Krzysztof Oleś

Publications of Krzysztof Oleś

• [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.

• [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.

• [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.

• [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.

• [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.

• [Endoscopic surgical treatment of patients with isolated sphenoid sinus disease]

  Authors: Pawel Strek, Olaf Zagólski, Jacek Składzień, Krzysztof Oleś, Marcin Konior, Karolina Hydzik-Sobocińska, Roman Głowacki

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(3):254-9.

  INTRODUCTION: Cases of isolated lesions of the sphenoid sinus are rare. For descriptive purposes, clinicians divide them into inflammatory and non-inflammatory with prevalence of the former. SymptomsINTRODUCTION: Cases of isolated lesions of the sphenoid sinus are rare. For descriptive purposes, clinicians divide them into inflammatory and non-inflammatory with prevalence of the former. Symptoms of the sphenoid sinus disease are difficult to characterise, the most common of them being vague headache and visual disturbances. Thorough preoperative evaluation of the lesion is essential - nasal endoscopy must be performed and computerised tomography or magnetic resonance imaging results analysed. The purpose of the study is to present the assessment of endoscopic surgery outcome in the own group of patients with isolated sphenoid disease. MATERIAL AND METHODS: Clinical data of 22 subjects were analysed retrospectively. There were 5 patients with bacterial sinusitis, 6 with fungal sinusitis, 4 with allergic thickening of the mucous membrane with no evidence of bacterial or fungal infection, 2 with mucocele, 1 with sphenoid osteoma, 1 with inverted papilloma, 1 with a foreign body and 2 with cerebral fluid fistula. Each patient had preoperative nasal endoscopy and CT/MRI imaging performed. Then they underwent endoscopic transnasal sphenoethmoidectomy with removal of the lesion or closure of the fistula. The sphenoid sinus was approached through its front wall. RESULTS: The patients' postoperative course was uneventful. They noted improvement in all preoperative symptoms, except for bilateral oculomotor nerve paralysis in one individual, and were asymptomatic to ophthalmological examination. CONCLUSIONS: Isolated lesions of the sphenoid sinus, even very rare tumours like those presented here, can be in most cases safely approached and removed endoscopically. All risks of the method must be considered prior to the operation. High frequency of fungal sinusitis should be noted.

• [Endoscopic management of osteomas of the paranasal sinuses--own experience]

  Authors: Pawel Strek, Olaf Zagólski, Jacek Składzień, Krzysztof Oleś, Marcin Konior, Karolina Hydzik-Sobocińska, Roman Głowacki

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(3):260-4.

  Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal is done if they extendOsteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, keep enlarging, are localised in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, irrespective of their size, in symptomatic tumours. Progressive headaches and chronic inflammation of the adjacent mucous membrane are most common symptoms. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim. The aim of the paper was to report own experience in endoscopic treatment of patients with osteomas of the paranasal sinuses. Material and methods. 6 patients with osteomas of paranasal sinuses were included in the group, mean age 36 years (range 15-52). Most common involvement was ethmoid cells (3). There were also patients with frontal, maxillary and sphenoid osteoma. All tumours were removed under endoscopic giudance. Frontoethmoidectomy was performed to remove ethmoid and frontal osteomas. Antrotomy was used in case of maxillary involvement and sphenoethmoidectomy in the patient with sphenoid sinus osteoma. Sphenoid sinus was approached through its anterior wall with a Stammberger punch. All the tumours were removed using fine forceps. Results. No post-operative complications were observed. No recurrences were noted. All patients remain asymptomatic. Conclusions. Resection of small and medium size osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects.

• [Endoscopic treatment of patients with intracranial complications of sinusitis]

  Authors: Paweł Strek, Olaf Zagólski, Jacek Składzień, Krzysztof Oleś, Karolina Hydzik-Sobocińska, Daniel Najdzionek, Roman Głowacki

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(2):131-6.

