Anna Pajor
Research interests
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InterestsOtology, Hearing Loss, Audiology
Publications
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2.90Impact points
Evaluation of the smooth pursuit tests in multiple sclerosis patients.
Journal of neurology. 03/2011; 258(10):1795-800.
In multiple sclerosis (MS), randomly located demyelination lesions may involve a large part of the central nervous system and disturb oculomotor activity, including impairment of saccadic and pursuit systems. The aim of the work was to determine the frequency of smooth pursuit disturbances in MS pat... [more] In multiple sclerosis (MS), randomly located demyelination lesions may involve a large part of the central nervous system and disturb oculomotor activity, including impairment of saccadic and pursuit systems. The aim of the work was to determine the frequency of smooth pursuit disturbances in MS patients and assess the feasibility of various methods for smooth pursuit assessment: the clinical bedside examination and quantitative electrooculographic (EOG) recordings. In addition, we analyzed the effects of age on the results of smooth pursuit tests. Sixty MS patients and 50 volunteers underwent clinical bedside examination and EOG evaluation in a tertiary referral university hospital. EOG recordings of smooth pursuit tests with 0.3, 0.4, 0.5 and 15 Hz amplitude and gain calculation were preformed. In clinical bedside examination, disorders were found in 25%, and with EOG in 76.6% of patients. In the MS patients and subgroups the mean gain for all frequencies were significantly lower compared with the control group. There were significant differences in gain between younger and older subjects in the control group but no significance in all MS patients their subgroups. Patients with abnormalities in clinical bedside examination had poorer results in EOG tests. There were correlations between gain values and Expanded Disability Status Scale score in MS patients. Smooth pursuit examination provides a valuable parameter of brain dysfunction in MS patients. The EOG test is more useful in detecting subclinical cases than clinical bedside examination, and is not affected by test paradigm or age in MS patients.
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0.58Impact points
Auditory function in patients with systemic lupus erythematosus.
Auris, nasus, larynx. 02/2011; 38(1):26-32.
Patients with systemic lupus erythematosus (SLE) may develop hearing and balance disorders as a result of the immune-mediated inner ear damage due to vasculitis or ototoxicity of drugs used in SLE treatment. The aim of the study was evaluation of the hearing organ disorders in patients with SLE with... [more] Patients with systemic lupus erythematosus (SLE) may develop hearing and balance disorders as a result of the immune-mediated inner ear damage due to vasculitis or ototoxicity of drugs used in SLE treatment. The aim of the study was evaluation of the hearing organ disorders in patients with SLE with particular regard to their prevalence and relationship to duration and severity of disease. The severity was assessed from involvement of organs that resulted in poorer SLE outcome, i.e. kidneys and central nervous system (CNS), and from the presence of antibodies associated with unfavourable SLE prognosis. Thirty-five unselected, consecutive patients (33 women, two men, mean age 47.8 years) with SLE diagnosed in compliance to the international diagnostic criteria of the American Rheumatism Association (1982) were enrolled into the study. The control group consisted of 30 otologically healthy persons matched to the SLE group for age and sex. Case history was recorded for all patients from questionnaire data and laryngological examinations were performed, followed by pure-tone, speech and impedance audiometry and auditory brainstem response audiometry (ABR). In the anamnesis 71.4% of patients reported vertigo, 62.9% headaches, 40% tinnitus, 25.7% hyperacusis, 17.1% hearing loss and 2.9% ear fullness. It was found that SLE patients had a significantly poorer mean hearing thresholds than the control group for all frequencies, except for 500; 2000 and 4000 Hz. Longer ABR latency averages were observed in the group of SLE patients compared to control. Ten patients (28.6%) developed high-frequency and symmetric sensorineural hearing loss (SNHL). Significant positive correlation between mean air-conduction hearing thresholds and SLE duration (r = 0.46, p < 0.001) was found. After taking age into consideration, hearing acuity in SLE was related to duration of disease in younger patients. Furthermore, no relation was seen between hearing level and severity of disease. Auditory system involvement ought to be considered as one of elements of the clinical picture of systemic lupus erythematosus while determination of its character, original or secondary, requires further research.
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[Skin self-injuries in psychodermatological aspect].
Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(2):142-6.
Mental disorders are the most frequent cause of self induced injuries (self-injury). Self-mutilation is a form of auto-aggression, which is a manifestation of psychic discomfort. Skin changes, defined as self-induced skin diseases, constitute the secondary problem, and require patients to consult de... [more] Mental disorders are the most frequent cause of self induced injuries (self-injury). Self-mutilation is a form of auto-aggression, which is a manifestation of psychic discomfort. Skin changes, defined as self-induced skin diseases, constitute the secondary problem, and require patients to consult dermatologists. Self-induced skin diseases include Münchhausen syndrome, acne excoriée, trichotillomania, nail biting (onychophagia), dermatitis artefacta, neurotic self-mutilation, self-mutilation when associated with hallucinations and delusions. A knowledge of psycho-dermatological issues among dermatologists, general practitioners, psychiatrists and psychologists facilitates proper diagnosis and the appropriate choice and form of treatment and enables patients to be provided with more complex medical care.
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1.08Impact points
Participation of mast cells in chronic otitis media.
Folia histochemica et cytobiologica / Polish Academy of Sciences, Polish Histochemical and Cytochemical Society. 01/2011; 49(3):479-85.
In the pathogenesis of chronic otitis media (COM), much attention is paid to the molecular mechanisms of local inflammatory reactions in which mast cells (MCs) may be involved due to their role not only in allergic but also inflammatory processes. The aim of this study was to assess the density of m... [more] In the pathogenesis of chronic otitis media (COM), much attention is paid to the molecular mechanisms of local inflammatory reactions in which mast cells (MCs) may be involved due to their role not only in allergic but also inflammatory processes. The aim of this study was to assess the density of mast cells in chronic otitis media in relationship to different clinical courses of COM, bacterial infections and types of disease. The MCs expression was measured immunohistochemically in paraffin-embedded granulation tissue specimens taken during surgery, by staining with a monoclonal antibody against tryptase. The density of tryptase-positive mast cells was lower in tissue samples from the group with a good clinical course than in those from the group with poor healing and recurrence (p = 0.006). There were no differences between the groups of patients with granulomatous and cholesteatomatous chronic otitis media (p = 0.66) or between the groups of patients with and without bacterial infection (p = 0.30), although the density of mast cells was lower for those with Pseudomonas aeruginosa/Proteus sp./ /Staphylococcus MRSA infection. In conclusion, the expression of mast cells in chronic otitis media granulation tissue was found to differ depending on the clinical course of the disease, but not on bacterial infection or type of COM. This may suggest that mast cells contribute to the maintenance of the inflammatory process, but not to antibacterial defense in chronic otitis media.
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1.49Impact points
Hearing organ disorders in patients with systemic sclerosis.
Rheumatology international. 05/2010; 31(11):1423-8.
In systemic sclerosis (SSc), there may develop hearing and balance disorders as a result of the immune-mediated vasculitis and fibrosis in the inner ear. The objective of the study was evaluation of the hearing organ function in patients with SSc with relationship to duration of the disease and Rayn... [more] In systemic sclerosis (SSc), there may develop hearing and balance disorders as a result of the immune-mediated vasculitis and fibrosis in the inner ear. The objective of the study was evaluation of the hearing organ function in patients with SSc with relationship to duration of the disease and Raynaud phenomenon and also to type and severity of the disease. Twenty unselected, consecutive patients with SSc diagnosed in compliance with the international diagnostic criteria of the American Rheumatism Association (1982), were enrolled into the study. The control group consisted of 26 otologically healthy persons matched to the SSc group for age and sex. Case history was recorded for all patients from questionnaire data. Otolaryngological examination and battery of audiological tests (pure tone audiometry, speech audiometry, impedance audiometry and auditory brainstem response-ABR) were performed. In the anamnesis 60% of patients reported vertigo, 55% headaches, 50% tinnitus, 40% hyperacusis, 40% hearing loss and 30% ear fullness. It was found that patients with SSc had significantly poorer mean hearing thresholds than the control group for 0.5, 1, 6 and 8 kHz. In ABR there were no differences between SSc and control groups although an increase of latency averages in the group of limited patients with SSc compared with the diffuse patients with SSc was observed. In eight patients (40%) sensorineural hearing loss, mostly bilateral and symmetrical was found. Furthermore, no relation was seen between hearing level and duration, type and severity of the disease. Ear involvement is frequent in systemic sclerosis and should be taken into consideration during diagnostic and therapeutic procedures.
