Czesław Stankiewicz

Publications of Czesław Stankiewicz

• Jan Mikulicz-Radecki (1850-1905): a fundamental contributor to world surgery; surgeon of the head, neck, and esophagus.

  Authors: Jerzy Kuczkowski, Czesław Stankiewicz, Lukasz Plichta, Joanna Cieszyńska

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 03/2012;

  We present some of many valuable and unique achievements of Jan Mikulicz-Radecki with special regard to his contribution to laryngology. He constructed esophagogastroscope, and was one of the firstWe present some of many valuable and unique achievements of Jan Mikulicz-Radecki with special regard to his contribution to laryngology. He constructed esophagogastroscope, and was one of the first to perform endoscopy of esophagus and ventricle. He published several papers describing new approaches to maxillary sinus through inferior meatus, surgical management of tonsillar cancer via lateral pharyngotomy, correction of post-traumatic nasal deformations, and the use of iodophorm in healing wounds. Among Mikulicz's many celebrated scientific achievements, the most important remains the development of asepsis and creation of a surgical school, which was a modernized continuation of Langenbeck-Billroth achievements.

• [Managment of head and neck cancers during pregnancy].

  Authors: Krzysztof Kiciński, Andrzej Skorek, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):326-32.

  The coincidence of malignant disease during pregnancy is uncommon. The incidence of cancer in pregnancy has increased, due to the tendency to postpone childbirth to an older age. Cancer complicatesThe coincidence of malignant disease during pregnancy is uncommon. The incidence of cancer in pregnancy has increased, due to the tendency to postpone childbirth to an older age. Cancer complicates approximately 0.1% of all pregnancies. Managing head and neck cancers during pregnancy requires additional pregnancy-related understanding of the aetiological effect of pregnancy on cancer, knowledge of the direct and indirect effects of cancer on pregnancy, and the effect of diagnostic and treatment modalities on pregnancy. The timing of treatment is an important determinant on foetal wellbeing. A multidisciplinary approach should be adopted to enable parents and clinicians to make the best clinical decision. Clinicians must be cognizant with the ethical dilemmas of treatment. In head and neck cancers, pregnancy has no effect on maternal prognosis when compared to non-pregnant patients matched by age, cancer stage and treatment.

• [Major salivary gland disorders in children and adolescents].

  Authors: Tomasz Przewoźny, Dominik Stodulski, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):350-6.

  The aim of this study was a review of 67 children treated for salivary gland tumors in the ENT Department Medical University of Gdańsk since 1974 to 2008. In that group we observed 52 children withThe aim of this study was a review of 67 children treated for salivary gland tumors in the ENT Department Medical University of Gdańsk since 1974 to 2008. In that group we observed 52 children with tumor of the parotid gland, 13 with tumor of submandibular gland and 2 with subligual gland tumors. Tumor-like lesions were stated the largest group of tumors and were observed in 33 (49%) of children, mainly of chronic sialadenitis (17 cases). Predominant number of tumors was observed in scholarship children. The most common symptoms were slow enlargement of tumor and swelling of the salivary gland. In the group of benign tumors most common was pleomorphic adenoma (19 cases) and in the group of malignant tumors most common was clear cell carcinoma (2 cases) and rhabdomyosarcoma (2 cases). In this report the authors describe basic epidemiological and clinical data (age, sex, duration of symptoms, histological structure of tumor, diagnostic methods, methods and results of treatment) and observations connected with differences of salivary gland tumors in that group of patients.

• Sir Felix Semon (1849-1921): pioneer in neurolaryngology.

  Authors: Jerzy Kuczkowski, Lukasz Plichta, Czesław Stankiewicz

  Journal of voice : official journal of the Voice Foundation. 04/2011; 26(1):87-9.

  This article will attempt to review the historical and scientific literature pertaining to the life and work of Felix Semon (1849-1921). Sir Felix Semon was one of the most distinguished figures inThis article will attempt to review the historical and scientific literature pertaining to the life and work of Felix Semon (1849-1921). Sir Felix Semon was one of the most distinguished figures in the early development of laryngology. He was an astute researcher of laryngeal pathophysiology and an active participant in laryngological scientific societies. Felix Semon was a talented doctor and was one of the most esteemed laryngologists in London for 35 years (1875-1910). Primarily, his scientific interests included complications after thyroid surgery, laryngeal cancer, tuberculosis and motor innervation of the larynx, and movement disorders of the larynx. Semon formulated the law regarding the sequence of occurrence of the laryngeal muscle paralysis-abduction before adduction. The 132 articles he had published over the years have had a significant impact on contemporary medical knowledge. At the 160th anniversary of Semon's birth, we attempt to summarize his invaluable contribution to laryngology.

