Jarosław Miłoński

Publications of Jarosław Miłoński

• The comparison of the influence of various types of anaesthesia on perioperative bleeding control in endoscopic paranasal sinus surgery.

  Authors: Jarosław Miłoński, Hanna Zielińska-Bliźniewska, Rafał Sobański, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 03/2012; 66(2):122-125.

• [Analysis of histopathological evaluation of pathological lesions removed by endoscopic surgery of the nose and paranasal sinuses in the own material].

  Authors: Jarosław Miłoński, Hanna Zielińska-Bliźniewska, Piotr Pietkiewicz, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 11/2011; 65(6):447-50.

  The work aimed at evaluating results of histopathological examination of postoperative material in endoscopic paranasal sinus surgery in the own material. The analysis covered 3,896 results ofThe work aimed at evaluating results of histopathological examination of postoperative material in endoscopic paranasal sinus surgery in the own material. The analysis covered 3,896 results of histopathological examination of routine postoperative material from the Department of Clinical Pathomorphology and Cytopathology Military Medical Academy University Clinical Hospital in Lodz. The study was conducted in hematoxylin and eosin staining according to the principles of this method. The postoperative material included pathological lesions removed by endoscopic surgery of the nose and paranasal sinuses in patients who were treated at Department of Otolaryngology and Laryngological Oncology between 2006 and 2010. The treatment included 1,118 patients, 509 women at the age of 15–79 and 609 men aged 17–77. The material for histopathological examination was sent from merely 1,176 operations because 57 patients were operated twice and one patient was operated three times. Polyps within the nose and paranasal sinuses were confirmed by histopathological examination in 705 patients, including 289 women and 416 men. Hypertrophic changes were diagnosed in 404 patients, including 218 women and 186 men. Inverted papilloma was recognised in histopathological examination in 9 patients, including 2 women and 7 men. Hypertrophies were slightly more common in women than in men. Both in men and women unilateral hypertrophic changes within the ostiomeatal complex were predominant, 42.66% in women and 40.86% in men. Histopathological examination of postoperative material in patients under endoscopic treatment due to paranasal sinusitis is considerably important for complex evaluation of inflammation type and confirmation of indications for appropriate anti-inflammatory therapy.

• [The analysis of mean arterial pressure and heart rate in patients treated with laryngological surgery within pre- and peri- and postoperative periods].

  Authors: Jarosław Miłoński, Joanna Urbaniak, Hanna Zielińska-Bliźniewska, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):357-62.

  This work aimed to analyse the mean arterial blood pressure (MBP) and heart rate (HR) in patients who underwent laryngological surgery within the preoperative, perioperative and postoperativeThis work aimed to analyse the mean arterial blood pressure (MBP) and heart rate (HR) in patients who underwent laryngological surgery within the preoperative, perioperative and postoperative periods. The study covered 502 patients, including 209 women and 293 men, aged 18-85, who were divided into 6 groups according to the type of surgery: I - FESS (Functional Endoscopic Sinus Surgery), II - septoplasty, III - endoscopic re-operation of the paranasal sinuses, IV - microlaryngoscopy, V - tonsillectomy, VI - middle ear surgery. Only the patients with BP below 140/90 mmHg and maximum class 2 in the ASA scale were qualified for the surgical procedure. On admission, the arterial blood pressure was measured and diagnostic investigations like FBC, blood grouping determination, coagulogram, ESR, CRP and imaging studies were performed in each patient. Every operation was conducted under TIVA. BT and HR were monitored during an operation as well as through the four following hours in a recovery room. The youngest group of patients with chronic palatine tonsillitis showed the lowest pressure values while the oldest studied group consisted of patients who were operated due to chronic otitis media and this group demonstrated the highest BP values. The patients with treated or untreated hypertension should be pharmacologically normalised by an anaesthesiologist. However, considerable lowering of BP can often be not possible, contrary to the patients with normal BP. The own experience indicates that perioperative lowering of BP, including hypotension, ought to be avoided in cardiology patients. The postoperative BP raise, usually accompanied by pain, was noticed in the own studies. Therefore, effective analgesic treatment should be implemented in a recovery room.

