Click evoked otoacoustic emissions in occupational exposure to lead, concentrations of selected essential elements and markers of oxidative stress.

PURPOSE: This study focused on the selected markers of oxidative stress, impact of elevated lead levels on long-term hearing quality. We investigated whether the presence of certain essential minerals might provide protection to the auditory system against the effects of lead (and cadmium) compounds. METHODS: The research group included 280 male employees of the zinc and lead smelter, which was divided into: L-Pb-low blood lead concentration (PbB) subgroup, H-Pb-high PbB subgroup. Hearing tests were performed using the click evoked otoacoustic emission (CEOAE). RESULTS: Zinc protoporphyrin level was significantly higher in the H-Pb subgroup by 68%. Cd concentration was significantly higher in H-Pb by 33%. The Ca concentration was significantly lower in the H-Pb by - 2%. Selected oxidative stress markers concentration were significantly higher in the H-Pb group: malondialdehyde (MDA) by 4%, and lipofuscin (LPS) by 9%. In the CEOAE results showed statistically significant differences between the L-Pb and H-Pb subgroups. Larger negative changes in otoemission amplitude were observed in H-Pb subgroup. All otoemission results showed a statistically significant negative correlation with age, time of work, MDA concentration, and with PbB. Selected CEOAE parameters showed a significant negative correlation with cadmium blood concentration (CdB), and a positive correlation with Ca and Zn. CONCLUSION: Elevated blood lead content in occupational exposure is associated with an increase in MDA and LPS concentration, which negatively correlates with CEOAE parameters. This suggests an important role of oxidative stress in the long-term deterioration of hearing.

Salvage surgery in laryngeal cancer after radiotherapy and partial surgery - comparative results.

Objective: The study is a retrospective comparison of the usefulness of salvage surgery between a group of previously radiotherapy-treated patients (RTPs) and a group of patients who previously underwent partial surgery with both local and ± nodal recurrence. Study Design: Retrospective study. Setting: Multi-center academic hospital. Materials and Methods: The former group was comprised 30 previously RTPs, whereas the latter group consisted of 20 patients after partial laryngeal surgery with optional subsequent adjuvant radiotherapy (PSPs). Treatment efficacy was compared in both groups in relation to overall survival (OS) and the locoregional control rate (LCR). Local and ± nodal recurrence was considered primary treatment failure. All patients underwent total laryngectomy. Results: The updated 5-year OS in the PSPs was 31%, while the percentage of the updated 5-year LCR was 42%. In the RTPs the updated 5-year OS was 21%, and the percentage of 5-year LCR was 38%. No statistically significant differences were found in terms of the comparison of OS or the comparison of LCR results in both groups (P = 0.427, P = 0.704, respectively). Conclusions: Based on the analysis, it was found that irrespective of the initial treatment, salvage surgery was associated with decreased survival and cure rates (by 50%) compared to the group of patients with advanced laryngeal cancer who underwent primary total laryngectomy.

Phenotypes of Chronic Rhinosinusitis and Peripheral Blood Leukocytes Parameters in Elderly Patients.

Background and Objectives: Chronic rhinosinusitis (CRS) is a common disease that can be differentiated into two phenotypes, with or without polyps (CRSwNP) or CRSsNP), which may be unilateral (UNIL) or bilateral (BIL). CRS may have an impact on absolute neutrophils and lymphocytes count in peripheral blood. The aim of the study was to investigate whether the incidence of a specific CRS phenotype changes with age and to compare the values of neutrophils, lymphocytes and neutrophil-to-lymphocyte ratio in the peripheral blood between groups of patients below and above 65 years of age with different CRS phenotypes. Material and Methods: A total of 235 patients aged 65 and over were examined, including 140 (59.6%) males. The group of patients <65 years of age comprised 160 subjects, including 103 (64.4%) males. In both groups, the sequence of frequency of particular phenotypes was similar: the most common phenotype was bilateral CRSwNP followed by CRSsNP BIL, CRSsNP UNIL, and finally, CRSwNP UNIL. Direct comparisons between determined phenotype in both groups of different ages revealed that, in the group ≥65 years, CRSwNP BIL occurred significantly more often than in the group <65 years of age. In fact, in the <65 group, bilateral CRSsNP was more common. The absolute neutrophils and lymphocytes counts were significantly higher in the whole group of patients with CRS ≥65 years of age and absolute number of neutrophils was higher in ≥65 years of age group with bilateral CRSsNP. Conclusions: The higher number of neutrophils in the whole ≥65 years of age group and in older patients with bilateral CRSsNP may indicate that CRS, despite of phenotype, may be an important source of infection that requires surgical treatment in elderly patients as well.