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0.65Impact points
Prognostic factors for vestibular impairment in sensorineural hearing loss.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 05/2008; 265(4):403-7.
The clinical course and prognosis in sensorineural hearing loss (SNHL) may be even worse if vestibular system is also involved, especially due to near location of anatomical structures in the inner ear. The aim of the study was to determine prognostic value of some clinical, audiological and demogra... [more] The clinical course and prognosis in sensorineural hearing loss (SNHL) may be even worse if vestibular system is also involved, especially due to near location of anatomical structures in the inner ear. The aim of the study was to determine prognostic value of some clinical, audiological and demographic factors associated with SNHL in predicting a possibility of vestibular impairment. The study was conducted on 124 consecutive patients (183 ears) diagnosed for sensorineural hearing loss during 1 year in our department. In all of them, audiological (pure-tone, speech and impedance audiometry, ABR) and ENG examinations (visual ocular-motor, positional, kinetic and caloric tests) were performed. The correlations between ENG outcome and the following variables associated with sensorineural hearing loss were investigated: audiological (degree and location of hearing loss, audiogram configuration), clinical (tinnitus, vertigo, dizziness) and demographic (age, sex) factors. Normal ENG was recorded in 26.6%, vestibular impairment of peripheral type in 38.7%, and central type in 34.7% of the patients. In a multivariate stepwise linear regression analysis, the degree of hearing loss was the main variable correlating with abnormal ENG result. Tinnitus and location of hearing loss were also found to be the two other variables which, to some minor extent, can influence the ENG outcome. Peripheral vestibular impairment was observed more frequently in patients with residual hearing/deafness. The degree of hearing loss, presence of tinnitus and location of hearing loss are factors predicting the possibility of abnormal ENG outcome in sensorineural hearing loss.
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[The estimation of behavioral audiograms, auditory brainstem response (ABR) thresholds and auditory steady-state response (ASSR) thresholds of young adults with normal hearing]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(6):735-9.
INTRODUCTION: One of the basic audiological parameter in estimation of hearing sensitivity is hearing threshold. The need for an objective tool to efficiently predict the audiogram caused that the use and importance of ASSR method is growing in recent times. However, the technique is quite new and n... [more] INTRODUCTION: One of the basic audiological parameter in estimation of hearing sensitivity is hearing threshold. The need for an objective tool to efficiently predict the audiogram caused that the use and importance of ASSR method is growing in recent times. However, the technique is quite new and needs to be still improved. Aim of the study was the estimation of behavioral audiogram in comparison with ABR and ASSR threshold of young adults with normal hearing. MATERIAL AND METHODS: The study sample included 9 subjects with normal hearing (18 ears) with no abnormalities in otoscopy. Behavioral hearing thresholds and ASSRs to carrier frequencies of 0.5, 1, 2, and 4 kHz were obtained. The ASSRs were assessed with Bio-logic MASTER system by the use of four sinusoidal tones both frequency--and amplitude--modulated given simultaneously to every ear for each carrier frequency. The potentials are collected, averaged and analyzed in this method by the fast Fourier transform to yield statistically significant responses. Electrophysiologic threshold responses for click ABR stimuli for the same carrier frequencies for right and left ear were obtained by the use of Bio-logic Navigator Pro unit. Differences and correlations between the ASSRs, ABRs and the behavioral thresholds were determined. RESULTS: We discovered that the values of pure tone audiograms and ABRs thresholds values differ from ASSRs considerably. We could also observed that the difference between behavioral and ABRs threshold is less than for behavioral and ASSRs threshold. CONCLUSION: To conclude, this study shows that auditory steady-state responses technique is not useful method in estimating of hearing threshold of young adults with normal hearing.
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[Phenotypic evaluation of patients with Pendred syndrome]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(6):740-6.
