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1.
Laryngorhinootologie ; 100(6): 460-466, 2021 06.
Artigo em Alemão | MEDLINE | ID: mdl-32823369

RESUMO

BACKGROUND: Symptoms of chronic rhinitis in old and very old populations may result from isolated hyperplasia of nasal inferior turbinates. Turbinoplasty is a possible method of treatment in these individuals. However, preoperative concerns are associated with their poor general condition: tendency to epistaxis, treatment with anticoagulants, hypertension, and less effective healing. OBJECTIVE: The aim of this study was to determine differences in results of turbinoplasty obtained in old and very old individuals with chronic rhinitis, compared to young and otherwise healthy patients. MATERIAL AND METHODS: We analyzed records of 130 patients with hyperplasia of the inferior turbinates, who had undergone bipolar diathermy turbinoplasty: 82 individuals aged 18-59 (mean = 33.8; SD = 10.2), 30 patients aged 60-74 (mean = 66.0; SD = 3.7) and 18 participants aged 75 + years (mean = 85.3; SD = 6.5). The patients were questioned about the intensity of their symptoms before and one month after the surgery, using the SNOT-20 questionnaire. The duration of wound healing and satisfaction scores were also noted. RESULTS: Nasal patency, nasal discharge and post-nasal drip improved in old and very old patients, similarly as in the young ones. Olfactory and taste function improved significantly more in young individuals. Postoperative healing time was significantly longer in very old patients. CONCLUSIONS: Some results of turbinoplasty in old and very old patients were significantly worse than in young ones.


Assuntos
Obstrução Nasal , Procedimentos de Cirurgia Plástica , Rinite , Humanos , Hiperplasia/patologia , Hiperplasia/cirurgia , Obstrução Nasal/patologia , Obstrução Nasal/cirurgia , Rinite/patologia , Rinite/cirurgia , Olfato , Resultado do Tratamento , Conchas Nasais/patologia , Conchas Nasais/cirurgia
2.
Int J Audiol ; 57(3): 236-239, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29187006

RESUMO

OBJECTIVE: To search for distinctive clinical features of patients with double tinnitus in a single ear. Design retrospective: Study sample: Six hundred and fourteen tinnitus patients were interviewed using a detailed questionnaire. They underwent thorough audiological evaluation. Records of seven patients reporting double tinnitus in 10 ears were identified and analysed. There were three women and four men in the group (mean age 40, range 29-49 years). RESULTS: All but two individuals declared sudden onset of the complaints. Three patients had been diagnosed with sudden sensorineural hearing loss. In all the patients, the components of double tinnitus were compared both to a pure tone and to a narrow band noise. The sounds were considered by the patients to be primary (more prominent) or secondary. All but one patient declared hypersensitivity to loud sounds. Vertigo was present in only two of the double tinnitus sufferers. Abnormal DPOAEs frequency values and audiogram notch frequencies were closer to the primary than the secondary tinnitus matches. CONCLUSIONS: In our study, double tinnitus was rare, mostly perceived by patients with a sudden onset of tinnitus. This is the first report presenting audiological findings in patients with double tinnitus in a single ear. Prospective search of cohorts of tinnitus sufferers for such patients and functional neuroimaging of their auditory pathways for determining underlying mechanisms of the complaints is advocated.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Audição , Hiperacusia/diagnóstico , Percepção Sonora , Pessoas com Deficiência Auditiva/psicologia , Percepção da Altura Sonora , Zumbido/diagnóstico , Estimulação Acústica , Adulto , Audiometria de Tons Puros , Limiar Auditivo , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/psicologia , Humanos , Hiperacusia/fisiopatologia , Hiperacusia/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Zumbido/fisiopatologia , Zumbido/psicologia
3.
Int J Mol Sci ; 18(4)2017 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-28346382

RESUMO

The aim of the study was to analyse the disturbances of the oro-pharyngeal swallowing phase of dysphagia in amyotrophic lateral sclerosis (ALS) patients with the use of specific manometric measurements and to evaluate their plausible association with the duration of the disease. Seventeen patients with ALS were evaluated with manometric examinations of the oral and pharyngeal part of the gastrointestinal tract. Tests were carried out by using the oesophageal balloon-based method with four balloon transducers located 5 cm away from each other. The following manometric parameters were analysed: the base of tongue contraction (BTC) and the upper oesophageal sphincter pressure (UESP), and the hypopharyngeal suction pump (HSP) as well as the oro-pharyngeal, pharyngeal and hypopharyngeal transit time and average pharyngeal bolus velocity (oropharyngeal transit time (OTT), pharyngeal transit time (PTT), hypopharyngeal transit time (HTT) and average pharyngeal bolus velocity (APBV), respectively). Manomatric examinations during swallowing in patients with ALS showed significant weakness of BTC, a decrease of HSP and a decrease of the velocity of bolus transit inside the pharynx which were particularly marked between the first and the third examination. Manometric examinations of the oro-pharyngeal part of the gastrointestinal tract are useful and supportive methods in the analysis of swallowing disturbances in ALS patients.


