The development of postural control in 6-17 old years healthy children. Part II Postural control evaluation - Limits of Stability Test (LOS) in 6-17 old year children.

<b>Introduction</b>: The ability to Reach quickly to changing external stimuli, to move the body quickly and precisely in any direction and to maintain the centre of gravity above the support base, all contribute to maintaining balance in dynamic conditions. The Limits of Stability Test (LOS) provides information on the state of dynamic equilibrium in a standing position.<br> <b>Aim</b> : Assessment of dynamic postural control in developmental age.<br> <b>Material</b> : 127 healthy children (65 girls and 62 boys) aged 6 - 17years. <br> <b>Methods</b>: All children underwent LOS test (posturograph NeuroCom) with registration of reaction time (RT), movement velocity (MVL), directional control (DCL) , maximum excursion (MXE) and endpoint excursion (EPE).<br> <b>Results</b>: At the age of 6-7 years, not fully developed jumping strategy and visual feedback mechanism in the control of movement were observed. All tested parameters were significantly worse in children aged 6 - 9 years. After this period, a significant improvement in TR and MVL was observed, with no significant changes in subsequent age groups while significant improvement in MXE up to 12 , EPE and DCL up to 13 years of age was noted. No significant gender differences were fund in the LOS test parameters. <br> <b>Conclusions</b>: 1 The LOS test showed significantly lower dynamic balance development in children aged 6 - 7 years. 2 The study showed a significant improvement in all parameters of the LOS test up to 13 years of age, which supports the termination of the function at that time.

The development of postural control in 6-17 old years healthy children. Part I Postural control evaluation in modified Clinical Test for The Sensory Interaction on Balance in 6-17 old year children (mctsib).

INTRODUCTION: Proper development of postural control in children is connected with the maturation of the central nervous system, development of sensory organisation with appropriate use of proprioceptive, visual, vestibular information as well as reactions and postural strategy which allow the maintenance of balance in changeable environmental conditions. Developmental disturbances in this particular area is reflected in postural disfunctions and the assessment of these disfunctions and disturbances needs referring to normative values of the healthy population of children. AIM: Examination of postural control development in children aged 6-17 years. MATERIAL: 127 healthy children were tested (65 girls and 62 boys) aged 6-17 years. METHOD: Laryngological investigation, medical history interview, audiometry and tympanometry were conducted in all children. In the evaluation of postural control (mCTSIB-modified Clinical Test For The Sensory Interaction On Balance) a computer posturography system was used (Balance Master Neurocom). R esults: Further development of postural control was found in healthy children up to the age of 13 years of age. The development was not linear but showed transient characteristics with a faster development stage between the age of 6-7 and 8-9. Better postural control in girls, particularly the youngest, in comparison with boys was noticed. C onclusions: 1. The values of norm postural control in posturographic test mCTSIB in children aged 6-17 was established. In this test postural control development was completed in children before 13 year and it was not linear. 2. Due to gender differences it seems appropriate to use separate norms in order to evaluate the development of postural control in boys and girls.

Diagnostic and Therapeutic Difficulties in Carotid Body Paragangliomas, Based on Clinical Experience and a Review of the Literature.

BACKGROUND: Paragangliomas are rare neuroendocrine tumors, representing 0.03% of all tumors. Half of them develop in the head and neck, and among these 50% are sporadic cervical tumors. OBJECTIVES: The aim of the study was to carry out an epidemiological and clinical analysis of paraganglioma patients diagnosed and treated at the authors' clinics between 1985 and 2014. MATERIAL AND METHODS: The medical data of 47 patients were analyzed. All the patients were qualified for surgery. In 43 cases (88%), simple resection of the tumor was performed, including 11 cases (22%) that additionally required vascular suturing, and 5 (10%) that required reconstruction of the internal carotid artery. Carotid vessel repair was performed by shortening the internal carotid artery in 3 cases (6%), using a saphenous vein graft in 2 cases (4%), and by creating an anastomosis between the external carotid artery and the distal portion of the internal carotid artery in one case (2%). RESULTS: In 40 cases (82%), the course of treatment was uneventful. Three patients (6%) were reoperated because of symptoms of cerebral stroke. Palsy of the hypoglossal nerve occurred in 3 cases (6%), and facial nerve palsy in 2 patients (4%). Six patients (12%) developed postoperative hematomas in the wound. In all the cases, histopathological examinations confirmed carotid paraganglioma. CONCLUSIONS: Cooperation with an otolaryngologist and vascular surgeon during surgery is recommended due to frequent damage to carotid vessels by carotid paragangliomas. Detection of the tumor in the early stages improves surgical treatment outcomes and reduces the number of complications. Regular postoperative check-ups are necessary due to possible occurrences of multiple tumors.

