Robert Przeklasa

Publications of Robert Przeklasa

• [Applicability of artificial neural networks in postoperative hearing improvement prognosis in patients with chronic otitis media].

  Authors: Joanna Szaleniec, Maciej Wiatr, Maciej Szaleniec, Jacek Składzien, Jerzy Tomik, Paweł Strek, Ryszard Tadeusiewicz, Robert Przeklasa

  Przegla̧d lekarski. 01/2009; 66(11):924-9.

  The primary objective of surgical treatment of chronic otitis media is to remove the pathological changes and restore the biology of the middle ear. Subsequently, ossicular chain reconstruction isThe primary objective of surgical treatment of chronic otitis media is to remove the pathological changes and restore the biology of the middle ear. Subsequently, ossicular chain reconstruction is performed in order to restore hearing. The aim of the study was to evaluate the efficacy of mathematical models (artificial neural networks) in postoperative hearing improvement prognosis. The models based on preoperative anamnesis and data concerning the operative procedure. The analyzed group comprised of 135 patients operated for chronic otitis media in the Department of Otolaryngology CM UJ in Krakow. The measure of postoperative hearing improvement was cochlear reserve (air-bone gap) closure depending on the type of ossicular chain reconstruction. The artificial neural networks provided 100% correct predictions basing on preoperative clinical examination, pathological changes found in the middle ear and description of the surgical procedure. The study proves that artificial neural networks are effective in functional result prognosis in tympanoplastic surgery.

• [Defects of facial nerve canal according to a character and localisation of lesions in middle ear].

  Authors: Karolina Hydzik-Sobocińska, Maciej Wiatr, Zbigniew Baran, Jacek Składzień, Jerzy Tomik, Agnieszka Morawska, Robert Przeklasa

  Przegla̧d lekarski. 01/2009; 66(11):930-2.

  The aim of this study is the assessment the occurence of facial nerve canal (Fallopian canal) dehiscence in patients operated due to chronic medial otitis (depending on the location and type ofThe aim of this study is the assessment the occurence of facial nerve canal (Fallopian canal) dehiscence in patients operated due to chronic medial otitis (depending on the location and type of inflammatory lesions) and in patients operated due to otosclerosis. Facial nerve paresis in patients with dehiscence found during surgery was also assessed. The study group consisted of 456 patients operated at the Department of Otolaryngology at the University Hospital in Krakow, 359 due to chronic otitis media and 97 due to otosclerosis. Facial nerve canal dehiscence was found during surgery in 26 patients (6% of operated patients) more frequently in men. In most cases (54%) dehiscence was observed in patients with chronic medial otitis with cholesteatoma (27% with choleseatoma and 27% with cholestatoma and granulation), and equally (23% each) dehiscences were observed in patients with granulation and even in patients with otosclerosis and chronic simple otitis media. In over than half (54%) of patients with dehiscence inflammatory lesions involved all the middle ear spaces, in 15% the tympanic cavity, attic and antrum while in 4% of patients inflammatory lesions were limited to the tympanic cavity, attic or antrum. The facial canal nerve dehiscence is observed in majority in patients with cholestatoma and granulation, especially in tympanic region. In some cases its coexistence with circuit canals dehiscence.

• [Necessity of chorda tympani cutting from data collected at Department of Otolaryngology at the Collegium Medicum of the Jagiellonian University].

  Authors: Maciej Wiatr, Jacek Składzień, Jerzy Tomik, Robert Przeklasa, Krzysztof Oleś, Jolanta Gawlik

  Przegla̧d lekarski. 01/2009; 66(11):933-6.

  Chorda tympani nerve is a branch of the facial nerve which enables perception of taste of 2/3 anterior part of tongue and it is responsible for unilateral parasymphatetic nerve supplying of theChorda tympani nerve is a branch of the facial nerve which enables perception of taste of 2/3 anterior part of tongue and it is responsible for unilateral parasymphatetic nerve supplying of the submandibular and sublinqual salivary glands. Prospective analysis of patients operated on middle ear in ENT Department Jagiellonian University of Krakow between 2004-2008 was performed. Nearly 650 operations were done in that period of time. Chorda tympani nerve was cut in 96 individuals. Most of them were treated for chronic otitis media. When chorda tympani nerve was cut--the majority of cases did not complain of dysgeusia. Disturbance of taste was observed in ca. 2% of patients but it was transitory. The subject experienced sour/metallic taste. Taste disturbance following unilateral injury to the chorda tympani nerve was usually the most intense in the first few weeks and improves with time.

• [Olfactory neuroblastoma removed under endoscopic guidance]

  Authors: Paweł Strek, Olaf Zagólski, Jacek Składzień, Robert Przeklasa, Joanna Blaschke, Magdalena Białas, Andrzej Urbanik

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(3):433-6.

  INTRODUCTION: Olfactory neuroblastoma is a rare tumour associated with high rates of recurrence and mortality. Treatment includes surgery, radiotherapy, chemotherapy, or a combination. The idealINTRODUCTION: Olfactory neuroblastoma is a rare tumour associated with high rates of recurrence and mortality. Treatment includes surgery, radiotherapy, chemotherapy, or a combination. The ideal treatment modality has yet to be determined. MATERIAL AND METHODS: 46-years old male underwent bilateral endoscopic ethmoidectomy due to chronic sinusitis. During surgery, a 5 mm in diameter tumour was identified in the left superior nasal meatus. On histopathological examination the diagnosis of esthesioneuroblastoma was established and confirmed by immunohistochemistry. The tumour was classified according to Kadish as stage A, according to Biller as T1. MR scans performed two months later disclosed pathological tissues in the left ethmoid region. RESULTS: Multiple biopsies taken on subsequent frontosphenoethmoidectomy did not contain tumour cells. The patient declined radiotherapy. He has been asymptomatic over the 12 monthsí follow-up period. CONCLUSIONS: The exclusively surgical treatment proved effective due to early stage of the tumour and no evidence of infiltration of the frontal skull base. This strategy, however, requires frequent follow-up visits.