  INTRODUCTION: Intracranial complications of sinusitis (cerebral, epidural, and subdural abscesses, meningitis, and dural sinus thrombophlebitis) remain a challenging and current topic. Although theyINTRODUCTION: Intracranial complications of sinusitis (cerebral, epidural, and subdural abscesses, meningitis, and dural sinus thrombophlebitis) remain a challenging and current topic. Although they are nowadays relatively rare, prompt recognition of these disease states is important to prevent permanent neurological deficit or fatality. Infection may spread hematogenously or by direct extension. Patients with complications require surgery to remove the focus of infection from the sinuses and drain the abscess. Recently, endoscopic frontal and sphenoid sinus surgery has emerged as the preferred technique for the treatment of the most advanced and complicated chronic sinusitis. MATERIAL AND METHODS: Records of 7 patients aged from 13 to 65 (mean 30.6) years treated in our department for intracranial complications between January 2002 and September 2006 were analysed retrospectively. The diagnosis of meningitis was established in 2 patients, in one case with accompanying bilateral oculomotor nerve palsy. Cavernous sinus thrombosis, frontal abscess with hemiplegia, cerebral oedema, bilateral oculomotor nerve palsy and retrobulbar optic nerve neuritis with blindness was diagnosed each in one individual. 5 endoscopic bilateral frontosphenoethmoidectomies and 2 endoscopic sphenoethmoidectomies were performed. In one case a frontosphenoethmoidectomy was combined with craniotomy. RESULTS: All preoperative symptoms subsided in 4 operated individuals. Vision improved in the patient with bilateral retrobulbar optic nerve neuritis. In patients with hemiplegia and bilateral oculomotor nerve palsy the symptoms persisted. No complications of the surgery were observed. CONCLUSIONS: Surgical treatment of the focus of infection in the sinuses can be accomplished endoscopically via an intranasal approach with less morbidity, easy identification of anatomical structures, physiological drainage of the sinuses and superior cosmetic effects.

• [Preemptive analgesia in postoperative pain for children in otolaryngological department]

  Authors: Anna Przeklasa-Muszyńska, Klaudia Nosek-Kozdra, Tomasz Muszyński, Magdalena Kocot-Kepska, Henryk Podziorny, Krzysztof Oleś, Jan Dobrogowski, Jerzy a Wordliczek, Wiktor Dardziński

  Przegla̧d lekarski. 02/2006; 63(11):1168-72.

  Although much more about the safe and effective management of pain in children is now known, this knowledge has not been widely or effectively translated into routine clinical practice. Pain inAlthough much more about the safe and effective management of pain in children is now known, this knowledge has not been widely or effectively translated into routine clinical practice. Pain in children is still a big problem even thought available many possibilities to cure it. Malpractice during postoperative period influence not only for recovery, but also causes long lasting consequences (emotional changes). The most common applied method for treatment postoperative pain in children is still pharmacotherapy. One of the most effective form of it is preemptive analgesia. Specifically, preemptive analgesia may be defined as an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The most important conditions for establishment of effective preemptive analgesia are the establishment of an effective level of antinociception before injury, and the continuation of this effective analgesic level well into the post-injury period to prevent central sensitization during the inflammatory phase. Although single-agent therapy may attenuate the central nociceptive processing, multi-modal therapy is more effective, and may be associated with fewer side effects compared with the high-dose, single-agent therapy. Practical in the pediatric patients in laryngological ward seems to be one of the most effective method of pain therapy in postoperative period. Laryngological procedures in children cause a severe pain. The most common procedure in children in laryngological practice is adenotomy. There is a pressing need for further research and clinical development in the management of pain in children.

• [Characteristics of non-infectious rhinitis in patients residing in a large city and in a small town]

  Authors: Krzysztof Oleś

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(3):455-7.

• [Current views of surgical procedures in the treatment of hypertrophic nasal conchae]

  Authors: Krzysztof Oleś, Jacek Składzień

  Przegla̧d lekarski. 02/2002; 59(12):1011-2.

  Surgical treatment aiming at decreasing the size of the nasal conchae is controversial and it should be performed only after all alternative kinds of therapy have appeared unsuccessful. The incisionSurgical treatment aiming at decreasing the size of the nasal conchae is controversial and it should be performed only after all alternative kinds of therapy have appeared unsuccessful. The incision of hypertrophic nasal conchae can also be performed together with the operation of the nasal septum. The excision of the entire concha is performed very infrequently. Usually, only the soft tissue of the concha is excised, but the excision of the hypertrophied tissue is most desirable. Some patients may undergo the cryotherapy.

• [Prognostic factors in patients operated on eardrum perforation with intact ossicular chain].

