Polish version of the COMQ-12 questionnaire, a new validated tool for the assessment of the quality of life in patients with chronic otitis media.

<b><br>Introduction:</b> The COMQ-12 questionnaire is a tool to assess the quality of life in patients with chronic otitis media in many countries. The questionnaire consists of 12 questions: seven relating to the severity of symptoms, two regarding the impact of the disease on lifestyle and work, two concerning the impact on the need for healthcare, and one is a general question. Each question is rated on a scale from 0 to 5.</br> <b><br>Aim:</b> To present the validation process and the final version of the Polish version of the COMQ-12 questionnaire.</br> <b><br>Material and methods:</b> The Polish version of the COMQ-12 questionnaire was prepared based on an independent translation of the English version by three physicians (two otolaryngology specialists and one physician in the process of specialization in otolaryngology). The questionnaire was validated in a study including 60 participants: 30 patients with chronic otitis media and 30 volunteers without a history of middle ear diseases or hearing disorders. Each participant was asked to complete the COMQ-12 questionnaire twice at an interval of 4 weeks apart. The internal consistency, reliability, and construct validity of the questionnaire were analyzed using Cronbach's alpha and McDonald's omega coefficients, Spearman's rho correlation coefficient, and the Mann-Whitney test, respectively.</br> <b><br>Results:</b> High internal consistency, reliability, and construct validity of the Polish version of the COMQ-12 questionnaire were shown in the course of statistical analysis. The overall internal consistency was 0.95 and 0.97 as assessed by Cronbach's alpha and McDonald's omega coefficients, respectively. Spearman's rho correlation coefficient was above 0.89 for each question. Statistically significant differences in the COMQ-12 total scores were obtained between patients with chronic otitis media and the control group.</br> <b><br>Conclusions:</b> The Polish version of the COMQ-12 questionnaire can be a valuable clinical tool for the assessment of the quality of life in patients suffering from chronic otitis media.</br>.

Effect of Neonatal Hearing Screening Results on the Lost to Follow-Up at the Diagnostic Level.

(1) Background: An important part of any neonatal hearing screening program is monitoring diagnostic visits to confirm or exclude the presence of hearing loss. In addition, time plays an important role in the diagnosis. We identified the number of children who came for a diagnostic visit and analyzed the time of the first audiological visit, depending on the result of the hearing screening test performed in the first days of a child's life and the presence or absence of risk factors of hearing impairment. (2) Methods: We analyzed 6,580,524 children, of which 8.9% required further diagnostics. The mean time of follow-up diagnostic visit in the analyzed group was 130 days and differed due to the presence or absence of risk factors for hearing loss before and after the neonatal period. (3) Results: Although the risk of hearing loss in children with risk factors is 2.31 to 6.38 times higher than in children without risk factors depending on the result of the screening test, more than 40% of parents do not report to scheduled audiological visits. (4) Conclusions: Doctors, nurses, and midwives who screen hearing at the neonatological level play an important role in educating parents about the possibility of hearing loss in a child and the need for an audiological examination.

The impact of the COVID 19 pandemic on the functioning of the Universal Newborn Hearing Screening Program in Poland.

The Newborn Hearing Screening Program has existed in Poland for almost 20 years. However, for the first time in the history of his activity, he had to deal with large logistic and staffing problems. The analysis compared the years 2020 and 2021 in terms of the functioning of centers that conduct audiological diagnostics of the Program during the Covid-19 pandemic. In order to obtain relevant information, a telephone survey was conducted at the beginning of 2022 with questions about the performance of standard activities related to the Program. Results In 2020, 60 centers conducting audiological diagnostics (66.67%) were suspended, and 30 were working under the sanitary and epidemiological regime (33.33%). In 2021, only 5 (5.26%) diagnostic centers with their headquarters in facilities transformed into so-called homonymous hospitals, dealing only with the treatment of patients infected with SARS-CoV-2 virus, were suspended. Discussion The development of the pandemic and the related limitations around the world had a significant impact on the quality and scope of medical services provided. Many hospitals were quickly transformed into closed centers treating only patients with SARS-CoV-2. Audiological consultations take place in closed, soundproof rooms. Face-to-face contact was required for hearing assessment, fitting hearing aids, troubleshooting, and rehabilitation. The COVID-19 pandemic has forced audiology to modify existing practices. The use of telemedicine was increasingly preferred. In Poland, as all over the world, the scope of remote consultations has expanded, but due to technological and hardware limitations, audiological procedures remained in the sphere of direct contact with the patient. Conclusions In the first year after the announcement of the pandemic, significant difficulties were observed in the functioning of centers dealing with the diagnosis of children with suspected hearing loss. The appearance of the SARS-CoV-2 virus forced us to develop innovative methods of early diagnosis and treatment of children with hearing impairment, which resulted in the stabilization of the work of individuals in the following year.

