[16 years of experience in laryngeal microsurgery with use laser CO2: cooperation between laryngologist and anesthesiologist - in material of ENT Department of Silesian Medical University]. / 16 lat doswiadczen w mikrochirurgii krtani z uzyciem lasera CO2: aspekt wspólpracy anestezjologa i laryngologa - w materiale Katedry i Kliniki Laryngologii SUM w Katowicach.

UNLABELLED: Laryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laser technology. The laryngeal microsurgery is used mainly laser CO2. Endoscopic laryngeal microsurgery using the laser poses a unique challenge to the anesthesiologist, ensuring safe conditions of anesthesia, the patient and simultaneously appropriate operating conditions for the surgeon for precisely perform the procedure. MATERIAL AND METHODS: Between 1995 and 2010 carried out in the Department of Otolaryngology SUM 832 microsurgical operations of the larynx using a CO2 laser. CONCLUSION: The perioperative management and close cooperation with the surgeon and anesthesiologist are essential for safe and efficient conduct of the operation the larynx using a microsurgical CO2 laser.

[Analysis of results of stapedotomy in patients with obliterative otosclerosis]. / Ocena wyników stapedotomii u chorych z obliteracyjna postacia otosklerozy.

INTRODUCTION: In obliterative type of otosclerosis the stapes footplate is greatly thickened and diffusely replaced by a massive otosclerotic masses that fill in the oval window niche, often annular ligament cannot be visualized. In the case of obliterative otosclerosis the only effective way of treatment is surgery. MATERIAL AND METHODS: The analysed group consisted of 53 patients with primary obliterative otosclerosis. In the control group there were 30 consecutive patients treated for otosclerosis. The auditory organ was assessed on the ground of the following criteria for the frequencies 0.5, 1, 2 and 4 kHz.: 1. Change of pure tone thresholds of air conduction (AC) 2. Change of pure tone thresholds of bone conduction (BC) 3. Change of pure tone thresholds of air-bone gap (ABG) as the difference between the mean AC and BC thresholds before the operation (AC0 and BC0) and 12 months after the operation (AC1 and BC1). RESULTS: Postoperatively mean value of change of AC thresholds in the analysed group was about 24 +/- 2 dBHL and in the control group about 25 +/- 2 dBHL (no significant difference). In the analysed group the mean value of BC thresholds varied about 8 dBHL and in the control group about 11 dBHL (no significant difference). The average values of ABG after the operation varied about 14 +/- 1 dBHL in both--the analysed and the control group. Postoperatively the mean value ABG was amounted to 20 +/- 1 dBHL in the analysed group and in the control group to 18 +/- 1 dBHL (no significant difference). On the basis of the subjective assessment completely subsidence of aural tinnitus reported 70% patients in the analysed group and 80% patients in the control group. CONCLUSION: 1. The incidence of obliterative otosclerosis represents 9,6% of all otosclerotic patients treated surgically. 2. Stapedotomy is the treatment of choice in patients with obliterative otosclerosis, because significant improvement of AC, BC and ABG 12 months after the operation was reported, mean values did not differ between the above and control group. 3. Complete subsidence of aural tinnitus was reported in 70% patients with obliterative otosclerosis.

[Treatment results in external and middle ear malignant neoplasms of patients treated at the Laryngology Department of Medical University of Silesia between 1991-2001]. / Wyniki leczenia nowotworów zlosliwych ucha zewnetrznego i srodkowego u chorych leczonych w Katedrze i Klinice Laryngologii Sl. AM w Katowicach w latach 1991-2001.

The authors present 18 patients with malignant neoplasms of the ear and temporal bone who were treated in the Clinic of Laryngology Medical University of Silesia in Katowice in the years 1991-2001. The most frequent was squamous cell carcinoma (11 patients--61%). The neoplasm was located on the auricle in 7 patients (39%), in the external auditory canal in 4 (22%) patients, in the middle ear in 5 patients (28%) and in 2 cases (11%) it was difficult to establish primary site. Ten patients (55.5%) were treated in stage T4. All patients had surgery and in advanced cases the radiotherapy was added. The best outcomes were in auricular neoplasms. The treatment results were much worse in neoplasms of the external auditory canal and the middle ear. Over 3 year follow-up in 10 patients (55%) with ear and temporal bone neoplasms shows no recurrence.

[Results of stapedotomy in the cases of "floating footplate"]. / Wyniki stapedotomii w przypadkach "plywajacej plytki".

One of the problems in the stapes surgery is the floating footplate. The frequency of incidence of this complication is 2% to 5.8% of all operations. The authors present the results of stapes operations in a group of 28 cases (2.5%) from all the 1120 operations, in which the surgeon experienced a floating footplate. The hearing results were evaluated on the base of the average gain of air-conduction thresholds and air-bone gap levels at 500, 1000, 2000 and 3000 Hz. The improvement of hearing we observed in 24 patients, 4 patients heard worse.

[The evaluation of distortion product otoacoustic emissions after stapedotomy]. / Ocena pomiarów otoemisji akustycznej produktów znieksztalcen nieliniowych slimaka (DPOAE) po stapedotomii.

34 patients with otosclerosis operated at the ENT Clinic, were enrolled in this study. Prior and 4 months after stapedotomy the signal of DPOAE and the threshold levels for air and bone conduction were evaluated. No signal of otoacoustic emissions was registered in any of the patients prior stapedotomy. After operation DPOAE was registered in 23 out of 34 examined patients (67.6%).

[The estimation of air--conduction threshold in extended range of high frequencies in young adult patients suffering from primary arterial hypertension]. / Pomiary progowe przewodnictwa powietrznego w rozszerzonym zakresie wysokich czestotliwosci u mlodych doroslych chorych na pierwotne nadcisnienie tetnicze.