• [The use of VHIT (videonystagmography head impulse test) in the diagnostics of semicircular canal injuries].

  Authors: Jurek Olszewski, Piotr Pietkiewicz, Jarosław Miłoński, Marzena Bielińska

  Otolaryngologia polska. The Polish otolaryngology. 06/2010; 64(7):32-5.

  The aim of that work was to evaluate the usefulness of VHIT (Videonystagmography Head Impulse Test) in the diagnostics of injuries to the semicircular canals. The tests covered 58 patients agedThe aim of that work was to evaluate the usefulness of VHIT (Videonystagmography Head Impulse Test) in the diagnostics of injuries to the semicircular canals. The tests covered 58 patients aged 20-27, including 34 women and 24 men. Any deviations within the vestibular organs was excluded in the interview, otorhinolaryngological examination and full videonystagmographic test. The tests checked functions of the semicircular canals in the following way: in a sitting position and the head leaned forward at 30 degrees the patient was looking at a motionless point while quick movements to the left or right were performed to stimulate a particular lateral semicircular canal. When the vertical semicircular canals were tested the head was inclined laterally to the right side at 45 degrees. Then similar movements were performed forwards (stimulation of the left anterior semicircular canal) and backwards (stimulation of the right posterior semicircular canal). When the head was leaned laterally to the left at 45 degrees the right or left anterior semicircular canal was stimulated respectively. Functions of the canal were determined on the basis of gain (%). RESULTS OF THE TESTS: In 58 patients the gain value for particular semicircular canals was normal, and the mean values presented as follows: the lateral semicircular canal: 11.9% +/- 10.2, the anterior semicircular canal: 17.5% +/- 11.6 and the posterior semicircular canal: 19.2% +/- 13.5, whereas on the left side: 10.3% +/- 7.9, 18.1% +/- 11.1, 15.1% +/- 12.3 respectively. In one man the gain value for the right posterior semicircular canal was found significantly above the standard value--71%. VHIT showed much more sensitive than a full videonystagmographic test.

• [Endoscopic treatment of patients with paranasal sinusitis and co-occurring anatomic disorders in nasal patency].

  Authors: Jarosław Miłoński, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 09/2009; 63(7):16-9.

  The aim of the study was to evaluate the frequency of co-occurrence of anatomic disorders within the nasal area in patients suffering from chronic paranasal sinusitis. Between 2006-2008 there wereThe aim of the study was to evaluate the frequency of co-occurrence of anatomic disorders within the nasal area in patients suffering from chronic paranasal sinusitis. Between 2006-2008 there were 446 endoscopic operations performed on patients with chronic paranasal sinusitis. Apart from paranasal sinuses surgeries, 172 patients underwent an additional operation on anatomic deviations within the nasal area. The study group included 98 women and 74 men. First, the nasal septoplasty was performed in a typical way according to the Cottle's principles with the use of endoscope, which was followed by functional endoscopic operations on paranasal sinuses. The middle concha bullosa operations were performed by opening the pneumatisized bony part and removing the lateral part. Among 446 patients who underwent endoscopic treatment due to chronic paranasal sinusitis substantial anatomic disorders were found in 38.6% of the cases qualifying the patients for further surgical procedures. Simultaneously, bilateral plasties of the middle concha bullosa were conducted in 25.1% of the cases whereas 10.3% of the patients underwent lateral operations on the middle concha bullosa. In the studied group the septoplasty was performed in 37.4% of the cases. Rarely unilaterally, with the use of endoscope, we removed spines or ledges from the nasal septum in 19.5% and 7.7% of the cases respectively. Moreover, 14 patients underwent operations on the nasal septum and middle concha bullosa at the same time. The co-occurrence of the spine in the nasal septum and middle concha bullosa was found in 6 operated patients. Bilateral middle concha bullosa and nasal septum ledge were operated three times. The anatomic causes of disorders in nasal patency were frequently found in the studied material. Thus, it proves their substantial part in patomechanism of paranasal sinusitis. Correcting anatomical anomalies ought to be performed simultenously with the operation within the paranasal sinuses. Endoscopically controlled limited septoplasty is a crucial element of complex surgical approach in the paranasal sinusitis.