  Authors: Maciej Wiatr, Krzysztof Oleś, Jerzy Tomik, Jacek Składzień, Agnieszka Morawska, Paweł Stręk, Robert Przeklasa, Karolina Hydzik-Sobocińska, Joanna Szaleniec, Aleksandra Boroń, Aneta Pałasz, Patryk Hartwich

  Otolaryngologia polska. The Polish otolaryngology. 65(4):266-71.

  Ear drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. This paper is intended to evaluate effectiveness ofEar drum perforation is a typical feature in chronic otitis media. It can have posttraumatic etiology or it is observed in acute otitis media too. This paper is intended to evaluate effectiveness of tympanic membrane reconstruction and indicate factors which have an influence on hearing improvement after myringoplasty. Analysis involves ca. 500 individuals operated on ear in Department of Otolaryngology at the Jagiellonian University between 2004 and 2009. 120 individuals were operated on for the first time due to chronic otitis media with intact ossicular chain. Statistically significant heating improvement was observed in patients with discharge, without discharge and in group with scars. The presence of granulation changes is an unfavorable prognostic condition in the patients with ear drum perforation. In clinical practice, the criterion which often determines the application of either of the materials in myringoplasty are operator's preferences, as well as the availability of given material for transplanting.

• [Isolated inverted papilloma of the sphenoid sinus - case report].

  Authors: Krzysztof Oleś, Maciej Wiatr, Paweł Stręk, Jacek Składzień, Jerzy Tomik, Henryk Podziorny, Aleksandra Boroń, Joanna Szaleniec

  Otolaryngologia polska. The Polish otolaryngology. 65(4):293-6.

  Primary inverted papilloma of the sphenoid sinus is rare. The tumor is considered locally aggressive. In selected cases inverted papilloma can be associated with squamous cell carcinoma. RadiologicPrimary inverted papilloma of the sphenoid sinus is rare. The tumor is considered locally aggressive. In selected cases inverted papilloma can be associated with squamous cell carcinoma. Radiologic imaging is a key to an accurate diagnosis. We analyzed patient with inverted papilloma in sphenoid sinus which was removed with endoscopic surgery. We discuss patient with isolated inverted papilloma located in the sphenoid sinus. Performed endoscopic treatment enabled removal of tumour with no complications. Transnasal endoscopic large sphenoidotomy remains an effective modality for management of patients with inverted papilloma. This method does not require external approach and it is performed with no scars, with minimal injury of tissues.

• [Reoperations in patients with chronic otitis media cholesteatomatosa].

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

  Otolaryngologia polska. The Polish otolaryngology. 64(5):313-7.

  Chronic cholesteatoma otitis media, apart from destruction of bones and possibility of otogenous complications, is characterized by possibility of recurrence of the disease after non radicalChronic cholesteatoma otitis media, apart from destruction of bones and possibility of otogenous complications, is characterized by possibility of recurrence of the disease after non radical treatment or presence of risk factors. This paper intends to analyze changes typical for cholesteatoma, observed during otosurgery including the results of bacteriological investigations. Nearly 450 otosurgeries were performed in Department of Otolaryngology at Jagiellonian University 2004-2007. Analysis refers to patients reoperated on chronic cholesteatoma otitis media. 47 reoperations in the course of chronic choleateatoma otitis media were performed. Bacteriological analysis was provided in 21 cases. The most common bacteria were Staphylococcus aureus and Pseudomonas aeruginosa. Biofilms were not observed in specimens. The recurrence of the process should be expected in patients with cholesteatoma. They require regular, periodical follow-up examination.

• [Cat scratch disease--an underestimated diagnosis]

  Authors: Joanna Szaleniec, Krzysztof Oleś, Jacek Składzień, Pawel Strek

  Otolaryngologia polska. The Polish otolaryngology. 63(3):271-3.

  INTRODUCTION: Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellularINTRODUCTION: Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellular bacilli Bartonella, transmitted by domestic animals. AIM: We present a case report of a patient treated in the Department of Otolaryngology UJCM in Krakow. The patient presented with a neck tumor. Due to unclear clinical manifestation he underwent surgical treatment. The postoperative histopathological examination suggested cat scratch disease. In detailed anamnesis the patient admitted contact with cats and dogs in his household. No posoperative complications were observed. CONCLUSIONS: In every case of neck tumor it is advisable to consider cat scratch disease, remembering that exclusion of a neoplastic process remains a priority.