Dr. Witold Polanski, MD - Neurosurgery, University Hospital of Dresden - Dr. med.

Dr. Witold Polanski

MD

Neurosurgery, University Hospital of Dresden

Dr. med.

Dresden | Germany

Main Specialties: Neurological Surgery

Additional Specialties: Neuromodulation, Deep Brain Stimulation

ORCID logohttps://orcid.org/0000-0002-6603-5375


Top Author

Dr. Witold Polanski, MD - Neurosurgery, University Hospital of Dresden - Dr. med.

Dr. Witold Polanski

MD

Introduction

Experience:
08/2011 – 04/2018 Assistant doctor at the Department of Neurosurgery, medical school ‘Carl Gustav Carus’ of the Technical University of Dresden, Germany
Since 03/2016 Quality management representative doctor
Since 05/2018 Consultant at the Department of Neurosurgery, medical school ‘Carl Gustav Carus’ of the Technical University of Dresden, Germany
Since 07/2018 Additional designation „Ärztliches Qualitätsmanagement“

Education And Qualifications:
1998 – 2003 Secondary school „Glückauf“-Gymnasium Dippoldiswalde
09/2003 - 06/2004 Alternative service in the hospital Dippoldiswalde at hospital ward 5 / IC
10/2004 - 07/2011 Studies of medicine at the medical faculty „Carl Gustav Carus“ of the Technical University of Dresden
01/2008 – 09/2010 Fellowship of the MD-Programm of the medical faculty „Carl Gustav Carus“ of the Technical University of Dresden (equivalent to a PhD training course)
06/2010 Good Clinical Practice am KKS Dresden
10/2012 – 04/2014 Young Neurosurgeon Training Programm III for deep brain stimulation (DBS) (Medtronic) with hospitations in:
- Landeskrankenhaus Innsbruck, Austria (Prof. Eisner)
- National Hospital for Neurology & Neurosurgery Queen Square in London, England (Prof. Zrinzo/ Prof. Hariz)
- Academisch Medisch Centrum in Amsterdam, Netherlands (Prof. Schuurman)
09/2013 European Continuing Medical Training (ECMT): DBS for OCD at the Hospital Gasthuisberg of Leuven, Belgium (Prof. Gabriëls und Prof. Nuttin)
07/2014 Workshop „Hygienebeauftragter Arzt“ at the University Hospital of Dresden
09/2015 Didaktik-Workshop at the medical faculty „Carl Gustav Carus“ of the Technical University of Dresden
06/2016 Workshop „Risikomanagement“ of the DGQ at University Hospital of Dresden
10/2016 Workshop „Interner Auditor“ of the DGQ at University Hospital of Dresden
10/2016-12/2017 Curriculum „Ärztliches Qualitätsmanagement“ at the Bundesärztekammer Berlin
11/2017 Workshop „Fehlermöglichkeits- und Einflussanalyse (FMEA)“ of the DGQ at University Hospital of Dresden
05/2018 DBS advanced programming course (Abbott; Prof. Schnitzler) in Milan, Italy

Academic career:
10/2007 – 09/2010 Doctoral dissertation: Topic: “Effects of 9-methyl-ß-carboline on dopaminergic neurons in primary culture“ at the Department of Neurology (supervisor: Ass. Prof. Gabriele Gille (PhD), chair: Prof. Heinz Reichmann (MD, PhD) at the Technical University of Dresden; rating: “summa cum laude”
03/2006 – 11/2009 Instructor for medical students in anatomical and neuroanatomical preparation at the Technical University of Dresden
Since 10/2011 Instructor for medical students for seminars and workshops in „Neurochirurgie“ and „Einführung in die klinische Medizin“ at the medical faculty „Carl Gustav Carus“ of the Technical University of Dresden
2015/2016 Lecture for Studium generale at the Technical University of Dresden. Topic: Deep Brain Stimulation
10/2017 Lecture: DGQ RK. Topic: Improvement of treatment quality for DBS using the Six Sigma concept
Since 06/2018 Free lecturer at Dresden International University with reads about quality management in hospitals

