Oral cavity morphology among children at risk of sleep disordered breathing.

PURPOSE: The aim of this study was to evaluate oral cavity morphology in children at risk of sleep disordered breathing (SDB). METHODS: The study included children 3-17 years of age. The risk of SDB was evaluated using the paediatric sleep questionnaire (PSQ); afterwards, children at risk of SDB were enrolled in the study group. A control group was randomly established from patients with negative PSQ results. The oral cavity morphology evaluation included assessment of the oropharynx using Mallampati classification (MC), palatine tonsil size using the Pirquet scale, occlusion and the presence of a high-arched palate and lingual frenulum. RESULTS: A total of 131 children were evaluated, 65 in the study and 66 in the control group. The mean ages were 9.5 ± 3.0 and 9.4 ± 3.1 years, respectively. The presence of higher scores on the MC, higher scores in the Pirquet scale, a crossbite, a high-arched palate and a short frenulum were significantly more frequent in the study group than the control group. CONCLUSION: The evaluation of oral morphology is an important part of paediatric examination. Enlarged palatine tonsils; higher scores on the MC; and the presence of a crossbite, short lingual frenulum and high-arched palate may suggest abnormal breathing during sleep in children.

Inflammatory cytokines gene expression in bone tissue from patients with chronic rhinosinusitis- a preliminary study.

BACKGROUND: It is unclear whether mucosal inflammation has an effect on the bone under the mucosa in patients with chronic rhinosinusitis (CRS). OBJECTIVES: The aim of this study was evaluation of inflammatory cytokines genes expression in bone tissue taken from the patients who had undergone endoscopic sinus surgery for CRS. METHODS: A total group of a consecutive 49 patients with diagnosis of chronic rhinosinusitis based on EPOS 2007 criteria undergoing endoscopic sinus surgery for CRS were enrolled in the study. Based on histopathologic findings of the mucosal and bone tissues we evaluated the rate of inflammation. Expression of target genes: interleukin 1ß (IL1ß), interleukin 6 (IL6), interleukin 11 (IL11), tumor growth factor ß (TGF ß) and tumor necrosis factor α (TNF α) were analysed by real-time PCR method in samples of the ethmoid bone taken during endoscopic sinus surgery for CRS. RESULTS: Based on histopathological findings in the studied population we found symptoms of osteitis in 5 patients. In the studied population we found significant differences between patients with osteitis and without osteitis with respect to IL6 gene expression in bone tissue (p=0.0003), IL11 gene expression (p=0.02) and TNFα gene expression in bone tissue (p=0.0035). CONCLUSION: In our study we have demonstrated that in some patients with CRS and coexisting symptoms of osteitis some inflammatory markers genes expression are increased in this population.

[Foreign body in the frontal sinus]. / Cialo obce zatoki czolowej.

The authors describe the case of the foreign body in frontal sinus left there after prior surgery. The case was treated surgically with good results.

[Iatrogenic esophageal perforation]. / Jatrogenne przedziurawienie przelyku.

A total of 213 patients with a foreign body in the oesophagus was treated in our unit between 1980-1990. Most of the foreign bodies were impacted in the cervical oesophagus. Oesophagoscopy were carried out under general anaesthesia in all cases. iatrogenic perforation of oesophagus was encountered in ten cases. Our results suggest that most instrumental perforation of the esophagus should be managed surgically. Drainage and closure of cervical perforations yields good results. Nonoperative management night be entertained in minimally symptomatic patients harboring a late, locally contained perforation without signs of ongoing sepsis.

[Endoscopic surgery of the paranasal sinuses]. / Chirurgia endoskopowa zatok przynosowych.

The endoscopic surgery of the paranasal sinuses has been introduced as a method of treating recurring sinusitis during last fifteen years. Clinical observation showed that the most of cases of sinusitis are rhinogenic. Although the clinically dominating symptoms may be due to disease inside the frontal or maxillary sinuses, the underlying causes are in the middle meatus or anterior ethmoid. Consequently, endoscopic identification and operation of these diseased ethmoid areas aim to reestablish normal function of sinuses. The endoscopic techniques are safe and effective forms of sinus surgery.

[Laryngeal cancer: postop complications and possibilities of their correction]. / Niepowodzenia leczenia operacyjnego raka krtani i mozliwosci ich korygowania.

