Witold Szyfter

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

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Publications (405)194.48 Total impact

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    ABSTRACT: The aim of this study was to analyze two cases with advance tumors of the neck with infiltration of the common or internal carotid artery. Patients were surgically treated in Department of Otolaryngology Poznan University of Medical Sciences. Authors present the current state of knowledge concerning the proceedings in unresectable tumors of the neck and possibility to use the salvage surgery. Based on literature data and our own experience a risk of the carotid artery infiltrations is difficult to assay in diagnostic procedure. It decrease the possibility of radical surgery resection and indicate the most advance stage. Choosing the proper treatment requires interdisciplinary cooperation: ENT specialist, radiologist, vascular surgeon and oncologist. The high rate of complications and local recurrence rate makes the results of treatment are unsatisfactory.
    No preview · Article · May 2014 · Otolaryngologia polska. The Polish otolaryngology
  • Tomasz Kopeć · Lukasz Borucki · Witold Szyfter
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    ABSTRACT: The treatment of choice in juvenile nasopharyngeal angiofibroma (JNA) is surgery - nowadays endoscopic techniques. The aim of the study was to present the results of endoscopic treatment in patients diagnosed with juvenile angiofibroma. In this retrospective case series, 10 patients with a diagnosis of JNA treated at the Department of Otolaryngology of the Medical University in Poznań from 2006 to June 2013 were included. The age of patients were between 11 and 19 years old (14.6 on average). In 9 out of 10 patients the treatment was preceded by embolization. The surgery used the endoscopic approach through one nostril and the four-handed technique. Total resection was possible in all cases. Blood loss ranged from 100 to 250ml. Post-operative hospitalization lasted from 3 to 5 days (3.3 days on average). Recurrence was reported in one patient. The observation lasted from six months to seven years (3.55 on average). Endoscopic resection of juvenile angiofibroma is safe for the patient. Moreover, if the evaluation of the tumour size and staging is correct, the ability of total removal of the tumour is very high. It is also connected with small blood loss, short hospital stay and good cosmetic effects.
    No preview · Article · Apr 2014 · International journal of pediatric otorhinolaryngology
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    ABSTRACT: Aim of study was to present material of open partial horizontal laryngectomies (OPHL) in T1b, T2 and T3 larynx cancer treatment in single tertiary referral institution. Material and Methods Retrospective analysis of operating protocols in patients treated in Poznań ENT University Department between 2000–2012 with glottis (T1b – 185, T2 – 185,T3 – 231) and supraglottis tumors (T1 – 80, T2 – 104, T3 – 206), potentially available for organ preservation treatment. Transoral laser microsurgery, OPHL, radiotherapy and total laryngectomy were treatment options in 210, 191, 271 and 326 patients respectively. OPHL was applied in glottic tumors: 21 – T1b, 103 – T2, 27 – T3 and in supraglottic tumors: 4 – T1, 29 – T2. All procedures were re-evaluated acc. to European Laryngogical Society working committee on nomenclature new classification presented in 2014. Results There was no discrepancies in supraglottic laryngectomies (4 cases), classified as OPHL Typ I. All the rest: 84 transglottic, 96 supracricoid with CHEP and 7 supracricoid with CHP laryngectomies were re-classified into Typ II (172) and Type III (15) OPHL. Thus, revision of inferior incision changed classification of procedure into supratracheal laryngectomy in 15 cases. Transglottic laryngectomies, in which upper part of thyroid cartilage was preserved and crito-thyreo-pexy was performed (84 pts), have not been distinguished any more. In 7 cases superior incision included epiglottis; thus 165 patients were distinguished as Typ II a and 7 patients as Typ IIb OPHL. The most pronounced difference was stated in description of structures additionally included into surgical specimen: arytenoid (+ARY) in 24, crico-arytenoid-unit (+CAU) in 5 and piriform sinus (+PIR) in 17 cases; none had the base of tongue (+BOT) resected. Conclusions In 36/191 additional structures and in 15/191 the cricoid ring resection was re-evaluated and pointed out. All these data were available retrospectively in the operating protocols but not pronounced in surgery headlines. Thanks to the univocal, simple new classification all operation details can be included into operation title.
