Andrzej Skorek

Publications of Andrzej Skorek

• [Managment of head and neck cancers during pregnancy].

  Authors: Krzysztof Kiciński, Andrzej Skorek, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):326-32.

  The coincidence of malignant disease during pregnancy is uncommon. The incidence of cancer in pregnancy has increased, due to the tendency to postpone childbirth to an older age. Cancer complicatesThe coincidence of malignant disease during pregnancy is uncommon. The incidence of cancer in pregnancy has increased, due to the tendency to postpone childbirth to an older age. Cancer complicates approximately 0.1% of all pregnancies. Managing head and neck cancers during pregnancy requires additional pregnancy-related understanding of the aetiological effect of pregnancy on cancer, knowledge of the direct and indirect effects of cancer on pregnancy, and the effect of diagnostic and treatment modalities on pregnancy. The timing of treatment is an important determinant on foetal wellbeing. A multidisciplinary approach should be adopted to enable parents and clinicians to make the best clinical decision. Clinicians must be cognizant with the ethical dilemmas of treatment. In head and neck cancers, pregnancy has no effect on maternal prognosis when compared to non-pregnant patients matched by age, cancer stage and treatment.

• [Our experience in the treatment advanced neoplasms of floor of the mouth].

  Authors: Andrzej Skorek, Jerzy Jankau, Barbara Drogoszewska, Krzysztof Kiciński, Dominik Stodulski, Magdalena Graczyk, Aleksandra Ankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):345-9.

  The aim of this study was to evaluate results of our surgical treatment of advanced neoplasms of the floor of the mouth, treated from 2005-2011 in Department of Otolaryngology and Department ofThe aim of this study was to evaluate results of our surgical treatment of advanced neoplasms of the floor of the mouth, treated from 2005-2011 in Department of Otolaryngology and Department of Plastic Surgery Medical University of Gdańsk We analyzed group of 12 patients (aged 36 to 70 years, mean 55) treated by primary surgical excision of neoplasms of the floor of the mouth (with tracheotomy and mandibulotomy) and selective or radical neck dissection (uni- or bilateral) in combination with chemoradiotherapy. All patients referees with advancement of locoregional disease: primary tumors (T3 or T4) and neck metastases (N1 or N2b) Most of the patients required to use free microvascular reconstruction with free forearm skin flaps. Histological examinations revealed squamous cell carcinoma (11/12) and adenocarcinoma (1/12). Two patients die in 1 and 4 months after surgery. Three die from 2 to 3 years after surgery. Rest live from 6 month to 6 year after therapy. Free forearm skin microvascular flap is good (anatomical and functional) for reconstruction for large defects after resection neoplasms of the floor of the mouth.

• [Orbital trauma]

  Authors: Andrzej Skorek, Czesław Stankiewicz, Dariusz Babiński, Anna Ostrowska, Dominik Stoduski

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):409-15.

  INTRODUCTION: Single or multifragmental orbital fractures may be a difficult diagnostic and therapeutic dilemma. Dislocation of the orbital contain into maxillary and ethmoid sinus may take placeINTRODUCTION: Single or multifragmental orbital fractures may be a difficult diagnostic and therapeutic dilemma. Dislocation of the orbital contain into maxillary and ethmoid sinus may take place during trauma. The main topics: is when and what surgical technique should be applied in these cases. MATERIAL AND METHODS: Material consists of retrospective analysis of 23 cases with fracture of medial and interior wall of orbit hospitalized in ENT Department of Medical University in Gdansk from 1999 to 2005. External ethmoidectomy was performed in cases with medial wall fracture and loose bone fragments are removed with reposition of orbit tissue. Transantral approach was applied in cases with inferior wall fractures. Loose bone fragments were replaced with autogenic bone or fascia graft, or synthetic material--bone cement. RESULTS: Complete or partial recovery was achieved in 91% of cases. Only in 2 cases (9%) recovery was not obtained after surgery--in these cases treatment started later then 60 days after fracture. CONCLUSIONS: In our opinion the optimal results of surgery may be achieved when treatment is begining before 14 day after fracture. If the later treatment is applied the worse results are achieved. Most of the cases must had been completed by rehabilitation after surgery.

• [Sphenoid sinusitis]

  Authors: Dariusz Babiński, Wojciech Brzoznowski, Andrzej Skorek, Anna Ostrowska, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):452-7.

