Małgorzata Witkowska

Publications of Małgorzata Witkowska

• [16 years of experience in laryngeal microsurgery with use laser CO₂: cooperation between laryngologist and anesthesiologist - in material of ENT Department of Silesian Medical University].

  Authors: Jarosław Markowski, Zdzisława Sachajdak-Michalewska, Tatiana Gierek, Danuta Zbrowska-Bielska, Małgorzata Witkowska, Jarosław Paluch

  Otolaryngologia polska. The Polish otolaryngology. 11/2011; 65(6):417-22.

  Laryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laserLaryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laser technology. The laryngeal microsurgery is used mainly laser CO₂. Endoscopic laryngeal microsurgery using the laser poses a unique challenge to the anesthesiologist, ensuring safe conditions of anesthesia, the patient and simultaneously appropriate operating conditions for the surgeon for precisely perform the procedure. MATERIAL AND METHODS: Between 1995 and 2010 carried out in the Department of Otolaryngology SUM 832 microsurgical operations of the larynx using a CO₂ laser. CONCLUSION:The perioperative management and close cooperation with the surgeon and anesthesiologist are essential for safe and efficient conduct of the operation the larynx using a microsurgical CO₂ laser.

• Assessment of vestibulocochlear organ function in patients meeting radiologic criteria of vascular compression syndrome of vestibulocochlear nerve--diagnosis of disabling positional vertigo.

  Authors: Jarosław Markowski, Tatiana Gierek, Ewa Kluczewska, Małgorzata Witkowska

  Medical science monitor : international medical journal of experimental and clinical research. 02/2011; 17(3):CR169-73.

  This study sought to assess the vestibulo-cochlear organ in patients meeting radiologic criteria of vascular compression syndrome (VCS) of the eighth cranial nerve. The authors performed aThis study sought to assess the vestibulo-cochlear organ in patients meeting radiologic criteria of vascular compression syndrome (VCS) of the eighth cranial nerve. The authors performed a retrospective analysis of 34 patients (18 women, 16 men; mean age, 49 years) treated in between 2000 and 2007, with VCS of the eighth cranial nerve by MRI. Contrasted magnetic resonance imaging identified an anterior inferior cerebellar artery vascular loop adhering to the vestibule-cochlear nerve in all 34 cases. All patients were given pure tone audiometry, distortion product otoacoustic emissions, auditory brainstem response, and electroneurographic examinations. Most-common symptoms were unilateral hearing loss (82%), unilateral tinnitus (80%), and dizziness (74%). Most-frequent abnormalities in performed examinations were specific auditory brainstem response changes (interpreted according to Möller's criteria) in 86% of cases and sensorineural hearing loss in pure tone audiometry (82%). Abnormal changes in electronystagmography were found in the absence (12%) or weakness (35%) of a caloric response. No patients were surgically treated. Significantly, there is no more weakness or absence of the caloric response of a vestibular organ in a patient with vascular compression of the vestibulo-cochlear nerve. Despite an absence of electrophysiologic testing of vestibular organ dysfunction, most examined patients (meeting the radiologic criteria of VCS of the eighth cranial nerve) had subjective symptoms like vertigo and dizziness. Disabling positional vertigo should be considered in the differential diagnosis of vertigo when accompanied by tinnitus or deafness.

• The assessment of hearing organ of school children in Upper Silesia region.

  Authors: Tatiana Gierek, Małgorzata Gwóźdź-Jezierska, Jarosław Markowski, Małgorzata Witkowska

  International journal of pediatric otorhinolaryngology. 10/2009;

  Because at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a researchBecause at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a research programme. An important advantage of this study is the assessment of hearing in children from Upper Silesian region, a top ranking region in Europe in industrialisation and environmental pollution. In the selected population of primary school children in the province of Silesia, hearing loss occurred in 6% of the examined pupils; in schools located in urban areas it was higher than in schools from rural areas. In the group of children aged 6-10 years conductive hearing loss occurred significantly more frequently, than main cause of that hearing loss was Eustachian tube dysfunction. The obtained results testify about the society being hardly aware of the problems related to hearing loss, which stresses the necessity of conducting screening examinations of hearing organ in children at school age, as well as improving the health care and prevention in that respect.

