[Narrow-band imaging endoscopy for diagnosis of adult laryngeal papillomatosis - case raports].

The laryngeal papillomas belong to the group of non-malignant tumours. The risk of getting sick increases with the number of contingent sexual contacts, smoking, alcohol abuse and untreated gastro-oesophageal reflux. This paper describes five cases presenting different levels of exposure to the risk factors and variable course of adult laryngeal papillomatosis. These people, in addition to routine diagnostics, were examined using endoscopy with the use of narrow beam of light, which turns out to be a useful diagnostic tool in the case of laryngeal papillomatosis.

Effects of oral contraceptives on selected parameters of the homeostatic control system in young women having a sudden disorder of the auditory and/or balance system.

The purpose of the paper was to assess the effects of oral contraceptives on selected parameters of the homeostatic control system in women having a sudden disorder of the auditory and/or balance system. The study included 105 young women divided into two groups: Group I--52 women with the disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 20-49; and Group II--53 women without any disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 18-40. The patients included in the study underwent a full otoneurological evaluation, detailed laryngological diagnostics and an evaluation of selected parameters of the homeostatic control system--fibrinogen level, D-dimer level, evaluation of APTT and PT indicator, plasma estradiol and progesterone with the Roche Cobas analyser by means of chemiluminescence. The vertigo occurring in the study group was most often central (59.6% of cases), mixed with compensation in 36.6% of cases, and peripheral only in 3.8% of cases, indicating labyrinth damage in 40.4% of cases. An analysis of the progesterone level, considering the menstrual cycle phase in the group, showed that its value was abnormal in 51.0% of women in the study group and 47.1% in the control group. In their own studies, the authors observed that the estradiol level in the plasma, considering the menstrual cycle phase in the study group, was abnormal in 41.2% of women and that the differences in its concentration were statistically significant in the study and control groups (p = 0.005), which may have a negative impact on the possibility of a thromboembolic episode.

Significance of CYCLOOXYGENASE-2(COX-2), PERIOSTIN (POSTN) and INTERLEUKIN-4(IL-4) gene expression in the pathogenesis of chronic rhinosinusitis with nasal polyps.

The purpose of this paper was to evaluate the level of Cyclooxygenase-2 (COX-2), Periostin (POSTN) and Interleukin-4(IL-4) gene expression in patients with chronic rhinosinusitis with nasal polyps, without polyps and with a nasal septum deviation. The tests were performed on 63 patients (24 women and 39 men) with chronic rhinosinusitis and polyps (CRSwP-study group I), with determination of the COX-2, POSTN and IL-4 gene expression; an allergy was diagnosed in 38 cases. The reference groups were patients with chronic rhinosinusitis without polyps--CRS (n = 23, including 14 women and 9 men) and patients with nasal septum deviation--DSN (n = 18, including 9 women and 9 men). The expression level was determined in the polyp tissue and the mucosa of paranasal sinus collected during an FESS. The expression level of studied genes was also evaluated in the material. Immediately after being collected, the tissue fragments were placed in test tubes with 1 ml of RNAlater (Qiagen, Hilden, Germany) preventing the degradation of RNA and frozen at -70 °C. The studies revealed an increased level of POSTN, IL-4 gene expression and a decreased level of COX-2 gene expression that may be associated with the development of chronic rhinosinusitis with nasal polyps. An analysis of the expression level indicates the participation of POSTN and IL-4 in the development of chronic rhinosinusitis with nasal polyps in patients with atopy.

Association of IL1ß and IL4 gene polymorphisms with nasal polyps in a Polish population.

Imbalance between proinflammatory and anti-inflammatory cytokines may regulate the inflammatory reaction in the nasal polyps. Polymorphisms in the regulatory regions of the cytokines genes may influence their expression. The aim of this study was to investigate the relationship between an IL-1ß and IL-4 promoter polymorphisms and nasal polyps. The C-511T promoter polymorphism of the IL-1ß gene and C-590T promoter polymorphism of the IL-4 gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis in 208 Polish patients with nasal polyps and 200 healthy Polish subjects. The risk of susceptibility to NP was significantly higher in patients with NP who had -511 T/T genotype of IL1ß than in controls (OR 3.07; 95 % CI 1.18-7.99). No statistically significant differences were found between NP patients and the control group with regard to genotype distribution and allele frequencies of C/T polymorphism of IL4 gene. Our study demonstrated that the TT genotype for C-511T mutation associated with the risk of developing NP in a Polish population.

