Jacek Składzień

Publications of Jacek Składzień

• Cribriform adenocarcinoma of the tongue.

  Authors: Paul Borowski-Borowy, Grzegorz Dyduch, Bolesław Papla, Izabela Gabryś, Jacek Składzień, Krzysztof Okoń

  Polish journal of pathology : official journal of the Polish Society of Pathologists. 01/2011; 62(3):168-71.

  We report a case of a 73-year-old female with a tumour of the tongue, operated with two relapses. A single metastasis to the lymph node was present. Currently, the patient is alive without evidenceWe report a case of a 73-year-old female with a tumour of the tongue, operated with two relapses. A single metastasis to the lymph node was present. Currently, the patient is alive without evidence of disease. The histological diagnosis of cribriform adenocarcinoma of the tongue was rendered. The differential diagnosis of adenocarcinomas of the tongue is discussed.

• [Quality of life in patients treated for cancer of paranasal sinus and other area at head and neck].

  Authors: Paweł Strek, Krzysztof Oleś, Jacek Składzień, Jerzy Tomik, Sebastian Gajec, Sebastian Kocoń, Magdalena Dutsch-Wicherek, Patryk Hartwich, Joanna Szaleniec

  Przegla̧d lekarski. 01/2010; 67(12):1298-301.

  The oncology efficiency and quality of life are both important for patients with head and neck cancer in every-day life. Evaluation of the dysphagia discomfort was made of 240 patients (190 male andThe oncology efficiency and quality of life are both important for patients with head and neck cancer in every-day life. Evaluation of the dysphagia discomfort was made of 240 patients (190 male and 50 female). The primary location of the tumor was: paranasal sinuses, oral cavity, oropharynx, hypopharynx and larynx. The treatment was surgical or sugical and radiotherapy. Patient's quality of life was evaluated according to the self-administered questionnaire (M.D. Anderson Dysphagia Inventory MDADI). The comparison of the influence of dysphagia on the quality of life was made in two groups of patients. The first group consist of maxillectomy patients wearing obturator protheses, the second one were treated for cancer located in other mentioned area. Patients with primary tumors of the oral cavity, oropharynx, hypopharynx and larynx had significantly greater swallowing disability with an adverse impact on their quality of life compared with patients after maxillectomy. Method of treatment and stage of head and neck cancer greatly affected dysphagia-related quality of life. The longer the interval between completion of treatment and assessment by the MDADI, the higher the total score, thus reflecting a higher quality of life and funcional status as related to swallowing. The MDADI is the validated and reliable self-administered questionnaire designed specifically for evaluating the impact of dysphagia on the quality of life of patients with head and neck cancer.

• [Analysis of oropharyngeal phase of swallowing in patients with amyotrophic lateral sclerosis].

  Authors: Jerzy Tomik, Barbara Tomik, Jacek Składzień, Sebastian Gajec, Paweł Strek, Krzysztof Oleś, Jolanta Gawlik, Maciej Wiatr

  Przegla̧d lekarski. 01/2009; 66(11):905-8.

  Dysphagia is a common symptom of amyotrophic lateral sclerosis (ALS) and leads to increased risk of aspiration, malnutrition and dehydration. Swallowing mechanism in ALS patients has not beenDysphagia is a common symptom of amyotrophic lateral sclerosis (ALS) and leads to increased risk of aspiration, malnutrition and dehydration. Swallowing mechanism in ALS patients has not been systematically studied. Based on the manometry analysis of upper investigate tract we have measured base of tongue contraction, resting pressure of the upper esophageal sphincter and average pharyngeal bolus velocity 10 ALS patients with slight dysphagia and have compared them to control group. All parameters measured were significantly changed in ALS patients indicting disturbances of oro-pharyngeal phase of swallowing even in ALS patients with slight dysphagia. Early diagnosis of the swallowing disturbances is important for symptomatic therapy.

• [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.

• [Vertigo and labyrinthine fistules at the patients operated on chronic otitis media].

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

  Przegla̧d lekarski. 01/2009; 66(11):948-51.