• [Evaluation results of treatment polyps of nose and paranasales sinuses by endoscopic method]

  Authors: Jurek Olszewski, Jarosław Miłoński

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):400-2.

  INTRODUCTION: This work aimed at the analysis of results of the treatment of nasal and paranasal sinus polyps by the endoscopic method. MATERIAL AND METHODS: The tests were conducted on 142 patients,INTRODUCTION: This work aimed at the analysis of results of the treatment of nasal and paranasal sinus polyps by the endoscopic method. MATERIAL AND METHODS: The tests were conducted on 142 patients, including 75 women and 67 men at the age of 17-68, who underwent the endoscopic surgical treatment due to nasal polyps and paranasal sinus polyps between 2006-2007. In all the patients we conducted functional surgical procedures of the nose and paranasal sinuses by the endoscopic method. In the post-operative treatment we applied the nasal steroid therapy and guided antibiotic therapy. The efficiency of the treatment was assessed 6 months after the procedure. RESULTS: All in all, we conducted 278 polipectomies (163 repolipectomies) of the nose, 278 ethmoidectomies (56 reethmoidectomies), 188 ostium-ductal complex operations, 43 maxillary sinus operations, 21 sphenoid sinus operations and 64 surgical dilatations of the sphenoid sinus ostinum, 49 surgical dilations of the frontal sinuses. In 7 cases the nasal septum operation was conducted simultaneously. Six months following the operation, the endoscopic test showed a correct patency in the ostinum of the paranasal sinuses, sphenoid and frontal sinuses, and no inflammatory traits like reddening, swelling of the nasal mucosa or any pathological secretion. Four times we noticed reddening and swelling of the nasal mucosa, and the mucopurpulent secretion accompanying correct patency of the ostinum in the paranasal sinuses. The control examination carried out 6 months after the surgical treatment showed, according to the patients, the appropriate nasal patency in 93.7%, sensation of the blood flowing down the throat in 20.4%, mucorrhoea in 2.8%, smell impairment in 17.6% and headache in 2.8%. CONCLUSIONS: In the majority of the cases we conducted nasal and paranasal sinus re-operations after the prior traditional procedures, which are still used in many institutions not equipped with endoscopic surgery appliances.

• [The analysis of the bacterial and fungal flora in maxillary sinuses in patients operated due to FESS method]

  Authors: Jurek Olszewski, Jarosław Miłoński

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):458-61.

  INTRODUCTION: The aim of this work was to analyse the bacterial and fungal flora in maxillary sinuses in patients operated due to the FESS method. MATERIAL AND METHODS: Studies were conducted on 110INTRODUCTION: The aim of this work was to analyse the bacterial and fungal flora in maxillary sinuses in patients operated due to the FESS method. MATERIAL AND METHODS: Studies were conducted on 110 patients, including 47 women aged 17-78 and 63 men aged 17-66, who underwent endoscopic surgical procedures due to chronic polypoid maxillary sinusitis between 2006 and 2007. 214 cultures were prepared altogether. During the endoscopic operation on paranasal sinuses, a cannula was introduced along the natural entrance and material for the culture and antibiogram was removed by suction. RESULTS: In the studied material of 214 cultures, 72 (33.6%) cultures obtained positive results, including 2 cases with bacterial and fungal floras present simultaneously (Aspergillus fumigatus and Aspergillus niger) in 38 operated patients. In 25 (34.5%) cultures we noted the presence of Staphylococcus epidermidis, which was sensitive to the following antibiotics: Cotrimoxazole, Rifampicin, Vankomycin, Teicoplanin and Levofloxacin. Staphylococcus epidermidis was isolated in 22 (31.0%) cultures, showing 100% sensitivity to similar antibiotics like the previous one. Another bacteria (Escherichia coli) was cultured in 10 cultures (13.8%), in 70% of the cases every second bacteria was Staphylococcus epidermidis with 100% sensitivity mainly to cephalosporins and aminoglycosides. In 3 cultures (4.17%) we found Klebsiella pneumoniae, with 100% sensitivity to cephalosporins and aminoglycosides and 100% resistance to penicillins. In three cases Pseudomonas fluorescens and Proteus mirabilis (4.17% each) were cultured with their sensitivity and resistance similar to those of Klebsiella pneumoniae. Two cases (2.8% each) in the cultures were noted: Citrobacter freundii, Streptococcus oralis and Hafnia alvei, which were 100% sensitive to some cephalosporins and aminoglycosides whereas their resistance to penicillins and Cefuroxime was as high as 100%. CONCLUSION: In the operated patients suffering from chronic polypoid maxillary sinuses we found 33.6% of positive results in the bacterial flora. This indicates that the changes were accompanied by an acute inflammatory condition, thus surgical procedures had to be followed by a guided antibiotic. The cultured bacteria demonstrated sensitivity to some cephalosporins and aminoglycosides and resistance to penicillins, which proves the abuse of penicillins in the treatment of acute inflammatory states of upper airways.