INTRODUCTION: The Pendred syndrome (PS) is an autosomally recessively inherited disease. Its diagnosis requires identification of the classical triad of symptoms, including hypoacusis, thyroid goitre and iodine organification defect in the thyroid, which may lead to thyroid functional disorders of h... [more] INTRODUCTION: The Pendred syndrome (PS) is an autosomally recessively inherited disease. Its diagnosis requires identification of the classical triad of symptoms, including hypoacusis, thyroid goitre and iodine organification defect in the thyroid, which may lead to thyroid functional disorders of hypothyroidism. SP is accompanied by anatomical anomalies. The objective is the hearing and balance system evaluation and the analysis of the inner ear structure and also the assessment of the function and structure of thyroid gland. MATERIAL AND METHODS: For the research four families were qualified, 7 persons with PS, 12 persons altogether. In all the patients the anamnesis in the form of a questionnaire and laryngological examination were performed. It was followed by pure tone, speech and impedance audiometry and brainstem response testing as well. ENG was also conducted. Patients with hearing loss were subjected to magnetic resonance of temporal bone. For the whole group thyroid hormones levels and iodine organification in the thyroid identified in a test with potassium perchlorate were measured and also USG and scyntography were conducted. RESULTS: In audiological examination in 3 cases deafness, in 2 cases profound hypoacusis and in 2 mild hypoacusis were recognised. In the group in 2 patients the hypoacusis was of a mixed type. In radiological assessment the labirynth showed anatomical anomalies in the form of enlargement of the vestibular aqueduct and the endolyphatic sac, yet in 3 patients the anomalies also concerned the structure of cochlear and semicircular canals. Endocrine examination showed hypothyroidism in 5, its subclinical form in 1, diffuse thyroid goitre in 4 and nodular thyroid goiter in 2 cases. CONCLUSIONS: A complex clinical evaluation: endocrine and audiological, together with radiological diagnostic imaging, supported by molecular studies of SLC26A4 gene, are the procedures, necessary for complete and accurate diagnosis of PS and EVAS.
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[Results of treatment papilloma of nasal cavity and paranasal sinuses]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):574-7.
INTRODUCTION: Papilloma of the nose and paranasal sinuses is a benign tumor originated from nose mucosa. Especially inverted papilloma tumor has a significant recurrence and malignancy potential rate. The aim of the study was the analysis of clinical and treatment outcomes of patients with papilloma... [more] INTRODUCTION: Papilloma of the nose and paranasal sinuses is a benign tumor originated from nose mucosa. Especially inverted papilloma tumor has a significant recurrence and malignancy potential rate. The aim of the study was the analysis of clinical and treatment outcomes of patients with papilloma of the nose and paranasal sinuses. MATERIAL AND METHODS: The retrospective analysis was curried out on 41 patients--16 with papiloma of the nasal vestibule and 25 with inverted papilloma the nose and paranasal sinuses surgically treated in I ENT Clinic Medical University in Lodz between 1998-2004 years. We analyzed patient's complains, clinical data and surgical follow-up results. RESULTS: The most frequent complains was increasing unilateral nasal obstruction and rhinorhea. Nasal vestibule papilloma were intranasal removed in all cases. In extended tumor nose and paranasal sinuses in 14 cases intranasal procedures, in 7 sublabial approached, in 4 lateral rhynothomy were performed. In 5 patient local recurrences was observed and in 3 neoplasmatic transformation. CONCLUSION: The choice of surgical management should be individual with respect to tumor localization and extension of neoplasmatic process. The treatment result depends of radical tumor resection.
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[Own experience in stapes revision surgery--analysis of indications]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):468-70.
AIM: Analysis of indications for stapes revision surgery in patients qualified for the secondary procedure at the Otosurgery Dept. Medical University of Lodz. MATERIAL AND METHODS: 25 cases of stapes revision surgery out of the 385 total treated surgically otosclerosis cases are discussed. RESULTS: ... [more] AIM: Analysis of indications for stapes revision surgery in patients qualified for the secondary procedure at the Otosurgery Dept. Medical University of Lodz. MATERIAL AND METHODS: 25 cases of stapes revision surgery out of the 385 total treated surgically otosclerosis cases are discussed. RESULTS: In group A (patients after total stapedectomy) the following indications for the secondary surgical procedure were observed: 12 cases--platinum wire prosthesis displacement with ossicular chain discontinuity; 3 cases--perichondrium or adipose tissue atrophy; 2 cases of incudo-stapedial joint luxation. Group B was composed of 8 patients after stapedotomy (teflon piston operation, 0.6 mm). CONCLUSIONS: (1) The most common indication for the stapes revision surgery in patients after total stapedectomy were prosthesis displacement and necrosis of the long crus of the incus. (2) Obliteration of the stapes footplate after small fenestra operation was observed in our material to be the most frequent indication for the secondary stapes procedure.