  Otitis media is a frequent condition. Chronic infections of the middle ear can lead to defects of bony walls and development of complications. We performed prospective analysis of patients operatedOtitis media is a frequent condition. Chronic infections of the middle ear can lead to defects of bony walls and development of complications. We performed prospective analysis of patients operated on chronic otitis media in ENT Department Jagiellonian University of Krakow between 2004-2008. Nearly 650 operations on ears were performed in that period of time. Labyrinthine fistule was observed in 40 patients: 36 with COM, 3 with otosclerosis and 1 after head trauma. Vertigo was mentioned in ca. 30% of individuals in preoperative history. Labyrinthine fistule was usually noticed in the course of chronic cholesteatoma otitis media and chronic granulomatous otitis media and almost always it was located on lateral semicircular canal. In these patients defects of facial nerve bony canal were more frequent but the frequency of skull base defects was like in patients without labyrinthine fistule. The fistules were sealed routinely with a fragment of fascia. This procedure proved effective.

• [Meningeal empyema--still actual topic].

  Authors: Krzysztof Oles, Jacek Składzień, Paweł Strek, Maciej Wiatr, Jerzy Tomik, Henryk Podziorny

  Przegla̧d lekarski. 01/2009; 66(11):996-9.

  Pus collection between dura matterand arachnoidis not an abscess but an empyema. Complains of severe headache, a lack of cooperation is observed, sometimes high fever, seizures, which may lead to anPus collection between dura matterand arachnoidis not an abscess but an empyema. Complains of severe headache, a lack of cooperation is observed, sometimes high fever, seizures, which may lead to an epileptic like condition. Patient gives an impression of a severely ill person. We report four different cases of intracranial complications, in the form of dural empyema diagnosed and treated in our Department. In the pre antibiotic therapy era, cerebrospinal meningeal empyema inevitably led to paralysis, paresis and death.

• [Cysts of the orbital bone and orbital sinus: clinical and morphological characteristics of the three cases].

  Authors: Jolanta Gawlik, Jacek Składzień, Jerzy Stachura, Romana Tomaszewska, Joanna Szpor, Krzysztof Oleś, Jerzy Tomik

  Przegla̧d lekarski. 01/2009; 66(11):1000-2.

  Solitary bone cyst is rarely situated in facial bones. We discuss clinical view, results of radiological examinations and differential histopathological diagnostics of cases. We present 3 cases ofSolitary bone cyst is rarely situated in facial bones. We discuss clinical view, results of radiological examinations and differential histopathological diagnostics of cases. We present 3 cases of patients: 51 year old man with cyst in frontal sinus; 29 year old man and 46 year old woman--both with changes in bones of the orbit. In all the cases results of histopathological examinations were similar. Cystic-shape pieces of vascularizated connective tissue were observed. Multiple cracks filled with cholesterol, macrophages with hemosiderin and occasionally multinuclear cells were noticed. Solitary bone cyst may be located in the periorbital bone, especially frontal. Excellent laryngological, optic and cosmetic results are results of the surgery. Suspicious of the solitary bone cyst is possible due to MR or CT imaging, but final diagnosis must be confirm by histological examination.

• [Orbital complications of sinusitis treated endoscopically]

  Authors: Paweł Strek, Olaf Zagólski, Jacek Składzień, Marian Kurzyński, Krzysztof Oleś, Piotr Muszyński, Marcin Konior, Karolina Hydzik-Sobocińska

  Przegla̧d lekarski. 02/2008; 65(5):221-4.

  BACKGROUND: Subperiosteal inflammatory disease, subperiosteal abscess and orbital cellulitis are the most common sequelae of both acute and chronic sinusitis. Early, appropriate evaluation andBACKGROUND: Subperiosteal inflammatory disease, subperiosteal abscess and orbital cellulitis are the most common sequelae of both acute and chronic sinusitis. Early, appropriate evaluation and management observing signs and symptoms of orbital inflammation are required to prevent blindness. Computerised tomography (CT) is the investigation of choice in diagnosing the discussed pathological conditions. Cellulitis does not require drainage of the orbit on a routine basis. Conventionally, the orbital abscess is drained via an external incision and sinus surgery is performed at the same time to remove the focus of infection. More recently, successful treatment both of the sinuses and decompression of the orbit has been accomplished endoscopically via an intranasal approach. Aim: The aim of the paper was to analyse the results of intranasal endoscopic procedures performed in individuals with orbital complications of sinusitis in search for optimal treatment of this group of patients. MATERIAL AND METHODS: Records of 7 patients aged from 14 to 68 (mean 33) years treated in our department for orbital complications of sinusitis between February 2005 and August 2006 were analysed retrospectively. One retrobulbar abscess was diagnosed. In the remaining 6 patients the diagnosis of cellulitis, in one case complicated with cavernous sinus thrombosis, was established. 7 endoscopic frontosphenoethmoidectomies, one with endonasal decompression of the orbital abscess, were performed. RESULTS: All preoperative symptoms subsided in all operated individuals. No complications were observed. CONCLUSIONS: Surgical treatment of the focus of infection in the sinuses and drainage of orbital abscess can be accomplished endoscopically via an intranasal approach with little morbidity, easy identification of anatomical structures, physiological drainage of the sinuses and superior cosmetic result. Our experience suggests that the optimal method of treatment consists in surgical endoscopic removal of the focus of infection located in the sinuses with simultaneous drainage of the abscess in the orbit.

