The use of pulse transit time in diagnostics of sleep-disordered breathing in children.

INTRODUCTION: Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres. Disordered breathing during sleep impairs its morphology and results in major disorders in any age group. Adverse effects of Obstructive Sleep Apnea Syndrome in children and poor availability of centers offering children's polysomnography call for a reliable and easily accessible screening method. AIM: The aim of the study were to evaluate the usefulness of pulse transit time in the diagnostics of disordered sleep breathing in children and to attempt to employ the parameter in screening tests. Pulse transit time is a physiological parameter determining the time needed for the pulse wave to travel between two measurement points. MATERIAL AND METHODS: Enrolled in the retrospective study were 153 patients (100 boys and 53 girls) suspected of obstructive sleep apnea syndrome who underwent polysomnography at I. Moscicki ENT Hospital in Chorzów. RESULTS: Statistically significant relations between apnea/hypopnea index and pulse transit time were observed in both, individual age groups and all of the patients. Pulse transit time results proved a negative correlation with apnea/hypopnea index values commonly accepted as a parameter concluding the polysomnography procedures. CONCLUSIONS: The results of the study indicate that pulse transit time measurements may find application in screening tests of sleep-disordered breathing in children.

Reconstruction of Ovine Trachea with a Biomimetic Composite Biomaterial.

The aim of this study was to evaluate a novel composite material for tracheal reconstruction in an ovine model. A polymer containing various forms of carbon fibers (roving, woven, and nonwoven fabric) impregnated with polysulfone (PSU) was used to create cylindrical tracheal implants, 3 cm in length and 2.5 cm in diameter. Each implant, reinforced with five rings made of PSU-impregnated carbon-fiber roving, had three external layers made of carbon-fiber woven fabric and the inner layer formed of carbon-fiber nonwoven fabric. The inner surface of five implants was additionally coated with polyurethane (PU), to promote migration of respiratory epithelium. The implants were used to repair tracheal defects (involving four tracheal rings) in 10 sheep (9-12 months of age; 40-50 kg body weight). Macroscopic and microscopic characteristics of the implants and tracheal anastomoses were examined 4 and 24 weeks after implantation. At the end of the follow-up period, outer surfaces of the implants were covered with the tissue which to various degree resembled histological structure of normal tracheal wall. In turn, inner surfaces of the prostheses were covered only with vascularized connective tissue. Inner polyurethane coating did not improve the outcomes of tracheal reconstruction and promoted excessive granulation, which contributed to moderate to severe stenosis at the tracheal anastomoses. The hereby presented preliminary findings constitute a valuable source of data for future research on a tracheal implant being optimally adjusted for medical needs.

The surgical treatment results of otosclerosis at the Department of Otolaryngology Silesian Medical University in Zabrze in years 2000-2010.

BACKGROUND: Otosclerosis is a cause of 5-9% of all hearing loss. The most effective treatment of otoslerosis is stapedotomy. AIM: The aim of this study was to evaluate the results of otosclerosis surgical treatment and to examine the impact of disease stage, time of the signs, age and sex on the results. MATERIAL AND METHODS: 105 patients who underwent operation due to otosclerosis at the Department of Otolaryngology University Hospital in Zabrze at the age of 18-65 were analyzed. In 25 patients stapedotomy was bilateral. 130 cases of treated ears were included in the statistical analysis. The state of hearing after operation was evaluated with regard to guidance of Hearing and Balance Committee of American Academy of Otolaryngology - Head and Neck Surgery and with consideration of suggestions made by European Academy of Otolaryngology and Neurootology. Mean values of bone and air conduction, air bone gap before, one year after treatment, and at least 4 years after surgery were compared. The influence of stage of the disease in terms of Shambaugh index, lasting of signs, age and sex were evaluated with regard to change of mean hearing loss according to Bell Telephone Laboratories. RESULTS: On the basis of hearing examination evaluating improvement in air and bone conduction and reduction of cochlear reserve, very good and good treatment results were obtained in over 90% of patients in short and long term observations. No influence of disease stage, time of signs lasting, age and sex on the results of treatment - with regard to change in mean hearing loss was shown.

[Operation treatment results of laryngeal cancer in different types of partial laryngectomy based on own material]. / Wyniki leczenia operacyjnego raka krtani w róznych typach laryngektomii czesciowej na podstawie materialu wlasnego.