Grants:
02/2009 Travel Grant of the Philipps-University in Marburg for the 6. German Parkinson’s Disease congress
12/2009 Travel Grant of the XVIII WFN World Congress on Parkinson’s disease and Related Disorders and of the Melvin Yahr International Parkinson’s Disease Foundation (Chair: Dr. Alessandro Di Rocco) in Miami, Florida, USA
12/2011 Carl Gustav Carus Förderpreis of the medical faculty „Carl Gustav Carus“ of the Technical University of Dresden
05/2013 Posterpreis Neuromodulation of the German Society for Neurosurgery (DGNC) 2013
03/2017 Travel Grant of the German Society of the surgical society (DGCH) 2017

Primary Affiliation: Neurosurgery, University Hospital of Dresden - Dresden , Germany

Specialties:

Additional Specialties:

Research Interests:


View Dr. Witold Polanski’s Resume / CV

Education

Dec 2017
Bundesrztekammer Berlin
Curriculum rztliches Qualittsmanagement
Nov 2017
DGQ
Workshop Fehlermglichkeits- und Einflussanalyse (FMEA)
Oct 2016
DGQ
Workshop Interner Auditor
Jun 2016
DGQ
Workshop Risikomanagement
Sep 2015
medical faculty Carl Gustav Carus of the Technical University of Dresden
Didaktik-Workshop
Apr 2014
Medtronic
Young Neurosurgeon Training Programm III for deep brain stimulation
Sep 2013
Hospital Gasthuisberg of Leuven, Belgium
European Continuing Medical Training (ECMT): DBS for OCD
Jul 2011
medical faculty Carl Gustav Carus of the Technical University of Dresden
Fellowship of the MD-Programm

Experience

Mar 2017
Travel Grant of the German Society of the surgical society (DGCH) 2017
May 2013
Posterpreis Neuromodulation of the German Society for Neurosurgery (DGNC) 2013
Dec 2011
Carl Gustav Carus Frderpreis of the medical faculty Carl Gustav Carus of the Technical University of Dresden
Dec 2009
Travel Grant of the XVIII WFN World Congress on Parkinsons disease and Related Disorders and of the Melvin Yahr International Parkinsons Disease Foundation (Chair: Dr. Alessandro Di Rocco) in Miami, Florida, USA
Feb 2009
Travel Grant of the Philipps-University in Marburg for the 6. German Parkinsons Disease congress

Publications

12Publications

615Reads

222Profile Views

7PubMed Central Citations

Clinical Validation of Quality Improvements Using the Six Sigma Concept: A Case Study for Deep Brain Stimulation in Parkinson's Disease.

Stereotact Funct Neurosurg 2019 25;97(3):195-201. Epub 2019 Sep 25.

Department of Neurosurgery, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.

Background: The Six Sigma concept allows for the evaluation of quality changes after the implementation of new technical equipment or adjustment of perioperative procedures. Exemplarily, we applied this method for quality assessment in deep brain stimulation surgery (DBS) for Parkinson's disease.

Methods: The medical procedure and possible errors were registered. Then, 6 critical-to-quality characteristics regarding clinical outcome, surgical precision, and the surgical process were measured. The surgical procedure was then optimized in 2 steps, and its measurement, along with the analysis, was repeated twice.

Results: By optimizing perioperative settings, the operation time could be reduced, and the precision of the lead placement could be increased. Clinical outcome, as measured by improvement in UPDRS-III, IV, and reduction of medication could also be improved with smaller required stimulation voltage. With directional leads considerable reduction of medication was achieved in 97% of patients (?-value 3.39) compared to 83.7% (?-value 2.53) with nondirectional leads.

Conclusion: This study shows that the Six Sigma concept is a suitable quality tool to analyze and improve treatment quality of complex medical procedures such as lead positioning in DBS surgery in clinical routine. Our results suggest that directional leads in subthalamic nucleus DBS may have a favorable impact on patients' outcome.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1159/000502654DOI Listing
February 2020
4 Reads
1.905 Impact Factor

Somatosensory functional MRI tractography for individualized targeting of deep brain stimulation in patients with chronic pain after brachial plexus injury.

Acta Neurochir (Wien) 2019 12 7;161(12):2485-2490. Epub 2019 Oct 7.