Summary of the Polish Universal Neonatal Hearing Screening Program 2021year review.

The Polish Universal Neonatal Hearing Screening Program (PUNHSP) has been carried out in Poland for 20 years. Its main goal is to screen newborns for hearing. This examination is performed on the 2-3 days of a child's life, and in addition, information is collected on the risk factors for the development of hearing loss. In total, 486 centers participate in PPPBSuN at three reference levels. By the end of 2021, 7 million children were registered in the PPPBSuN Central Database. The most common type of hearing loss in children was bilateral sensorineural hearing loss, diagnosed in 2021 in 160 children. The report below presents the most important results and conclusions from the functioning of PPPBSuN in 2021.

Intraoperative margins in oral and oropharyngeal cancer transoral surgery benefit from sampling method modifications.

OBJECTIVES: To investigate the impact on local relapse rate (LRR) and disease specific survival (DSS) of intraoperative margins (FS) obtained by circumferential sampling method, corresponding to the lesion shape and marked using clock-face orientation combined with narrow band imaging (NBI) in head and neck squamous cell carcinoma Materials and Methods: 147 consecutive patients who underwent primary surgery with radical intent for oral and oropharyngeal cancer between 2011 and 2016 were prospectively enrolled. Patients were assigned to 3 groups with different sampling methods. In group A (n=44) a classical FS sampling method was used. In group B (n=73), the clock-face orientation sampling method (FS oclock) was used, whereas in group C (n=30), the FS oclock method combined with NBI. The primary outcome measure was the interdependence between FS sampling methods and oncological outcomes measured by LRR and DSS. RESULTS: In total, 1534 FS samples were obtained with range of 3-24 FS taken per case, median 7.25 in group A, 8.15 in group B and 7.52 in group C. When compared FS histology and final histology in all groups the sensitivity, specificity and accuracy were 61.54%, 98.51% and 95.24%, respectively. The overall LRR equaled 8.8%. The lowest LRR was observed in FS oclock method combined with NBI (6.67%) followed by FS oclock (6.85%) and FS classic (13.64%). For all patients, DSS achieved 95.92% - 95.45% in FS classic, 95.89% in FS oclock and 96.67%. in FS oclock combined with NBI. CONCLUSION: The FS oclock sampling method combined with NBI increases the chance of achieving tumor-negative margins and in result improves the treatment outcome reflected by LRR and DSS.

Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages.

BACKGROUND: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. METHODS: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic otitis media (n = 30) with a clinical indication for surgery. The primary measurement was the subjective estimation of quality of the visibility of the operating field provided by the 3D exoscope-VITOM-3D (Karl Storz, Tuttlingen, Germany) in comparison to the operating microscope. RESULTS: All procedures, except for two (3.3%) converted to the microscope, were successfully completed using a 3D exoscope. In both stapedotomy and tympanoplasty, the exoscope was superior to the microscope during more superficial portions of the procedures. By contrast, in deeper areas of the middle ear, the exoscope provided significantly worse visibility, but usually not suboptimal. Both intraoperative bleeding and the narrow surgical field substantially reduced the visibility with the 3D exoscope in comparison to the microscope. CONCLUSIONS: Overall, our study shows that the 3D exoscope offers excellent, highly magnified, and well-illuminated high-definition images of the surgical field. However, our experience revealed several important limitations of this system, including decreased depth perception in deep areas of the tympanic cavity and reduced visibility in a difficult surgical field, with subsequent need to switch to an operating microscope in select cases.