The aim of the paper is to present the surgical methods applied in a 76 year old patient treated for carcinoma of the larynx. As an effect of the carried out total laryngectomy, extensive pharyngeal fistula occurred. The fistula was closed with myocutaneous flap which was pedunculated on double reversed pectoral major muscle. Due to lymphatic metastases surgical dissection of lymphatic system of the left side of the neck was performed 2 years after laryngectomy. During this operation the left common cervical artery was removed (Goretex graft). Next-cobaltotherapy was applied. After following 2 years the skin necrosis just over the flap occurred. It was caused by shirt collar pressure. Because of the major bleeding common cervical artery was oligated. During this procedure the frontal wall of the oesophagus was damaged and again pharyngeal fistula appeared. Attempts at closing it with flaps pedunculated on pectoral major muscle and trapezius muscle did not succeed. Finally fistula was closed with cylindric flap from the abdomen connected with the cutaneous flap from surrounding fistula tissues. Following recognition of this illness the patient had undergo nine consecutive, extensive operations. Ten years after diagnosis he is still alive and leads a life appropriate to his age.

[Use of Solcoseryl DAP after nasal septum surgery]. / Zastosowanie preparatu Solcoseryl DAP po operacjach przegrody nosa.

Solcoseryl is a biological agent, which accelerates the healing tissue procedure. This influence was studied during the nasal septum surgery. In 25 patients the postoperational nasal plug was inserted with the Solcoseryl and in 10 (control) with the paraffin. The cytologic verifications were performed before and after the surgery. In the solcoseryl group the mucosa regeneration procedure was accelerated and the inflammation reduced.

[Aspergillosis in the anterior ethmoid: case report]. / Aspergilloza sitowia przedniego i zatoki szczekowej--opis przypadku.

The case of aspergillosis in the anterior ethmoid and maxillary sinus was described. The clinical course, diagnostic and treatment were discussed.

Chronic rhinosinusitis: relationship between the time of illness, extent of the disease process and results of surgical treatment. / Przewlekle zapalenie zatok przynosowych--zaleznosc miedzy zaawansowaniem procesu chorobowego, czasem jego trwania i uzyskanymi wynikami leczenia operacyjnego.

The object of this study was to determine the relationship between the extent of the disease in the paranasal sinuses and the time of illness. The study included a group of 158 patients treated surgically because of CRS. The evaluation of the extent of the disease process was done according to Kennedy's classification. Statistical correlation between the time of the illness and the extent of the disease process was observed. It was shown that in the group of patients where the disease process was longer than 3 years, changes due to the disease were present on both sides in the ethmoid and dependent sinuses. A relationship was also proved between the time of the illness and the results of the surgical treatment. The patients having had the illness for less than 3 years had a complete recovery rate of 83%. However, those who were ill for over 3 years had only a 49% complete recovery rate.

[The role of endoscopic surgery in the treatment of chronic inflammation of paranasal sinuses]. / Rola czynnosciowej chirurgii endoskopowej w leczeniu przewleklego zapalenia zatok przynosowych.

This paper discusses the latest advances in diagnosis, medical treatment, and functional surgery for the treatment of chronic rhinosinusitis.

[Mucocele of the paranasal sinuses]. / Mucocoele zatok przynosowych.

Twelve cases selected from the group of 123 chronic rhinosinusitis patients are presented in the paper. Severe headaches were noted as the most typical complaints of the clinical picture of the disease. The most cases were accompanied by rhinitis and paranasal sinusitis symptoms. The best diagnostic method of mucocele is MRI. The endoscopic sinus surgery is a safe and effective method of the treatment in a case of mucocele.

[Classification of rhinosinusitis]. / W sprawie klasyfikacji zapalen zatok przynosowych.

Rhinosinusitis is a multifactorial disease which has been variously defined by far. There is a strong need among all physicians to create a commonly accepted classification of rhinosinusitis, providing indications for an appropriate evaluation, diagnosis and treatment of the disease. The goal of this review is to present leading definitions of different forms of rhinosinusitis as well as classifications based on clinical findings, temporal considerations and the patophysiology of rhinosinusitis.

[The classification of nonallergic eosinophilic rhinitis and sinus]. / Klasyfikacja niealergicznych eozynofilowych niezytów nosa i zatok.