• [A 20-year retrospective histoclinical analysis of parotid gland tumors in the ENT Department AM in Katowice]

  Authors: Tatiana Gierek, Krystyna Majzel, Edyta Jura-Szołtys, Aleksandra Slaska-Kaspera, Małgorzata Witkowska, Lucyna Klimczak-Gołab

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):399-403.

  INTRODUCTION: Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons. MATERIAL AND METHODS: The study is analysis of 531 patients with parotid glandINTRODUCTION: Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons. MATERIAL AND METHODS: The study is analysis of 531 patients with parotid gland tumours in patients treated in ENT Department during 1986-2006. We analysed surgical treatment and intraoperative tumour stage. The results of histological diagnosis were presented. RESULTS: The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma--75% and adenolymphoma--16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3-T4 was in 90%.

• [The histo-clinical analysis of 95 malignant neoplasms of parotid gland]

  Authors: Tatiana Gierek, Krystyna Majzel, Edyta Jura-Szołtys, Małgorzata Witkowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(3):313-6.

  INTRODUCTION: Malignant tumors constituted 25% of all gland tumors, the most frequently in parotid gland. MATERIAL AND METHODS: The study is analysis of 436 patients with parotid gland tumors whoINTRODUCTION: Malignant tumors constituted 25% of all gland tumors, the most frequently in parotid gland. MATERIAL AND METHODS: The study is analysis of 436 patients with parotid gland tumors who underwent surgery in ENT Department. The results of histopatological diagnosis are presented. We analysed surgical treatment, intraoperative tumor stage and accuracy of fine - needle aspiration cytology in diagnosis. RESULTS: Malignant tumors constituted 22% of all gland tumors. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumor. Tumor stage T3-T4 was in 88,5% cases. Accuracy of fine-needle aspiration cytology in diagnosis of parotid tumors is 81,2%.

• [Analysis of results of stapedotomy in patients with obliterative otosclerosis]

  Authors: Tatiana Gierek, Małgorzata Witkowska, Danuta Zbrowska-Bielska, Lucyna Klimczak-Gołab

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(3):377-83.

  INTRODUCTION: In obliterative type of otosclerosis the stapes footplate is greatly thickened and diffusely replaced by a massive otosclerotic masses that fill in the oval window niche, often annularINTRODUCTION: In obliterative type of otosclerosis the stapes footplate is greatly thickened and diffusely replaced by a massive otosclerotic masses that fill in the oval window niche, often annular ligament cannot be visualized. In the case of obliterative otosclerosis the only effective way of treatment is surgery. MATERIAL AND METHODS: The analysed group consisted of 53 patients with primary obliterative otosclerosis. In the control group there were 30 consecutive patients treated for otosclerosis. The auditory organ was assessed on the ground of the following criteria for the frequencies 0.5, 1, 2 and 4 kHz.: 1. Change of pure tone thresholds of air conduction (AC) 2. Change of pure tone thresholds of bone conduction (BC) 3. Change of pure tone thresholds of air-bone gap (ABG) as the difference between the mean AC and BC thresholds before the operation (AC0 and BC0) and 12 months after the operation (AC1 and BC1). RESULTS: Postoperatively mean value of change of AC thresholds in the analysed group was about 24 +/- 2 dBHL and in the control group about 25 +/- 2 dBHL (no significant difference). In the analysed group the mean value of BC thresholds varied about 8 dBHL and in the control group about 11 dBHL (no significant difference). The average values of ABG after the operation varied about 14 +/- 1 dBHL in both--the analysed and the control group. Postoperatively the mean value ABG was amounted to 20 +/- 1 dBHL in the analysed group and in the control group to 18 +/- 1 dBHL (no significant difference). On the basis of the subjective assessment completely subsidence of aural tinnitus reported 70% patients in the analysed group and 80% patients in the control group. CONCLUSION: 1. The incidence of obliterative otosclerosis represents 9,6% of all otosclerotic patients treated surgically. 2. Stapedotomy is the treatment of choice in patients with obliterative otosclerosis, because significant improvement of AC, BC and ABG 12 months after the operation was reported, mean values did not differ between the above and control group. 3. Complete subsidence of aural tinnitus was reported in 70% patients with obliterative otosclerosis.