Review and characteristics of 585 salivary gland neoplasms from a tertiary hospital registered in the Polish National Major Salivary Gland Benign Tumors Registry over a period of 5 years: a prospective study.

<b>Introduction:</b> A Polish National Major Salivary Gland Benign Tumors Registry (SGR) is a report of benign salivary gland neoplasms (SGNs) from 26 different centres in Poland, introduced in 2014. The aim of this study is to analyze demographic characteristics and clinico-pathological factors of benign SGNs treated in large tertiary institutions and to determine possible correlations between selected variables. <br><b>Material and method:</b> Analysis of 585 patients recorded in SGR and operated on for SGNs in the Department of Otolaryngology and Laryngological Surgery, University of Medical Sciences, Poznan, Poland, over a 5-year period. Patient age, sex, occupation, place of residence, tumor location, size, histology, recurrence, facial nerve function after surgery, wound healing, surgery procedure, availability of pre-operative imaging examinations, fine-needle aspiration cytology (FNAC) results were analyzed. <br><b>Results:</b> 338 females and 247 males with a mean age of 53 years were operated on. In total, 96.2% of tumors originated from the parotid and 3.8% from the submandibular gland. The most frequent primary tumor diameter was 2-4 cm (59.5%) followed by <2 cm (29.2%) and >4 cm (8.4%). Tumors of over 4 cm were frequently removed by partial superficial parotidectomy, while those under 2 cm - by extracapsullar dissection (ECD). Pleomorphic adenomas (PA) were predominant (58.8%), followed by Warthin's tumor (WT) - 37.1%. Patients with WT were on average 13.3 years older than patients with PA. <br><b>Discussion:</b> This research can be helpful to better understand the clinico-pathological features of SGNs. Long-termin hospital-based analysis is important for subsequent metaanalyses and comparisons with other centers. The reasons why not all patients' data are reported to the national SGR should be further precisely analyzed.

Follow-up on the diagnostic level of children covered by the Universal Neonatal Hearing Screening Program in Poland, divided into voivodships.

INTRODUCTION: Thanks to the Polish Universal Neonatal Hearing Screening Program (PUNHSP), all newborns in Poland undergo a free, screening hearing examination. Between 2006 and 2015, the average number of tested children per year was 373,477. According to the analysis of The Central Database (CDB), only 55.8% of the children attended the detailed hearing examinations at the second level of the Program. AIM: The aim of this study is to analyse the dates concerning the attendance of the children at the diagnostic level of PUNHSP in different regions of Poland. MATERIALS AND METHODS: To conduct an analysis of this fact and find out the reasons for low attendance at the second level in 2015, a telephone survey questionnaire was developed for parents who had not registered their babies for further consultation - 3,239 randomly selected parents. RESULTS: The analysis revealed that the number of children examined at the second diagnostic level of the program is in fact much higher than the results of The Central Database show. The actual number is 83.6% as opposed to 55.8%. As a result of the telephone questionnaire some inaccuracies in the input data to the CDB were detected. The main errors in gathering the information for the CDB were incorrect OAE test result and no examination performed. C onclusion: In Poland the worst results (i.e. questionnaire results compared to CDB) for the attendance at the diagnostic level were shown in Pomorskie, Lubelskie, Mazowieckie and Podlaskie regions. In many cases there was a large discrepancy between the reality and the information in the CDB. The improvement of clarity concerning the CDB application is important in order to minimise the possibility of malformation in the CDB.

Analysis of the changes in the Polish Universal Neonatal Hearing Screening Program over 15 years of activity.