THE AIM: of the study was to evaluate the oncological results of laryngeal cancer treatment performed in the Laryngology University Ward in Zabrze in the years 1990-2000, depending on the type of partial surgery applied. MATERIALS AND METHODS: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. In all 209 patients the squamous cell carcinoma of various degree of malignancy (G1-G3) was found. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), next, vertical partial laryngectomies - 38 (18%), horizontal glottis surgeries - 28 (13%). In 79 patients (38%) partial laryngectomy was complemented with a nodal operation. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to overall survival, disease-free survival, cause specific survival and local control. All the above-mentioned parameters were analyzed with the updated percentages method. The level of statistical significance was assumed to be p≤0.05. RESULTS: The best oncological results were observed after vertical operations. In the vertical operations group the most favourable oncological results were noted after chordectomy. 83% overall survivals, 82% disease-free survivals, 93% cause specific survivals and 96% local controls in the 5-year observation. On the other hand, the least favourable treatment results were observed after ¾ subtotal partial operation, after horizontal supraglottic operation and after reconstruction operation with CHP. Statistically significant differences in treatment results between the groups of patients after various types of partial operations were found in relation to local controls and disease-free survivals.

Influence of aging on medial olivocochlear system function.

BACKGROUND: There is still controversy regarding the influence of aging on medial olivocochlear (MOC) system function. The main objective of this study is to measure age-related changes of MOC system function in people with normal hearing thresholds. METHOD: Bilateral assessment of the MOC effect for click-evoked otoacoustic emissions (CEOAEs; at 70±3 dB peak sound pressure level [pSPL], click at 50/second, 260 repeats, 2.5-20 millisecond window) and for distortion product otoacoustic emissions (DPOAEs; with [frequencies] f2/f1=1.22, [levels of primary tones] L1=65 dB SPL and L2=55 dB SPL; DP-grams for 2f1-f2 were collected for the f1 frequencies varying from 977 Hz to 5,164 kHz, with the resolution of four points per octave) was performed in a group of 146 (n=292 ears) healthy, right-handed subjects aged from 10-60 years with a bilateral hearing threshold from 0.25-4.0 kHz, not exceeding 20 dB hearing level; normal tympanograms; and a threshold of the contralateral stapedial reflex for broadband noise (BBN) of 75 dB SPL or higher. The MOC inhibition was assessed on the basis of changes in OAE level during BBN contralateral stimulation at 50 dB sensation level (mean, 65±3 dB SPL). RESULTS: Comparative analysis of the MOC effect for CEOAE and DPOAE showed the weakest effect in the oldest age group (41-60 years) at almost all tested frequencies. Moreover, a weak, albeit significant, positive correlation between the level of OAE and the size of the MOC effect was documented. CONCLUSION: On the basis of our study, we have found a decrease in the strength of the MOC system with increasing age in normally hearing subjects, as reflected by a decrease of the OAE suppression effects in older individuals and an increase of the number of CEOAE and DPOAE enhancements during contralateral acoustic stimulation in the elderly, especially in the high-frequency range.

Endoscopic evidence of reflux disease in the larynx.

CONCLUSION: The severity of laryngeal mucosal lesions in patients with gastroesophageal reflux disease (GERD) is significantly greater than in controls. A higher degree of laryngeal mucosal injury is documented in patients in whom GERD is associated with more advanced esophageal lesions. OBJECTIVES: (1) To confirm the presence of inflammatory lesions in the laryngopharynx of patients with GERD. (2) To analyze the relationship between the severity of laryngopharyngeal and esophageal lesions on the basis of the reflux finding score (RFS) and the Los Angeles (LA) scale of esophageal mucosal injury. METHODS: The study included 92 subjects, among them 46 patients with GERD and 46 individuals without endoscopic evidence of esophageal lesions, qualified for routine endoscopy due to other indications. The endoscopic images of the inferior pharynx, larynx, and esophagus were analyzed during the video-endoscopic examination of the upper gastrointestinal tract. The laryngeal images were assessed according to RFS criteria and the numeric value of RFS was calculated. The degree of esophageal mucosal injury was described according to the LA scale. RESULTS: Both global RFS score and the scores of all RFS parameters except the presence of granulomatous tissue were significantly higher in patients with GERD than in the controls. Patients in whom GERD was associated with more severe esophageal lesions (group B according to the LA scale) had significantly higher global RFS score and scores of all analyzed parameters of laryngeal injury except subglottic edema than individuals in whom the degree of esophageal involvement was classified as group A.