• [Distant metastases to the parotid gland--review of the literature and report of own two cases]

  Authors: Jarosław Markowski, Tatiana Gierek, Ewa Zielińska-Pajak, Małgorzata Witkowska, Anatol Wodołazski, Jacek Pajak, Jarosław Paluch

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(4):547-52.

  Metastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland. The parotid gland and its lymph nodes are possible sites of metastases from head andMetastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland. The parotid gland and its lymph nodes are possible sites of metastases from head and neck cancers. However, metastasis from distant primary neoplasm below clavicle is possible, too. The authors presented the two cases of distant metastases to the parotid gland. The women with breast cancer and metastases to the parotid gland 11 years after surgery, radio- and chemotherapy of breast cancer. She died 7 months after parotid surgery of systemically advanced disease. The man with metastasis of malignant melanoma of unknown primary site. He underwent total parotid surgery with the tumor and lymph nodes. He died 7 months after surgery. In spite of intensive exam the primary location of the melanoma was unknown. The authors described pathophysiology of distant metastases to the parotid gland with special attention to possibilities of treatment and survival.

• [Analysis of 216 cases of pleomorphic adenoma of the parotid gland]

  Authors: Tatiana Gierek, Krystyna Majzel, Małgorzata Witkowska, Edyta Jura-Szołtys

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(3):329-32.

  Pleomorphic adenoma is the most frequent benign tumour of the salivary glands. The most common localization is the parotid gland. The authors present a clinical analysis of the group of 216 patients,Pleomorphic adenoma is the most frequent benign tumour of the salivary glands. The most common localization is the parotid gland. The authors present a clinical analysis of the group of 216 patients, who was treated in ENT Department and who was diagnosed as pleomorphic adenoma. The frequency of incidence of mixed tumours is 50.70% of all 426 cases of parotid gland's tumours. In 92, 13% cases the tumours was localized in the superficial part, only in 7.87% in deep part of the gland. Sixteen patient was operated on because of the recurrence of mixed tumours. In one case we observed the syndrome of the auriculotemporal nerve. The temporary paresis of facial nerve after operation occurred in 19 patients. We don't noticed the incidence of salivary fistula in our material.

• [Primary extranodal non-Hodgkin's malignant orbital lymphomas treated surgically in ENT Department of Medical Academy of Silesia in Katowice in the years 1996-2001]

  Authors: Tatiana Gierek, Jarosław Markowski, Ewa Zielińska-Pajak, Małgorzata Witkowska, Maciej Kajor, Jacek Pajak, Lukasz Kulesa, Jarosław Paluch

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2005; 58(11-12):598-601.

  The authors presented 7 cases of primary extranodal non-l-odgkin's malignant orbital lymphomas in patients treated surgically in the ENT Department of the Medical University of Silesia in the yearsThe authors presented 7 cases of primary extranodal non-l-odgkin's malignant orbital lymphomas in patients treated surgically in the ENT Department of the Medical University of Silesia in the years 1996-2001. In the course of the diagnostic process we examined the patients carefully to be sure that the cancer had not disseminated. We used some imaging techniques such as: ultrasonography (USG), computer tomography (CT) and magnetic resonance imaging (MRI). We also used the needle aspiration biopsy, as an additional examination. However the material was no significant in the most cases and we were unable to make a definitive diagnosis on the basis of this method alone. After prior examinations we performed the radical operations and removed the tumors. In each case the postoperative material was examined using histopatological and immunohistochemical methods. Afterwards the pathomorphological diagnosis was made by the specialists. Next the patients were observed and treated in the Haematological and Radiotherapy Departments.