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[Does the material of stapes prosthesis influence hearing improvement in stapes surgery--retrospective analysis of 350 cases]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):480-2.
AIM: Retrospective analysis of the post-op hearing results in stapes surgery using different types of materials for stapes prosthesis after 12 months follow up. MATERIAL AND METHODS: The total number of 350 otosclerosis patients who underwent surgical treatment at the Otosurgery Department, Medical ... [more] AIM: Retrospective analysis of the post-op hearing results in stapes surgery using different types of materials for stapes prosthesis after 12 months follow up. MATERIAL AND METHODS: The total number of 350 otosclerosis patients who underwent surgical treatment at the Otosurgery Department, Medical University of Lodz from 1980-2002. All patients included in the study were divided into 4 groups: group 1 (N=54)--Portmann's method interposition, group 2 (N=160)--stapes replaced with the Shea-type prosthesis, group 3 (N=60)--platinum wire prosthesis (Zini-type), group 4 (N=76)--teflon-piston operation (Fisch-type). RESULTS: The 12 months post-op mean value for air-bone gap (500, 1000, 2000 Hz) presented the following values: group 1-19 dB, group 2-15.9 dB, group 3-18.4 dB, group 4-13.5 dB. The percentage of patients with the mean air-bone gap value of 15 dB or less (500, 1000, 2000 Hz) has the following values in each group: group 1-75%, group 2-81.3%, group 3-83%, group 4-85%. CONCLUSIONS: 12 months post-op hearing results compared between the 4 studied groups showed statistically not significant differences. Our experience with teflon-piston prosthesis shows the lowest post-op mean value of the air-bone gap.
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[Juvenile angiofibroma in adults].
Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(1):20-6.
Juvenile nasopharyngeal angiofibroma is a benign lesion which is characterized by three distinctive features: it occurs only in one sex, one period of age and in one location in the organism. Basing on literature and our series concerning 36 patients treated during 50 years, we present atypical case... [more] Juvenile nasopharyngeal angiofibroma is a benign lesion which is characterized by three distinctive features: it occurs only in one sex, one period of age and in one location in the organism. Basing on literature and our series concerning 36 patients treated during 50 years, we present atypical cases of angiofibroma. All of them accomplished patomorphological and clinical criteria of this neoplasm, beside of age and sex. Our study reports three cases of angiofibroma, two of them concerning males aged 34 and 49 years and one case - female aged 68 years. Clinical and radiological investigation revealed tumor in typical location - posterior part of nasal cavity and nasopharynx in all patients, with it's extension to paranasal sinuses in 2 cases. The preoperative supraselective embolisation was performed in two cases. Results of histological examination of our atypical cases were similar as in angiofibromas observed in adolescents. All patients were treated surgically by different approaches according to tumor's extension. A recurrence has occurred in one patient after nearly two years and was treated successfully by reoperation. In two other patients no recurrence was observed during follow-up. Our study concerning the occurrence of juvenile angiofibroma in adults, also in female, as the other observations from literature may constitute some remarks in discussion about the pathogenesis and clinics of this tumor.
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[Coexistence of acoustic neuroma and pineal region tumor in patient with sudden deafness].
Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(2):204-8.
