Biomedical subjects
Publications and source records attributed to E Olszewski.
During the years 1986--90 about 480 patients with tumors of the larynx were treated in Cracow Otolaryngological Clinic. In this group were two cases of neurofibroma of the larynx. These patients were treated upon by various types of surgically operations.
Three and five years survival rates in a group of 3440 patients surgically treated for carcinoma of the larynx in four ENT Departments in the years 1977-86 were presented. 5 years survival rate was obtained in 70% of patients treated only surgically, and in 46% patients treated with surgery combined with radiotherapy.
From September 1991 till January 1994 in ENT Clinic in Cracow 5 patients with far advanced laryngeal cancer involving hypopharynx were treated surgically. Total laryngectomy with partial or total hypopharyngectomy was performed and then the reconstruction of hypopharynx one stage procedure using lingual flap was done. In all patients functional results were acceptable. The main contraindications for using lingual flap is tumor infiltration of the base of tongue.
Results are reported from a population study of 1700 patients of larynx cancer and 1206 cases controls without larynx cancer. If the patients have larynx cancer they won't have pollinosis and allergic asthma. The bloods groups AB0 all the cases were analysed. But we don't find interdependence.
During the years 1990-92 three patients with dynamically developing paranasal sinuses infections and orbital complications were treated in ENT Department of Medical Academy in Cracow. In two cases sinuses were early opened and drained, resulting in improvement in local and main status of the patients. Delayed surgical treatment in third patient caused visual loss in ipsilateral side. Indications for sinuses opening were based on the CT examination.
The Fourier analysis of auditory brain stem responses in 45 patients aged 19 to 56 treated because of perceptive hearing loss in Cracow ORL Clinic was carried out. The group consisted of: 15 patients with sudden deafness, 15 patients with Menier's disease and 15 cases with retrocochlear hearing impairment. In cases with recruiting cochlear hearing loss considerable and significantly extension of frequency range in brain stem responses was observed. Moreover, responses induced by stimulus intensity causing recruitment are identical for both ears as far as their shape and power spectrum is concerned, despite wide variety of responses caused by stimulus of different intensity. It is assumable that Fourier analysis of auditory brain stem responses gives possibility of objective evaluation of subjectively determined recruitment syndrome.
In the years 1986-91, five patients with neoplasms of neurolemmal sheath were treated in the Department of Otolaryngology, Medical University in Cracow. Two patients suffered from malignant neurinoma (malignant neurinoma of orbit or maxillary sinus) and the other three had neurinoma (neurinoma of the floor of mouth, nasal cavity and neck). There were four men and one woman. The age of patients ranged from 23 to 52 years. The tumors were surgically removed, patients with malignant neurinoma required additional irradiation. Currently, no tumor recurrence has been noticed.
Stenosis of the pharynx resulting from trauma is a major problem. Lateral pharyngotomy provides excellent exposure for this reconstruction. We present the case of traumatic stenosis of the pharynx and its treatment.
40 thyroid cartilages were used to investigations, they were taken from bodies of people, died between the ages of 19-99, by the use of the endurance machine with controlled speed of the increase of deformation. It was observed that the durability for flexion and the inflexibility of the investigated cartilages depends on the level of the process of their ossification, that is estimated by the help of the radiological index of the ossification (RIO). On the other hand, the searches of durability forcing of the regions of cartilages that presented different levels of the ossification process, proved the heterogenicity of the structure of the cartilage, in which ossified parts are separated by zones, that did not submit to this process.
The architecture of the cartilage already developed within ossified areas have shown apparent differences not only depending on their location within cartilage territory but also due to their chemical composition. The cartilage areas exhibiting a markedly advanced ossification process have shown rather high concentration level of Ca, P and Si.
Homograft of incus was applied for reconstruction of the ossicular chain in 34 patients. Two basic variations of plastics have been performed. The handle of malleus was supported by the body of the incus with the drilled hole, while the long process of the incus, after a little shortening, was put on the movable footplate of stapes. In the second variation the long process of the incus was amputated--here the drill hole was performed for the head of stapes and the second one in the body of the incus for the handle of malleus. In the average three years after the operation the good hearing results were achieved in 19 (55.9%) patients. From this group in 8 (23.5%) patients aerbone gap closure was at the level of 10 dB. The bad morphologic results was ascertained in 3 patients.
In the years 1990-1991, 2 patients with the foreign body of orbit were successfully operated. Preoperative diagnosis was based on the CT examination.
In the years 1973-1990, 48 children with laryngeal papillomatosis were treated in the Department of Otolaryngology, Medical University of Cracow. The data was obtained in 42 children. In 51% children the entire and long-lasting (from 4 to 8 years) remission of papillomatosis was ascertained. In 39% patients the considerably limited papillomatosis with distinctly prolonged remission time was obtained and in 9% of the patients the development of papillomatosis in low respiratory tract was noted.
A rare case of the malignant form of Gorlin's cyst is reported in a 42-year-old woman. The neoplasm developed in the right maxilla, infiltrated the anterior wall and roof of the sinus and grew into the nasal cavity. Based upon literature data we characterized various clinical and histological forms of Gorlin's cyst (calcifying odontogenic cyst).
In the years 1966-80, 96 patients with malignant tumors of nasal cavity and paranasal sinuses were surgically treated in the Department of Otolaryngology, Medical University in Cracow. Out of 29 patients with macro and microscopic radical surgical treatment, 11 (37.9%) survived 5 years. The remained 62 patients, considering non-radical surgical treatment, have been additionally treated by full course of irradiation. Out of this group 34 (54.8%) survived 5 years. These data suggest that indications for additional irradiation should be extended.
Six patients were treated by the new method of vocal cord latero-fixation which was the combination of the extra-laryngeal and intra-laryngeal approach. The functional contraindication for this procedure is the anatomic configuration of larynx.
In the ENT Department, Medical Academy of Cracow, the patient with tinnitus synchronized with pulse as a first symptom of chronic granulomatous otitis media was treated. The diagnosis was made on the basis of the CT examination. The tympanoplasty was successfully performed.
A case is described of surgically treated refractory epistaxis in a man aged 56 years. The role of angiography in the choice of suitable management was pointed out.