INTRODUCTION: One of the examples of a nationwide pro-health program in Poland is the Polish Universal Neonatal Hearing Screening Program (PUNHSP). The Program is aimed at early diagnosis and intervention in children with hearing impairments and it is an example of a well-managed program. Presenting the results of the PUNHSP activity as well as organizational aspects and own experience can significantly help institutions managing other programs to achieve high efficiency in their functioning. The aim of this work is a detailed analysis of the Program evaluation during the 15 years of its activity, i.e. the identification of changes and the consequences of their introduction in the perspective of improving quality and efficiency. MATERIALS AND METHODS: The material is PUNHSP data, registered in the Central Database of the Program and organizational information related to management, IT support and PUNHSP infrastructure. The analysis was based on quality assessment parameters (identification of changes and the purpose of their introduction) and effectiveness (consequences of introducing changes). The analysis concerns the whole period of PUNHSP activity - from 2002 to 2017. RESULTS: As a result of the analysis, 13 main modifications of the Program were identified as the "change" criteria and 11 smaller ones - side ones resulting from the necessity to adapt the PUNHSP functionality to current needs. The changes were grouped into five categories: legal, administrative, management, audit and control, as well as IT, changes. DISCUSSION: When analyzing the PUNHSP evaluation, it can be assumed that the changes introduced positively influenced the various aspects of the PUNHSP activity, but do not exhaust the possibilities of further optimization of its activity. CONCLUSIONS: The Program requires constant development in order to increase the efficiency and effectiveness of its operation, and the solutions used in it could be a stimulus to improve and create other pro-health programs.

The report of the Polish Universal Neonatal Hearing Screening Program in 2016.

The Polish Universal Neonatal Hearing Screening Program (PUNHSP) has been carried out in Poland for 14 years. The main aim of this Program is to organize hearing screening tests and to gather the information about risk factors of hearing loss in almost all newborns in Poland. It consists of 496 centers at 3 referral levels. A total of 5 458 114 children had been registered in the Central Database (CDB) of PUNHSP by the 22nd of August 2017. Bilateral sensorineural hearing loss was the most frequently appearing hearing impairment in children. It was diagnosed in 260 cases in 2016. This report presents the most important results and conclusions concerning the running of the PUNHSP in 2016.

Sensorineural and conductive hearing loss in infants diagnosed in the program of universal newborn hearing screening.

OBJECTIVE: The aim of this study was to analyze infants diagnosed with sensorineural or conductive hearing deficit and to identify risk factors associated with these defects. MATERIAL AND METHODS: A retrospective analysis of infants diagnosed with hearing deficit based on the database of the universal newborn hearing screening program and medical records of the patients. RESULTS: 27 935 infants were covered by the universal neonatal hearing screening program. 109 (0.39%) were diagnosed with hearing deficit and referred for treatment and rehabilitation. 56 (51.4%) children were diagnosed with conductive, 38 (34.9%) with sensorineural and 15 (13.8%) with mixed type of hearing deficit. Children with sensorineural hearing deficit more frequently suffered from hyperbilirubinemia (p < 0.05), while infants with conductive hearing loss were more frequently diagnosed with isolated craniofacial anomalies (p < 0.05). The prevalence of other risk factors did not differ between the groups. Sensorineural hearing deficit occurred almost 3 times more often bilaterally than unilaterally (p < 0.05). In other types of hearing deficit, the difference was not significant. In children with conductive and mixed type of hearing loss the impairment was mainly mild while among those with sensorineural hearing deficit in almost 45% it was severe and profound (p < 0.05). When analyzing the consistency between hearing screening test by means of otoacoustic emissions and the final diagnosis of hearing deficit we found that the highest agreement rate was observed in children with sensorineural hearing loss (p < 0.01). CONCLUSIONS: The prevalence of most risk factors of hearing deficit was similar in children with sensorineural, conductive and mixed type of hearing loss, only hyperbilirubinemia seemed to predispose to sensorineural hearing deficit and isolated craniofacial malformations seemed to be associated with conductive hearing loss. Sensorineural hearing deficit usually occurred bilaterally and was severe or profound, while conductive and mixed type of hearing deficit were most often of mild degree. Most children with the final diagnosis of sensorineural hearing deficit had positive result of hearing screening by means of otoacoustic emissions.

