Publications by authors named "Małgorzata Wierzbicka"

173 Publications

Vocal Fold Leukoplakia: Which of the Classifications of White Light and Narrow Band Imaging Most Accurately Predicts Laryngeal Cancer Transformation? Proposition for a Diagnostic Algorithm.

Cancers (Basel) 2021 Jun 30;13(13). Epub 2021 Jun 30.

Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, 49 Stanisława Przybyszewskiego St., 60-357 Poznań, Poland.

The management of Vocal Fold Leukoplakia (VFL) remains problematic. There is no consensus on the indications or the timing for surgery. The objective was to select the most accurate classification for predicting low- and high-risk VFL in White Light Imaging (WLI) and Narrow Band Imaging (NBI) and to establish a diagnostic algorithm with a timely referral for treatment. A total of 259 VFL patients were included in the study; 186 lesions were classified as low-grade and 110 as high-grade dysplasia. The results of WLI acc. to the two-tier and the three-tier Chen 2019 classifications and NBI classifications: ELS, Ni 2011, and Ni 2019 with different cut-off points were compared with the pathological examination (HP). In WLI, the greatest agreement was obtained between type 3 of the three-tier classification and high-grade dysplasia (accuracy, specificity, and PPV: 80.4%, 92.0%, and 81.5%, respectively). Assessing VFL periphery in NBI, cut-off point 5 (Ni 2011 type V) demonstrated a higher accuracy, specificity, and PPV than 4 (83.1%, 93.6%, 85.5% and 77.4%, 74.9%, and 65.4%, respectively). In NBI, we observed higher accuracy, sensitivity, and PPV (84.1%, 93.0%, 85.2% vs. 80.7%, 81.3% and 71.3%, respectively) for cut-off point 5 (Ni 2019 type V and VI) in comparison to the cut-off point 4 group (type IV, V, and VI) (80.7%, 81.3%, 71.3%, respectively), and a higher kappa value (0.68 vs. 0.58) was obtained. We have shown that both the plaque image and the microvascular pattern on the leukoplakia periphery are critical in the diagnosis of high-risk VFL. The most accurate predictor of VFL malignant transformation in WLI is type 3 according to the Chen 2019 classification, while in NBI type V and VI according to the Ni 2019 classification.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/cancers13133273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268866PMC
June 2021

"Sandwich technique" enables preservation of hearing and antivertiginous effect in cholesteatomatous labyrinthine fistula.

Eur Arch Otorhinolaryngol 2021 Jun 18. Epub 2021 Jun 18.

Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355, Poznan, Poland.

Purpose: The aim of the study was to assess hearing, surgical and clinical results of the treatment in patients with cholesteatomatous labyrinthine fistula (LF) focusing on the different techniques and materials used in the management.

Methods: Study group included 465 patients. Cases with LFs discovered or confirmed during surgical procedure were thoroughly analyzed.

Results: LFs were noted in 11.4% of all cases. Thirty-eight patients, with all follow-up data available, were included into the further analysis. Most LFs were located in the lateral semicircular canal (87%). LFs were assessed as small in 2 cases, as medium in 24 patients while 12 were described as large. Based on Dornhoffer and Milewski classification, 50% of LFs were classified as IIa, 24% as IIb, 6 LFs were very deep (type III), while 4-superficial (type I). The size and type of LF did not influence postsurgical complaints (p = 0.1070, p = 0.3187, respectively). Vertigo was less frequent in LFs treated by "sandwich technique", especially those with opened endosteum. In 30 (79%) patients, hearing improved or did not change after surgery. Hearing outcomes were significantly better in the ears operated by means of CWU technique (p = 0.0339), in LFs with intact membranous labyrinth (p = 0.0139) and when "sandwich technique" was performed (p = 0.0159). Postsurgical bone conduction thresholds levels were significantly better in LFs covered by "sandwich method" (p = 0.0440).

Conclusion: "Sandwich technique" (temporal fascia-bone pate-temporal fascia) enables preservation of hearing as well as antivertiginous effect in patients with cholesteatomatous labyrinthine fistula.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00405-021-06934-yDOI Listing
June 2021

Survival on railway tracks of Geranium robertianum-a glyphosate-tolerant plant.

Ecotoxicology 2021 Aug 10;30(6):1186-1202. Epub 2021 Jun 10.

Institute of Environmental Biology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096, Warsaw, Poland.

Geranium robertianum is a herbaceous plant that prefers shady and fertile forest habitats. However, it also occurs on railway tracks, where there are difficult conditions for plant growth and regular herbicide spraying (in high concentrations, twice a year). One of the most commonly used herbicides in railway areas is glyphosate. The effect of the glyphosate on the G. robertianum plants found on railway tracks and in nearby forests in north-eastern Poland was checked. The aim of the study was to explain how G. robertianum can survive on railway tracks despite spraying with the glyphosate. Increased tolerance to the glyphosate of the G. robertianum plants from track populations was demonstrated compared to the plants from forest populations that had not previously been in contact with the herbicide. After 35 days after treatment with the herbicide, 75% of the plants from the observed forest populations withered, while only 38% did from the track populations. Ultrastructure of plant leaf cells from forest populations was strongly disturbed, which was not observed in plants from track populations. It was also shown that plants from track populations accumulated more glyphosate and AMPA in their tissues than plants from forest populations. The obtained results indicate that long-term use of herbicides may cause formation of biotypes of plants resistant to a given herbicide. This fact explains the possibility of G. robertianum occurring on railway tracks, despite spraying with the glyphosate. It is also a manifestation of microevolutionary processes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10646-021-02430-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295122PMC
August 2021

Association between the Area of the Highest Flank Temperature and Concentrations of Reproductive Hormones during Pregnancy in Polish Konik Horses-A Preliminary Study.

