A comparative study: TTS Vs wave V after exposure to noise.

The pattern of recovery from noise exposure was monitored, with regards to the behaviour and electrophysiology in 25 normal-hearing subjects, at 4 KHz frequency for 30 min. Fatiguing stimulus was an octave band noise with centre frequency of 3 KHz. Subject's behaviour following to the auditory fatigue was studied by temporary threshold shift (TTS) paradigm. In the electrophysiological study, the auditory fatigue was measured as a shift of the wave V latency in the auditory brainstem responses (ABR) after noise exposure. This shift was measured at 40 dB nHL stimulus intensity ("Logon" with centre frequency at 4 KHz). The ABR recordings started immediately after cessation of noise exposure and threshold measurements 2 min later. The recovery of latency shift began immediately after the exposure and ended faster than the auditory threshold. From a practical point of view it means that in order to measure maximal values of latency shift, the ABR recordings should be performed immediately after cessation of noise exposure.

[20 years of joint research on the carcinoma of the larynx conducted by teams from clinics in Crakow, Poznan, Warsaw and Lublin]. / 20 lat wspólnych badan nad rakiem krtani zespolów klinik krakowskiej, poznanskiej, warszawskiej i lubelskiej.

A twenty-year scientific cooperation has been discussed (1979-1998) between four clinics for laryngology at Medical Universities in Cracow, Poznan, Warsaw and Lublin. The results of research concerning the epidemiology, diagnostics and treatment of the carcinoma of the larynx are presented.

[Evolution of vestibular schwannoma: radiological evaluation]. / Ewolucja nerwiaków nerwu VIII--ocena radiologiczna.

Objective evaluation of natural history of vestibular schwannomas can be performed based on the modern radiological investigations, mainly MR. This study included 7 vestibular schwannomas. The average observation period was 28 months. Tumor growth was calculated based on the comparison of volume on the first and subsequent MR image using a special dedicated software. All tumors in this study were growing. The average growth rate was 143 mm3/month. Among 7 primarily observed tumors, 4 schwannomas were already removed surgically. The remaining 3 tumors are still observed. The authors pointed out that longer were the radiological observations of vestibular schwannomas greater was the conviction about progression of majority of these tumors.

[Tumors of the parotid glands in the material of the Department of otolaryngology of the Medical Academy in Warsaw in 1986-1995]. / Guzy slinianek przyusznych w materiale Kliniki Otolaryngologii AM w Warszawie w latach 1986-1995.

In the Department of Otolaryngology, Medical Academy in Warsaw, 332 patients were surgically treated between 1986 and 1995 because of parotid gland tumors. In 275 cases benign tumors, in 57 cases--malignant tumors were observed. The majority of benign tumors were pleomorphic adenoma (61.45%) and lymphadenoma (22.54%); the majority of malignant tumors were adenocarcinoma (28%), adenoid cystic carcinoma (21%), mucoepidermoid carcinoma (15.78%). All patients with benign tumors were surgically treated, patients with malignant tumors were operated on and irradiated. The surgical procedure used superficial parotidectomy and total parotidectomy with preservation of facial nerve where possible. Ten patients required total parotidectomy with facial nerve resection because of malignant tumors, six patients had neck dissection performed. Of the 57 patients treated on account of malignant tumors 43 survived; 14 patients died of a local recurrence or generalization neoplasm disease.

[Pathology of the parotid gland in the parapharyngeal space]. / Patologia slinianki przyusznej w przestrzeni przygardlowej.

In Otorhinolaryngology Department of Medical Academy in Warsaw 49 cases of tumors of the parapharyngeal space were recognized and treated in the period between 1977 and 1996. 48 patients were operated on, one died in the terminal phase of cancer disease. General rules of qualification for operation are as follows: a) CT scans, b) arteriography, c) in changes suggesting neoplasms histological examination during operation is necessary. External approach was applied in all cases, which gave full control over vascular structures. In 49% of cases malignant neoplasms were recognized. Each operation of malignant neoplasms of the parapharyngeal space, as not radical, was supplemented with radiation.

[Surgical management of the advanced orbit malignancies]. / Postepowanie chirurgiczne w przypadkach zaawansowanych guzów zlosliwych oczodolu.

