Tomasz Durko
Research interests
-
InterestsOtology
Publications
-
[Fungal rhinosinusitis - still unsolved problem].
Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):369-76.
Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nose and paranasal sinuses. Fungi are considered to be one of the pathogens responsible for some kinds of CRS. Fungal rhinosinusitis - the classifications schemes, the diagnostic criteria and methods of treatment are still being d... [more] Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nose and paranasal sinuses. Fungi are considered to be one of the pathogens responsible for some kinds of CRS. Fungal rhinosinusitis - the classifications schemes, the diagnostic criteria and methods of treatment are still being discussed. 338 patients underwent the endoscopic sinus surgery due to CRS in the Otolaryngology Department of the Medical University of Lodz in the years 2009-2011 (February). The histopathological examination revealed fungi only in three patients. The authors report three cases of patients with fungal rhinosinustis - the fungal ball of the sphenoid sinus in one patients, the fungal ball of the maxillary sinus in the second one and non-invasive fungal rhinosinusitis. The different classifications and diagnostic criteria are also presented. Based on the publications using updated diagnostic standards and sensitive techniques to detect fungi, a higher number of patients can now be diagnosed with fungal rhinosinusitis.
-
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.
-
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.
-
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.
-
[Extrapulmonary tuberculosis in the patients of otholaryngology department--case reports].
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 03/2008; 24(141):247-50.
Tubercle bacillus infection is widespread in all areas of the world and affects one-third of the human population. Tuberculosis can affect each organ in the body and although the most common presentation is pulmonary tuberculosis it can also develop in laryngological organs. THE AIM OF THE STUDY was... [more] Tubercle bacillus infection is widespread in all areas of the world and affects one-third of the human population. Tuberculosis can affect each organ in the body and although the most common presentation is pulmonary tuberculosis it can also develop in laryngological organs. THE AIM OF THE STUDY was the analyze symptomatology and also the diagnostic and therapeutic process of tuberculosis in the larynx, the lymph nodes of the neck, the ear and the palatine tonsils. The evaluation of medical documentation of 9 patients hospitalized in department of otholaryngology in the period of last 4 years was conducted. In all of them extrapulmonary tuberculosis developed in tissues and organs of the upper respiratory tract, neck and middle ear was detected. In the analyzed group there were 5 women and 4 men. The age of patients varied from 40 to 75 years (average 56.3). In the examined group there were three cases of the larynx tuberculosis, three cases of tuberculosis of the lymph nodes, two cases of the ear tuberculosis and one case of tuberculosis of the palatine tonsils. The source of the diagnosis in analyzed cases was first of all histopathological examination. Tuberculosis process found in the area of middle ear and palatine tonsils imitated chronic, non-specific inflammation and in the case concerning the ear was the only location of the illness. Tuberculosis of larynx in all the patients co-existed with specific changes in lungs and took the form of tumors suggesting neoplasmatic background of the disease. Tuberculosis of the lymph nodes can take the form of the neck abscess.
-
[The rare case of metastasis to lumbar part of spinal column from laryngeal cancer]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(6):787-90.
A rare case of distant metastasis to spinal column--lumbar vertebra (L5)--from laryngeal cancer was reported. It must be noted that in 10% of cases metastases to vertebral column are first symptom of a neoplastic disease and sixty-five percent of patients with advanced cancer present bone metastases... [more] A rare case of distant metastasis to spinal column--lumbar vertebra (L5)--from laryngeal cancer was reported. It must be noted that in 10% of cases metastases to vertebral column are first symptom of a neoplastic disease and sixty-five percent of patients with advanced cancer present bone metastases. Metastatic involvement of the bone is one of the most frequent causes of pain in cancer patients and represents one of the first signs of widespread neoplastic disease. Nevertheless metastases to lumbar vertebral column from laryngeal cancer is very rare. In presented case MRI and CT were performed to confirm metastasis. Laryngological examination revealed tumor of a right part of larynx--squamous cell carcinoma (G2) in histopathological examination. The patient was qualified to palliative radiotherapy and still is under laryngological observation.
-
[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.
-
[Analysis of TIMP-1, TIMP-2 and TIMP-3 expression as a prognostic factor of laryngeal cancer progression]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):380-7.
