Tomasz Przewoźny

Publications of Tomasz Przewoźny

• [Major salivary gland disorders in children and adolescents].

  Authors: Tomasz Przewoźny, Dominik Stodulski, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):350-6.

  The aim of this study was a review of 67 children treated for salivary gland tumors in the ENT Department Medical University of Gdańsk since 1974 to 2008. In that group we observed 52 children withThe aim of this study was a review of 67 children treated for salivary gland tumors in the ENT Department Medical University of Gdańsk since 1974 to 2008. In that group we observed 52 children with tumor of the parotid gland, 13 with tumor of submandibular gland and 2 with subligual gland tumors. Tumor-like lesions were stated the largest group of tumors and were observed in 33 (49%) of children, mainly of chronic sialadenitis (17 cases). Predominant number of tumors was observed in scholarship children. The most common symptoms were slow enlargement of tumor and swelling of the salivary gland. In the group of benign tumors most common was pleomorphic adenoma (19 cases) and in the group of malignant tumors most common was clear cell carcinoma (2 cases) and rhabdomyosarcoma (2 cases). In this report the authors describe basic epidemiological and clinical data (age, sex, duration of symptoms, histological structure of tumor, diagnostic methods, methods and results of treatment) and observations connected with differences of salivary gland tumors in that group of patients.

• Risk factors of sensorineural hearing loss in patients with ischemic stroke.

  Authors: Tomasz Przewoźny, Dariusz Gasecki, Waldemar Narozny, Walenty Nyka

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 09/2008; 29(6):745-50.

  We investigated risk factors of sensorineural hearing loss (SHL) in patients with early stage of ischemic stroke (IS). Our study consisted of 60 patients with IS who were treated at Department ofWe investigated risk factors of sensorineural hearing loss (SHL) in patients with early stage of ischemic stroke (IS). Our study consisted of 60 patients with IS who were treated at Department of Neurology, Medical University of Gdansk between 2006 and 2007. A multivariate stepwise linear regression was used to identify the risk factors that were related to SHL as measured by pure-tone average (0.5, 1, and 2 kHz), the high-tone average (4, 6, and 8 kHz), the pure-tone middle-tone average (0.5, 1, 2, and 4 kHz), and the overall average (0.5, 1, 2, 4, 6, and 8 kHz). The following factors were included in the analysis: age, sex, smoking habit, addiction to alcohol, presence of tinnitus and vestibular symptoms, arterial hypertension, cardiac ischemic disease, hyperlipidemia, diabetes, number of risk factors, neurologic state at the admission, localization of stroke, cause of stroke, number of ischemic focuses, the side and diameter of ischemic focuses, the result of directional hearing acuity angle test, results of certain laboratory tests, blood morphology parameters, and coagulogram. Values for p less than 0.05 were considered significant. Our analysis suggests the presence of the following risk factors of SHL in patients with IS: 1) older age (>60 yr); 2) male sex; 3) presence of tinnitus; 4) arterial hypertension; 5) lacunar type of stroke; 6) presence of multiple ischemic focuses; 7) presence of bilateral ischemic focuses; 8) changes in blood cell count; and 9) disturbances of agglutination. The highest risk of hearing loss in the group of IS patients occurred at older people, particularly men with tinnitus, lacunar stroke, multiple, bilateral ischemic focuses, and arterial hypertension. A negative statistically significant influence of decreased level of red cells, platelets, and hematocrit value on hearing loss was found. Abnormally lowered levels of activated partial thromboplastin time, activated partial thromboplastin time ratio, prothrombin index, and abnormal lowered level of international normalized ratio statistically impaired hearing.

• [Audiologic symptoms in early stage of ischemic stroke]

  Authors: Tomasz Przewoźny

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(6):1034-7.

• Otitic hydrocephalus associated with lateral sinus thrombosis and acute mastoiditis in children.

  Authors: Jerzy Kuczkowski, Mirosława Dubaniewicz-Wybieralska, Tomasz Przewoźny, Waldemar Narozny, Bogusław Mikaszewski

  International journal of pediatric otorhinolaryngology. 11/2006; 70(10):1817-23.