  INTRODUCTION: Isolated sphenoid sinusitis is being diagnosed quite rare and it is caused by uncharacteristic evidences. Acute sphenoid sinusitis is usually diagnosed when intracranial complicationsINTRODUCTION: Isolated sphenoid sinusitis is being diagnosed quite rare and it is caused by uncharacteristic evidences. Acute sphenoid sinusitis is usually diagnosed when intracranial complications are seen. MATERIAL AND METHODS: 11 cases aged 8-74 years hospitalized between 1999-2005 are retrospective analyzed. Diagnosis of isolated sphenoid sinusitis was made after ENT and radiological examination. RESULTS: The most common evidence (10/11 cases) was headache, they last 1 week-1 year, in 1 case 30 years. Acute inflammation was diagnosed in 2 cases and in all intracranial complication was developed. Meningitis, temporal lobe abscesses, orbital cellulitis and paresis of CN VI in case of 11 years old girl and in other case of 37 years old man aseptic meningitis developed. Chronic sinusitis was diagnosed in 6 cases and in other 3 mucocele was present. Progressive atrophy of CN II was the only complain in case of 8 years boy, in rest of cases of chronic sinusitis headache was the only complain. External approach sphenoidotomy in 3 cases and endoscopic approach in 8 cases was managed. CONCLUSIONS: Isolated sphenoid sinusitis was usually diagnosed when neurological or ophthalmologic evidences were being evaluated. Surgical treatment is indicated in chronic sinusitis and in cases with no recovery after i.v. antibiotic course or when complication develops. Complications of isolated sphenoid sinusitis often anticipate rhinologic evidences that can be absent.

• [Sensorineural hearing loss as a consequence of carbon monoxide intoxication]

  Authors: Wojciech Skrzypczak, Katarzyna Gałecka, Andrzej Skorek

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):479-83.

  The authors describe the case of acute carbon monoxide intoxication in a 19 year old female patient, which caused, among other symptoms, bilateral sensorineural hearing loss. The symptoms, diagnosticThe authors describe the case of acute carbon monoxide intoxication in a 19 year old female patient, which caused, among other symptoms, bilateral sensorineural hearing loss. The symptoms, diagnostic methods and treatment with a particular regard to audiological examination were presented. Pathomechanism of carbon monoxide intoxication was also discussed. Despite the treatment, the effects of therapy have not been satisfactory.

• [Noninvasive fungal sinusitis (fungus ball)--diagnostic difficulties]

  Authors: Dariusz Babiński, Waldemar Narozny, Andrzej Skorek, Robert Rzepko, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):694-7.

  Noninvasive fungal sinusitis (fungus ball) is usually found in one sinus and the most frequently is caused by Aspergillus. Diagnostic criteria are based on histopathology, and fungal cultures areNoninvasive fungal sinusitis (fungus ball) is usually found in one sinus and the most frequently is caused by Aspergillus. Diagnostic criteria are based on histopathology, and fungal cultures are frequently negative. The clinical symptomatology mimics chronic rhinosinusitis and radiology, specially CT and MRI are helpful for making decision of surgery. The authors present 4 cases of fungus ball of the paranasal sinus. In one case clinical symptoms, endoscopic examination of nasal cavity and CT scans suggested foreign body in the maxillary sinus. In other case clinical and radiological evidences made us to thing of neoplasmatic disease of the frontal sinus. In remaining two cases mycetoma was found in the sphenoid sinus. Surgical removal was the treatment in all cases and followed by systemic antifungal therapy in one case because of bone destruction. Histopathology revealed hyphae of Aspergillus without evidence of tissue invasion, fungal cultures in two cases were negative, an in other two Aspergillus fumigatus culture were obtained.

• [Malignant tumors of the nose and paranasal sinuses in the years 1992-2001]

  Authors: Stanisław Betlejewski, Robert Bilewicz, Czesław Stankiewicz, Andrzej Skorek, Tatiana Gierek, Piotr Wardas, Wiesław Gołqbek, Marcin Szymański, Maciej Gryczyński, Zygmunt Szmeja, Witold Szyfter, Ewa Osuch-Wójcikiewicz, Oksana Korolkowa, Dariusz Jurkiewicz, Dagmara Kenig, Lucyna Pośpiech, Krzysztof Preś, Grzegorz Namysłowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(5):729-36.

  On the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment ofOn the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment of basic epidemiological data, including the localization of tumor, and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 10 years the trends to change the mentioned above parameters has been examined. The index of morbidity in this period was constant and compareable with figures published earlier. In the analyzed material there is a predominance of males and the sex ratio was 1.45. The majority of cases were between 50-69 years (55%).The most common histopathological diagnosis was carcinoma (58%).The majority of cases of malignant tumors of the nose and paranasal sinuses was diagnosed in the advanced stage T3-T4 (72.3%) with the highest percentage in the middle region. 90% of all cases were treated surgically, but in about 30% it was the only treatment (also in cases of stage T2-T4). In 56% of all patients the surgical procedure was completed by radiotherapy. This data suggest that indications for additional irradiation should be extended.

