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.     

Comparison of the application methods and effects of skin flaps in the repair of defects in different parts of the nose according to the concept of aesthetic nosesubunits北大核心CSCD

Objective To analyze the difference of application methods and effects of local flap in small and medium‑sized defects of different aesthetic subunits of nose, in order to provide reference for clinical work. Methods A retrospective analysis was made on 59 patients with external nasal masses and scars who underwent surgical treatment in the Department of Aesthetic Plastic Surgery of the Affiliated Hospital of Qingdao University from July 1, 2021 to January 30, 2022, including 27 females and 32 males, aged 15 to 69 years. Using Likert scale, the repair methods and effects of local flap for nasal soft tissue defects were evaluated and summarized from three aspects of texture, flatness and scar concealment. GraphPad Prism 5.0 software was used for data statistics and analysis. Results The use of skin flaps to repair small and medium‑sized areas of the nose could achieve satisfactory results. For patients with different subunits, in terms of skin flatness and scar concealment degree in the operation area, patients′ satisfaction with the dorsal and lateral nasal areas was higher than that of the alar and tip areas, respectively (F=6.40, P=0.001; F=10.57, P<0.001). For patients with different skin flap repair methods, the satisfaction of patients with Z‑plasty and Dufourmentel skin flap was higher than that of other skin flap repair methods (F=4.38, P=0.002), and the satisfaction of patients with Dufourmentel skin flap was the highest in the degree of scar concealment (F=2.57, P=0.038). Conclusions In the small and medium‑sized defects of the nose, the use of multiple local flaps can achieve good cosmetic effects and functional recovery. The operator should select the appropriate flap repair method according to the characteristics of different aesthetic subunits of the nose. © 2023 Authors. All rights reserved.     

Outcomes in the use of intra-tympanic gentamicin in the treatment of Ménière's disease

The pathogenesis of Ménière's disease is associated with a disorder of ionic homeostasis, with the pathologic correlate being endolymphatic hydrops. Despite uncertainty as to its particular mode of action, it is accepted wisdom that intra-tympanic gentamicin has a definite therapeutic role in the control of symptoms in patients who fail to respond to medical therapy. This study reports an evaluation of the efficacy of intra-tympanic gentamicin in the treatment of Ménière's disease and also presents a simple, reliable, safe method of administering gentamicin for this purpose. A retrospective review of 56 patients undergoing intra-tympanic gentamicin treatment for Ménière's disease was conducted. Response to treatment was analysed using a patient survey and examination of pure-tone averages. An overall significant improvement in vertigo symptoms of 81.3 per cent was found. There was a 21.4 per cent rate of significant hearing loss, defined as greater than 10 dB, with an average loss in this group of 18.5 dB. A single dose of gentamicin applied directly to the round window resulted in a high rate of control of vertigo, with acceptably low rates of hearing loss.     

Measuring the density of the fissula antefenestram and the section of the basal turn of the cochlea: Are they useful in the radiological diagnosis of otosclerosis?

IntroductionThe role of objective parameters in terms of improvement of the accuracy of high-resolution computed tomography (HRCT) of the temporal bone in the diagnosis of otosclerosis remains unclear.ObjectivesTo investigate the relationship between the density of the fissula antefenestram (FAF) and of the width of the transversal section of the basal turn of the cochlea (BTC), and the diagnosis of otosclerosis.MethodsThis is a retrospective study in which preoperative HRCT data from ears of patients submitted to stapedotomy due to otosclerosis (case group) were evaluated. For the control group, normal hearing ears having undergone HRCT for other purposes were included. Case and control HRCT images were objectively assessed by an experienced blinded radiologist. During this evaluation, measurements of the relative radiological density of the FAF and of the transversal section of the BTC were obtained. The results were compared between the groups. Also, a receiver operating characteristic curve was created and the area under the curve (AUC) was calculated for each variable. Significance level was set at .05.Results40 ears were included in each group. Case ears presented reduced values for the relative radiological density on the FAF (p-value<0.0001). Moreover, ears with otosclerosis (p-value: 0.022) presented lower transversal section of the BTC. The AUC for these variables reached 0.929 and 0.646, respectively.ConclusionsOtosclerotic ears present reduced radiological density on the FAF and narrower BTC. The relative density of the FAF also shows a great diagnostic power in the context of this disease.     

