Jarosław Kosek

Publications of Jarosław Kosek

• [Application of lasers in treatment of larynx diseases].

  Authors: Andrzej Wojdas, Jarosław Kosek, Karolina Dzaman, Kornel Szczygielski, Jan Ratajczak, Dariusz Jurkiewicz

  Otolaryngologia polska. The Polish otolaryngology. 09/2009; 63(7):76-9.

  In otolaryngology, CO2 laser is the first and most commonly applied device. Such lasers as Ny:YAG generating visible light having wavelength 532 nm referred to as KTP laser due to the Name of theIn otolaryngology, CO2 laser is the first and most commonly applied device. Such lasers as Ny:YAG generating visible light having wavelength 532 nm referred to as KTP laser due to the Name of the crystal where infrared light is converted to visible light. Such wavelenght, having green colour, due to strong absorption in haemoglobin is applied in treatments on tissues having dense blood vessels. The object of the work is to analyze larynx microsurgery laser treatments performer between 1994-2008 in the Otolaryngology Department of the Military Medical Institute CSK MON in Warsaw. The examination covered 445 patients including 142 women (31.9%) and 303 men (68.1%) aged between 12 and 80 (the average age of 48.2 year olds) who Were qualified in 1994-2003 for endoscopic laser surgery of the larynx. The operations field was watched using OPMI-11 operating microscope (Zeiss, Germany) allowing 4-16 times blow-up. Larynx laser microsurgery was performer using white laser beam: CO2 Illumina 40 (Heraeus LaserSonics, Germany) and green laser beam using KTP AURA XP laser (AMS, USA). The total of 445 larynx laser microsurgeries were performer. In recent years our clinic has seen an increase in the number of operations using this technique. The largest group were patients with recognized precancerous conditions (33.0%) and larynx carcinoma (26.4%). The next group in terms of the number of patients were 114 patients (20.6%) with recognized juvenile papilloma. Complications were observed in 180 patients. Table III show the type of recognized complications. The most commonly observed was swelling of the mucous membrane (48.3%), the rarest type was subcutaneous emphysema (3.3%). It was concluded that larynx laser microsurgery is a safe method and a valuable tool in treatment of larynx diseases, especially precancerous conditions and early forms of larynx carcinoma; that complications following procedure are relatively rare, usually mild, not life-threatening, and most often subsiding after a few days.

• [Case of paraganglioma of the originally numerous location in the 24 year old male].

  Authors: Dariusz Jurkiewicz, Kazimierz Niemczyk, Andrzej Wojdas, Ireneusz Kantor, Bernard Jaroń, Jarosław Kosek

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(2):212-5.

  Paragangliomas, in other words chemodectomas were bening tumors arising from the paragangliomas cells of the parasympathetic system. There are four kinds of paragangliomas: carotic arteryParagangliomas, in other words chemodectomas were bening tumors arising from the paragangliomas cells of the parasympathetic system. There are four kinds of paragangliomas: carotic artery baroreceptors (glomus caroticum), tympanic cavity (glomus tympanicum), internal jugular vein (glomus jugulare) and placed along vagal nerve (glomus vagale). Overall 5-10% of all paragangliomas are malignant. The bening lorms paragangliomas, of the originally numerous location are rare described. The authors describe the rare case of 24 yrs old male, of the bening form paraganglioma of the originally numerous location - glomus tympanicum on the left site, glomus caroticum on the right site. The patient was successfuly treated surgicaly. The first choice of treatment is surgery. The diagnosis of a suspected paraganglioma can be confirmed with USG, CT, Angio CT, Angiography and MRI. Radiation therapy may be usefull in those cases in which the residual tumor was known to be left.

• [Bacterial flora in paranasal sinuses of the chronic inflammation]

  Authors: Andrzej Wojdas, Janusz Ratajczak, Agnieszka Syryło, Kornel Szczygielski, Jarosław Kosek

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):595-7.

  OBJECTIVE: To investigate the bacteriological profile in patients with chronic rhinosinusitis. MATERIALS AND METHODS: We enrolled to this trial 100 patients (56 females and 44 males) aged from 18 toOBJECTIVE: To investigate the bacteriological profile in patients with chronic rhinosinusitis. MATERIALS AND METHODS: We enrolled to this trial 100 patients (56 females and 44 males) aged from 18 to 62 (mean 41.3), with chronic rhinosinusitis. Control group were 20 patients (9 females and 11 males) aged from 19 to 44 (mean 29.4). RESULTS: In collected material from 87 patients (87%) growth of bacteria on 89 blood agar were received. In two cases mixed flora was observed. In 13 specimens there was no growth of any bacteria. Comparing results of studied cultures: in 78 patients pathological flora were discovered whereas in 8 patients saprophytic bacteria. In the group of pathological flora 71.57% cultured bacteria was aerobe, among it the commonest were: Staphylococcus aureus (13.73%), Streptococcus pneumoniae (10.78%), Haemophilus influenzae (9.8%), Staphylococcus coagulase negative (9.8%). In anaerobe group most frequently bacteria isolated was Prevotelle sp. (6.86%). CONCLUSIONS: In our trial 15 different bacterial types were identified. In 72% cases aerobic bacteria were cultured. The most commonest pathogens were: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus coagulase negative.