• [The evaluation of usefullnes of hearing protectors while exposure to impulse noise]

  Authors: Jarosław Miłoński, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):877-9.

  INTRODUCTION: It is generally agreed that impulse noise that occurs mainly in industrial processes, military forces and recreational target practice und hunting is especially hazardous to the ear.INTRODUCTION: It is generally agreed that impulse noise that occurs mainly in industrial processes, military forces and recreational target practice und hunting is especially hazardous to the ear. From the physical point of view the phenomenon is defined as an acoustic pressure disturbance of short duration less than 1 sec and high intensity with the peak sound pressure levels greater than 100 dB SPL. MATERIALS AND METHODS: The study included 80 subjects (160 ears) aged 19-23 with correct tympanic membrane and thresholds measured by pure tone audiometry less than 20 dB. There were divided into two groups: I comprised 40 recruit soldiers put to the shooting training and group II consisted of 40 recruit soldiers using hearing protectors during shooting. Transient evoked otoacoustic emission (TEOAE) measurements were performed by ILO 292 Echoport Otodynamics device 3-5 min before shooting and then 2 min, 1, 2 and 3 hours respectively after shooting in both groups. RESULTS: It was found that the gunshot impulse noise from kbk AKMS rifle caused in group I temporary hearing threshold shift (TTS) for 1, 2, 3, 4 and 5 kHz frequencies of 1.07; 0.96; 1.41; 0.88 and 1.25 dB SPL respectively. TTS turned out to be maximum at 4 and 5 kHz and minimum at 1 and 2 kHz. In group II the soldiers used ear-muffs post-exposure changes were not significant. CONCLUSIONS: Short-term impulse noise generated by the rifle gunshots induced threshold shift of hearing. The usage of hearing protectors should be highly recommended because most of them seem to sufficiently attenuate impulse noise from firearms should be highly recommended because most of them seem to sufficiently attenuate impulse noise from firearms.

• [History of tracheotomy]

  Authors: Jurek Olszewski, Jarosław Miłoński

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(3):349-52.