Effects of three different types of anaesthesia on perioperative bleeding control in functional endoscopic sinus surgery.

The aim of the study was to assess the effect of three different types of anaesthesia on perioperative bleeding control and to analyse the mean arterial blood pressure and heart rate in patients undergoing endoscopic paranasal sinus surgery. Ninety patients (30 women and 60 men, aged 18-85 years) scheduled to undergo functional endoscopic sinus surgery in the years 2008-2010 were identified as candidates for inclusion in the study. Patients were randomly assigned to one of three groups (30 patients each) according to the type of general anaesthesia to be administered. Groups I and II both received inhalation anaesthesia (sevoflurane for sedation) and intravenous anaesthesia (fentanyl in group I, remifentanil in group II). Anaesthesia was delivered solely via intravenous route (TIVA) in group III, with propofol used for sedation and remifentanil for analgesia. Blood pressure and heart rate were monitored during surgery and post-surgically for 4 h. Mean anaesthesia duration in groups I, II and III was 108.7 ± 20.8, 112.6 ± 22.2 and 103.7 ± 17.5 min and the surgery duration was 71.3 ± 16.7, 78.8 ± 24.2 and 66.5 ± 15.5 min, respectively. Mean blood loss during surgery was 365.0 ± 176.2, 340.0 ± 150.5 and 225.0 ± 91.7 ml, with a mean blood loss rate of 5.1 ± 2.4, 4.5 ± 2.2 and 3.4 ± 1.1 ml/min in groups I, II and III, respectively. Technologically advanced control of the drug dose with the TIVA technique allows for better control of perioperative bleeding.

Title Expression of FOXO3 and MAPK1 Genes in Patients with Benign Salivary Gland Tumors.

Pleomorphic adenomas (PAs) and Warthin tumors (WTs) are the most common benign tumors that occur in the salivary gland. PA has a tendency towards malignant transformation. Thus, searching for new methods to diagnose salivary gland tumors and treatment is important. The members of the class O forehead box transcription factor (FOXO3) and mitogen-activated protein kinase 1 (MAPK1) genes participate in the cellular processes, including in cell proliferation. The aim of this study was to analyze these genes' expression in the salivary gland tissues and in salivary gland tumors. The study group consisted of 50 patients treated for salivary gland tumors. For genetic tests, fresh samples of tissue collected during the surgery were used. The expression levels of the FOXO3 and MAPK1 genes were statistically significantly lower in PA tissue than in normal salivary gland tissue and WT tissue. This research revealed that the FOXO3 and MAPK1 genes are present in benign salivary gland tumors and also indicated a role of these genes in the development of benign salivary gland tumors. The cause of the development of pleomorphic adenomas may be apoptotic disorder and the activation of the inflammatory process. The examined genes may have potential to be new therapeutic targets for the treatment of pleomorphic adenomas.

PD-1 and PDL-1 gene expression in nasal polyp tissue from patients with asthma exacerbated by non-steroidal anti-inflammatory drugs correlates with the severity of the disease.

INTRODUCTION: The clinical syndrome that includes asthma, nasal polyps and hypersensitivity to nonsteroidal anti-inflammatory drugs is referred to as airway disease exacerbated by nonsteroidal anti-inflammatory drugs. Patients usually have the most severe form of nasal polyps. Asthma and chronic rhinosinusitis with nasal polyps share a common inflammatory profile, involving type 2 helper T lymphocytes. T-cell activity can be inhibited via the programmed death receptor, PD-1, leading to modulation of the immune response. Therefore, the purpose of this study is to evaluate the expression of genes encoding PD-1 and its ligand PD-L1 in nasal polyp tissue in patients with asthma exacerbated by non-steroidal anti-inflammatory drugs and to correlate the results with clinical data. MATERIAL AND METHODS: The material used for the study consisted of 54 tissue sections of nasal polyps. In the specimens, the expression of PD-1 and PD-L1 genes was determined at the mRNA level by qPCR. Statistical analysis was used to evaluate the results of the study. RESULTS: The expression of PD-1 and PD-L1 genes in the tissue of polyps was statistically significantly higher than in the nasal mucosa of patients in the control group. In addition, there was a correlation between the expression of both genes at the mRNA level and the severity of nasal polyps in the paranasal sinuses analyzed from computed tomography images of the paranasal sinuses and assessed using the Kennedy scale. CONCLUSIONS: Determining the expression of PD-1 and PD-L1 genes may provide a marker for the severity of polypoid lesions. In addition, learning more about the PD-1/PD-L signaling pathway and how it can be modulated may provide a potential therapeutic strategy for patients with inflammatory diseases.