• [Results of stapedotomy in the cases of "floating footplate"]

  Authors: Tatiana Gierek, Lucyna Klimczak-Gołab, Danuta Zbrowska-Bielska, Krystyna Majzel, Małgorzata Witkowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(2):263-6.

  One of the problems in the stapes surgery is the floating footplate. The frequency of incidence of this complication is 2% to 5.8% of all operations. The authors present the results of stapesOne of the problems in the stapes surgery is the floating footplate. The frequency of incidence of this complication is 2% to 5.8% of all operations. The authors present the results of stapes operations in a group of 28 cases (2.5%) from all the 1120 operations, in which the surgeon experienced a floating footplate. The hearing results were evaluated on the base of the average gain of air-conduction thresholds and air-bone gap levels at 500, 1000, 2000 and 3000 Hz. The improvement of hearing we observed in 24 patients, 4 patients heard worse.

• [Adenolymphoma of parotid gland--analysis of 75 cases]

  Authors: Tatiana Gierek, Krystyna Majzel, Małgorzata Witkowska, Edyta Jura-Szołtys

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(5):899-902.

  The authors present a clinical analysis of the group of 75 patients, who was treated in Department of Otolaryngology in the years 1986-2000 and who was diagnosed as adenolymphoma. The frequency ofThe authors present a clinical analysis of the group of 75 patients, who was treated in Department of Otolaryngology in the years 1986-2000 and who was diagnosed as adenolymphoma. The frequency of incidence of Warthin's tumour is 17,6% of all 426 cases of parotid gland's tumours. In 72 cases (96%) the tumour was localized in the superficial part, only in 3 cases (4%)--in the deep part of the gland. In one patient we observed recurrence of adenolymphoma. In one case adenolymphoma coexisted with carcinoma planoepitheliale of parotid gland.

• [Hidradenoma of external ear]

  Authors: Tatiana Gierek, Danuta Zbrowska-Bielska, Wojciech Smółka, Maciej Kajor, Małgorzata Witkowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(6):1141-2.

  The authors present a rare case of hidradenoma of the external ear and discussed the clinical picture, as well as diagnostic and therapeutic procedures.

• [Histologic and clinical assessment of primary extranodal non-Hodgkin malignant lymphomas of the head and neck region]

  Authors: Jarosław Markowski, Maciej Kajor, Tatiana Gierek, Małgorzata Witkowska, Lukasz Kulesa, Maciej Ligienza, Jacek Pajak, Joanna Wolańska-Karut

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(3):429-35.

  The authors presented 27 cases of primary extranodal non-Hodgkin's malignant lymphomas of the head and neck area in patients treated surgically in the ENT Department in the years 1996-2001. WeThe authors presented 27 cases of primary extranodal non-Hodgkin's malignant lymphomas of the head and neck area in patients treated surgically in the ENT Department in the years 1996-2001. We observed tumors in the various areas: palatine tonsil, naso-pharynx, eye socket, paranasal sinuses, parapharyngeal space and lingual base. In the course of the diagnostic process we examined the patients carefully to be sure that the cancer had not disseminated. We used some imaging techniques such as: ultrasonography, CT and MRI. We also used the needle aspiration biopsy, as a additional examination. However the material was not significant in the most cases and we were unable to make a definitive diagnosis on the basis of this method alone. After prior examinations we performed the radical operations and removed the tumours. In each case the postoperative material was examined using immunohistochemical methods. Afterwards the pathomorphological diagnosis was made by the specialists. Next the patients were observed and treated in the Haematological Department and Radiotherapy Department. In all cases pathomorphological diagnosis were performed on the base of usage postoperative histochemical examinations. All treated patients were performed as diagnostic preoperative USG, CT, MRI and fine-needle biopsy aspiration exam. All patients for further treatment were observed at Haematological Department.

• [Neuroendocrine carcinoma of the larynx--review of literature and report of 2 own cases]

  Authors: Jarosław Markowski, Tatiana Gierek, Maciej Kajor, Łukasz Kulesa, Małgorzata Witkowska, Monika Ciupińska-Kajor

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(2):291-4.