Assuntos
Esclerose Lateral Amiotrófica/fisiopatologia , Deglutição/fisiologia , Adulto , Idoso , Esclerose Lateral Amiotrófica/diagnóstico , Estudos de Casos e Controles , Esôfago/fisiologia , Feminino , Trato Gastrointestinal/diagnóstico por imagem , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Língua/fisiologia , Adulto Jovem
4.
Wiad Lek ; 70(2 pt 2): 405-409, 2017.
Artigo em Polonês | MEDLINE | ID: mdl-29059666

RESUMO

INTRODUCTION: The palatal mucosa requires careful testing prior to prosthetic treatment. Pathological changes may occur during the period of use of a dental prosthetic, especially when worn constantly. Aim of the report: We describe the case of a patient who experienced extensive changes in the mucosa of the hard palate over 12 years of dentures used. CASE PRESENTATION: The 78-year-old female patient was referred to the Department of Otolaryngology of the Jagiellonian University Hospital in Krakow with a diagnosis of adenocarcinoma of the palate. In connection with the planned extensive surgery, there was indication for the use of a palatal plate with an obturator in order to close the expected gap in the palate structure. No recurrence of the tumor was seen in the period examined. Summation: Despite the extensive tumor, two small defects in the palate remained after surgery. These were effectively sealed and the patient reached the five-year survival point.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Palatinas/cirurgia , Palato/patologia , Idoso , Feminino , Humanos , Recidiva Local de Neoplasia , Palato/cirurgia
5.
Int J Exp Pathol ; 96(6): 378-86, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26765504

RESUMO

A key role of bacterial biofilm in the pathogenesis of chronic rhinosinusitis (CRS) with (CRSwNP) and without nasal polyps (CRSsNP) is commonly accepted. However, the impact of some bacterial species isolated from inflamed sinus mucosa on biofilm formation is unclear. In particular, the role of Staphylococcus epidermidis as aetiological agents of CRS is controversial. Moreover, the effect of biofilm formation on neutrophil infiltration and activity in CRSwNP calls for explanation. In this study, biofilms were found in three of 10 patients (mean age = 46 ± 14) with CRS undergoing endoscopic sinus surgery by means of scanning electron microscopy. Unexpectedly, S. epidermidis was the primary isolated bacteria and was also found to be present in all biofilm-positive mucosa specimens, indicating its pivotal role in the pathogenesis of severe chronic infections associated with biofilm formation. We have also measured the activity of myeloperoxidase (MPO), the most abundant neutrophil enzyme, to demonstrate the presence of neutrophils in the samples tested. Our present results show that the level of MPO in CRS associated with biofilm is lower than that without biofilm. It may suggest either a low number of neutrophils or the presence of a type of neutrophils with compromised antimicrobial activity, described as biofilm-associated neutrophils (BAN). Finally, we conclude that further studies with a large number of CRS cases should be performed to establish the association between S. epidermidis and other frequently isolated bacterial species from paranasal sinuses, with the severity of CRS, biofilm formation and the infiltration of BAN.


Assuntos
Biofilmes , Mucosa Nasal/microbiologia , Neutrófilos/microbiologia , Rinite/microbiologia , Sinusite/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus epidermidis/crescimento & desenvolvimento , Adulto , Biomarcadores/análise , Doença Crônica , Contagem de Colônia Microbiana , Método Duplo-Cego , Feminino , Humanos , Masculino , Microscopia Eletroquímica de Varredura , Pessoa de Meia-Idade , Mucosa Nasal/imunologia , Mucosa Nasal/ultraestrutura , Infiltração de Neutrófilos , Neutrófilos/enzimologia , Neutrófilos/imunologia , Peroxidase/análise , Estudos Prospectivos , Rinite/diagnóstico , Rinite/imunologia , Índice de Gravidade de Doença , Sinusite/diagnóstico , Sinusite/imunologia , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/imunologia , Staphylococcus epidermidis/imunologia , Staphylococcus epidermidis/isolamento & purificação , Staphylococcus epidermidis/ultraestrutura
6.
Prostaglandins Other Lipid Mediat ; 121(Pt B): 163-9, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26209241

