Biomedical subjects

Witold Szyfter

Publications and source records attributed to Witold Szyfter.

69 records · Page 4Linked to original sources

PubMed2003

[A case of an uncommon foreign body in the esophagus].

Esophagial foreign bodies are mostly located in the sites of the physiological and pathological narrowings. A case of 58 year old patient with profound mental impairment, who swallowed a stone of 3 cm in diameter and a molar tooth has been presented. The treatment and prognosis was complicated by retention of barium contrast in the lungs. The patient underwent the bronchoscopy and double esophagoscopy. Foreign body was successfully removed through external approach (oesophagotomy).

Barium Radioisotopes↗

PubMed2003

[Changes in reaction on stress situations in children after cochlear implantation].

Hearing impaired child has no chance to receive any sounds informations about his/her environment. It is strictly connected to speech development inhibition. It reflects on thinking process and disturbs social and emotional development of hearing impaired child. It also creates isolation from hearing environment. Cochlear implants improve hearing and may improve contacts with hearings environment through its better understanding. These devices may also change reaction on stress situations. The aim of this paper was assessmant of this changes before and after implantation. In our group majority of children after implantation feel able to overcome any difficulties during contacts with hearing environment. This makes speech rehabilitation easier as well.

Child↗

PubMed2003

[Glomus vagale tumor--diagnosis and treatment].

Paraganglioma, being tumors arising from the paraganglion cells of the parasympathetic system, were first reported in man in 1935. Within, the head and neck glomus vagale tumors account for less than 5% of all paragangliomas, with approximately 10% being multicentric. Although histologically these tumors have been shown to contain neurosecretory granules, they are rarely functional. Vagal chemodectomas are histologically benign, but are one of the most difficult tumors of the skull base to manage. Authors present a case of 56 years old woman with glomus vagale tumor treated in ENT Dept. in Poznań.

Aortic Bodies↗

PubMed2002

Mutation A1555G in the 12S rRNA gene and its epidemiological importance in German, Hungarian, and Polish patients.

The A1555G mutation in the 12SrRNA gene has been associated with aminoglycoside induced and nonsyndromic sensorineural hearing impairment. In this study we analyzed Hungarian, Polish and German patients with nonsyndromic severe to profound hearing impairment of unknown origin for this mutation. The frequency of the A1555G mutation in the Hungarian hearing impaired population was below 1.8 %. Three out of 125 Polish patients carrying the A1555G mutation were identified. Among German patients one carrier was found (0.7 %) revealing a homoplastic A1555G mutation, whereas no mutation was detected in control individuals with normal hearing (frequency < 0.6%). In summary the frequencies of the A1555G mutation are low in the hearing impaired as well as in the normal population in Hungary, Poland and Germany. Since the importance of this mutation and its relationship with aminoglycoside exposure is not well understood yet, patients with nonsyndromic hearing impairment should be routinely screened for this mutation to avoid aminoglycoside induced hearing impairment due to increased sensitivity of maternal relatives.

Adult↗

PubMed2002

[Effect of ultrasonography on postoperative changes in treatment of neck lymph nodes and improvement of long term results in patients with laryngeal neoplasms].

Ultrasonography (US) is a well-known and valuable method of detecting lymph nodes in the neck. It is widely used in the preoperative neck assessment and in follow-up patients treated for head and neck cancer. The aim of the study was to compare the larynx cancer patients in two decades: the 80-ies and the 90-ies and the influence of a single diagnostic tool, i.e. ultrasonography, on therapeutic decisions and final results. Two groups of patients were selected: 737 patients treated between 1981-1985 (before the introduction of US) and 840 patients treated between 1991-1995 (routinely examined with the help of US) in ENT Dept. of Karol Marcinkowski University of Medical Sciences in Poznań. We aimed at analysing the percentages of neck metastases at the moment of diagnosis, the frequency of particular types of primary neck treatment, the percentages of neck recurrences, their advancement at the diagnosis and the methods of secondary treatment. Particular attention to feasibility of salvage was paid. Mean survival time in the group of patients with recurrence and the overall 5-year-long survival rates were analysed. No marked differences were stated between both groups as to epidemiological data, primary tumor advancement and types of the performed larynx surgery. Neck metastases occurred in both groups, 34% and 42%, respectively. Relapse rates were 12.9% and 12.6%, respectively. It was found that the number of elective neck dissections over the period given above became smaller, the number of radical neck dissections was stable, while the number of patients referred to wait and see policy increased. The number of successful neck salvage surgeries markedly increased while the number of patients not qualified for salvage decreased. For the both studied data, the curves on diagrams cross around the year 1992. The turning point situated in this time shows that ultrasound, introduced in 1991, gradually changed the types of primary treatment and possibilities of salvage neck treatment. The statistically significant differences in both groups were shown as to: types of the initial i.e. first neck treatment, relapse rate and the possibility of performing surgical salvage, while the only change was the introduction of a new diagnostic tool, i.e. neck ultrasonography. Survival rate was markedly better in the second group of patients. The methods of qualifying patients for the primary neck treatment and follow-up schedule have been changed since ultrasonography diagnostics was introduced in 1991 for routine assessment of the neck lymphatics in the larynx cancer patients. Strict follow-up schedule allow for early detection and successful treatment in high percentage of relapses.

