Oral squamous cell carcinoma - clinical characteristics, treatment, and outcomes in a single institution retrospective cohort study.

<b>Introduction:</b> Squamous cell carcinoma (SCC) is a common malignancy with high morbidity and mortality. </br></br> <b>Aim:</b> The aim of this study was to analyze the data of patients treated for malignant tumours of the oral cavity at the Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology Ludwik Rydygier Collegium Medicum in Bydgoszcz between 2003-2011 to asses the influence of risk factors on survival in patients with squamous cell carcinoma of the oral cavity. </br></br> <b> Material and methods:</b> Material was collected from 62 patients treated for oral SCC between 2003-2011. Forty-three were men (69.35%) with a mean age of 56.33 years. The medical records were analysed, especially history, operative reports, histopathology reports, survival, adjuvant treatment and recurrence. </br></br> <b>Results:</b> All patients underwent surgical treatment (33.87% also had partial removal of the lower jaw, 67.74% adjuvant radio-therapy, 11.29% radiochemotherapy). More than half reported to the doctor within 6 to 15 weeks from the onset of symptoms. The majority smoked and drank alcohol (96.32%). Five-year disease specific survival (DSS) was 68.69%. </br></br> <b>Conclusions:</b> The age over 65 did not significantly influence DSS. The location on the anterior two thirds of the tongue gave the best outcome, while the worst outcome was observed in the retromandibular triangle area which was statistically almost significant (p = 0.06843). In the case of higher degrees of local and regional advancement and a higher stadium, a worse out-come was recorded. Positive surgical margins were identified in 11.29% of the cases, but they had no impact on the results of treatment. No worsening of the outcome was proven for the patients who reported to the doctor later than 15 weeks following the occurrence of symptoms.

Cerebral Blood Flow and Other Predictors of Responsiveness to Erenumab and Fremanezumab in Migraine-A Real-Life Study.

Introduction: Monoclonal antibodies (mAbs) showed efficacy in migraine prevention. The aim of this study was to check if baseline clinical parameters and cerebral blood flow (CBF) measured by transcranial Doppler (TCD) may help predict mAbs efficacy. Methods: Electronic charts of migraineurs treated with erenumab or fremanezumab, with baseline TCD evaluations were collected, including data on migraine type, pain localization, monthly migraine days (MMD), medication overuse headache (MOH), mean blood flow velocity (Vm), and pulsatility index (PI) in cerebral arteries. Results: A total of 123 patients were enrolled, mean age 38, 75 years, 87 with chronic migraine, 61 with MOH, 72 were good responders (GR), and reported ≥50% reduction in MMD, 43 ≥75% reduction in MMD. Baseline Vm values in MCAs were significantly lower in GR as compared with non-responders. MAbs responsiveness ≥50% was positively associated with unilateral pain localization (OR: 6.53, 95% CI: 2.01-23.93; p = 0.003) and HIT-6 score (OR: 1.14, 95% CI: 1.01-1.30; p = 0.036) whereas negatively associated with Vm in right MCA (OR: 0.96, 95% CI: 0.92-0.99; p = 0.012), and having no relatives with migraine (OR: 0.40, 95% CI: 0.16-0.95; p = 0.040). Conclusions: Baseline Vm in MCA is lower in mAbs GR as compared with non-responders which may reflect increased secretion of CGRP with further vasodilation in GR. Simple clinical features and baseline CBF in anterior circulation might help to predict the patient's responsiveness.

Results of Hearing Screening in School-Age Children from Rural Areas of the Kujawsko- Pomorskie Region in Poland.