RESUMO

BACKGROUND: Isoprostanes are bioactive compounds formed by non-enzymatic oxidation of polyunsaturated fatty acids, mostly arachidonic, and markers of free radical generation during inflammation. In aspirin exacerbated respiratory disease (AERD), asthmatic symptoms are precipitated by ingestion of non-steroid anti-inflammatory drugs capable for pharmacologic inhibition of cyclooxygenase-1 isoenzyme. We investigated whether aspirin-provoked bronchoconstriction is accompanied by changes of isoprostanes in exhaled breath condensate (EBC). METHODS: EBC was collected from 28 AERD subjects and 25 aspirin-tolerant asthmatics before and after inhalatory aspirin challenge. Concentrations of 8-iso-PGF2α, 8-iso-PGE2, and prostaglandin E2 were measured using gas chromatography/mass spectrometry. Leukotriene E4 was measured by immunoassay in urine samples collected before and after the challenge. RESULTS: Before the challenge, exhaled 8-iso-PGF2α, 8-iso-PGE2, and PGE2 levels did not differ between the study groups. 8-iso-PGE2 level increased in AERD group only (p=0.014) as a result of the aspirin challenge. Urinary LTE4 was elevated in AERD, both in baseline and post-challenge samples. Post-challenge airways 8-iso-PGE2 correlated positively with urinary LTE4 level (p=0.046), whereas it correlated negatively with the provocative dose of aspirin (p=0.027). CONCLUSION: A significant increase of exhaled 8-iso-PGE2 after inhalatory challenge with aspirin was selective and not present for the other isoprostane measured. This is a novel finding in AERD, suggesting that inhibition of cyclooxygenase may elicit 8-iso-PGE2 production in a specific mechanism, contributing to bronchoconstriction and systemic overproduction of cysteinyl leukotrienes.


Assuntos
Anti-Inflamatórios não Esteroides/toxicidade , Aspirina/análogos & derivados , Asma Induzida por Aspirina/metabolismo , Inibidores de Ciclo-Oxigenase/toxicidade , Dinoprostona/análogos & derivados , Isoprostanos/agonistas , Pulmão/efeitos dos fármacos , Lisina/análogos & derivados , Mucosa Respiratória/efeitos dos fármacos , Adulto , Aspirina/toxicidade , Asma/metabolismo , Asma/fisiopatologia , Asma Induzida por Aspirina/fisiopatologia , Asma Induzida por Aspirina/urina , Biomarcadores/análise , Biomarcadores/metabolismo , Biomarcadores/urina , Testes Respiratórios , Testes de Provocação Brônquica , Broncoconstrição/efeitos dos fármacos , Dinoprostona/agonistas , Dinoprostona/análise , Dinoprostona/metabolismo , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Isoprostanos/análise , Isoprostanos/metabolismo , Leucotrieno E4/antagonistas & inibidores , Leucotrieno E4/urina , Pulmão/metabolismo , Pulmão/fisiopatologia , Lisina/toxicidade , Masculino , Pessoa de Meia-Idade , Mucosa Respiratória/metabolismo , Mucosa Respiratória/fisiopatologia , Índice de Gravidade de Doença , Método Simples-Cego
7.
Med Sci Monit ; 21: 2997-3002, 2015 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-26434686

RESUMO

BACKGROUND: Polyvalent bacterial lysate (PBL) is an oral immunostimulating vaccine consisting of bacterial standardized lysates obtained by lysis of different strains of bacteria. Autovaccines are individually prepared based on the results of smears obtained from the patient. Both types of vaccine can be used to treat an ongoing chronic infection. This study sought to determine which method is more effective against nasal colonization by potential respiratory tract pathogens. MATERIAL AND METHODS: We enrolled 150 patients with aerobic Gram stain culture and count results indicating bacterial colonization of the nose and/or throat by potential pathogens. The participants were randomly assigned to each of the following groups: 1. administration of PBL, 2. administration of autovaccine, and 3. no intervention (controls). RESULTS: Reduction of the bacterial count in Streptococcus pneumoniae-colonized participants was significant after the autovaccine (p<0.001) and PBL (p<0.01). Reduction of the bacterial count of other ß-hemolytic streptococcal strains after treatment with the autovaccine was significant (p<0.01) and was non-significant after PBL. In Haemophilus influenzae colonization, significant reduction in the bacterial count was noted in the PBL group (p<0.01). Methicillin-resistant Staphylococcus aureus colonization did not respond to either treatment. CONCLUSIONS: The autovaccine is more effective than PBL for reducing bacterial count of Streptococcus pneumoniae and ß-hemolytic streptococci, while PBL was more effective against Haemophilus influenzae colonization.