• [HIV infected child in otolaryngological practice].

  Authors: Tomasz Smiatacz, Waldemar Narozny, Jerzy Kuczkowski, Hanna Trocha, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 01/2008; 62(2):145-8.

  The authors present material about 12 HIV infected children at the age between 0 and 18 years observed and treated in Department of Infectious Diseases Medical University of Gdansk in the periodThe authors present material about 12 HIV infected children at the age between 0 and 18 years observed and treated in Department of Infectious Diseases Medical University of Gdansk in the period between 1991 till 2006. Retrospectively medical records of 4 of them currently undergoing observation and treatment have been analyzed taking into consideration: ways of HIV infection, applying the possible retroviral profilactic to a mother and a child, the damaging o of immunological condition in the period of observation and treatment as well as the possible head and neck changes. The authors come to conclusion that changes in oral cavity may be the first symptom of child HIV infection and in the oral candidiasis symptoms the possibility of HIV infection should be taken into account.

• [Orbital trauma]

  Authors: Andrzej Skorek, Czesław Stankiewicz, Dariusz Babiński, Anna Ostrowska, Dominik Stoduski

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):409-15.

  INTRODUCTION: Single or multifragmental orbital fractures may be a difficult diagnostic and therapeutic dilemma. Dislocation of the orbital contain into maxillary and ethmoid sinus may take placeINTRODUCTION: Single or multifragmental orbital fractures may be a difficult diagnostic and therapeutic dilemma. Dislocation of the orbital contain into maxillary and ethmoid sinus may take place during trauma. The main topics: is when and what surgical technique should be applied in these cases. MATERIAL AND METHODS: Material consists of retrospective analysis of 23 cases with fracture of medial and interior wall of orbit hospitalized in ENT Department of Medical University in Gdansk from 1999 to 2005. External ethmoidectomy was performed in cases with medial wall fracture and loose bone fragments are removed with reposition of orbit tissue. Transantral approach was applied in cases with inferior wall fractures. Loose bone fragments were replaced with autogenic bone or fascia graft, or synthetic material--bone cement. RESULTS: Complete or partial recovery was achieved in 91% of cases. Only in 2 cases (9%) recovery was not obtained after surgery--in these cases treatment started later then 60 days after fracture. CONCLUSIONS: In our opinion the optimal results of surgery may be achieved when treatment is begining before 14 day after fracture. If the later treatment is applied the worse results are achieved. Most of the cases must had been completed by rehabilitation after surgery.

• [Complications of acute mastoiditis in children]

  Authors: Jerzy Kuczkowski, Waldemar Narozny, Czesław Stankiewicz, Bozena Kowalska, Wojciech Brzoznowski, Mirosława Dubaniewicz-Wybieralska

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):445-51.

  OBJECTIVE: The incidence of complications resulting from acute otitis media has significantly decreased since the introduction of antibiotics. The use of antibiotics has lead to decrease in theOBJECTIVE: The incidence of complications resulting from acute otitis media has significantly decreased since the introduction of antibiotics. The use of antibiotics has lead to decrease in the complications of acute mastoiditis as well as the mortality of the disease. The purpose of the study was to review our experience in the diagnosis and treatment of complications of acute mastoiditis in children. Study design. Retrospective clinical study. MATERIAL AND METHODS: We present a retrospective study of 70 children with extracranial and intracranial complications of acute mastoiditis who were treated in the period from 1968 to 2006 at Department of Otolaryngology, Medical University of Gdansk. Their treatment has been documented with long period of otologic follow-up. RESULTS: Extracranial complications occurred in 41 (30.4%) of treated acute mastoiditis cases, and subperiostal abscess was the commonest one in 37 (90.2%) patients. Intracranial complications occurred in 29 (21.4%) of acute mastoiditis cases and facial paralysis was the commonest one in 14 (40.0%) cases, followed by sigmoid sinus thrombosis and perisinus abscess. Ear cultures grew in patients with otogenic complications, the most often Staphylococcus aureus, Streptococcus sp. and Pseudomonas aeruginosa were found. Mastoidectomy with myringotomy resolved the disease in 46 (65.7%) children, only myringotomy in 6 (8.6%) and canal wall down mastoidectomy in 18 (25.7%) children. Complete resolution was achieved in all cases. CONCLUSION: The persistent othorrea, otalgia and headache, prolonged high fever, neurological signs were the most common symptoms associated with the development of intracranial complications of acute mastoiditis in children. Computed tomography and MRI are necessary tools for diagnosis and surgery planning in every case of latent mastoiditis. Antibiotic treatment of acute mastoiditis does not prevent otogenic complications. Extracranial or intracranial complications of acute mastoiditis need surgical treatment and prolonged antibiotic therapy. The present study found evidence for decreased incidence of mastoiditis and their suppurative complications during last years.