INTRODUCTION: Tissue inhibitors of matrix metalloproteinases (TIMPs) are natural regulator of activity of matrix metalloproteinases, that are responsible for ECM degradation. TIMPs have been identified in various carcinomas and in most of them dependence between TIMPs and clinical course of the dise... [more] INTRODUCTION: Tissue inhibitors of matrix metalloproteinases (TIMPs) are natural regulator of activity of matrix metalloproteinases, that are responsible for ECM degradation. TIMPs have been identified in various carcinomas and in most of them dependence between TIMPs and clinical course of the disease have been observed. AIM: Of the research was to evaluate expression of TIMP-1, TIMP-2 and TIMP-3 in laryngeal cancer and to asses the prognostic significance of these factors. MATERIAL AND METHOD: 104 patients with laryngeal cancer, that underwent surgical treatment were included in the study. Only cases with at least a 5-year follow-up were included. Immunohistochemical studies were performed on formalin fixed, paraffin embedded sections by using monoclonal antibodies against TIMP-1, -2 and -3 antigens and ABC detection system. Results. TIMPs expression was cytoplasmatic, mainly in cancer cells, but also in some stromal cells. TIMP-1 and TIMP-2 correlated with grading (TIMP-1 p = 0,05; TIMP-2 p = 0,001). There was an association between TIMP-2 and TIMP-3 expression and tumor size (TIMP-2 p = 0,037; TIMP-3 p = 0,022). TIMP-3 expression correlated with clinical stage of the disease (p = 0,037). There was an association between TIMP-2 expression and nodal recurrence (p = 0,05). Both overall and disease-free survival were shorter in cases with positive TIMP-2 expression (p = 0,049). CONCLUSIONS: Our results demonstrate that there is an association between TIMPs expression and clinicopathological features of laryngeal cancer. Moreover TIMP-2 could be an important marker in prognosis of laryngeal cancer patients.
-
[Diagnostic and therapeutic problems in parapharyngeal space tumor--case report]
Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):631-5.
Only 0.5% of head and neck tumors originate from parapharyngeal space. Malignant neoplasms of parapharyngeal space are exceptionally rare (20% of all tumors in this area). Their rarity form a complex diagnostic and therapeutic problem. Authors reports a case of 53-year old woman with squamous cell c... [more] Only 0.5% of head and neck tumors originate from parapharyngeal space. Malignant neoplasms of parapharyngeal space are exceptionally rare (20% of all tumors in this area). Their rarity form a complex diagnostic and therapeutic problem. Authors reports a case of 53-year old woman with squamous cell carcinoma of parapharyngeal space that caused particular difficulties in diagnosis. Diagnostic and therapeutic procedures and preliminary outcome of treatment are presented.
-
[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.
-
[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.
-
[Role of IFN-gamma and TNF-alpha in etiology of nasal polyps--initial studies].
Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(1):54-8.
Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of interferon gamma and TNF-alpha secreted by Th1 lymphocytes and to an... [more] Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of interferon gamma and TNF-alpha secreted by Th1 lymphocytes and to analyze their role in the etiology of nasal polyps. 12 patients with nasal polyposis were selected - 6 of them allergic and 6 non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Blood sample was obtained from patients and examined for the expression of IFN-gamma and TNF-alpha by intracellular staining procedure after stimulation with PMA/ionomycin and allergen. Negative correlation was found between expression of IFN-gamma and TNF-alpha after PMA/ionomycin stimulation and allergen stimulation (p > 0,05). Statistical analysis of two groups of patients demonstrated that no significant differences in the cytokine expression in allergic versus non-allergic patients were observed although mean value of IFN-gamma and TNF-alpha were lower in allergic patients in comparison to non-allergic (p > 0,05). We didn't observed any correlation between expression of INF-gamma and TNF-alpha and: coexistence of bronchial asthma, allergy to aspirin and local corticosteroid treatment. In patients with recurrent polyposis the expression of INF-gamma was significantly lower (p = 0,05). This research suggests that IFN-gamma and TNF-alpha play a role in the pathogenesis of nasal polyps but the allergic mechanism may not play a fundamental role in this process. It needs further investigations.
-
[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.
-
[Surgery of chronic otitis media--strategy of treatment]
Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):373-7.
-
[Unilateral tuberculosis of middle ear in patient previously treated for rhabdomyosarcoma embryonal in the contralateral middle ear--case report]
Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):497-500.