Assuntos
Autovacinas/uso terapêutico , Infecções Bacterianas/prevenção & controle , Extratos Celulares/uso terapêutico , Doenças Nasais/prevenção & controle , Doenças Faríngeas/prevenção & controle , Infecções Respiratórias/prevenção & controle , Administração Oral , Adolescente , Adulto , Autovacinas/química , Extratos Celulares/química , Doença Crônica , Feminino , Haemophilus influenzae , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina , Pessoa de Meia-Idade , Doenças Nasais/microbiologia , Doenças Faríngeas/microbiologia , Estudos Prospectivos , Sistema Respiratório/microbiologia , Infecções Respiratórias/microbiologia , Streptococcus pneumoniae , Adulto Jovem
8.
Med Sci Monit ; 21: 2345-51, 2015 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-26259623

RESUMO

BACKGROUND: Middle ear surgery aims to eliminate pathology from the middle ear, improve drainage and ventilation of the postoperative cavity, and reconstruct the tympanic membrane and ossicles. The aim of this work is to define the factors that affect ABG (air-bone gap) and bone conduction in the patients operated on due to chronic otitis media. MATERIAL AND METHODS: A prospective analysis of patients operated on due to diseases of the middle ear during 2009-2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were analyzed. The analysis encompassed patients who had undergone middle ear surgery. The patients were divided into several groups taking into account the abnormalities of the middle ear mucous and damage of the ossicular chain observed during otosurgery. RESULTS: A significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a PORP was used in the reconstruction. Granulation tissue was an unfavorable factor of hearing improvement following tympanoplasty. A significant improvement of bone conduction was observed in the patients with dry perforation without other lesions in the middle ear. The elimination of granulation lesions was a positive factor for the future improvement of the function of the inner ear. CONCLUSIONS: The presence of granuloma-related lesions in the middle ear spaces is likely to impede hearing improvement. Damage to the ossicular chain rules out the possibility of bone conduction improvement after surgery. The prognosis on tube-related simple chronic otitis media after myringoplasty, with the preserved continuity of the ossicular chain, consists of closing the ABG and leads to significant improvement of bone conduction.


Assuntos
Condução Óssea/fisiologia , Otite Média/fisiopatologia , Otite Média/cirurgia , Procedimentos Cirúrgicos Otológicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Colesteatoma da Orelha Média/patologia , Colesteatoma da Orelha Média/fisiopatologia , Colesteatoma da Orelha Média/cirurgia , Doença Crônica , Feminino , Tecido de Granulação/patologia , Tecido de Granulação/fisiopatologia , Tecido de Granulação/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Miringoplastia , Prótese Ossicular , Otite Média/patologia , Estudos Prospectivos , Timpanoplastia , Adulto Jovem
9.
Neurodegener Dis ; 15(4): 225-32, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25967115

RESUMO

OBJECTIVE: Voice abnormalities are among the symptoms occurring in patients with amyotrophic lateral sclerosis (ALS). They are divergent and range from hoarseness, through the excessive adduction of false folds, up to the weakness of the vocal folds. The aim of the study was to analyze the phonatory function of the larynx in ALS patients. METHODS: Seventeen patients with ALS were evaluated with subjective perceptual voice assessment (including the GRBAS scale), videolaryngostroboscopy including voice range and maximum phonation time (MPT), and objective acoustic voice analysis with IRIS software (including evaluation of jitter, shimmer, mean fundamental frequency, and noise-to-harmonics ratio (NHR)). Examinations were performed three times at 6-month intervals. RESULTS: Hoarseness, roughness, and breathiness of voice were all found more frequently in the majority of these patients. Voice range, amplitude of vibration, mucosal wave, and glottal closure showed significant abnormalities with repeated examinations. MPT was shortened especially among women with ALS. Acoustic analysis of voice among men showed increased jitter value in the first examination only, while jitter, shimmer, and NHR in women with ALS were increased in all examinations. CONCLUSIONS: Analysis of voice qualities among patients with ALS allows for the detection of various abnormalities associated with the natural progression of the disease.


Assuntos
Esclerose Lateral Amiotrófica/fisiopatologia , Laringe/fisiopatologia , Fonação , Qualidade da Voz/fisiologia , Adulto , Idoso , Esclerose Lateral Amiotrófica/complicações , Feminino , Rouquidão/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Fonação/efeitos dos fármacos
10.
J Allergy Clin Immunol ; 134(4): 883-90, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24767875

RESUMO

BACKGROUND: Numerous open trials have demonstrated the beneficial clinical effects of aspirin desensitization (AD) in patients with aspirin-induced asthma (AIA). These beneficial effects might be attributable to aspirin's potent anti-inflammatory properties, but that supposition requires further corroboration. OBJECTIVE: We sought to compare the clinical and biochemical responses to chronic oral AD in 20 patients with AIA and 14 patients with aspirin-tolerant asthma (ATA). All of the patients had chronic rhinosinusitis and nasal polyposis, and these responses were investigated in a pilot, double-blind, placebo-controlled study. METHODS: Twelve patients with AIA and 6 patients with ATA were randomly assigned to receive 624 mg of aspirin, and 8 patients with AIA and 8 patients with ATA received placebo. Both aspirin and placebo were administered once daily for 6 months. Nasal symptoms, Sino-Nasal Outcome Test (SNOT20) scores, peak nasal inspiratory flows, Asthma Control Questionnaire scores, spirometric parameters, peak expiratory flows, blood eosinophilia, and corticosteroid doses were assessed on a monthly basis. Levels of urinary leukotriene E4 and the stable plasma prostaglandin (PG) D2 metabolite 9α,11ß-PGF2 were evaluated at baseline and after 1, 3, 5, and 6 months. RESULTS: Only the patients with AIA subjected to AD reported improvements in smell and reductions in sneezing and nasal blockade. The SNOT20 and Asthma Control Questionnaire scores of these patients decreased, and their peak nasal inspiratory flows increased. The dosages of inhaled corticosteroids were reduced. There were no changes in leukotriene E(4) or 9α,11ß-PGF(2) levels after AD. CONCLUSION: The clinically beneficial effects of AD on nasal and bronchial symptoms occurred only in the patients with AIA.


