Sex-Related Cochlear Impairment in Cigarette Smokers.

BACKGROUND A number of studies have documented the influence of cigarette smoking on hearing. However, the association between sex and hearing impairment in smokers as measured by otoacoustic emissions (OAEs) has not been clearly established. The aim of this study was to analyze sex-specific effects of smoking on hearing via conventional and ultra-high-frequency pure tone audiometry (PTA), and OAEs, specifically spontaneous OAEs, click-evoked OAEs, and distortion-product OAEs. MATERIAL AND METHODS The study included 84 healthy volunteers aged 25-45 years (mean 34), among them 46 women (25 non-smokers and 21 smokers) and 38 men (16 non-smokers and 22 smokers). The protocol of the study included otoscopic examination, tympanometry, low-, moderate-, and ultra-high-frequency PTA, evaluation of spontaneous click-evoked (CEAOEs) and distortion-product otoacoustic emissions (DPOAEs), assessment of the DP-grams for 2f1-f2 (f1 from 977 to5 164 Hz), and input/output function at L2 primary tone level of 40-70 dB SPL. RESULTS Smokers and non-smokers did not differ significantly in terms of their hearing thresholds assessed with tone audiometry. Male smokers presented with significantly lower levels of CEAOEs and DPOAEs than both male non-smokers and female smokers. CONCLUSIONS Smoking does not modulate a hearing threshold determined with PTA at low, moderate, and ultra-high frequencies, but causes a significant decrease in OAE levels. This effect was observed only in males, which implies that they are more susceptible to smoking-induced hearing impairment. Sex-specific differences in otoacoustic emissions level may reflect influences of genetic, hormonal, behavioral, and/or environmental factors.

[A case of subclinical frontal lobe abscess as a complication of sinusitis]. / Przypadek skapoobjawowego zatokowopochodnego ropnia plata czolowego mózgu.

Nowadays suppurative complications of sinusitis are uncommon in orderto widespread treatment with antibiotics. Intracranial complications include bacterial meningitis, encephalitis, brain abscess, epidural or subdural abscess and sinus thrombophlebitis.The 13-40% of all brain abscesses are sinogenic complications. The inflammation process spreads from sinuses by valveless diploic veins of the skull as thrombophlebitis or by direct extension of osteomyelitis. Jatrogenic, posttraumatic or natural fissures in bony walls can also take part in spreading the infection. Diagnostic process includes laryngological and neurological evaluation with the computer tomography scanning or magnetic resonance imaging. Patients with intracranial complications require broad-spectrum antibiotic therapy and surgical treatment in orderto remove the origin of infection in the sinuses. For physicians they are always challenging conditions according to their significantly high mortality. The case of the 24 year old patient with sinogenic brain abscess was shown in this paper. He neglected ambulatory treatment of chronic sinusitis because of lack of the medical insurance. After episode of losing the consciousness he was admitted to the ENT Department with headache, nausea, fever and dehydration. The diagnose was established based on laryngological and neurological examination and visualization of brain abscess on CT scans. He was treated by surgical intervention conducted by team of head and neck surgeons and neurosurgeons. Intensive antibiotic therapy with the Uffenorde operation of frontal sinuses and neurosurgical removal of the brain abscess was performed.The epidemiology, clinical course, diagnostic problems and therapy were described.

[The case of malignant melanoma of the external ear with hidden location]. / Przypadek czerniaka malzowiny usznej o wyjatkowo skrytej lokalizacji.

Melanoma is one of the most malignant neoplasm. Mostly it is located in skin but also can appear in every place where melanocytes are present. Approximately 25% of all of these tumours is located in head and neck region probably because of intensive sun exposure of the skin. The case of the 44-year-old, male patient with malignant melanoma of the external ear was shown in this paper. The patient was asymptomatic and diagnosed accidentally. The suspicion of metastatic lymph nodes of neck was based on CT and ultrasonography examination. The patient was treated by surgical excision (total resection of the right auricle) with one centimeters of free margins. Additionally elective neck's lymph nodes dissection was performed. The histopathological evaluation has shown radical excision of stage II (Clark's scale) malignant melanoma of the ear with negative margins and without metastatic lymph nodes of the neck. The patient was not qualified to radiotherapy by oncologist. No evidence of local recurrences or distant metastasis was detected during a 3 years follow-up period. The epidemiology, clinical and pathological classification of the tumour, diagnostic problems and therapy were described. The prognosis of melanoma depends mostly on the thickness of the tumour but also on level of invasion and presence of ulceration.

[Rare case of haemangioma of the pharynx]. / Rzadki przypadek duzego naczyniaka gardla.

The hemangioma is a benign tumour located mostly in the region of head and neck. It can appear at any age but especially it is diagnosed among children. The disease can be successfully treated with surgery, criotherapy, propranolol or endovascular procedures. The rare case of the 59-year-old, male patient with huge heamangioma of the pharynx was shown in this paper. The patient was mildly symptomatic - he neglected difficulty with swallowing or breathing and there was no pain. The only one complaint was experiencing a worsened hearing in the left ear. The patient was referred to the laryngologist with acute pharyngitis and with the suspicion of peritonsillar abscess. In the ENT examination apart from acute tonsillitis, the tumour of pharynx was diagnosed. Diagnostic puncture of the tumour showed blood. Ambulatory treatment with antibiotics was administered. The inflammation of pharynx was cured but the tumour remained. In the ENT department the patient underwent diagnostic process including CT of the head, angioCT of carotid arteries and consultation of vascular surgeon. The diagnosis was established and patient was referred for endovascular treatment. The outcome of the embolization of hemangioma resulted in reducing the tumour size and decreasing patient's symptoms. The epidemiology, diagnostic problems and therapy were described.

[The case of giant rhabdomyosarcoma of the head and neck and meagre symptomatology]. / Przypadek olbrzymiego miesaka prazkowanokomórkowego glowy i szyi o skapoobjawowym przebiegu klinicznym.

The case of the 27-year old patient with huge tumour of the right parotid gland was shown in this article. The right parotid gland, the right parapharyngeal space, region of the right maxillary sinus and the right temporal lobe of the brain were involved. Histopathological examination revealed alveolar rhabdomyosarcoma. The epidemiology, diagnostic problems and therapy were described.

[Rare case of upper respiratory tract obstruction secondary to massive hematoma of pharynx, larynx and trachea]. / Rzadki przypadek rozleglego samoistnego krwiaka gardla, krtani i tchawicy jako przyczyna zwezenia dróg oddechowych u 75-letniej pacjentki.

The rare case of 75-years-old female patient was presented in this paper. She reported hoarseness in addition to pharyngeal pain, dysphagia and medium level dyspnea. Her exploration revealed a wide hematoma of the left lateral wall of orohypopharynx spreading to the left aryepiglottic fold, left aryepiglottic cartilage, false and true vocal fold and later to left lateral and posterior tracheal wall. The patient did not require a control of airway by intubation or tracheotomy according to quick relief after pharmacological treatment.