  The present notion - tracheotomy, originates from the Latin words trachea - windpipe, which comes from the combination of Latin "tracheia" and Greek "arteria" indicating an uneven road, and "tome" -The present notion - tracheotomy, originates from the Latin words trachea - windpipe, which comes from the combination of Latin "tracheia" and Greek "arteria" indicating an uneven road, and "tome" - cut. Procedures of pharyngotomy have a long-lasting history. First similar operations were found on the ancient Egyptian clay tablets dating back to 3600 BC. Mentions of pharyngotomy operations were found in the papyrus called Ebers's Papyrus dating back to about 1550 BC, which can obviously be treated as an encyclopaedia of the medical knowledge that the ancient Egyptians possessed. Guidelines for the person performing pharyngotomy were described in Rig Veda - the holy scriptures of Hindi medicine, about 2000 BC. Asclepiads of Prussia in Bithynia (124-156 BC), a Greek physician practising in Rome, is commonly considered the father of pharyngotomy. In the 1st century BC he documented an operation similar to pharyngotomy. Procedures similar to pharyngotomy were conducted by Claudius Galenus of Pergamon (about 130-200 AD) who was treating gladiators at the beginning of his medical career. A precise description of the technique in pharyngotomy performed by the method adopted from Antilla (3rd century AD) was presented by Paulos Aeginata (625-690 AD), whereas in modern times the first surgical pharyngotomy was performed by Antonio Brasavola (1490-1554) in 1546. In those times pharyngotomy operations were applied as life saving procedures and were associated with a desperate fight for life. The best example is given by Sanctorio Santorius (1561-1636) who pierced the trachea lumen with a trocar. All the experiences connected with the pharyngotomy technique were collected by Lorenz Heister (1683-1758) and published in his work "Surgery" in 1716. Until the end of 18th century the work finally established views about performing pharyngotomy operations. In 1856 Eugeniusz Bonchut conducted the first pharyngotomy in a child with passing an intubation tube into the trachea lumen. The operation was performed according to theoretical assumptions by Armando Trausseau (1801-1867), whose contributions to emergency pharyngotomy methods are enormous. Finally, at the beginning of the 20th century Chevalier Jackson (1865-1958) set principles for surgical techniques in pharyngotomy that still remain in force. The return to Sanctorius's method and also adaptation of Selinger's method (1953) of cannulation of blood vessels turned out to be fundamental for the further development of transdermal pharyngotomy. The first set for multistage, dilatation pharyngotomy was provided by P. Ciaglia et al. in 1985. A one-stage pharyngotomy by special forceps was described by W. M. Griggs et al. in 1990. A technique of transdermal pharyngotomy from inside the trachea was presented in 1995 by A. Fantoni with his group. Modern methods of transdermal pharyngotomy are good complementary techniques for classical methods of pharyngotomy in both emergency and chronic cases.

• Hearing threshold shift measured by otoacoustic emissions after shooting noise exposure in soldiers using hearing protectors.

  Authors: Jurek Olszewski, Jarosław Miłoński, Sławomir Olszewski, Joanna Majak

  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 02/2007; 136(1):78-81.

  OBJECTIVE: The aim of the study was to assess the influence of short-term impulse noise to temporary threshold shift in soldiers using hearing protectors. STUDY DESIGN AND SETTING: The study includedOBJECTIVE: The aim of the study was to assess the influence of short-term impulse noise to temporary threshold shift in soldiers using hearing protectors. STUDY DESIGN AND SETTING: The study included 80 subjects with correct tympanic membrane and thresholds measured by pure-tone audiometry less than 20 dB. There were two groups: 40 soldiers protected during shooting and 40 young males who didn't shoot. TEOAE were performed by ILO 292 Echoport Otodynamics device 3 to 5 minutes before shooting and 2 minutes and 1, 2, and 3 hours after shooting. RESULTS: Short-term exposure to impulse noise generated by five gunshots from the rifle kbk AKMS hasn't induced temporary threshold shift of hearing for chosen frequencies in soldiers using hearing protectors. Spectral analysis for chosen frequencies revealed that measurement reproducibility, stimuli level, and probe stability appeared to be comparable and repeatable. CONCLUSION: Our results show that the use of hearing protectors safeguarded against impulse noise. SIGNIFICANCE: The use of earmuffs is strongly recommended because they seem to sufficiently attenuate shooting noise.

• [Assessment of temporary threshold l shift after short-term impulse noise exposure]

  Authors: Jarosław Miłoński

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(3):451-3.

• [Sarcoidosis limited to the lymph nodes of the neck]

  Authors: Jarosław Miłoński, Jurek Olszewski, Wiesław Konopka, Piotr Pietkiewicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 10/2005; 19(111):438-9.

  A case of isolated neck sarcoidosis is presented. Isolated sarcoidosis confined to the neck lymph node is rare. Sarcoidosis is a systematic disease usually involving pulmonary findings.A case of isolated neck sarcoidosis is presented. Isolated sarcoidosis confined to the neck lymph node is rare. Sarcoidosis is a systematic disease usually involving pulmonary findings. Extrapulmonary involvement including the liver, eyes, lymph nodes, central nervous system, muscles and bones is common. This report documents a very rare case of isolated sarcoidosis of the neck, which is very rare diagnosed by otolaryngologists.