• [Sphenoid sinusitis]

  Authors: Dariusz Babiński, Wojciech Brzoznowski, Andrzej Skorek, Anna Ostrowska, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):452-7.

  INTRODUCTION: Isolated sphenoid sinusitis is being diagnosed quite rare and it is caused by uncharacteristic evidences. Acute sphenoid sinusitis is usually diagnosed when intracranial complicationsINTRODUCTION: Isolated sphenoid sinusitis is being diagnosed quite rare and it is caused by uncharacteristic evidences. Acute sphenoid sinusitis is usually diagnosed when intracranial complications are seen. MATERIAL AND METHODS: 11 cases aged 8-74 years hospitalized between 1999-2005 are retrospective analyzed. Diagnosis of isolated sphenoid sinusitis was made after ENT and radiological examination. RESULTS: The most common evidence (10/11 cases) was headache, they last 1 week-1 year, in 1 case 30 years. Acute inflammation was diagnosed in 2 cases and in all intracranial complication was developed. Meningitis, temporal lobe abscesses, orbital cellulitis and paresis of CN VI in case of 11 years old girl and in other case of 37 years old man aseptic meningitis developed. Chronic sinusitis was diagnosed in 6 cases and in other 3 mucocele was present. Progressive atrophy of CN II was the only complain in case of 8 years boy, in rest of cases of chronic sinusitis headache was the only complain. External approach sphenoidotomy in 3 cases and endoscopic approach in 8 cases was managed. CONCLUSIONS: Isolated sphenoid sinusitis was usually diagnosed when neurological or ophthalmologic evidences were being evaluated. Surgical treatment is indicated in chronic sinusitis and in cases with no recovery after i.v. antibiotic course or when complication develops. Complications of isolated sphenoid sinusitis often anticipate rhinologic evidences that can be absent.

• Angiomyolipoma of the larynx: case report.

  Authors: Dominik Stodulski, Czesław Stankiewicz, Robert Rzepko, Bozena Kowalska

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 02/2007; 264(1):89-92.

  The authors present the report of the first ever case of angiomyolipoma arising in the larynx. The tumor was found in a 61-year-old man and was resected through laryngofissure. HistopathologicThe authors present the report of the first ever case of angiomyolipoma arising in the larynx. The tumor was found in a 61-year-old man and was resected through laryngofissure. Histopathologic examination of the tumor revealed numerous smooth muscle cells, mature adipose tissue and numerous thin and large irregular vessels. Both histological and immunohistochemical findings were typical for tumors of the mucocutaneous angiomyolipoma group.

• [Noninvasive fungal sinusitis (fungus ball)--diagnostic difficulties]

  Authors: Dariusz Babiński, Waldemar Narozny, Andrzej Skorek, Robert Rzepko, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):694-7.

  Noninvasive fungal sinusitis (fungus ball) is usually found in one sinus and the most frequently is caused by Aspergillus. Diagnostic criteria are based on histopathology, and fungal cultures areNoninvasive fungal sinusitis (fungus ball) is usually found in one sinus and the most frequently is caused by Aspergillus. Diagnostic criteria are based on histopathology, and fungal cultures are frequently negative. The clinical symptomatology mimics chronic rhinosinusitis and radiology, specially CT and MRI are helpful for making decision of surgery. The authors present 4 cases of fungus ball of the paranasal sinus. In one case clinical symptoms, endoscopic examination of nasal cavity and CT scans suggested foreign body in the maxillary sinus. In other case clinical and radiological evidences made us to thing of neoplasmatic disease of the frontal sinus. In remaining two cases mycetoma was found in the sphenoid sinus. Surgical removal was the treatment in all cases and followed by systemic antifungal therapy in one case because of bone destruction. Histopathology revealed hyphae of Aspergillus without evidence of tissue invasion, fungal cultures in two cases were negative, an in other two Aspergillus fumigatus culture were obtained.