  The incidence of intracranial complications of acute otitis media (AOM) has decreased and the need for operative and medical treatment is declined during the antibiotic era. To describe pathognomonicThe incidence of intracranial complications of acute otitis media (AOM) has decreased and the need for operative and medical treatment is declined during the antibiotic era. To describe pathognomonic signs, evaluation management, operative findings, clinical course and outcome of otitic hydrocephalus and lateral sinus thrombosis as complications of AOM and mastoiditis in pediatric patients. Two children, 9 and 13 years old, with the diagnosis of OH and TK and MRI findings are presented. Intracranial complications in children resulted from unsuccessful treatment of AOM, which led to acute mastoiditis and lateral sinus thrombosis. Both of the presented children had thrombus in their sigmoid sinus preoperatively, demonstrated by MRI, causing decreased blood flow. Both patients underwent a mastoidectomy and delamination of sigmoid sinus with puncture of sinuses. After medical and surgical treatment, blood flow through the sinus increased significantly. In both cases signs of increased intracranial pressure ceased. The clinical presentation of otogenic lateral sinus thrombosis (LST) as a complication of acute otitis media (AOM) can be masked by antibiotic treatment. The episodes of vomiting, headache, visual impairment and a history of AOM seem to be indicative for otitic hydrocephalus. MRI scans of patients with similar symptoms should be carefully studied to facilitate the early diagnosis of dural sinus thrombosis with increased intracranial pressure. Contrast-enhanced computed tomography scan and magnetic resonance imaging play a major role in determining diagnosis and treatment plans in this intracranial complications. Management included systemic antibiotics, short-term heparin anticoagulation and surgical decompression. In our patients intensive i.v. antibiotic treatment, steroids, anticoagulants and surgery led to a significant improvement in the clinical condition.

• Neoplasms of the parotid gland in northern Poland, 1991-2000: an epidemiologic study.

  Authors: Tomasz Przewoźny, Czesław Stankiewicz

  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. 09/2004; 261(7):369-75.

  A review of patients treated for malignant and benign parotid tumors in a 10-year period (1991-2000) in the Pomeranian County of Poland revealed 417 new cases. The age-standardized incidence rate wasA review of patients treated for malignant and benign parotid tumors in a 10-year period (1991-2000) in the Pomeranian County of Poland revealed 417 new cases. The age-standardized incidence rate was 0.23 and 1.35 per 100,000 inhabitants for malignant and benign tumors, respectively. The following data were collected: age, sex, place of living, education, job, smoking, symptoms, duration of symptoms at the time of diagnosis, result of histopathological tumor examination, tumor size, TNM staging and distant metastases. The results were divided into two parts: malignant neoplasms and benign neoplasms. The most common malignant neoplasms were carcinomas (96.8%), and among them the most numerous were mucoepidermoid carcinoma (22.2%), carcinoma in pleomorphic adenoma (20.6%) and adenoid cystic carcinoma (15.9%). The most common benign neoplasms were adenomas (95.5%), most frequently pleomorphic adenoma (65.5%) and adenolymphoma (24.0%), but rarely basal cell adenoma (4.2%). We also observed a steady increase in the number of benign parotid tumors in the examined period of time.

• More about Mikulicz.

  Authors: Jerzy Kuczkowski, Tomasz Przewoźny, Waldemar Naroźny, Boguslaw Mikaszewski

  South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 06/2004; 94(5):318.

• [Sialolithiasis of the parotid gland]

  Authors: Tomasz Przewoźny, Waldemar Narozny, Czesław Stankiewicz, Jerzy Kuczkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(4):785-90.

  Sialolithiasis of the parotid gland is a rare diagnostic and therapeutic problem in otorhinolaryngology. The authors describe opinions concerned with symptomatology, localization, diagnostics andSialolithiasis of the parotid gland is a rare diagnostic and therapeutic problem in otorhinolaryngology. The authors describe opinions concerned with symptomatology, localization, diagnostics and methods of treatment in parotid sialolithiasis in support of clinical material of three patients treated in the ENT Department, Medical University of Gdańsk in years 1993-2002. One patient was treated with antibiotics while the other two patients were treated surgically--partial parotidectomy was performed, removing in one case intraparenchymal calculus 15 mm in diameter and in second case--from proximal part of parotid duct with 5 mm of diameter. After treatment there were not observed any symptoms of the disease.