• [Application of microsurgery in diagnosis and treatment of larynx diseases]

  Authors: Andrzej Wojdas, Agnieszka Syryło, Dagmara Kenig, Piotr Rapiejko, Jarosław Kosek, Dariusz Jurkiewicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 06/2006; 20(119):519-22.

  THE AIM OF THE STUDY: was analyzing cases of laryngeal diseases and their location that required treatment by surgical procedure as well as analyzing complications resulting from microsurgery of theTHE AIM OF THE STUDY: was analyzing cases of laryngeal diseases and their location that required treatment by surgical procedure as well as analyzing complications resulting from microsurgery of the larynx and their location during surgical procedures and treatment performed in the Otolaryngology Clinic at Military Institute of the Health Services Central Military Hospital in Warsaw (years 1994-2003). MATERIAL AND METHODS: We analyzed 713 patients, of which 248 were women (34.8%) and 465 were men (65.2%) aged between 12 and 80 (the average age was 49.4 +/- 11.8), who were diagnosed as requiring microsurgery of the larynx using the Kleinsasser's set together with operating microscope and CO2 laser in selected cases. RESULTS: The total of 713 microsurgical operations was performed in the larynx area. The largest group were the patients who were diagnosed as having polyps (33.0%), chronic laryngitis (19.6%) and an established diagnosis of laryngeal carcinoma. Complications were observed in 416 patients (58.3%). CONCLUSIONS: Microsurgery of the larynx was the most often applied form of treatment of vocal fold polyps, chronic laryngitis and laryngeal carcinoma; pathological changes that require microsurgical treatment are mostly located in the epiglottis and the central part of the glottis whilst the major complications resulting from the microsurgery of the larynx are limited to superficial damage of the mucous membrane, mostly on the lips.

• [The rare case of nasal glioma]

  Authors: Andrzej Wojdas, Jarosław Kosek, Janusz Patera, Dariusz Jurkiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(4):617-21.

  The authors presented a case of nasal glioma in an adult man which had performed as nasal polyp. Histopathologic studies confirmed neuroglial tissue--Astrocytoma fibrillare. These tumor cells wereThe authors presented a case of nasal glioma in an adult man which had performed as nasal polyp. Histopathologic studies confirmed neuroglial tissue--Astrocytoma fibrillare. These tumor cells were immunohistochemically positive for glial fibrillary acidic protein as well as for S-100 protein and vimentin. There was no communication between the tumor and the cranial cavity on radiological examination (TC, MRI). Treatment is usually surgical. In this article authors describe a case of a nasal glioma that was removed via a lateral rhinotomy.

• [The application of KTP laser in otolaryngology - 3 years experience].

  Authors: Andrzej Wojdas, Kornel Szczygielski, Jarosław Kosek, Jan Ratajczak, Dariusz Jurkiewiczc

  Otolaryngologia polska. The Polish otolaryngology. 65(4):281-4.

  The KTP laser is popularly called the green laser is a type of Nd: YAG laser zawdzięczający its name from the additional element of KTP crystal which is a wavelength of 532 nm. The aim of this paperThe KTP laser is popularly called the green laser is a type of Nd: YAG laser zawdzięczający its name from the additional element of KTP crystal which is a wavelength of 532 nm. The aim of this paper is to present our 3-year experience in the application of KTP laser in otolaryngology. In the Department of Otolaryngology, CSK MON Military Medical Institute in Warsaw from 2008, performed 211 operations using the green laser. The study group was 89 women and 122 men aged 12 to 94 years (mean age 53.2 years). The surgery was performed 15-watt KTP Aura laser. All guestrooms are fibers with a diameter of 0.2, 0.4 and 0.6 mm, and guides for inserting the fiber ends are not. Results: In 3-year period have made a 211 KTP laser surgery including the nasal cavity, mouth, larynx and trachea, and the outer ear. In the procedure adopted one day 76 people, and at least 111 patients stayed in hospital for 4 days. In our material patients after UPPP tonsillectomy and operations, in addition to a negligible bleeding during surgery, rarely also had late bleeding (5%). In our clinic konchoplastyki performed based on the so-called. technique of “cross-hatching”. The laryngeal endoscopic surgery is used micromanipulator, if we are to remove a large tumor of the larynx much better to use the guide laryngeal. The KTP laser is an important tool in the operational procedures in otolaryngology in large part due to the high activity and its complexity hemostatycznemu assistant. Become familiar with the operation of the laser and improvement of surgical techniques allows patients to propose a modern surgical procedures. Improves the possibility of radical treatment of tumors of the larynx endoscopic method.