Analysis of follow-up at the diagnostic level in the Polish Universal Neonatal Hearing Screening Programme.

Objectives Routine analysis showed that between 1 June and 30 November 2014, only 47.6% of expected follow-up visits at the diagnostic level were registered in the Polish Universal Neonatal Hearing Screening Programme central database. We attempted to detect and analyse the reasons for this low percentage. Methods A telephone survey questionnaire was developed for parents whose children had not registered for consultation at the diagnostic level, or had not received a final diagnosis according to the programme database. Questions aimed to verify the database records and compare these with information received from and given to parents. From the 7888 children not registered at the diagnostic level, 3239 records were randomly selected, i.e. 52.4% of those who had been expected to attend. Results Questions were answered by 1950 parents (60.2% of the selected group). Of these, 52.1% ( n = 734) had attended for diagnostic tests, but this was not recorded in the database. The most common reasons for not attending were the long waiting time for the visit (36.09%), lack of referral to a visit (25.9%) and conscious parent decision (16.35%). Conclusion The telephone survey disclosed omissions in database registration, and that in fact 83.6% of children had attended at the diagnostic level.

Primary and salvage laser surgery of 341 glottic cancers-Comparison of treatment outcomes between University Head Neck Tertiary Referral Center and Local Head Neck Department.

OBJECTIVE: The main goal was to compare the clinical data of patients with T1 and T2 glottic cancer treated with CO2 transoral laser microlaryngoscopy (TLM) in the Tertiary Referral University Department of Otolaryngology, Head Neck Surgery, Poznan and the local Department of Otolaryngology, Oncology and Maxillofacial Surgery, Bydgoszcz. MATERIAL AND METHODS: Unified databases for the 7-year period January 2005-December 2011 were created to compare these two cohorts. The database contained 341 patients: 231 from the tertiary center and 110 from the local department, of which 298 (87%) were men, and 43 (13%) were women. RESULTS: Cordectomy type I-IV was performed in 250 (73%) patients, cordectomy type V-VI in 84 (25%) patients, and cordectomy enlarged to epiglottic petiole in 7 (2%) patients. Local recurrence was observed in 96 (28%) cases. Among these cases, 81 (87.5%) patients had salvage surgery: 43 re-cordectomy, 10 open partial laryngectomy, and 28 total laryngectomy. The outcomes for the whole cohort, Tertiary Referral Center and Local Department respectively were as follows: larynx preservation rate was 91.8%, 93.6%, and 88%; 3-year disease specific survival was 97.4%, 97.9%, and 93.3%; 3-year overall survival was 93.5%, 96.6%, and 85.5%; 5-year disease specific survival was 95.2%, 95.2%, and 96.3%; and 5-year overall survival was 84.5%, 88.7%, and 76%, respectively. CONCLUSION: Comparison of the cohorts showed that outcomes of primary treatment were similar but there were noticeable differences in salvage treatment efficacy, favoring patients from the Tertiary Referral Center. Lasers Surg. Med. 50:311-318, 2018. © 2017 Wiley Periodicals, Inc.

The analysis of expression of p16 protein in group of 53 patients treated for sinonasal inverted papilloma.

INTRODUCTION: Sinonasal inverted papilloma constitute relevant therapeutic problem due to destructive character of growth, tendency to recur and the possibility of malignant transformation. Therefore, many attempts to identify risk factors for inverted papilloma occurrence have been undertaken, as well as research to find markers that would allow for the earlier detection of tumors and the application of adequate therapy. A widely known risk factor of inverted papilloma is HPV infection. One of the markers of HPV infection and the ongoing effect of this change (although arousing some controversy) is the expression of the p16 protein. OBJECTIVE: The aim of the study was to analyze the correlation between the expression of p16 as a surrogate of HPV infection in analyzed histopathological material and epidemiological variables, recurrences or malignant transformation. METHODS: The retrospective study includes a group of 53 patients (18 women and 35 men) undergoing treatment for sinonasal inverted papilloma in the period of 2002-2012. The intensity of the p16 protein in histopathological material was scored as: 0 - no expression, 1 - diffuse expression (borderline) and 2 - positive expression; or 0 - no expression/diffuse expression (borderline); 1 - positive expression. The Ethics Committee agreement was obtained (1089/12; 245/13). RESULTS AND CONCLUSION: There was no statistically significant relationship between the expression of p16 and the age of patients, cigarette smoking, tumor location, tumor staging according to the Krouse and Cannady classification, the presence of dysplasia or the occurrence of relapse.