The function of the vestibular organ in Hashimoto's thyroiditis.

INTRODUCTION: The aim of the study was to identify the prognostic factors and the relationship between vertigo and the results of objective assessment of the vestibular organ and the levels of thyroid status in patients with Hashimoto's thyroiditis. MATERIAL AND METHODS: The study population consisted of 28 women with Hashimoto's thyroiditis and coexisting chronic vertigo. In all patients, audiological assessment of hearing (tonal audiometry and impedance audiometry), Dix-Hallpike manoeuvre, caloric test, and kinetic tests (rotary chair test and swing chair test) were evaluated. Thyroid hormone levels [thyroid-stimulating hormone (TSH), free thyroxine (FT4)] and thyroid antibodies [autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-TG)] were determined. The relationships between age, weight, height, and BMI and the results of the objective assessment of the vestibular organ were calculated. RESULTS: In the study group the mean age was 48 years and the mean BMI was 26.425. Normal hearing was found in 15 patients (54%). BPPV (n = 19), followed by Meniere's disease (n = 7) and vestibular neuronitis (n = 2), were the causes of chronic vertigo in this group of patients. The analysis of the objective assessment of the vestibular organ showed decreased excitability of the labyrinth in 15 patients (54%). Twenty-four patients presented with normal TSH and FT4 levels (85%). All patients presented with elevated anti-TPO and anti-TG levels. CONCLUSION: No correlation was found between age, weight, height, BMI, and the results of thyroid function tests or the assessment of the vestibular organ. We did not confirm the negative influence of thyroid levels or the increase in thyroid antibodies on the abnormal results of the rotary chair test or the caloric test.

Assessment of life quality and health perception among recovered COVID-19 patients: multivariate analysis - own material and a review of previous reports on life quality assessment among convalescents.

BACKGROUND: The SARS-CoV-2 virus, causing acute respiratory disease, is responsible for the COVID-19 pandemic, which began in early 2020. In addition to symptoms typical of respiratory tract infections, the virus causes a number of non-specific, often long-lasting effects that hinder the daily functioning of individuals. The aim of the study was a subjective assessment of life quality and health perception among recovered COVID-19 patients. MATERIAL AND METHODS: The study included 337 subjects who had been infected with SARS-CoV-2 confirmed by a positive RT-PCR test. The study participants were of legal age. The convalescents completed a questionnaire that contained 26 questions about gender, height, body weight, blood type, general and specific symptoms, comorbidities, hospital stay and duration of specific symptoms, the severity of which was assessed on the Visual Analogue Scale (VAS). The subjects determined whether the COVID-19 infection influenced their health perception and life quality. RESULTS: According to 46% of the respondents, COVID-19 had an impact on their quality of life and health. The chance for patients to notice the negative effects of COVID-19 on their current health status and life quality increased with each subsequent symptom of the disease by 49%, with each day of its occurrence by 3%, and with each VAS point of the severity of all infection symptoms by 30%. CONCLUSIONS: The study shows that COVID-19 disease affects life quality and overall health perception after recovery. Significant impact of COVID-19 on the quality of life should be a signal to create mental support and rehabilitation programs for convalescents to minimize discomfort and shorten the duration of absenteeism from work. Med Pr. 2022;73(6):449-56.

