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ABSTRACT: The study aim was to analyse the frequency of simultaneous smoking and alcohol consumption in 142 patients with oral cancer and in the control group. A connection between the prevalence of these habits and epidemiological traits of the patients and features of malignant lesions was evaluated. Statistical analysis revealed that simultaneous smoking and alcohol abuse were significantly more frequent in the cases group. A strong influence of these habits on the development of oral squamous cell carcinoma was noted.
Przegla̧d lekarski 01/2009; 66(10):722-6.
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ABSTRACT: Cholesteatoma of the middle ear or mastoid is a hyperproliferative disorder of keratinocytes characterized by a progressive bone erosion. Matrix metalloproteinase (MMP)-2 and MMP-9 gelatinases are endopeptidases targeting extracellular protein. Several studies examined the role of gelatinases in the pathogenesis of cholesteatoma, but the biologic mechanism by which cholesteatoma destroys the bone tissue remains unclear.
The aim of this study was to characterize the activity of MMP-2 and MMP-9 in human cholesteatoma and external auditory canal skin.
In the study, specimens of cholesteatoma and middle ear canal skin from 14 patients treated surgically at the Department of Otolaryngology were used. After two-step extraction of MMP-2 and MMP-9 from tissue samples, gelatinolytic activity was assessed with zymography.
We noticed the augmentation of MMP-9 (p = .0001) and MMP-2 (p = .046) activity obtained from cholesteatoma in comparison with control skin. The MMP-9 active to latent ratio was significantly higher in cholesteatoma samples versus normal skin.
The present study indicates that MMP-9 and, to a lesser degree, MMP-2 overexpression may be implicated in the molecular mechanisms of cholesteatoma invasion and bone destruction.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 11/2008; 37(5):628-32. · 0.71 Impact Factor
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ABSTRACT: The aim of the study was to analyse if work related risk factor had any influence on stage, localisation and histology of type of malignant tumour. Demographic and risk factors and results of treatment of farmers with patients working outside farming were compared. The group included 148 patients with primary laryngeal squamous cell carcinoma (LSCC) diagnosed and treated in our institution in the years 1999-2002. 84 (56.8%) of 148 patients were farmers and 64 (42.2%) patients worked outside farming. The univariate analysis of demographical and clinicopathological features of the farmers' group versus the other professions group with LSCC showed a statistical significance for sex, age and G stage. Nearly statistical significance was observed for the N stage (p=0.06) and for primary localisation of the tumour (p=0.05). The difference in 3 and 5-year survival rates between the group of farmers in comparison with the group of patients working outside farming and with LSCC was not significant for most of the demographical and clinicopathological features. Local, nodal or local plus nodal recurrence occurred in 15 (21.1%) of 84 farmers during 3 years follow-up. Distant metastases were observed in 7 (8.3%) of 84 farmers with LSCC, 6 to the lungs and one to the liver. Farmers with larynx cancer had different presentation pattern than other profession patients. The incidence of glottic cancer and well differentiated cancer was higher in farmers than in other professions. The prevalence of larynx cancer in women was significantly lower among farmers than in other professions. There were older patients in the group of farmers and relatively less women than in the group of patients with other professions.
Annals of agricultural and environmental medicine: AAEM 02/2008; 15(1):13-9. · 2.31 Impact Factor
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ABSTRACT: Juvenile nasopharyngeal angiofibromas (JNA) are highly vascular, locally invasive tumours which originate in the sphenopalatine foramen. Several surgical approaches are described for this tumour. The aim of this study was to evaluate the transpalatal approach for juvenile angiofibroma.
In a group of 22 patients with JNA transpalatal approach was employed. A retrospective patients notes review was done. Extension of tumour, complications of surgery and recurrences were analyzed.
In 17 patients the tumour was confined to the nasal cavity and the nasopharynx. In 5 patients the tumour invaded the sphenoid sinus. No complications were observed after surgery. Two (9%) patients had recurrence.
Transpalatal approach is best suited to small tumours (Andrews grade I and II) limited to the nasopharynx, nasal cavity and sphenoid sinus.
Otolaryngologia polska. The Polish otolaryngology 01/2008; 62(1):16-9.
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ABSTRACT: Contrary to most reports, our study shows that the expression of cyclin D1 is not an independent prognostic factor in patients with laryngeal cancer (LC). No correlation between cyclin D1 expression and survival rates in LC was found in a multivariate analysis.
The aim of this study was to determine the possible relevance of the expression of cyclin D1 protein in LC as prognostic criteria and to analyse correlation of the expression with clinicopathological features and survival rates.
Immunohistochemistry staining was used to detect the expression of cyclin D1 in 130 samples of laryngeal cancer and in 22 specimens of laryngeal nodules.