OBJECTIVE: There is a need for regular surveillance of the hearing of children, no matter what their age. Screening of the hearing of school children can be done quickly and cheaply using teleaudiology. The primary aim of this study was to identify children who showed a suspected hearing impairment from rural areas of the Kujawsko-Pomorskie region and refer them for further audiological testing. A secondary aim was to estimate the prevalence of hearing loss in those children. METHODS: There were 4754 children, made up of 1840 children aged 6-7 years old and 2914 children aged 12-13 years old. Pure-tone air conduction thresholds were obtained at 0.5-8 kHz. Audiometric test was supplemented by results of a brief questionnaire filled in by parents. RESULTS: Of the 4754 children, 618 (13%) failed screening and were referred for detailed audiological diagnostics. The prevalence of hearing loss was estimated to be 7% and was significantly higher (OR = 2.12) in the group aged 6-7 y/o (10.1%) than in the group aged 12-13 y/o (5.0%). In our study the estimated prevalence of HL was twice as high in children aged 6-7 y/o (10.1%) than in children 12-13 y/o (5.0%). This difference was also evident in another study of Polish children from rural areas, where the prevalence of HL was 11.4% in younger children (6-9 y/o) and 5.5% in older children (12-13 y/o). CONCLUSION: Large numbers of school-age children in rural areas have hearing problems. It is recommended that a hearing screening program in primary schools based on e-health solutions should be adopted.

The visual-ocular and vestibulo-ocular reflexes in vestibular migraine.

Vestibular migraine is a disease from the border of neurology and otoneurology. The diagnosis depends on patient history. There are no valuable laboratory or imaging tests, therefore the examination of visual-ocular and vestibulo-ocular reflexes is very useful in this group of patients. The material was collected from patients diagnosed due to dizziness at the Department of Otolaryngology and Oncology with the Subdepartment of Audiology and Phoniatrics, CM UMK in Bydgoszcz in 2019-2021. We considered patients with vestibular migraine and analyzed videonystagmographic tests in this study. The most common VNG abnormalities in patients suffering from vestibular migraine were an increased labyrinthine response, increased time constant of the rotational response and abnormal optokinetic response. There was not a single case of canal paresis in the group of patients with vestibular migraine.

Risk factors of tympanoplasties in long-term observation.

OBJECTIVES: The aim of the study was to evaluate risk factors influencing the results of tympanoplasties on the base of material taken from the Department of Otolaryngology and Laryngological Oncology Collegium Medicum of Nicolaus Copernicus University in Bydgoszcz between 2004-2009. In this period 98 operations were done. The time from operation to hearing examination was 3 to 7 years, mean 5,43. Tympanoplastic operation were divided according to Tos classification. Measuring hearing results, tonal audiometry was done and mean air bone gap on four frequencies was assesed (500, 1000, 2000, 3000 Hz), according to AAO-HNS guidelines (1995). This parameter was compared between groups separated according to risk factors, that could potentially affect the results. Those risk factors were: disfunction of the Eustechian tube, localisation and size of the perforation of the tympanic membrane, damage of the ossicles, the state of the mastoid process, the number of operations, the presence of the cholesteatoma or granulating tissue, chronic otitis media in the opposite ear, smoking cigarettes, mastoidectomy, canal wall down technique. The results were analysed using statistical test. RESULTS: The most impotant risk factor affecting treatment's results (besides discharge from the ear) is damage of the ossicles, especially the malleus and stapes. Well done operation ensures good hearing results irrespectively of the presence of cholesteatoma or granulating tissue, and also in case of reoperation. For all types of tympanoplasties neither the localisation, nor the size of perforation do not influence on hearing results in long term observation.

The late results of 4000 Hz frequency bone conduction after tympanoplasty.