Relationship between Postural Stability, Lead Content, and Selected Parameters of Oxidative Stress.

This study attempts to determine whether the increased blood lead concentration affects the posturographic test and to determine the relationship between the parameters of posture stability and selected parameters of oxidative stress. The study population consisted of 268 male employees and was divided into two equal subgroups, depending on the lead content in the blood. A posturographic examination was performed. Concentrations of lead, cadmium, zinc protoporphyrin, selected essential elements, and selected markers of oxidative stress in the blood were tested. Higher blood lead concentrations positively affected the values of the sway results: the field and the mean velocity of the center of the feet pressure in posturography. The absolute value of the proprioception ratio was similar in both subgroups. The content of malondialdehyde shows a statistically significantly higher value in a subgroup with high blood lead concentration and exhibits significant correlations only with some of the posturography parameters. The lipofuscin content in erythrocytes correlates with the results of the posturography test. Zinc protoporphyrin, total oxidant status, total antioxidant capacity, selected minerals, and metals did not correlate with the results of the posturography test. In conclusion, posturographic results correlate only with selected markers of oxidative stress, so it can be assumed that the effect on the body balance is only partial.

Does Thyroid Hormone Metabolism Correlate with the Objective Assessment of the Vestibular Organ in Patients with Vertigo?

The aim of this study was to assess the relationship between the results of the objective assessment of the vestibular organ in patients with peripheral vertigo with Hashimoto's thyroiditis and thyroid hormone metabolism. Twenty eight women with Hashimoto's thyroiditis and chronic vertigo were enrolled in the study. Patients underwent audiological assessment of hearing, Dix-Hallpike test, videonystagmography with caloric test, head impulse test (HIT) and cervical vestibular-evoked myogenic potentials (cVEMPs). Levels of thyroid hormones and anti-thyroid antibodies were determined. Relationships between age, weight, height, BMI and the results of the objective assessment of the vestibular organ were calculated. The mean age in the study group was 48 years, while the mean BMI was 26.425. The causes of peripheral vertigo in the study group were benign paroxysmal positional vertigo (BPPV) (n = 19), Meniere's disease (n = 7) and vestibular neuronitis (n = 2). No correlation was found between age, weight, height, BMI and the results of thyroid function tests or the objective assessment of the vestibular organ. The study did not confirm the influence of thyroid metabolism (i.e., thyroid hormone levels or the increase in antithyroid antibodies) on the results of cVEMP or the directional preponderance in the caloric test.

Frequency and Severity of Ear-Nose-Throat (ENT) Symptoms during COVID-19 Infection.

Background and Objectives: Coronavirus disease 2019 (COVID-19) is a new disease entity caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main symptoms of infection at the onset of the pandemic include dyspnea, cough and high fever. Ear−nose−throat (ENT) symptoms are among the ones presented by patients in the course of infection. The aim of the study was to analyze the frequency of ENT symptoms and to assess their severity and duration in COVID-19 patients. Materials and Methods: The study included 337 patients who had been infected with SARS-CoV-2, as confirmed by a PCR test. The study participants were >18 years old; the mean age was 43.98 years ± 13.47 SD. The convalescents completed a questionnaire that contained 26 questions, including 9 detailed questions related to ENT symptoms, such as sore throat, vertigo, dizziness, hearing disorders, olfactory disorders, taste disturbance, headache, cough and dyspnea. The severity of symptoms was assessed using a Visual Analogue Scale (VAS). Results: The most reported ENT symptoms were olfactory disorders, which occurred in 72% of patients. The second most frequent symptom was taste disturbance (68%), VAS = 6.79 ± 3.01. Vertigo and dizziness were reported by 34% of respondents (VAS = 4.01 ± 2.01). Tinnitus was observed in 15% of patients, VAS = 3.87 ± 1.98; 14% of the subjects reported hearing impairment (VAS = 3.81 ± 2.37). Conclusions: Symptoms related to the sense of smell, taste and hearing are some of the most common symptoms in the course of COVID-19, which is important in the therapeutic and epidemiological management of patients. Delayed diagnosis and treatment of symptoms, especially those related to the hearing organ, may result in greater permanent damage.