Assuntos
Aspirina/administração & dosagem , Asma Induzida por Aspirina/terapia , Asma/terapia , Dessensibilização Imunológica/métodos , Eosinófilos/imunologia , Pólipos Nasais/terapia , Rinite/terapia , Sinusite/terapia , Administração Oral , Adulto , Idoso , Alérgenos/imunologia , Aspirina/imunologia , Asma/diagnóstico , Asma/imunologia , Asma Induzida por Aspirina/diagnóstico , Asma Induzida por Aspirina/imunologia , Doença Crônica , Dinoprosta/sangue , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Leucotrieno E4/urina , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/diagnóstico , Pólipos Nasais/imunologia , Projetos Piloto , Prostaglandina D2/sangue , Rinite/diagnóstico , Rinite/imunologia , Sinusite/diagnóstico , Sinusite/imunologia , Espirometria , Resultado do Tratamento
11.
Med Sci Monit ; 20: 974-9, 2014 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-24935173

RESUMO

BACKGROUND: The principal objective of ossiculoplasty is to reconstruct the sound-conducting system in the ear to the best possible degree after the elimination of pathological lesions from the middle ear. The ossicular chain is reconstructed with the use of the patient's own properly modelled ossicles and synthetic prostheses. The objective of the study was to assess the degree of hearing improvement after tympanoplasty in patients for whom a ventilation tube was used as a partial ossicular replacement prosthesis (PORP). MATERIAL AND METHODS: Between 2009 and 2012, 387 patients underwent ear surgery at the Otolaryngological Teaching Hospital of the Collegium Medicum at the Jagiellonian University of Cracow. We focussed on the patients in whom a vibrating element in the form of a properly modelled anvil or a ventilation tube was attached to the preserved and normally mobile stapes. RESULTS: A significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a ventilation tube was used as a PORP in the reconstruction. Granulation tissue was determined to be an unfavorable factor in the prognosis of hearing improvement following tympanoplasty. CONCLUSIONS: Significant hearing improvement was observed after type 2 tympanoplasty in patients with cholesteatoma whose ossicular chain was not appreciably damaged. A ventilation tube used as a PORP is an effective alternative in the reconstruction of the ossicular chain.


Assuntos
Ventilação da Orelha Média , Prótese Ossicular , Otite Média/cirurgia , Procedimentos Cirúrgicos Otológicos/métodos , Doença Crônica , Humanos , Muco/metabolismo , Resultado do Tratamento , Timpanoplastia
12.
Eur Arch Otorhinolaryngol ; 271(5): 1015-21, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23864247

RESUMO

The aim of this study was to assess the influence of bacterial biofilms in chronic rhinosinusitis (CRS) patients on the clinical outcomes following endoscopic sinus surgery (ESS). This was a prospective, double-blind study. Patients undergoing ESS, because of CRS, were recruited. Overall 80 patients were qualified. For each of these demographic, clinical and radiologic characteristics were recorded. During surgery each patient had at least 7 mucosal specimens taken to assess, using scanning electron microscopy, the possible presence of bacterial biofilms. Prior to mucosa specimen excision, swabs for bacteriological and fungal analyses were taken. Each patient underwent perioperative and follow-up assessment at 3 and 6 months post-ESS. Biofilms were found in 33 (41.3%) patients (study group). From among the 47 patients without the presence of biofilms, 33 (control group) were taken to match the study group in age, gender and clinical characteristics. The intensity of subjective and objective CRS symptoms, as well as patient quality-of-life, did not correlate with the Lund and Mackay score (p > 0.05). Analysis of variance showed that, in the control group or the group as a whole, the intensity of subjective and objective symptoms decreased (p < 0.05), and the quality-of-life increased with time (p < 0.05). In conclusion, biofilm-positive patients tend to have a greater severity of disease preoperatively and continue to have persistent and more severe symptoms post-ESS. This study supports the role of biofilms in maintaining the chronic and recalcitrant nature of CRS. The lack of planktonic bacteria in post-operative sinus swabs does not rule out the presence of bacterial biofilms.


