[Haemangiopericytoma of the nasal cavity as a cause of recurrent epistaxis--case report]. / Haemangiopericytoma nosa jako przyczyna nawracajacych krwawien--opis przypadku.

A case of haemangiopericytoma of the nasal septum in 73-year-old female admitted to the Department of Otolaryngology of Wroclaw Medical University with a history of recurrent epistaxis and progressive right monolateral nasal respiratory obstruction is reported. On admission presented smooth, cyanotic, easily bleeding lesion in the nasal cavity on the right. Nose CT scans identified presence of a soft-tissue mass arising from the nasal septum. She was treated with a complete surgical resection of the mass. The diagnosis was established based on the careful histopathological examination. Haemangiopericytomas are rare soft-tissue neoplastic lesions, occurring mainly in adults, originating from pericytes and primarily arising in the lower extremities and retroperitoneum. Haemangiopericytomas of head and neck are very unusual and comprise about 15 to 30%; of these, approximately 5% occur in the sinonasal area. Authors have presented etiology, symptomatology, histopathological features, differential diagnoses, diagnostic and therapeutic management. Malignant and benign clinical course have been described.

[A case of polyostotic fibrous dysplasia]. / Przypadek wieloogniskowej dysplazji wlóknistej kosci.

Fibrous dysplasia (FD) is a benign but slowly progressive disorder of bone in which normal cancellous bone is replaced by immature woven bone and fibrous tissue. Fibrous dysplasia is a very uncommon disorder and the total number of cases is not known. It is usually diagnosed in children and young adults. Some patients have only one bone affected (monostotic), whereas other patients have numerous bones affected (polyostotic). Multiple affected bones are often found on one side of the body. The craniofacial involvement causes very difficult therapeutic problem due to localisation and uncontrolled proliferation followed by compression, both resulting in facial asymmetry, pain, cranial nerve deficiencies, alterations in hearing and loss of vision. Treatment of FD depends on the associated symptoms and may include a range of therapies from observation to complete surgical excision. We describe a rare case of polyostotic fibrous dysplasia with craniofacial localisation associated with the involvement of the humerus in a 65-year-old female patient. The first symptoms in the patient were noted 4 years ago. The diagnosis was based on clinical examination, X-ray, CT and histological examination.

[DPOAE in tinnitus patients with cochlear hearing loss considering hyperacusis and misophonia]. / Otoemisja DPOAE u osób z szumami usznymi i niedosluchem slimakowym z uwzglednieniem nadwrazliwosci na dzwieki i misophonii.

UNLABELLED: The most probable place generating tinnitus in auditory pathway are outer hair cells (OHC) inside cochlea. To asses their activity otoacoustic emission is used. The goal of the investigation was estimation the features of otoemission DPOAE in groups with tinnitus patients with cochlear hearing loss, estimation of diagnostic value of DPOAE parameters for analysis of function of the cochlea in investigated patients emphasizing DPOAE parameters most useful in localizing tinnitus generators and estimation of hypothetic influence of hyperacusis and misophony on parameters of DPOAE in tinnitus patients with cochlear hearing loss. The material of the study were 42 tinnitus patients with cochlear hearing loss. In the control group there were 21 patients without tinnitus with the same type of hearing loss. Then tinnitus patients were divided into three subgroups--with hyperacusis, misophony and without both of them, based on audiologic findings. METHOD: after taking view on tinnitus and physical examination in all the patients pure tone and impedance audiometry, supratreshold tests, ABR and audiometric average and discomfort level were evaluated. Then otoemission DPOAE was measured in three procedures. First the amplitudes of two points per octave were assessed, in second--"fine structure" method-- 16-20 points per octave (f2/f1 = 1.2, L1 = L2 = 70 dB). Third procedure included recording of growth rate function in three series for input tones of value f2 = 2002, 4004, 6006 Hz (f2/f1= 1.22) and levels L1=L2, growing by degrees of 5dB in each series. RESULTS: DPOAE amplitudes in recording of 2 points per octave and fine structure method are very valuable parameters for estimation of cochlear function in tinnitus patients with cochlear hearing loss. Decreasing of DPOAE amplitudes in patients with cochlear hearing loss and tinnitus suggests significant role of OHC pathology, unbalanced by IHC injury in generation of tinnitus in patients with hearing loss of cochlear localization. DPOAE fine structure provides us the additional information about DPOAE amplitude recorded in two points per octave, spreading the amount of frequencies f2, where differences are noticed in comparison of two groups--tinnitus patients and control. Function growth rate cannot be the only parameter in estimation of DPOAE in tinnitus patients with cochlear hearing loss, also including subjects with hyperacusis and misophony. Hyperacusis has important influence on DPOAE amplitude, increases essentially amplitude of DPOAE in the examined group of tinnitus patients.

DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing.

OBJECTIVE: The most probable place generating tinnitus in the auditory pathway is the outer hair cells (OHCs) inside the cochlea. Otoacoustic emissions are used to assess their activity. The objective of the investigation was to measure the features of distortion product otoacoustic emissions (DPOAE) in a group of tinnitus patients without hearing loss, estimate the diagnostic value of the parameters for the analysis of cochlear function in the patients, emphasizing those most useful in localizing tinnitus generators, and determine the hypothetical influence of hyperacusis and misophony on DPOAE parameters in tinnitus patients. PATIENTS AND METHODS: The material consisted of 44 patients with tinnitus and without hearing loss. In the control group were 33 patients without tinnitus with the same state of hearing. The tinnitus patients were divided into three subgroups: those with hyperacusis, those with misophonia, and those with neither. After collecting medical history and performing clinical examination of all the patients, tonal and impedance audiometry, ABR, and discomfort level were evaluated. Then DPOAE were measured using three procedures. First the amplitudes of two points per octave were assessed, second the "fine structure" method with 16-20 points per octave (f2/f1=1.22, L1=L2=70 dB), and the third procedure included recording the growth function in three series for input tones of f2=2002, 4004, and 6006Hz (f2/f1=1.22) and L1=L2 levels increasing by increments of 5 dB in each series. RESULTS AND CONCLUSIONS: Hyperacusis was found in 63% and misophonia in 10% of the tinnitus patients with no hearing loss. DPOAE amplitudes in recordings with two points per octave and the fine structure method are very valuable parameters for estimating cochlear function in tinnitus patients with normal hearing. Function growth rate cannot be the only parameter in measuring DPOAE in tinnitus patients, including subjects with hyperacusis and misophonia. The markedly higher DPOAE amplitudes in the group of tinnitus patients without hearing loss suggest that tinnitus may be caused by increased motility of the OHCs induced by decreasing efferent fiber activity, and not by OHC failure. Hyperacusis significantly increases the amplitude of DPOAE in tinnitus patients with no hearing loss.