Association of the -33C/G OSF-2 and the 140A/G LF gene polymorphisms with the risk of chronic rhinosinusitis with nasal polyps in a Polish population.

Nasal polyps are strongly associated with a risk of chronic rhinosinusitis development as well as other obstruction including asthma and allergy. The following study tested the association of the 140A/G polymorphism of lactoferine (LF) encoding gene and the -33C/G polymorphism of osteoblast-specific factor-2 (OSF-2) encoding gene with a risk of chronic rhinosinusitis with nasal polyps in a Polish population. One hundred ninety five patients of chronic rhinosinusitis with nasal polyps as well as 200 sex, age and ethnicity matched control subjects without chronic sinusitis and nasal polyps were enrolled in this study. Among the group of patients 63 subjects were diagnosed with allergy and 65 subjects with asthma, respectively. DNA was isolated from peripheral blood lymphocytes of patients as well as controls and gene polymorphisms were analyzed by restriction fragments length polymorphism polymerase chain reaction (RFLP-PCR). We reported that the 140A/G LF (OR 4.78; 95% CI 3.07-7.24), the -33C/G OSF-2 OR 3.48; 95% CI 2.19-5.52) and the -33G/G OSF-2 (OR 16.45; 95% CI 6.71-40.30) genotypes were associated with an increased risk of chronic rhinosinusitis with nasal polyps among analyzed group of patients. Moreover, the group of patients without allergy or asthma indicated the association of the -33C/G (OR 3.72; 95% CI 2.24-6.19 and OR 15.11; 95% CI 5.91-38.6) and -33G/G (OR 3.73; 95% CI 2.24-6.19 and OR 14.07; 95% CI 5.47-36.16) genotypes of the OSF-2 as wells as 140A/G (OR 3.89; 95% CI 2.40-6.31 and OR 3.62; 95% CI 2.45-5.34) genotype of OSF-2 with an increased risk of chronic rhinosinusitis with nasal polyps. Finally, it was also found that the selected group of patients with allergy or asthma indicated a very strong association of the -33C/G (OR 2.40; 95% CI 1.23-4.69 and OR 2.40; 95% CI 1.23-4.69, respectively) and -33G/G (OR 16.01; 95% CI 5.77-44.41 and OR 17.90; 95% CI 6.53-49.05, respectively) genotypes of the OSF-2 as wells as 140A/G (OR 3.22; 95% CI 1.74-6.11 and OR 3.25; 95% CI 1.75-6.04, respectively) genotypes with an increased risk of chronic rhinosinusitis with nasal polyps. Thus, our results suggest that LF and OSF-2 gene polymorphisms may have deep impact on the risk of rhinosinusitis nasal polyps' formation which may also depend on asthma or allergy. Our results showed that the 140A/G polymorphism of LF gene and the -33C/G polymorphism of the OSF-2 gene may be associated with the risk of chronic rhinosinusitis with nasal polyps in a Polish population.

[The comparison of the influence of various types of anaesthesia on perioperative bleeding control in endoscopic paranasal sinus surgery]. / Porównanie wplywu róznych rodzajów znieczulenia na kontrole krwawienia sródoperacyjnego w operacjach endoskopowych zatok przynosowych.