Etiology, Early Diagnosis and Proper Treatment of Silent Sinus Syndrome Based on Review of the Literature and Own Experience.

PURPOSE: The authors' aim was to review the literature in terms of the etiology of the syndrome, the frequency of Silent Sinus Syndrome (SSS) and surgical procedure, as well as to present their own experience. METHODS: The authors used PubMed, Medline, and Science Direct websites to find and review the most significant papers related to SSS. The case reports of SSS published between 2010 and 2020 were reviewed. A retrospective case review of 8 patients with SSS treated at the authors' departments was done. RESULTS: The silent sinus syndrome has been reported in both children and adults. It is relatively rare and should be differentiated from congenital sinus hypoplasia or atelectasis. It most often affects the maxillary sinus. SSS is usually diagnosed when facial asymmetry or vision problems occur. Late diagnosis requires endoscopic sinus surgery, involving orbital wall reconstruction. The etiology of the syndrome, including the role of bacterial flora found in the sinuses, is unclear. CONCLUSION: Early diagnosis of SSS enables avoiding orbital complications and limits surgical intervention to endoscopic surgery. Further research into bacteriology may help to understand the pathophysiology of the silent sinus syndrome.

Factors Associated with Outcomes Following Salvage Surgery for Recurrent Laryngeal Cancer: A Retrospective Study of 50 Cases from a Single Center in Poland.

BACKGROUND This retrospective study from a single center in Poland aimed to identify factors associated with outcomes following salvage surgery in 50 patients with recurrent laryngeal cancer. MATERIAL AND METHODS The study group consisted of 50 patients with recurrent laryngeal cancer after primary organ preservation treatment (12 patients after partial surgery, 30 patients after radiation therapy, and 8 patients after prior treatment using both methods). None of the patients received chemotherapy before salvage surgery. All patients with recurrence of laryngeal cancer underwent total laryngectomy with elective bilateral nodal surgery. Local and/or nodal recurrence was considered the failure of primary organ preservation treatment. Efficacy of treatment was assessed in relation to overall survival (OS), disease-free survival (DFS), local control (LC), and locoregional control (LRC). RESULTS Treatment results showed a poor prognosis in patients with local and/or nodal recurrence of laryngeal cancer. In the study group, the updated 5-year rates were as follows: OS rate of 26%; DFS rate of 25%; LC rate of 44%; and LRC rate of 39%. Univariate analysis showed that the stage before primary treatment was a predictive factor of OS (P=0.012). CONCLUSIONS The findings from this retrospective study of 50 patients with recurrent laryngeal carcinoma showed that salvage surgery following organ preservation treatment resulted in a 5-year OS rate of 26%.

Bacteriological analysis of selected phenotypes of chronic rhinosinusitis with co-existing asthma, allergy and hypersensitivity to non-steroidal anti-inflammatory drugs.