• [Harmonic scalpel tonsillectomy--personal experience and review of literature]

  Authors: Marian Kurzyński, Joanna Szaleniec, Jacek Składzień

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):561-6.

  INTRODUCTION: The harmonic scalpel has been used in tonsil surgery for several years. The comparison of harmonic scalpel tonsillectomy with other tonsillectomy techniques has been the subject of manyINTRODUCTION: The harmonic scalpel has been used in tonsil surgery for several years. The comparison of harmonic scalpel tonsillectomy with other tonsillectomy techniques has been the subject of many studies. The research results proved to be contradictory, particularly concerning postoperative complications and complaints. Most authors observed reduced intraoperative bleeding during harmonic scalpel tonsillectomy. OBJECTIVE: Analysis of harmonic scalpel tonsillectomy results and review of literature. Material and methods. The harmonic scalpel was used for 71 tonsillectomies in the Department of Otolaryngology UJ CM between 2002-2007. The surgical procedure and postoperative results were analyzed retrospectively and compared with other tonsillectomy techniques. RESULTS: The harmonic scalpel provided sufficient intraoperative hemostasis in 67% of cases. 33% of patients required electrocautery, vessel ligation in the operation field or suturing of the marginal tissue to control bleeding. Postoperative hemorrhage requiring surgical intervention occurred in 3 patients. No other severe postoperative complications were observed in either group. CONCLUSIONS: Harmonic scalpel tonsillectomy is an effective and safe alternative technique in tonsil surgery. In some cases however other hemostasis techniques may be necessary to control intense bleeding.

• [Chronic otitis media as an introduction to intracranial otogenic complications].

  Authors: Maciej Wiatr, Jacek Składzień, Jerzy Tomik

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(1):49-53.

  Otogenic intracranial complications are rare. Misdiagnosed and untreated can be dangerous for health and life. They should be always kept in mind. AiM: We discuss patients in whom defects of skullOtogenic intracranial complications are rare. Misdiagnosed and untreated can be dangerous for health and life. They should be always kept in mind. AiM: We discuss patients in whom defects of skull base were observed during operation. These defects can lead to serious intracranial complications. We analyse patients with chronic otitis media operated in our department between 2004-2006. 250 operations on ears were performed in that period of time. We discuss patients with intracranial otogenic complications and patients in whom defects of skull base were noticed by chance during operations. Defects of skull base were observed in 24 cases. Intracranial complications were in 3 patients. 1 patiens died because of abscess of cerebellum, others were treated with good distant effect. Used methods of reconstruction were effective, we observed no discharge of cerebro-spinal fluid and no other intracranial complications. It exists group of patients with chronic otitis media that have asymptomastic defects of cranial fossa. These defects can be responsible for intracranial complications. MRI and TC are very important in preoperative diagnostics.

• [Laryngeal leiomyosarcoma in clinical cases of the Otolaryngology Departament in the University Hospital of Krakow].

  Authors: Agnieszka Morawska, Jacek Składzień

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(1):27-30.

  Leiomyosarcoma is a malign neoplasm coming from the non-epithelial tissue. It rarely developes in the larynx. 0,5-1% of all of the neoplasm of the larynx is leiomyosarcoma. It usually developes inLeiomyosarcoma is a malign neoplasm coming from the non-epithelial tissue. It rarely developes in the larynx. 0,5-1% of all of the neoplasm of the larynx is leiomyosarcoma. It usually developes in the age of 40-70 and mostly effects men. Improvement of the therapy of patients with leiomyosarcoma of the larynx. MATERIAL AND METODS: The analysis of the medical documentation of the 5 patients with the diagonosis of leiomyosarcoma laryngis treated in Otorhinolaryngologic Clinic UJ in 1996-2006 was performed. The procedures and effects of the therapy were analized. In this particular period of time 11 patients was operated because of the sarcoma of the larynx. In this group there were 5 cases of leiomyosarcoma, 4 cases of chodrosarcoma and 1 case of agniomyxofibrosarcoma and 1 case of sarcomy synoviale. On the basis of the material of the Clinic the frequency of these tumors was estimated and the therapeutic procedure including widening of the surgical indications for the partial laryngectomy and narrowing the indications for nodular surgery of the neck was proposed.