INTRODUCTION: Surgical treatment of conductive hearing loss runs the risk of damage to the inner ear in the mechanism of acoustic trauma. AIM: The aim of this study was to evaluate the function of the organ of Corti, expressed as bone conduction threshold at the frequency of 4000 Hz for selected operations: mastoidectomy and canal-wall-down procedure. MATERIAL AND METHODS: The material was collected from patients with chronic otitis media in the Department of Otolaryngology and ENT Oncology, Collegium Medicum of Nicolaus Copernicus University in Bydgoszcz in 2004-2009. All patients were examined with pure tone audiometry threshold before surgery and at least three years after surgery. The analyzed group of patients was divided into subgroups depending on the type of operation according to To classification and procedures for resection: mastoidectomy and canal-wall-down procedure. The results were statistically analyzed. RESULTS: In the analyzed period of three years after surgery there was no statistically significant difference between groups, although there were higher values for tympanoplasty type 1 with mastoidectomy compared with tympanoplasty type 1 without mastoidectomy - respectively 25.67 dB and 18.53 dB. In the study, there was no statistically significant the difference in bone conduction threshold for frequency 4000 Hz within the type 2 tympanoplasty according to Tosa comparing canal wall-up and canal-wall-down procedure. CONCLUSIONS: Mastoidectomy or canal-wall-down procedure do not affect the bone conduction threshold for a frequency of 4000 Hz after tympanoplasty in long-term observation.

Functional outcomes of tympanoplasty surgery.

OBJECTIVE: We reviewed functional outcomes of tympanoplasty. STUDY DESIGN: The results of tympanoplastic surgery are changing in time. We present late treatment outcomes among different types of tympanoplasty. METHODS: Eighty-six patients who underwent tympanoplasty were enrolled in the study. The results of pure tone audiometry performed 7 days before, then at 3 months, 1 year, and 3 years after the surgery were assessed. Type II tympanoplasty involved implantation of a partial ossicular replacement prosthesis and type III tympanoplasty involved reconstruction with a total ossicular replacement prosthesis and the use of autogenous homogenous material. Statistical analysis was performed. RESULTS: With all four types of tympanoplasty, hearing improvement was achieved at 3 months and 1 year after surgery based on the magnitude of the mean ABG reduction (p<0.001). In patients who underwent type I, type III, and type IV tympanoplasty, the ABG reduction at 3 years after surgery was maintained at the level reported at 3 months and 1 year after surgery (p<0.001). In patients who underwent type II tympanoplasty, however, the mean ABG value was increased at all tested frequencies (p<0.05). The mean ABG values reported 3 years after type II and type III tympanoplasty were similar. CONCLUSIONS: Based on the results over time, hearing improvement seems to be less durable after reconstruction with the partial ossicular replacement prosthesis procedure compared to the total ossicular replacement prosthesis procedure.

[The results of myringoplasty using underlay technique]. / Wyniki strukturalne myringoplastyki metoda podkladania.

INTRODUCTION: The method of tympanic membrane repairing is called myringoplasty. AIM OF THE STUDY: We analysed the reasons of failure of this procedure. MATERIAL AND METHODS: The structural results were observed among 36 patients under restricted criteria with diagnosed chronic otitis media. The unsuccessful procedure was one with reperforation. We studied Eustachian tube function and also localisation and size of the perforation. RESULTS: The failure rate was 25%, which was mainly observed among individuals with incorrect Eustachian tube function - 70% and margin perforations - 50%. The localisation and the size of the perforation did not matter. CONCLUSIONS: The main reasons of myringoplasty failure were incorrect Eustachian tube function and margin perforations of tympanic membrane.

[The treatment of malignant neoplasms of the external ear canal and temporal bone in the Department of Otolaryngology and Oncological Laryngology in Bydgoszcz]. / Leczenie nowotworów zlosliwych przewodu sluchowego zewnetrznego i kosci skroniowej w materiale Kliniki Otolaryngologii i Onkologii Laryngologicznej CM UMK w Bydgoszczy.