INTRODUCTION: Chronic rhinosinusitis (CRS) is one of the commonest chronic diseases. It is a systemic disease caused by many factors, including bacterial infections. There are two main types of CRS phenotypes: with polyps (CRSwNP) and without polyps (CRSsNP). AIM: Analysis of sinus mucosal microbiome in patients with CRS depending on the phenotype. Investigating a possible link between the type of bacterial flora and the coexistence of diseases present in the CRS (asthma, allergy or hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) as well as the number of performed operations. MATERIAL AND METHODS: The authors conducted a retrospective study of the bacterial flora of the nasal cavity in patients with CRS operated endoscopically from March 2016 to June 2017. The study consisted od 222 women and 248 men. On the basis of an endoscopic examination, patients were qualified for the phenotype with or without polyps. Based on the medical interview patients were divided into group with asthma, allergy, NSAID hypersensitivity, first and repeated operations. The statistical analysis was made. RESULTS: There is no statistically significant relationship (p = 0.8519) between the CRS penotypes. In the group with CRSsNP, a statistically significant relationship was found between the observed flora and the coexistence of asthma (p = 0.0409), a trend towards significance was also noticed in the case of allergy (p = 0.0947). There was no relationship between the flora and NSAID hypersensitivity (p = 0.7356). In the group of CRSwNP patients, no statistically significant relationship was found between the observed bacterial flora and the presence of asthma (p = 0.7393), hypersensitivity to drugs (p = 0.1509) or allergy (p = 0.7427). There is no statistical significance between the occurrence of particular flora and the multiplicity of operations in both the CRSwNP (p = 0.4609) and CRSsNP phenotypes (p = 0.2469). CONCLUSIONS: Gram-positive cocci were equally common in CRSwNP and CRSsNP. In the CRSsNP, there was a correlation between the coexistence of asthma and allergy, and the presence of Gram-positive cocci. There was no statistical significance between the occurrence of particular flora and the multiplicity of operations in both CRS phenotypes.

[Bilateral vestibular hypofunction: a literature review and a case report]. / Obustronna arefleksja bledników: przeglad pismiennictwa i opis przypadku.

Bilateral vestibular hypofunction (BVH) is a rare disorder of the peripheral part of the balance organ, which may cause chronic vertigo and oscillopsia accompanying body movements. The chronic and severe nature of the symptoms and difficulties in maintaining balance and performing precise movements may cause the patient's withdrawal from professional activity. A frequently long period from the onset of the symptoms to the diagnosis of BVH, which should be based on the objective examination of the peripheral part of the vestibular organ, drastically reduces the chances of improving the patient's precise movement motility and significantly deteriorates the quality of life. Due to the fact that this disease most often affects professionally active patients in the sixth decade of their life, it can become the cause of a loss of the source of income. The publication presents a case report and examination methods of a patient with BVH caused by the administration of gentamicin in the course of phlegmon of the thumb. The case analysis was performed on the basis of a literature review on the diagnosis and treatment of patients with BVH. Med Pr. 2021;72(2):185-92.

Natural Killer (NK)//T-Cell Lymphoma, Nasal Type, with Periorbital Involvement: A Case Report and Literature Review.

BACKGROUND Extranodal natural killer (NK)/T-cell lymphomas are rare neoplasms that result in the destruction of mid-facial tissues. Infrequently seen in ear, nose, and throat clinical practice, they are often misdiagnosed and treated as chronic sinusitis, which delays proper diagnosis. This study aimed to describe the insidious course of NK/T-cell lymphomas, nasal type. CASE REPORT A 36-year-old woman with a 2-year history of recurrent exacerbation of chronic sinusitis and allergies was admitted to our clinic. Multiple endoscopic sinus surgical procedures were performed. Repeated histopathological tissue examinations revealed extranodal NK/T-cell lymphoma, nasal type. Positron emission tomography combined with computed tomography (PET-CT) was performed to assess the extent of the disease. The patient was treated with antibiotics, steroids, and antifungal drugs for many months before the definitive diagnosis was made. The patient was eligible for modified SMILE chemotherapy; however, the patient died suddenly from septic shock several days before the beginning of treatment. CONCLUSIONS Chronic rhinosinusitis with progressive necrosis of sinonasal tissue that persists despite adequate antibacterial and antifungal treatment should prompt further investigation. In such cases, it is important to consider the diagnosis of NK/T-cell lymphomas, nasal type. Early diagnosis increases the opportunity for successful treatment.

Nanoscale infrared probing of amyloid formation within the pleomorphic adenoma tissue.