INTRODUCTION: The study aimed at evaluating the influence of targeted hypotension with three types of anaesthetics on the amount of blood loss in extensive endoscopic operations of polyps of the nose and paranasal sinuses. MATERIAL AND METHODS: Ninety patients, including 30 women aged 31-73 and 60 men aged 21-79, who were operated within the period of 2008-2010 at Department of Otolaryngology and Laryngological Oncology Military Medical Academy University Clinical Hospital in Lodz, were qualified for the study. The bilateral removal of nasal polyps, bilateral ethmoidectomy, and surgery or revision of the maxillary, sphenoid and temporal sinuses in endoscopy were conducted in each patient. Due to the type of general anaesthesia the patients were divided into three groups, 30 patients each: I ­ sevoflurane inhalation (sedation) and fentanyl I.V., II ­ sevoflurane inhalation (sedation) and remifentanil I.V. (analgesia), III ­ TIVA, propofol sedation and remifentanil analgesia. The drugs were administered via the infusion pomp TCI. RESULTS: In group I the mean anaesthesia time was 108.67±20.80 min., group II ­ 112.63±22.17 min., group III ­ 103.67±17.47 min. The surgery time in the studied groups was as follows: I ­ 71.33±16.71 min, II ­ 78.83±24.24 min, III ­ 66.5±15.49 min. During the operation the mean blood loss was: group I ­ 365±176.2 ml, group II ­ 340±150.5 ml, group III ­ 225±91.7 ml. During the operation the mean rate of blood loss was: group I ­ 5.118±2.38 ml/min, II ­ 4.507±2.215 ml/min, group III ­ 3.416±1.059 ml/min. CONCLUSIONS: In TIVA the advanced technologically control of a drug dose allows for a better control of hypotension, which, finally, results in lower haemorrhage within the operation area, a favourable condition for both a patient and a physician. Perioperative bleeding was independent on sex in every type of anaesthesia.

[Role of the -765 G/C polymorphism of COX-2 gene in pathogenesis of chronic rhinosinusitis with nose polyps in a Polish population]. / Znaczenie polimorfizmu -765G/C genu COX-2 dla patogenezy przewleklego zapalenia zatok przynosowych z polipami nosa w populacji polskiej.

INTRODUCTION: It is believed that local factors within the nasal cavities contribute to the formation of nasal polyps. The disruption of local homeostasis mechanisms in a chronic inflammatory process is one of those factors. Cyclooxygenase (COX)-2 expression is activated in the course of the immune response to extracellular and intracellular stimuli. Also, an increase of the gene expression can be associated with the development of nasal polyps in patients with chronic sinusitis. THE AIM OF THE STUDY: The aim of this study was an evaluation of the role of the -765G/C COX-2 polymorphism in sinusitis pathogenesis in patients with nasal polyps. MATERIALS AND METHODS: The study group consisted of 100 patients, aged 35-65, with chronic sinusitis and nasal polyps and 150 people in the age, sex-, age- and ethnicity-matched control group. The study material included DNA isolated from peripheral blood lymphocytes of the patients and the controls. PCR-RFLP method was used in genotyping polymorphic variants of COX-2. RESULTS: In comparison to the control group, the group of the patients with chronic sinusitis and nasal polyps showed a statistically significant increase in the occurrence frequency of the -765G/C polymorphic variant of COX-2 gene (OR 4.04; 95% CI 2.32-7.03; p > 0.001) and C allele (OR 3.68; 95% CI 2.38-5.68; p < 0.001). CONCLUSIONS: The -765G/C genotype of COX-2 can be associated with an increased risk of the occurrence of chronic sinusitis with nasal polyps in the Polish population.

[Early complications of Griggs percutaneous tracheotomy in own material]. / Wczesne powiklania tracheotomii przezskórnej metoda Griggsa w materiale wlasnym.