Department of Neurosurgery, University Hospital CarlGustavCarus, Technical University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Background: The optimal targets for deep brain stimulation (DBS) in patients with refractory chronic pain are not clearly defined. We applied sensory functional MRI (fMRI)- and diffusion tensor imaging (DTI)-based DBS in chronic pain patients into 3 different targets to ascertain the most beneficial individual stimulation site.

Methods: Three patients with incapacitating chronic pain underwent DBS into 3 targets (periventricular gray (PVG), ventroposterolateral thalamus (VPL), and posterior limb of the internal capsule according to fMRI and DTI (PLIC). The electrodes were externalized and double-blinded tested for several days. Finally, the two electrodes with the best pain reduction were kept for permanent stimulation. The patients were then followed up for 12 months. Outcome measures comprised the numerical rating scale (NRS), short-form McGill's score (SF-MPQ), and health-related quality of life (SF-36).

Results: Continuous pain (mean NRS 6.6) was reduced to NRS 3.6 after 12 months. Only with stimulation of the PLIC pain attacks, that occurred at least 3 times a week (mean NRS 9.6) resolved in 2 patients and improved in one patient concerning both intensity (NRS 5) and frequency (twice a month). The mean SF-MPQ decreased from 92.7 to 50. The health-related quality of life improved considerably.

Conclusion: fMRI- and DTI-based DBS to the PLIC was the only target with a significant effect on pain attacks and seems to be the most promising target in chronic pain patients after brachial plexus injury. The combination with PVG or VPL can further improve patients' outcome especially in terms of reducing the continuous pain.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00701-019-04065-2DOI Listing
December 2019
2 Reads
1.834 Impact Factor

[Accreditation and digitization - just a load of crap? Systematic risk analysis among medical employees - today and 12 years ago].

Z Evid Fortbild Qual Gesundhwes 2019 Nov 11;147-148:67-72. Epub 2019 Nov 11.

Klinik und Poliklinik für Neurochirurgie des Uniklinikums DresdenDresden, Deutschland.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.zefq.2019.09.006DOI Listing
November 2019

Application of the Six Sigma concept for quality assessment of different strategies in DBS surgery.

Int J Qual Health Care 2018 Dec;30(10):760-768

Department of Neurosurgery, University Hospital Carl-Gustav-Carus, Technical University of Dresden, Fetscherstr. 74, Dresden, Germany.

Background: For quality analysis, we applied the Six Sigma concept to define quality indicators and their boundaries as well as to compare treatment-dependent outcome data of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease (PD).

Methods: The Unified Parkinson Disease Rating Scale (UPDRS) III with on medication and on stimulation, the reduction of daily levodopa equivalence doses (LED), and the stimulation amplitude 1 year after surgery were registered. Regarding the results of the EARLYSTIM study, sigma values for applicable studies were calculated and compared. Further, the impact of perioperative conditions on patients' outcomes was analyzed.

Results: Forty-one studies with 2184 patients were included. The bleeding risk was 1.36%. In median, UPDRS III on/on improved by 19.9% while the LED was reduced by 45.2%. The median stimulation amplitude was 2.84 V. With the Six Sigma principle, a comparison between different centers was possible. Microelectrode recordings (MER) did not correlate with occurrence of bleedings and did not impact patient outcome.

Conclusions: The Six Sigma principle can be simply used to analyze, improve and compare complex medical processes, particularly, the DBS surgery. Based on these data, higher sigma values were reached for clinical improvement in UPDRS III on/on for patients who underwent surgery in local anesthesia with intraoperative test stimulation compared to surgery in general anesthesia. However, the difference was not statistically significant. Application of MER was found to be optional with no increased bleeding risk and no improvement on patient's outcome.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/intqhc/mzy129DOI Listing
December 2018
378 Reads
2.554 Impact Factor

ActiGait implantable drop foot stimulator in multiple sclerosis: a new indication.

J Neurosurg 2017 May 1;126(5):1685-1690. Epub 2016 Jul 1.

Department of Neurosurgery and.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3171/2016.4.JNS1660DOI Listing
May 2017
32 Reads
3.737 Impact Factor

Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy.

J Neurosurg 2016 Jan 24;124(1):70-6. Epub 2015 Jul 24.