Evaluation of usefulness of hs-CRP and ferritin assays in patients with nasal polyps.

BACKGROUND: Chronic nature of the nasal polyps, tendency to recurrence, and lack of satisfying treatment need the diagnostic's parameters which show early inflammatory state as ferritin and hs-CRP. The Aim of Study. Assessment of hs-CRP and ferritin blood levels in nasal polyps patients in evaluation of treatment efficacy. METHODS: All 38 patients were divided into 2 groups. Group I included 19 patients with anti-inflammatory therapy 2 weeks after surgery. Group II included 19 patients without anti-inflammatory therapy 2 weeks after surgery. The levels of hs-CRP and ferritin have been assessed before and 2 and 6 weeks after surgical treatment. RESULTS: Research showed statistically significant difference of ferritin's concentration between examined groups 6 weeks after surgery (P < 0.05) and statistically significant difference of hs-CRP concentration 2 and 6 weeks after surgery (P < 0.05). CONCLUSION: (1) The analysis of serum ferritin and hs-CRP concentrations can be useful in early postoperative detection of inflammatory state in patients with nasal polyps and for the effectiveness of therapy. (2) Lack of correlation between mean ferritin and hs-CRP serum levels, at each diagnostic and monitoring stage, shows that they are independent and cannot be determined interchangeably.

[Results of radical surgery in group of 355 patients with advanced laryngeal cancer]. / Wyniki radykalnego leczenia chirurgicznego 355 chorych z zaawansowanym rakiem krtani.

INTRODUCTION: The aim of the study was to evaluate the results of radical surgery in group of 355 patients with advanced laryngeal cancer. MATERIAL AND METHOD: The paper presents results of treatment in group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998-2007. The advancement stage was defined as III in 147 patients (42%), as IV in 208 patients (58%). Group of 250 patients (70%) underwent total laryngectomy and group of 105 patients (30%) underwent pharyngolaryngectomy. In the group of 327 patients (92%) operation was performed microscopically radically. 298 patients (84%) underwent postoperative radiotherapy. Median follow-up period was 5 years. Local recurrence, nodal recurrence and distant metastasis were rated as treatment failure. Treatment effectiveness was evaluated in relation to overall survival, disease-free survival, local control, locoregional control and observation free from metastases. All of these parameters were analyzed with the method of updated percentages. RESULTS: During observation period 177 patients (50%) died. Local recurrence occurred in 47 patients (13%), nodal recurrence occurred in 19 patients (5%). Distant metastases occurred in 26 patients (7%). 5-year overall survival rate (OS) was 50%. 5-year disease-free survival rate (DFS) was 47%. 5-year local control rate (LC) was 81%. 5-year locoregional control rate (LRC) was 75%. The updated 5-year observation free from metastases rate (FFM) was 89% respectively. CONCLUSION: Radical surgery is the chance of 5-year survival of 50% of patients with advanced cancer of the larynx and of 5-year locoregional control of 75% patients.

[The influence of selected clinical and morphological factors on treatment results of patients with advanced cancer of the larynx]. / Wplyw wybranych czynników kliniczno-morfologicznych na wyniki leczenia chorych z zawansowanym rakiem krtani.

INTRODUCTION: The aim of the study was to indicate independent prognostic factors of treatment in group of patients with advanced cancer of the larynx. MATERIAL AND METHOD: The paper presents results of univariate and multivariate analysis of selected clinical and morphological factors in the group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998-2007. The analysis of the results of treatment in relation to clinical and morphological features of the tumor was based on overall survival, disease-free survival, local control and locoregional control. The results of analysis allowed to indicate the independent prognostic factors for outcome in patients with advanced laryngeal cancer. RESULTS: Univariate analysis showed that the increase of clinical advancement of laryngeal cancer was associated with worse prognosis, as well as the fact that the primary location of the tumor in supraglottis and infiltration in laryngeal part of pharynx determined the worse outcome. Univariate and multivariate analysis confirmed that the number of lymph node metastases in the surgical specimen and microscopic radical of surgery were the most important prognostic factors for survival and cure in the study group. CONCLUSION: The strongest independent prognostic significance for all efficacy criteria have: completeness of operation and number of metastatic lymph nodes.