Bone markers in craniofacial bone deformations and dysplasias.

Various forms of bony deformations and dysplasias are often present in the facial skeleton. Bone defects can be either localized or general. Quite often they are not only present in the skull but also can be found in other parts of the skeleton. In many cases the presence and levels of specific bone markers should be measured in order to fully describe their activity and presence in the skeleton. Fibrous dysplasia (FD) is the most common one in the facial skeleton; however, other bone deformations regarding bone growth and activity can also be present. Every clinician should be aware of all common, rare and uncommon bony diseases and conditions such as cherubism, Paget's disease, osteogenesis imperfecta and others related to genetic conditions. We present standard (calcium, parathyroid hormone, calcitonin, alkaline phosphatase, vitamin D) and specialized bone markers (pyridinium, deoxypyridinium, hydroxyproline, RANKL/RANK/OPG pathway, growth hormone, insulin-like growth hormone-1) that can be used to evaluate, measure or describe the processes occurring in craniofacial bones.

[Bilateral squamous carcinoma of the external auditory canal--a case report]. / Obustronny rak plaskonablonkowy przewodu sluchowego zewnetrznego--opis przypadku.

Squamous cell carcinoma of the external auditory canal is a very rare and unusual malignancy, representing less than 0.2% of all head and neck cancers. The authors present a case of 78-year-old patient with bilateral squamous cell carcinoma of the external auditory canal-cT4N0M0 G2, pT4N2bM0, initially treated as a chronic otitis external. The patient was qualifies for the one-step removal of cancer of the earlobe and the external auditory canal. Because of complications during the operation, the plan of treatment was changed. The patient is under oncological control for 13 months.

[Bilateral external auditory canal cholesteatoma - a case report]. / Obustronny perlak przewodu sluchowego zewnetrznego - opis przypadku.

The external auditory canal cholesteatoma is a rare and difficult to diagnose disease. Symptoms are similar to the external ear canal inflammation and can be masked by retained cerumen. In the article we described a case of 22 year old, mentally impairment women with bilateral otorrhea, in the past treated for external ear canal inflammation. The otoscopic examination showed bilateral congenital auditory canal stenosis, with masses obstructing ear canals. Imaging and histopathologic studies revealed bilateral external ear canal cholesteatoma. The patient was qualified for surgery, which, together with a guardian, did not consent. Presented case indicates the necessity for widening the diagnostic of recurrent external ear canal inflammation.

[Epidemiological evaluation of salivary gland tumors in the Wroclaw ENT Department patients in the years 2001-2010]. / Ocena epidemiologiczna nowotworów gruczolów slinowych u pacjentów leczonych w Klinice Otolaryngologii we Wroclawiu w latach 2001-2010.

UNLABELLED: Salivary gland tumors represents approximately 3% of all head and neck neoplasms. Most of them are benign and located in the parotid gland. AIM: Epidemologic analysis of salivary gland neoplasms in the Wroclaw ENT Department. MATERIAL AND METHODS: 304 patients (170 women, 134 men) with histologically confirmed salivary gland tumors treated in the years 2001-2010 were reviewed retrospectively. RESULTS: Benign tumors were diagnosed in 83.9% of patients, malignant lesions constituted 16.1% of cases. The average age of patients were 55 years. Pleomorphic adenoma and Warthin's tumor constituted the most common benign tumor (93.3%). Among malignant tumors--adenoid cystic carcinoma (24.5%) and adenocarcinoma (22.5%) were the most frequent. Neoplasms located in submandibular gland and in minor salivary gland in the vast majority of cases were malignat: 35.1% and 38.9%, respectively. Parotid gland tumors were malignant in 11.7%. An increase of salivary gland neoplasms total number, predominantly in men, and in malignant neoplasms percentage: from 13.8% in the years 2001-2005 to 17.7% in the years 2006-2010, was noted. CONCLUSIONS: Most of salivary gland neoplasms are benign. Pleomorphic adenoma and Warthin's tumor (93.3%) constituted the most common benign tumors, adenoid cystic carcinoma (24.5%) and adenocarcinoma (22.5%) were the most frequent malignant tumors. Malignant tumor patients were avereage 12.5 years older than benign tumors persons. More than 1/3 of submandibular gland and minor salivary glands neoplasms were malignant. An increase of malignant lesions was noted--from 13.8% to 17.7% of the total number of salivary gland neoplasms.

[Sepsis in the sphenoiditis patient]. / Posocznica u pacjentki z zapaleniem zatoki klinowej.