Department of Neurological Surgery, Carl-Gustav-Carus University Hospital of the Technical University of Dresden; and.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3171/2014.12.JNS142110DOI Listing
January 2016
14 Reads
3.737 Impact Factor

New Therapeutic Option for Drop Foot with the ActiGait Peroneal Nerve Stimulator--a Technical Note.

World Neurosurg 2015 Dec 9;84(6):2037-42. Epub 2015 Jul 9.

Department of Neurosurgery, University Hospital Carl-Gustav-Carus, Technical University of Dresden, Dresden, Germany.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.wneu.2015.06.074DOI Listing
December 2015
11 Reads
2.417 Impact Factor

Accuracy of subthalamic nucleus targeting by T2, FLAIR and SWI-3-Tesla MRI confirmed by microelectrode recordings.

Acta Neurochir (Wien) 2015 Mar 18;157(3):479-86. Epub 2015 Jan 18.

Department of Neurosurgery, Medical school 'Carl Gustav Carus' of the Technical University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany,

Background: Successful deep brain stimulation is mostly dependent on accurate positioning of the leads at the optimal target points. We investigated whether the identification of the subthalamic nucleus in T2-weighted 3-T MRI, fluid-attenuated inversion recovery 3-T MRI and susceptibility-weighted 3-T MRI is confirmed by intraoperative neurological microelectrode recording.

Methods: We evaluated 182 microelectrode recording leads in 21 patients with bilateral deep brain stimulation, retrospectively. Consequently, 728 electrode contact positions in T2-weighted 3-T MRI, 552 electrode contact positions in fluid-attenuated inversion recovery 3-T MRI and 490 electrode contact positions in susceptibility-weighted 3-T MRI were evaluated for a positive nucleus subthalamicus signal.

Results: The highest sensitivity was measured for fluid-attenuated inversion recovery 3-T MRI with 82.5 %, while the highest specificity was observed for susceptibility-weighted 3-T MRI with 90.6 %. The negative predictive value was nearly equal for susceptibility-weighted MRI and fluid-attenuated inversion recovery MRI with 87.5 % vs. 87.1 %, but the positive predictive value was higher in susceptibility-weighted 3-T MRI (86.0 %) than in the other MRI sequences.

Conclusions: The susceptibility-weighted 3-T MRI-based subthalamic nucleus localization shows the best accuracy compared with T2-weighted and fluid-attenuated inversion recovery 3-T MRI. Therefore, the susceptibility-weighted 3-T MRI should be preferred for surgical planning when the operation procedure is performed under general anesthesia without microelectrode recordings.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00701-014-2328-xDOI Listing
March 2015
30 Reads
1.788 Impact Factor

Autologous bone flap cranioplasty following decompressive craniectomy is combined with a high complication rate in pediatric traumatic brain injury patients.

Acta Neurochir (Wien) 2014 Apr 16;156(4):813-24. Epub 2014 Feb 16.

Department of Neurological Surgery, University Hospital Carl-Gustav-Carus, Technical University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany,

Objective: Decompressive craniectomy (DC) is a last treatment option of refractory intracranial hypertension in traumatic brain injury (TBI) patients. Replacement of the autologous bone flap is the preferred method to cover the cranial defect after brain swelling has subsided. Long term outcomes and complications after replacement of the autologous bone flap in pediatric patients were studied in comparison to young, healthy adults.

Methods: Medical records of 27 pediatric patients who underwent DC and subsequent replacement of the bone flap between 1998 and 2011 were reviewed retrospectively. Patients were divided into two age groups (group 1: 18 children?<?15 years; group 2:9 adolescents 15-18 years). For comparative reasons, a young adult control group of 39 patients between 18 and 30 years was additionally evaluated.

Results: With 81.8 % resorption of the bone flap, this was the major complication in young children. In up to 54.4 % of patients, a surgical revision of the osteolytic bone flap became necessary. However, in some pediatric patients, the osteolysis resolved spontaneously and further operations were not required. Probable enabling factors for bone flap resorption were young age (0-7 years), size of craniectomy, permanent shunt placement, and extent of dural opening/duraplasty. Other complications were bone flap infections, loosening of the re-inserted bone flap, and postoperative hematomas.