Assuntos
Bactérias/crescimento & desenvolvimento , Biofilmes/crescimento & desenvolvimento , Endoscopia , Fungos/fisiologia , Microscopia Eletrônica de Varredura , Complicações Pós-Operatórias/patologia , Rinite/patologia , Rinite/cirurgia , Sinusite/patologia , Sinusite/cirurgia , Adulto , Doença Crônica , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/microbiologia , Mucosa Nasal/patologia , Mucosa Nasal/cirurgia , Complicações Pós-Operatórias/microbiologia , Estudos Prospectivos , Qualidade de Vida , Rinite/microbiologia , Sinusite/microbiologia , Resultado do Tratamento
13.
Int J Audiol ; 53(7): 482-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24684405

RESUMO

OBJECTIVE: We sought to determine whether the results of audiological tests and tinnitus characteristics, particularly tinnitus pitch and minimum masking level (MML), depend on tinnitus etiology, and what other etiology-specific tinnitus characteristics there are. DESIGN: The patients answered questions concerning tinnitus laterality, duration, character, aggravation, alleviation, previous treatment, and circumstances of onset. The results of tympanometry, pure-tone audiometry, distortion-product otoacoustic emissions, tinnitus likeness spectrum, MML, and uncomfortable loudness level were evaluated. STUDY SAMPLE: Patients with several tinnitus etiological factors were excluded. The remaining participants were divided into groups according to medical history: acute acoustic trauma: 67 ears; chronic acoustic trauma: 82; prolonged use of oral estrogen and progesterone contraceptives: 46; Ménière's disease: 25; congenital hearing loss: 19; sensorineural sudden deafness: 40; dull head trauma: 19; viral labyrinthitis: 53; stroke: 6; presbycusis: 152. Data of 509 ears were analysed. RESULTS: Tinnitus pitch was highest in patients with acute acoustic trauma and lowest in patients receiving estrogen and progesterone. MML was lowest after acute acoustic trauma and in congenital hearing loss, and highest after a stroke and in the case of presbytinnitus. CONCLUSIONS: Tinnitus pitch and MML are etiology dependent.


Assuntos
Vias Auditivas/fisiopatologia , Percepção Auditiva , Mascaramento Perceptivo , Zumbido/etiologia , Estimulação Acústica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Limiar Auditivo , Feminino , Humanos , Percepção Sonora , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Zumbido/diagnóstico , Zumbido/fisiopatologia , Zumbido/psicologia , Adulto Jovem
14.
Folia Phoniatr Logop ; 66(3): 95-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25377515

RESUMO

OBJECTIVE: Our purpose was to determine how anatomical conditions of the throat influence the degree and duration of posttonsillectomy transient hypernasality. PATIENTS AND METHODS: A total of 82 tonsillectomies were performed. The participants were divided into groups: 1 ­ small tonsils, high soft palate position; 4 ­ large tonsils, low soft palate position, and 2 and 3 ­ intermediate tonsil dimensions and soft palate positions. Variables studied included the diameter of vapor (DV) on the mirror positioned under the patient's nose while articulating nasal sentences before and after surgery, the distance from the uvular tip to the posterior pharyngeal wall, healing grading as well as the degree and duration of hypernasality. RESULTS: The mean hypernasality after tonsillectomy was greatest in group 4 and lowest in group 2. Before tonsillectomy, the mean DV was largest in group 2 and smallest in group 4. After tonsillectomy, the mean DV was largest in group 4 and smallest in group 3. Overall, the mean DV was significantly greater after tonsillectomy compared to the value before surgery. CONCLUSION: The degree of hypernasality after tonsillectomy depends on the soft palate position in relation to the tongue base and the size of the tonsils. Hypernasality is greatest in patients with large tonsils and a low soft palate position in relation to the tongue base.


Assuntos
Complicações Pós-Operatórias/etiologia , Tonsilectomia/efeitos adversos , Distúrbios da Voz/etiologia , Qualidade da Voz , Adulto , Antropometria , Feminino , Humanos , Masculino , Tamanho do Órgão , Palato Mole/patologia , Tonsila Palatina/patologia , Faringe/patologia , Complicações Pós-Operatórias/patologia , Língua/patologia , Distúrbios da Voz/patologia
15.
Przegl Lek ; 70(7): 421-6, 2013.
Artigo em Polonês | MEDLINE | ID: mdl-24167940