• [Ways of treatment of non-malignant laryngeal tumors in older patients--laryngeal amyloidosis].

  Authors: Agnieszka Morawska, Maciej Wiatr, Jacek Składzień

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(2):141-4.

  Amyloidosis' are the heterogeneous group of diseases characterized by extracellular accumulation of secondary protein structures causing progressive disturbances of the organs. Amyloid deposits areAmyloidosis' are the heterogeneous group of diseases characterized by extracellular accumulation of secondary protein structures causing progressive disturbances of the organs. Amyloid deposits are localized mainly in the tissues of parenchymal origin (spleen, kidneys, liver) and as far as otorhinolaryngologic organs are concerned the primary pathological process is rare. The case presentation and the diagnostic and surgical procedure analysis with the assessment of the effects of therapy in patients in elderly age with amyloidosis of larynx. A 82-year-old patient with a tumor of the larynx hospitalized in Otorhinolaryngology Clinic in Cracow. The first symptom of the pathologic process in this patient was an increasing laryngeal dyspnoe and the preliminary macroscopic assessment based on indirect laryngoscopy and endoscopy suggested the proliferative process from the group of non-epithelial neoplasm. In this case tracheotomy was performed and four days later the pathologic change was endoscopically removed from larynx. The improvement of the local state was achieved which enabled to decannulate the patient. The amyloid deposits in otorhinolaryngologic organs are rare. Isolated changes in larynx suggesting malign neoplasm are the benign changes but on account of the specificity of the organ they can be a real threat to life.

• [An analysis of indications orthodontic for surgical treatment of Waldeyer ring hyperplasia in pediatric patients of the Otolaryngology and Stomatology department of the University Hospital of Krakow].

  Authors: Agnieszka Morawska, Justyna Łyszczarz, Jacek Składzień

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(3):272-7.

  The lymphatic system of a child's throat has got a special role to play. It is the first line of contact for a developing organism with antigens in the environment. For a particular group of childrenThe lymphatic system of a child's throat has got a special role to play. It is the first line of contact for a developing organism with antigens in the environment. For a particular group of children Waldeyer ring hyperplasia is much bigger than it is for a usual group of patients. And that's what causes different illnesses The analysis of ortodonthic indications for surgical treatment of adenotomy and tonsillotomy. The research was conducted on a group of hospitalized children in the Otorhinolaryngologic and in Stomatology Departament of Jagiellonian University Hospital in Krakow. The were treated for pathologic hypertrophy of adenoid and palatine tonsils. The analysis of occlusion disorder was carducted and the assessment of surgical and orthodontic treatment was performed. In the years 2002-2006 in the Otorhinolaryngologic and in Stomatology Departament of Jagiellonian University Hospital in Krakow 24 children were being treated for pathologic hypertrophy of adenoid and/or palatine tonsils accompanied by an occlusion disorder. Adenotomy with or without tonsillotomy is one of the most frequently performed surgical operations on children. Throughout many years the indications for this procedure were infringed. Nowadays the operation is being performed mainly because of the rhinological and/or otological indications for the pathologic hypertrophy of adenoid and/or palatine tonsils. There is also another indication although it is less frequently used. This indication is an occlusion disorder which needs to be treated orthodontically.

• [Biofilm from patients with chronic rhinosinusitis. Morphological SEM studies].

  Authors: Roman Głowacki, Paweł Strek, Katarzyna Zagórska-Swiezy, Jacek Składzień, Krzysztof Oleś, Karolina Hydzik-Sobocińska, Adam Miodoński

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(3):305-10.