Twenty one patients with advanced malignant tumors of the orbit have been treated in the Department of Otolaryngology, Medical Academy in Warsaw, between 1980 and 1995. There were two groups of patients: five with primary orbital tumors and sixteen with secondary tumors that penetrated from sinuses. In all cases surgical treatment with orbital exenteration has been performed, as well as postoperative radiotherapy. The local cutaneus flaps and temporalis muscle flap have been used for reconstruction of the orbitomaxillary defects. The authors suggest that one-stage reconstruction of maxillo-facial region after surgery decreases facial deformation and allows to apply ocular prothesis guickly.

[The surgical treatment of malignant tumors of the maxillo-ethmoid complex]. / Leczenie nowotworów zlosliwych masywu szczekowo-sitowego.

Forty-seven patients were treated in the Department of Laryngology, Medical Academy in Warsaw between 1980 and 1989. Twenty-seven patients had squamous cell carcinoma. All cases were advanced. The patients were treated by combination of surgery and postoperative radiotherapy. Nineteen patients (40.4%) survived five years.

[The results of surgical treatment of patients with laryngeal carcinoma in years 1988-1989 in four departments of otorhinolaryngology]. / Wyniki operacyjnego leczenia chorych na raka krtani w latach 1988-1989 w czterech osrodkach klinicznych.

In a group of 579 patients with laryngeal carcinoma treated surgically in years 1988-1989 in four departments of otorhinolaryngology of the Medical Academies in Poznan, Warsaw, Cracow and Lublin, 72% survived 3 years without recurrence and 59% survived 5 years. Similar results were obtained in years 1986-1987. The authors discuss in detail the reasons for failures of the surgical treatment, i.e.: supraglottic localization of the cancer, its extensiveness in the larynx, the stage of clinical development, general condition of the patient, effectiveness of the operation, regularity of postsurgical examination, the degree of histological malignancy, blood transfusion during the operation, distant metastases, little efficiency of medical service in early diagnosis of laryngeal cancer, avoiding postsurgical radiation, subjective factors of the patients and the choice of the optimal method of the treatment. Few patients can be cured if the initial treatment fails.

[Study of the vestibule in patients with dizziness and vertigo after 60 years of age]. / Badania narzadu równowagi u chorych z zawrotami glowy i zaburzeniami równowagi po 60 roku zycia.

Aging of the vestibular apparatus is shown to consist of processes similar to those occurring in other parts of the nervous system. The recognition of these findings is a first step in the clinical differentiation of presbyastasis from symptoms related to specific disease processes. Authors had reviewed results of otoneurological investigations in the material of 8328 patients and realised that 1034 of them (12.4%) were over-60-year-old. These patients suffered from pathology of peripheral as well as central part of vestibular system.

[Efficiency of surgical treatment in patients with laryngeal cancer depending on age]. / Wydolnosc operacyjnego leczenia chorych na raka krtani w zaleznosci od wieku.

In the group of 578 patients with larynx cancer that underwent surgical treatment in four clinics of Medical Academies between 1986-87 a comparable analysis of the efficiency of surgical treatment depending on age of the operated patients was carried out. It was found that the difference between age average and the general state of patients was statistically highly important: Statistically significant was also the dependence between the patients' age and the postoperative complications; close to importance was also the dependence between the age and the survival period of patients. 68% of operated patients up to 65 year of age had five-year survival period without any symptoms; but in the group of patients over 65 years of age the analogical survival value was 51%.

[The role of endoscopic surgery in the treatment of chronic inflammation of paranasal sinuses]. / Rola czynnosciowej chirurgii endoskopowej w leczeniu przewleklego zapalenia zatok przynosowych.

This paper discusses the latest advances in diagnosis, medical treatment, and functional surgery for the treatment of chronic rhinosinusitis.

[The reasons for failures of laryngeal cancer surgeries]. / Przyczyny niepowodzen operacyjnego leczenia chorych na raka krtani.

In 4 ENT Clinics of Medical Academies in Poznan, Warszawa, Kraków, Lublin 2620 laryngeal cancer patients were operated upon during the years 1980-1987. The treatment failure occurred in 760 cases (29%). The following possible to discover factors were probably responsible for unsuccessful results: senility, other concomitant diseases (especially cardiac), prolonged diagnostic procedure, no up to date diagnostic methods, giving up the radiotherapy (38% of cases), upper laryngeal localization of tumors (87%), advanced extents T3 and T4 (83%), advanced clinical stages of cancer (III degrees and IV degrees 85%), lack of surgical radicality especially in neck dissection, unsuccessful neck dissection behind the accessory nerve, omittance of taking the specimens to the pathomorphologic examinations from the marginal part of the operational field in 25% of patients. The early recurrences in these places in apart of patients spoke for the presence of the neoplasmatic cells in this region.