Cyclin D1 expression was found in 52 (40%) LC samples and in 3 (13.6%) samples of laryngeal nodules. There was no significant correlation between cyclin D1 expression and clinicopathological features of LC. A multivariate analysis of survival confirmed that cyclin D1 expression was not an independent prognostic factor in LC.
Acta Oto-Laryngologica 08/2007; 127(7):760-9. · 1.08 Impact Factor
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ABSTRACT: To assess whether the incidence of complications of stapes surgery depended on the sequence of surgical steps and CO2 laser use in stapes surgery.
Retrospective and prospective analysis of 420 consecutive stapedotomies was set in tertiary referral University Hospital.
376 patients with otosclerosis in whom 420 primary stapedotomies were performed.
Stapedotomy under local anesthesia using manual perforators and CO2 laser.
The incidence of incus subluxation, floating footplate during stapedotomy.
Comparison of the incidence of incus luxation in groups with the piston inserted after removal of the stapes arch, and groups with the piston inserted on the intact ossicular chain showed statistical significance. In the group where perforation of the footplate was performed after removal of the stapes arch floating footplate occurred more often than in groups with reversed sequence of steps.
Perforation of the footplate before removal of stapes arch reduces the risk of floating footplate, and placing the prosthesis on the incus before removal of stapes arch reduces the risk of subluxation of the incus. CO2 laser stapedotomy with reversed sequence of steps was the safest method of stapes surgery.
Ontology & Neurotology 03/2007; 28(2):152-6. · 1.90 Impact Factor
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ABSTRACT: The extension of paranasal sinus cancer into the orbit is one of arguments for carrying out orbital exenteration. Until the advent of high-resolution computed tomography, en bloc radical resection, including the orbit, was the most effective method of treating a cancer, whose size could not be adequately judged before surgery. Patient evaluation with computed tomography (CT) and magnetic resonance imaging (MR) is described. Different clinical situations relating the orbital content to sinus tumour and their management are discussed. Prosthetic options after orbital exenteration are also presented.
Otolaryngologia polska. The Polish otolaryngology 02/2007; 61(5):764-8.
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ABSTRACT: Paragangliomas are rare tumours deriving from paraganglia--small bodies of neuroendocrine tissue. Approximately 3% of paragangliomas occur in the head and neck area accounting for about 0,6% of all tumours of this region. Head and neck paragangliomas are divided into two groups: neck tumours (carotid body tumor and vagal paraganglioma) and temporal paragangliomas (jugular bulb tumor and tympanic paraganglioma). Temporal paragangliomas arise from paraganglia located in the petrous part of the temporal bone. Radiological evaluation of these lesions is essential for confirming the diagnosis and surgery planning. Most useful methods are magnetic resonance imaging and computed tomography. These modalities deliver important information about tumour location, extension and the state of the surrounding structures. Carotid angiography is a second step diagnostic method, performed in patients with jugular bulb paraganglioma. It has a diagnostic value and allows palliative or preoperative embolization of the tumor. Ultrasonographic evaluation and scintigraphy also provide advantages in diagnostic management.
Otolaryngologia polska. The Polish otolaryngology 02/2007; 61(6):931-6.
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ABSTRACT: Location and extension of tumour are crucial for results of treatment and prognosis in patients with nasal and paranasal sinus malignancies. The aim of the study was to evaluate the site and extension of nasal and paranasal sinus malignancies using computed tomography (CT).
The group included 124 patients aged 5-83 years. Biopsy confirmed malignant neoplasm in all the patients. Surgery was performed in 92 patients, for 32 inoperable patients palliation was applied.
CT revealed that the most common (just above 70%) tumour sites were the nasal cavity, maxillary and ethmoid sinuses. The most common (about 50%) extrasinusal involvements were the orbit, subcutaneous cheek tissue and infratemporal fossa. Only 24.2% of patients had tumour limited to the nose and sinuses.
CT well demonstrates extension of nasal and paranasal sinus malignancies. Vast majority of patients (75.8%) present with tumour extended beyond sinuses.
Otolaryngologia polska. The Polish otolaryngology 02/2007; 61(4):576-80.