• [Sudden sensorineural hearing loss: a treatment protocol including glucocorticoids and hyperbaric oxygen therapy]

  Authors: Waldemar Narozny, Zdzisław Sićko, Tomasz Przewoźny, Czesław Stankiewicz, Jacek Kot, Jerzy Kuczkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(4):821-30.

  The aim of this study was to evaluate the efficacy of pharmacological treatment (corticosteroids, vasodilators, vitamins, Betaserc) combined with hyperbaric oxygen therapy (HBO) in the suddenThe aim of this study was to evaluate the efficacy of pharmacological treatment (corticosteroids, vasodilators, vitamins, Betaserc) combined with hyperbaric oxygen therapy (HBO) in the sudden sensorineural hearing loss (SSNHL). We reviewed 52 patients with SSNHL treated pharmacologically and with HBO (group A) between 1997 and 2000. All patients in this group received once daily, five days a week, 100% oxygen in a multiplace chamber under pressure of 2.5 ATA for 60 minutes (plus two 5 minutes air breaks). The other group (group B) consisted of 81 patients treated only pharmacologically between 1980 and 1997. Both groups were similar regarding age, season of the year in which deafness occurred, presence of vestibular symptoms and tinnitus, therapeutic delay from initial symptoms to start of treatment, and initial hearing loss, however there were significant differences in gender and shape of hearing loss. The improvement after treatment was measured by tonal audiometry. The retrospective analysis of audiometries performed in all patients was conducted. The improvement of hearing loss was statistically significantly better for group A (vasodilators, high-dose of corticosteroids, vitamins, Betaserc, HBO) than group B (vasodilators, lower-dose of corticosteroids, vitamins) in any single frequency (500-1000-2000-3000-4000-6000-8000 Hz) and in 4 ranges of frequencies (PTA, HTA, PMTA, OAA) both for relative and absolute values. We concluded that the combined therapy of high-dose corticosteroids and HBO improved the clinical results of treatment in the SSNHL, and therefore should be performed in such cases. We also observed that therapeutic delay and flat hearing loss are predictors of poor clinical outcome.

• [Bilateral Warthin's tumor of the parotid gland]

  Authors: Tomasz Przewoźny, Czesław Stankiewicz, Waldemar Narozny, Jerzy Kuczkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(6):1203-9.

  Three cases of bilateral Warthin's tumor (adenolymphoma) of the parotid gland in patients treated in the ENT Department, Medical University of Gdańsk were presented. They were stated 3.3% of allThree cases of bilateral Warthin's tumor (adenolymphoma) of the parotid gland in patients treated in the ENT Department, Medical University of Gdańsk were presented. They were stated 3.3% of all Whartin's tumors in our institution. In two cases the contralateral tumor developed after 2.5 and 15 years and in one case arised synchronically. Our three patients were males, 50-65 years old, cigarette smokers more than 25 years. All of the patients were treated surgically--conservative parotidectomy was performed. We did not observe the complications and reccurence of the disease. Opinions on the diagnostic and therapeutic methods in that disease reported in Polish and foreign references are discussed.

• [Warthin's tumor of the parotid gland. Epidemiological and clinical analysis of 127 cases]

  Authors: Tomasz Przewoźny, Czesław Stankiewicz, Waldemar Narozny, Jerzy Kuczkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(3):583-92.