BACKGROUND: The process of malignant transformations of many tumour cases is still unclear and more specific experimental approaches are necessary. The detailed identification of the pathological changes may help in the therapy progression through the development of drugs with more selective action. METHODS: In this study, the AFM-IR nanospectroscopy was applied for the first time to the pleomorphic adenoma (TM) and the marginal tissue characterizations. In order to verify the obtained spectral information, conventional FT-IR investigations were also performed. RESULTS: The AFM-IR data (topographies, intensity maps, and spectra) show structural changes observed for the margin and TM samples. Additionally, within the tumour tissue the fibril-like areas, characteristic for amyloid diseases, were distinguished. CONCLUSIONS: The application of AFM-IR allows to determine changes in the protein secondary structures between the fibrils and the regions outside them. It has been proved that, for the former areas, the α-helix/random coil/ ß-sheet components dominate, while for the latter regions the α-helix/random coil indicate the main contribution to the protein composition. GENERAL SIGNIFICANCE: The FT-IR results remain in good agreement with the AFM-IR data recorded for the areas outside the fibrils of the TM. This observation confirms that by means of the conventional FT-IR method the identification of the considered fibrils structure would be impossible. Only application of the AFM-IR nanospectroscopy allow for characterization and visualization of the fibrillization process occurring within the investigated tumour tissue.

Can Hashimoto's thyroiditis cause vertigo? [Czy choroba Hashimoto moze byc przyczyna zawrotów glowy?].

Vertigo and balance disorders are common symptoms reported by approximately 15-20% of the adult population worldwide. For many years thyroid diseases have been suspected as the cause of vertigo by ENT physicians. Almost every patient hospitalised due to severe vertigo is investigated for thyroid disease as a suspected cause of acute vestibulopathy. The issue presented in this paper is related to a difficult and poorly understood relationship between autoimmune thyroid disease and peripheral vertigo.

Bacterial Flora of the Nose and Paranasal Sinuses Among Patients Over 65 Years Old with Chronic Rhinosinusitis Who Underwent Endoscopic Sinus Surgery.

PURPOSE: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in the geriatric population. However, CRS inflammatory mechanisms in older people have not been thoroughly investigated. Our work aimed to analyze the bacterial flora of the nose and paranasal sinuses in patients with CRS over 65 years of age, including comorbidities, previously performed endoscopic sinus surgery (ESS), presence or absence of polyps and the extent of the inflammatory process. PATIENTS AND METHODS: The study involved 529 patients between 18 and 84 years of age with chronic rhinosinusitis who underwent endoscopic sinus surgery. There were 101 patients separated over 65 years of age (M = 52, K = 49, mean age 69 ± 0.7 years). The control group consisted of 168 patients aged 18-40 years with CRS. The bacterial culture of material collected from the patients during ESS was analyzed. RESULTS: In the group of patients over 65 years of age, more frequent occurrence of Proteus spp. and Pseudomonas aeruginosa was found in comparison to younger patients. In older patients with bronchial asthma, the occurrence of S. aureus, Escherichia coli, and Citrobacter spp. was more frequent than in control group. Multiple sinus surgical procedures in older patients were associated with the dominance of Staphylococcus aureus and Escherichia coli, which was not demonstrated in the control group. There were no statistically significant differences between the occurrence of bacterial strain and the presence of polyps, both in the group of patients over 65 years of age as well as in the control group. CONCLUSION: The bacterial flora of patients with CRS is different in older and younger patients. A different therapeutic approach should be considered in older patients with CRS, but this problem requires further studies.

Does the transplantation of keratinocytes really reduce the risk of death? Survival analysis of patients hospitalized at the Dr Stanislaw Sakiel Centre for Burns Treatment in 2008-2015.