    No preview · Article · Jan 2014
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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.
    No preview · Article · Dec 2013 · Archives of Oto-Rhino-Laryngology
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    ABSTRACT: The aim of the study was to evaluate the treatment outcomes in the group of 108 T1b glottic cancer patients with the anterior commissure involvement treated with open horizontal glottectomy and to compare them with transoral laser microsurgery (TLM) or primary radiotherapy (XRT) results from the literature review. Status of surgical margins, local and nodal recurrence, organ preservation and survival rates, functional outcomes were major end points of interest. Recurrence rate was 16.7% and was correlated with histologically confirmed prelaryngeal node metastases. Salvage laryngectomy was performed in 10 patients, organ preservation rate was 90.7%. Mean survival was 41.9 months, while 5-year overall survival 97.2%. Local control and survival rates presented by the authors are comparable or even better than in TLM procedures or XRT outcomes from the literature. Positive prelaryngeal lymph nodes constituted a significant prognostic factor for nodal and local recurrence in the analyzed group. © 2013 Wiley Periodicals, Inc. Head Neck, 2013.
    No preview · Article · Dec 2013 · Head & Neck
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    ABSTRACT: We report a case of a 20-year-old man who presented with discreet dysphagia for several months. Indirect laryngoscopy showed a swollen, reddened, thickened epiglottis and smooth, thickened, injected mucosa of aryepiglottic folds and postcricoid region. Thorough work-up was undertaken to exclude specific and non-specific infectious diseases, neoplasm, vascular disorders, immunodeficiency syndrome. Histology revealed actinomycotic colonies in biopsy specimen taken from the epiglottis. The inflammation was resolving gradually during long-term antibiotic-therapy. Actinomycosis should be considered in the differential diagnosis in unclear long-lasting inflammation of the supraglottis. The course of untreated actinomycosis can be fatal which is connected with progressive dissemination of the process and secondary abscesses formation in the lungs, liver and brain.
    No preview · Article · Nov 2013 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: The aim of this study is the evaluation of results of using new Baha abutment covered by hydroxyapatite (Baha® BA400, Cochlear Ltd.) which enables new surgical technique without soft tissue reduction. Material and methods The results of treatment of 9 adult patients were compared with results of 126 patients implanted earlier by standard technique with soft tissue reduction. Results In analyzed group we find: slight shortening of time of surgery, similar results of implant stability (RFA) before sound processor connection, very good cosmetic results in 6 patients, some soft tissue overhanging in 2 and retraction pocket formation and inflammation (Holgers 2) in 1, no numbness and pain in operated area in all operated. Conclusions New Baha abutment covered by hydroxyapatite (Baha® BA400) enables to safely use new surgical technique without soft tissue reduction. In authors’ opinion the most important benefit from this technique is limited bleeding during operation, reduction of using of coagulation and less risk of lesion of nerves and numbness or pain after operation. This technique required less time, but the need of measuring of soft tissue and choosing of proper abutment cause longer preoperative time, so the time of all procedure is only slightly shorter. The esthetic results and healing process confirm the advantage of technique without soft tissue reduction over standard technique. However in patients with a thick soft tissue there is a risk of soft tissue overhanging, so in such cases it is better to make a partial soft tissue reduction.
    No preview · Article · Nov 2013 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: Cochlear implants programme in Poznań started in 1994 and till now consists of over 1020 systems (including 29 hybrid ones). Bilateral implantations were done in 25 patients, including 5 simultaneous and 20 sequential implantations. Simultaneous implantations were performed in 3 cases with radiological symptoms of cochlea fibrosis/ossification (meningitis, temporal bone trauma) and in 2 cases due to vision loss in Usher syndrome. Sequential implantations were performed in 3 adults (in 2 due to intensive tinnitus, in 1 to improve sound localisation) and in 17 children (in 1 due to vision loss, in 2 due to skin flap problems and in 14 to improve sound localisation and speech discrimination in noise). The time interval between surgeries in the group of 14 children was 1 year 7 months till 12 years 4 months (average 3 years 10 months). All the children in this group use both devices for all the time – from the speech processor switch-on they used second device for the whole day. More observations and rehabilitation results are required to acquire experience from bilateral implantations in small children in the developmental age.