• [Influence of positional blood flow disorders in the vertebral and basilar arteries on the prevalence of vertigo in patients with cervical spondylosis]

  Authors: Joanna Majak, Jurek Olszewski, Jarosław Miłoński, Krzysztof Kuśmierczyk

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 10/2005; 19(111):398-9.

  The aim of present study was to characterize the association between prevalence of vertigo and age, grade of radiological changes and positional vertebral (VA) and basilar artery (BA) flow lesion inThe aim of present study was to characterize the association between prevalence of vertigo and age, grade of radiological changes and positional vertebral (VA) and basilar artery (BA) flow lesion in patients with cervical spondylosis. We examined 80 patients with radiological evidence of cervical spondylosis. Forty patients complained positional vertigo. Patients with neurological symptoms were excluded from the study. ENG was used to exclude patients with another causes of vertigo. TCD evaluations of the distal part of VA and the proximal part of BA were performed with a 2-MHz probe via the suboccipital window. We showed significant and independent association between prevalence of vertigo and age, grade of radiological changes, and positional vertebral and basilar artery flow lesion velocity in multivariate logistic regression model. Spondylotic-induced VA compression may be the reason of decreased blood flow velocity in the basilar artery during head rotation, causing positional vertigo.

• [Rare case of papillary cystic carcinoma of ectopic thyroid gland in glossothyroid ductus]

  Authors: Jurek Olszewski, Krzysztof Zieliński, Jarosław Miłoński, Robert Koktysz

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(3):437-9.

  The neck midline cyst is the most common congenital malformation in the neck area. In described case of 33 years women the diagnosis was established on clinical examination, the results of USG andThe neck midline cyst is the most common congenital malformation in the neck area. In described case of 33 years women the diagnosis was established on clinical examination, the results of USG and the aspiration biopsy. The tumor was surgically excited and the microscopy examination revealed papillary cystic carcinoma of ectopic thyroid gland in glossothyroid ductus. In the every case of neck tumor we have to consider neoplastic process.

• Temporary hearing threshold shift measured by otoacoustic emissions in subjects exposed to short-term impulse noise.

  Authors: Jurek Olszewski, Jarosław Miłoński, Wiesław J Sułkowski, Joanna Majak, Sławomir Olszewski

  International journal of occupational medicine and environmental health. 02/2005; 18(4):375-9.

  OBJECTIVES: The aim of the study was to assess the influence of short-term impulse noise on the size and dynamics of temporary threshold shift, which precedes permanent threshold shift, i.e.OBJECTIVES: The aim of the study was to assess the influence of short-term impulse noise on the size and dynamics of temporary threshold shift, which precedes permanent threshold shift, i.e. noise-induced hearing loss. It was hoped to use the findings for preventive activities. MATERIALS AND METHODS: The study included 80 healthy subjects (160 ears), aged 19-23 years, divided into two groups: group I comprised 40 recruit soldiers put to the shooting training, and group II consisted of 40 young male controls. All subjects had to show normal hearing with pure tone audiometric thresholds between 10-15 dB. Transient evoked otoacoustic emission (TOAE) measurements were performed by ILO 292 Echoport Otodynamics device 3-5 min before shooting and then 2 min, 1, 2 and 3 h, respectively after shooting. In group II the time intervals were similar. RESULTS: It was found that the gunshot impulse noise from the kbk AKMS rifle caused temporary hearing threshold shift (TTS) at 1, 2, 3, 4 and 5 kHz frequencies of 1.07, 0.96, 1.41, 0.88 and 1.25 dB SPL, respectively. TIS turned out to be maximum at 4 and 5 kHz and minimum at 1 and 2 kHz. CONCLUSIONS: Short-term impulse noise generated by the rifle gunshots induces rather small temporary threshold shift of hearing. Anyhow, considering possibilities of different weapon noises in the military environment as well as various sources of industrial impulse noise, the usage of hearing protectors should be highly recommended.