Conclusion: There is an unacceptably high complication rate after reimplantation of the autologous bone following DC in pediatric TBI patients, especially in young children up to seven years of age. Artificial or synthetic cranioplasties may be considered as alternatives to initial bone flap reimplantation in the growing child. Despite the fact that DC is an effective treatment in TBI with persistent intracranial hypertension, it is important to realize that DC is not only combined with replacement of the autologous bone flap but also with a high rate of additional complications especially in pediatric patients.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00701-014-2021-0DOI Listing
April 2014
22 Reads
1.788 Impact Factor

Anticoagulation management of myocardial infarction after deep brain stimulation: a comparison of two cases.

Acta Neurochir (Wien) 2013 Sep 7;155(9):1661-5; discussion 1664-5. Epub 2013 Apr 7.

Departement of Neurosurgery, Carl Gustav Carus Medical School, Technical University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Deep brain stimulation (DBS) is an established treatment of various diseases, particularly used for idiopathic Parkinson's disease. Frequently, DBS patients are multimorbid and managing them may be challenging, since postoperative complications can become more likely with age. In this article, we present two cases of myocardial infarction after DBS with different therapeutic strategies. Case 1 was anticoagulated with a heparin infusion with a target partial thromboplastine time (PTT) between 50 and 60 s after the myocardial infarction and showed 3 days later, after an initial postoperative inconspicuous cranial computer tomography, an intracerebral haematoma, which was evacuated without explanting the DBS lead. Case 2 was only treated with enoxaparine 40 mg s.c. twice a day after the myocardial infarction without any further complications. Both cases benefited from the DBS with respect to the motor fluctuations, but case 1 continued to suffer from psychomotor slowdown, mild hemiparesis of the left side, visual neglect and a gaze paresis. Unfortunately, there are no established guidelines or therapy recommendations for the management of such patients. An individual therapy regime is necessary for this patient population regarding the bleeding risk, the cardial risk and the symptoms of the patient. Retrospectively, the rejection of the intravenous application of heparin in case 2 seems to be the right decision. But regarding the small number of cases, it remains still an individual therapy. Further experience will help us to develop optimal therapy strategies for this patient population.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00701-013-1679-zDOI Listing
September 2013
40 Reads
1.788 Impact Factor

Stimulation, protection and regeneration of dopaminergic neurons by 9-methyl-β-carboline: a new anti-Parkinson drug?

Expert Rev Neurother 2011 Jun;11(6):845-60

Department of Neurology, Technical University of Dresden, Fetscherstr. 74, 01307 Dresden, Germany.

View Article

Download full-text PDF

Source
http://www.tandfonline.com/doi/full/10.1586/ern.11.1
Publisher Site
http://dx.doi.org/10.1586/ern.11.1DOI Listing
June 2011
23 Reads
2 Citations
2.834 Impact Factor

The exceptional properties of 9-methyl-beta-carboline: stimulation, protection and regeneration of dopaminergic neurons coupled with anti-inflammatory effects.

J Neurochem 2010 Jun 31;113(6):1659-75. Epub 2010 Mar 31.

Department of Neurology, Technical University of Dresden, Dresden, Germany.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1471-4159.2010.06725.xDOI Listing
June 2010
59 Reads
5 Citations
4.281 Impact Factor

Top co-authors

Stephan B Sobottka
Stephan B Sobottka

Universitätsklinikum Carl Gustav Carus

10
Gabriele Schackert
Gabriele Schackert

Carl Gustav Carus University Hospital

10
Mareike Fauser
Mareike Fauser

Dresden University of Technology

3
Alexander Storch
Alexander Storch

Dresden University of Technology

3
Lisa Klingelhoefer
Lisa Klingelhoefer

University of Dresden Medical School

3
Heinz Reichmann
Heinz Reichmann

Dresden University of Technology

3
Johann Klein
Johann Klein

Faculty of Medicine and University Hospital Carl Gustav Carus

2
Amir Zolal
Amir Zolal

J.E. Purkinje University and Masaryk Hospital

2
Gabriele Gille
Gabriele Gille

Technical University of Dresden

2