    No preview · Article · Oct 2013
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    ABSTRACT: The main aim of this article is the epidemiological analysis of patients treated due to oral and oropharyngeal cancer, with a special interest in the group under the age of 40, evaluation of the differences in the clinical course of the disease as well as assessment of the treatment results, regarding the age of the affected individuals. 523 individuals affected by oral and oropharyngeal cancer who were treated in the Otolaryngology and Laryngeal Oncology Department between 2000 and 2008. Precise analysis was performed on 360 out of 523 affected individuals, in whom full clinical status was determined; 13 patients were young adults. The retrospective analysis was created based on case histories, surgical protocols and emergency records. In young adults there is a markedly increased risk of organ involvement according to the Mann-Whitney U-test analysis (p = 0.044907). The probability of recurrence in the group of young adults is also much higher. Analysis of Kaplan-Meier test results indicated that the chance for the lack of recurrence within a 6-month period was 85.7%; however, the risk of recurrence increased, and after 12 months was equal to the arithmetic data (50%). Among young adults there is an increased risk of local recurrence following 12 months after surgical intervention. According to our observations, despite rapid progression and early recurrence in young adults (4/7) the prognosis for both groups is not statistically different.
    Preview · Article · Jun 2013 · Contemporary Oncology / Wspólczesna Onkologia
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    Tomasz Kopeć · Małgorzata Wierzbicka · Witold Szyfter
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    ABSTRACT: Stensen's duct injuries are uncommon but troublesome sequelae of facial surgery or other external traumas. To investigate the feasibility of sialendoscopic control of Stensen's duct in iatrogenic injuries and the efficiency of botulinum toxin adjuvant therapy. In 2008 and 2010, 5 patients with parotid sialoceles or fistulas, infrequent complications after plastic surgery or trauma, were treated in a single institution, Poznan University of Medical Sciences ENT Department. The group consisted of 5 patients with diagnosed Stensen's duct injuries, which were post-surgery and post-traumatic sequelae. All were treated by means of open surgery. Botulinum toxin injection was administered during the procedure to decrease the saliva secretion and to improve the healing process. A sialendoscopy was performed to control the lumen of the junction after the duct injury was repaired. Complete healing of the fistulas and sialoceles after the reparative surgery followed by a single botulinum toxin application was observed in all patients within 10-14 days. No side effects were noticed. Our findings suggest that sialendoscopy is a valuable tool and an important step of control in the surgery of parotid duct injuries and the injection of botulinum toxin is an effective and safe second-line treatment.
    Preview · Article · Jun 2013 · Videosurgery and Other Miniinvasive Techniques / Wideochirurgia i Inne Techniki Malo Inwazyjne
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    ABSTRACT: We reinvestigated rearrangements occurring in region q13 of chromosome 11 aiming to: (i) describe heterogeneity of the observed structural alterations, (ii) estimate amplicon size and (iii) identify of oncogenes involved in laryngeal cancer progression as potential targets for therapy. The study included 17 cell lines derived from laryngeal cancers and 34 specimens from primary laryngeal tumors. The region 11q13 was analyzed by fluorescence in situ hybridization (FISH), array comparative genomic hybridization (aCGH) and gene expression microarray. Next, quantitative real time PCR was used for chosen genes to confirm results from aCGH and gene expression microarray. The observed pattern of aberrations allows to distinguish three ways, in which gain and amplification involving 11q13 region may occur: formation of a homogeneously staining region; breakpoints in/near 11q13, which lead to the three to sevenfold increase of the copy number of 11q13 region; the presence of additional copies of the whole chromosome 11. The minimal altered region of gain and/or amplification was limited to ~1.8 Mb (chr.11:69,395,184-71,209,568) and comprised mostly 11q13.3 band which contain 12 genes. Five, out of these genes (CCND1, ORAOV1, FADD, PPFIA1, CTTN) had higher expression levels in comparison to healthy controls. Apart from CCND1 gene, which has an established role in pathogenesis of head and neck cancers, CTTN, ORAOV1 and FADD genes appear to be oncogene-candidates in laryngeal cancers, while a function of PPFIA1 requires further studies.