• [Bezold's abscess: a rare complication of otitis media]

  Authors: Andrzej Steczko, Robert Przeklasa, Jacek Składzień, Marian Kurzyński

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(4):581-6.

  The authors present the case of a 21-year-old female in who, during the course of cholesteatoma, extracranial complications occurred twice in the form of Bezold's abscess. This type of theThe authors present the case of a 21-year-old female in who, during the course of cholesteatoma, extracranial complications occurred twice in the form of Bezold's abscess. This type of the complication of otitis media occurs extremely rare. Medical literature has recorded about 20 cases of such complications. Due to commonly applied antibiotic therapies, extracranial and intracranial complications are rarely recorded in the course of otitis media, their mortality rate, however, amounts to a dozen or so per cent. The paper presents the way in witch the infection of otitis media spreads towards the neck. The authors stress the significance of computer tomography in diagnostic. Radical mastoidectomy and exploration of the neck were performed on the patient. Antibiotic regimens were based on antimicrobial sensitivity patterns. Presently, the patients is under constant laryngologist observation.

• [Prognostic factors in patients operated on eardrum perforation with intact ossicular chain].

  Authors: Maciej Wiatr, Krzysztof Oleś, Jerzy Tomik, Jacek Składzień, Agnieszka Morawska, Paweł Stręk, Robert Przeklasa, Karolina Hydzik-Sobocińska, Joanna Szaleniec, Aleksandra Boroń, Aneta Pałasz, Patryk Hartwich

  Otolaryngologia polska. The Polish otolaryngology. 65(4):266-71.

  Ear drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. This paper is intended to evaluate effectiveness ofEar drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. This paper is intended to evaluate effectiveness of tympanic membrane reconstruction and indicate factors which have an influence on hearing improvement after myringoplasty. Analysis involves ca. 500 individuals operated on ear in Department of Otolaryngology at the Jagiellonian University between 2004 and 2009. 120 individuals were operated on for the first time due to chronic otitis media with intact ossicular chain. Statistically significant heating improvement was observed in patients with discharge, without discharge and in group with scars. The presence of granulation changes is an unfavorable prognostic condition in the patients with ear drum perforation. In clinical practice, the criterion which often determines the application of either of the materials in myringoplasty are operator's preferences, as well as the availability of given material for transplanting.

• [Neurothekeoma of the orbit].

  Authors: Sebastian Gajec, Jacek Składzień, Robert Przeklasa, Jerzy Tomik, Jacek Czopek

  Otolaryngologia polska. The Polish otolaryngology. 65(1):54-8.

  The aim of this study was to present a rare benign tumour of neural origin located in the orbit. Authors describe case of six-year-old boy with tumour of the right orbit, upper eyelid and rightThe aim of this study was to present a rare benign tumour of neural origin located in the orbit. Authors describe case of six-year-old boy with tumour of the right orbit, upper eyelid and right zygomatic fossa. Medical history revealed gradually increasing in size, painless tumour. Before admission to the hospital computed tomography was taken to assess the size, localization of the tumour and to plan the proper treatment. The patient was operated on using Krönlein approach. Tumour was removed in macroscopically radical limits without need to incise the muscles responsible for eye movement. Histopathological examination revealed: Neurothekeoma, classic type. During one year follow-up there was no recurrence. Neurothekeoma may occur in young boys in eyelid and orbit. A unique localization of neurothekeoma in the orbit, close to the lacrimal gland shows that this kind of histopatological tumours may infiltrate deeper tissues. Surgical treatment of neurothekeoma is the same as in other benign tumours.

• [Reoperations in patients with chronic otitis media cholesteatomatosa].

  Authors: Maciej Wiatr, Karolina Hydzik-Sobocińska, Agnieszka Morawska, Jacek Składzień, Jerzy Tomik, Robert Przeklasa, Krzysztof Oleś, Adam Miodoński

  Otolaryngologia polska. The Polish otolaryngology. 64(5):313-7.

  Chronic cholesteatoma otitis media, apart from destruction of bones and possibility of otogenous complications, is characterized by possibility of recurrence of the disease after non radicalChronic cholesteatoma otitis media, apart from destruction of bones and possibility of otogenous complications, is characterized by possibility of recurrence of the disease after non radical treatment or presence of risk factors. This paper intends to analyze changes typical for cholesteatoma, observed during otosurgery including the results of bacteriological investigations. Nearly 450 otosurgeries were performed in Department of Otolaryngology at Jagiellonian University 2004-2007. Analysis refers to patients reoperated on chronic cholesteatoma otitis media. 47 reoperations in the course of chronic choleateatoma otitis media were performed. Bacteriological analysis was provided in 21 cases. The most common bacteria were Staphylococcus aureus and Pseudomonas aeruginosa. Biofilms were not observed in specimens. The recurrence of the process should be expected in patients with cholesteatoma. They require regular, periodical follow-up examination.