Animals (Basel) 2021 May 23;11(6). Epub 2021 May 23.

Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland.

Determination of the pregnancy status is one of the most important factors for effective pregnancy management. Knowledge of the stage of pregnancy is important to interpret many of the reproductive hormones' concentrations, including progesterone (P4), estrone sulfate (E1S), 17-ß estradiol (E2), and relaxin (REL). However, it is limited in wildlife or captive equids that cannot be handled. Reproductive hormones affect regional blood flow, the proliferation of tissues, and local metabolism intensity. Therefore, this preliminary study aimed to assess changes in thermal features of the abdomen lateral surface and concentrations of reproductive hormones in Polish native pregnant mares. The study was carried out on 14 non-pregnant and 26 pregnant Polish Konik mares during eleven months of pregnancy. Infrared thermography was conducted to image the lateral surface of mares' abdomen (Px1) and flank area (Px2); P4, E1S, E2, and REL concentrations in serum were also determined. The evidence of the association between the area with the highest temperatures (Area of Tmax) and serum concentrations of P4 (the slope = 1.373; = 0.9245) and REL (the slope = 1.342; = 0.4324) were noted dependent across months of pregnancy. Measures of superficial body temperatures were found to change monthly, similarly to ambient temperatures, with no evidence of coincidence with changes in reproductive hormone concentrations. Individual thermal characteristics of the lateral surface of the abdomen differed between pregnant and non-pregnant mares in other periods. Differences in maximal and average temperature and Area of Tmax were observed from the sixth month of pregnancy, and those in minimal temperature were observed from the eighth month.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ani11061517DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224734PMC
May 2021

Is the 3D exoscope better than the surgical microscope in parotid surgery: a prospective, randomized single-center study.

Eur Arch Otorhinolaryngol 2021 May 28. Epub 2021 May 28.

Department of Otolaryngology and Head and Neck Surgery, Poznań University of Medical Sciences, Poznan, Poland.

Background: High-definition, three-dimensional (3D) exoscopes are being used to perform a growing number of head and neck surgeries. However, the use of the 3D exoscope in parotid gland surgery has not been previously described. Our initial experience with the VITOM 3D exoscope in the surgical treatment of parotid gland tumors is detailed here.

Methods: We made a prospective study of patients with benign parotid gland tumors indicated for surgical resection. Between January and December 2018, patients were randomly assigned to undergo surgery assisted with the VITOM 3D system (n = 31) or an operating microscope (n = 40). Visualization quality (greater auricular nerve, digastric muscle, tragal pointer), operating time, conversion rates, and surgical outcomes were compared.

Results: A total of 71 patients underwent superficial (n = 18) or total parotidectomy (n = 53). No exoscope-related complications were observed. Five patients undergoing exoscope-guided deep lobe surgery required intraoperative conversion to a microscope. No differences were observed in the subjective quality of intraoperative visualization of key anatomical structures. However, a significantly higher percentage of patients in the exoscope group developed transient facial nerve paralysis (n = 9; 29% vs. n = 4, 10%).

Conclusions: These findings suggest that the VITOM 3D is a valid visualization tool for parotid gland surgery, comparable to the operating microscope but with higher resolution 3D visualization, an increased degree of freedom of movement, and better ergonomics. However, the high rate of transient nerve palsy, possibly related to decreased depth perception and the brief learning curve, merits further investigation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00405-021-06876-5DOI Listing
May 2021

An Incidental Finding of a Double-Lumen Trachea.

Acta Med Port 2021 Mar 1;34(3):229-231. Epub 2021 Mar 1.

Department of Otolaryngology, Head and Neck Surgery. University of Medical Sciences. Poznań. Institute of Human Genetics. Polish Academy of Sciences. Poznań. Poland.

The aim of this case report is to present an incidental finding of a firm tracheal septum in a 61-year-old woman. The patient was admitted to the hospital with mild dyspnea and a preliminary diagnosis of a tracheal subglottic stenosis. During microlaryngoscopy, just below the subglottic stenosis, a firm, vertical symphysis (septum), forming a double-lumen trachea was found. There was no record of any previous difficulties with intubation. A computed tomography scan performed after the microlaryngoscopy revealed an airway branch arising from the trachea at the level of thyroid gland and joining its lumen below. The radiological and endoscopic findings in the presented case hardly resemble the conditions described in the literature, as the discovered septum does not have a pseudomembranous nature, nor does it form a tracheal bronchus. Therefore, the finding is thought to be an unusual complication of multiple intubations in the past. This is an extremely rare finding and it is important to share our experience in managing a patient with the aforementioned post-intubation complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.20344/amp.12000DOI Listing
March 2021

The impact of accurate documentation of parotid tumor operative reports on secondary surgical procedure.

Otolaryngol Pol 2020 Dec;75(3):1-5

Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland.

Objective: To develop a comprehensive operative report schema based on the accuracy of primary operative reports (OpR) assessed on a department's experience with parotid gland tumor re-operations.

Design: Retrospective cross-sectional study.

Setting: A tertiary referral center, the Department of Otolaryngology and Laryngological Surgery, Poznan University of Medical Sciences, Poland from 2008 to 2017.

Subjects: Out of 1154 surgeries, 71 patients underwent reoperation. Their OpR were categorized into accurate and non-accurate, and re-operation field and re-operation course were categorized as anticipated or unanticipated, according to defined criteria.

Intervention: None Main outcome measures: The impact of accuracy of the first OpR on re-operation course.

