Sinus tympani in surgery of the middle ear and skull base

Tympanic sinus is located at the medial wall of the tympanic cavity. It's visualisation is difficult from most of approaches. Tympanic sinus is often filled with cholesteatoma in course of chronic otitis. Intraoperative assessment of tympanic sinus was performed in 29 patients with facial recess cholesteatoma, and in 20 patients with acoustic neuroma operated with translabyrinthine approach. In the group of patients with cholesteatoma four patients underwent canal wall up tympanoplasty with posterior tympanotomy, 25 underwent canal wall down tympanoplasty. Tympanic sinus was assessed during surgery with 30 degrees endoscope. In all cases depth of the sinus was measured with the use of calibrated hook. In 11 patients depth of the sinus exceeded 4 mm. In 6 among these features of bone destruction was found.     

Glandular neoplasms of the external auditory canal--clinical and morphologic observations

In the article cases of glandular neoplasms of the external auditory canal were presented. Ceruminous adenoma was diagnosed in three persons, adenoid cystic carcinoma--in three patients and ceruminous adenocarcinoma in one patient. All of them were treated surgically or by combined method with radiotherapy. Difficulties with exact histopathological diagnosis and with choice of a method of treatment were stressed. Classification of the glandular neoplasms of the external auditory canal was also presented underlying a histopathological and clinical diversity of these tumors, which had previously been incorrectly qualified in one group ceruminoma.     

Hysteroscopic evaluation of the uterine cavity in postmenopausal women with uterine bleeding

Postmenopausal uterine bleeding is the most characteristic and frequent endometrial adenocarcinoma symptom. Patient with uterine bleeding appeared at least 12 months after the last menstruation needs diagnostic management before initiation of any treatment. OBJECTIVES: Evaluation of hysteroscopy for the recognition of pathologies causing postmenopausal uterine bleeding. MATERIALS AND METHODS: Seventy-nine women aged 48-80 without hormonal replacement therapy hospitalized in the 1st Department of Gynecology and Gynecological Oncology of the Medical University of ?ód? between 1998-2002 because of postmenopausal uterine bleeding were included in the study. In each case diagnostic hysteroscopy with visualisation of the uterine cavity was performed and then histopathologic biopsy by a curretage was taken. Hysteroscopic images were analyzed and compared with the histopathological results. RESULTS: 2 women had the oncologically suspected hysteroscopic images. In both cases endometrial adenocarcinoma was histopathologically confirmed. Among 5 patients with hysteroscopic images suggesting non-malignant endometrial proliferation 4 cases of endometrial hyperplasia were found. 11 times hysteroscopic visualisation of endometrial polyps enabled their complete deletion. In 8 cases intrauterine adhesions were found and dissected: 11 patients presented submucous myomas during hysteroscopy. In 3 cases visualisation of the uterine cavity was not possible because of technical failure. Any patient with absence of hysteroscopically found uterine abnormalities had a poor histopathological result. CONCLUSIONS: Hysteroscopic investigation in postmenopausal women with uterine bleeding reduce the risk of false negative histopathological result. Hysteroscopy is useful method of the uterine cavity visualisation. Thanks to localization and elimination of the pathologies like endometrial polyps and intrauterine adhesions the repeated bleeding and the second time admission of the patient for the same reason can be avoided.     

Evaluation of the advantages of laparoscopic procedures for hysterectomy

OBJECTIVE: The objective of this publication was the analysis of 102 laparoscopic hysterectomy. The results were discussed in comparison with traditional laparotomy. MATERIAL AND METHODS: There was the analysis of 102 hysterectomy by the means of laparoscopy done in 2000-2002. Following parameters were evaluated: duration of the operation, blood loss, complication, the day of introducing enteral nutrition and duration of hospitalization. RESULTS: It was observed, that laparoscopic operation took more time than laparotomy (average time: 96.4 min vs 62.37 min). Blood loss was similar in both procedures. Comparing the changes of hemoglobin concentration in serum before and after the procedures it was observed average change 1.75 g% for laparoscopy and 1.71 g% for laparotomy. Time introducing enteral nutrition and duration of hospitalization was shorter for laparoscopic procedures. 87.25% of patients was able to eat in next day after laparoscopic operation. Average amount of days of hospitalization after laparoscopic procedures was 3.75 days, after laparotomy 6.44 days. The infections were the most common postoperative complications. The infections were more common in laparotomy group. CONCLUSIONS: The new method causes: shortened time of hospitalization, quicker introducing of general diet, avoiding the large wound of abdominal segments, small amount of complications.     

Prophylactic medical examinations for breast cancer and uterine cervix cancer in Regional Oncological Center of Bydgoszcz in year 2002

OBJECTIVES: Kujawsko-pomorskie province is a region with high morbidity and death-rate from breast cancer and uterine cervix cancer. One method of improving this situation is prophylactic medical examinations aiming to find out the less advanced forms. DESIGN: The aim of work was to estimate the results of prophylactic medical examinations that were taken in Regional Oncological Center of Bydgoszcz during a 2002 year. MATERIALS AND METHODS: Mammography were taken using 3 devices. First one so called "mobile" localized in chosen health service centres, second in mammobus reaching distant communes and third taking examinations locally, where gynaecologic examination and breast examination took place. Cytologic examination were rated with Bethesda's system and according to Papanicolau. There was 23923 people examined for breast cancer (age 35-79) and 7946 for uterine cervix cancer (age 30-74). 9183 medical examinations were taken by "mobile" device, 4592 in mammobus and 10148 locally. 11986 people had breast examination, 6118 had gynaecologic examination. RESULTS: Among cytologic examinations results were: I group--3902, II group--4019, III group--21, IV group--3, V group--1. Ten uterine cervix cancers were found, that makes 0.13% of examined population. Five of them were carcinoma planoepitheliale praeinvasivum. Among prophylactic of breast cancer 91 cases were discovered (0.38% of examined population). Five of them were carcinoma intraductale typus comedo (3 were mastectomy simplex, 2 tumorectomy with radiotherapy). The treatment of invasive carcinomas was breast conserving. CONCLUSIONS: Prophylactic medical examinations let to find cancer in early state of development, and number of detection of carcinomas is a justification of continuation of this project. Possibility to do examinations for women from villages should have influence on detection early breast cancer and uterine cervix cancer.     

Clinical course of clarocellular ovarian cancer in 27-year old woman. Laparoscopy in management of malignant ovarian tumors

A case of clarocellular ovarian cancer in 27-year old woman is reported. Authors present the diagnostic and management problems, their experience and the review of current literature. The place of laparoscopy in management of malignant ovarian tumors is discussed.     

The effectiveness of postoperative external beam radiotherapy for incompletely resected non-small cell lung cancer

In a retrospective analysis of 150 incompletely resected NSCLC patients treated with adjuvant external beam radiotherapy 32 (21.3%) survived 3 years with no symptoms of disease. Ipsilateral mediastinal/hilar lymph node involvement and macroscopic incomplete surgery were the prognostic factors that unfavourably influenced survival in Cox's proportional hazards model. Postoperative external beam radiotherapy was the efficient adjuvant treatment method in microscopically incompletely resected NSCLC, predominantly with no nodes involvement, but had no benefit in those with macroscopic incomplete surgery.