Carcinoma↗

PubMed2002

[Anastomosis of hypoglossal-facial nerves by modified May technique].

Facial palsy is a unpleasant disorder, which handicaps habitual vital movements and the expression of the face. There are many surgical techniques, which use the neighboring nerve fibers to reanimate the face, such as the end to end or side to end anastomosis with hypoglosal, glosopharyngeal, axesorius, or mandibular nerves. The donor fiber can be derived from homolateral or heterolateral side. The reconstruction can be completed by cosmetic surgery using parietal muscle or free muscular flaps. The authors wanted to present the modified May technique described by Darrouzet with the rerouting of the facial nerve in the mastoid portion of the temporal bone. This procedure aimed at elongation of the facial nerve stumps with simultaneous rerouting of the facial nerve. Three temporal bone blocks with adjacent tissues were taken from cadavers. The temporal bones were dissected under operating microscope ZEISS OPM 11. The standard set of instruments for the ear microsurgery was used. As the first step retroauricular incision and large antromastoidectomy were performed. The facial nerve was found and exposed in its mastoid portion, then rerouted out of the temporal bone. The length of the isolated nerve stump was measured. The photos were also taken as documentation. The length of the prolonged nerve stump was 13 mm in each case. After adding to this value the length of the trunk, i.e. the portion between stylomastoid foramen and pes anserinus, the fragments of rerouted nerve were elongated up to 21 mm. This distance allowed for performing the facial-hypoglosal anastomosis using only one neuroraphy without increased tension.

Anastomosis, Surgical↗

PubMed2002

[Social integration of children with multichannel cochlear implant in the mainstream education system].

This paper is a preliminary report concerning result of social integration of children after cochlear implantation in the mainstream education system. It has been proofed that the presence of hearing impaired child in the class has an influence on other children. These other became more sensitive, less selfish and able to see needs of other human being. The tests were conducted on the group of 34 children and adolescents implanted in Poznań, learning in schools in the mainstream education system.

Adolescent↗

PubMed2002

[Tinnitus in systemic diseases].

Permanent or temporary degenerative changes in the internal ear causing tinnitus may occur with particular intensity in patients suffering from systemic disease (diabetes, hypertension, rheumatic diseases, kidney and thyroid gland diseases). Pathomechanisms of hearing impairment and the risk of tinnitus and its character in particular cases are discussed in the paper. The research was carried out on 1200 patients treated in the Laryngological Rehabilitation Centre in Poznań between 1.1.1998 and 04.2001 due to tinnitus. The analysis included the diagnosis of general health condition, general laryngological examination as well as additional tests. In the examined group 34% suffered from systemic diseases. Among them the highest percentage (47%) suffered from hypertension, 41% from hypercholesterolaemia, 22% from rheumatic diseases and 16% from diabetes. 96% of the patients had a long family history of diseases. The additional factor causing damage of the internal ear may be ototoxic drug used in the treatment of many systemic diseases.

Adult↗

PubMed2002

[Sono-morphologic criteria of metastatic and reactive modes in the neck].

Real time high resolution ultrasonography (US) is thought to be the diagnostic tool of high sensitivity in detecting lymph nodes in patients diagnosed and follow-up for head and neck malignancies. Sensitivity and specificity of US are determined by quality of equipment, the kind of transducer and the experience of ultrasonographer. The diagnostic difficulties are met in small lymph nodes, less than 10 mm. Which sonographic picture is ambigious. It is very important in follow-up to avoid false-negative nodes and possibility of overtreatment of patient. The aim of the paper was to determine the sonomorphogic criteria which enable improving the specificity of neck ultrasonography especially in assessing the small, less then 10 mm lymph nodes. MATHERIAL AND METHOD: Ultrasonograph Aloka SSD 3500 and transducer 7.5 Mhz with 42 mm linear probe. The neck US was performed before the surgery. Maximal longitudinal diameter (L), maximal diameter (S), their ratio (S/L) which indicate the lymph node shape, echogenicity and internal echostructure were assessed. The features of the lymph node capsule, i.e. continuity, lost of echos were taken into consideration. The high echogenicity, the round shape of the node, lost of hilus central echo or it's marginal displacement correlate with malignant character of the node. Lost of echos in node capsule are not the indicator of the extracapsular spread. Using sonomorphologic criteria in assessment of small lymph nodes in the neck the authors stated the meaningful improving of US specificity.

Carcinoma, Squamous Cell↗

PubMed2002

[The problem of tinnitus in patients with presbyacusis].

At the ENT Rehabilitation Centre as part of ENT Department University of Medical Sciences in Poznań over 900 patients with tinnitus were diagnosed and treated. Among them were 128 patients over 65 years of age, who in addition to tinnitus, reported hearing loss. After a battery of audiological tests, blood tests and additional specialist consultation, mixed hearing loss was found in 5 patients and senso-neural hearing loss (presbyacusis) was found in remaining 123 patients. For various reasons only 75 patients began treatment. Treatment of tinnitus was threefold: electrostimulation: 40 patients (53%); fitting of hearing aid: 29 patients (39%); TRT according to Jastreboff's model: 6 patients (8%). The authors described results of treatment patients with tinnitus and presbyacusis. The treatment model adopted at the ENT Rehabilitation Centre in Poznań has produced satisfactory therapeutic results.