INTRODUCTION: Acoustic neuroma usually presents as an unilateral tumor, seldom - bilateral and rarely in coexistence with other central nervous system neoplasms. The following paper reports such a case of a 21-year-old male patient presented with sudden deafness in left ear accompanied with tinnitus... [more] INTRODUCTION: Acoustic neuroma usually presents as an unilateral tumor, seldom - bilateral and rarely in coexistence with other central nervous system neoplasms. The following paper reports such a case of a 21-year-old male patient presented with sudden deafness in left ear accompanied with tinnitus and vertigo. Symptoms started 4 weeks prior hospitalization. Their aggravation has been observed 7 days before admission to the hospital. Audiometry revealed moderate sensorineural hearing loss in left ear (for low and middle frequencies), brainstem auditory evoked potentials were absent on the left side and ENG examination showed left peripheral vestibular impairment. Initially patient received i.v. vasodilatators showing 20-25 dB improvement in low frequencies after 3 days of treatment. MRI study revealed in the left internal acoustic meatus mass (7 x 7 x 14 mm) suggesting acoustic neuroma and an oval mass (7 x 9 x 14 mm) in the pineal gland presenting radiological features of pinealoma. Patient has been qualified for neurosurgical treatment. Acoustic neuroma has been removed by suboccipital approach and pinealoma has been left for further observation as it was found incidentally. Histopathological examination confirmed diagnosis of left VIII nerve schwannoma. The left facial palsy (House-Brackmann III/IV grade) and profound hearing loss appeared after surgery. The postoperative course shows no evidence of acoustic neuroma recurrence.
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[Secondary tuberculosis of palatine tonsils--the case report and review of literature]
Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(6):1000-3.
INTRODUCTION: Tuberculosis, though rarely, is still present in the anatomical area of the laryngological examination. MATERIAL AND METHODS: A case of 45-year-old woman with secondary tonsillar tuberculosis and poorly symptomatic pulmonary involvement is reported. RESULTS: She presented with symptoms... [more] INTRODUCTION: Tuberculosis, though rarely, is still present in the anatomical area of the laryngological examination. MATERIAL AND METHODS: A case of 45-year-old woman with secondary tonsillar tuberculosis and poorly symptomatic pulmonary involvement is reported. RESULTS: She presented with symptoms of chronic tonsillitis and was subjected to tonsillectomy. Because of systemic infection ailments she underwent further internal diagnosis. The histopathological examination of palatine tonsils and result of chest X-ray established the diagnosis of tuberculosis. She was treated with antituberculous drugs for 6 months and achieved improvement. CONCLUSIONS: The difficulties in diagnosis in this unusual presentation of tuberculosis mimicking chronic non-specific inflammation as well as poorly symptomatic massive pulmonary involvement are outlined.
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[Bacteriological evaluation in chronic otitis media]
Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(5):757-63.
INTRODUCTION: In chronic otitis media bacterial infection is often a cause of exacerbation in the clinical course and failure in treatment. The aim of the study was to investigate the incidence and profile of the aerobic bacterial flora in chronic otitis media and to determine the drug susceptibilit... [more] INTRODUCTION: In chronic otitis media bacterial infection is often a cause of exacerbation in the clinical course and failure in treatment. The aim of the study was to investigate the incidence and profile of the aerobic bacterial flora in chronic otitis media and to determine the drug susceptibility of selected isolated bacteria. MATERIAL AND METHODS: The samples of 274 consecutive middle ear discharges taken from 228 patients with chronic otitis media were analysed (which constitutes 41.3% all bacteriological examinations made during 3 years). The smears were obtained using sterile cotton swabs, then incubated and identified. Drug susceptibility was determined by disc-diffusion method. RESULTS: Monocultures were observed in 77% and mixed infections in 17.5% of smears, no growth was found in 5.5%. The 308 pathogen isolates were recovered, among them--273 bacterial (88.6%) and 35--fungal (11.4%). Twenty five species of bacterial microorganisms were found, among them the most common isolates were Staphylococcus aureus--42.9% and Pseudomonas aeruginosa---19.8%. Rarely were recovered Acinetobacter spp.--4.1%, Proteus mirabilis--37%, Proteus vulgaris--3.3% and methicillin-resistant Staphylococcus--1.5% of bacterial isolates. Among fungal pathogens (n=35) Aspergillus spp. was isolated in 37.1%, and Candida albicans--22.9% of cases. CONCLUSIONS: (1) Aerobic pathogens ---aphylococcus aureus and Pseudomonas aeruginosa were most frequently found microorganisms in chronic otitis media. (2) Mixed infections comprised only a 17.5% of all cultured cases of chronic otitis media. (3) Pseudomonas aeruginosa was highly susceptible in vitro to imipenem (100%), piperacillin-tazobactam (100%), ceftazidime (98%) and amikacin (89.7%), less susceptible to ciprofloxacin (77.6%) and much less susceptible to pefloxacin (33.6%) and cefotaxim (33.3%).