• Cerebellopontine angle tumours: radiologic-pathologic correlation and diagnostic difficulties.

  Authors: Ewa Izycka-Swieszewska, Edyta Szurowska, Wojciech Kloc, Robert Rzepko, Mirosława Dubaniewicz-Wybieralska, Andrzej Skorek, Elzbieta Drozyńska, Mirosław Stempniewicz

  Folia neuropathologica / Association of Polish Neuropathologists and Medical Research Centre, Polish Academy of Sciences. 02/2006; 44(4):274-81.

  A group of 119 cases of cerebellopontine angle (CPA) tumours was studied looking at the pathological composition, relative incidence of tumour types, their radiological features and theA group of 119 cases of cerebellopontine angle (CPA) tumours was studied looking at the pathological composition, relative incidence of tumour types, their radiological features and the pathological-radiological correlations. Tumours with preoperative radiological diagnosis and verified pathologically were analyzed. Histopathologically the material consisted of 77 schwannomas and 42 non-acoustic tumours. Radiological retrospective evaluation of CT and/or MRI documentation was performed in 84 patients. The tumours were classified according to Koos's staging scale. Diagnostic discrepancies (histopathological vs radiological) according to the clinical stage of CPA tumours were analyzed. In our series non-acoustic tumours made up 37% of CPA lesions. Sharp tumour-pyramis angle and intracanalicular fraction are not exclusive features of schwannomas. Tumours in stage IV are the most heterogeneous and diagnostically difficult group.

• [Renal cell carcinoma metastases to the head and neck]

  Authors: Dominik Stodulski, Czesław Stankiewicz, Andrzej Skorek

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(6):893-9.

  INTRODUCTION: The kidney is the third primary infraclavicular localization of malignant neoplasms metastasizing to the head and neck. The objective of this paper is to analyze the clinicalINTRODUCTION: The kidney is the third primary infraclavicular localization of malignant neoplasms metastasizing to the head and neck. The objective of this paper is to analyze the clinical presentation, diagnostic difficulties, management and outcome of metastatic renal cell carcinoma to the head and neck. MATERIAL AND METHODS: Retrospective review of four patients with renal cell carcinoma who have developed head and neck metastases and have been hospitalized in the ENT Department of the Medical University of Gdansk over the past 35 years. RESULTS: There were three women and one man in the examined material. The localizations of metastasizing renal cell carcinoma were: the larynx, the parotid gland, the cervical lymphnodes and the nasopharynx. In two patients metastatic tumor was the first clinical presentation of the disease and in the next two, time between treatment of the primary localization and occurring head and neck metastases was one and ten years. All patients, except one, were treated surgically. Two patients died, two are alive and the survival periods are one and three years. CONCLUSIONS: Renal cell carcinoma metastases to the head and neck region are infrequent but can cause difficulties in diagnosis and proper management. Despite of possibility of local excision, prognosis in metastasizing renal cell carcinoma is still unfavourable.

• [Chronic maxillary atelectasis (silent sinus syndrome)]

  Authors: Dariusz Babiński, Andrzej Skorek, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(6):929-33.

  INTRODUCTION: We discuss 3 cases with chronic maxillary atelectasis presenting as enophthalmos without any particular evidences of sinus pathology. MATERIAL AND METHODS: We report clinical featuresINTRODUCTION: We discuss 3 cases with chronic maxillary atelectasis presenting as enophthalmos without any particular evidences of sinus pathology. MATERIAL AND METHODS: We report clinical features and imaging data of sinus atelectasis in 2 men and 1 woman, 20-39 years old. Only 1 patient complained of diplopia, in 2 patients we found allergic rhinitis, in 2 cases septal deviation. Hertel enophthalmometry demonstrated enophthalmos 1-4 mm. Evidences have lasted for 2-6 months. CT scans revealed unilateral complete antral opacification, inward bowing of the antral medial and postero-lateral walls and collapse of orbital floor. RESULTS: Three patients with enophthalmos and asymptomatic maxillary sinus disease were identified. All patients underwent successful functional endoscopic sinus surgery with endoscopic maxillary antrostomy and in one case anterior ethmoidectomy. Additionally septoplasty was performed in two cases. We did not need to repair orbital floor in any case. Patient with diplopia achieved spontaneous return of orbital floor to almost normal position with enophthalmos -1 mm and all three were asymptomatic. Intrasinus manometry was performed in one case and confirmed the presence of negative pressure (-2,8 cm H2O). CONCLUSION: Chronic maxillary atelectasis presenting as enophthalmos is a rare evidence and sinus component of the disease mostly remains asymptomatic. The most effective treatment is endoscopic maxillary antrostomy.