• [Mucoceles of the paranasal sinuses]

  Authors: Jerzy Kuczkowski, Waldemar Narozny, Czesław Stankiewicz, Ewa Izycka-Swieszewska, Wojciech Skrzypczak, Ewa Kowalska, Lukasz Plichta

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):680-6.

  INTRODUCTION: Paranasal sinus mucocoele is a benign pseudocystic lesion, which may originate from any sinus cavities when their natural ostia are blocked. Raising mucocoele in frontal, ethmoid orINTRODUCTION: Paranasal sinus mucocoele is a benign pseudocystic lesion, which may originate from any sinus cavities when their natural ostia are blocked. Raising mucocoele in frontal, ethmoid or sphenoid sinus causes headache, disorders of eye mobility and deformities of forehead or orbit. AIM OF THIS STUDY: was clinical analysis of treatment results taking into consideration the method of surgical treatment. MATERIAL AND METHOD: Presented material consists of 42 patients (39 adults and 3 children), 22 females and 20 males, in the age from 8 to 76 treated at Department of Otolaryngology of Medical University of Gdansk in the years from 1995 to 2005 for paranasal sinuses mucocoele. RESULTS: Fronto-ethomidal mucocoele was found in 22 (52.4%) patients, ethmoidal--in 10 (23.8%), frontal--in 4 (9.5%), spheno-ethmoidal--in 4 (9.5%) and maxillar in 2 (4.8%) patients. 14 (33.3%) cases were primary and 28 (66.7%) secondary of mucocoeles. The most frequent symptoms of frontal or ethmoidal mucocoele were: headache, lacrimation, deformity of orbit, blepharoedema, and diplopia. Sphenoethmoidal and maxillar mucocoele caused mostly nose obstruction and severe headache. Destruction of sinuses and orbital bony wall was found in 16 patients (38.1%), and in 9 of them (21.4%) there were in medial wall of orbit, in 3 (7.1%)--in inferior wall of frontal sinus, in 3 (7.1%)--in anterior wall of frontal sinus, and in 1 (2.3%) in anterior wall of maxillary sinus. In 3 patients (97.1%) with fronto-ethmoidal mucocoele as the consequence of disease the development of empyema was observed. Endoscopic intranasal treatment was applied in 9 patients (21.4%) with fronto-ethmoidal, spheno-ethmoidal and maxillar mucocoele. Complete recovery was observed in 30 (71.4%) patients, recurrence was noted in 12 (28.6%) and these patients were operated from extranasal approach. CONCLUSIONS: Paranasal sinuses mucocoele is found when natural ostia of sinuses are blocked after prior operation. They cause destruction of bony walls of sinuses. Extranasal approach is an optimal method of treatment in extended mucocoele and their complications.

• [Carcinoma ex pleomorphic adenoma of major salivary glands--a clinicopathologic review]

  Authors: Dominik Stodulski, Robert Rzepko, Bozena Kowalska, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(5):687-93.