Authors present a case of a female patient surgically treated for chronic otitis media (radical middle ear surgery) in which basing on postoperative pathology report a specific inflammatory process (tuberculosis) has been diagnosed. It is pointed out that in this patient there is a history of malign... [more] Authors present a case of a female patient surgically treated for chronic otitis media (radical middle ear surgery) in which basing on postoperative pathology report a specific inflammatory process (tuberculosis) has been diagnosed. It is pointed out that in this patient there is a history of malignant neoplastic process (rhabdomyosarcoma embryonal) treated previously at the contralateral middle ear.
-
Revision stapes surgery: retrospective analysis of surgical findings in a series of 21 otosclerosis patients.
Advances in oto-rhino-laryngology. 02/2007; 65:273-7.
AIM: Retrospective analysis of surgical findings in revision stapes surgery in a group of 21 otosclerosis patients qualified for the secondary procedure at the Otosurgery Department of the Medical University of Lodz, Poland, from 1980 to 2002. MATERIALS AND METHODS: 21 cases of revision stapes surge... [more] AIM: Retrospective analysis of surgical findings in revision stapes surgery in a group of 21 otosclerosis patients qualified for the secondary procedure at the Otosurgery Department of the Medical University of Lodz, Poland, from 1980 to 2002. MATERIALS AND METHODS: 21 cases of revision stapes surgery out of a total of 350 surgically treated otosclerosis cases are discussed. Group A consisted of 17 cases of revision surgery out of 274 patients who had undergone total stapedectomy (1980-1995) and group B consisted of 4 cases out of 76 patients after stapedotomy (1996-2002). RESULTS: In group A, 17 patients underwent revision surgery, corresponding to 6.2% out of 274 total stapedectomy cases. Among the indications for the secondary surgical procedure in this group of patients were: (a) platinum wire prosthesis displacement with ossicular chain discontinuity (n = 12); (b) perichondrium or adipose tissue atrophy (n = 3), and (c) incudostapedial joint luxation (n = 2). Group B was composed of 4 cases, i.e. 5.3% out of 76 stapedotomy patients (Teflon piston operation, 0.6 mm). For both groups, the mean percentage of revision cases was 6% of all patients operated for otosclerosis. Time from the initial surgical procedure to reoperation varied from 1 to 8 years. CONCLUSIONS: (1) The most common indication for revision stapes surgery in patients after total stapedectomy was prosthesis displacement and necrosis of the long crus of the incus. (2) Obliteration of the stapes footplate after small fenestra operation was observed to be the most frequent indication for the secondary stapes procedure in our patient groups.
-
[Advance or stabilization in the middle ear surgery]
Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(4):501-6.
-
[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.
-
[Wegener's granulomatosis--diagnostic problem]
Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(3):355-62.
Wegener's granulomatosis there is a small--and middle--vessels vasculitis. The pathomorphological diagnostic criteria is known as Wegener's triad: 1) necrotizing granlomatous inflammation of upper and/or lower respiratory tract, 2) systemic or focal necrotizing vasculitis involving arteries ... [more] Wegener's granulomatosis there is a small--and middle--vessels vasculitis. The pathomorphological diagnostic criteria is known as Wegener's triad: 1) necrotizing granlomatous inflammation of upper and/or lower respiratory tract, 2) systemic or focal necrotizing vasculitis involving arteries and vein, and 3) focal segmental necrotizing crescentic gromerulonephritis. According to the current theory of pathogenesis of Wegener's granulomatosis, Staphylococcus aureus is involved. The rise in ANCA level during vascular inflammation is very important for monitoring disease. The main localization of Wagener's granulomatosis is in lung, nasal sinusites, nose, kidneys and nasal pharynx. MATERIAL AND METHODS: The history of 60-years old female patient who was being treated in Department of Otolaryngology for chronic bilateral otitis media for many years is presented. During hospitalization the sinusites, rhinitis and renal failure additionally were found. The CT sinuses and head, histopatological and ANCA exam in patient were performed. RESULTS: Based on clinical, physical, additional exam Wegener's granulomatosis was diagnosed. CONCLUSIONS: 1) Surgical procedure is not indicated method of treatment of Wegener's granulomatosis, because it can increase the pathologic process. 2) The prognosis of Wegener's granulomatosis depends mainly on the ability to diagnose the early disease and the aplication of adequate treatment.
-
[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)
-
Ludomir Stefańczyk
Madical university, lodz -
Elzbieta Waszczykowska
Medical University of Lódz -
Marian Danilewicz
Medical University of Lódz
Topics (1)