  A review of the international medical literature was conducted regarding the laryngeal neuroendocrine tumors. This paper discusses the diagnosis, histopathology, treatment, and prognosis in laryngealA review of the international medical literature was conducted regarding the laryngeal neuroendocrine tumors. This paper discusses the diagnosis, histopathology, treatment, and prognosis in laryngeal neuroendocrine tumors. It also discusses the heterogenous classification schema of such tumors. Two cases of a very rare neuroendocrine cancer of larynx are described. Both were localized in the supraglottic area and occurred in the 5th and 6th decades of life, consistent with previously reported cases of such neoplasms.

• [Head and neck tuberculosis - still current problem in ENT practice].

  Authors: Jarosław Markowski, Małgorzata Witkowska, Tatiana Gierek, Katarzyna Pasternak, Monika Ciupińska-Kajor, Maciej Kajor, Jarosław Paluch, Katarzyna Smółka

  Otolaryngologia polska. The Polish otolaryngology. 65(4):272-5.

  It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009 estimately 9 million new cases were registered worldwide, mortality due tuberculosis reached 1.5 million. In Poland extrapulmonary tuberculosis is rare (7% of overall morbidity) and most commonly affects pleura, lymph nodes, bones, joints and genitourinary system. Head and neck tuberculosis is rare and causes many diagnostics problems. Retrospective analysis of case histories of patients admitted to ENT Department of Silesian Medical University in Katowice. Between 1993 and 2010 four cases of head and neck tuberculosis were diagnosed in our Clinic. Two of patients were admitted to the hospital with symptoms of laryngeal tumor such as difficulty in swallowing. During direct laryngoscopy tissue specimens were taken. Examination of the third patient showed tumor located below left angle of mandibule. During superficial parotidectomy tumor was removed. In the fourth registered case tuberculosis manifested as tumor of nasopharynx. In every case which is mentioned above pathology reports revealed epithelioid cell granulomas with caseous necrosis typical for tuberculosis. Patients underwent tuberculostatic treatment. Rare occurrence and lack of characteristic symptoms of head and neck tuberculosis often lead to misdiagnosis. Histopathological examination is the most important diagnostic procedure. Microbiological examination is difficult in extrapulmonary tuberculosis, because of low concentration of pathogens in specimens. Tuberculostatic therapy is the leading method of treatment in every case of tuberculosis.

• [Küttner's tumor (chronic sclerosing sialadenitis) - a rare cause of submandibular gland enlargement].

  Authors: Jarosław Markowski, Tatiana Gierek, Małgorzata Witkowska, Jarosław Paluch, Monika Swiderek, Ewa Zielińska-Pająk, Jacek Pająk, Lucyna Klimczak-Gołąb, Katarzyna Smółka

  Otolaryngologia polska. The Polish otolaryngology. 65(4):289-92.

  Küttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis ofKüttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis of submandibular gland. This is an underrecognized entity in the surgical pathology and cytology literature. Most patients experience recurrent pain, discharge and swelling that is often associated with eating, but others only have asymptomatic hard swelling of the submandibular gland. Histologic examination of the excised submandibular glands revealed preserved lobular architecture, thickening of interlobular septa by sclerotic tissue, dense lymphoplasmacytic infiltrate, preservation of ducts with periductal fibrosis, and variable loss of acini. The morphologic appearance, in conjunction with the elevated IgG4 expression, distinguishes chronic sclerosing sialadenitis from other inflammatory diseases of the salivary glands. Chronic sclerosing sialadenitis belongs to the spectrum of IgG4-related diseases. We present a case of Küttner's tumor in a 62-year-old female treated by surgery. Although this disease was first described by Küttner in 1896, this clinical entity which masquerades as carcinoma is underdiagnosed by many surgeons. There is not enough evidence to support any diagnostic means that could help in the differential diagnosis of this benign condition. Given the high rate of malignancy in firm, painless lesions of the submandibular gland, surgical excision is often advocated and Küttner's tumor is usually diagnosed by the histopathologist.