INTRODUCTION, MATERIAL AND METHODS, AIM OF THE STUDY: Evaluation of the methods and results of treatment of 19 cases of malignant tumors of the external auditory meatus and/or temporal bone was performed. RESULTS: In 10 cases planoepithelial carcinoma was diagnosed; in 7 cases basocellulare carcinoma; in 1 case rhabdomyosarcoma; and in 1 case malignant peripheral nerve sheath tumor were histopathologically established. In stage T1 were 8 cases, in T2 - 7, in T3 - 1 and in T4 3 patients were stated based upon clinical and radiological (HRCT and MRI) examination. Three patients in T4 stage were qualified to palliative therapy. In 2 cases radical mastoidectomy was performed, 8 patients underwent partial temporal bone resection. In 6 cases removal of cartilaginous and osseous external auditory meatus was done. In 9 cases local recurrence of tumor was observed during 2 years after surgery. The last 7 cases are under oncological observation. CONCLUSIONS: In conclusion we stressed that patients with malignant tumors of this region are treated in late stages of the disease; it is a main cause of poor diagnosis.

[The results of operational otosclerosis treatment after stapedotomy]. / Wyniki operacyjnego leczenia otosklerozy u chorych po wykonanej stapedotomii.

INTRODUCTION: There are many ways of presenting the treatment's results for otosclerosis. Because of loss of the uniform standard, it is impossible to compare these results between various health centres. But the most important is, which way of presenting seems to be the best. AIM: The aim of the study was to propose a scheme of presenting the treatment's results for otosclerosis. MATERIAL AND METHODS: In order to devise method, medical documentation of 81 patients, treated for otosclerosis in Otolaryngological and Oncological Laryngology Clinic with Audiology and Phoniatrics Department, was analysed retrospectively. RESULTS: The received results were analysed for each patient and divided into 3 groups: first - changes of the air conduction, second - changes of the air-bone gap, third - changes of the bone conduction. The value of the air-bone gap is a measure of surgeon's effectiveness interpreting as the reconstruction of the conductive chain in the middle ear. The loss of bone conduction before and after the operation can evaluate the improving hearing after the operation of otosklerosis due to overclosure and also can take under consideration the sensoneurinal hearing loss induced by moving of the stapes. Only comparison these three parameters is correct to evaluate the operation's results, especially the air conduction. So that de Bruijn et al. proposed a diagram, called Amsterdam Evaluation Hearing Plots - AEHPs. That diagram compares the pre-operative mean air-bone gap to post-operative change of loss of air - conduction. Thanks to that, the overclosure and post-operative sensorineurinal hearing loss were taken under consideration. CONCLUSIONS: The presentation of the treatment's results for otosclerosis should include, besides the air-bone gap, the air conduction and bone conduction too. The AEHPs meet the requirements.

[The early functional effects of tympanoplasty in the Otolaryngology and Laryngological Oncology Department of the University School of Medicine in Bydgoszcz, Poland, from 2004 to 2009]. / Wczesne wyniki czynnosciowe operacji tympanoplastycznych w materiale Kliniki Otolaryngologii i Onkologii Laryngologicznej CM UMK w Bydgoszczy w latach 2004-2009.

OBJECTIVE: The aim of the study was to evaluate the results of the tympanoplasty in chronic otitis media in its functional aspect. METHODS: We analysed and categorized 489 tympanoplasties using Wullstein classification. The operations were performed in the Otolaryngology and Laryngological Oncology Department of the University School of Medicine in Bydgoszcz, Poland, from 2004 to 2009. The group consisted of 421 patients (221 women, 253 men, mean age 52.2 years). RESULTS: Type I tympanoplasty was performed in 133 patients (31.59%), type II tympanoplasty was performed in 191 patients (45.36%), type III tympanoplasty was performed in 93 patients (22.09%) and type IV tympanoplasty was performed in 4 patients (0.95%). The audiometry was done one year after the operations. We observed good effect in 116 cases (86.9%) of type I tympanoplasty, good or satisfactory in 150 cases (78.6%) of type II tympanoplasty and satisfactory in 63 cases (67.7%) of type III tympanoplasty. There were no hearing improvement and its deterioration results in 61 cases (14.48%), including all treated by type IV tympanoplasty. CONCLUSIONS: 1. There were improvement of hearing in audiometry in majority of our patients. 2. The functional effect of hearing depends on the function of conductive mechanism of the ear before the treatment. 3. We prefer among all types canal wall-up tympanoplasty.