• [Assessment and analysis of the acoustic environment of soldiers exposed to impulse noise]

  Authors: Wiesław Konopka, Małgorzata Pawlaczyk-Łuszczyńska, Piotr Zalewski, Jarosław Miłoński

  Medycyna pracy. 02/2002; 53(5):391-6.

  The aim of the study was to assess the acoustic environment of soldiers attending a one year basic military service. The study material comprised 13 types of weapons used by this group of soldiers.The aim of the study was to assess the acoustic environment of soldiers attending a one year basic military service. The study material comprised 13 types of weapons used by this group of soldiers. During the target practice, the following parameters were measured separately for the right ear and the left ear: equivalent sound pressure level A (LA eq, Te); maximum sound pressure level A (LA F max) and peak sound pressure level C (LC peak). The measurements covered several single shots or a shot series. In addition, a spectroanalysis in 1/3-octave band frequency of 40-50,000 Hz, was conducted. There were following values of measurements in the direct vicinity of the ears: LA eq, Te fell within the range of 106.2-119.5 dB (mean, 112.2 dB) for the right ear and 104.2 dB-118.4 dB (mean, 113.2 dB) for the left ear; LA F max within the range of 124.5-132.3 dB (mean, 128.3 dB) for the right ear and 116.3-135.1 dB (mean, 128.1 dB) for the left ear; LC pcak within the range of 151.8-156.5 dB (mean, 154.8 dB/155 dB) for the right ear and 151.9-156.2 dB (mean, 155.4 dB) for the left ear. In the noise spectrum, components of audible frequencies predominated, 160-300 Hz (mainly for high caliber weapon); 1600-6300 Hz for the right ear and 2500-4000 Hz for the left peak (small caliber weapons); 6300-16,000 and ultrasonic 25,000-50,000 Hz. No significant differences were found in the measurements of the right ear and the left ear.

• An assessment of concentrations of soluble CD4 and CD8 receptors in serum before and after surgical treatment in patients with chronic maxillary sinusitis.

  Authors: Jurek Olszewski, Wiesław Chudzik, Kazimierz Wiśniewski, Jarosław Miłoński, Robert Matyja

  American journal of rhinology. 17(3):123-6.

  BACKGROUND: The aim of this study was to assess the concentrations of soluble CD4 (sCD4) and sCD8 receptors in serum of patients before and after surgical treatment of chronic maxillary sinusitis.BACKGROUND: The aim of this study was to assess the concentrations of soluble CD4 (sCD4) and sCD8 receptors in serum of patients before and after surgical treatment of chronic maxillary sinusitis. METHODS: We examined 57 patients, aged 20-63 years (mean age, 41 +/- 0.5 years), and divided them into four groups: group I, 14 patients with chronic maxillary sinusitis without allergy; group II, 15 patients with chronic maxillary sinusitis with allergy; group III, 16 patients with cyst of maxillary sinuses without allergy (control); and group IV, 12 patients with cyst of maxillary sinuses with allergy (control). The assay of sCD4 and sCD8 receptor concentrations was performed by means of enzyme-linked immunosorbent assay method. The concentrations of sCD4 and sCD8 receptors before and after 30 days of surgical treatment of maxillary sinuses were examined. RESULTS: In our studies the increase of concentration of sCD4 in groups I and II in comparison with the concentration in control groups were statistically significant. The differences between mean concentrations of sCD8 in groups I and II and in the control groups were not statistically significant. After surgical treatment of chronic maxillary sinusitis, a significant decrease in values of sCD4 and sCD8 in comparison with the results before surgical treatment suggest that the measurement of cell suppression product concentration can be used to assess the extirpation of the inflammatory process and the effectiveness of the operation method. CONCLUSION: Changes in concentration of sCD4 and sCD8 manifest activation or suppression of cells with particular receptor expression.

• [Comparative assessment of cryosurgical treatment results in allergic and non-allergic rhinitis].

  Authors: Hanna Zielińska-Bliżniewska, Marcin Repetowski, Jarosław Miłoński, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 65(4):276-80.

