average number of points (according to Silvoniemi scale) on the basis of ten everyday activities, was lower after 6 weeks of treatment than before the treatment and the lowest after 12 weeks of treatment. The difference was higher in group II than in group I. CONCLUSIONS: Patients treated by physiotherapy (group II) performed better in everyday activities than the patients treated by pharmacotherapy (group I). Cervical vertigo treatment by physiotherapy is cheap and underestimated method.

[Influence of positional blood flow disorders in the vertebral and basilar arteries on the prevalence of vertigo in patients with cervical spondylosis]. / Ocena wplywu czynnosciowych zaburzen predkosci przeplywu w tetnicach kregowych i w tetnicy podstawnej na wystepowanie zawrotów glowy u pacjentów ze zmianami zwyrodnieniowymi odcinka szyjnego kregoslupa.

The aim of present study was to characterize the association between prevalence of vertigo and age, grade of radiological changes and positional vertebral (VA) and basilar artery (BA) flow lesion in patients with cervical spondylosis. We examined 80 patients with radiological evidence of cervical spondylosis. Forty patients complained positional vertigo. Patients with neurological symptoms were excluded from the study. ENG was used to exclude patients with another causes of vertigo. TCD evaluations of the distal part of VA and the proximal part of BA were performed with a 2-MHz probe via the suboccipital window. We showed significant and independent association between prevalence of vertigo and age, grade of radiological changes, and positional vertebral and basilar artery flow lesion velocity in multivariate logistic regression model. Spondylotic-induced VA compression may be the reason of decreased blood flow velocity in the basilar artery during head rotation, causing positional vertigo.

[Phlegmon neck and face as a complication peritonsillar abscess--case report]. / Ropowica tkanek miekkich szyi i twarzy jako powiklanie ropnia okolomigdalkowego--opis przypadku.

The authors describe a 46-year-old male patient. Inflammatory state of tonsils and peritonsillar abscess caused a serious complication which came to parapharyngeal phlegmon and superficial soft tissue phlegmon face and neck. A wide application of antibiotic gives a rare complication, but mortality reaches a few percent. A basic method is a surgical treatment--a wide cut of tissues in many places, to drainage interfascia space and compound aim intravenous antibiotic therapy.