[Peripheral blood cell count and inflammation-based markers in chronic rhinosinusitis]. / Zellzahl und Entzündungsparameter im peripheren Blut bei chronischer Rhinosinusitis.

OBJECTIVE: The aim of this study was to verify whether the following peripheral blood cell count and inflammation-based markers differ between various types of chronic rhinosinusitis (CRS): neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), as well as erythrocyte sedimentation rate (ESR) and C­reactive protein (CRP) levels. MATERIALS AND METHODS: In all, 386 patients had complete peripheral blood count, ESR, CRP and nasal cytology. The severity of CRS symptoms was assessed using three-stage Lund-Mackay computed tomography (CT) scores. The participants were stratified based on the results of nasal cytology and by the presence of nasal polyps (NP). The inflammation-based markers were calculated by dividing the cell numbers of the different cell types by numbers of the other cell types. RESULTS AND CONCLUSIONS: Blood leukocyte and neutrophil counts were higher in neutrophilic CRS. Differences between patients with CRS with nasal polyps (NP) and CRS without NP were significant for blood leukocytes, neutrophils, monocytes, eosinophils, CRP, NLR and MLR values. In CRS with NP, peripheral blood leukocyte, neutrophil, monocyte and eosinophil counts, as well as CRP, NLR and MLR values were higher than in CRS without NP. Our results show that all individuals with CRS could benefit from the analysis of blood counts and inflammation-based markers at the beginning of their evaluation. High levels of inflammation-based markers might guide the clinician towards planning more radical CRS therapy and use of systemic anti-inflammatory medication.

Vestibular-evoked myogenic potentials and caloric tests in infants with congenital rubella.

UNLABELLED: Vestibular-evoked myogenic potentials and caloric tests in infants with congenital rubella. OBJECTIVE: Congenital rubella is rare due to maternal vaccination, but vestibular function can be markedly impaired in affected infants. Currently, vestibular testing is not routinely performed in infants. This study evaluated inner ear function in infants with congenital rubella. METHODOLOGY: The study included 54 3-month-old infants: 40 healthy controls and 14 with congenital rubella that was serologically confirmed in mothers and infants. There were two subgroups of infants with congenital rubella: 6 infants with clinical symptoms of intrauterine rubella infection present at birth and 8 asymptomatic infants. Caloric testing and vestibular-evoked myogenic potential (VEMP) testing were performed on all of the infants. RESULTS: In congenital rubella there was no reaction to caloric stimulation in 43% of the ears, and no VEMPs were recorded in 64%. The hearing thresholds were below 80 dB hearing level in 21% of the ears and greater than 80 dB hearing level in 43% of the ears. CONCLUSIONS: The degree of vestibular organ impairment in infants with congenital rubella is higher in individuals with profound hearing loss. VEMPs were absent more frequently than were caloric responses. Vestibular testing should be routinely performed in all infants with congenital rubella.

Electroglottography in the follow-up of bilateral vocal fold palsy.

UNLABELLED: Electroglottography in the follow-up of bilateral vocal fold palsy. OBJECTIVES: The aim of the study was to determine if electroglottography provides useful information concerning vocal perturbations within the glottis in the follow-up of patients with bilateral vocal fold palsy. METHODOLOGY: Electroglottography was performed in 8 patients with bilateral vocal fold palsy (aged 43-77 years; mean, 62.6; standard deviation, 3.8; median, 66) and 8 healthy age-matched controls. Percent (%) irregularity, jitter, and shimmer were calculated by Speech Studio. The patients' severity of dysphonia was rated by experts on a four-point scale. RESULTS: Percent irregularity was significantly higher in patients with vocal cord palsy than in controls (p < 0.05). There was strong correlation between percent irregularity, jitter, and shimmer, and perceptual degree of dysphonia in all examinations during 6-month follow-up. CONCLUSIONS: Electroglottographic recordings can give an objective measure of glottal disturbances in patients with bilateral vocal fold palsy. It is possible to track improvement in vocal fold contact due to return of vocal fold mobility and functional compensation in consecutive examinations. Percent irregularity, jitter, and shimmer adequately represent changes in glottal function in individuals with bilateral vocal fold palsy during 6-month follow-up.