Results: In this series, OpR were 39% (14/36) accurate, 61% (22/36) non-accurate. Re-operation fields were 16% (11/71) anticipated, 37% (26/71) unanticipated. Re-operation courses were 37% (26/71) anticipated, 63% (45/71) unanticipated. An anticipated re-operation course followed 20% (5/26) of accurate and 20% (5/26) of non-accurate primary OpR. An unanticipated re-operation course followed 20% (9/45) of accurate and 40% (18/45) of non-accurate OpR. There is no significant relationship between the re-operation course and accuracy of the first OpR (Chi2(1)=0.69; p=0.40466). The most common variable that affected non-accuracy of the OpR was facial nerve function after surgery (6/12).

Conclusions: The operative report should be based on clear criteria, robust classification and comprehensive protocol. This will improve follow-up and facilitate the planning of re-operation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5604/01.3001.0014.6240DOI Listing
December 2020

Juvenile nasopharyngeal angiofibroma-20 years of experience in endoscopic treatment.

Otolaryngol Pol 2021 Feb;75(2):9-14

Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poland.

Introduction: Juvenile nasopharyngeal angiofibroma is a rare, benign tumor; however, it shows local aggression and leads to profuse nosebleeds. <br/>Aim: The aim of the study is to present 20 years of experience in endoscopic treatment of this tumor. <br/>Material and methods: The material covers 71 patients treated in the years 1985-2019 at the Department of Otolaryngology and Laryngological Oncology in Poznań. In these patients, either the classic external approach, or the double approach - external with the use of endoscopes, or only the endoscopic approach was used. In the entire population, external surgeries were performed in 37 patients, double access in 8 and endoscopic access in 26 patients. <br/>Results: Complete resection of the tumor was achieved in 51 patients (72%). The remaining 20 patients (28%) had a residual or recurrent tumor and all of these patients underwent reoperation.<br/> Conclusions: The endoscopic approach with the use of various optics and navigation allows for the removal of not only small tumors but also much more advanced ones. Pre-operative evaluation of imaging results is extremely important to avoid incomplete tumor removal. Individual development of an operating strategy, a wide range of optics and various surgical methods, and especially endoscopic ones, are the guarantee of therapeutic success.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5604/01.3001.0014.5220DOI Listing
February 2021

Expression of p16 protein in pleomorphic adenoma and carcinoma ex pleomorphic adenoma proves diversity of tumour biology and predicts clinical course.

J Clin Pathol 2021 May 3. Epub 2021 May 3.

Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland.

Aims: The aim of the study is to correlate p16 expression with the clinical courses of pleomorphic adenoma (PA), its malignant transformation (CaexPA) and treatment outcomes.

Methods: Retrospective analysis (1998-2019) of 47 CaexPA, 148 PA and 22 normal salivary gland samples was performed. PAs were divided into two subsets: clinically 'slow' tumours characterised by stable size or slow growth; and 'fast' tumours with rapid growth rate.

Results: Positive p16 expression was found in 68 PA and 23 CaexPA, and borderline expression in 80 and 20, respectively. All 22 (100%) normal salivary gland samples presented with no p16 expression. Significant difference in p16 expression was observed between normal tissue, PA and CaexPA (χ (4)=172,19; p=0.0001). The PA clinical subgroups were also evaluated separately, revealing additional statistical relations: 'fast' PA and CaexPA differed significantly in p16Ink4a expression (χ (2)=8.06; p=0.01781) while 'slow' PA and CaexPA did not (χ (2)=3.09; p=0.2129). 3-year, 5-year and 10-year survival among p16 positive CaexPA patients was 100%, 90.56% and 60.37%, respectively, and in CaexPA patients with borderline p16 expression was 90.0%, 73.64% and 22.20%, respectively. Statistically significant difference between expression pattern and survival rate was observed (F Cox test - F (16, 24)=2.31; p=0.03075).

Conclusions: Our study confirms no p16 expression in normal tissue, but reveals differences in expression between 'fast' and 'slow' PA. We suggest that p16 overexpression is connected to PA proliferation and subsequent malignant transformation to CaexPA. Borderline p16 staining correlates with worse prognosis of CaexPA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/jclinpath-2021-207440DOI Listing
May 2021

Assessing Various Control Samples for Microarray Gene Expression Profiling of Laryngeal Squamous Cell Carcinoma.

Biomolecules 2021 04 16;11(4). Epub 2021 Apr 16.

Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland.

Selection of optimal control samples is crucial in expression profiling tumor samples. To address this issue, we performed microarray expression profiling of control samples routinely used in head and neck squamous cell carcinoma studies: human bronchial and tracheal epithelial cells, squamous cells obtained by laser uvulopalatoplasty and tumor surgical margins. We compared the results using multidimensional scaling and hierarchical clustering versus tumor samples and laryngeal squamous cell carcinoma cell lines. A general observation from our study is that the analyzed cohorts separated according to two dominant factors: "malignancy", which separated controls from malignant samples and "cell culture-microenvironment" which reflected the differences between cultured and non-cultured samples. In conclusion, we advocate the use of cultured epithelial cells as controls for gene expression profiling of cancer cell lines. In contrast, comparisons of gene expression profiles of cancer cell lines versus surgical margin controls should be treated with caution, whereas fresh frozen surgical margins seem to be appropriate for gene expression profiling of tumor samples.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/biom11040588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072880PMC
April 2021

Long-Term Recording of Reticulo-Rumen Myoelectrical Activity in Sheep by a Telemetry Method.

Animals (Basel) 2021 Apr 8;11(4). Epub 2021 Apr 8.

Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-797 Warsaw, Poland.

