51 research outputs found

    The balloon-based manometry evaluation of swallowing in patients with amyotrophic lateral sclerosis

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    The aim of the study was to analyse the disturbances of the oro-pharyngeal swallowing phase of dysphagia in amyotrophic lateral sclerosis (ALS) patients with the use of specific manometric measurements and to evaluate their plausible association with the duration of the disease. Seventeen patients with ALS were evaluated with manometric examinations of the oral and pharyngeal part of the gastrointestinal tract. Tests were carried out by using the oesophageal balloon-based method with four balloon transducers located 5 cm away from each other. The following manometric parameters were analysed: the base of tongue contraction (BTC) and the upper oesophageal sphincter pressure (UESP), and the hypopharyngeal suction pump (HSP) as well as the oro-pharyngeal, pharyngeal and hypopharyngeal transit time and average pharyngeal bolus velocity (oropharyngeal transit time (OTT), pharyngeal transit time (PTT), hypopharyngeal transit time (HTT) and average pharyngeal bolus velocity (APBV), respectively). Manomatric examinations during swallowing in patients with ALS showed significant weakness of BTC, a decrease of HSP and a decrease of the velocity of bolus transit inside the pharynx which were particularly marked between the first and the third examination. Manometric examinations of the oro-pharyngeal part of the gastrointestinal tract are useful and supportive methods in the analysis of swallowing disturbances in ALS patients

    Objawy otolaryngologiczne u chorych leczonych z powodu chor贸b przenoszonych przez kleszcze

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    Wst臋p: Choroby przenoszone przez kleszcze sta艂y si臋 w ci膮gu kilkunastu ostatnich lat bardzo powa偶nym problemem. Najbardziej rozpowszechnionymi s膮 borelioza oraz kleszczowe zapalenie m贸zgu (KZM). W ostatnim czasie znacz膮co ro艣nie r贸wnie偶 liczba zaka偶e艅 patogenami z rodzaju Bartonella, Babesia, Anaplasma, Brucella i in. Podobie艅stwo objaw贸w chor贸b odkleszczowych do objaw贸w innych chor贸b jest powa偶nym wyzwaniem diagnostycznym. Materia艂y i metody: Badaniem obj臋to grup臋 216 chorych w wieku 18鈥55 lat, zg艂aszaj膮cych si臋 na wizyt臋 w poradni otolaryngologicznej z powodu chor贸b odkleszczowych w latach 2014鈥2016. Chorzy mieli zdiagnozowan膮 borelioz臋 i koinfekcje, a g艂贸wnymi testami potwierdzaj膮cymi obecno艣膰 tych chor贸b by艂y testy: ELISA, Western-Blot oraz badanie KKI (kr膮偶膮ce kompleksy immunologiczne). Wyniki: Spo艣r贸d 216 chorych wyodr臋bniono grup臋 162 pacjent贸w manifestuj膮cych objawy otolaryngologiczne. G艂贸wnym objawem zg艂aszanym przez pacjent贸w by艂y uci膮偶liwe szumy uszne (76,5%) 鈥 w przewa偶aj膮cej mierze wysokocz臋stotliwo艣ciowe, zawroty g艂owy i zaburzenia r贸wnowagi (53,7%), b贸le g艂owy (39%), niedos艂uch odbiorczy jednostronny (16,7%). W艣r贸d badanych opr贸cz boreliozy zaobserwowano r贸wnie偶 obecno艣膰 innych chor贸b odkleszczowych. Najliczniejsz膮 grup臋 stanowili pacjenci zaka偶eni bakteriami z rodzaju Bartonella henselae (33,4%) oraz Bartonella quintana (13%). Dyskusja: Objawy otolaryngologiczne s膮 cz臋st膮 manifestacj膮 chor贸b przenoszonych przez kleszcze. Najcz臋艣ciej wyst臋puj膮 w przebiegu boreliozy oraz zaka偶e艅 bakteriami z rodzaju Bartonella spp. Objawy ze strony narz膮d贸w g艂owy i szyi najcz臋艣ciej wyst臋puj膮 w przebiegu przewlek艂ego procesu chorobowego. 艢wiadczy o tym zdecydowana przewaga przeciwcia艂 IgG i antygenu VlsE w grupie badanych chorych

    Stability of ABR Wave V threshold in early hearing diagnostics in children from selected groups at risk of congenital hearing loss

