Zbigniew Kozłowski

Publications of Zbigniew Kozłowski

• [Fungal rhinosinusitis - still unsolved problem].

  Authors: Katarzyna Dąbrowska, Zbigniew Kozłowski, Tomasz Durko, Ramzes Stańczyk, Wioletta Pietruszewska

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):369-76.

  Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nose and paranasal sinuses. Fungi are considered to be one of the pathogens responsible for some kinds of CRS. FungalChronic rhinosinusitis (CRS) is an inflammatory disease affecting the nose and paranasal sinuses. Fungi are considered to be one of the pathogens responsible for some kinds of CRS. Fungal rhinosinusitis - the classifications schemes, the diagnostic criteria and methods of treatment are still being discussed. 338 patients underwent the endoscopic sinus surgery due to CRS in the Otolaryngology Department of the Medical University of Lodz in the years 2009-2011 (February). The histopathological examination revealed fungi only in three patients. The authors report three cases of patients with fungal rhinosinustis - the fungal ball of the sphenoid sinus in one patients, the fungal ball of the maxillary sinus in the second one and non-invasive fungal rhinosinusitis. The different classifications and diagnostic criteria are also presented. Based on the publications using updated diagnostic standards and sensitive techniques to detect fungi, a higher number of patients can now be diagnosed with fungal rhinosinusitis.

• [Tumors of the parotid gland--management and results of surgical treatment]

  Authors: Izabela Olejniczak, Zbigniew Kozłowski, Katarzyna Dabrowska, Marek Lukomski

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):446-50.

  INTRODUCTION: Tumors of the salivary glands are uncommon and represent 2-4% of head and neck neoplasms. Most tumors originate in the parotid gland, from which 10 to 15% are found to be malignant.INTRODUCTION: Tumors of the salivary glands are uncommon and represent 2-4% of head and neck neoplasms. Most tumors originate in the parotid gland, from which 10 to 15% are found to be malignant. Different methods of surgical treatment can be performed depending on the type, localization and size of tumor. MATERIAL AND METHODS: Retrospective analysis of the medical data of 138 patients with parotid gland tumors who where treated in our departament between 1997-2007 was done. RESULTS: There were 74 women and 64 men. Benign tumors were found in 104 patients with the pleomorphic adenoma as the most common (53 cases). The rest histological type were Whartin's tumor, myoepithelial and basal cell adenoma respectively. Malignant neoplasms were diagnosed in 16 patients, most commonly mucoepidermoid carcinoma. The most frequent localization of the tumor after dividing the parotid gland into four parts was postero-inferior pole. 68 patients (49.27%) had superficial parotidectomy, extracapsular dissection was performed in 65 cases (47.1%). CONCLUSIONS: Frequency of tumors of the parotid gland, their histological types and methods of surgical treatment in our data support other studies. Ultrasonography is the key procedure in the diagnosis of tumors of the parotid gland, qualification into surgical treatment and postoperative observation. In extracapsular dissection the risk of the facial nerve paralysis is lower than in other technics.

• [Clinical evaluation of CT scans of nasal cavity and paranasal sinuses]

  Authors: Wojciech Skóra, Zbigniew Kozłowski, Katarzyna Dabrowska, Marcin Mazerant

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):553-7.