Current view on nasal polyps management in Samter's triad patients.

UNLABELLED: The nasal polyps associated with Samter's triad are often very extensive, difficult to treat, with great tendency to recurrence. In this paper the current opinion on nasal polyps management in aspirin triad patients was presented. PATHOGENESIS: Opinions on pathogenesis of these disease was remembered as well as its epidemiology. DIAGNOSTIC METHODS: The available diagnostic methods were presented. Treatment options: The available preservative treatment options was analyzed including aspirin desensitization. The role of surgical treatment, functional endoscopic sinus surgery was analyzed.

Comparative assessment of the voice in patients treated for early glottis cancer by laser cordectomy or radiotherapy.

INTRODUCTION: Adaptation of laser surgery in laryngeal cancer treatment in 1970s led to great successes and common acceptation of this treatment method in cancer treatment. The results of cancer treatment with CO(2) laser are the same as after radiotherapy or external access method. MATERIAL AND METHODS: The study included 63 patients treated for glottis cancer T1. 33 persons were treated by cordectomy type III with transmuscular cordectomy using CO(2) laser. The remaining 30 persons are patients treated using radiotherapy with so called "small spots". The tested material consisted of 100% squamosus carcinoma. The patients qualified for the examination received a card of voice self-examination. The perceptive examination of the voice was performed according to the GRBAS scale where each of parameters is defined in a four degree scale of the particular disturbance degree. The mobility and vibrations of the vocal folds were accessed using videolaryngoscopy while the acoustic analysis was performed on the basis of the acoustic analysis module. RESULTS: On the basis of the patients' voice quality self-assessment and the perceptive assessment of the voice quality based on the GRBAS scale, no significant differences between the groups were found. Furthermore no statistically significant differences were found for the phonation closure and maximal phonation time in both groups.

[Postoperative vertigo caused by too long stapes prosthesis--radiological diagnostics]. / Pooperacyjne zawroty glowy zwiazane z nadmierna dlugoscia protezki strzemiaczka--diagnostyka radiologiczna.

The aim of the study was to describe the value of High Resolution Computed Tomography (HRCT) with MPR and VR reconstruction of the temporal bone in patients with persistent vertigo after stapedotomy. High Resolution Computed Tomography with MPR and VR reconstruction of the temporal bone in the axial and coronal planes with 0.625 - mm slice thickness were performed in 2 patients with persistent vertigo after stapedotomy. Persistent vertigo were observed in 2 patients suffered from otosclerosis several months after stapedotomy. High Resolution Computed Tomography with MPR and VR reconstruction of the temporal bone showed in both cases too long stapes prosthesis. On the base of HRCT results restapedotomy and length reduction of stapes prosthesis were done. The vertigo was resolved in all the cases with revision surgery. HRCT with MPR and VR reconstruction can diagnosed the possible cause of persistent vertigo in patients after stapedotomy.

An updated view on tuberculous lymphadenitis in the context of HIV epidemic as well as multidrug and extensively drug-resistant tuberculosis.

BACKGROUND: An updated view on tuberculous lymphadenitis was presented in this paper. OBJECTIVES: This article describes tuberculous lymphadenitis as the most common presentation of extrapulmonary tuberculosis and reviews its epidemiology, clinical aspects, diagnosis and treatment methods. The role of surgical procedures was also underlined. MATERIAL AND METHODS: Since the 1990's, the incidence and severity of tuberculosis - particularly the prevalence of extrapulmonary tuberculosis - are increasing internationally, mainly due to the HIV epidemic and the emergence of multidrug-resistant and extensively drug-resistant strains. Hence, tuberculosis is once again a serious global problem not only in the developing countries of Africa or South East Asia, but also in highly-developed communities. CONCLUSIONS: The latest data suggest that tuberculosis should be included in the list of differential diagnoses for all neck lymph node involvements, even in the absence of pulmonary involvement, in HIV-positive patients. If the otolaryngologist maintains a high index of suspicion, an early diagnosis can be made to contribute to more successful outcome of the disease.