Adaptation, Psychological↗

PubMed2002

[Unilateral tinnitus--diagnostics and treatment].

900 patients with tinnitus were treated between January 1998 and August 2000 in ENT Rehabilitation Center in Poznan. Unilateral tinnitus was observed in more than 50% of the patients. In all the patients a history was taken paying a special attention to the loudness estimation by the patient and to the influence of the tinnitus on the everyday life. Laryngological, audiological and neurological examinations and laboratory tests were performed. In some cases endocrinological examination was performed. In the group of patients with unilateral tinnitus a special attention was paid to the possibility of ponto-cerebellar angle tumour. After audiological diagnostics CT or MRI examinations were performed. Authors emphasize, that in patients with unilateral tinnitus a proper observation is required to exclude expansive process within the acoustic nerve.

Activities of Daily Living↗

PubMed2002

[Prevalence of conductive hypoacusis in children aged 5-9 years old from rural area in Poland--prospective screening of healthy subjects].

Otitis media with effusion (OME) is a process, which goes on by inner side of intact tympanic membrane. Oligosymptomatic and deceitful course is characteristics for this disease. Fluid filling middle ear structures causes long-lasting hypoacusis. Chronic consequences of the OME are morphologic changes within the middle ear, especially in the tense part of the tympanic membrane, causing strengthened conductive hypoacusis. The OME morbidity peak falls in 3-6 year of life, which is the period of the most intense development of the child and speech creation. Discreet symptoms, like fullness and feeling of fluid movement, not advanced hypoacusis, causes many problems in putting proper diagnosis. There should be aimed at quick detection of these symptoms, otherwise long persisting hypoacusis can have permanent negative influence on child's development. The aim of this study was to show the effectiveness of screening in population of children in their pre-elementary school and at the elementary school, focused on discreet pathology of the middle ear (OME) and low grade conductive hypoacusis. The study has a prospective character. Screening has covered a group of 927 children, aged 5-10. Examination concerned a population of healthy children, attending pre-elementary school and first classes of elementary school. Past otiatric history was the first step of diagnostic process, followed by full ENT examination and tympanometry. Special stress was laid on collecting medical history directed on the existence of discreet symptoms, like: low-grade hypoacusis manifested by some elements of child's behaviour (non responding on instructions, louder speaking, higher volume in TV-set), articulation disorders, difficulties in communication and problems at school. A group of 116 children actually presenting aural complaints lasting several weeks to several years were separated from the while examined group. Every 10th child from analyzed population submitted hypoacusis, 32 children had discreet symptoms, which allows to suspect hypoacusis. 330 children manifested otoscopic changes, which frequency was proportional to the time that aural symptoms have been lasting and correlate with other complaints, such as: allergy, rhinitis, sleep with open mouth, adenoidal hypertrophy. Pathological results of tympanometry was obtained in 23.3% of examined population, 16.6% made children, who neither actually, neither in anamnesis had ENT complaints. It is important to emphasize that age analysis in examined population shows directly that children in their 6th year of life are the group which should be comprised by screening on middle ear pathology.

Acoustic Impedance Tests↗

PubMed2002

[Nonchromaffinic paraganglioma (chemodectoma) of tympanic cavity].

Nonchromaffinic paraganglioma derives from neuroectoderma. It is characterised by plenty vascularisation. Histopathologically it is a benign tumor, and doesn't give any metastasis. Although because of localisation, vascularisation and possibility of bone destruction is clinically malignant. In this paper we present three cases of paraganglioma localised in tympanic cavity treated surgically.

Adult↗

PubMed2002

[Objective audiometry in diagnosis of tinnitus].

During last 3 years there have been 900 tinnitus patients treated at ENT Rehabilitation Center in Poznan. Everyone underwent a thorough laryngological and audiological examination. Diagnostic procedure comprised also neurological and endocrinological consultations with accessory blood tests. Wide group of audiological tests used for diagnosis was divided into objective (BERA, OAE, tympanometry, stapedius reflex) and subjective (pure tone audiometry, speech audiometry, suprathreshold audiometry) methods. Otological diagnostic in tinnitus patients is difficult due to its subjective character. That is why it is so important to have objective methods for its evaluation. In this paper authors present results of BERA tests and impedance conducted on group of 900 patients. Performed objective tests enabled to diagnose otosclerosis, chronic otitis media and pathology in cerebello-pontine angle in patients without any abnormalities on physical examination.

Audiometry↗

PubMed2002

[Laryngocoele].

Three cases of laryngocoele operated in ENT Department University of Medical Sciences in Poznań by an external approach are presented. Role of larynx tomography in diagnosis procedure and surgical technique is emphasised. Origin, classification, diagnosis and treatment methods are discussed.

Adult↗