Pleomorphic adenomas in the materials of the Department of Otolaryngology of the Academy of Medical Sciences in Poznań

In the years 1958-1997 were surgically treated in the Department of Otolaryngology Karol Marcinkowski University of Medical Sciences in Poznań 365 patients with pleomorphic adenomas. Majority of the tumors originated of the major salivary glands was parotid gland (273 cases). The given materials confirms the viewpoint that enucleation in the pleomorphic adenomas of the parotid salivary gland--based on total removal of the tumor together with the capsule and pouch constitute a completely sure surgical procedure.     

Localisation and direction of spread in oral and oropharyngeal cancer in the material of Head and Neck Oncological Surgery Department, University of Medical Sciences in Poznań

The directions of tumor spread are determined by the anatomy of the affected organ. The vessel, nerve anatomy and presence of structures, that may potentially constitute a barrier for spread out of the tumor are of crucial importance. The aim of this paper was to presentation of the spreading directions of oral cavity and oropharyngeal squamous cell cancer based on the own experience. Material include 163 patients surgically treated between 2003-2003 in Department of ENT, Head and Neck Oncological Surgery Department in Poznań. The examination was conducted on the base of retrospective analysis of ambulatory charts and the hospital files. Results: 163 (90%) patients were operated for primary oral and oropharyngeal cancer. The primary localization included in the palatine tonsil (82 patients), trunk of the tongue (48 patients) and floor of the mouth (20 patients) were predominated. The spread directions included: floor of the mouth (36) soft palate (35), base of tongue (33), hypopharynx (20) and trunk of tongue (16). The 31 crossed the midline, 27 infiltrated the tonsillopalatine angle, 9 retromolar area and 3 the mucosa of the cheek. Knowledge of anatomy facility in clinical evaluation of spreading malignancy. It helps in proper qualification to surgery or radiotherapy.     

Results of treatment tinnitus patients using TRT in ENT Rehabilition Center in Poznań

The authors describe results of treatment tinnitus patients using TRT method. Since 4 years over 2000 patients were diagnosed and part of them were treated on basis neurophysiological model. In details the authors inform about method TRT and estimated results of audiological examination and treatment.     

Poznań's program of cochlear implantation: 10 years experience

The first cochlear implant in the ENT Department in Poznań was introduced in adult patient in January 1994. One year later the first deaf child was implanted. During 10 years over 200 deaf people were operated on. Modifications of diagnostics, surgery and rehabilitation were presented. Lowering the age of the implantation, changes of audiological criteria, genetic diagnostic and possibility of implantation in multi-handicapped patients were emphasized. Almost all surgeries were performed through the posterior tympanotomy and in one cases through the middle fossa approach. In one child with total ossification in CT scans Nucleus Double Array was used. Speech rehabilitation bases on auditory-verbal therapy. Rehabilitation consists of individual sessions with speech therapist and group therapy. Logorytmics exercises were introduced.     

9-years results of the functional endoscopic sinus surgery in ENT department in Poznań--from microscope to four hands technique

Surgical procedure is used in chronic rhinosinusitis and aims at restoring proper drainage and ventilation. For this reason the surgery of this region is referred to as functional and in English literature is termed as FESS. It supplanted classical method of Caldwell-Luc or Denker. In the study nine years experience in the Department of Otolaryngology, Head and Surgery University of Poznań in the treatment of chronic sinusitis has been presented. 1463 patients treated with FEES were analyzed. Moreover, the method of selecting patients for the surgery, the diagram showing surgeries performed step by step as well as a list of various surgeries and intraoperative complications were presented. This work is the first part of the study. In the other part the results of the treatment based on the questionnaires sent to patients will be presented.     

Treatment results of patients with adenoid cystic carcinoma in the Otolaryngology Department at the University School of Medical Sciences in Poznań between 1958-1999

In the years 1958-1999 the ENT Department at the University School of Medical Sciences in Poznań treated 125 patients suffering from adenoid cystic carcinoma located in the head and neck area. The aim of this study was to assess treatment results over a span of 41 years. The cases treated included 68 women and 57 men. The highest incidence of the disease was observed in men in their 70's--16 cases and women in their 50's--19 cases. In a majority of cases, the cancer started in major salivary glands, specifically parotid--51, submandibular--11, sublingual--4. Other places included minor salivary glands located in the palate--15, cheek--8, oral cavity--5 and tongue--4. Other glands affected by the tumor were those in the ethmoidomaxillary area--23. The treatment of choice was surgery with subsequent radiation. All patients were subjected to surgical treatment, 89 of them being subsequently radiated. Local recidivation was observed in 12 patients (i.e. 10%), metastases to neighbouring lymph nodes in 9 patients (i.e. 7%). Distant metastases affected the lungs--4 cases, liver--1 and bone--1.     