The reticulum and rumen are considered a single functional unit (the reticulo-rumen) with regards to myoelectrical and contractile activities. The specialized contractions of the reticulo-rumen provide constant mixing of partially digested material (cycle A), its flow into the omasum during eructation (cycle B), and regurgitation-rumination (cycle C). This study aimed to investigate the feasibility of electromyography (EMG) registered by a long-term telemetry method for assessment of the basic reticulo-rumen myoelectrical activity in sheep, to develop the effective recognition of the reticulo-rumen cycles at rest with no food stimulation, and to investigate the relationship between cycles A, B, and C in such basic conditions. The experiment was carried out on nine ewes. Myoelectric activity of the rumen, reticulum, and abomasum was recorded by the combination of three silver bipolar electrodes and a 3-channel transmitter implant. The myoelectrical activity registered successfully in the reticulum and rumen was determined as three characteristic patterns of cycles A, B, and C. The percentage of each type of cycle changed at different intervals from equally cycles A (43-50%) and B (50-56%), occurring when cycle C was not observed to the domination of cycle C (57-73%) with a decrease of cycles A (6-14%) and B (20-28%). The long-term EMG telemetry registration is feasible in the assessment of the reticulo-rumen myoelectrical activity in sheep.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ani11041052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068381PMC
April 2021

Differences in Intestinal Barrier Development between Intrauterine Growth Restricted and Normal Birth Weight Piglets.

Animals (Basel) 2021 Apr 1;11(4). Epub 2021 Apr 1.

Veterinary Research Centre, Centre for Biomedicine Research, Centre for Regenerative Medicine, Department of Large Animal Diseases and Clinic, Institute for Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 100, 02-797 Warsaw, Poland.

Intrauterine growth restricted (IUGR) piglets are born at term but have low birth mass and a characteristic shape of the head. Impaired general condition, especially in intestinal function, leads to an increase in the occurrence of diarrhoea and high mortality in the first days of life. So far, the mechanical and immunological gut barrier functions in IUGR are poorly understood. The aim of this study was to microscopically evaluate the early postnatal changes in the gut mucosa occurring in IUGR piglets. Whole-tissue small intestine samples were collected from littermate pairs (IUGR and normal) on postnatal day (PD) 7, 14 and 180 and analysed by light microscopy. We found that in the IUGR piglets, the percentage of intraepithelial leukocytes was reduced in the duodenum on PD 7, but it increased in the proximal and middle jejunum both on PD 7 and PD 14, which suggested the development of an inflammatory process. The number of goblet cells was also reduced on PD 14. The average size of the Peyer's patches in the distal jejunum and ileum showed significant reduction on PD 7 as compared to normal pigs; however, on PD 14, it returned to normal. On PD 180, we did not find any differences in the measured parameters between the IUGR and the normal pigs. In conclusion, we found that in one-week-old IUGR pig neonates, the gut barrier and the immune system structures display signs of retarded development but recover within the second postnatal week of life.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ani11040990DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065605PMC
April 2021

Oral and laryngeal HPV infection: Incidence, prevalence and risk factors, with special regard to concurrent infection in head, neck and genitals.

Vaccine 2021 04 31;39(17):2344-2350. Epub 2021 Mar 31.

Amsterdam UMC, University of Amsterdam, Department of Otorhinolaryngology, Head and Neck Surgery, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. Electronic address:

This review focuses on the importance of oral and laryngeal HPV infection which is present in majority of sexually active individuals at least once in their lifetime. Despite testing, still little is known about prevalence rates, determinants and, especially, the concurrent HPV infection in head and neck, and genitals. The purpose of this review is to clarify some issues of oral HPV incidence, prevalence, and to demonstrate the difficulties in identification of asymptomatic oral HPV carriers. The main premise to take up this topic is the high and still increasing risk for development of oropharyngeal cancer, and potential benefit from screening strategies, education programs and HPV vaccination. Transmission of HPV to the oral cavity and oropharynx is hypothesized to occur mainly through sexual contact. The exposure of oropharyngeal mucosa to HPV infection with consequence of increased risk for oropharyngeal carcinoma depends on specific sexual behavior. Male gender, older age, race or ethnicity, oral hygiene and current cigarette smoking are independently associated with any prevalent oral HPV infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.vaccine.2021.03.047DOI Listing
April 2021

Conductive hearing loss after surgical treatment of otosclerosis - long-term observations.

Otolaryngol Pol 2020 Dec;75(1):1-6

Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poland.

<b>Introduction:</b> For many years, surgical treatment of otosclerosis has been a widely accepted approach. Hearing improvement following stapes surgery is sometimes spectacular, and good treatment results are obtained in many centers in over 90% of patients. However, in the subsequent years after the treatment, some patients develop permanent or progressive conductive hearing loss. <br><b>Aim:</b> The aim of the study is to present a group of patients with conductive hearing loss after the first otosclerosis surgery and to analyze the causes of its occurrence. <br><b>Materials and Methods:</b> The retrospective review covered patients who underwent the initial surgery in the years 2000-2009. We analyzed the patients' medical records from before the end of 2019, which provided results of at least 10 years of postoperative follow-up. The group consisted of 1118 patients aged 14-82, including 802 women and 316 men.<br><b> Results:</b> Reoperations due to conductive hearing loss were performed on 93 patients, who accounted for 8.3% of the originally operated patients. They were much more common in patients after stapedectomies (19.7%) than in patients after stapedotomy (5.5%). Prosthesis dislocation was found to be the most frequent intraoperative observation (44.1%) and was often associated with erosion or necrosis of the long process of incus (28%). Less frequent reasons for hearing loss were: adhesions around the prosthesis (10.8%), too small hole in the stapes footplate (8.6%), too short prosthesis (8.6%), progression of otosclerosis (7.5%), too long prosthesis (6.4%), presence of a granuloma around the prosthesis (5.4 %), and displacement of incus (4.3%). <br>Conclusions:</b> Surgical treatment of otosclerosis is a widely accepted and good method. It allows to achieve an improvement in hearing in the vast majority of patients treated in this way. Unfortunately, over the years some patients develop recurrent conductive hearing loss. Reoperation creates an opportunity for finding the cause and improving hearing in the majority of cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5604/01.3001.0014.6216DOI Listing
December 2020

Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages.

