Biomedical subjects

Krzysztof Dalke

Publications and source records attributed to Krzysztof Dalke.

6 recordsLinked to original sources

PubMed2006

[Rotation suction-knife (shaver) in otorhinolaryngological surgery].

INTRODUCTION: Rotation suction knife (shaver or microdebridor) was developed in beginning 1985 in orthopedic surgery. In the field of otolaryngology it was used in 1992-1994. Shaver is a combination of suction and cutting round knife working together. Knives of different shapes are put into handpiece. They have outer sheath with window, which protect the inner rotating blade. The blade is connected to suction and cutting tissue is removed from the operation field. In otolaryngology surgery we mostly used the oscillation cutting mode which is the most sufficient. Shaver surgery is precise in soft tissue resection, so the most advantages to powered the system is in rhinosurgery, polypectomy with extension to pansinus surgery. Microdebridor can be also used for nasopharynx-adenoidectomy, chonanal atresia surgery, turbinoplasty, dacryocystorhinostomy, sella turcica tumor resection or laryngeal surgery. MATERIAL AND METHODS: We used the Storz's shaver system with a handpiece with a motor in the vertical part of the T-shaped handle. Suction and transport of rejected material does not pass through the motor system. The suction channel is straight and clogging is minimized. We performed shaver surgery during functional endonasal endoscopic surgery (FESS) for polypectomy in 15 cases, medial antrostomy (uncinectomy for "swinging door" procedure) in 10 cases, nasopharyngeal-adenoidectomy in 3 cases and turbinoplasty (inferior turbinectomy) in 10 cases. RESULTS: In our material we did not observe any complications during and after surgery. The healing process is very good without obstruction and crusting. The shaver system has an excellent protection for surrounding tissue and minimalized the tissue destruction. CONCLUSIONS: Shaver is an excellent powered instruments for rhinosurgery especially massive polyps of nose and sinuses. It is very sufficient to prevent normal tissue and remove pathological one, this can be achieved in no bleeding area.

Adolescent↗

PubMed2006

[Cervical sympathetic chain neurilemmoma--a case report].

INTRODUCTION: Neurilemmoma is benign, slowly growing tumour that arise from nerves. Cervical sympathetic chain neurilemmoma is rare. The majority of neurilemmomas are asymptomatic at the time of presentation. The incidence of Horner's syndrome before excision has been reported only once. Surgical resection almost leaves the patient with a Horner's syndrome. MATERIAL AND METHODS: A 28 years old woman was admitted to Otolaryngology Department with left side neck mass. The tumor was first noticed 6 month later, and it was slowly growing. It was completely asymptomatic. She underwent excision of the tumor through an incision parallel with the anterior border of the strenomastoid muscle. RESULTS: Histology showed the tumour to be a neurilemmoma arising within the cervical sympathetic chain. During postoperative period in 2 day we observed a left side Horner's syndrome, completely asymptomatic. CONCLUSIONS: Neurilemmomas very rarely arise from the cervical sympathetic chain. They usually present as asymptomatic neck mass. The only complication encountered after surgery is Horner's syndrome, which required no treatment.

Adult↗

PubMed2006

[A simple-irrigating system for endoscopic sinus surgery].

INTRODUCTION: The most troublesome problem during endoscopic surgery is fouling of the endoscope lens (tip) with blood. Irrigating systems are available on the market but they are relatively very expensive. We present our own simple irrigating system, very effective and inexpensive. MATERIAL AND METHODS: The system consists of: polyethylene catheter No 6, sterile intravenous line with interposed stopcock, 500 ml saline solution, endoscope. The catheter is fixed to the endoscope with sterile sticks and connected to the bottle of saline solution with intravenous line. During the operation the irrigant solution flow is controlled with interposed stopcock. CONCLUSIONS: A simple irrigating system allows cleaning of blood from the endoscope obviating the need for frequent removal of the endoscope from the nose. This allows more rapid and safer endoscopic surgery. It is very simple and cheap.

Endoscopes↗

PubMed2006

[Functional endoscopic sinus surgery in children--our experience].

INTRODUCTION: Pediatric functional endoscopic sinus surgery (FESS) is now commonly performed for chronic rhinosinusitis therapy. The surgery is necessary when symptoms of sinusitis persist after maximal medical treatment. Apart from anatomic and technical issues the main difference between adult and pediatric FESS is related to postoperative care. In earlier reports a second-look endoscopy in general anaesthesia was recommended to inspect, debride and clean the operative site in young patients. MATERIAL AND METHODS: The aim of the study was to estimate the results of FESS surgery in children and to propose a relevant way for postoperative care. FESS surgery was performed in 64 children (mean age 13, 2 years) and postoperative follow-up was available in 47 children (33 girls, 14 boys). The protocol for postoperative follow-up based on our notes and literature is suggested. All patients after surgery were instructed to use saline solution or Ringer solution for nose cleaning. Seven days after surgery nasal steroids were implemented. Second look endoscopy with wound debridement in general anaesthesis was necessary in 8 children (13%) after major procedures, where a lot of crust and blood clots in postoperative site were noted. RESULTS: It is suggested that formation of synechiae and granulation tissue in the early postoperative period is one of the adverse prognostic factors in FESS outcome. In spite of not aggresive approach to follow-up, wound inspection and postoperative site cleaning the synechiae were found in 2 (3%) patients only. 30 children (64%) were symptoms--free after surgery. CONCLUSIONS: Functional endoscopic sinus surgery (FESS) is efficient treatment for chronic rhinosinusitis in children. Aggresive post operative site debridement is rarely necessary. Postoperative general anaesthesia "second-look procedure" is indispensable in a few patients only but it needs an individual approach for each child.

Adolescent↗

PubMed2006

[The use of Nd-Yag laser in the treatment of tracheal tumor in 14 years old child with mukopolisacharydosis type II].

Hunter's Syndrome (MPS II) is a class of hereditary disorder characterized by a deficiency of specific enzyme--iduronate sulphatase required to break down mucopolisacharides and occurs in Poland in one of 100-150 thousand male live births. MPS II may be lethal in the second decade of life as a result of infiltrativ cardiomiopathy leading to irreversible heart failure or upper airway obstruction caused by infiltration, granulation and deformation in trachea or larynx. We report a case of 14-year-old male with Hunter Syndrome who developed tracheal obstruction and was treated with Nd-Yag laser. We discuss the possibility of treatment and our results--improvement in patient's symptomatic and functional status.

Adolescent↗

PubMed2005

[Carbon granuloma--an unwanted effect of laryngeal laser microsurgery].

Over recent twenty years, laser microsurgery has gained great recognition in the treatment of early carcinoma. From 1990 to 2004, more than 800 operations on the larynx were performed using laser microsurgery, including 167 chordectomies for squamous cell carcinoma. In 14 patients who were on the follow-up for 1 to 6 months, we observed a spherical, smooth structure (3-5 mm in diameter) in the middle part of the scar, which imitated local relapse of the neoplastic process. The lesion was removed with CO2 laser. Histopathologic examination revealed, in all cases, the presence of nonspecific, inflammatory process and development of granulation tissue. In only one patient in further follow-up, neoplastic growth recurred. Such lesions were not observed in other than chordectomy laser microsurgical procedures.

Carbon↗