  BACKGROUND: Pleomorphic adenoma (PA) is the most common neoplasm of the major salivary glands. There are three subtypes of malignant PA: carcinoma ex pleomorphic adenoma (CXPA); carcinosarcoma (trueBACKGROUND: Pleomorphic adenoma (PA) is the most common neoplasm of the major salivary glands. There are three subtypes of malignant PA: carcinoma ex pleomorphic adenoma (CXPA); carcinosarcoma (true malignant mixed tumor) and metastasizing pleomorphic adenoma. The most common subtype of malignant PA is CXPA which develops in primary or recurrent PA. For proper diagnosis of CXPA, a statement of coexistence of pleomorphic adenoma and carcinoma (or carcinoma after prior PA surgery) is needed. Own material is presented because of rarity and clinicopathologic specificity of this neoplasm. METHODS: Retrospective analysis of the medical data of 19 patients who were treated at our department because of CXPA from 1990 to 2002 was done. The following clinical factors were evaluated: age, sex, symptoms (time of lasting, evolution), tumor size, invasion of the adjacent structures and facial nerve, neck nodes, clinical stage, treatment outcome. One pathologist reviewed histological material of 18 out of 19 patients who had been operated and pathological factors such as sensitivity and accuracy of fine needle aspiration biopsy, grade, histology and proportion of malignant component in tumor, lymph nodes metastases were analyzed. RESULTS: There were 11 men and 8 women, the mean age was 57 years. In 15 cases, tumor was localized in the parotid and in 4 in the submandibular gland. Two patients had history of prior surgery of PA. Duration of symptoms of benign PA was from 2 to 40 years (mean 17.8 years). Symptoms of malignant transformation occurred in 15 patients, the most common were rapid enlargement of tumor, pain and facial nerve palsy. Tumor size varied from 2 to 20 cm with a mean of 6 cm. In 14 patients, the neck was evaluated clinically as No, in 5, examination identified enlarged lymph nodes. Adjacent structures were invaded by neoplasm in 5 cases. Sensitivity and accuracy of fine needle aspiration biopsy in detection of malignant character of PA were 60% and 46% respectively. 17 out of 18 tumors reviewed by the pathologist were high grade. Only in 6 patients, proportion of carcinoma in the mass was less than 50%. The most common malignant component in CXPA was adenocarcinoma (9 cases) and undifferentiated carcinoma (6 cases). Pathologic examination showed metastases to the lymph nodes in 7 out of 10 patients with prior neck dissection. 16 patients were treated surgically (12 of them had also radiation therapy) and 3 patients underwent only (chemo)radiotherapy. Determinate survival at 5 years was 73.6% and in the group treated surgically (alone or with postoperative irradiation) 87.5%. CONCLUSIONS: Malignant transformation of PA occurs in 5 to 25% untreated patients, usually after 15-20 years and warning symptoms are present in the most cases. Fine needle aspiration biopsy has insufficient sensibility and accuracy in detection of malignant character of PA. Clinical picture and histopathological examination determinate the diagnosis of CXPA. Proper histological classification of malignant component can be found difficult. Surgical treatment (alone or with postoperative irradiation), if possible, allows to achieve good locoregional control of CXPA. 5-years survival varied between 30 to 76%. The best method of prevention and treatment of CXPA is early and radical removal of all major salivary glands tumors.

• [Tobacco smoking and multiple primary cancers]

  Authors: Zygmunt Chodorowski, Czesław Stankiewicz, Jacek Sein Anand, Marek Wiśniewski, Wojciech Sierszeń

  Przegla̧d lekarski. 02/2007; 64(4-5):374-5.

  Seventy six patients (55 males and 21 females) aged from 39 to 89 (mean 63.7 +/- 9.7) years with multiple primary cancers were described. Larynx cancer was the most commonly seen multiple primarySeventy six patients (55 males and 21 females) aged from 39 to 89 (mean 63.7 +/- 9.7) years with multiple primary cancers were described. Larynx cancer was the most commonly seen multiple primary cancer component (35.5%) followed by lung cancer (12.5%). Combination of larynx cancer and lung cancer was the most often observed connection (21.1%). In seventeen patients two cancers were diagnosed concurrently. In other cases the interval between two cancers varied from 1 to 24 (mean 6.9 +/- 6.1) years. Smoking rate was 80.3% at diagnosis of the second cancer and only 10 patients (13.1%) quit smoking when first cancer was recognized. The results of the research indicate the necessity of conducting wide prophylactic actions.

• [Proceedings from the 6th European Laryngological Society (ELS)]

  Authors: Czesław Stankiewicz, Bozena Kowalska, Beata Zielnik-Jurkiewicz, Dariusz Jurkiewicz, Maciej Misiołek, Eugeniusz Czecior

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(1):115-6.

• Otogenic skull base osteomyelitis caused by invasive fungal infection. Case report and literature review.

  Authors: Dominik Stodulski, Bozena Kowalska, Czesław Stankiewicz

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 01/2007; 263(12):1070-6.

  Otogenic skull base osteomyelitis (SBO) of fungal etiology is a very rare but life-threatening complication of inflammatory processes of the ear. The authors present a case of otogenic SBO caused byOtogenic skull base osteomyelitis (SBO) of fungal etiology is a very rare but life-threatening complication of inflammatory processes of the ear. The authors present a case of otogenic SBO caused by Aspergillus flavus in a 65-year-old man with a fatal course. Because of the encountered difficulties with the proper diagnosis and treatment, the authors reviewed the literature on the subject.