  Bacterial biofilm is a three-dimensional structure made of aggregates of bacterial cells (microcolonies) and the extra cellular matrix released by them, adhering to organic and inorganic surfaces. ItBacterial biofilm is a three-dimensional structure made of aggregates of bacterial cells (microcolonies) and the extra cellular matrix released by them, adhering to organic and inorganic surfaces. It is estimated that 99% of all bacteria exist in biofilms, and only 1% live in a free-floating or planktonic state at any given time. The aim of the study was to demonstrate biofilms in mucosal specimens of patients undergoing endoscopic sinus surgery for chronic rhinosinusitis and co-occurrence of such illnesses as nasal polyps, bronchial asthma, NSAIDs allergy, and aspirin-induced asthma. A prospective study of 25 patients suffering from chronic rhinosinusitis. All patients underwent completed a otolaryngological examination and paranasal sinus CT scans. Endoscopic surgery of nasal sinuses (ESS) was performed in all patients. The mucous membrane samples were taken from the inside of the sinus and concha bullosa. They were prepared and examined with a scanning electron microscope (SEM). The images were then compared with the available database of the biofilm images. Using SEM morphologic criteria, the biofilms were identified in the studied material in nineteen patients (83%). In four patients with chronic rhinosinusitis, no biofilms were found on the samples taken. A bacteriological examination of smears from inside of the sinus, revealed the presence of various types of bacteria. In two patients no bacteria was found in the smears. It is supposed that bacterial biofilms perform an essential role in the pathogenesis of chronic sinusitis. One may speculate that, the presence of biofilms in patients with chronic rhinosinusitis could induce the co-occurrence of such illnesses as nasal polyps, bronchial asthma, aspirin-induced asthma or a NSAIDs allergy. In order to evaluate better the role of biofilms in chronic rhinosinusitis, it seems justified to extend the research to a larger group of patients and a control group.

• Osteomas of the paranasal sinuses: surgical treatment options.

  Authors: Paweł Strek, Olaf Zagólski, Jacek Składzień, Marian Kurzyński, Grzegorz Dyduch

  Medical science monitor : international medical journal of experimental and clinical research. 06/2007; 13(5):CR244-50.

  BACKGROUND: Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses occurring mainly in the frontal and ethmoid sinuses. Surgical removal is doneBACKGROUND: Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses occurring mainly in the frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, continue to enlarge, are localized in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, regardless of size, in symptomatic tumors. Progressive headaches and chronic inflammation of the adjacent mucous membrane are the most common symptoms. Surgical approaches are divided into external, endoscopic drill-out, and combined endoscopic and external procedures. MATERIAL/METHODS: Seventeen patients with osteomas of the paranasal sinuses were studied (mean age: 42.7 years, range: 15-73 years). Most commonly involved was the frontal sinus (11 cases, including a giant tumor comprising both frontal sinuses and 2 osteomas penetrating to the orbit), followed by ethmoid cells (3) and maxillary sinuses (2). RESULTS: One osteoma was diagnosed in the sphenoid sinus. All were removed surgically. Eight open procedures were performed to remove frontal and maxillary osteomas, five tumors were removed under endoscopic guidance, and four via combined procedures. No postoperative complications were observed. No recurrences were noted. All patients remain asymptomatic. CONCLUSIONS: Resection of small and medium-sized osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects. Giant frontal sinus osteomas can be effectively approached by a combined external and endoscopic procedure. Obliteration of the sinus is not mandatory if the mucous membrane is intact.

• [Transient evoked otoacustic emission in children with juvenile idiopatic arthritis]

  Authors: Piotr Muszyński, Jacek Składzień, E Reroń, P Strek, L Popielski, M Dutsch-Wicherel, S Kocoń, J Bartnik

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(6):972-8.

  Juvenile idiopathic arthritis (JCA) is an inflammatory systemic disease of connective tissue which etiology is still unknown. Progressive arthritis is the basic symptom, with pain, oedema, stiffnessJuvenile idiopathic arthritis (JCA) is an inflammatory systemic disease of connective tissue which etiology is still unknown. Progressive arthritis is the basic symptom, with pain, oedema, stiffness and movement impediment are typical for. Chronic process of arthritis might be accompanied by rheumatoid nodes, pericarditis, myocarditis, changes in the lungs and kidney, which appear with various frequency and indicates on systemic form of disease. The incudo-malleolar and incudo-stapedial joints are synovial in type. It should be expected that these joints might be affected by rheumatoid changes similar to those observed in joints in other parts of the body. Copeman was the first who described transient conductive hearing loss in patients with exacerbated rheumatoid process--and he called it oto-arthritis. He stressed that it was the consequence of the rheumatoid lesions in joints of ear ossicules. In adult patients with JCA in 60% of cases the perceptive hearing-loss is observed possibly because of the chronic course of the disease and its farmacological treatment. The aim of the study was the assessment of the functional state of the peripheral part of hearing organ on the basis of TEOAE. This study was preceded by examination of hearing with pure tone audiometry, speech audiometry, high frequency audiometry and impedance audiometry. The analysis of results was done in correllation to form of JCA and its activity. The research was carried out on the group of 45 children suffering from JCA; 14 boys and 31 girls between 5-18 years of age. In all children from experimental group the examination was performed in the active phase of disease process. Mean duration of the disease was 33.5 month. In all children TEOAE was obtained no matter on the form of JCA. Children with systematicus form of JCA--more aggressive type than others--have the recordings of TEOAE with small amplitude and narrow range of frequency. Those results show that rheumatoid lesions in conductive mechanism of the middle ear are insufficient for the development of the conductive hearing loss. As a results of chronic pathological process destructions of hearing organ may lead to the cochlear lesions and this way to perceptive hearing loss.