J Clin Med 2021 Feb 16;10(4). Epub 2021 Feb 16.

Department of Otolaryngology and Laryngological Oncology, Poznań University of Medical Sciences, 60-355 Poznań, Poland.

Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope.

Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis ( = 30) or chronic otitis media ( = 30) with a clinical indication for surgery. The primary measurement was the subjective estimation of quality of the visibility of the operating field provided by the 3D exoscope-VITOM-3D (Karl Storz, Tuttlingen, Germany) in comparison to the operating microscope.

Results: All procedures, except for two (3.3%) converted to the microscope, were successfully completed using a 3D exoscope. In both stapedotomy and tympanoplasty, the exoscope was superior to the microscope during more superficial portions of the procedures. By contrast, in deeper areas of the middle ear, the exoscope provided significantly worse visibility, but usually not suboptimal. Both intraoperative bleeding and the narrow surgical field substantially reduced the visibility with the 3D exoscope in comparison to the microscope.

Conclusions: Overall, our study shows that the 3D exoscope offers excellent, highly magnified, and well-illuminated high-definition images of the surgical field. However, our experience revealed several important limitations of this system, including decreased depth perception in deep areas of the tympanic cavity and reduced visibility in a difficult surgical field, with subsequent need to switch to an operating microscope in select cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/jcm10040777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919662PMC
February 2021

An unusual neck mass in an adult: epidermoid cyst.

Pol Arch Intern Med 2021 02 10;131(2):193-194. Epub 2021 Feb 10.

Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.20452/pamw.15803DOI Listing
February 2021

Salivary Gland Pleomorphic Adenomas Presenting With Extremely Varied Clinical Courses. A Single Institution Case-Control Study.

Front Oncol 2020 8;10:600707. Epub 2021 Jan 8.

Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland.

Objective: Pleomorphic adenomas (PAs) with divergent clinical behavior, differing from the vast majority of PAs, were distinguished. "Fast" PAs are characterized by an unexpectedly short medical history and relatively rapid growth. The reference group consisted of "slow" PAs with very stable biology and long-term progression. We divide the PA group as a whole into three subsets: "fast," "normal," and "slow" tumors. Our goal is a multifactorial analysis of the "fast" and "slow" PA subgroups.

Methods: Consecutive surgeries in a tertiary referral center, the Department of Otolaryngology and Laryngological Surgery, Poznan University of Medical Sciences, Poland, were carried out between 2002 and 2011. Out of 1,154 parotid tumors, 636 (55.1%) were PAs. The data were collected prospectively in collaboration with the Polish National Registry of Benign Salivary Gland Tumors. The main outcome measure was the recurrence rate in "fast" and "slow" PA subgroups. All surgical qualifications and surgeries were performed by two experienced surgeons.

Results: Slow PAs, compared to fast PAs, presented in older patients (53.25 ± 15.29 versus 47.92 ± 13.44 years). Multifactor logistic regression analysis with recurrence (yes/no) as the outcome variable, fast/slow as the predictor variable and age, gender, margin, FN status as covariates showed that fast PAs were significantly predicting recurrence vs. slow PAs (p = 0.035). Fast PAs were increasing the risk of PAs 10-fold vs. slow PAs, exp β = 10.20, CI [1.66; 197.87]. The variables impacting relapse were recent accelerated growth of the tumor OR = 3.35 (SE = 0.56), p = 0.030, positive margins OR = 7.18 (SE = 0.57), p < 0.001, incomplete or bare capsule OR = 9.91 (SE = 0.53), p = 0.001 and location III OR = 3.12 (SE = 0.53), p = 0.033. In the multivariate model only positive margin was selected as the best predictor of relapse, OR = 5.01 (SE = 0.60), p = 0.007.

Conclusions: The simple clinical aspect of slow or fast PA progression is of great practical importance and can constitute a surrogate of the final histopathological information that is derived from the surgical specimen. The slow or fast nature of the PA to some extent indicates prognostic features such as recurrence risk. This finding requires correlation with histological and molecular features in further stages of research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2020.600707DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820779PMC
January 2021

Proteogenomic insights into the biology and treatment of HPV-negative head and neck squamous cell carcinoma.

Cancer Cell 2021 Mar 7;39(3):361-379.e16. Epub 2021 Jan 7.

Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

We present a proteogenomic study of 108 human papilloma virus (HPV)-negative head and neck squamous cell carcinomas (HNSCCs). Proteomic analysis systematically catalogs HNSCC-associated proteins and phosphosites, prioritizes copy number drivers, and highlights an oncogenic role for RNA processing genes. Proteomic investigation of mutual exclusivity between FAT1 truncating mutations and 11q13.3 amplifications reveals dysregulated actin dynamics as a common functional consequence. Phosphoproteomics characterizes two modes of EGFR activation, suggesting a new strategy to stratify HNSCCs based on EGFR ligand abundance for effective treatment with inhibitory EGFR monoclonal antibodies. Widespread deletion of immune modulatory genes accounts for low immune infiltration in immune-cold tumors, whereas concordant upregulation of multiple immune checkpoint proteins may underlie resistance to anti-programmed cell death protein 1 monotherapy in immune-hot tumors. Multi-omic analysis identifies three molecular subtypes with high potential for treatment with CDK inhibitors, anti-EGFR antibody therapy, and immunotherapy, respectively. Altogether, proteogenomics provides a systematic framework to inform HNSCC biology and treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ccell.2020.12.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946781PMC
March 2021

The survey of parents' and adults recipients' satisfaction with cochlear implantation determined by the place of residence.

Otolaryngol Pol 2020 Aug;74(6):21-28

Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, Poznan.