The aim of the study was evaluation of the hearing ability on the base of air conduction threshold at extended range of high frequencies in young subjects with primary arterial hypertension. Lack of internationally accepted reference value of air conduction hearing threshold at extended frequency range resulted in own evaluation of the audiometric zero point for air conduction at the range 8-18 kHz in "otologically healthy" subjects younger than 20 years. Detection of impaired hearing of the extended high frequencies range in young subjects with primary arterial hypertension may be useful in diagnostics of hypertension as well as in prophylactic examinations in the group of individuals with high risk of primary hypertension. Evaluation of air conduction threshold at extended frequency range allows to detect sensorineural hearing impairment undetectable with application of conventional frequency range.

[30 years of stapes surgery]. / 30 lat chirurgii strzemiaczka.

This study reports the results of otosclerosis surgery performed during the past thirty years (1973-2002) in the ENT Clinic in Katowice. The authors present difficult anatomic relationships in the tympanic cavity which might have an influence on stapes surgery. Audiometric evaluation of 100 bilateral stapedotomies performed in 50 patients revealed that a small--hole stapedotomy is a safe technique and could be performed bilaterally. The group of 55 stapedotomies with stapedial tendon preserved was compared to the group of 55 stapedotomies with dissected tendon. SRT was better in the group where the tendon was preserved. In the group of 32 patients ABR before and after stapedotomy was recorded. The latency of V wave after the operation was reduced to the normal values what indicated a correct function of the ossicular chain postoperatively. In the group of 60 patients DPOAE prior and after stapedotomy was evaluated. Prior to the operation no signal of otoacoustic emission was registered, in 37 patients out of 60 the signal was present after the operation. DPOAE obtained postoperatively indicated successful ossicular chain restoration and inner ear function. Audiometric evaluation in reference to the group of 905 stapedotomies performed in years 1992-2001 showed that most of the patients were in group B--443/905 and C--402/905 according, in A group--60/905 according to Shambaugh. A-B gap < or = 10 dB was obtained in 469/905 (51.8%), the mean of the hearing threshold at 500, 1000, 2000 and 4000 Hz was 24.3 dB (+/- 8.3, med. 25.0) in A group and 32.0 dB in B and C group. The result of stapedotomy in reference to tinnitus based on the patients' subjective opinion. We may conclude that the key to the stapes surgery lies in the training and skillfulness of the surgeon using save small hole technique with stapedial tendon preservation to obtain the optimal physiologic function of the middle ear and to gain the best hearing results.

[Hidradenoma of external ear]. / Hidradenoma przewodu sluchowego zewnetrznego.

The authors present a rare case of hidradenoma of the external ear and discussed the clinical picture, as well as diagnostic and therapeutic procedures.

[Schwannoma of the cervical plexus: a case report]. / Schwannoma nerwu splotu szyjnego--opis przypadku.

A case of 70 years old man with cervical plexus schwannoma is presented. The tumor was removed surgically using extracapsular technique. The differential diagnosis and surgical techniques are discussed. The pre-operative symptoms, impressions and post-operative neurological status were shown and discussed. The review of literature is presented.

[Spectral and spectrographic voice acoustic analysis in selected patients after various types of partial laryngectomy for malignant neoplasms after radiotherapy]. / Spektrograficzna i widmowa analiza akustyczna glosu wybranych chorych po róznych typach operacji czesciowych krtani z powodu nowotworów zlosliwych oraz po radioterapii.

The aim of this study is the assessment of voice pathology in patients after various types of partial laryngectomy because of malignant neoplasms and after Co--60--therapy. Voice quality in above mentioned diseases and in healthy patients was compared. Voice was analysed by subjective (videostroboscopy) and objective spectrographic methods. This method seems to be very valuable to assess social efficiency of voice.

[Granular cell tumor (Abrikosov's tumor) of the larynx--literature review and 2 case reports]. / Guz ziarnistokomórkowy (guz Abrikosowa) krtani--przeglad literatury i opis 2 przypadków.

Granular cell tumors are uncommon neoplasms of the head and neck and they are rare in the larynx. About 200 cases had a laryngeal setting. The origin of these tumors is still unknown, but most authors believe it to be neural in origin. Authors described two laryngeal sites of granular cell myoblastoma. In the first case (44 year old man) tumor was located at the vocal fold. It was removed by laryngofissurae. In the second case (56 year old woman) tumor was located at the arytenoid cartilage and was removed radically during Kleinssaser directoscopy.

[The estimation of hearing threshold for high frequencies in children from the Upper Silesia]. / Wyznaczenie progu slyszenia dla wysokich czestotliwosci u mlodziezy zamieszkalej na Górnym Slasku.

Study was carried out in frequency range 8-18 kHz with audiometer AS 10 HF. Lack of internationally accepted reference value of the hearing threshold of air conduction at extended frequency range resulted in own evaluation of the audiometric zero point for air conduction at the range 8-18 kHz in "otologically healthy" subjects younger than 20 years. They were divided into subgroup A and B according to age. Investigation of the threshold values for air conduction at extended range of high frequencies were base for evaluation of the audiometric zero value for the used equipment.

[A case of bilaterally elongated styloid processes]. / Przypadek obustronnie przedluzonych wyrostków rylcowatych.

Elongated styloid process gives a complex of symptoms described by Eagle such as unilateral craniofacial and cervical pain, recurrent throat pain, dysphagia and foreign body sensation. Symptoms might be similar to those caused by calcified stylohyoid ligament. Diagnosis of the elongated styloid process is based on the palpation of the tonsillar area and should be confirmed radiologically. Surgical shortening of the elongated process is the only way to give symptomatic relief to the patient. The authors present a surgically treated case of bilaterally elongated styloid processes and unilateral symptoms.