[Computer analysis of nystagmus]. / Komputerowa analiza sygnalu ENG.

An algorithm for the computer analysis of nystagmus is described in this paper. This algorhythms was based on digital differentiator, which monitors the eye position. The computed eye velocity is next used as an input to the fast phase detector. Several procedures, including minimum velocity test, slope sense test, SPV and FPV relationship test are invoked to extract the fast phases from the recorded signal. Based on three-years experience (approx. 3000 examinations) using the ENG-PC System in clinical practice we can conclude, that application of the nystagmus detector was useful in most cases. In our opinion, despite from system imperfection which is observed during the analysis of recording disturbed by artifacts, this system has unquestionable advantage over the traditional technique.

[Multiple primaries in head and neck malignant neoplasms]. / Mnogie pierwotne nowotwory zlosliwe glowy i szyi.

Multiple primary neoplasm has developed in 70 patients with head and neck cancer who were treated in Otorhinolaryngology Department Medical Academy in Warsaw. Two primary neoplasm has been recognised in 63 patients, three independent tumors in 7 patients. The most common site for a first tumor was laryngeal carcinoma, for a second - lung, skin and tongue. The squamous cell carcinoma was the most common in the first as well as in the second malignancies.

[Efficiency of surgical treatment in patients with laryngeal cancer in four clinical centers]. / Wydolnosc operacyjnego leczenia chorych na raka krtani w czterech osrodkach klinicznych.

A group of 578 patients with larynx cancer underwent surgical treatment in four Otolaryngological Clinics of Medical Universities in Poznan, Warsaw, Cracow and Lublin between 1986-1987. Within this group, 75% of operated patients had a three--year survival rate without symptoms, and 58% of patients had a five-year survival rate. A detailed evaluation of causes of failures in surgical treatment dealt with e.g. the initial placement of the cancer including entrance margins of larynx in a rich net of lymphatic vessels, extensiveness of organs, the degree of clinical progressions, general physical condition of a patient, radicality of treatment, regularity of check-ups after the operation, high degree of histological malignancy unfavourable configuration of TNM feature blood transfusions, the appearance of remote metastases low efficiency in the early diagnostics of larynx cancer, subjective conditions of patients, discontinuation of complementary irradiation.

[Failure of surgical treatment in patients with laryngeal cancer]. / Niepowodzenia operacyjnego leczenia chorych na raka krtani.

In 4 ENT Clinics of Medical Akademies in Poznan, Warszawa, Kraków, Lublin 2620 laryngeal cancer patients were operated upon during the years 1980-1987. The treatment failure occurred in 760 cases (29%). The following possible to discover factors were probably responsible for unsuccessful results: prolonged diagnostic procedure, upper laryngeal localization of tumors, advanced extents T3 and T4 (83%), advanced clinical stages of cancer (III degree and IV degree 85%), lack of surgical radicality especially in neck dissection. The early recurrencies in these places in apart of patients spoke for the presence of the neoplasmatic cells in this region.

[Ototoxicity of drugs]. / Ototoksycznosc leków.

The paper included the most current information about the mechanisms of ototoxicity of five groups of the most popular drugs: a) antibiotics, b) chemotherapeutics (cytostatic) agents, c) loop diuretics, d) salicylate and nonsteroidal anti-inflammatory drugs, as well as e) progestagen contraceptives minimized or even prevented by thoughtful selection of drug, attention to risk factors and careful patient monitoring.

[The head and neck metastases from clear cell carcinoma of the kidney]. / Przerzut raka jasnokomórkowego nerki do glowy i szyi.

The kidney carcinoma is the commonest tumour to metastasize to the head and neck. The majority of renal metastases occur in the nose and paranasal sinuses. This paper presents four cases of metastatic tumour in the nasal cavities, paranasal sinuses, frontal bone and piriform fossa. The difficulties in diagnosis and management was also presented.

[Lateral rhinotomy is still a useful surgical approach]. / Rynotomia boczna wciaz uzyteczna.

Experience with 130 patients requiring a lateral rhinotomy is reported. It is concluded that excellent surgical exposure is assured by this approach and that minimal postoperative complications are attributable to the incision. An understanding of the advantages and disabilities associated with each of several extensions may help to the surgeon to tailor the approach to individual case. The lateral rhinotomy approach allows wide access to the nose, some elements of skull base, the nasopharynx and the paranasal sinuses for removal of benign and malignant lesions.