Development of galanin-containing nerve fibres in rat tibia.

Galanin exerts tonic inhibition of nociceptive input to the central nervous system. Recently, this peptide was demonstrated in several neuronal and non-neuronal structures in bones and joints. In this study, the time of appearance and topographic localization of galanin-containing nerve fibres in bone were studied in rats from gestational day 16 (GD16) to postnatal day 21 (PD21). The tibia was chosen as a model of developing long bone and indirect immunofluorescence combined with confocal laser scanning microscopy was used to identify galanin-immunoreactive (GAL-IR) nerve fibres. The earliest, sparse GAL-IR fibres were observed on GD21 in the perichondrium of both epiphyses and in the periosteum of the diaphysis. From PD1 onwards, GAL-IR fibres were also seen in the bone marrow cavity and in the region of the inter-condylar eminence of the knee joint. Intramedullary GAL-IR fibres in proximal and distal metaphyses appeared around PD1. Some of them accompanied blood vessels, although free fibres were also seen. GAL-IR fibres located in the cartilage canals of both epiphyses were observed from PD7, in the secondary ossification centres from PD10 and in the bone marrow of both epiphyses from PD14. The time course and localization of galanin-containing nerve fibres resemble the development of substance P- and CGRP-expressing nerve fibres, thus suggesting their sensory origin.

A giant cranial aneurysmal bone cyst associated with fibrous dysplasia.

An aneurysmal bone cyst (ABC) is a rare, benign fibro-osseous lesion, considered a vascular phenomenon secondary to fibrous dysplasia or a giant-cell tumour, and occurs mainly in long bones and vertebrae. In this case report a 16-year-old male presented with massive epistaxis. He was admitted with a 3-year history of chronic rhinitis, headaches, right ocular pain and recurrent epistaxis. CT scans showed a predominantly cystic, expansive mass obstructing both nasal cavities, extending to all paranasal sinuses and both orbits, with evidence of anterior cranial fossa skull base destruction. The patient underwent a craniofacial resection of the tumour performed with an external approach and an immediate reconstruction of the dural defect. Histology confirmed the lesion was an ABC associated with fibrous dysplasia. The patient's recovery was complete. A large facial aneurysmal bone cyst can damage the facial skeleton and skull base, and requires excision by a combined external approach.

Vestibular-evoked myogenic potentials and caloric stimulation in infants with congenital cytomegalovirus infection.

BACKGROUND: The influence of congenital cytomegalovirus infection on cochlear function has been well recognised; however, its impact on the vestibular system in infants has not been examined. The purpose of the present study was to evaluate vestibular function in a group of infants, using caloric stimulation tests and vestibular-evoked myogenic potential measurements. MATERIALS AND METHODS: Vestibular-evoked myogenic potentials and auditory brainstem responses were recorded and caloric stimulation was performed in 66 infants aged three months, comprising 40 healthy controls and 26 infants with congenital cytomegalovirus infection. RESULTS: No reaction to caloric stimulation was elicited from 16 examined ears, no vestibular-evoked myogenic potentials were recorded from 12 ears, and profound sensorineural hearing loss was diagnosed in eight ears. Pathological results were observed predominantly in infants with symptoms of intrauterine congenital cytomegalovirus infection present at birth. CONCLUSIONS: In infants with clinical symptoms of congenital CMV infection present at birth, abnormal vestibular test results occurred more frequently than abnormal auditory brainstem response results. Vestibular organs should be routinely examined in individuals with congenital cytomegalovirus infection.

Sphenoid sinus pyocele with intracranial extension managed under endoscopic guidance: a report of an extremely rare case.