• [Nd:YAG laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnea syndrome]

  Authors: Dariusz Babiński, Czesław Stankiewicz, Bozena Kowalska, Mikołaj Majkowicz

  Otolaryngologia polska. The Polish otolaryngology. 01/2007; 61(3):295-300.

  INTRODUCTION: Surgical treatment of OSAS is focused on removal of narrowing that increase airway resistance in upper respiratory tract. Nd:YAG laser beam penetrates deeper into tissue than CO2 laserINTRODUCTION: Surgical treatment of OSAS is focused on removal of narrowing that increase airway resistance in upper respiratory tract. Nd:YAG laser beam penetrates deeper into tissue than CO2 laser followed by superior scarification ability. In this study we investigate efficacy of surgery with Nd:YAG laser assisted uvuloplasty (LAUP). MATERIAL AND METHODS: The subject was 51 patients with OSAS treated in Department of Otolaryngology, Medical University of Gdansk during the 2004-2005 period. All patients underwent all-night PSG and the ESS (Epworth Sleepiness Scale) score was used to assess the daytime sleepiness. Surgery treatment was performed and all patients underwent LAUP and additionally lingual base laser vaporization, tonsillectomy and nasal surgery where needed. The postoperative control ENT examination including ESS and all-night PSG was performed after 6 months. RESULTS: Success was found in 29 patients, they achieved AHI<10 and ESS<12. In another 22 patients improvement at PSG parameters and ESS score were evaluated but they were still beyond normal range. Success was obtained in 14/16 patients with preoperative AHI I degree, 10/19 AHI II, and 4/16 AHI III. Nasal surgery for enlargement of airway passage was performed more frequently (25/32) in the group with success then in the group with partial improvement (9/19). Preoperative PSG parameters were better in patients with nasal obstruction. Patients with BMI> or =30 succeeded rarely (10/22) in compare with patients with BMI<30 (success in 24/29). Preoperative PSG parameters were better in patients with BMI<30. CONCLUSION: LAUP with Nd:YAG laser wit additional tonsillectomy, lingual base surgery and nasal surgery were needed is successful method for surgery at light and medium stage of OSAS in nonobese patients.

• [Malignant tumors of the nose and paranasal sinuses in the years 1992-2001]

  Authors: Stanisław Betlejewski, Robert Bilewicz, Czesław Stankiewicz, Andrzej Skorek, Tatiana Gierek, Piotr Wardas, Wiesław Gołqbek, Marcin Szymański, Maciej Gryczyński, Zygmunt Szmeja, Witold Szyfter, Ewa Osuch-Wójcikiewicz, Oksana Korolkowa, Dariusz Jurkiewicz, Dagmara Kenig, Lucyna Pośpiech, Krzysztof Preś, Grzegorz Namysłowski

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(5):729-36.

  On the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment ofOn the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment of basic epidemiological data, including the localization of tumor, and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 10 years the trends to change the mentioned above parameters has been examined. The index of morbidity in this period was constant and compareable with figures published earlier. In the analyzed material there is a predominance of males and the sex ratio was 1.45. The majority of cases were between 50-69 years (55%).The most common histopathological diagnosis was carcinoma (58%).The majority of cases of malignant tumors of the nose and paranasal sinuses was diagnosed in the advanced stage T3-T4 (72.3%) with the highest percentage in the middle region. 90% of all cases were treated surgically, but in about 30% it was the only treatment (also in cases of stage T2-T4). In 56% of all patients the surgical procedure was completed by radiotherapy. This data suggest that indications for additional irradiation should be extended.

• [Renal cell carcinoma metastases to the head and neck]

  Authors: Dominik Stodulski, Czesław Stankiewicz, Andrzej Skorek

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(6):893-9.