Is there a consensus in the division of the vocal folds in thirds?

INTRODUCTION: In clinical routine we have noticed a disagreement of ENT-specialists and phoniatricians in the division of the vocal folds in thirds. To show if there is consensus in this field by the german phoniatricians this study was done. MATERIAL AND METHODS: In two parts of a study, a pilot study and a follow up study, we sent twelve different images of the larynx to all german phoniatricians. In six of these images the physicians should set the marks of the ventral and dorsal limitation of the second third of the vocal folds. In six different images a mark should be related to the particular third of the vocal folds. The phoniatricians were asked to assess how certain they were in their valuation. They were asked either, how long they have been working as a physician and how long they have been specialized as a phoniatrician and as an ENT-surgeon. In the follow up study the phoniatricians were requested to first divide up the thirds in a way that the dorsal third corresponds to the cartilaginous part of the vocal folds (scheme 1) and second divide up the thirds in a way that all three thirds correspond to the ligamental part of the vocal folds. DISCUSSION AND FINDINGS: In the pilot study, when no instructions for the division of the thirds were given, the data differed much more than in the follow up study, when the physicians were told to use scheme 1 and scheme 2. That was because some phoniatricians divided up just the ligamental part and others the ligamental plus the cartilaginous part of the vocal folds in thirds. The more the physicians could overlook the membraneous part of the vocal folds the more certain they were in their assessment. CONCLUSION: The assessment of the division of the vocal folds in thirds is more homogeneous when the phoniatricians were requested to divide up the thirds in a way that the dorsal third corresponds to the cartilaginous part of the vocal folds (scheme 1). Therefore we suggest that this way of division should be used further on.     

Influence of Human Leukocyte Antigen in the Pathogenesis of Me´nie`re's Disease in the South Korean Population

In order to study the associations of Ménière's disease (MD) with human leukocyte antigen (HLA) alleles in the South Korean population, we examined the distribution of HLA class I and II alleles in 39 MD patients and 199 healthy controls. The frequencies of HLA-Cw*0303 (relative risk (RR) = 2.5; p < 0.02) and -Cw*0602 (RR = 3.7; p < 0.03) were significantly increased in patients with MD compared to controls. However, HLA-B44 (RR = 0.2, p < 0.004) and -Cw*0102 (RR = 0.3; p < 0.03) were significantly decreased in patients compared to controls. When the association between hearing level and the presence of HLA alleles was evaluated, the frequencies of HLA-B13 (RR = 7.4; p < 0.004), -B39 (RR = 45.7; p < 0.003), -Cw*0303 (RR = 4.5; p < 0.02) and -Cw*0602 (RR = 6.5; p < 0.02) were significantly increased and those of -B44 (RR = 0.1; p < 0.02) and -Cw*0102 (RR = 0.1; p < 0.03) were significantly decreased in MD patients with hearing losses (stages II-IV) compared to controls. The frequency of HLA-B13 was significantly higher in MD patients with hearing loss (stages II-IV) than in those with normal hearing (stage I). In terms of HLA-DRB1, -DQA1 and -DQB1 allele frequencies, a significantly higher frequency of DRB1*15 was seen in the patients (RR = 2.4; p < 0.03). These results suggest that some HLA alleles may be a useful genetic marker for predicting prognosis in South Korean patients with MD.     

Communication disorders in the practice of Department of Phoniatrics ad Audiology in Poznań

The relations between audiology and phoniatrics which formed the base for the present name of Poznań Department of Phoniatrics and Audiology are presented. It is specific for this Department to include the olfacto-gustometry into clinical evaluation of sensory organs. The periodic "Informacje Foniatryczne" which were published in 1966-1972 in our Department were exception in the history of Polish phoniatrics. The communications disorders should be inspected by rehabilitation team: phoniatrician, psychologist and logopedist, but the leading role is left for the physician. The prevention, prophylaxis and rehabilitation of professional voice disorders is one of the main social goals for audiology and phoniatrics.     