  The aim of this study was a review of 127 patients treated for Warthin's tumor of parotid gland during 15-years period 1988-2003 in Pomeranian Voivodeship of Poland. The age-standardised incidenceThe aim of this study was a review of 127 patients treated for Warthin's tumor of parotid gland during 15-years period 1988-2003 in Pomeranian Voivodeship of Poland. The age-standardised incidence rate of this tumor was 0.32/100,000. There were 73.2% males and 26.8% females. Age ranged at presentation from 18 to 88 years (average 59.8+/-11.6). Workers from cities over 100,000 inhabitants, with technical education constituted the largest group. Almost 70% of the patients were smokers. Most frequently patients reported slow enlargement of tumor (55.9%), presence of tumor (24.4%) and rapid tumor enlargement (7.1%). Average duration of symptoms was 27 months. The average size of the tumor was 36+/-19 mm. More than half of tumors had less than 30 mm in diameter. After histopathological assessment the average size of tumor was 21+/-17 mm and the tumors less than 30 mm in diameter were 73.1%. There were 2.4% of bilateral neoplasms. Pre-operative cytological examination was not correlated with histopathological examination in less than half of cases (39.5%). All patients were treated surgically and in 81.9% the parotidectomy was performed. The most common localization of the tumor (52.4%) was lower pole of parotid gland. There were also stated 12.4% multifocal neoplasms and 3.8% tumors arising extraglandularly. The main complication after surgical treatment was temporary or permanent facial nerve palsy (10.8%). In 1 case the residual tumor was observed which required reoperation. In time of postoperative observation up to 15 years 1 case (0.9%) of recurrence which required surgical intervention. We noted an increase in number of Warthin's tumor in the analysed period of time.

• [An application of hyperbaric oxygen therapy in otolaryngological oncology]

  Authors: Waldemar Narozny, Zdzisław Sićko, Czesław Stankiewicz, Tomasz Przewoźny, Jacek Kot, Jerzy Kuczkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(6):799-807.

  Postradiation changes in the tissues and delayed wound healing were presumed by all hyperbaric medicine societies including Undersea and Hyperbaric Medical Society (UHMS) and European Committee forPostradiation changes in the tissues and delayed wound healing were presumed by all hyperbaric medicine societies including Undersea and Hyperbaric Medical Society (UHMS) and European Committee for Hyperbaric Medicine (ECHM) as one of the basic indications for hyperbaric oxygen therapy (HBO). The authors estimated the influence of hyperbaric oxygen on molecular, biochemical and cellular changes in injured tissues including that after radiotherapy. Reviewing the references the authors tried to state the actual role of HBO in oncology of head and neck tumors. The authors referred their experiences in adjuvant therapy of head and neck neoplasms with HBO: 1] postradiation changes of head and neck after adjuvant radiotherapy (7 cases) and after primary radiotherapy (1 case); 2] delayed postoperative wound healing (1 case).

• [Giant pleomorphic adenomas of the parotid gland]

  Authors: Tomasz Przewoźny, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(5):691-7.

  The authors describe four cases of giant pleomorphic adenomas of the parotid gland with the diameter greater then 15 cm in patients treated in the ENT Department, Medical University of Gdańsk inThe authors describe four cases of giant pleomorphic adenomas of the parotid gland with the diameter greater then 15 cm in patients treated in the ENT Department, Medical University of Gdańsk in years 1989-2002. Three of the patients were treated surgically--parotidectomy was performed, in first case removing tumor of 28 cm in diameter and 3.2 kg, in second case 15 cm and 0.7 kg and in third case 18 cm and 1.3 kg. The forth patient was disqualified from the surgical treatment because of the metastases to the lungs from the giant malignant pleomorphic adenoma involving half of the head. The authors presented opinions on the diagnostic and therapeutic methods in that disease and also present case reports from Poland and other countries.

• [Pleomorphic adenomas of the nasal cavity]

  Authors: Waldemar Narozny, Tomasz Przewoźny, Czesław Stankiewicz, Jerzy Kuczkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(5):661-5.

  The authors presents three cases of pleomorphic adenoma of the nasal cavity treated in the ENT Department, Medical University of Gdańsk in years 1974-2002. That material was also extended in analysisThe authors presents three cases of pleomorphic adenoma of the nasal cavity treated in the ENT Department, Medical University of Gdańsk in years 1974-2002. That material was also extended in analysis of fourth case treated in our Department and described earlier. In that group were three men and one woman in age of 31-62 years. The most common symptoms were unilateral nasal obstruction, headache or feel of expansion in the nose lasted from 3 months to 10 years. In three cases the tumor was localized in the nasal septum and in one case on the lower nasal concha. All cases were treated surgically--in three cases the lateral rhinotomy was performed and in one case--subperichondral excision of the tumor. In none of cases the recurrence was observed. The authors reviewed polish references and found four cases of these tumor localized in the nasal cavity. This material extended of our cases served to the attempt of epidemiological-clinical evaluation of these tumors.

