The aim of the work was to analyse sudden deterioration of hearing and/or vertigo occurrence as an early symptom of posterior cranial fossa tumours. Among 1.394 people who reported vertigo and hearing impairment and were hospitalised at the Department of Otolaryngology and Laryngological Oncology Military Teaching Hospital in Lodz within the years of 2007–2010 twenty-seven patients were analysed. This group included 19 women aged 20–80 (mean age 45.7 years) and 8 men aged 25–73 (mean age 54.0 years) who had posterior cranial fossa tumours diagnosed on the basis of MRI. Each patient underwent a detailed interview, otorhinolaryngological and otoneurological examinations, pure tone, speech and impedance audiometry, suprathreshold tests (SISI, TDT), tinnitus pitch and frequency evaluation, auditory brainstem response (ABR), complete videonystagmography. The studied material revealed: acoustic neuroma in 15 patients, cerebellar meningioma in 5 patients, cerebellar cyst in 4 patients and cerebellar angioma in 3 patients. Sudden vertigo was present in 27 patients, including mixed-type vertigo in 15 cases and central vertigo in 12 cases. In 19 patients dizziness was accompanied by tinnitus. In 22 patients hearing disorders were diagnosed in a form of: sensorineural hearing loss in 14 subjects, bilateral in 7 subjects, left-lateral in 5 subjects and right-lateral in 2 subjects respectively, as well as deafness in 8 patients, including left ear deafness in 5 cases, right ear deafness in 1 case and bilateral deafness in 2 cases (7.4%). The early phase diagnosis of a posterior cranial fossa tumour as a cause of sudden hearing deterioration and/or vertigo is very seldom and often accidental because GPs, also otolaryngologists, who follow routine and economy, are not used to refering given patients for complete and objective audiological, otoneurological and imaging diagnostics.
The authors present a rare case of the primary multiple planoepithelial laryngeal cancer and clarocellular renal cancer in a patient operated in the Clinic. The patient, called F.J., was admitted to the Clinic of Otolaryngology and Laryngological Oncology due to hoarse voice he had been suffering for 6 months. On the interview with the patient, otolaryngological and videolaryngostroboscopic examinations we diagnosed hypertrophic changes in the whole length of the right vocal fold with the fold mobility preserved. The hypertrophic changes in the right vocal fold were removed by Kleinsasser direct microlaryngoscopy. However, the histopathological examination showed carcinoma planoepitheliale keratodes infiltrans mucosae laryngis G-2. In the further treatment the patient was qualified to the dexter chordectomy by the CO2 laser. The histopathological examination confirmed the total removal of the changes within the healthy cells. After about one year from the completed laryngological treatment the patient visited the urological outpatient clinic due to pain ailments in the right lumbar part. The urographic examination and CT of the abdominal cavity showed a tumour (8 × 9 cm), in the right kidney. The patient was admitted to the 1st Clinic of Urology the Chair of Urology and qualified to the dexter nephrectomy. Following the operation the histopathological examination indicated carcinoma clarocellulare partim cysticum renis dextri. Class, Fuhrman 20, pT2 Nx Mx. The hyperplasia limited to the renal parenchyma. Cut-off lines of the ureter and vessels without neoplastic infiltration. The patient remains under constant catamnesis at the urological and laryngological outpatient clinic, no symptoms of the neoplasm relapse.
The aim of present study was to characterize the association between prevalence of vertigo and age, grade of radiological changes and positional vertebral (VA) and basilar artery (BA) flow lesion in patients with cervical spondylosis. We examined 80 patients with radiological evidence of cervical spondylosis. Forty patients complained positional vertigo. Patients with neurological symptoms were excluded from the study. ENG was used to exclude patients with another causes of vertigo. TCD evaluations of the distal part of VA and the proximal part of BA were performed with a 2-MHz probe via the suboccipital window. We showed significant and independent association between prevalence of vertigo and age, grade of radiological changes, and positional vertebral and basilar artery flow lesion velocity in multivariate logistic regression model. Spondylotic-induced VA compression may be the reason of decreased blood flow velocity in the basilar artery during head rotation, causing positional vertigo.
The electrochemical behavior of the Pt - Au alloys in the whole composition range has been studied by cyclic voltammetry. The alloys were prepared by electrochemical deposition and the bulk compositions were determined byEDAX analysis. The surface areas of the electrodes were calculated from charges needed for oxidation of hydrogen adsorbed on platinum and reduction of gold or platinum oxide monolayer. These data were used for the estimation of the surface composition. The results were compared with data obtained from double layer capacity measurements. The surface area and platinum concentration on the surface, calculated from charges needed for platinum and gold oxides reduction, are overestimated, because the charge needed for platinum oxide reduction corresponds to more than a one monolayer.