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[Evaluation of intensity of angiogenesis in granulation tissue in chronic otitis media--preliminary report]
Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(4):571-6.
In chronic otitis media molecular pathogenetic mechanisms are still unknown, however, angiogenesis may play a role. The aim of the study was to determine the intensity of angiogenesis in granulation tissue in chronic otitis media of different clinical course. Twenty six granulation tissue specimens ... [more] In chronic otitis media molecular pathogenetic mechanisms are still unknown, however, angiogenesis may play a role. The aim of the study was to determine the intensity of angiogenesis in granulation tissue in chronic otitis media of different clinical course. Twenty six granulation tissue specimens (twenty two--from chronic otitis media, four--from prolongated otitis externa) taken during surgery were analyzed. The angiogenesis (microvessel density) was measured in paraffin-embedded tissue by an immunohistochemical method, by staining for endothelial cells with a monoclonal antibody against CD 34. The presence of CD 34 was found in all specimens. The expression was more intense in tissue samples from the group with good clinical course (good healing and without recurrence) than those in the group with poor healing and recurrence (mean number of dots for mm2 589,2 vs 533,3, respectively) and from the group without bacterial infection by Pseudomonas aeruginosa than those with this infection (mean number of dots for mm2 645,5 vs 440,8, respectively), but differences were not significant. In conclusion it is suggested that angiogenesis may contribute to different clinical course of chronic otitis media.
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[A case of renal clear cell carcinoma metastasis to the oropharynx]
Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(1):97-100.
A rare case of 61-yrs-old male was reported, in whom distant metastasis from renal clear-cell carcinoma to the oropharynx had been diagnosed. It was presented as pedunculated tumor at the level of palatine tonsil, 11 months after nephrectomy, and treated by surgical excision. Other metastatic sites-... [more] A rare case of 61-yrs-old male was reported, in whom distant metastasis from renal clear-cell carcinoma to the oropharynx had been diagnosed. It was presented as pedunculated tumor at the level of palatine tonsil, 11 months after nephrectomy, and treated by surgical excision. Other metastatic sites--pulmonary and skeletal had also developed and a patient died 16 months after the time of primary diagnosis.
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[Vestibular compensation in patients with vestibular neuronitis]
Otolaryngologia polska. The Polish otolaryngology. 01/2006; 60(5):747-52.
The aim of the study was to compare the clinical and ENG outcome in different time in patients with peripheral vestibular loss diagnosed as a vestibular neuronitis in order to establish degree of compensation. MATERIAL AND METHODS: Clinical observations were made on 30 patients with vestibular neuro... [more] The aim of the study was to compare the clinical and ENG outcome in different time in patients with peripheral vestibular loss diagnosed as a vestibular neuronitis in order to establish degree of compensation. MATERIAL AND METHODS: Clinical observations were made on 30 patients with vestibular neuronitis treated from 1999 to 2003 year in ENT Department Medical University of Lodz. Mean age of patients was 37 +/- 11.7 years. In all of them clinical neurootological and audiological examination were performed. Balance system was evaluated by 4-channel ENG system during first two weeks after onset of the symptoms and later between 12-16 months. We compared clinical findings and ENG outcome applying modified vestibular index proposed by Toth et al., which defines the lesion extend and recovery during follow-up. RESULTS: A mean value of vestibular index in the first examination was significantly higher than in the second examination (11.3 +/- 2.7 vs. 4.0 +/- 1.6; p < 0.001). The recovery was found in clinical and ENG outcome except caloric test, in which canal paresis (more than 26%) was recorded in 19 patients (63.3%). The patients were classified according to vestibular index scores in the first examination as acute--subacute stage--20 patients and compensation stage--10 patients; in the second examination--as remission stage--19 patients, and compensation stage--11 patients. A comprison of vestibular index in each patient during follow-up revealed that 13 patients (43.3%) had presented dynamic recovery and changed acute--subacute stage to remission stage. In others a recovery was slower, so 13 patients (43.3%) changed acute-subacute stage to compensation stage and 4 patients (13.3%) stayed all the time in compensation stage. CONCLUSIONS: (1) Most of the patients with vestibular neuronitis had satisfactory recovery, evaluated by vestibular index. (2) These patients, in whom recovery was not enough, must be submitted to detail clinical and electronystagmographical evaluation in late period after peripheral vestibular loss. (3) Vestibular index may be useful in evaluation the extend of vestibular lesion and compensation status in patients with vestibular neuronitis.
