[Diagnostic and treatment in nasal polyps of children treated in Wroclaw ENT department in the years 1991-2001]. / Diagnostyka i leczenie polipów nosa u dzieci hospitalizowanych w Klinice otolaryngologii we Wroclawiu w latach 1991-2001.

BACKGROUND: Nasal polyposis is not often observed in children and usually follows general chronic diseases or disorders of cilliary structure or function and occurs mostly after 10 years of age. This is why in children clinical changes qualified as nasal polyposis should always be verified as congenital diseases or neoplasmatic changes. CASE REPORT: The population: of children treated in the years 1991-2001 in the Wroclaw ENT Department with initial diagnosis of nasal polyposis was presented. Material consisted of 52 children admitted in the years of 1991-2001 to Wroclaw ENT Department with already diagnosed nasal polyposis. In each case medical history was collected together with routine physical ENT examination complemented with fiberoendoscopic examination of the nose end epipharynx. In 7 children with initial diagnosis of nasal polyposis hypertrophy of pharyngeal tonsil with vasomotor rhinitis was diagnosed. Those children underwent adenectomy. Remaining group of 45 children aged from 2 to 16 years was analysed. Surgical treatment (polypectomy, FESS) was performed in 44 children. There was antrochoanal polyp in 10 cases (20,4%), monolateral choanal atresy in 1 case, foreign body of nasal cavity in 1 case and neoplasmatic tumour diagnosed in 5 cases. CONCLUSIONS: The diagnostic difficulties in nasal polyposis in children, except neoplasm, are reflected by the cases with initial diagnosis of nasal polyp and finally diagnosed as foreign body with inflammatory reaction or monolateral choanal atresy. Endoscopic examination of nasal cavity together with radiological diagnostic should be ordered routinely in the unclear cases.

[Nasal glioma--case report]. / Glioma nasi--doniesienie o przypadku.

Benign congenital lesions resulting from the deficient regression of neuroglial tissue in normal embryonic development are called gliomas. They are usually located in the nasofrontal region and are diagnosed in the postnatal period. They are included in the differential diagnosis of nasofrontal midline masses. We present a case of the 9-year-old boy treated in the ENT Department of Wroclaw Medical University with the initial diagnosis of nasal polyposis or tumour which appeared to be glioma in the postoperative histological evaluation. The tumour was removed endoscopically. We present magnetic resonance imaging of the case together with the review of the literature concerning gliomas. We conclude that each doctor has to be aware of possible neoplasm even in the youngest groups of the patients.

Histological and electron microscopic investigation of Reinke's edema.

Reinke's edema is a benign lesion of vocal fold affecting subepithelial space. This paper describes the histological features of Reinke's edema on the basis of an extensive number of cases (203 women and 58 men). In 10 cases the electron microscopic examination was performed. Edema of subepithelial tissue was present in 138(62%) cases. This phenomenon was observed more frequently in women than in men (p=0.01). In the subepithelial tissue there were a numerous wide vessels with oedematous endothelium. Leukoplakia and dysplasia of epithelium were present in 21(8%) and 16(6%) specimens, respectively. Leukoplakia was detected more often in men than in women. This relation was close to statistical significance (p=0.055). The presence of dysplastic lesions of the epithelium was correlated with the age of the patients and smoking habit (p=0.0042, p=0.0021). Electron microscopic investigations revealed loosened intercellular junctions and widening of intercellular spaces, especially in basal and spinous layers.

Treatment of Reincke's edema among different professional groups: presentation of results.

OBJECTIVES: Reincke's edema is one of the most common voice disorders in adults. The main purpose of our study, was to analyze factors that may influence the development of this disease. We also estimated the results of surgical treatment. MATERIALS AND METHODS: The research was performed on a group of 261 patients with Reincke's edema treated in the ENT Department of the Medical University of Wroclaw in the years 1994--2000. In the study population, women were in a majority and teachers formed the largest occupational group (30%) followed by salespersons (15%). Most of the patients (86%) were tobacco smokers. All of the patients underwent detailed videostroboscopic examination of the larynx and perceptual analysis of the voice quality before and after treatment. RESULTS: The symmetry of vocal cords before and after treatment was found in 75 patients. Lack of symmetry before treatment, and proper symmetry after surgery was observed in 71 subjects. Fifty patients showed less symmetry after treatment, and 65 patients were asymmetric before and after surgery. The difference between the symmetry of vocal folds before and after treatment was at the border of statistical significance (p = 0.069). The number of patients with full vocal cords closure increased after treatment. This difference was statistically significant (p = 0.032). The periodicity of vocal cord movements was significantly higher after treatment (p < 0.001). CONCLUSIONS: The perceptual assessment of voice, before and after treatment, revealed statistically significant post-treatment improvement in voice quality.

[Epidemiology of secretory otitis media in children examined at the Otolaryngologic Clinic in Wroclaw in 1996-1999]. / Epidemiologia otitis media secretoria u dzieci na podstawie badan Kliniki Otolaryngologicznej we Wroclawiu w latach 1996-1999.

The aim of the work was an evaluation of epidemiological factors in otitis media with effusion (OME) in children. Material consisted of 191 children treated surgically in Wroclaw ENT Clinic. The control group consisted of 95 healthy children. The evaluation was based on detailed history of the patients and physical ORL examination. The factors taken into considerations were: age, sex, birth factors, breast feeding, attending to kindergarten, passive smoking, social and environmental factors, incidents of upper respiratory airways and middle ear infections before OME being diagnosed. Frequent upper respiratory infections, acute and recurrent middle ear infections, staying with other children (kindergarten) and passive smoking increase the risk of OME incidence.