[Cochlea development in infants with central nervous system impairment occurring as an effect of perinatal asphyxia]. / Rozwój slimaka u niemowlat ze zmianami w obrebie osrodkowego ukladu nerwowego powstalymi w nastepstwie asfiksji okoloporodowej.

UNLABELLED: Asphyxia in neonates with inadequate blood-inner ear barrier function causes damage to the inner ear included the degeneration of outer hair cells of the organ of Corti and oedematous changes in stria vascularis. The major consequences in the central nervous system (CNS) are found to be hypoxic-ischemic encephalopathy (HIE) in term newborns, peri- (PVH) or intraventricular hemorrhages (IVH) and periventricular leucomalacia (PVL) in preterm neonates. THE AIM OF THE STUDY: was to carry out the objective assessment of the cochlea development using CEOAEs in infants with CNS impairment occurring as an effect of perinatal asphyxia, imaged during trans-fontanel ultrasonography. MATERIAL AND METHODS: To the investigation 36 infants with HIE, IVH or PVL were included, the control group encompassed 32 born at term, health children. In all children three times otoscopic examination and CEOAEs recordings were performed: after birth, in 3rd and in 6th month of life using Otodynamics Otoacoustic Analyser ILO-88 in Quick Screen version. Perinatal anamnesis, general pediatric status, results of trans-fontanel ultrasonography and biochemical test results were taken into account in statistical analyses. RESULTS: The mean amplitudes of CEOAEs in the first days of life were significantly reduced in InvG comparing to control babies. In half-octave frequency bandwidth analysis significant reduction of S/N Ratio at 1,5­4 kHz in InvG was observed. 3 and 6 months later the recorded responses significantly increased, they didn't reach values of CG but no statistical differences between groups were observed. CONCLUSION: In conclusion, the outer hair cells activity in first days of life is reduced in newborns with CNS impairment and perinatal asphyxia in anamnesis comparing to health children. The maturation of the cochlea is intensive during first 3 months of life, later only subtle changes in CEOAEs are observed.

[The quality of voice in coal-miners after burn/inhalation injury due to methane explosion]. / Jakosc glosu u górników po urazie inhalacyjnym górnych dróg oddechowych w wyniku wybuchu metanu.

The job as a coal-miner exposes to the greatest risk. One of the most dangerous health hazard is a burn/inhalation injury during the methane explosion. The victims undergo physical trauma, effect of high temperature and inhalation of toxic gases and products of incomplete combustion, As a result of inhalation injury both, upper and lower airways are affected. The aim of the study was to analyse the relationship between burn/inhalation injury and quality of voice in affected coal-miners. A group of 23 patients (men) in age from 28 to 59 (mean 38.5) 3 years after burn/inhalation injury participated in this study. The voice evaluation based on ENT examination, videlaryngostroboscopy, acoustic analysis, MPT parameter and GRBAS analysis was performed. The special control group of coal-miners served as a control. On the basis of the subjective evaluation and the objective acoustic analysis, aerodynamic parameter and videlaryngostroboscopy the worse quality of voice in the group of injured coalminers was shown in comparison to the control group. No substantial correlation between the acoustic parameters, MPT parameter and ventilating rates was found.

[Usefulness of laser arytenoidectomy and laterofixation in treatment of bilateral vocal cord paralysis]. / Przydatnosc arytenoidektomii laserowej i laterofiksacji w leczeniu obustronnego porazenia faldów glosowych.