INTRODUCTION: The aim of the work was to assess early complications of Griggs percutaneous tracheotomy in the own material. MATERIAL AND METHODS: The study covered 155 patients aged 17-88, including 36 women and 119 men. The patients were treated at the Department of Anaesthesiology and Intensive Therapy between 2006-2010. They underwent Griggs percutaneous tracheostomy by a laryngologist or a trained anaesthesiologist. Each surgical procedure was conducted with the use of Portex Blue Line Ultra Percutaneous Tracheotomy Kit (Smiths Medical Co., USA), the trachea was intubated while the patient was under general anaesthesia with propofol, fentanyl and relaxation with atracurium. RESULTS: The studied material revealed Griggs percutaneous tracheotomy complications in 26 patients (16.8%), in which 11 patients (7.1%) presented complications within the perioperative period while 15 patients (9.7%) reported early complications. Haemorrhage, usually not very profuse, occurred 7 times (4.6%), mainly in tracheopunction, and was the most often perioperative complication. Moreover, in the perioperative period, 3 patients (1.9%) had trachea identifications difficulties, which required tracheopunction many a time, and 1 patient (0.65%) encountered sudden circulatory arrest with asystolia and effective CPR. In the early postoperative period after Griggs percutaneous tracheotomy, the most common complication was haemorrhage in the operative twenty-four hours, which was noted in 10 patients (6.5%). Among other adverse complications were found: infection of the tissues near the tracheostomal region in 3 patients (1.9%), subcutaneous oedema in 1 patient (0.65%), accidental removing the tube from an unformed tracheostoma in 1 patient (0.65%). CONCLUSIONS: In the studied material, complications after Griggs percutaneous tracheotomy amounted to 16.8%, of which 7.1% occurred in the perioperative period while 9.7% were early complications, mainly light bleeding. This may prove good preparation of the surgical team for the surgical procedures.

Will the Use of Pharmacogenetics Improve Treatment Efficiency in COVID-19?

The COVID-19 pandemic is associated with a global health crisis and the greatest challenge for scientists and doctors. The virus causes severe acute respiratory syndrome with an outcome that is fatal in more vulnerable populations. Due to the need to find an efficient treatment in a short time, there were several drugs that were repurposed or repositioned for COVID-19. There are many types of available COVID-19 therapies, including antiviral agents (remdesivir, lopinavir/ritonavir, oseltamivir), antibiotics (azithromycin), antiparasitics (chloroquine, hydroxychloroquine, ivermectin), and corticosteroids (dexamethasone). A combination of antivirals with various mechanisms of action may be more efficient. However, the use of some of these medicines can be related to the occurrence of adverse effects. Some promising drug candidates have been found to be ineffective in clinical trials. The knowledge of pharmacogenetic issues, which translate into variability in drug conversion from prodrug into drug, metabolism as well as transport, could help to predict treatment efficiency and the occurrence of adverse effects in patients. However, many drugs used for the treatment of COVID-19 have not undergone pharmacogenetic studies, perhaps as a result of the lack of time.

Adjuvant radiotherapy in parotid gland pleomorphic adenoma - recommendations.

<b>Introduction:</b> Standard treatment for pleomorhic adenoma (PA) of the parotid gland is complete surgical excision. Radiotherapy (RT) as a primary treatment method is controversial and generally is not applied. However, RT might be considered as an adjuvant therapy in some selected cases. </br></br> <b>Aim:</b> The aim of this work was to define recommendations for RT in patients with parotid gland PA after primary surgical treatment.</br></br> <b>Material and methods:</b> Based on the results currently published in the literature and the authors' own experiences from leading Polish laryngological and oncological clinical centers dealing with the treatment of salivary gland tumors, the indications for irradia- tion and its methods in patients with PA of the salivary glands were discussed. </br></br> <b>Results and discussion:</b> Authors recommend personalized treatment based on multidisciplinary panel decisions in each patient. Adjuvant RT should be considered in cases of suboptimal resection of primary PA (close margin, intraoperative tumor spillage, risk of recurrence based on clinical factors and histological features), and in cases of PA recurrence. Doses/ fractions and techniques of irradiation are recommended depending on the clinical extension of the primary or recurrent tumor. </br></br> <b> Conclusions:</b> Adjuvant RT in PA treatment should be a result of a personalized multidisciplinary decision after considering all possible risks of irradiation consequences. Recommendations for this treatment should be taken into consideration.

[Endoscopic operations of the nose and paranasal sinuses in the own material]. / Operacje endoskopowe nosa i zatok przynosowych w materiale wlasnym.