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Electronystagmography outcome and neuropsychological findings in tinnitus patients.
The international tinnitus journal. 02/2005; 11(1):54-7.
Because psychological aspects often are underscored in the generation of tinnitus, we assessed the neuropsychological status in our group of patients. We found an increased number of abnormal electronystagmography (ENG) recordings in tinnitus patients. The aim of this study was to compare the ENG ou... [more] Because psychological aspects often are underscored in the generation of tinnitus, we assessed the neuropsychological status in our group of patients. We found an increased number of abnormal electronystagmography (ENG) recordings in tinnitus patients. The aim of this study was to compare the ENG outcome with the patients' neuropsychological status. We carried out the study on 69 subjects complaining of tinnitus and on 43 healthy persons. We performed clinical neurootological examinations and ENG tests on all patients. Neuropsychological evaluation was conducted by means of the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression (HAD) test, the Mini Mental Status (MMS) test, and the Trail-Making Test (TMT). In 46 patients (66.6%), we found abnormal ENG outcomes (central, 42%; peripheral, 13.0%; mixed, 11.6%). Neuropsychological tests revealed abnormal scores: for the BDI, 43.5% of patients; for the HAD-A, 72.5%; for the HAD-D, 47.8%; for the MMS, 27.5%; and for the TMT, 55.1%. We did not find correlation between the ENG outcomes and neuropsychological test scores. We did not find correlation between the overall ENG outcomes and neuropsychological test scores, with one exception; we found the occurrence of abnormal neuropsychological test scores and the ENG outcome indicating central vestibular dysfunction. Our study showed that despite a high frequency of vestibular system dysfunction signs and a high incidence of abnormal neuropsychological test scores in tinnitus patients, only one correlation existed between these two results.
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[Malignant neoplasms of external and middle ear]
Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(2):251-6.
INTRODUCTION: Neoplasms of external and middle ear are rare, which cause several problems in diagnosis and therapy. The purpose of the study was to analyze retrospectively patients with malignant neoplasms of the ear. METHODOLOGY: The study was carried out on 53 patients treated for malignant ear ne... [more] INTRODUCTION: Neoplasms of external and middle ear are rare, which cause several problems in diagnosis and therapy. The purpose of the study was to analyze retrospectively patients with malignant neoplasms of the ear. METHODOLOGY: The study was carried out on 53 patients treated for malignant ear neoplasms in single institution during 25 years (1978-2002). RESULTS: The most frequent neoplasm was squamous cell carcinoma--36 cases (67.9%), then basal cell carcinoma--9 cases (16.9%). Neoplasm primarily involved auricle in 26 patients (49.1%), external auditory canal in 15 patients (28.3%) and middle ear in 12 patients (22.6%). They were classified according to Stell and McCormick (1985) as follows: stage I--29 tumours (54.7%), stage T2--15 tumours (28.3%), stage T3--9 tumours (17%). Facial nerve paresis occurred in 15 patients (28.3%). The most often treatment modality was surgery--32 persons (60.4%), then surgery followed by radiotherapy--17 persons (32.1%). The characteristics of neoplasms related to the site of location were described. The difficulties in precise histopathologic diagnosis and extent of disease were pointed out. RESULTS: Neoplasms of external and middle ear constitute a group of various histopathological and clinical tumours, which differ in diagnostic difficulties, treatment and prognosis. A diagnosis was often made in advanced stages of neoplasms, especially for middle ear tumours, that diminished a possibility of effective treatment.
Following (3)
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Ludomir Stefańczyk
Madical university, lodz -
Elzbieta Waszczykowska
Medical University of Lódz -
Marian Danilewicz
Medical University of Lódz
