Cochlear implant and congenital cholesteatoma.

BACKGROUND: The occurence of cholesteatoma and cochlear implant is rare. Secondary cholesteatomas may develop as a result of cochlear implant surgery. Primarily acquired cholesteatoma is not typically associated with congenital sensorineural hearing loss or cochlear implant in children. The occurrence of congenital cholesteatoma during cochlear implant surgery has never been reported before, partly because all patients are preoperatively submitted to imaging studies which can theoretically exclude the disease. CASE PRESENTATION: We have reported a rare case of congenital cholesteatoma, found during sequential second side cochlear implantation in a 3-year-old child. The child underwent a computed tomography (CT) scan and magnetic resonance imaging (MRI) at 12 months of age, before the first cochlear implant surgery, which excluded middle ear pathology. The mass was removed as an intact pearl, without visible or microscopic violation of the cholesteatoma capsule. All the areas where middle ear structures were touching the cholesteatoma were vaporized with a laser and the cochlear implant was inserted uneventfully. Further follow-up excluded residual disease. CONCLUSION: We believe that primary, single stage placement of a cochlear implant (CI) with simultaneous removal of the congenital cholesteatoma can be performed safely. However, to prevent recurrence, the capsule of the cholesteatoma must not be damaged and complete laser ablation of the surface, where suspicious epithelial cells could remain, is recommended. In our opinion, cholesteatoma removal and cochlear implantation should be staged if these conditions are not met, and/or the disease is at a more advanced stage. It is suspected, that the incidence of congenital cholesteatoma in pediatric CI candidates is much higher that in average pediatric population.

[Estimation larynx function after inhaled corticosteroids in the management of asthma]. / Ocena funkcji krtani po stosowaniu steroidów wziewnych w terapii astmy oskrzelowej.

The aim of study was the estimation larynx function in patients with chronic asthma after prolonged use of inhaled corticosteroids. Phoniatric examination and laryngovideostroboscopy were carried out. Patient were stayed under phoniatric et laryngologic control during the period of 12 months. Casual pharynx et larynx disorders were treated symptomatically. Dysphonia has been reported in the most of observed cases (70% patients). We explain it to be due to a laryngeal myopathy secondary to local corticosteroid effects. Larynx dysfunction was the reversible and did not depend of the corticosteroid use period.

[Otolaryngologic symptoms from tumors of the posterior cranial fossa]. / Objawy otolaryngologiczne w guzach tylnego dolu czaszki.

The aim of the paper was the estimation of the otolaryngological signs in the patients with the tumor of posterior cranial cavity. Each one was underwent the otoneurological diagnosis inclusive of electronystagmography. The most frequent symptoms we noticed were headache, vertigo together with cerebellar signs and disorder of the VII, VIII and IX-th cranial nerves, The ENG seemed to be a useful method in a localizing process of intracranial damages.

[Epidemiology of malignant neoplasms of the upper respiratory tract and oral cavity in the Bydgoszcz region]. / Epidemiologia nowotworów zlosliwych górnych dróg oddechowych i jamy ustnej w województwie bydgoskim.

The authors performed epidemiological analysis of malignant neoplasms of the nose, paranasal sinuses, throat, tongue, larynx and salivary glands in Bydgoszcz area. All the patients were treated in the Otolaryngological Clinic of Medical Academy in Bydgoszcz. Patient's sex, age, profession, living and environmental conditions as well as histopathological diagnosis were taken into analysis. The data were referred to various regions of Bydgoszcz province, which were elucidated on the basis of microclimate conditions, industry, soil conditions, density of the forest area, and cultivated agriculture plants. Correlations between occurrence of oral cavity and the upper respiratory tract malignant neoplasms and living conditions as well as kind of profession in different parts of Bydgoszcz province were estimated.

[Malignant neoplasms of the tongue and tonsil-glossal angle from material obtained in the otolaryngology clinic in Bydgoszcz in the years 1981-1994]. / Nowotwory zlosliwe jezyka i kata migdalkowo-jezykowego w materiale Kliniki Otolaryngologii w Bydgoszczy w latach 1981-1994.

In the period 1981-1994 in the ENT Department, University School of Medical Sciences in Bydgoszcz, 102 patients with malignant neoplasms of the tongue and the tonsillo-glossal angle were treated. The most common group comprised patients diagnosed with "planoepithelial carcinoma" (94 persons). The number of patients with tongue malignancies increased every year. Similarly, increasing of the neoplastic grade was observed. The majority of patients underwent surgery and, in the next step, radiotherapy. We preferred a total tumor excision involving half of the tongue. Often we had to extend surgery to resection of the lateral part of throat and, in situation of extreme penetration of neoplasms, we removed the bottom of oral cavity. We concluded that in patients with malignant neoplasms of the tongue, planoepithelial carcinoma is present in more than 90 percent of cases. The tumors are diagnosed in the late period. On initiation of treatment half of the patients were presenting with T2 tumors. We confirmed infiltration of the tonsillo-glossal angle in half of the patients. Five years survival without tumor recurrence in our material was 26.47%.