• [Fibrous dysplasia in 8 year old child. Case report]

  Authors: Andrzej Skorek, Czesław Stankiewicz, Dariusz Babiński, Ewa Izycka-Swieszewska

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(1):75-8.

  The authors described fibrous dysplasia in 8 years old boy with inferior orbit wall destruction and with penetration of the lesion inside the orbit. Surgery with facial degloving approach wasThe authors described fibrous dysplasia in 8 years old boy with inferior orbit wall destruction and with penetration of the lesion inside the orbit. Surgery with facial degloving approach was performed. Well therapeutic and cosmetic outcome was achieved. Usefulness of imaging data, especially CT, in diagnostic procedure was stressed. The review of contemporary literature on fibrous dysplasia was discussed.

• [History of treatment and classification of maxillary sinus neoplasms].

  Authors: Andrzej Skorek

  Otolaryngologia polska. The Polish otolaryngology. 01/2005; 59(5):771-6.

  History of treatment of maxillary malignant neoplasms goes back to the middle of 19th century, when Gensoul and Lizzard performed their first maxillectomy. However the development of maxillar surgeryHistory of treatment of maxillary malignant neoplasms goes back to the middle of 19th century, when Gensoul and Lizzard performed their first maxillectomy. However the development of maxillar surgery is connected with achivements of Moure, who as the first one characterized and applied innovative skin cut on the face. Author presents the history of other surgical procedures in therapy of maxillary tumors and describes methods which are apply nowaday. Attention is paid to the Polish contributions and accomplishments in diagnostics and treatment of tumors localized in this area. The classification of maxillary tumors from Sebileau dissertation till the newest TNM classification from 2001 is described.

• [Severe regional and distant complication of tonsillitis. Case report]

  Authors: Andrzej Skorek, Dominik Stodulski, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(5):999-1003.

  The authors describe a 66-year-old male patient treated for angina that was complicated by para- and retropharyngeal phlegmon, mediastinitis and pleuropneumonia. The role of imaging procedures andThe authors describe a 66-year-old male patient treated for angina that was complicated by para- and retropharyngeal phlegmon, mediastinitis and pleuropneumonia. The role of imaging procedures and bacteriological examination was found especially important in establishing the diagnosis and introducing the right treatment. Efficacy of external (transcutaneus) approach to the para- and retropharyngeal space and phlegmon drainage of these spaces preceded with tracheotomy and tonsillectomy was underlined. Surgical treatment was supplemented with multi-component antibiotic therapy and gammaglobulin administration.

• [Calcification of the auricular cartilages--case report]

  Authors: Katarzyna Poławska, Andrzej Skorek, Józef Stromkowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(3):619-21.

  Calcification of the auricular cartilages is a very rare disease. Its etiology remains unclear. It may be caused by trauma of cartilage, for example during acupuncture. Sometimes, as reported inCalcification of the auricular cartilages is a very rare disease. Its etiology remains unclear. It may be caused by trauma of cartilage, for example during acupuncture. Sometimes, as reported in literature, calcification of the auricular cartilages is observed in metabolic disorders like Addison disease, adrenal insufficiency or diabetes. The authors present a case of auricular calcification, probably as a result of previous acupuncture.

• [Long-term results of treatment of malignant maxillary neoplasms]

  Authors: Andrzej Skorek

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(5):769-70.

• [Pleomorphic adenoma of minor salivary glands]

  Authors: Piotr Cwalina, Andrzej Skorek, Waldemar Narozny, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2002; 56(6):737-40.

  Pleomorphic adenoma, a benign tumor often seen in ENT practice, arises either from minor as well from major salivary glands. 5-14% of tumors occur in minor glands. Sixteen cases of minor salivaryPleomorphic adenoma, a benign tumor often seen in ENT practice, arises either from minor as well from major salivary glands. 5-14% of tumors occur in minor glands. Sixteen cases of minor salivary gland pleomorphic adenomas are studied. Eight of them originate from the oral cavity: 6 from the palate, one from the lower lip and one from the cheek. Two oral adenomas were malignant. In 4 patients tumors occur in the nasal cavity and in two other patients--in the neck. The clinical and pathological features of these patients are presented. Special attention is given to malignant transformation and the rate of recurrence of the tumors.