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    Introduction: Upon hearing that the 鈥渓ittle鈥 patient has trouble with hearing, we are mostly interested in the level of his hearing threshold. When the child is in the first year of life, results can only be achieved by means of ABR test. Subsequent control tests, especially in children from the hearing loss risk groups selected in this study, show that the obtained outcomes are subject to fluctuations. Their fluctuating nature is manifested by the instability of wave V threshold in subsequent diagnostic periods. Such variability often delays the implementation of the appropriate proceeding. Knowledge of the dissimilarity of behavior of the wave V threshold occurring in individual groups at risk of hearing loss allows for the correct interpretation of the obtained results, and thus, effective therapeutic measures. Aim: The aim of the paper is to analyze the stability of wave V threshold during the first year of life in children from selected risk groups for congenital hearing disorders. Material and methods: From the patient population of 2,114 individuals examined in 2015鈥2016 at a reference center participating in the Universal Neonatal Hearing Screening Program in 2015鈥2016, the results of 250 children were subjected to retrospective analysis. Furthermore, 4 groups of little patients were formed (children with Down syndrome; children with other diseases or damage to the nervous system; children with cleft palate or cleft lip and cleft palate; children with congenital cytomegaly) in whom diagnostic practice revealed variable results of the wave V threshold. We analyzed the results of tests obtained during the first year of the child鈥檚 life divided into 4 diagnostic periods. Results: The highest percentage of instability in the established threshold of wave V between individual diagnostic periods occurred in the group of children with cleft palate or cleft lip and cleft palate. In the group of children with Down syndrome, it was observed that the instability of the ABR test results decreased over time. In the group of children with other diseases or damage of the nervous system, the highest percentage of the lack of stable ABR wave V thresholds was observed between the 1st and 2nd as well the 1st and 4th diagnostic periods. On the other hand, in the group of children with congenital CMV, there was a relatively low percentage of instability of results. Conclusions: (1) Although the ABR test is a diagnostic standard, in particular groups of patients the study is burdened with high variability of measurement results in subsequent diagnostic periods. Such a group of patients are children with cleft palate or cleft lip and cleft palate; therefore, it must receive particular attention in treatment planning; (2) in selected groups at risk of hearing loss, due to the high percentage of children with hearing impairment (70%), the validity of performing newborn hearing screening tests was confirmed

    Extensive neck trauma in material of Otolaryngology Department of the Jagiellonian University in Krakow 2009-2012

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    Isolated laryngeal fractures quite rarely can occur following trauma to the neck region, but because of the variety and dynamic growth of symptoms or possible injury of the main structures on the neck may be life-threatening. The appropriate treatment of these patients is quick surgical intervention proceeded by imaging techniques. Here we report the cases of three patients treated in our Department between 2009 and 2012: two of them with penetrating injury and one with blunt trauma. The appropriate treatment of these patients requires that airway patency be the first priority and if possible quick reconstruction. These cases illustrate the individualized treatment and multidisciplinary approach in managing such cases

    Endoscopic treatment of giant skull base osteomas

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    Introduction: Osteomas are relatively common, benign, slow-growing neoplasms. Mainly occurring in frontal and ethmoid sinuses. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim: We discuss our experiences in endoscopic treatment of giant osteomas. Results: In giant osteomas Draf III or Lothrop approaches are prefered. Periostium of the orbit was intact in all cases. Discharge of cerebrospinal liquid was not observed. Conclusions: Size of tumor determines type of surgical aprroach. Endoscopic surgery is more and more popular way in surgical treatment of giant osteomas

    Isolated inverted papilloma of the sphenoid sinus : case report

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    Background: Primary inverted papilloma of the sphenoid sinus is rare. The tumor is considered locally aggressive. In selected cases inverted papilloma can be associated with squamous celt carcinoma. Radiologic imaging is a key to an accurate diagnosis. Aim: We analyzed patient with inverted papilloma in sphenoid sinus which was removed with endoscopic surgery. Material and methods: We discuss patient with isolated inverted papilloma located in the sphenoid sinus. Results: Performed endoscopic treatment enabled removal of tumour with no complications. Conclusions: Transnasal endoscopic large sphenoidotomy remains an effective modality for mangement of patients with inverted papilloma. This method does not require external approach and it is performed with no scars, with minima) injury of tissues

    Normative Values for Heart Rate Variability Parameters in School-Aged Children: Simple Approach Considering Differences in Average Heart Rate

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    Background: Heart rate variability (HRV) analysis is a clinical tool frequently used to characterize cardiac autonomic status. The aim of this study was to establish normative values for short-term HRV parameters by considering their main determinants in school-aged children.Methods: Five-minute electrocardiograms were taken from 312 non-athlete children (153 boys) at age of 6 to 13 years for computation of conventional time- and frequency-domain HRV parameters. Heart rate (HR), respiratory rate, age, body mass index, and sex were considered as their potential determinants. Multiple regression analysis revealed that HR was the principal predictor of all standard HRV indices. To develop their universal normative limits, standard HRV parameters were corrected for prevailing HR.Results: The HRV correction for HR yielded the parameters which became independent on both sex and HR, and only poorly dependent on age (with small effect size). Normal ranges were calculated for both time- and frequency-domain indices (the latter computed with either fast Fourier transform and autoregressive method). To facilitate recalculation of standard HRV parameters into corrected ones, a calculator was created and attached as a Supplementary Material that can be downloaded and used for both research and clinical purposes.Conclusion: This study provides HRV normative values for school-aged children which have been developed independently of their major determinants. The calculator accessible in the Supplementary Material can considerably simplify determination if HRV parameters accommodate within normal limits
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