<b>Introduction:</b> The use of cochlear implants (CI) has been a remarkable success in reducing disabilities in patients with impaired hearing. The definition of success for those patients means improvement of hearing ability for adults, possibility to develop speech and language for children, quality of life improvement and satisfaction with the whole CI implantation procedure. <br><b>The aim:</b> To examine patient satisfaction, determined by their place of residence, with all activities in progress during CI implantation including care in subsequent years. Material and methods: The study was conducted prospectively. Online surveys were sent to 1,906 CI patients, with the response rate reaching 33%; thus 630 surveys were analyzed. Demographic data of the respondents were collected: gender, age of implantation, one- or two-sided implantation, place of residence and implanting clinic. A detailed statistical analysis of the obtained data was performed. <br><b>Results:</b> One of the problems observed was the aspect of waiting time for qualification, implantation and replacement of the speech processor. The second problem was the travel time to the CI center and that was strictly connected with the place of the residence of a patient. Patients' satisfaction with the control visit was high for majority of them. <br><b>Conclusions:</b> This research highlighted the limitations of the current CI service delivery. Significant differences concerning the CI pathway were found for particular regions of Poland. One of the future goals for healthcare providers should be to level out the differences in access to CI services between different regions of Poland.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5604/01.3001.0014.3434DOI Listing
August 2020

The holmium:YAG laser lithotripsy-a non-invasive tool for removal of midsize stones of major salivary glands.

Lasers Med Sci 2020 Nov 21. Epub 2020 Nov 21.

Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.

Incorporeal lithotripsy by using holmium:YAG laser has been recently successfully spread and used in the treatment of urolithiasis. Although this method is not as common in salivary gland surgery, it is also recommended for endoscopic treatment of sialolithiasis. In this study, we decided to analyse effectiveness of holmium:YAG laser method among patients with midsize stones as the treatment in this particular population is still not determined and remains in dispute. Thus, the primary aim of the study is a prospective, complex analysis of incorporeal holmium:YAG laser lithotripsy effectiveness and safety in patients suffering from sialolithiasis. The examined group consisted of 32 consecutive patients, 17 female (53%) and 15 male (47%). The average age was 42 (age range 22-70). In our series, sialoendoscopy with intraductal lithotripsy was performed in patients with wide range of stone's diameter (3 to 10 mm). The calculi were removed with foreign body forceps or retrieval basket, after stone fragmentation with holmium:YAG laser. The power of the laser during surgery was set at 2.5 to 3.5 W. One shot energy equalled 0.5-0.7 J with frequency of 5 Hz. The bivariate Pearson Correlation and a point-biserial correlation were used to analyse the data. Total success rate of holmium:YAG laser lithotripsy in this consecutive group was equal to 90% and efficacy in the group with excluded cases when endoscopic approach difficulties were experienced (stone not visible) reached 93%. The long-term follow-up revealed that in 26 patients (84%), complete recovery was achieved. Two patients developed Wharton's duct stenosis and one Stensen's duct orifice stenosis (9.5%), of whom one required reoperation. Two patients eventually underwent total excision of submandibular gland. Sialoendoscopy combined with incorporeal laser-assisted lithotripsy proved to be effective and safe method for treatment of sialothiasis with midsize stones (4-8 mm) in population of clinic. Even taking into account the prevalence of complications associated with holmium:YAG laser, it is still safer alternative compared to open surgery where there is a significant risk of the bleeding, wound infection or injury of the facial nerve.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10103-020-03201-0DOI Listing
November 2020

Head and Neck Paragangliomas-A Genetic Overview.

Int J Mol Sci 2020 Oct 16;21(20). Epub 2020 Oct 16.

Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, 60-355 Poznań, Poland.

Pheochromocytomas (PCC) and paragangliomas (PGL) are rare neuroendocrine tumors. Head and neck paragangliomas (HNPGL) can be categorized into carotid body tumors, which are the most common, as well as jugular, tympanic, and vagal paraganglioma. A review of the current literature was conducted to consolidate knowledge concerning PGL mutations, familial occurrence, and the practical application of this information. Available scientific databases were searched using the keywords head and neck paraganglioma and genetics, and 274 articles in PubMed and 1183 in ScienceDirect were found. From these articles, those concerning genetic changes in HNPGLs were selected. The aim of this review is to describe the known genetic changes and their practical applications. We found that the etiology of the tumors in question is based on genetic changes in the form of either germinal or somatic mutations. 40% of PCC and PGL have a predisposing germline mutation (including and ). Approximately 25-30% of cases are due to somatic mutations, such as , and . The tumors were divided into three main clusters by the Cancer Genome Atlas (TCGA); namely, the pseudohypoxia group, the Wnt signaling group, and the kinase signaling group. The review also discusses genetic syndromes, epigenetic changes, and new testing technologies such as next-generation sequencing (NGS).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijms21207669DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589036PMC
October 2020

The Impact of Virtual Reality Training on the Quality of Real Antromastoidectomy Performance.

J Clin Med 2020 Oct 2;9(10). Epub 2020 Oct 2.

Department of Otolaryngology and Laryngological Oncology, Poznań University of Medical Sciences, 60-355 Poznań, Poland.

Background: The aim of this paper is to analyze the results of virtual reality (VR) antromastoidectomy simulation training and the transferability of the obtained skills to real temporal bone surgery.

Methods: The study was conducted prospectively on a group of 10 physicians, and was composed of five VR simulation training sessions followed by live temporal bone surgery. The quality of performance was evaluated with a Task-Based Checklist (TBC) prepared by John Hopkins Hospital. Additionally, during every VR session, the number and type of mistakes (complications) were noted.