• [Malignant Triton tumor of the nose--case report]

  Authors: Małgorzata Potocka, Andrzej Skorek, Ewa Izycka-Swieszewska

  Otolaryngologia polska. The Polish otolaryngology. 63(2):165-7.

  Malignant Triton tumor (MTT) is classified as a variant of a malignant peripherial nerve sheath tumor with a focal rhabdomyosarcomatous differentiation. Nearly one third of described MTTs wereMalignant Triton tumor (MTT) is classified as a variant of a malignant peripherial nerve sheath tumor with a focal rhabdomyosarcomatous differentiation. Nearly one third of described MTTs were located at the head and neck region. In following paper we described a case of MTT of the external nose in a 24 year old man. The tumor was totally exised surgically with the broad margins. Histopathological diagnosis of the tumor was made on the surgical specimen, based on immunohistochemical analysis. Radiation therapy as the next step of treatment of choice was performed in presented case.

• [A case of maxillary sinus carcinoma of a 24-year-old man, holistic aspects of care].

  Authors: Krzysztof Kicińiski, Andrzej Skorek, Czesław Stankiewicz, Grazyna Kobierska-Gulida

  Otolaryngologia polska. The Polish otolaryngology. 65(2):122-7.

  The aim of this study is to report a carcinoma affecting the maxillary sinus of a 24-years old man. Malignant tumors of the nasal cavity and paranasal sinuses are rare and a very heterogeneous groupThe aim of this study is to report a carcinoma affecting the maxillary sinus of a 24-years old man. Malignant tumors of the nasal cavity and paranasal sinuses are rare and a very heterogeneous group of tumors. The most common is a squamous cell carcinoma. Sinonasal malignances usually present as a difficult diagnostic and therapeutic problem. The treatment depended on location, extension and histology of the tumor, clinical condition and the patient desire. It consisted of surgery, RT, surgery and postoperatory R, and concurrent QT and RT. The treatment should be assessed individually for each patient. The treatment of patients with paranasal neoplasms requires a multidisciplinary cooperation. High quality care requires the preparation of a team of professionals dedicated to their work. We observe generally human trends to restore well being in difficult situation. Patients transform the information about them or change the values system. Psychooncological help in this field reinforces natural mechanism of restoring well being, increasing positive emotions and patient's own activity.

• [Orbital decompression for thyroid orbitopathy].

  Authors: Dariusz Babiński, Andrzej Skorek, Adam Nałęcz, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 65(4):262-5.

  Thyroid orbitopathy may result in significant proptosis that causes visual lost. Besides pharmacologic and radiotherapeutic procedures surgically decompression of the orbital skeleton occasionally isThyroid orbitopathy may result in significant proptosis that causes visual lost. Besides pharmacologic and radiotherapeutic procedures surgically decompression of the orbital skeleton occasionally is managed. We present series of 3 patients (5 procedures) who underwent orbital decompressions. The preoperative proptosis ranged from 22 to 31mm. Decompression was performed by an external Walsh-Ogura approach in 3 orbits and in 2 by an endoscopic approach. The reduction in proptosis was 4-6mm in external approach cases and 4-5mm in endoscopic procedures. Diplopia was noted in 2 patients preoperatively, and no one had new postoperative diplopia. Surgical orbital decompression is occasionally necessary procedure or visual lost rescue in thyroid orbitopathy and in cases of diplopia can not improve muscular function. Endoscopic surgery is a safe and effective management in moderate proptosis. Autoimmunologic inflammatory changes in nasal mucosa do not increase postoperative complication risk.

• [Intracranial mucocele of the frontal sinus].

  Authors: Dariusz Babiński, Andrzej Skorek, Czesław Stankiewicz, Wojciech Wasilewski, Wojciech Kloc

  Otolaryngologia polska. The Polish otolaryngology. 65(1):62-5.

  We discuss a case of 49-year-old man admitted to our Department with headache and tumor of frontal region since 3 months. We report clinical features and imaging data of mucocele of frontal sinusWe discuss a case of 49-year-old man admitted to our Department with headache and tumor of frontal region since 3 months. We report clinical features and imaging data of mucocele of frontal sinus that penetrates into cranial cavity. The mucocele had damaged anterior and posterior walls of frontal sinus with intracranial penetration. There was intact dura of anterior fosse. External approach with coronal incision was performed, mucocele was evacuated and mucosa was removed. Then frontal sinus was cranialized with reconstruction of anterior wall and finally wide nasal drainage was performed. Intracranial mucocele of the frontal sinus is rere evidence. The key difficulties may be related to dura preservation and reconstruction of anterior wall of frontal sinus.