RESUMO

It is estimated that in Europe 10% of adults suffer from chronic sinusitis. Chronic sinusitis can be caused by many different diseases that share chronic inflammation of the sinuses as a common symptom. Rhinitis can be caused by stomach acid coming up from the stomach into the esophagus, which successively can result in chronic sinusitis. The current gold standard for diagnosing GERD is--bothersome for the patient--24 h esophageal pH monitoring. This method can be unpleasant for the patients, which makes it less acceptable. Because of that the criteria for symptomatic GERD were made an alternative diagnostic way. We acknowledge that the presence of heartburn and stomach acid coming up from the stomach into the esophagus at least once a week can be diagnosed as symptomatic GERD. The aim of the study is the assessment of the frequency of symptomatic GERD in patients operated because of chronic sinusitis and impact of symptomatic GERD on the follow-up treatment up to 12 months after endoscopic nasal surgery. The authors analysed 144 patients operated at the JUCM Otolaryngological Clinic in Kraków between 2011 and 2013 because of sinusitis. The inclusion criteria were: diagnosed chronic sinusitis, indications for endoscopic sinus surgery, and a written consent for the research. Each patient was examined laryngologically and surveyed. Patients were divided into two groups: with and without symptomatic GERD. We analysed the symptoms in patients treated for sinusitis with or without GERD before, between 3 and 6 as well as in the 12th month after endonasal surgery. Moreover, we analysed the intensity of the global symptoms (expressed in the VAS scale) and separately for each of the 13 symptoms of chronic sinusitis (expressed on a scale 0 - 3). We established that 33 out of the 144 patients (22.9%) qualified for the first survey reported the symptoms of GERD. In the second survey, which was conducted between 3 and 6 month after ESS, 24 out of 119 (20%) people reported the symptoms and in the third survey, which took place in the 12th month after ESS, 14 out of 52 patients reported symptomatic GERD. The intensity of global symptoms rated in the VAS scale in patients with chronic sinusitis during the first survey was 7.8 and in the second and third survey the intensity was 4.2 and 4.3 respectively. But in patients without any symptoms they were 7.4, 2.8, 3.2. We also analysed 13 symptoms of chronic sinusitis rated on a scale 0 - 3. The result of the research was that in patients with symptomatic GERD, even after FESS and the appropriate follow-up, we can still suspect such symptoms as streaming the fluid over the back side of the throat, cough, pain or the feeling of fullness in the ear, headache or halitosis. We should take it under consideration during qualification for the surgery as well as predicting the results of the treatment. Further research is required to state if and how different methods and procedures used in case of patients with symptomatic GERD can reduce the uncomfortable influence of this disease on the effects of chronic sinusitis treatment.


Assuntos
Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/cirurgia , Sinusite/epidemiologia , Adolescente , Adulto , Idoso , Criança , Doença Crônica , Comorbidade , Monitoramento do pH Esofágico , Esofagoscopia , Feminino , Seguimentos , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Cuidados Pós-Operatórios/métodos , Sinusite/diagnóstico , Sinusite/cirurgia , Resultado do Tratamento , Adulto Jovem
16.
Med Sci Monit ; 18(6): BR215-20, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22648242

RESUMO

BACKGROUND: Bony wall damages in the region of the middle and posterior cranial fossa are usually observed in cases of chronic otitis media. These defects can also be congenital, post-traumatic, iatrogenic or due to tumors. They can potentially lead to the development of intracranial complications. MATERIAL/METHODS: We analyzed patients who were diagnosed as having bony wall damage in the region of the middle and/or posterior cranial fossa. We also discuss methods of reconstruction during otosurgery. The analysis involves patients who underwent middle ear operations in the Department of Otolaryngology at the Jagiellonian University of Krakow between 2004 and 2008; 495 otosurgeries were performed during this period of time. RESULTS: In 70% of patients the reason for otosurgery was chronic otitis media. In 20%, bone defects occurred simultaneously with otosclerosis. Less than 10% underwent otosurgery for other reasons. Bony wall damage in the region of the middle and posterior cranial fossa were diagnosed in 46 patients who underwent surgery. In patients with bony wall damage, otogenic intracranial complications were described in 14 cases. CONCLUSIONS: The performed reconstruction methods for bony wall damage, which used the fascia, strengthened with the pedicle muscle flap for larger defects and with either bone lamella or cartilage in specific cases, proved successful. Nearly 80% of bony wall damages in the region of the middle and posterior cranial fossa remain asymptomatic and are discovered incidentally during middle ear surgery. The above observations emphasize the significant role of pre-operative imaging diagnostics.


Assuntos
Fossa Craniana Posterior/cirurgia , Orelha Média/cirurgia , Procedimentos Cirúrgicos Otológicos/métodos , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Idoso , Criança , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/patologia , Orelha Média/diagnóstico por imagem , Orelha Média/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/patologia , Otite Média/cirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Otolaryngol Pol ; 65(4): 293-6, 2011.
Artigo em Polonês | MEDLINE | ID: mdl-22000149

RESUMO

BACKGROUND: Primary inverted papilloma of the sphenoid sinus is rare. The tumor is considered locally aggressive. In selected cases inverted papilloma can be associated with squamous cell carcinoma. Radiologic imaging is a key to an accurate diagnosis. AIM: We analyzed patient with inverted papilloma in sphenoid sinus which was removed with endoscopic surgery. MATERIAL AND METHODS: We discuss patient with isolated inverted papilloma located in the sphenoid sinus. RESULTS: Performed endoscopic treatment enabled removal of tumour with no complications. CONCLUSIONS: Transnasal endoscopic large sphenoidotomy remains an effective modality for management of patients with inverted papilloma. This method does not require external approach and it is performed with no scars, with minimal injury of tissues.