  INTRODUCTION: Computed tomography is a basic imaging technique in nose and paranasal sinuses disease's nowadays. AIM: The aim of the study was to outline current methodology of CT scanning of noseINTRODUCTION: Computed tomography is a basic imaging technique in nose and paranasal sinuses disease's nowadays. AIM: The aim of the study was to outline current methodology of CT scanning of nose and paranasal sinuses. MATERIAL AND METHODS: This study is based on the experience of Department of Otorhinolaryngology of Medical University of Lódź in evaluation by CT scanning patients with nose/paranasal sinuses problems and on the literature concerning this problem. RESULTS: Pictures in three planes (axial, coronal, sagittal) are obtained from multi-row CT scanner. However in some cases 3D reconstructions are useful. The thickness of the single layer is 0.625 or 1 mm. In case of tumor suspicion contrast CT scanning is a routine procedure. The analysis of pictures is preceded by anamnesis and careful rhinologic examination. Coronal scans are evaluated as first and they are divided into four zones (frontal sinus, anterior ethmoid cells, posterior ethmoid cells and sphenoid sinus zones) for more systematic analysis. Then axial and sagittal scans are examined. Every single structure and its anatomical variations are named by using current terminology outlined during International Conference of Sinus Disease in Princeton in 1993 by The Anatomic Terminology Group. CONCLUSIONS: Quality and quantity of the information from CT of nose and paranasal sinuses depends on keeping some rules concerning the stage of performing the examination and the stage of its evaluation and applying current anatomic terminology.

• [Sphenoidotomy--the treatment of patients with isolated sphenoid sinus diseases]

  Authors: Zbigniew Kozłowski, Marcin Mazerant, Wojciech Skóra, Katarzyna Dabrowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):582-6.

  INTRODUCTION: The standart terms and definitions for paranasal sinuses operations were published in 2005 by Simmen and Jones. Sphenoidotomy is a surgical procedure when the natural ostium of sphenoidINTRODUCTION: The standart terms and definitions for paranasal sinuses operations were published in 2005 by Simmen and Jones. Sphenoidotomy is a surgical procedure when the natural ostium of sphenoid sinus is enlarged in varying degrees. Microscopic, endoscopic or ballon-assisted endoscopic sphenoidotomy are performed in endonasal sinus surgery and endonasal neurosurgery. This approach is considered for cases of isolated lesions of the sphenoid sinus, the sella lesions, the cerebrospinal fluid leaks into the sphenoid sinus and also for the treatment pathological conditions in the skull base. Isolated lesions of the sphenoid sinus are very rare with uncharacteristic symptoms. Headache is the most common. Vision disturbances occur occasionally. Endoscope assisted physical examination and CT scans of paranasal sinuses are necessary to make a diagnose. MATERIAL AND METHODS: 5 patients suffering from the isolated sphenoid sinus lesion were diagnosed and treated at the Otolaryngology Department of Medical University of Lodz in 2007. Clinical data of these patients were analysed retrospectively. 4 underwent the transnasal endoscopic sphenoidotomy. There were 3 patients with chronic sinusitis, 1 with pyocele. 1 patient didn't agree for the operation. RESULTS: All treated patients noted improvement in the preoperative symptoms. There were no complications during and after the operation. CONCLUSIONS: Endoscopic sphenoidotomy is an effective and safe method of treatment of the isolated sphenoid sinus diseases. Nasal endoscopy and CT imaging are necessary for a precise diagnosis and treatment decision.

• [Maxillary sinus cyst--methods of surgical treatment]

  Authors: Marcin Mazerant, Wojciech Skóra, Katarzyna Dabrowska, Zbigniew Kozłowski

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(5):578-81.

  INTRODUCTION: Retention cysts of maxillary sinus are therapeutic problem for laryngologists and maxillo-facial surgeons. They develop slowly and often without symptoms. The aim of the work was toINTRODUCTION: Retention cysts of maxillary sinus are therapeutic problem for laryngologists and maxillo-facial surgeons. They develop slowly and often without symptoms. The aim of the work was to compare the different methods of surgical treatment of maxillary sinus cysts performed in Department of Otolaryngology, Medical University of Lodz between 2003 and 2007. MATERIAL AND METHODS: 113 patients with cyst of maxillary sinus were treated surgically between 2003 and 2007--74 men and 39 women. Between 2003 and 2005 Caldwell-Luc procedure was performed on 75 patients. In 2006 and 2007 38 patients underwent endoscopic removal of maxillary sinus cyst. RESULTS: The average time of the endoscopic removal of maxillary sinus cyst was 10 minutes sorter than in Caldwell-Luc procedure (34 min versus 44 min, p < 0.05). 84.2% cases of the endoscopically treated patients had no pain after surgery. There was no discomfort in the operation area. In the Caldwell-Luc group only 5.3% patients had no pain and in 78.7% cases discomfort on the face was present (p < 0.05). Endoscopically treated patients were discharged from hospital after 3,6 days and in the Caldwell-Luc procedure patients stayed in hospital for 5.8 days. CONCLUSION: Endoscopic sinus surgery is an effective treatment for retention cysts and should be widely used. Computer tomography should be performed before each procedure.

