[Comparative analysis of the treatment results of the nasal obstruction using septoplasty and septokonchoplasty]. / Analiza porównawcza wyników leczenia zaburzen droznosci nosa z zastosowaniem septoplastyki i septokonchoplastyki.

The nasal septal deviation coexistent with turbinate hypertrophy is considered one of the most common causes of nasal patency disorders. There is no doubt that septoplasty in most such cases is a proper treatment method. It is more difficult to clearly identify indications and predict the consequences of septoconchoplasty. The main aim of this study is to compare the impact of each of these procedures on subjective and objective measures of nasal patency. The authors retrospectively reviewed 132 medical records of patients treated in the Department of Otolaryngology, Medical University of Warsaw in the period from March 2012 to January 2013 due to nasal obstruction. Each patient had septoplasty or septoconchoplasty performed. Before treatment, each patient responded to questions in a standardized questionnaire SNOT 20. In addition, each patient was performed upon for anterior rhinomanometry before and after shrinking the nasal mucosa. Finally, the study involved a group of 30 people - 15 after septoplasty (group A) and the same number after septoconchoplasty (group B), who attended control examination carried out by the same scheme 6 weeks and 6 months after surgery. SNOT 20 poll was repeated 6 months after surgery. Analysis of the rhinomanometry results showed no statistically significant differences between the two treatment groups. Average values of the nasal resistance after surgery as compared to their baseline values in all measurements were smaller in each of the groups but the differences were also not statistically significant. However, comparing the results of the subjective assessment of nasal patency and associated signs and symptoms showed statistically significant differences between pre and postoperative results in both groups and the patients of group B felt more improvement than patients in group A. The study authorizes the conclusion that in justified cases septoconchoplasty gives better results than septoplasty.

[Treatment results of temporal bone area paragangliomas]. / Wyniki leczenia przyzwojaków kosci skroniowej.

INTRODUCTION: Temporal bone paragangliomas are rare, benign neuroendocrine tumors. Depend on their location at skull base, they can extend intracranially and extracranially. They characterize by slowly growth and late nonspecific clinical manifestation. Location of tumor and anatomical condition require suitable operational technique and cause related complications. AIM: The aim of this study was analysis of surgical procedure and evaluation of treatment results of patients with paragangliomas of the temporal bone hospitalized in Department of Otolaryngology of Warsaw Medical University in years 2000-2010. MATERIAL AND METHODS: 34 cases of patients were retrospectively studied. Clinical data, level of tumor advancement according to Glasscock & Jackson and Fisch classification were analyzed. Intraoperative and imaging studies data were used to evaluate extent of lesions. Suitable operative approaches and outcome of treatment were also analyzed. CONCLUSION: In group of 34 patients 26 of them had monocentric and 8 multicentric neoplasms. Age ranged 15-73-years-old. Most common symptoms were: loss of hearing, tinnitus and headache. Preoperative embolization was carried in 10 cases. Most common surgery technique: tympanotomy and hypotympanotomy posterior and infratemporal fossa of Fisch type A approaches. Radiotherapy was used in 2 cases and surgery with radiation therapy in 7 cases. Most commonly observed complication in surgical treatment was intermittent paresis.

[The significance of electrophysiologic examinations in vestibular schwannomas diagnosis]. / Znaczenie badan elektrofizjologicznych w diagnostyce guzów nerwu VIII.

UNLABELLED: The most important for the diagnosis of vestibular schwannoma is MRI technic, which allows assessing its size and shape. The gold diagnostic standard includes also PTA, SD and ABR, nystagmography with calorics and VEMP. Nystagmography with calorics reflects the status of superior vestibular nerve. The sensitivity of calorics amounts to 61-87%. VEMPs reflect the status of interior vestibular nerve; its sensitivity is about 80%. The greatest diagnostic sensitivity shows ABR method, which is estimated for about 96-99%. AIM: analysis of PTA, ABR, VEMP and calorics results in smaller G1(≤10mm) and greater G2 (>11mm) tumors, and assessement of influence of the size of the tumor for auditory and vestibular function. MATHERIAL: PTA, ABR, VEMP and calorics results performed in 33 patients with CPA tumors. RESULTS: CPA tumors originate from inferior vestibular nerve in most cases; there is no statistical PTA differences in G1 and G2 groups; sensitivity of calorics (G1 53%, G2 95%), and ABR (G1 75%, G2 100%) depend on tumor size and tumor size has significant influence on results of both of these methods; sensitivity of VEMPs is similar in G1 and G2 groups (83% and 89%). CONCLUSIONS: there is no strict correlation between tumor origin and calorics and ABR results; greatest sensitivity in our material show VEMP, what is probably results of frequent tumors origin from inferior vestibular nerve.

[The analysis of the admissions to the laryngological emergency service in Otolaryngology Department of Warsaw Medical University]. / Analiza przypadków zglaszanych na ostry dyzur laryngologiczny w Klinice Otolaryngologii Akademii Medycznej w Warszawie.

OBJECTIVE: The aim of our work was to carry out an qualitative analysis of the all cases delt with in otorhinolaryngological emergency unit throughout one year. The information gathered and observations made can result in the valid grounds for streamlining of otorhinolaryngological emergency services in the future. RESEARCH DESIGN AND METHODS: We examined the medical documentation of 7930 subjects (3.972 females and 3.958 males, of the average age 42 years), who appeared in the otorhinolaryngological emergency unit of SP CSK AM in Warsaw from the 1th of January to the 31th of December 2006. RESULTS: The actual emergency cases accounted for 40% of all cases. The most common were: injuries (12.80%), epistaxises (13.11%), foreign bodies (5.11%). The rest of the cases did not need the summary intervention on emergency admission. These were mostly: ear inflamations (21.32%), upper respiratory tract infecions (10.77%), cerumen in the external ear (8.98%). In 2006, 5,51% of all cases were admitted to the otorhinolaryngological ward and up to 5.22% sent to other specialists. CONCLUSIONS: The majority of the cases delt with in the otorhinolaryngological emergency unit did not need the immediate intervention. A part of these was not within the competence of the otorhinolaryngologist. The high proportion of such patients can prolong the time of anticipation for highly specialised aid in the states of real threat to human's life and health and cause other damages that can be harmful to the pacient himself.