INTRODUCTION: The aim of the study was to evaluate the results and 4-year own experience in the endoscopic treatment of the nose and paranasal sinuses. MATERIAL AND METHODS: In the Clinic of Otolaryngology and Laryngological Oncology of the Medical University of Lodz between 2006 and 2009 there were 603 endoscopic operations performed on patients with chronic paranasal sinusitis, including 287 females aged 17-80 and 316 males aged 18-87. The patients were qualified for the operation on the basis of an interview, objective otorhinolaryngological examination, frontal and transverse computerized tomography of the nose and paranasal sinuses, laboratory tests (blood cell count, sedimentation tests, urine tests, electrolytes tests). Moreover, allergological diagnostics (skin prick tests, intranasal provocation tests), a histopathological examination of the removed lesions and a culture of biological material from the paranasal sinuses were done. The 0 degree and 30 degrees endoscopes of Storz GMBH and Wolf and the video rotation microtome (debrider). RESULTS: Possible reasons for paranasal sinusitis were: viral infection (34.8%), anatomical disorders (28.5%), irritating factors like tobacco smoke (17.9%), allergy (13.4%), tumours (3.2%) and gastroesophageal reflux (2.1%). Finally, the following endoscopic operations were conducted: revision surgery of the maxillary sinuses in 680 cases (56.4%), ethmoidectomy in 586 cases (48.6%), polypectomy in 273 cases (22.6%), re-polypectomy in 232 cases (19.2%), sphenoid sinus revision in 229 cases (19.0%), frontal sinus revision in 80 cases (6.6%) and re-ethmoidectomy in 77 cases (6.4%). The average stay in the Clinic lasted 3.2 days. CONCLUSIONS: Advantages of the complex surgical treatment are found in both post-operative and pharmacological procedures. The FESS surgery should be only a minimally invasive technique, which subsequently could guarantee an effective treatment, slight post-operative complications, a short hospitalization period and a quick return of the patient to work, as it is proved by the own study.

[The analysis of mean arterial pressure and heart rate in patients treated with laryngological surgery within pre- and peri- and postoperative periods]. / Analiza sredniego cisnienia tetniczego krwi i czestosci akcji serca u chorych operowanych z powodów laryngologicznych w okresie przedoperacyjnym oraz sródoperacyjnym i pooperacyjnym.

INTRODUCTION: This work aimed to analyse the mean arterial blood pressure (MBP) and heart rate (HR) in patients who underwent laryngological surgery within the preoperative, perioperative and postoperative periods. MATERIAL AND METHODS: The study covered 502 patients, including 209 women and 293 men, aged 18-85, who were divided into 6 groups according to the type of surgery: I - FESS (Functional Endoscopic Sinus Surgery), II - septoplasty, III - endoscopic re-operation of the paranasal sinuses, IV - microlaryngoscopy, V - tonsillectomy, VI - middle ear surgery. Only the patients with BP below 140/90 mmHg and maximum class 2 in the ASA scale were qualified for the surgical procedure. On admission, the arterial blood pressure was measured and diagnostic investigations like FBC, blood grouping determination, coagulogram, ESR, CRP and imaging studies were performed in each patient. Every operation was conducted under TIVA. BT and HR were monitored during an operation as well as through the four following hours in a recovery room. RESULTS: The youngest group of patients with chronic palatine tonsillitis showed the lowest pressure values while the oldest studied group consisted of patients who were operated due to chronic otitis media and this group demonstrated the highest BP values. The patients with treated or untreated hypertension should be pharmacologically normalised by an anaesthesiologist. However, considerable lowering of BP can often be not possible, contrary to the patients with normal BP. CONCLUSIONS: The own experience indicates that perioperative lowering of BP, including hypotension, ought to be avoided in cardiology patients. The postoperative BP raise, usually accompanied by pain, was noticed in the own studies. Therefore, effective analgesic treatment should be implemented in a recovery room.

[Comparative assessment of cryosurgical treatment results in allergic and non-allergic rhinitis]. / Porównawcza ocena wyników leczenia alergicznych i niealergicznych niezytów nosa za pomoca kriochirurgii.