Eosinophil granulocyte plays a crucial role in the pathogenesis of allergic and non-allergic upper and lower respiratory tract diseases. A number of diseases and syndromes of nonallergic mechanisms (non IgE mediated) with nose and sinus symptoms and the presence of eosinophilic cells have been described in the recent decade. The paper focuses on the discussion of the symptomatology and classification of such cases.

[Topographic anatomy of the nose and paranasal sinuses for the needs of endoscopic surgery]. / Anatomia topograficzna nosa i zatok przynosowych dla potrzeb chirurgii endoskopowej.

The paper presents topographic anatomy of the nose and paranasal sinuses, which excellent known is necessary for surgeon who operates using endoscopic method. The difficulties and dangerous situations during operations as a consequence of the surgical activity in such complicated region are also described.

[Classification of the rhinitis]. / Wspólczesne zasady klasyfikacji niezytów nosa.

The development of differential diagnosis of rhinitis has multiplied their present classification. Generally, there are known two types of classifications: a) based on nasal cytology (Connell 1983); b) arising from clinical evaluations (Mygind 1985). Zeiger's work (1989) takes into consideration both types of classifications and describes them widely. This paper presents different methods used as background in contemporary classifications rhinitis.

[The role of the anterior ethmoid in pathogenesis of paranasal sinusitis]. / Rola sitowia przedniego w patogenezie zapalen zatok przynosowych.

Maxillary and frontal sinuses communicate with nasal cavity via very narrow and complicated clefts, which are the part of anterior ethmoid. Any disease changes in this area usually cause the obstruction of ventilation and drainage of these larger sinuses. Subsequently the inflammation can develop. Therefore these narrow clefts of anterior ethmoid hold the key position for normal function and the pathophysiology of larger paranasal sinuses. Accurate diagnosis of diseased areas and reestablishing sinus ventilation and drainage via natural ostia is the base of treatment of sinusitis.

[The principles of investigation of nasal resistance by active rhinomanometry]. / Zasady badania droznosci jam nosowych technika rynomanometrii aktywnej.

Anterior (ar) and posterior (pr) active rhinomanometry is the most common technique for assessment of nasal resistancy. The curve presents the interdependence of physiological transnasal pressure and air nasal flow. Following the Versick and Clement polynominal mathematical model (delta P = K0+K1V+K2V2,0) as well as the Broms polar coordinate model best fit the recorder pressure flow data. Computer simultaneously draws the pressure/flow curve and calculates resistance at particular pressure points (75, 150, 300 Pa in ar and 50, 75, 100 Pa in pr). The paper also presents indications for application of rhinomanometry and methodology of its execution.

[Indications and counterindications for topical corticosteroidotherapy]. / Wskazania i przeciwskazania do miejscowej kortykosteroidoterapii.

This paper presents indications for topical corticosteroidotherapy in rhinitis and nasal polyps. The differential diagnosis including etiology and pathogenesis of diseases especially aspirin intolerance, are taken into consideration. The main indication for topical corticosteroidotherapy is local nasal eosinophilia. The authors everyday clinical practice help to establish considerations for the use of corticosteroids.

[The usefulness of CT studies for the needs of endoscopic surgery of the nose and paranasal sinuses]. / Przydatnosc badan tomograficzno-komputerowych dla celów endoskopowej chirurgii nosa i zatok przynosowych.

CT is very important diagnostic investigation before endoscopic nasal or paranasal sinuses surgery. It is basic procedure to establish indications and to make plan of the operation. The technic should take into consideration the clinical stage of the patients. The paper presents methodology of nasal and paranasal sinuses CT and describes the radiological anatomy of these regions.

[Paranasal sinuses CT scans analysis of patients with cystic fibrosis]. / Analiza obrazów tomografii komputerowej zatok przynosowych u chorych z mukowiscydoza.

Thirty patients with cystic fibrosis (CF) were diagnosed of the otolaryngological outpatient clinic, a part of Department of Otorhinolaryngology Medical Academy in Warsaw, in 1996-1998. The control group was formed by thirty patients with chronic rhinosinusitis (CRS). Computed tomography (CT) scans were estimated in all cases. Results showed, that inflammatory changes are more advanced in patients with cystic fibrosis than in patients with chronic rhinosinusitis. The high progression of inflammatory changes in patients with cystic fibrosis, observed in CT scans, caused: disturbed development of a frontal and maxillary sinuses, destruction of bony structures formed the lateral wall of the nasal cavity, medical bulging of the lateral nasal wall.