Hearing impairment in premature newborns-Analysis based on the national hearing screening database in Poland.

OBJECTIVES: The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2-4 per 100 in high-risk infants. The national universal neonatal hearing screening carried out in Poland since 2002 enables selection of infants with suspicion and/or risk factors of hearing loss. In this study, we assessed the incidence and risk factors of hearing impairment in infants ≤33 weeks' gestational age (wga). METHODS: We analyzed the database of the Polish Universal Newborns Hearing Screening Program from 2010 to 2013. The study group involved 11438 infants born before 33 wga, the control group-1487730 infants. Screening was performed by means of transient evoked otoacoustic emissions. The risk factors of hearing loss were recorded. Infants who failed the screening test and/or had risk factors were referred for further audiological evaluation. RESULTS: Hearing deficit was diagnosed in 11% of infants ≤25 wga, 5% at 26-27 wga, 3.46% at 28 wga and 2-3% at 29-32 wga. In the control group the incidence of hearing deficit was 0.2% (2.87% with risk factors). The most important risk factors were craniofacial malformations, very low birth weight, low Apgar score and mechanical ventilation. Hearing screening was positive in 22.42% newborns ≤28 wga and 10% at 29-32 wga and in the control group. CONCLUSIONS: Hearing impairment is a severe consequence of prematurity. Its prevalence is inversely related to the maturity of the baby. Premature infants have many concomitant risk factors which influence the occurrence of hearing deficit.

The rapid change in sinonasal inverted papilloma incidence - the epidemiological analysis.

In recent years, the incidence of sinonasal inverted papilloma (IP) in a stable population has increased significantly. The aim of the study was to analyze the occurrence of IP between the years 2002-2012 in relation to epidemiological factors in an unalterable area. Moreover, we wanted to start a discussion about the difficulties in determining the inci¬dence of benign lesions that are not included in registers. This retrospective study included a group of 69 patients who were treated in the Department of Otolaryngology, ENT Oncology, Poznan University of Medical Sciences. In 2006, we noticed a sudden change in referrals. We compared two groups of patients who were referred during two differ¬ent time periods: 11 patients (2002-2006) and 58 patients (2007-2012). Despite a marked difference in the number of patients, there were no differences between the groups in tumor location (p>0.05), stage (p=0.16), duration of symp¬toms (p=0.39), place of residence, and smoking (p=0.41). The patient`s age was the only variable that differed significantly between the groups (48.45 vs. 56.93 years; p=0.043569, respectively).

The results of newborn hearing screening by means of transient otoacoustic emissions - has anything changed over 10 years?

OBJECTIVES: Universal newborn hearing screening (UNHS) has become the standard of care in many countries. The aim of this study was to evaluate the results of UNHS after ten years of the program in Poland and to compare them with the results of 2003. METHODS: In the study, we analyze the results of UNHS in the University Hospital in Poznan, Poland. Between 01.01.2013 and 31.12.2013, 6827 children were examined by means of otoacoustic emissions. RESULTS: Risk factors (RF) were identified in 772 (11.3%) newborns, which is significantly less than 10 years ago (p < 0.05). The most frequent RF were: ototoxic medications, treatment in neonatal intensive care unit (NICU) and prematurity < 33 weeks of gestation. In 2003, the most frequent were ototoxic medications and prematurity, less frequent was treatment in NICU and more common was low Apgar score. In 51 (6.6%) newborns with RF, the result of OAE was positive either unilaterally or bilaterally. In infants without RF the result was positive unilaterally in 22 (0.4%) and bilaterally in 14 (0.2%) patients. These results are significantly lower than in our former study. The relative risk of positive result was the highest in infants with complex congenital anomalies (RR = 44.99), craniofacial anomalies (RR = 17.46) and mechanical ventilation for > 5 days (RR = 10.69). In our previous study, the highest RR of positive test results was in infants with family history, congenital malformations and low Apgar score. We found that most predictive as to the final diagnosis was bilaterally positive OAE test. In most patients, the second check confirmed the diagnosis, independently of RF. The number of false positive tests at the 1st level of screening is significantly lower now than 10 years ago, probably due to better staff training. CONCLUSIONS: Long term monitoring and the appropriate management of hearing deficit in children is essential. UNHS seems to be the most efficient way of finding children who require treatment of hearing impairment. The prevalence of most risk factors of hearing deficit has significantly changed over the years. The number of false positive results has significantly decreased over the years thanks to better staff training.