INTRODUCTION: The aim of the work was to assess the treatment efficiency in patients with allergic and non-allergic vasomotor rhinitis after cryoablation procedures. MATERIAL AND METHODS: The study covered 60 patients, including 32 women and 28 men, aged 18-66. The patients were divided into two groups: I - 30 patients with chronic allergic rhinitis, II - 30 patients with non-allergic vasomotor rhinitis. The study methodology involved: an otorhinolaryngological interview with a questionnaire and an allergological interview, an objective otolaryngological and rhinomanometrical examination with Homoth apparatus, a subjective evaluation questionnaire for nasal blockage intensification (the scale ranging from 0 to 10), skin tests to aeorallergens and food allergens (Allergopharma Co.), nasal endoscopy with a straight rigid Eleps endoscope before the treatment and 3 months following it. The cryoablation of nasal conchas was performed under local infiltration anesthesia (1% Xylokaina solution) using the Cryo-S apparatus from CryoFlex Poland Company and a flat probe in a spatula shape (L-50) that was placed on the outer surfaces of the inferior nasal concha. RESULTS: The inferior nasal concha cryoablation resulted in a statistically significant improvement in the subjective assessment scale in group I by 82.6% and group II by 141.2%. In the endoscopic examination 3 months following the cryoablation a good nasal patency was achieved in 63.3% patients from group I and 76.7% patients from group II. The conducted studies show a better nasal passages patency in patients with non-allergic rhinitis than in those with allergic rhinitis. CONCLUSIONS: Cryoablation procedures on the inferior nasal conchas are not the primary therapy, but together with other methods they can immensely improve the life comfort of a rhinitis patient.

[Analysis of histopathological evaluation of pathological lesions removed by endoscopic surgery of the nose and paranasal sinuses in the own material]. / Analiza oceny histopatologicznej zmian patologicznych usunietych w endoskopowych operacjach nosa i zatok przynosowych w materiale wlasnym.

INTRODUCTION: The work aimed at evaluating results of histopathological examination of postoperative material in endoscopic paranasal sinus surgery in the own material. MATERIAL AND METHODS: The analysis covered 3,896 results of histopathological examination of routine postoperative material from the Department of Clinical Pathomorphology and Cytopathology Military Medical Academy University Clinical Hospital in Lodz. The study was conducted in hematoxylin and eosin staining according to the principles of this method. The postoperative material included pathological lesions removed by endoscopic surgery of the nose and paranasal sinuses in patients who were treated at Department of Otolaryngology and Laryngological Oncology between 2006 and 2010. The treatment included 1,118 patients, 509 women at the age of 15­79 and 609 men aged 17­77. The material for histopathological examination was sent from merely 1,176 operations because 57 patients were operated twice and one patient was operated three times. RESULTS: Polyps within the nose and paranasal sinuses were confirmed by histopathological examination in 705 patients, including 289 women and 416 men. Hypertrophic changes were diagnosed in 404 patients, including 218 women and 186 men. Inverted papilloma was recognised in histopathological examination in 9 patients, including 2 women and 7 men. Hypertrophies were slightly more common in women than in men. Both in men and women unilateral hypertrophic changes within the ostiomeatal complex were predominant, 42.66% in women and 40.86% in men. CONCLUSION: Histopathological examination of postoperative material in patients under endoscopic treatment due to paranasal sinusitis is considerably important for complex evaluation of inflammation type and confirmation of indications for appropriate anti-inflammatory therapy.

[The use of VHIT (videonystagmography head impulse test) in the diagnostics of semicircular canal injuries]. / Zastosowanie testu VHIT (videonystagmography head impulse test) w diagnostyce uszkodzen kanalów pólkolistych.

INTRODUCTION: The aim of that work was to evaluate the usefulness of VHIT (Videonystagmography Head Impulse Test) in the diagnostics of injuries to the semicircular canals. MATERIAL AND METHODS: The tests covered 58 patients aged 20-27, including 34 women and 24 men. Any deviations within the vestibular organs was excluded in the interview, otorhinolaryngological examination and full videonystagmographic test. The tests checked functions of the semicircular canals in the following way: in a sitting position and the head leaned forward at 30 degrees the patient was looking at a motionless point while quick movements to the left or right were performed to stimulate a particular lateral semicircular canal. When the vertical semicircular canals were tested the head was inclined laterally to the right side at 45 degrees. Then similar movements were performed forwards (stimulation of the left anterior semicircular canal) and backwards (stimulation of the right posterior semicircular canal). When the head was leaned laterally to the left at 45 degrees the right or left anterior semicircular canal was stimulated respectively. Functions of the canal were determined on the basis of gain (%). RESULTS OF THE TESTS: In 58 patients the gain value for particular semicircular canals was normal, and the mean values presented as follows: the lateral semicircular canal: 11.9% +/- 10.2, the anterior semicircular canal: 17.5% +/- 11.6 and the posterior semicircular canal: 19.2% +/- 13.5, whereas on the left side: 10.3% +/- 7.9, 18.1% +/- 11.1, 15.1% +/- 12.3 respectively. In one man the gain value for the right posterior semicircular canal was found significantly above the standard value--71%. CONCLUSION: VHIT showed much more sensitive than a full videonystagmographic test.