The aim of the work was to assess early complications of Griggs percutaneous tracheotomy in the own material.The study covered 155 patients aged 17-88, including 36 women and 119 men. The patients were treated at the Department of Anaesthesiology and Intensive Therapy between 2006-2010. They underwent Griggs percutaneous tracheostomy by a laryngologist or a trained anaesthesiologist. Each surgical procedure was conducted with the use of Portex Blue Line Ultra Percutaneous Tracheotomy Kit (Smiths Medical Co., USA), the trachea was intubated while the patient was under general anaesthesia with propofol, fentanyl and relaxation with atracurium.The studied material revealed Griggs percutaneous tracheotomy complications in 26 patients (16.8%), in which 11 patients (7.1%) presented complications within the perioperative period while 15 patients (9.7%) reported early complications. Haemorrhage, usually not very profuse, occurred 7 times (4.6%), mainly in tracheopunction, and was the most often perioperative complication. Moreover, in the perioperative period, 3 patients (1.9%) had trachea identifications difficulties, which required tracheopunction many a time, and 1 patient (0.65%) encountered sudden circulatory arrest with asystolia and effective CPR. In the early postoperative period after Griggs percutaneous tracheotomy, the most common complication was haemorrhage in the operative twenty-four hours, which was noted in 10 patients (6.5%). Among other adverse complications were found: infection of the tissues near the tracheostomal region in 3 patients (1.9%), subcutaneous oedema in 1 patient (0.65%), accidental removing the tube from an unformed tracheostoma in 1 patient (0.65%).In the studied material, complications after Griggs percutaneous tracheotomy amounted to 16.8%, of which 7.1% occurred in the perioperative period while 9.7% were early complications, mainly light bleeding. This may prove good preparation of the surgical team for the surgical procedures.
There were examined 261 patients aged 18-62 ambulatory treated and divided into five groups: I--65 patients with acute maxillary sinusitis, II--43 patients with exacerbation of chronic maxillary sinusitis, III--40 patients with angina, IV--61 patients with acute otitis media and V--52 patients with exacerbation of chronic otitis media. Cefuroxime axetil have applied 2 times a day in 500 mg oral dose by 4 days. The therapeutic efficacy of cefuroxime axetil was assessed on the basis: fever chart and self assessment chart of showed symptoms which were assessed from 0 to 4.4 days course antibiotic therapy showed that the total receding of illness symptoms stated in 90.8% patients with acute maxillary sinusitis, in 69.8% patients with exacerbation of chronic maxillary sinusitis, in 62.5% patients with angina, in 91.8% patients with acute otitis media and receding of acute symptoms of exacerbation with chronic otitis media--a ear pain in 88.5% patients and a ear leakage in 44.2% patients. The obtained results stated that the 4 days course of cefuroxime axetil can be sufficient and efficacy in treatment of acute bacterial infections of maxillary sinuses and ear media.
Introduction: The objective of the paper is to evaluate the influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives. Material and methods: 105 young women participated in the study who were divided into 2 groups. Group I: 52 women disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 20–49; Group II: 53 women with no disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 18–40. Patients entering the study underwent full otoneurological examination, detailed laryngological assessment and the examination of selected parameters of the hemostasis system, including the evaluation of fibrinogen and D-dimer levels, APTT and PT, estradiol and progesterone concentrations in the blood serum and evaluation of the body mass index (BMI). Results: Central vertigo was the most common type of vertigo in the study group (59,6% of cases). Other vertigo types in this group included compensated vertigo of mixed origin (36,6% of cases) and peripheral vertigo (only 3,8% of cases), which indicates that 40.4% of the cases suffer from damage to the labyrinth. The analysis of the concentration of estradiol in the blood serum revealed, after consideration of a menstrual cycle phase, that estradiol concentration exceeded normative values significantly more often in the study group than in the control group and that estradiol concentration was significantly less frequently below the norm in the study group; the difference was statistically significant (p=0,048). The body mass index (BMI) of women participating in the study significantly correlated with the concentration of D-dimers only in the study group (p=0,35 vs p=0,012). Conclusions: Evaluating the body mass index before administering hormonal contraception can be useful to eliminate other risk factors for thromboembolism. In order to prevent potential thromboembolism episodes, administering hormonal contraception only after lowering the body mass index may also be worth considering.
Introduction Craniofacial injuries are a complex clinical issue and their treatment requires multi-specialty intervention. We present the case of a man hospitalized at the Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University in Lodz, Poland, due to extensive craniofacial injury caused by a circular saw. Case report A 61-year-old male patient (Z.K.) was transported by ambulance to the Emergency Department of the University Clinical Hospital, Military Memorial Medical Academy, Lodz, due to extensive craniofacial injury. The patient was conscious and remembered the course of the event. He exhibited stable respiratory and cardiovascular function and was in logical verbal contact. A CT scan revealed fracture of the anterior wall of the frontal sinus, with dislocation of fragments to the area of the piriform aperture on the right side, and a hematoma in the right frontal and maxillary sinus. The diagnostic and therapeutic management was successful, with the patient discharged from hospital on the 9th day in good general condition. The external appearance after treatment was fully satisfactory for the patient. There were no inflammatory complications in the healing of wounds and no evidence of lagophthalmos, facial nerve paresis, ocular complications, or excessive lacrimation which could result of nosolacrimal duct obstruction. The success of the therapy, both functionally and aesthetically, was achieved due to quick diagnosis and appropriate surgical and pharmacological treatment, including broad-spectrum antibiotics. Conclusions In the case of extensive craniofacial injuries, rapid diagnosis and implementation of appropriate, highly specialized multidisciplinary treatment is needed. Patients such as this should be referred to the highest level centers.