Results: The quality of performance measured by the TBC increased significantly during consecutive VR sessions. The mean scores for the first and fifth sessions were 1.84 and 4.27, respectively ( 0.001). Furthermore, the number of mistakes in consecutive VR sessions was gradually reduced from 11 to 0. During supervised surgery, all the participants were able to perform at least part of an antromastoidectomy, and the mean TBC score was 3.57. There was a significant strong positive correlation between the individual results of the fifth VR session and the individual results of supervised surgery in the operating room (r = 0.89, 0.001).

Conclusions: Virtual reality for temporal bone training makes it possible to acquire surgical skills in a safe environment before performing supervised surgery. Furthermore, the individual final score of virtual antromastoidectomy training allows a prediction of the quality of performance in real surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/jcm9103197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600885PMC
October 2020

A new taxon within L. (Brassicaceae) endemic to calamine areas in southern Poland.

PhytoKeys 2020 8;160:123-129. Epub 2020 Sep 8.

Icelandic Institute of Natural History, Borgir vid Nordurslod, 600 Akureyri, Iceland Icelandic Institute of Natural History Akureyri Iceland.

A new taxon Biscutella laevigata subsp. woycickii (Brassicaceae) is described from southern Poland. The taxon is similar to B. laevigata subsp. gracilis, but differs in having thin, light-green rosette leaves very densely covered by simple non-glandular trichomes, smaller seeds and the ability to tolerate and accumulate high amounts of heavy metals. This new taxon is supported by results of cultivation experiments, as well as genetic and paleobotanical evidence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3897/phytokeys.160.53937DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492185PMC
September 2020

Common sense and tumor treatment. A case of pilomatrical carcinoma in a 21-year-old patient with surprisingly rapid tumor progression.

Oral Oncol 2021 01 22;112:105007. Epub 2020 Sep 22.

Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland.

Pilomatrical carcinoma is a rare tumor originating from skin appendages, usually occurring between the 5th and 7th decade of life. We present a case of an exceptionally young, 21-year-old patient with surprisingly rapid tumor progression and answer the question, what was the reason for such uncontrolled tumor growth. The main concern is the diagnostic challenge and a peculiar, one week race against time and tumor progression so that the least disfiguring surgery could be done.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oraloncology.2020.105007DOI Listing
January 2021

: An Enemy after Head and Neck Cancer Operations with Microvascular Free Flap Reconstruction?

Surg Infect (Larchmt) 2021 May 11;22(4):442-446. Epub 2020 Sep 11.

Department of Otolaryngology, Head, and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.

Patients after head and neck cancer reconstructive surgical procedures are predisposed to have post-operative surgical site infections (SSI) develop. They are very often caused by multi-drug resistant strains, including as the most common one. The aim of the study was to determine important risk factors contributing to SSI of origin. The analysis included 134 head and neck cancer patients after salvage operations with microvascular free flap reconstruction. The was cultured in 27 of all 48 infected patients. The following risk factors were significantly associated with infection: re-hospitalization before reconstructive operation (p = 0.00011), massive blood loss (p = 0.00277), and need of revision surgical procedure (p = 0.00419). Of patients with infection, 48% were hospitalized in a general intensive care unit (ICU) after operation that, together with prolonged intubation, constituted a strong risk factor of that infection (p = 0.01077). Mean time of hospital stay was significantly longer in the group (58 days vs. 35 days; p = 0.02697). Our analysis identified a subset of head and neck cancer patients after salvage operation with microvascular free flap reconstruction who are at high risk of infection developing. Previously hospitalized patients with extensive blood loss and need of surgical revision necessitate increased monitoring for the development of this complication. Mechanical ventilation and hospital stay in an ICU should be shortened maximally or avoided in that challenging group of patients. Early recognition of patients at high risk remains a key point to prevent or limit the spread of infections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/sur.2020.214DOI Listing
May 2021

Evaluation of the modified Pittsburgh classification for predicting the disease-free survival outcome of squamous cell carcinoma of the external auditory canal.

Head Neck 2020 12 13;42(12):3609-3622. Epub 2020 Aug 13.

Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.

Background: Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is a rare disease, which is commonly classified with the modified Pittsburgh classification. Our aim was to evaluate the predictive performance of this classification in relation to disease-free survival (DFS).

Methods: We examined retrospective data from a nationwide Dutch cohort study including patients with primary EAC SCC. These data were combined with individual patient data from the literature. Using the combined data, the predictive performances were calculated using the c-index.

Results: A total of 381 patients were included, 294 for clinical and 281 for the pathological classification analyses. The c-indices of the clinical and the pathological modified Pittsburgh classification predicting DFS were 0.725 (0.668-0.782) and 0.729 (0.672-0.786), respectively.

Conclusion: The predictive performance of the modified Pittsburgh classification system as such appears to be acceptable to predict the DFS of EAC SCC. Other factors need to be added to a future model to improve the predicted performance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hed.26424DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754129PMC
December 2020

The usefulness of the narrow band imaging (NBI) in decision-making process regarding second look procedure (SL) in laryngeal cancer follow-up after transoral laser microsurgery.

PLoS One 2020 7;15(8):e0236623. Epub 2020 Aug 7.

Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.

Background: The prognostic value of positive surgical margins after transoral laser microsurgery (TOLM) is still under debate. In case of positive superficial margins, some experts recommend a second-look surgery (SL) and some recommend wait and watch approach with close observation. Narrow band imaging (NBI) is an advanced imaging system used to enhance visualization of mucosal vascular pattern. In laryngology, NBI is used to improve the detection of premalignant, dysplastic and malignant lesions.

Aim: To assess the usefulness of NBI imaging in guiding clinical decision making regarding follow-up plan and SL after TOLM.