INTRODUCTION: Bilateral vocal cord paralysis is caused by the damage of both recurrent laryngeal nerves. Such a pathology is not commonplace in the ordinary medical practice. It most often occurs as a complication after the thyroid gland surgery or thyroid re-surgery. In the case of bilateral vocal cord paralysis the treatment of the patient includes performing immediate tracheotomy or one of the surgeries aiming at widening the glottis because of dyspnea caused by the upper respiratory tract obstruction on the glottis level. AIM: The comparison of efficacy and usefulness of two surgical techniques performed to widen the glottis ­ laser arytenoidectomy with posterior cordectomy and laterofixation. MATERIAL AND METHODS: The research was carried out on the group of 57 patients suffering from bilateral vocal cord paralysis who, in the period of 1997­2009, underwent treatment in ENT Department in Zabrze Medical University of Silesia in Katowice. The first group included 36 patients who underwent laser arytenoidectomy with posterior chordectomy. The second group included 21 patients who underwent laterofixation. All of the patients treated with the laser arytenoidectomy with posterior cordectomy and laterofixation were subjected to respiratory system ventilation examinations before the procedure of widening the glottis and after the healing, at least 4 months after the surgery. Making self-evaluation, each of the patients answered a question concerning the improvement of their breathing comfort after the surgery. The patients from both groups underwent the vocal apparatus examination which included: subjective perceptive voice analysis according to GRBAS scale, videolaryngostroboscopy, evaluation of the maximum phonation time, self-evaluation survey of the post-surgical voice quality. RESULTS: Among 57 patients suffering from bilateral vocal cord paralysis and operated by arytenoidectomy with posterior cordectomy (group I) and laterofixation (group II), a subjective improvement of the comfort of living was achieved which resulted in the possibility of making more physical activities. From the first group, 35 out of 36 patients were decannulated. In the second group, both patients who had previously undergone tracheotomy were successfully decannulated. There were no statistically significant differences in the increase of selected ventilation markers between the patients who underwent laser arytenoidectomy and those who underwent laterofixation. There were no substantial discrepancies in the perceptive voice analysis in GRBAS scale between the patients after laser arytenoidectomy and those treated with the technique of laterofixation. When asked about their post-surgical voice quality, the patients of the first and the second group rated their voice as worse than before the surgery. CONCLUSION: Both surgical techniques, laser arytenoidectomy with posterior cordectomy and laterofixation, are efficient and useful in widening the glottis in the case of bilateral vocal cord paralysis. The improvement of the ventilation markers allows the growth in the comfort of living, restoration of the physiological respiratory tract and decannulation of the patients who had undergone tracheotomy. The deterioration of the voice quality is characteristic of both surgical techniques.

[Long term results of partial laryngectomies in patients suffering from laryngeal cancer]. / Wyniki odlegle operacji czesciowych u chorych na raka krtani.

AIM: The aim of the study was to evaluate the results of partial laryngectomies in patients with laryngeal cancer treated in the 2(nd) Clinical Department of Laryngology SUM in Zabrze in the years 1990-2000. MATERIALS AND METHODS: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. The group consisted of 20 (10%) women and 189 (90%) men. The mean age was - 51.2 years. The stage of the neoplasm progression was defined as T1 in 91 patients (44%), T2 in 109 patients (52%). In other 9 patients (4%) the progression stage was T3 and T4. Clinical examination in 191 patients (91%) did not show enlarged lymph nodes in the area of head and neck (N0). In the group of remaining 18 patients (9%) the node progression was found to be N1-N3. In all 209 patients the squamous cell carcinoma of various stage of malignancy (G1-G3) was found in preoperative histopathological tests, out of which five cases were of papillary squamous cell carcinoma. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), followed by 38 (18%) vertical partial laryngectomies, 28 (13%) horizontal glottis surgeries, 19 (9%) frontal-lateral and frontal-anterior operations, and supracricoid operations with a reconstruction of CHEP and CHP type, a total of 20 operations (9%). Other types of partial operations were performed less commonly. In 79 patients (38%) partial laryngectomy was complemented with a nodal operation, while cervical lymph nodes were not removed in 130 patients (62%). In 19 cases (9%) the metastases of squamous cell carcinoma to regional lymph nodes were confirmed in postoperative material. 82 patients of the study group (39%) underwent radiotherapy. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to local control, overall survival, disease-free survival and cause specific survival. All the aforementioned parameters were analyzed with the method of updated percentages. The level of statistical significance was assumed to be p ≤ 0.05. RESULTS: The updated 5-year and 10-year percentage of overall survivals was respectively 75% and 63%. The updated 5-year and 10-year percentage of cancer specific survivals was 85% and 79%, respectively. The updated 5-year and 10-year percentage of disease-free survivals was 72% and 56%, respectively. The percentage of 5-year and 10 year local controls was 86% and 79%, respectively.

[Imaging and assessment of glomus jugulare in MRI and CT techniques]. / Rola tomografii komputerowej i rezonansu magnetycznego w obrazowaniu i ocenie zaawansowania klinicznego przyzwojaków opuszki zyly szyjnej.