  INTRODUCTION: The kidney is the third primary infraclavicular localization of malignant neoplasms metastasizing to the head and neck. The objective of this paper is to analyze the clinicalINTRODUCTION: The kidney is the third primary infraclavicular localization of malignant neoplasms metastasizing to the head and neck. The objective of this paper is to analyze the clinical presentation, diagnostic difficulties, management and outcome of metastatic renal cell carcinoma to the head and neck. MATERIAL AND METHODS: Retrospective review of four patients with renal cell carcinoma who have developed head and neck metastases and have been hospitalized in the ENT Department of the Medical University of Gdansk over the past 35 years. RESULTS: There were three women and one man in the examined material. The localizations of metastasizing renal cell carcinoma were: the larynx, the parotid gland, the cervical lymphnodes and the nasopharynx. In two patients metastatic tumor was the first clinical presentation of the disease and in the next two, time between treatment of the primary localization and occurring head and neck metastases was one and ten years. All patients, except one, were treated surgically. Two patients died, two are alive and the survival periods are one and three years. CONCLUSIONS: Renal cell carcinoma metastases to the head and neck region are infrequent but can cause difficulties in diagnosis and proper management. Despite of possibility of local excision, prognosis in metastasizing renal cell carcinoma is still unfavourable.

• [Sigmoid sinus thrombosis in 5-year old child with acute otitis media and acquired CMV infection]

  Authors: Jerzy Kuczkowski, Czesław Stankiewicz, Ewa Izycka-Swieszewska, Tomasz Przewozny

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(6):923-7.

  Cytomegalovirus (CMV) belongs to Herpesvirida family and it occurs quite frequently in the human environment. It is a very important pathogen in persons with suppressed or lowered resistance. HavingCytomegalovirus (CMV) belongs to Herpesvirida family and it occurs quite frequently in the human environment. It is a very important pathogen in persons with suppressed or lowered resistance. Having special kindship with epithelium, it may cause primary infection or reveal secondary influence in the latent form. Congenital CMV infection is a major cause of sensorineural hearing loss and neurological impairment in children. Otogenic complications may develop in patients with viral infection immunodeficiency. Aim of the paper was assessment of lateral sinus thrombosis (LST) in children with acute otitis media (AOM) and CMV infection. Authors present a case of LST in 5-year old child with AOM with mastoiditis and acquired CMV infection. In the first phase a disease appeared as mononucleosis-like infection with developing neurological signs resulting from meningitis. In the second phase the signs of acute otitis media, mastoiditis and lateral sinus thrombosis increased. Despite broad spectrum antibiotics therapy the intracranial complication developed which was surgically treated with good outcome. All the symptoms resulting from mastoiditis, LST and meningitis ceased. Clinical symptoms of the secondary CMV infection are rare in children. Complications may develop despite proper treatment of the ear and throat infections, and may result from immunodeficiency after CMV infection.

• [Chronic maxillary atelectasis (silent sinus syndrome)]

  Authors: Dariusz Babiński, Andrzej Skorek, Czesław Stankiewicz

  Otolaryngologia polska. The Polish otolaryngology. 02/2006; 60(6):929-33.

  INTRODUCTION: We discuss 3 cases with chronic maxillary atelectasis presenting as enophthalmos without any particular evidences of sinus pathology. MATERIAL AND METHODS: We report clinical featuresINTRODUCTION: We discuss 3 cases with chronic maxillary atelectasis presenting as enophthalmos without any particular evidences of sinus pathology. MATERIAL AND METHODS: We report clinical features and imaging data of sinus atelectasis in 2 men and 1 woman, 20-39 years old. Only 1 patient complained of diplopia, in 2 patients we found allergic rhinitis, in 2 cases septal deviation. Hertel enophthalmometry demonstrated enophthalmos 1-4 mm. Evidences have lasted for 2-6 months. CT scans revealed unilateral complete antral opacification, inward bowing of the antral medial and postero-lateral walls and collapse of orbital floor. RESULTS: Three patients with enophthalmos and asymptomatic maxillary sinus disease were identified. All patients underwent successful functional endoscopic sinus surgery with endoscopic maxillary antrostomy and in one case anterior ethmoidectomy. Additionally septoplasty was performed in two cases. We did not need to repair orbital floor in any case. Patient with diplopia achieved spontaneous return of orbital floor to almost normal position with enophthalmos -1 mm and all three were asymptomatic. Intrasinus manometry was performed in one case and confirmed the presence of negative pressure (-2,8 cm H2O). CONCLUSION: Chronic maxillary atelectasis presenting as enophthalmos is a rare evidence and sinus component of the disease mostly remains asymptomatic. The most effective treatment is endoscopic maxillary antrostomy.