• [10th Danube Symposium International Otorhinolaryngologic Congress]

  Authors: Tomasz Przewoźny

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(2):313-5.

• [Osteomas and exostoses of external auditory canal in material of Otolaryngology Department Medical University of Gdańsk].

  Authors: Jerzy Kuczkowski, Małgorzata Potocka, Grazyna Kobierska-Gulida, Tomasz Przewoźny, Mirosława Dubaniewicz-Wybieralska

  Otolaryngologia polska. The Polish otolaryngology. 64(6):365-9.

  Osteomas and exostoses of the external auditory canal are benign tumours arising in bones, leading to its obstruction and causing hearing loss. The treatment of these entities may present aOsteomas and exostoses of the external auditory canal are benign tumours arising in bones, leading to its obstruction and causing hearing loss. The treatment of these entities may present a therapeutic dilemma. To assess epidemiological and clinical data and surgical treatment effectiveness. The study group consisted of 21 patients (14 men and 7 women) between 18 to 63 years of age, treated in the Otorhinolaryngology Department of Medical University of Gdańsk from 1995 to 2009. The results of audiometric, radiological and histopathological examination were taken into consideration. Unilateral osteomas developing in tympanosquamous suture in 5 patients, in tympanomastoid suture in 4. Bilateral exostoses occured in 12 patients in anterior, posterior and inferior wall of the external auditory canal. In all patients: conductive hearing loss ranged from 15 to 30 dB (average 29.9 dB), in 6 patients with concomitant sensorineural component. Osteomas were removed via intrauricular approach according to Mawson-Goodhill's method. Exostoses were removed via intrauricular, intracanal or postauricular approach. Histological examination confirmed benign overgrowth of compact and trabecular bone. The auditory canal was successfully reamed, the hearing improved in all patients. Osteomas are benign tumours leading to obstruction of the external auditory canal. Exostosis is the overgrowth of the external auditory canal's compact bone in adults. Osteomas and exostoses may lead to hearing loss. Indications to surgical treatment are ear pain, progressive hearing loss and recurrent otitis external.

• [Nonchromaffin paragangliomas (chemodectoma) of the middle ear in the material of the ENT Department Medical University of Gdańsk].

  Authors: Jerzy Kuczkowski, Tomasz Przewoźny, Wojciech Biernat, Mirosława Dubaniewicz-Wybieralska

  Otolaryngologia polska. The Polish otolaryngology. 65(1):40-6.

  Nonchromaffin paraganglioma (chemodectoma) is the most common neoplasm of the middle ear. The diagnosis and treatment is one of the most challenging in otolaryngology. The aim of the study: wasNonchromaffin paraganglioma (chemodectoma) is the most common neoplasm of the middle ear. The diagnosis and treatment is one of the most challenging in otolaryngology. The aim of the study: was clinical and epidemiological analysis of patients with nonchromaffin paraganglioma of the middle ear. The material consisted of 13 patients (10 females, 3 males), age 19-62 years, treated for paraganglioma of the middle ear in the ENT Department Medical University of Gdańsk between 1968 and 2009. We analyzed the symptoms and results of additional diagnostic tests necessary to establish the diagnosis. We have diagnosed 12 cases of benign chemodectoma (92.3%) and 1 case of chemodectoma malignum (7.7%). The surgical treatment was applied in 6 patients (46.1%), 4 patients (30.8%) received complementary radiotherapy and 3 patients (23.1%) were treated only with radiotherapy. The diagnosis of paragangliomas of the ear is difficult and should be based on clinical data, audiometric tests, CT, MRI and histological examination. Surgical treatment of paragangliomas is limited to early stages of the disease. The results of the research show that the best therapeutic method in advanced cases is surgical treatment with complementary radiotherapy.