INTRODUCTION: Paragangliomas are rare group of tumors originating from paraganglionic tissue. The most common site of occurrence of the head and neck paragangliomas are: carotid body, jugular foramen (glomus jugulare) and tympanic cavity (glomus tympanicum). Magnetic resonance (MR), computed tomography (CT) and angiography are the modalities of choice in detecting and characterizing paragangliomas. AIM: The aim of this study was to compare different imaging techniques of CT and MR in visualization, detecting and characterizing paragangliomas of the jugular foramen. METHODY: Usefulness of CT and MR techniques was analyzed on the basis of CT and MR examinations performed in the group of three patients with different clinical history. CONCLUSIONS: Multidetector CT scanning is especially useful to show subtle destruction of the temporal bone on early stage of disease. MR is the modality of choice in assessing middle ear, scull base or posterior fossa involvement and monitoring growth of paraganglioma. MR and CT angiography are both useful methods to identify arterial feeders of the paragangliomas, and in some cases due to better availability in clinical practice can be alternative to angiography. Angiography in combination with embolization will mainly be used prior to surgical resection.

Assessment of hearing organ activity in a group of neonates with central nervous system impairment.

OBJECTIVE: Hypoxic-ischemic encephalopathy, primary subarachnoid hemorrhage in term newborns as well as periventricular leukomalacia and intraventricular hemorrhage in premature newborns are the major consequences of perinatal asphyxia. Intrauterine hypoxia and labor prolongation can also affect the hearing organ in newborns causing reversible or irreversible changes in the cochlea, brainstem or cortex. The aim of the study was to carry out the objective assessment of the cochlea and hearing pathway activity using CEOAEs and ABR; to find relationships between hearing status and parameters effecting on nervous system in neonates with central nervous system impairment occurring following perinatal asphyxia. METHODS: To the investigation 36 newborns with hypoxic-ischemic encephalopathy, periventricular leukomalacia or intraventricular hemorrhage were included. The control group encompassed 32 health newborns matched as to the age. In all newborns otoscopic examination, CEOAEs after birth and CEOAEs with ABR 3 months later were performed. Perinatal anamnesis, general pediatric status, results of trans-fontanel ultrasonography and biochemical test results were taken into account in statistical analyses. RESULTS: The mean amplitudes of CEOAEs in the first days of life were significantly reduced in investigation group comparing to control babies. 3months later the recorded responses significantly increased but did not reach values of control group. No differences were found between latencies of waves I and II. ABR latencies of waves III, IV, V and interpeak latencies I-III, III-V, I-V were delayed in investigation group when compared to control patients. Also morphology of ABR recordings in investigation group has slightly changed. Perinatal aspyxia leading to hypercapnia, low gestational age, prolonged artificial ventilation and meningitis were the main risk factors related to disturbances in ABR recordings. CONCLUSIONS: The combined use of CEOAEs and ABR in neonates with central nervous system impairment involvement revealed the existence of abnormalities in cochlear micromechanics and retrocochlear auditory pathway. Etiology seems to be multifactoral.

[Long-term results of airways' injury after a methane explosion]. / Odlegle skutki oparzenia dróg oddechowych w wyniku wybuchu metanu.

Injuries caused by thermal trauma more and more often affect people and they are an important problem of contemporary medicine. It is connected with the civilization development. Burn concerns not only the exterior integuments of the body but also airways, in those cases, the death rate among those who were injured with the thermal trauma increases. The treatment of both the burns and their complications is a long-lasting process, involving many specialists of various disciplines, and not always does it bring the wanted effects. The aim of the study was the assessment of the late morphological sequels inside the larynx and ventilation efficiency as a result of thermal inhalation trauma in the airways of the coal miners after the methane explosion. The methodology of examinations consisted of subjective evaluation of ventilation efficacy by MRC scale and ventilating rate measurement FEV1, FVC, FEV1%, PEF, MEF50, PIF, MIF 50, FIV. The morphological larynx evaluation was conducted based on videolaryngoscopy. 23 injured coal miners, who had been burnt at work in coal mines in 2003 in the methane explosion, were put under scrutiny. All the above mentioned examinations were done to the study group, but also to the specially selected control group, 23 coal miners. During the ventilating rates analysis in the study group, their lower values were noticed in comparison to the control group, however, the values were still within the clinical norms. Videolaryngoscopy showed hypertrophy of the laryngeal tissues.