INTRODUCTION: We present a case of sepsis caused by isolated sphenoiditis. MATERIAL AND METHOD: The case being described concerns 61-year-old woman treated at the Department of Occupational Diseases of Wroclaw Medical University due to body temperature maintaining for 2 months at above 38 degrees C, leucocytosis reaching 14-16 thousand and weight loss of about 4 kg. Detailed diagnostics did not confirm the preliminary diagnosis of system or neoplastic disease. Bacteriological blood examination revealed the presence of staphylococcus aureus susceptible to Vancomycin and Tienam. The attempt of pharmacological treatment did not produced the expected effect. NMR examination of the facial skeleton proved partial shadowing of the Sphenoidal sinus. The patient was admitted for surgical treatment. After the sphenoidal sinus was cut open, mucopurulent contents was found inside. During microbiological examination, staphylococcus aureus with identical susceptibility was cultured from the mucopurulent contents. After 3-week guided antibiotic therapy, permanent temperature regression and permanent improvement of the patient's condition were achieved. RESULTS: Surgical treatment combined with intensive antibiotic therapy caused the complete regression of symptoms. CONCLUSION: Isolated sphenoiditis occurs rarely but it still is a serious diagnostic and therapeutic problem. Diagnosis delay and disease progress may lead to life-threatening complications.

[Malignant neoplasm of nose and paranasal sinuses in Lower Silesia in years 1992-2001]. / Nowotwory zlosliwe nosa i zatok przynosowych na terenie Dolnego Slaska w latach 1992-2001.

UNLABELLED: Malignant neoplasms of the nose and paranasal sinuses occur rarely but due to late diagnosis and poor treatment effects still remain a serious problem. The aim of the study was the analysis of all nose and paranasal sinus neoplasms treated at Lower Silesia in the years 1992-2001. MATERIAL AND METHODS: In the years 1992-2001 in Lower Silesia region there were 182 patients treated for malignant nose and paranasal sinus tumors. Males outnumbered females significantly with male : female ratio was 1.9:1. Principal management was combined therapy--surgery with radiotherapy in 84% of the cases. Radiotherapy alone was performed in 8.8% and chemotherapy as palliative treatment in 7.1%. Fifteen patients (8.2%) underwent radical neck dissection followed by radiotherapy. RESULTS: The analysed group constituted 79.6% patients with epithelial tumors and 20.4% with nonepithelial tumors. Cases T3-T4 predominated in the material in amount of 77.9% (113). There were 15 T2 cases (10.4%) and none of T1. Most of the tumors (57%) arose from middle segment of ethmomaxillary sinuses. Upper segment tumors constituted 18.6% of cases and lower segment--10.4%. Enlarged lymph nodes were diagnosed in 8.2%. Survival rate analysis in patient treated in the years 1992-2001 revealed 37.9% (69) of 3-year survival and 30.2% (55) of 5-year survival. CONCLUSIONS: Unsatisfactory results of treatment are an effect of a high advanced stage of the tumor while diagnosed. Its direct causes are: asymptomatic course of the disease, localization in complex anatomical structure, not enough experience among medical staff dealing with the disease very rarely.

[A case of bilateral oncocytomas of the submandibular gland and synchronous renal oncocytomas]. / Przypadek równoczesnego wystepowania guzów onkocytarnych slinianek podzuchwowych z onkocytoza nerek.

A case of 42 years-old man with bilateral big sized (12 x 5 cm and 10 x 4,5 cm) oncocytoma in submandibular glands was presented. Oncocytoma is a rare benign neoplasm observed in numerous of organs. In the case described besides submandibular glands tumours, accessory oncocytic tumours in both kidneys were diagnosed. It was the reason of earlier unilateral nephrectomy. Surgical treatment was applied. The comparison of the both tumours histology allowed to establish proper diagnosis. The case is presented because of the explicitly of the oncocytoma location especially in the both submandibular glands simultaneously with tumour of the same histology in distant organs.

[Inverted papilloma of the nose and paranasal sinuses: diagnosis and treatment]. / Brodawczak odwrócony nosa i zatok przynosowych--diagnostyka i leczenie.

The authors present a retrospective study of 6 patients with inverted papilloma, which appeared in the material of ENT Clinic in Wroclaw in years 1996-2001. In the group of treated patients, we can recognize 5 men and one woman at the age between 42 to 82. Average age amounted to 62 years. At all the patients the papilloma inversum was diagnosed completely accidentally, during histopathological examination, after having polypectomy or Calwell-Luca operation. Operating treatment was proceeded by performing the CT or NMR test. In four cases the Denker's operation was done, in one case More's and in another one we performed the endoscopy operation (limited changes to ethmoidal labyrinth). The patients stay under the observation for 8 months to even 5 years. In one case we observed a relapse, which occurred after 8 months (patient after the Moure's operation). In all the rest cases a relapse was not identify.