    No preview · Article · May 2013 · Molecular Biology Reports
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    ABSTRACT: The role of human papilloma viruses (HPV) in malignant and nonmalignant ENT diseases and the corresponding epidemiological burden has been widely described. International head and neck oncology community discussed growing evidence that oral HPV infection contributes to the risk of oro-pharyngeal carcinoma (OPC) and recommended HPV testing as a part of the work up for patients with OPC. Polish Society of ENT Head Neck Surgery and National Chamber of Laboratory Diagnosticians have worked together to define the minimum requirements for assigning a diagnosis of HPV-related conditions and testing strategy that include HPV specific tests in our country. This paper briefly frames the literature information concerning low risk (LR) and high risk (HR) HPV, reviews the epidemiology, general guidance on the most appropriate biomarkers for clinical assessment of HPV. The definition of HPV-related cancer was presented. The article is aiming to highlight some of major issues for the clinician dealing with patients with HPV-related morbidities and to introduce the diagnostic algorithm in Poland.
    Full-text · Article · May 2013 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: Our research was conducted to determine the algorithm changes during the treatment of submandibular sialolithiasis. Two time periods were compared between 2004-2008 and 2009-2012. The turning point was December 2008, when sialendoscopy procedure was introduced. In the first period, 48 patients were treated: 31 outpatient duct incisions with stone evacuation and 17 surgical excision of submandibular gland. In the second period, 207 sialendoscopy procedures were performed on 197 patients. Out of this particular group, 158 patients were diagnosed with pathological obstruction of salivary glands and 64 of them were confirmed to have sialolithiasis of submandibular gland. Deposits of calcifications in 40 individuals (62.5 %) affected by sialolithiasis were removed endoscopically; however, in 21 patients, due to the increased circumference of the stone, the intimate association of deposits within the wall of the duct along with its presence inside the deep portions of the gland, double approach (incision of the floor of the mouth in hilar area and sialendoscopy) was performed. Three individuals had their salivary glands totally removed due to the presence of calcified deposits within the glandular parenchyma. Our results allow us to affirm that sialendoscopy is the current treatment of choice for submandibular glands affected by sialoliths. Indication for a complete removal of the gland is becoming uncommon as a first line treatment although still indispensable in chosen cases.
    Full-text · Article · Apr 2013 · Archives of Oto-Rhino-Laryngology
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    ABSTRACT: The face and neck are morphologically complex of anatomical structure. It determines the formation of a special susceptibility to various malformations. The aim of this study was to present anomalies of the first branchial cleft in unusual clinical course. Described three patients hospitalized in the Department of Otolaryngology in Poznan in the period from 2011 to 2012. In two patients the neck changes suggested the presence of a tumor and needed surgery twice. In one patient surgery was associated with a high risk of damage to the facial nerve. Discussed the pathogenesis, diagnosis and contemporary approach to the treatment of anomalies the first branchial cleft.
    No preview · Article · Mar 2013
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    ABSTRACT: Background and purpose: The object of the study was to present our own experience in the management of cervical oesophageal and hypopharyngeal perforations after anterior cervical spine surgery. Material and methods: The study group consists of 5 patients treated in Department of Otolaryngology Poznan University of Medical Sciences in 2009-2011. Different materials and techniques were used to repair the perforations: infrahyoid flap, primary sutures supported by sternocleidomastoid muscle flap, thigh flap and forearm flap in two cases. Results: Four out of 5 patients were referred to our department in a poor general condition, with infected neck fistulas, three patients after prolonged conservative treatment, and three patients after initial attempts to repair the perforation outside our institution. One-stage reconstructive surgery was successful in three cases, while in two others secondary interventions were necessary. Total hospital stay ranged in the analysed group from 23 to 191 days, hospital stay in our department from 1 to 62 days, hospital stay from the final procedure from 18 to 26 days. Swallowing function was within normal limits in all cases 12-14 days after the surgery. Conclusions: The authors' experience shows that in long-lasting and infected cervical oesophageal and hypopharyngeal perforations following anterior cervical spine surgery distant flaps should be primarily used as a source of a well-vascularized and unchanged tissue. It seems to be crucial to repair the perforations immediately after the first symptoms appear - such an approach significantly reduces total hospital stay and improves the prognosis.