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ABSTRACT: Nasopharyngeal angiofibromas occur predominantly in males in their puberty and adolescence; the incidence in other age groups and in women is exceptional. This report describes a case of a 57-year-old woman with nasopharyngeal angiofibroma presenting typical radiological findings in computed tomography, MR imaging and angiography. The tumour was successfully removed and histopathological examination confirmed the diagnosis. In 6 years follow-up the patient is free of symptoms.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 08/2006; 263(7):657-60. · 1.29 Impact Factor
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ABSTRACT: The aim of this study was to determine the prevalence of human papillomaviruses (HPV) types 6, 11, 16, 18, 31, 33, 42, 51, 52, 56 and 58 in laryngeal squamous cell carcinoma specimens using immunohistochemical reactions and to correlate the presence of HPV with the clinical and pathological characteristics of these patients. Tissue samples were collected from 40 patients with primary laryngeal squamous cell carcinoma (LSCC) and from 33 subjects with non-neoplastic laryngeal lesions or laryngeal nodules, which served as a control group. Human papilloma virus was detected in 6 (15%) of the 40 patients. Five (83.4%) of six patients with HPV positive tumors had G2 (moderately differentiated), one patient (16.6%) had G3 (poorly differentiated), and no patient with HPV positive tumor had a G1 (well-differentiated) tumor. Four (66.6%) of the six HPV positive tumors were in the supraglottic region, one (16.6%) tumor was located in the glottis, and one (16.6%) HPV positive tumor was in the subglotic region. Five (83.4%) of six HPV positive tumors were T3-T4, and one was T2. Three of six HPV positive patients had no clinically evident cervical lymph nodes (N0), and three of the HPV positive patients were N1 or N2. Human papillomavirus was not detected in any of the samples from the control group. The presence of HPV infection in 15% of the cases may suggest a possible role in the etiology of laryngeal squamous cell carcinoma. However, no significant correlation between HPV incidence and histological grading and clinical staging could be demonstrated.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 12/2005; 262(11):917-20. · 1.29 Impact Factor
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ABSTRACT: In a group of 124 patients a site of origin of paranasal sinus and nasal cavity malignancies was evaluated on the basis of computed tomography (CT) and on the basis of operative findings. The most common malignant tumor was squamous cell carcinoma (41, 1%) and then cancers of salivary origin (20, 2%). The most common site of origin was the maxillary sinus (53, 2%) and then the nasal cavity (31, 5%). Within the maxillary sinus the most frequent neoplasm was cancer whereas in the nasal cavity melanoma and olfactory neuroblastoma. In three (2, 4%) patients site of tumor origin demonstrated on CT was different form that of operative finding.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/2005; 19(111):413-4.
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ABSTRACT: Many authors suggest that HPV infection can play a great role in development of benign and malignant tumours of upper respiratory tract in human. The aim of this study was to determine the prevalence of E6/E7 HPV-16 in laryngeal squamous cell carcinoma, and normal laryngeal mucosa, and to analyse their correlation with sex, lymph node status, primary tumor stage, localization, and histological differentiation. HPV 16 DNA presence was analysed using PCR technique in 72 samples of laryngeal carcinoma and in samples of 50 normal mucosa. Human papillomavirus was detected in 26 (36.1%) of the 72 patients. There was no statistically significant correlation HPV positivity and clinicopathological features of the analysed group. In 5 (10%) of 50 samples of normal mucosal. HPV 16 presence in normal mucosa and in laryngeal squamous cell carcinoma was detected in 3 patients. Our observations suggest that HPV16 can play a role in pathogenesis of laryngeal cancer.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/2005; 19(111):291-3.
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ABSTRACT: The aim of the study was evaluation of the use of cartilage and perichondrium for reconstruction of meatal wall. In the group of 27 patients transmeatal atticotomy was performed to remove cholesteatoma from epitympanic recess. Auricular or tragal perichondrium with cartilage island were used for reconstruction of meatal wall and tympanic membrane defect. Good closure of the defect was obtained in 24 (89%) patients in 3-6 years follow up. We had one failure and no follow up in 2 patients. Of 7 patients with intact ossicular chain 0-10 dB air-bone gap was obtained in 5 and 11-20 dB gap in 2 patients. Perichondrium and cartilage are very good for reconstruction of meatal wall and drum defect.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/2005; 19(111):411-2.