• [Own experience in treatment of patients with advanced tumours of the paranasal sinuses and the orbit, penetrating to the anterior and medial cranial fossa--preliminary report]

  Authors: Jacek Składzień, Krzysztof Oleś, Marek Moskała, Paweł Strek, Andrzej Urbanik, Jerzy Stachura, Olaf Zagólski

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):416-22.

  AIM: Craniofacial resection provides multidirectional approaches to remove nasal and paranasal tumours that involve the skull base. Vital structures, such as the dura, brain, and blood vessels, canAIM: Craniofacial resection provides multidirectional approaches to remove nasal and paranasal tumours that involve the skull base. Vital structures, such as the dura, brain, and blood vessels, can be protected or resected and reconstructed safely. An en bloc excision of the tumour can be accomplished. The purpose of this study was to analyse oncological and functional results of craniofacial resection in our series of patients. MATERIAL AND METHODS: The medical records of 40 consecutive patients who had undergone craniofacial resection for tumours of the nasal cavity, paranasal sinuses, and adjacent areas were reviewed. The extent of disease, treatment results (the length of disease-free survival), complications, and prognoses were analysed. RESULTS: Lesions were malignant in 7 patients and benign in the remaining 33. All the patients had dural or intradural involvement. There was no operative death, and the rate of surgical morbidity was 20%. Craniofacial resection is the only surgical approach with acceptable rate of complications in selected patients with tumour comprising the anterior and medial cranial base, nasal cavity, paranasal sinuses, nasopharynx and orbits. Heroic resections are modern surgical procedures challenging both for ENT surgeons and neurosurgeons. The result is satisfactory when they are performed by a multi-specialist team.

• [Pseudomonas and alcaligenes--pathogens of the chronic ear infection in clinical cases at the Otolaryngology Department of the University Hospital in Krakow]

  Authors: Agnieszka Morawska, Maciej Wiatr, Jacek Składzień, U Pradel

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):440-4.

  INTRODUCTION: Otitis media chronica is the most common disorders encountered in otolaryngology. The great multitude of different bacteria which may couse otitis media constitutes the need forINTRODUCTION: Otitis media chronica is the most common disorders encountered in otolaryngology. The great multitude of different bacteria which may couse otitis media constitutes the need for bacteriological diagnostics, especially in cases where classical conservative treatement of the inflammatory process fails. MATERIAL AND METHODS: Bacterial culture results procured from hospitalized and ambulatory patients which chronic otitis media, admitted from 2003 to 2006 at the otolaryngological department were analyzed. RESULTS: In total 47 patients were found to have their middle ear infected with Pseudomonas species and 1 patient with Alcaligenes xylosoxidans rods. CONCLUSIONS: In cases of ear infection which fails conservative treatment, especially in immunocomprimised can be caused by pathogens which are resistant to most commonly administered antibiotics.

• [Benign tumors of the external and middle ear from data collected at the Otolaryngologyst Department of the Jagiellonian University in Cracow between 1992-2001]

  Authors: Maciej Wiatr, Jacek Składzień

  Przegla̧d lekarski. 02/2007; 64(12):1004-5.

  26 patients with benign tumors of the external and middle ear were treated at the Otolaryngology Department of the Jagiellonian University in Cracow between 1992-2001. Benign tumors of the external26 patients with benign tumors of the external and middle ear were treated at the Otolaryngology Department of the Jagiellonian University in Cracow between 1992-2001. Benign tumors of the external and middle ear are rare diseases, and it is usually easy to establish final diagnosis. Various histopathological types of these tumors are found. We discuss different kinds of tumors, their location and performed treatment. In our population the most common tumor was osteoma located in external ear canal. The best kind of treatment is radical surgical resection of the lesion. In cases when surgical treatment is impossible because of local progression of the disease, radiotherapy should be considered.