Jan Kulisiewicz

Publications (3)0.91 Total impact

• Article: Perioperative antibiotic in adenoidectomy with partial tonsillectomy: a randomized trial.

  Olaf Zagólski, Jan Kulisiewicz
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  ABSTRACT: To examine potential benefits of perioperative antibiotic therapy in children undergoing adenotonsillotomy. Adenoidectomy with tonsillotomy was performed in 124 children with obstructive symptoms, aged 5-7 years. Of these, 120 completed the study. Intraoperative intravenous and postoperative oral clindamycin, or placebo for 7 days, were administered. There were significant differences between the groups regarding pain intensity (p < 0.001) and duration (p < 0.05), day of return to normal physical activity (p < 0.05), occurrence and duration of oral malodor (p < 0.001), number of doses of additional analgesic (p < 0.001), healing grading (p < 0.05) and parents'/caregivers' satisfaction scores on the 4th postoperative day. There were indications for antibiotic in 2 individuals in the placebo group. There are significant differences in the course of convalescence related to perioperative antibiotic in children after adenotonsillotomy, but strict indications for antibiotics in these patients are rare.
  ORL 03/2012; 74(2):86-92. · 0.91 Impact Factor
• Article: [Sinonasal haemangiopericytoma of the nasal septum removed under endoscopic guidance].

  Olaf Zagólski, Jan Kulisiewicz, Jerzy Kekuś, Krzysztof Czajecki
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  ABSTRACT: Haemangiopericytomas originate in extravascular cells (pericytes). They are well-differentiated tumours with low potential for local recurrence or metastasis. The most common presenting symptoms are nasal obstruction and recurrent epistaxis. Differential diagnosis requires immunohistochemical staining. Treatment consists in wide surgical excision. Case report a 44-years old male turned up with symptoms of right-sided nasal obstruction and epistaxis. A reddish, tough tumour 10 mm in diameter was diagnosed, covered with unchanged mucous membrane with small ulceration 3 mm in diameter, growing in the nasal septum. The tumour was dissected from unchanged septal cartilage and removed under endoscopic guidance. Histopathological examination disclosed prolonged, multiangular cells, with no mitotic activity. Focal faint expression of actin was confirmed, while the tumour cells were negative for CD34, CD31, GFAP, EMA, CK and S-100. Endothelial cells were positive for CD31 and CD34. Epithelial cells were positive for EMA and CK. The results of differential diagnosis were consistent with the diagnosis of sinonasal haemongiopericytoma. The patient has been asymptomatic for 6 months. Conclusion. Transnasal endoscopic approach to the discussed sinonasal haemangiopericytoma located on the nasal septum allowed its optimal visualisation and removal with macroscopically sufficient margins.
  Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 05/2006; 20(118):445-7.
• Article: [Treatment of pain in patients after tonsillectomy].

  Olaf Zagólski, Jan Kulisiewicz, Marek Bernaś, Jerzy Kekuś
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  ABSTRACT: The aim of the study was to evaluate post-operative pain in patients after tonsillectomy, treated with non-steroid anti-inflammatory and opioid drugs. A group of 57 patients aged from 16 to 53 years was examined. 32 of them were treated with ketoprofen (Ketonal, Lek) in a dose 100 mg, 3 times a day and the remaining 25 with tramadol hydrochloride (Tramal) in daily doses 150-200 mg. The numerical 0 to 10 (VAS) and 6-grade verbal scales were used to assess pain intensity. Pain intensity was highest 3-4 days after tonsillectomy. The scores below 5 points (VAS) were noted by 65% of patients treated with ketoprofen and 90% of patients treated with tramadol after the first 24 postoperative hours. The pain reacted relatively well to oral analgesics and did not require prolonged hospitalisation. A double mechanism of reducing pain by tramadol--central and spinal--may be more effective in patients after tonsillectomy than ketoprofen that blocks production of arachidonic acid cascade. In the course of the first few postoperative days, inflammation is aggravated due to infection of the wound in the throat and the latter mechanism alone may be insufficient. Effectiveness of either ketoprofen or tramadol in treatment of post-tonsillectomy pain is good but better in the case of tramadol. Patients must be informed in advance about a possibility of more intense pain a few days after tonsillectomy, in order to avoid unjustified fear.
  Przegla̧d lekarski 02/2006; 63(12):1273-5.