    No preview · Article · Mar 2013 · Neurologia i neurochirurgia polska

  • No preview · Article · Mar 2013 · Epidemiology (Cambridge, Mass.)
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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.
    No preview · Article · Mar 2013 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: The main purpose of the study was to assess the role and efficacy of high-dose-rate (HDRBT) and pulsed-dose-rate (PDRBT) brachytherapy in the palliative treatment of recurrent or residual stomal tumor after total laryngectomy. STUDY DESIGN: We aimed at presenting a series of 22 consecutive patients treated in the Department of Otolaryngology, Head and Neck Surgery of Poznań University of Medical Sciences, and in the Brachytherapy Department of Greater Poland Cancer Center. METHODS: In 16 patients PDRBT was used and in six patients HDRBT was used. In three patients, BT procedures were performed in combination with simultaneous chemotherapy. Two patients were additionally treated with interstitial hyperthermia. In 16 patients, surgical cytoreduction of the tumor preceded the catheters placement. In six patients, a second course of BT was performed due to neck metastases. All patients were regularly followed up within 6 months. Local control, complications, and survival were assessed. RESULTS: Complete and partial remissions 6 months after finishing the treatment were achieved in four (20%) patients, while survival rates 24 months after BT were estimated for 22%. Severe late complications occurred in two (9%) patients. CONCLUSIONS: The results of our study show that HDRBT and PDRBT are feasible in previously irradiated patients with recurrent or residual stomal tumor after total laryngectomy. They provide acceptable toxicity and good palliative effect.
    Full-text · Article · Mar 2013 · The Laryngoscope
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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.
    No preview · Article · Mar 2013 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: Objective Evaluation the outcome after extensive surgery of salivary glands tumors with simultaneous reconstruction of soft tissue and skin defect.MaterialIn the period 2007–2011, surgery treatments performed in 295 of major salivary glands. 31 patients underwent surgery due to malignant parotid gland tumors: 19 women (61%) and 12 men (39%). In 8 (26%) presented skin infiltration. 10 (32%) patients had facial palsy between II-IV degree (House Brackmann scale). The radiographic findings in some patients showed infiltration of the deep lobe of parotid gland, external auditory canal, infiltration of mastoid process, skull base and the subtemporal fossa.Methods Of the 31 patients in 13 (42%) reconstruction techniques with muscle cutaneous trapezius flap were applied in 4 (31%) patients. In group of 7 (54%) patients using a muscle flap based on the sterno-cleido-gland, in 2 (15%) patients defects were covered using the free anterior lateral thigh flap.ResultsIn all patients, healing proceeded normally. In the operated patients, one patient did not receive radical surgery due to the infiltration of the skull base. Length of hospitalization ranged between 7–21 days. In no case was lost flap, also there was no local complications at the donor.Conclusions The choice of treatment for malignant parotid gland tumors which are usually radioresistant is surgical resection. In patients with extensive tumors with infiltration of neighbouring organs reconstruction with use of distant flaps are recommended. It provides a good oncological and aesthetic result.
    Full-text · Article · Feb 2013 · Otolaryngologia polska. The Polish otolaryngology

Publication Stats

2k Citations
194.48 Total Impact Points

Institutions

  • 1997-2015
    • Poznan University of Medical Sciences
      • • Department of Phoniatrics and Audiology
      • • Department of Otolaryngology Head and Neck Surgery and Laryngological Oncology
      Posen, Greater Poland Voivodeship, Poland
    • Poznan University of Technology
      Posen, Greater Poland Voivodeship, Poland
  • 2012-2014
    • Uniwersytet Medyczny im.Karola Marcinkowskiego w Poznaniu
      Posen, Greater Poland Voivodeship, Poland
  • 2011
    • Hannover Medical School
      Hanover, Lower Saxony, Germany
  • 2005
    • Polish Academy of Sciences
      • Institute of Human Genetics
      Warsaw, Masovian Voivodeship, Poland
  • 2002
    • University of Tuebingen
      Tübingen, Baden-Württemberg, Germany