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.     

Rehabilitation of benign paroxysmal positional vertigo in the experience of the Wrocław Clinics

Mechanical disturbances in inner ear in cupulo-utricular complex are the cause of Benign Paroxysmal Positional Vertigo (BPPV). Pharmacotherapy is ineffective in such cases. The results of rehabilitation with the use of Semont of Epley manoeuvres in 46 patients were presented. The regression of symptoms in 24 cases treated with the use of Semont manoeuvre was achieved in 62% and in 22 cases treated with the use of Epley manoeuvre in 73%. Theoretical assumptions of effectiveness of treatment applied were discussed on the basis of cupulolithiasis and canalolithiasis theories.     

The causes of the development of cicatrical stenosis of the larynx and trachea in the patients presenting with Guillain-Barré syndrome

The problem of rehabilitation of the patients presenting with post-intubation stenosis of the larynx and trachea remains unresolved despite the development of new methods for the diagnostics and treatment of this condition. One of the indications for long-term artificial lung ventilation is the severe form of Guillaine-Barret syndrome associated with paralysis of breathing muscles, development of bulbar symptoms, and disturbances of trophic process in the skin and mucous membranes. However, prolonged (mean 26 days) artificial lung ventilation may result in the formation of many-layer stenosis of the larynx and trachea whereas disturbed trophic processes in the skin and mucous membranes coupled to inadequate innervation complicate the postoperative conditions of the patients and promote restenosis of the tracheal lumen.     

Cell proliferation in the endolymphatic sac in situ during the immune response of inner ear

Background Normally, few immunocompetent cell are present in the endolymphatic sac (ES). During an active immune response in the inner ear, large amount of inflammatory cells, including immunocompetent cells, are seen in the ES. The current study aimed at assessing cellular proliferation within the ES during induced immune response in the inner ear. Methods Fifteen healthy, female SD rats were sensitized systemically with keyhole limpet hemocyanin (KLH), followed by local inoculation in the cochlea through basal turn fenestration with the same antigen. On Days 3, 7 and 14 following inoculation, the animal was sacrificed after intraperitoneal administration of 5-bromo-2'-deoxyuridine (BrdUrd), and the temporal bone harvested. Following decalcification, infiltration by BrdUrd- and IgG-positive cells in the ES was studied on frozen sections with H & E and immunohistochemical staining. Results During the secondary immune response in the inner ear against T-dependent antigens, there is increased cellular proliferation in the ES. The proliferated cells may differentiate into immunocompetent cells at the same location. Conclusions These findings indicate that the ES plays an important role in immune response of inner ear.     

prevalence of the gjb2 mutations in deafness patients of different ethnic origins in xinjiang

Objective To investigate GJB2 mutation prevalences in the Uigur and Han ethnic groups in Xinjiang, China, and determine the relationship between ethnicity and GJB2 gene mutations. Methods Information regarding ethnicity of patients' families was obtained through medical records review and/or patient interview. Blood samples were collected from 61 Uigurs and 66 Hans for direct sequencing of the coding region and intron/exon boundaries of the GBJ2 gene. Results Carrier frequency of GJB2 mutations was similar between the Uigur and Han subjects. The GJB2 35delG mutation was seen only in Uigur patients with hearing loss, whereas the 235delC mutation was identified in both Uigur and Han patients. The allelic Frequency of 35delG mutation was 7.4% (9/122) in Uigur deaf students, but none in Han deaf students (0/128) and Uigur controls (0/196). The allelic frequency of GJB2 235delC mutation in Uigur and Han deaf students was 5.7% and 9.8%, and that of 299-300delAT mutation was 0.8% and 5.5%, respectively. V27I and E114G were the most frequent types of polymorphism. Conclusion We found an Asian-specific GJB2 diversity among Uigurs, and comparable GJB2 contribution to deafness in Uigur and Han patients. The high carrier frequency of 35delG in Uigurs (11.5%) is probably defined by gene drift/founder effect in a particular group. Even though GJB2 mutations have been widely reported in the literature, this discussion represents the first report of GJB2 mutations in Chinese multi-ethnic populations.