Materials And Methods: A prospective cohort of 127 patients was divided into three groups based on the histology results and NBI vascular pattern of the mucosa. Group A (24/127, 18.90%) consisted of patients with suspicious vascular pattern in NBI or/and with positive deep margin. Group B (52/127, 40.94%) consisted of patients with positive or uncertain superficial margins and non-suspicious vascular pattern in NBI. Group C (51/127, 40.15%) had non-suspicious vascular NBI pattern and all negative margins.

Results: After the first TOLM procedure, 9/24 (37.5%) patients had positive deep margins, 1/24 (4.2%) had uncertain deep margin and 1/24 patient (4.2%) had both positive deep margin and suspicious vascular pattern in NBI. The remaining 13 cases in Group A had a suspicious NBI finding only during the first follow-up. All of the 24 patients (Group A) underwent a second look surgery. The final histology after SL showed squamous cell carcinoma in 10/24 (41.7%) patients. All 10 patients had suspicious vascular pattern in NBI and one patient had both a positive deep margins after the first TOLM and positive NBI finding. None of Group B and C subjects developed an early recurrence.

Conclusions: Our study provides evidence that NBI imaging will be a useful adjunct to margin status after TOLM and will facilitate clinical decision-making regarding performing the SL in patients with positive or uncertain superficial surgical margins in the first TOLM procedure. However, additional investigation with more subjects is required at this time to further validate this technique and change the standard of care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236623PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413545PMC
October 2020

The evaluation of a surgery and the short-term benefits of a new active bone conduction hearing implant - the Osia®.

Braz J Otorhinolaryngol 2020 Jul 4. Epub 2020 Jul 4.

Poznań University of Medical Sciences, Department of Otolaryngology and Laryngological Oncology, Poznań, Poland.

Introduction: Modern medicine offers a wide spectrum of different hearing devices, and bone conduction implants can be found among them.

Objective: The presentation of the outcomes of the implantation of a new active bone conduction hearing implant - the Osia®, and its comparison with the well-known passive transcutaneous system - the Baha® Attract.

Materials And Methods: Eight adult patients with bilateral mixed hearing loss were randomly divided into two groups. Group 1 was implanted with the Osia®, and group 2 was implanted with the Baha® Attract. The details of the surgery were analyzed, along with the functional and audiological results.

Results: In all the cases, the surgery was successful, and the healing uneventful. In both groups, it was observed that pure tone audiometry and speech audiometry in free field improved significantly after the implantation (mean gain in pure tone audiometry for the Osia group 42.8 dB SPL and for the Baha group 38.8 dB SPL). In the Osia group, the results after the surgery were much better than with the Baha® 5 Power processor on the Softband. The patients implanted with the Osia® evaluated the quality of their hearing as being superior to those implanted with the Baha® Attract. There was an evident improvement in the abbreviated profile of hearing aid benefit questionnaire and in the speech, spatial and qualities of hearing scale for both systems. In the abbreviated profile of hearing aid benefit, changes were more evident in the Osia group (in global score 49% vs. 37.2%).

Conclusions: Implantation of the Osia® is an effective treatment option for the patients with bilateral mixed hearing loss. The surgery is safe but more complex and time-consuming than the Baha® Attract implantation. The preliminary audiological results as well as the overall quality of life indicate that the Osia® is a better solution than the Baha® Attract. However, future studies should be carried out to make further observations in a larger group of patients, and with longer follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bjorl.2020.05.021DOI Listing
July 2020

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic for outpatient and hospital practices.

Otolaryngol Pol 2020 Jun;74(3):1-5

Katedra i Klinika Laryngologii Wydziału Lekarskiego, Śląski Uniwersytet Medyczny w Katowicach.

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5604/01.3001.0014.1320DOI Listing
June 2020

Voice improvement in patients with recurrent respiratory papillomatosis after combined treatment with cidofovir and CO laser surgery.

Lasers Med Sci 2019 Sep 14;34(7):1433-1440. Epub 2019 Feb 14.

Department of Otolaryngology, Head and Neck Surgery Poznań University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznań, Poland.

Mechanical debulking of laryngeal papillomas is associated with voice disorders due to impairment of the vocal fold's mucosa. Intraepithelial injection of cidofovir reduces damage to the laryngeal structures and thus improves vocal parameters. The aim of our study was to compare vocal quality before and after cidofovir and CO laser treatment by means of objective phoniatric parameters and to obtain evidence concerning voice outcomes. The vocal parameters of 42 patients with RRP were assessed before and after intralesional cidofovir and CO laser debulking treatment (Lumenis AcuPulse 40 CO laser, wavelength 10.6 μm; Lumenis Ltd., Yokneam, Israel). The laser was used in SuperPulse mode with power tailored on the target structures (average 7 W). The depth of tissue penetration was 1 mm with a single burst of energy lasting 0.3 ms. Most of the patients had previously undergone traditional surgery (1-105 procedures); in 7/42, the video stroboscopic examination revealed extensive scar tissue covering the mucosa of the vocal folds, limiting the mucosal wave. The significance level for all calculations was p < 0.05. Statistical analysis was performed using Statistica 10 by StatSoft Polska. The methodology included subjective voice evaluation (GRBAS), videostroboscopy, analysis of the acoustic laryngeal tone (MDVP), spectrographic analysis, and voice handicap index (VHI). The GRBAS scale during spontaneous conversation revealed better phonation results after cidofovir treatment in all 42 patients. Scars were not observed in the presented group. In the MDVP laryngeal tone analysis before surgery parameters defining the amplitude and frequency of laryngeal tone were significantly elevated compared to the state after surgery. After treatment, both jitter and shimmer were reduced in all subjects. Even more pronounced changes were observed in the spectrographic analysis. In all analyzed patients, there was a significant reduction in VHI scores showing improvement in voice self-assessment. A satisfactory improvement in voice quality was observed in all RRP patients treated with cidofovir and CO laser.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10103-019-02735-2DOI Listing
September 2019
-->