Anna Młodkowska

Poznan University of Medical Sciences, Posen, Greater Poland Voivodeship, Poland

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Publications (5)4.01 Total impact

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    ABSTRACT: Stapes surgery is performed using both conventional techniques and a variety of laser systems. The Er-Yag laser is a type of pulsation laser deemed by many to be the safest for ear surgery. The aim of this study was to assess the long-term effects of using the Er-Yag laser in stapes surgery and its impact on inner ear function. The study was conducted on 95 ears (48 right and 47 left) that had undergone Er-Yag laser-assisted stapedotomy. The follow-up time was at least 3 years. Pure tone audiometry was performed on all patients. The frequency ranged from 125 to 8,000 Hz. Air conduction and bone conduction were both assessed. Moreover, all patients had their stapedius reflex assessed and were given a Rinne test. The results were evaluated according to the Committee on Hearing and Equilibrium guidelines and then statistically analyzed using the Wilcoxon sequence pair test with a p value of <0.05. A decrease in the hearing threshold of 0.5, 1, and 3 kHz, for both bone and air conduction was observed for all patients (p < 0.0001). The Wilcoxon sequence pair test revealed a statistically significant correlation between the pre- and postoperative treatment mean air-bone gap values (p < 0.0001). No facial nerve paralysis was observed. No Er-Yag laser side effects were observed on inner ear function. The patients also had lower hearing thresholds. These observations demonstrate the usefulness of Er-Yag lasers in stapes surgery.
    Archives of Oto-Rhino-Laryngology 12/2013; · 1.29 Impact Factor
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    ABSTRACT: IntroductionCO2 laser is used in stapes surgery due to good water absorption and quite optimal ablation of a bony structure without the influence of inner ear parameters.Aim of the studythe assessment of the influence of CO2 – “one shot” laser on hearing results in the patients group with otosclerosis.Material and methodThe study was carried out on a patients group after surgical treatment. The follow up time was at least 6 months. The hearing results were described according to the guidelines of the American Committee on Hearing and Equilibrium. The obtained results were statistically analysed with the use of the Wilcoxon sequence pair test.ResultsThe CO2 – “one shot” laser has been used in Department of Otolaryngology in Poznań since July 2009. Using this system 101 operations were carried out to the end of December 2011. 54 patients were in the analysed group, there were 40 women and 14 men, the age range from 22 to 59. In the Wilcoxon sequence pair test there was a statistically significant correlation between the value of the hearing threshold in pre- and post-operative examinations at 0.5, 1, 2 and 3 kHz for bone and air conduction. We found also a statistically significant correlation between the mean value of the air-bone gap before and after treatment. In the group after the surgery the cochlear reserved became closed or decreased (p < 0.001).Conclusionbased of the hearing results we found great usefulness of CO2 – “one shot” laser in stapes surgery.
    Otolaryngologia polska. The Polish otolaryngology 03/2013; 67(2):87–94.
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    ABSTRACT: INTRODUCTION: CO2 laser is used in stapes surgery due to good water absorption and quite optimal ablation of a bony structure without the influence of inner ear parameters. AIM OF THE STUDY: the assessment of the influence of CO2 - "one shot" laser on hearing results in the patients group with otosclerosis. MATERIAL AND METHOD: The study was carried out on a patients group after surgical treatment. The follow up time was at least 6 months. The hearing results were described according to the guidelines of the American Committee on Hearing and Equilibrium. The obtained results were statistically analysed with the use of the Wilcoxon sequence pair test. RESULTS: The CO2 - "one shot" laser has been used in Department of Otolaryngology in Poznań since July 2009. Using this system 101 operations were carried out to the end of December 2011. 54 patients were in the analysed group, there were 40 women and 14 men, the age range from 22 to 59. In the Wilcoxon sequence pair test there was a statistically significant correlation between the value of the hearing threshold in pre- and post-operative examinations at 0.5, 1, 2 and 3kHz for bone and air conduction. We found also a statistically significant correlation between the mean value of the air-bone gap before and after treatment. In the group after the surgery the cochlear reserved became closed or decreased (p<0.001). CONCLUSION: based of the hearing results we found great usefulness of CO2 - "one shot" laser in stapes surgery.
    Otolaryngologia polska. The Polish otolaryngology 03/2013; 67(2):87-94.
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    ABSTRACT: OBJECTIVE: The aim of the study was to compare 2 laser systems, Er-Yag and CO2, in stapes surgery. STUDY DESIGN: The study design was retrospective. SETTING: The study was conducted at an academic tertiary referral center. PATIENTS: There were 88 women and 34 man in the analyzed group. The study was carried out on 142 ears: 52 on the right ear, 50 on the left ear, and 20 bilateral. Forty-seven ears underwent a CO2 laser-assisted stapedotomy, and 95 underwent Er-Yag-assisted stapedotomy; 23 left and 24 right ears were operated on using the CO2 laser. The Er-Yag laser was used in 48 right and 47 left ears. The follow-up time was at least 1 year. RESULTS: When the postoperative air-bone gap was compared with the preoperative air-bone gap for the 2 laser systems using the Student t test, as well as the Mann-Whitney U test, no statistical differences were found between the 2 groups, that is, with the use of Er-Yag and CO2 lasers. Also, no statistically significant differences were measured over all frequencies by the Student t test between preoperative and postoperative bone conduction in each group. CONCLUSION: To sum up, our observations have proven the usefulness of 2 laser systems: CO2 and Er-Yag lasers in stapes surgery. In both groups, a decrease in the hearing threshold was obtained.
    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 11/2012; · 1.44 Impact Factor
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    ABSTRACT: The aim of the study was to examine the impact of positive prelaryngeal node on the outcome of early glottic cancer and to compare the rate of local and regional recurrences and overall survival rates in patients with positive and negative Delphian node (DN). In the years 1989-2008, a consecutive cohort of 212 patients with T1b and T2 glottic cancer with anterior commisure involvement were treated by means of supracricoid partial reconstructive laryngectomies. No adjuvant radiotherapy was administered. Out of 212 patients, in 75 suspected prelaryngeal tissue was found, harvested and separately sent for histological investigation (16-thyroid, 11-fat, 14-connective tissue, 34-lymph nodes). In 137 remaining cases, there were only muscles and fascia without even a small amount of tissue to be taken. In 16 cases out of the whole group, metastases were found. 33 patients with positive ultrasound findings on the lateral neck underwent selective neck dissection; in 4 cases metastases were confirmed. Local and regional recurrence developed in 37 out of 212 patients (17.5%). There was significant correlation between local relapse and prelaryngeal node metastases; out of 20 cases with local recurrence, 13 had positive DN (P < 0.005). There was also significant correlation between nodal relapses and DN metastases; out of 22 cases with nodal relapse, 12 had positive DN and 10 were DN negative (P < 0.005). The organ preservation rates for DN positive and DN negative patients were 62.5 and 93.88%, respectively. There was noted a significant difference in the mean survival between the groups with positive and negative DN (P = 0.004; 38.7 vs. 49.3 months, respectively). In conclusion, positive DN seems to be a strong isolated factor influencing prognosis in patients with early glottic cancer. DN metastases are responsible for the increased rates of local and nodal relapses, decreased chances of organ preservation and poor overall survival rates.
    Archives of Oto-Rhino-Laryngology 09/2011; 269(1):193-9. · 1.29 Impact Factor