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ABSTRACT: Resection of the whole circumference of the pharynx and esophagus is usually reconstructed with gastric pull-up, jejunum free graft or free forearm flap. The aim of this study was to assess the use of pectoralis major myocutaneous flap for closure of total pharyngeal defect. In 11 patients with hypopharynx and larynx cancer, total pharyngo-laryngectomy and excision of the cervical part of the esophagus and neck dissections were performed; the defects were closed with pectoralis major myocutaneous flaps. The skin island was sutured to prevertebral muscles, forming a letter U shape. Good healing was obtained in six patients, and five patients developed fistula that closed spontaneously within 3-4 weeks. The use of U-shaped pectoralis major myocutaneous flap, suturing it to prevertebral muscles, gives good functional results, and it is a simple and time-saving second choice method of reconstruction of the pharynx after total pharyngo-laryngectomy.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 05/2005; 262(4):259-62. · 1.29 Impact Factor
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ABSTRACT: The aim of the study was evaluation of the use of tracheostomy T-tube in patients with tracheal stenosis. The advantages of closed T-tube over open tracheotomy are: 1/ normal breathing through the nose, 2/ normal speech without necessity to close the tube with a finger, 3/ no spitting during cough. Silicone tracheostomy T-tube was used in 12 patients with tracheal stenosis. The stenosis resulted in 7 patients from prolonged intubation, in 4 patients from defective tracheostomy and in one patient from failure of tracheal resection. In all the patients rigid tracheoscopy and/or flexible bronchoscopy revealed the length of the stenosis and the distance from vocal cords. T-tube was placed under local anesthesia. The patients used to wear closed T-tube from 1-12 years. The tube was exchanged every 2-4 years. The only adverse effect was recurrent granulation around tracheostomy in two patients. 7 of 12 patients were decannulated with good result in 3 months - 5 years follow up. In two decannulated patients stenosis recurred. One patient was retracheostomized and in another patient stenosis was resected with end to end anastomosis. Three patients were not decannulated. Tracheostomy T-tube can be used temporary in patients with tracheal stenosis before planned stenosis resection or as a sole treatment with good chances for successful decannulation. When stenosis resection is not possible, T-tube can be placed for long time.
Otolaryngologia polska. The Polish otolaryngology 02/2005; 59(3):361-4.
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ABSTRACT: The first voice prosthesis was described in 1972 by Mozolewski. Eight years later Blom and Singer constructed the first commercial prosthesis. In 1988 another prosthesis was presented as Provox system prosthesis. The aim of the study was to describe the technique of tracheoesophageal puncture (TEP) and to present two years results of the technique performed in 21 patients. Primary TEP with immediate implantation of the Provox 2 prosthesis was applied in 16 (76%) patients. In five patients (24%) secondary TEP was performed. All the patient with primary TEP had cricopharyngeal myotomy. In 7 patients the vocal prosthesis was exchanged. In five because of leakage through the valve and in two patients the vocal prosthesis was extruded. Leakage around the prosthesis occurred in two patients with secondary TEP. The mean device-related lifetime was 216 days and ranged from 30 to 540 days. In non-radiated patients the lifetime of the prosthesis was 255 days and in patients after radiotherapy the lifetime was 150 days. In all the patients the prosthetic voice was more similar to normal voice than in patients with esophageal speech. The implantation of the voice prosthesis is a simple method of restoring of a good quality voice enabling communication.
Otolaryngologia polska. The Polish otolaryngology 02/2005; 59(2):225-8.
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ABSTRACT: Juvenile angiofibroma is a rare, benign, hypervascular, nasopharyngeal tumour. The aim of the study was to assess the value of CT and MR in determining therapeutic approach and follow-up in patients with this condition. There were 40 patients with juvenile angiofibroma. All patients underwent angiography. In 24 patients CT and 5 patients MRI was performed. Most patients (67%) presented with tumour stage III according to Chandler. Preoperative tumour staging based on CT was in accordance with surgical evaluation in 92% of cases. In 4 (17%) of 24 patients CT and MRI showed a recurrence after surgery. On the bases of radiological findings 2 patients were referred to irradiation instead of surgery. CT allows correct tumour staging in 92% of patients. It well demonstrates the presence and extension of the recurrence.
Otolaryngologia polska. The Polish otolaryngology 02/2005; 59(1):85-90.
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ABSTRACT: Transglabellar, transorbital approach through the bottom of the frontal sinus for tumours invading anterior skull base in presented. Exposure was improved by rhinectomy and lateral swing of the nose. The most common tumours in the group of 11 patients were squamous cell carcinoma (4) and olfactory neuroblastoma (4). Skull base was excised en block with partial maxillectomy in 8 patients and with total maxillectomy in 3 patients. Orbitectomy was performed in 6 cases. Dura defect was closed with fascia lata and fibrin glue. No serious complications after surgery developed. Rhinoscopy and computed tomography demonstrated clear cavity and no dura prolapse. Transglabellar, transorbital approach provides good exposure for anterior skull base tumours excision and repair.
Otolaryngologia polska. The Polish otolaryngology 02/2004; 58(1):115-9.
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ABSTRACT: Cat-scratch disease is a mild disease associated with regional lymph node enlargement. We present a case of cat-scratch disease of the parotid gland in 10-year-old girl. She presented with painful parotid mass, after unsuccessful treatment with antibiotics. Computed tomography showed tumour like lesions in parotid gland. Subtotal parotidectomy with facial nerve preservation was performed as neoplastic disease was suspected. Histopathology examination of the sample revealed typical changes for cat-scratch disease. History of continuous contacts with cats was confirmed by the parents. Cat-scratch disease should be taken into account in differential diagnosis of parotid masses, especially in children.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2004; 57(11-12):704-6.