  The aim of the work was to assess the treatment efficiency in patients with allergic and non-allergic vasomotor rhinitis after cryoablation procedures. The study covered 60 patients, including 32The aim of the work was to assess the treatment efficiency in patients with allergic and non-allergic vasomotor rhinitis after cryoablation procedures. The study covered 60 patients, including 32 women and 28 men, aged 18-66. The patients were divided into two groups: I - 30 patients with chronic allergic rhinitis, II - 30 patients with non-allergic vasomotor rhinitis. The study methodology involved: an otorhinolaryngological interview with a questionnaire and an allergological interview, an objective otolaryngological and rhinomanometrical examination with Homoth apparatus, a subjective evaluation questionnaire for nasal blockage intensification (the scale ranging from 0 to 10), skin tests to aeorallergens and food allergens (Allergopharma Co.), nasal endoscopy with a straight rigid Eleps endoscope before the treatment and 3 months following it. The cryoablation of nasal conchas was performed under local infiltration anesthesia (1% Xylokaina solution) using the Cryo-S apparatus from CryoFlex Poland Company and a flat probe in a spatula shape (L-50) that was placed on the outer surfaces of the inferior nasal concha. The inferior nasal concha cryoablation resulted in a statistically significant improvement in the subjective assessment scale in group I by 82.6% and group II by 141.2%. In the endoscopic examination 3 months following the cryoablation a good nasal patency was achieved in 63.3% patients from group I and 76.7% patients from group II. The conducted studies show a better nasal passages patency in patients with non-allergic rhinitis than in those with allergic rhinitis. Cryoablation procedures on the inferior nasal conchas are not the primary therapy, but together with other methods they can immensely improve the life comfort of a rhinitis patient.

• [Endoscopic operations of the nose and paranasal sinuses in the own material].

  Authors: Jarosław Miłoński, Piotr Pietkiewicz, Jurek Olszewski

  Otolaryngologia polska. The Polish otolaryngology. 65(1):14-9.

  The aim of the study was to evaluate the results and 4-year own experience in the endoscopic treatment of the nose and paranasal sinuses. In the Clinic of Otolaryngology and Laryngological OncologyThe aim of the study was to evaluate the results and 4-year own experience in the endoscopic treatment of the nose and paranasal sinuses. In the Clinic of Otolaryngology and Laryngological Oncology of the Medical University of Lodz between 2006 and 2009 there were 603 endoscopic operations performed on patients with chronic paranasal sinusitis, including 287 females aged 17-80 and 316 males aged 18-87. The patients were qualified for the operation on the basis of an interview, objective otorhinolaryngological examination, frontal and transverse computerized tomography of the nose and paranasal sinuses, laboratory tests (blood cell count, sedimentation tests, urine tests, electrolytes tests). Moreover, allergological diagnostics (skin prick tests, intranasal provocation tests), a histopathological examination of the removed lesions and a culture of biological material from the paranasal sinuses were done. The 0 degree and 30 degrees endoscopes of Storz GMBH and Wolf and the video rotation microtome (debrider). Possible reasons for paranasal sinusitis were: viral infection (34.8%), anatomical disorders (28.5%), irritating factors like tobacco smoke (17.9%), allergy (13.4%), tumours (3.2%) and gastroesophageal reflux (2.1%). Finally, the following endoscopic operations were conducted: revision surgery of the maxillary sinuses in 680 cases (56.4%), ethmoidectomy in 586 cases (48.6%), polypectomy in 273 cases (22.6%), re-polypectomy in 232 cases (19.2%), sphenoid sinus revision in 229 cases (19.0%), frontal sinus revision in 80 cases (6.6%) and re-ethmoidectomy in 77 cases (6.4%). The average stay in the Clinic lasted 3.2 days. Advantages of the complex surgical treatment are found in both post-operative and pharmacological procedures. The FESS surgery should be only a minimally invasive technique, which subsequently could guarantee an effective treatment, slight post-operative complications, a short hospitalization period and a quick return of the patient to work, as it is proved by the own study.