BACKGROUND: Keratinocyte transplantation is an adjuvant procedure in the extensive burn therapy method. However, it must be taken into consideration that clinical results of keratinocyte transplantation are ambiguous and progress achieved in this method is still being verified, especially due to the high cost of cultured epithelial autograft (CEA) transplants. OBJECTIVES: The aim of this study was to verify the impact of cultured keratinocyte application on patients' survival. This study included a group of patients with the highest chance for a successful outcome of the therapy and excluded patients with no compelling reason to apply for such an expensive therapy. MATERIAL AND METHODS: This study included all the patients with burns diagnosed between January 1, 2008 and January 1, 2016, who were treated with cultured skin cells. Patients' age and gender, percentage of total body surface area (TBSA) affected, percentage of burn depth of the 3rd/4th degree, number of days between admission and surgery, and need for rehabilitation were analyzed. RESULTS: The cultured cell application did not significantly affect the risk of death (p > 0.05). CONCLUSIONS: Keratinocytes should be applied as an adjunctive method for the treatment of burns with at least 40% TBSA affected, but with a maximal burn depth of the 2nd degree. In the group of patients below 50 years of age, a higher number of transplants with a cell population above 20 million/mL and a significantly lower mortality rate were observed, which means that in the mentioned age group, this graft was more effective. It has been suggested that patients older than 50 years of age with burns deeper than of the 2nd degree should be treated with more advanced methods like, e.g., the application of stem cells.

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.

Bacteriological analysis of isolated chronic sinusitis without polyps.

INTRODUCTION: Chronic sinusitis (CRS) is phenotypically divided into inflammation with polyps (CRSwNP) or without polyps (CRSsNP). AIM: To try to explain the reasons for isolated sinusitis by analysing medical history as well as anatomical and bacteriological data. MATERIAL AND METHODS: In 2016, endoscopic surgery was performed in 103 patients with CRSsNP within 6 months. The authors evaluated 28 patients with lesions in one sinus. RESULTS: The patients did not report any previous facial trauma, dental procedures, there were no odontogenic causes of the disease. They had not been treated with antibiotics within 30 days prior to admission to hospital. Ninety-seven bacterial strains were grown, of which 32 in patients with isolated nasal sinusitis. Statistical analysis has shown that there is a trend toward a statistically significant (p = 0.0868) relationship between the presence of Staphylococcus aureus and the type of inflammation. CONCLUSIONS: There is an indication that the presence of Staphylococcus aureus is associated with isolated sinusitis, especially in women.

Fungal sinusitis among patients with chronic rhinosinusitis who underwent endoscopic sinus surgery.

INTRODUCTION: Fungal paranasal sinusitis can be either invasive or non-invasive. Saprophytic infections, fungus balls (FB) and allergic fungal rhinosinusitis are non-invasive (AFR). MATERIALS AND METHODS: The present study examined 521 patients who underwent endoscopic sinus surgery between January 2016 and April 2017 due to chronic paranasal sinusitis at the Department of Laryngology and Laryngological Oncology of the Upper Silesian Medical Centre in Katowice. The aim of the study was to analyse the histopathological and microbiological material collected intraoperatively and to determine the incidence and type of fungal infections among patients treated for chronic sinusitis. RESULTS: Chronic fungal sinusitis was confirmed in 10 of 521 operated patients. The study group consisted of 9 females and 1 male. Histopathological examination revealed dead mycelium in 5 patients and colonies of Aspergillus spp. in 4, while microbiological examination revealed Candida albicans infection in 1 case. Allergy to inhalant allergens of fungal spores of Alternaria and Penicillinum was confirmed in a 73-year-old patient, which, based on the whole clinical presentation, enabled to diagnose chronic allergic fungal sinusitis. The most common location of mycelium was the maxillary sinus, followed by the sphenoid sinus. DISCUSSION: The most common form of non-invasive fungal sinusitis is the so-called fungus ball, which was also confirmed in our report (95% of the test subjects). AFRS is more likely to occur in warm, moist climates that favour the growth of fungi.