Assuntos
Papiloma Invertido/patologia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Idoso , Endoscopia , Humanos , Masculino , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Seio Esfenoidal/patologia , Seio Esfenoidal/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
Otolaryngol Pol ; 65(4): 266-71, 2011.
Artigo em Polonês | MEDLINE | ID: mdl-22000143

RESUMO

BACKGROUND: Ear drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. AIM: This paper is intended to evaluate effectiveness of tympanic membrane reconstruction and indicate factors which have an influence on hearing improvement after myringoplasty. MATERIAL AND METHODS: Analysis involves ca. 500 individuals operated on ear in Department of Otolaryngology at the Jagiellonian University between 2004 and 2009. RESULTS: 120 individuals were operated on for the first time due to chronic otitis media with intact ossicular chain. Statistically significant heating improvement was observed in patients with discharge, without discharge and in group with scars. CONCLUSIONS: The presence of granulation changes is an unfavorable prognostic condition in the patients with ear drum perforation. In clinical practice, the criterion which often determines the application of either of the materials in myringoplasty are operator's preferences, as well as the availability of given material for transplanting.


Assuntos
Colesteatoma da Orelha Média/cirurgia , Ossículos da Orelha/cirurgia , Otite Média/cirurgia , Retalhos Cirúrgicos , Perfuração da Membrana Timpânica/cirurgia , Membrana Timpânica/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Colesteatoma da Orelha Média/complicações , Ossículos da Orelha/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miringoplastia/métodos , Otite Média/complicações , Polônia , Prognóstico , Estudos Retrospectivos , Perfuração da Membrana Timpânica/etiologia , Timpanoplastia/métodos , Adulto Jovem
19.
Otolaryngol Pol ; 65(6): 410-3, 2011.
Artigo em Polonês | MEDLINE | ID: mdl-22208936

RESUMO

INTRODUCTION: Osteomas are relatively common, benign, slow-growing neoplasms. Mainly occurring in frontal and ethmoid sinuses. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. AIM: We discuss our experiences in endoscopic treatment of giant osteomas. RESULTS: In giant osteomas Draf III or Lothrop approaches are prefered. Periostium of the orbit was intact in all cases. Discharge of cerebrospinal liquid was not observed. CONCLUSIONS: Size of tumor determines type of surgical aprroach. Endoscopic surgery is more and more popular way in surgical treatment of giant osteomas.


Assuntos
Osteoma/diagnóstico , Osteoma/cirurgia , Neoplasias da Base do Crânio/diagnóstico , Neoplasias da Base do Crânio/cirurgia , Adulto , Seio Etmoidal/cirurgia , Seio Frontal/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Invasividade Neoplásica , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
20.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32854929

RESUMO

INTRODUCTION AND OBJECTIVES: Chronic rhinitis-related complaints may result from isolated hypertrophy of the inferior nasal turbinates. If the symptoms persist despite conservative management, turbinoplasty is indicated. However, the nasal mucosa lining the inferior turbinates seems decongested immediately before the surgery performed under local anaesthesia, compared to the examination when the patients were entered for surgery. The study aimed to confirm this observation and to hypothesize as to the reasons for its occurrence. PATIENTS AND METHODS: The measurements of the longest distances between the medial rim of the inferior nasal turbinate mucosa and nasal septum and the shortest distances between the lower rim of the turbinate and floor of the nasal cavity in the inferior part of both common nasal meatus, were carried out on photos taken during endoscopic examinations: the one entering the patient for turbinoplasty, and the other immediately before the procedure. The results in this group were compared to those obtained from patients operated on under general anaesthesia. RESULTS: In 130 patients aged 18-60 (mean=40.7) years, operated on under local anaesthesia, the sum of the mean distances between the nasal septum and the medial rim of the lower turbinate in both nasal cavities, was 3.4mm during the first examination, and 4.5mm (p=.0008) during the second one. In the group of 42 participants aged 26-47, mean=36.8 years operated on under general anaesthesia, the values were: 4.8mm and 3.6mm (p=.02), respectively. The differences were significantly smaller in the smokers (.3) compared to non-smokers (1.3; p=.04) mm. CONCLUSIONS: Records of the entering examination must be considered before turbinoplasty under local anaesthesia.

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