The report on the Universal Neonatal Hearing Screening Program in Poland between 2003 and 2015.

The Universal Neonatal Hearing Screening Program (UNHSP) has been operating in the whole Poland since 2003. Its main goals are to perform a screening hearing in the 2-3 day of life in every newborn baby in Poland and to gather information on risk factors of hearing loss. In total, 505 centers participate in the UNHSP on three reference levels. As of January 19th 2016, the central data base (CDB) of the UNHSP has records of 4,845,036 children, which comprises 96% of all children born in Poland. Hearing loss was diagnosed in 12,974 children, i.e. in 3 out of 1000 children. Here, we present the most important results and conclusions of the UNHSP.

Clinical outcomes of treatment of sinonasal inverted papillomas (IPs) depending on the surgical technique and learning curve.

INTRODUCTION: Sinonasal inverted papillomas (IPs) are a major challenge for ENT specialists. In the last decades, the number of endoscopic procedures has increased, while the percentage of external or double approach procedures has decreased. The aim of this study was to evaluate long-term IP treatment outcomes according to the applied surgical method. MATERIAL AND METHODS: the retrospective study included 69 patients (28 women and 41 men) treated during 2002-2012 in the Department of Otolaryngology and Laryngological Oncology of Poznan University of Medical Sciences. Of these patients, 47 were operated endoscopically, 16 received a double procedure and six received an external procedure. RESULTS: The recurrence rate in patients treated endoscopically was 32%, while patients treated by the external/double approach showed 64% (p = 0.03306). The recurrence rate after endoscopic surgery was 75% during 2002-2006, but was 28% during 2007-2012. There was no correlation between recurrence rate and age (p = 0.087686), gender (p = 0.42810), type of symptoms (p = 0.20955), or Krouse staging (p = 0.23658). A significant impact on relapses was the position to Ohngren's plane (p = 0.004768) and tumor location in the anterior ethmoid (p = 0.00416). DISCUSSION: Endoscopic procedures are an effective method of IP treatment, however reasonable indications and surgeon experience should be taken into consideration.

Universal Neonatal Hearing Screening Program in Poland--10-year summary.

INTRODUCTION: The analysis was aimed to summarize the outcomes of Polish Universal Neonatal Hearing Screening Program (PUNHSP). MATERIALS AND METHODS: The analysis comprised the population of children registered in the PUNHSP database between 2003 and 2013. The evaluated parameters included: the program coverage (percentage of children covered by the Program in relation to the number of births), results of screening tests at different levels of the Program and hearing loss incidence. RESULTS: The average screened population was 96,0% with respect to total number of live births in Poland. Children requiring further evaluation represent annual average 8.5% of the study population. Among them, on average 55.8% were consulted in audiological centers. Hearing loss incidence was estimated to be 0,3%. The highest hearing loss incidence was detected in children which failed the OAE test with concomitant risk factors. 58.2% of children were fitted with hearing aids, 34.0% were referred for surgical treatment, and 7.8% for further rehabilitation. CONCLUSIONS: The results of the program evaluation confirmed its good efficiency. The coverage and hearing tests results are comparable to those from other countries conducting similar national hearing screening programs.