20 years of joint research on the carcinoma of the larynx conducted by teams from clinics in Crakow, Poznań, Warsaw and Lublin

A twenty-year scientific cooperation has been discussed (1979-1998) between four clinics for laryngology at Medical Universities in Cracow, Poznań, Warsaw and Lublin. The results of research concerning the epidemiology, diagnostics and treatment of the carcinoma of the larynx are presented.     

Poznań's program of cochlear and brainstem implantation: a general review

The cochlear implantation program in Poznań started in January 1994. Within 8 years, 151 patients were implanted (149 cochlear and 2 auditory brain-stem implants). The implanted group comprised 111 children and 40 adults. We have extended the lower age limit for cochlear implant candidates, and the youngest implanted patient was 18-months-old at the time of surgery. We have also implanted six multi-handicapped subjects. All patients were implanted with different nucleus devices (22, 24 M, 24 K, 24 Contour, 24 Double Array and 24 ABI). Insertion of the Nucleus 24 Contour electrode carrier requires a little larger cochleostomy in comparison with conventional straight array. After insertion, the intraoperative measurements are taken (impedance telemetry, electrically evoked stapedius reflex and NRT). The day after surgery, each patient undergoes an X-ray examination (the cochleogram or cochlear view). The calculated length of the electrode array insertion was 12.75-24.0 mm (mean: 22.05 mm) and the degree of electrode rotation was 180-540 degrees (mean: 292.82 degrees). After speech processor switch-on, we performed NRT measurements. Our results indicated that the NRT threshold was in 51.4% of the dynamic range within the group of examined patients. The adults' progress of rehabilitation was checked during individual sessions. The rehabilitation of children included two rehabilitation schedules: continuous ones and weekly rehabilitation camps. The progress of the recovery process of implanted children enabled them to change their school profile from hearing impaired to mainstream. Voice rehabilitation is often monitored by acoustic analysis using the Multi Dimensional Voice Program (MDVP).     

Methods of larynx phoniatory function measurement in the Poznań University Department of Ear, Throat, Nose and Larynx Diseases between 1922 and 1939

INTRODUCTION: Indirect laryngoscopy development and progress initiated in 1854 by the autolaryngoscopy of the famous singing voice teacher Manuel Garcia in ENT speciality is connected with the names of L. Tuerck and J.N. Czermak, the last one being called the father of laryngoscopy. In 1878 M. Oertel used for the first time stroboscopic light in indirect laryngoscopy. The perception of stroboscopic picture is based on the Talbot principle. OBJECT OF THE PAPER: Two apparatuses used for the evaluation of larynx function in the Poznań ENT Department before the II World War are presented:--Polylaryngoscop enabling evaluation the indirect laryngoscopy simultaneously by several individuals.--Mechanical stroboscop of Oertel type with perforated disc moved by electrical engine. CONCLUSION: For 130 years laryngostroboscopy belongs to the basic examination methods of larynx phonatory function.     

Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznań University of Medical Sciences, Poland

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.     

Analysis of vocal fold paresis in the patient material of the Department of Otolaryngology in Wrocław from 1993 to 2002

The aim of this paper was analysis of vocal fold paresis in the patients referred to ENT Department in Wroc?aw in the years 1993-2002. The study was performed on the base of 304 patients--209 women and 131 men. The average patient's age was 56 years. In all patients phoniatric examination and videostroboscopy were carried out. There were 38% cases of iatrogenic paresis mainly caused by thyroid surgery and cardiosurgery. In 30% causes we found the diseases which caused paresis (mainly infections, cancers, lesions of the central nervous system and injury of head, neck and chest). In about 30% causes we have not found the cause of paresis. Both vocal fold paresis in 98% was caused by thyroid surgery. Left vocal fold paresis was more often then paresis of the right side of vocal fold.     

The Lublańska classification of precancerous lesions of the larynx

Laryngeal carcinomas are preceded by precancerous lesions in about 20% of cases. The macroscopical appearance of these lesions is not enough characteristic to define their malignant potential. The accurate identification of epithelial abnormalities of the laryngeal mucosa requires biopsy and microscopic evaluation. There are many histological classifications of laryngeal precancerous lesions used at present. Many of them are highly subjective and have low reproducibility. Moreover, the different grades of these classifications not always give distinct guidelines for clinician concerning the treatment modality. The Ljubljana classification seems to be easier, more readily applied and more reproducible. It uses the name "epithelial hyperplastic laryngeal lesion" (EHLL) which includes all alterations in laryngeal squamous epithelium. The four grades of EHLL are: 1. simple hyperplasia (thickening of epithelium due to augmentation of normal prickle cells), 2. abnormal hyperplasia (with increase of basal-like cells), 3. atypical, or risky hyperplasia (epithelium thickened by increase of basal-like cells with pronounced atypical features), and 4. carcinoma in situ (i.e. full thickness change with the features of malignancy but without stromal invasion). The criteria of Ljubljana classification are precise and gives a possibility to make a more clear-cut separation of cases with risk of developing carcinoma from those without it.