Comparison of two VHIT software programs in diagnostics of semicircular canals.

INTRODUCTION: The aim of this work was to assess SCC function in VHIT test, using both versions of VHIT ULMER. MATERIAL AND METHODS: The study was performed in 57 subjects aged 22-33 years (48 women and 9 men) without vertigo in anamnesis. Patients did not complain of any "vertigo" ailments or any balance disorder incidents in the past. All tests using either VHIT I or VHIT II were performed by the same person. The function of lateral SCC in VHIT ULMER II was examined similarly like in VHIT ULMER I. In both methods was used the same sensitivity threshold parameters for horizontal and vertical accelerations (horizontal - 2500, vertical - 1600). Each of these sequences enables a parameter, called represented GAIN, to be calculated in form of a point on the canalogram. RESULTS: GAIN represents the deviation of the gaze in comparison to the deviation of the head between the first (t - 0 ms) and the fourth image (t = 120 ms). The calculation formula is: GAIN (in %) =100 x DG/RH. DG is deviation of the gaze ("gaze velocity in space") and RH is rotation of the head ("head velocity or impulse canal paresis"). Normal GAIN value ranges 1-40%. CONCLUSIONS: The examination using VHIT ULMER II appears to be a more sensitive diagnostic method than VHIT ULMER I. Improved software with automated functions such as camera adjustments, examination surface arrangement, of VHIT ULMER II, enables technician to shorten the time of examination, simultaneously providing a range of new information about the condition of oculo-vestibular system.

Own experience in the treatment of major salivary gland tumors.

INTRODUCTION: The paper aims to demonstrate the Clinic's and own research in the treatment of major salivary gland tumors. MATERIAL AND METHOD: In the years 2013-2019, there were 95 salivary gland surgeries, including 45 performed in women (47.36%) aged between 24 and 82 and in 50 men (52.64%) aged 29 to 86. Diagnostics of major salivary glands included: patient history, otolaryngological examination, ultrasound and fine needle aspiration (BACC) (of tumor), laboratory tests (morphology, CRP) and computed tomography (CT) or magnetic resonance imaging (MRI) to accurately assess salivary glands, location of lesion and lymph nodes prior to elective surgery. Research results: In the analyzed material patients with major salivary gland tumors were most frequently operated on at the age of 61-70 (34.7%) and 51-60 years (23.2%). Most patients with tumors were hospitalized in the last 4 years between 2016-2019, which accounted for 77.8% of all operated cases. Among the operated lesions, benign neoplasms and tumors occurred in 93.7%, of which the most frequent findings in histopathological examination were Warthin tumor in 50.5%, and multiform adenoma in 26.3%. The remaining tumors and benign neoplasms constituted only 16.9% and were observed in isolated cases, including eosinophilic adenoma, lymphoepithelial cyst, myoepithelial adenoma, lipofibrosarcoma, congestive cyst, air cyst, tubular adenoma, basal cell carcinoma, cyst with squamous metaplasia features, vascular malformation. Malignant salivary gland tumors were found in 6.3%, including the following malignant tumors were revealed histopathologically: adenocarcinoma, mucoepidermal carcinoma, acinocellular carcinoma, epithelialmyoepithelial carcinoma, ductal carcinoma. CONCLUSIONS: The majority of operated salivary gland tumors were benign (93.7%), of which the most common histopathologically were: Warthin tumor (50.5%) and multiform adenoma (26.3%), while malignant tumors occurred in 6.3%. Tumors were localized mainly in the parotid gland in as many as 93.7% cases, of which the most common localization concerned the superficial lobe in 56.8%. The most frequent surgical technique used in the Clinic was extracapsular dissection of the tumor in 88.4%, and other methods were used rarely.