[Epidemiological and demographic analysis of indications for Baha® surgery in Poland--multicenter study]. / Analiza epidemiologiczna i demograficzna wskazan do implantacji systemu Baha® w Polsce--badanie wieloosrodkowe.

AIM OF THE STUDY: To collect and analyze epidemiological and demographical data of patients qualified for and implanted with the Baha® system in Poland. MATERIAL AND METHOD: 17 out of 28 otolaryngology departments performing Baha® implantation in Poland participated in the study. Up to date there were 286 patients registered in database. Data were obtained from the preoperative questionnaires including information such as age and gender, indications for the implantation, previous hearing aid use as well as data regarding the surgical technique. RESULTS: The most frequent indication for the Baha® system was bilateral mixed hearing loss (51%), followed by SSD (18%), bilateral conductive hearing loss (17%), unilateral mixed (8%) and conductive (6%) hearing loss. In 11% of subjects hearing impairment was congenital versus 89% cases of acquired. The mean age was 44 years with the slight prevalence of women (52%). 63% of patients did not have previous experience with hearing aids. The most frequent surgical technique was classic dermatome single stage procedure performed under general anesthesia (65%). CONCLUSIONS: Data gather in this multicentre research serve as a valuable source of information on qualifications for the Baha®, shows demographic spectrum of adult recipients in Poland. It also presents the preferences of surgical procedures. Outcomes of the study may constitute a reference for each centre participating in this research as well as for new centers starting the Baha® procedure.

[Cervical tuberculosis -- scrofula]. / Skrofuloza - gruzlica wezlów chlonnych szyi.

We described a diagnostic procedure of two cases of extrapulmonary tuberculosis in elderly people. The paper presents the diagnostic difficulty caused by the lack of obtaining an adequate amount of material and low sensitivity and specificity of the conventional techniques. The probe Tec ET test was used with conventional microbiology and histology helps in diagnosis of extrapulmonary tuberculosis by improving specificity, sensitivity. Probe Tec ET test takes a few hours.

[Small cell neuroendocrine carcinoma of the larynx--a case report]. / Drobnokomórkowy neuroendokrynny rak krtani--opis przypadku.

This paper discusses a rare case of small cell neuroendocrine carcinoma of the larynx. The diagnosis was based on histological investigation expanded with immunohistochemical tests of a fragment of a tissue taken through laryngofissure. The treatment in case of small cell carcinoma diagnosis differs from the treatment in case of other neuroendocrine carcinomas and squamous cell carcinomas of the larynx.

[The case of otologic cerebrospinal fluid leak in patient with recurrent meningeal infection]. / Przypadek plynotoku usznego u chorej z nawracajacymi zapaleniami opon mózgowo-rdzeniowych.

The authors present a cause of 51 year old female with recurrent meningeal infection. The patient had a remote history of head injury that she had almost forgotten. CT was performed but no pathology of temporal bone origin was diagnosed. DTPA+Tc99m cisternography showed an abnormal radioactive accumulation in the right middle ear at 6 and 24 hours after intrathecal injection.

[Intracranial complications of sinusitis in patients of the otolaryngology Department of the regional hospital in Olsztyn treated between 2004-2007]. / Wewnatrzczaszkowe powiklania zatokopochodne u pacjentów Oddzialu Otolaryngologicznego Szpitala Wojewódzkiego w Olsztynie leczonych w Latach 2004-2007.

Sinusitis is common disease. However intracranial complications of sinusitis are rare, but they are still a serious problem that results in high mortality. Diagnostic advantages of CT scanning and magnetic resonance imaging as well as therapeutic advantages of FESS prevent spread of complications. Patients with intracranial complications require surgery to remove the focus of infection from the sinuses and neurosurgical drain the abscess in some cases, with intensive antibiotic therapy. We presented three cases of intracranial complications treated by endoscopic sinus surgery connected with extranasal drain of frontal sinus. It is worth to emphasize the advantages of FESS over the external approaches as follows: the method treats the causative source of the disease, the morbidity is low, and it avoids facial cosmetic trauma.

[Malignant melanoma of the auditory tube]. / Przypadek czerniaka zlosliwego trabki sluchowej.

Melanomas of the mucous membranes of airway tract constitute around 1% of the total melanomas of head and neck. The most common site of the tumor are the nasal and paranasal sinuses but melanomas of the oral cavity are described too. The location of malignant melanoma in the eustachian tube is very rare. We found five cases of this disease in the literature. In our article we present a 53-year-old woman with progressive left aural fullness and hearing impairment for two months. Clinical examination found left middle ear effusion. The nasopharyngoscopy revealed a bluish red, friable and granulomatous tumor occupying the whole pharyngeal orifice of the left auditory tube. The biopsy speciment was taken which established the diagnosis. Because of localization and spread of the melanoma we had a low opinion of surgical treatment and radiotherapy was recommended. The patient was under constant laryngologic and oncological observation. We did not notice the local recurrence of melanoma. She died two years after making the diagnosis because of the neoplasm dissemination.

[Case of esophageal foreign body complicated by mediastinitis and broncho-esophageal fistula]. / Przypadek ciala obcego przelyku powiklany zapaleniem sródpiersia i przetoka przelykowo-oskrzelowa leczony pomyslnie.

Authors describe the case of esophageal perforation in 85-year woman ended with good outcome. The patient was admitted to our ward with suspicion of foreign body in esophagus and the clinical manifestation of early stage mediastinitis. We resigned esophageal perforation debridement because of the old age and patient's poor general condition. Conservative treatment was administrated during a long period including high-doses of antibiotics and nutritional support. In the third week of patient's admission mediastinitis was cured but esophageal radiograms showed the bronchoesophageal fistula on the left side. There were no signs of self-existent closure of fistula. The patient was sent to the Thoracic Surgery Ward of John Paul Hospital in Cracow where the performance of thoracotomy was used as surgical treatment. Closure of fistula made that our patient was able to return to normal life.

[Parapharyngeal phlegmon as a complication after tonsillectomy]. / Ropowica przestrzeni przygardlowej jako powiklanie po tonsylektomii.

Authors wanted to draw attention to possibility of dangerous postoperative complications when the clinical manifestation of reactivation Herpes simplex virus infection develops during the postoperative period. We report a case of parapharyngeal phlegmon following tonsillectomy in a previously healthy 18-year old woman. On postoperative day six signs of Herpes simplex virus infection were presented in our patient. Hypoimmunity causing reactivation of virus led to evolution of septicemia and extended parapharyngeal phlegmon. Management involved parapharyngeal space drainage, broad spectrum antibiotics and gammaglobulin coverage. Treatment was successful. The patient was discharged in good condition in the fourth week of her admission.

[Tuberculosis of the inner ear]. / Gruzlica ucha srodkowego.

Tuberculosis of the middle ear is a rare, but not a nonexistent disease. It is well reported in literature that the typical features of this disease have been changing over the years, what can lead to delay in proper diagnosis and cause irreversible complications. Presented two cases of tuberculous otitis media confirm the opinion that historically classical triad of features: painless otorrhea, multiple perforations of the tympanic membrane and concomitant peripheral facial paralysis is often absent in the clinical picture of this disease.