• [Solitary fibrous tumor of the nasal cavity, paranasal sinuses and anterior fossa].

  Authors: Marek Łukomski, Agnieszka Wierzchniewska-Ławska, Zbigniew Kozłowski, Katarzyna Dabrowska

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(3):335-9.

  Solitary fibrous is rare mesenchymal neoplasm that usually arises in the pleura or less commonly is related to other serosal surfaces. There were reported SFTs in some extrapleural locations. ThereSolitary fibrous is rare mesenchymal neoplasm that usually arises in the pleura or less commonly is related to other serosal surfaces. There were reported SFTs in some extrapleural locations. There locations cause diagnostic difficulties. Ethmoid sinuses, nasal cavity and anterior fossa are rare site for SFTs. Authors report a case of SFT of the nasal cavity, paranasal sinuses and anterior fossa in 33 year-old woman to show the difficulty and importance of recognition. Diagnostic procedures and medical treatment are presented. This report pays attention that SFT should be taken into consideration during diagnostic process of spindle-cell lesions of the nasal cavity and paranasal sinuses in order to avoid some confusions.

• [Granular-cell myoblastoma of the larynx clinical analysis]

  Authors: Magdalena Józefowicz-Korczyńska, Zbigniew Kozłowski, Wioletta Pietruszewska, Marek Lukomski

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(6):807-12.

  Clinical date of four cases of granular-cell myoblastoma tumors arising in the larynx and clinical analysis of 11 cases published in Polish literature were reviewed and studied. Granular-cell tumorClinical date of four cases of granular-cell myoblastoma tumors arising in the larynx and clinical analysis of 11 cases published in Polish literature were reviewed and studied. Granular-cell tumor is a rare, usually benign neoplasm that can occur in various part of the body. The larynx tumor is accounting for 7% to 10% of all reported cases. The most common laryngeal location in our study were the posterior part of true vocal cord. Sex predilection was no observed. The tumor was generally presented in patients in their forth and fifth decade. Slowly increasing hoarseness was the most common symptoms but some patients reported moderate dysfagia as well. Typically the tumors were painless. Only in one case the breathing difficulty was the reason of tracheotomy. Clinically the tumors were considered benign. The most common clinical impressions was a vocal polyp, cysts, granulomas or nodules. The surgical procedure and local excision in laryngoscopy (in 9 patients), laryngofissura (in 5 patients) were mostly sufficient to radical treatment. In one case because the location and size of the tumor subtotal laryngectomy was necessary to conduct. After surgery the voice often was preserved but sometimes slightly hoarseness were observed. Treatment is usually curative with no recurrences. The knowledge about natural history and therapeutic implications of such tumors is essential to choose appropriate therapy and planning surgery.

• [On isolated neck sarcoidosis]

  Authors: Zbigniew Kozłowski, Beata Sikorska, Agnieszka Wierzchniewska, Maciej Gryczyński

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(6):1173-7.

  The authors present actual opinions concerning etiology, pathogenesis and diagnostics of sarcoidosis with specific evaluation of the role of T lymphocytes and cytokines in formation of sarcoidThe authors present actual opinions concerning etiology, pathogenesis and diagnostics of sarcoidosis with specific evaluation of the role of T lymphocytes and cytokines in formation of sarcoid granulation. Rareness of sarcoidosis in that region and difficulties in neck tumours diagnosis is emphasizing. In solitary sarcoidosis cases it is necessary to take a sarcoid reaction into consideration. It always can go into generalized form. The authors present a case of solitary sarcoidosis of the neck.