OBJECTIVES: Sphenoid pyoceles with intracranial extension are extremely rare lesions that can mimic tumours and usually cause ophthalmological symptoms. Their infectious nature mandates urgent surgical decompression since pyoceles can cause intracranial and orbital complications. CASE REPORT: A 16-year-old male presented with intense headache and dizziness lasting three days. On admission, the patient gave a five-year history of chronic rhinitis, nasal congestion, and progressively worsening headaches. Ophthalmological examination was normal. CT and MR scans disclosed distension of the sphenoid sinus by a pyocele 55 mm in diameter, extending to the presellar region through the eroded cribriform plate. The patient underwent an endoscopic transnasal sphenoethmoidectomy. After surgery he reported improvement in all preoperative symptoms and was asymptomatic at 3-months follow-up. CONCLUSIONS: A huge sphenoid sinus pyocele with intracranial extension may cause no ophthalmological symptoms. It can be safely managed using endoscopic techniques.

Osteoma of the sphenoid sinus.

OBJECTIVE: Only twenty cases of osteomas of the sphenoid sinus have been reported. This tumour causes progressively worsening headaches and visual disturbance and should be resected when symptomatic or fast-growing. In selected cases, endoscopic sinus surgery offers an effective alternative to open procedures. CASE REPORT: The authors report a case of sphenoid osteoma in a 19-year old woman. Computed tomography performed because of complaints of progressively worsening headaches identified a large osteoma of the sphenoid sinus. The clinical features and radiological assessment of the disease are presented together with a review of the literature. RESULTS: The endoscopic technique used for resection of the tumour gave a very good result. CONCLUSION: Sphenoid osteoma is an extremely rare lesion which can be approached endoscopically in selected cases.

Endoscopic removal of air gun pellet in the sphenoid sinus.

THE OBJECTIVE: The presence of an isolated foreign body in the sphenoid sinus is a rare finding, and a retained projectile in this sinus is even more uncommon. CASE REPORT: The authors report the case of a 15-year-old male that was shot in the face with an air gun but was nevertheless able to seek for medical help. The anatomical considerations of the gunshot injury are made, and radiological assessment of the foreign body is presented. THE RESULT AND CONCLUSION: The projectile could be successfully removed with an endoscopic technique, no short or long term sequelae occurred.

Electroglottographic measurements of glottal function in vocal fold paralysis in women.

The purpose of the study was to determine how electroglottographic measures change with voice recovery in women with vocal fold palsy compared with healthy speakers, and which coefficient best represents dysphonia. An electroglottograph with speech studio 1.04 software was used to record and analyse the data. Electroglottographic data were collected from 22 female patients and 16 healthy female speakers. Our findings show that the mean values of open quotient (OpQ), closing quotient (ClQ), % Irregularity and contact quotient (Qx) differ between the groups of patients and controls. % Irregularity, Qx and OpQ significantly correlated with the perceptual degree of dysphonia. Electroglottographic recordings can objectify dysphonia in patients with vocal fold palsy. Electroglottography is a suitable non-invasive tool for tracking the patients' long-term progress. % Irregularity best represents the vocal fold dysfunction in patients with a vocal fold palsy.

[Myoepitheliomas of the palate]. / Gruczolak z komórek mioepitelialnych podniebienia.

The authors present a case of myoepithelioma of the palate. Frequency, treatment and pathologic diagnosis of the disease are discussed. A Polish name of the disease is suggested.

[Laryngeal trauma of open and closed types]. / Urazy krtani typu otwartego i zamknietego.

We present two cases of laryngeal trauma treated in our department. Both of them were emergency cases, operated on at once after the injury. Planned surgery was performed later on in order to improve function of the larynx. In both cases results were satisfactory.

[Malignant melanoma of the head and neck]. / Czerniak zlosliwy glowy i szyi.

The authors present 29 cases of malignant melanoma of the head and neck, treated at the ENT Department of S. Zeromski's Hospital in Kraków. The localisation, symptoms, diagnostic methods and treatment are discussed.

[Inverted papilloma of the nose and paranasal sinuses]. / Brodawczak odwrócony nosa i zatok przynosowych.

The authors present 23 cases of inverted papilloma treated in the Department of Otolaryngology of S. Zeromski's Hospital in Kraków. The symptoms, methods of treatment and results are discussed.

[A case of laryngeal neurofibroma]. / Przypadek nerwiakowlókniaka krtani.

A rare case of laryngeal neurofibroma is presented. An enlarged chordectomy via laryngofissure was performed. The patient has survived 5 years with no symptoms of recurrence.