42 research outputs found

    Robotic surgery in otolaryngology

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    Exacerbations of chronic rhinosinusitis : microbiology and perspectives of phage therapy

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    The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS

    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

    Analysis of voice modifications for persons after tonsillectomy

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    The goal of the research described in the present paper was the determination of modification range for voice acoustic parameters resulting from tonsillectomy. Within the scope of the described research program, an attempt has been made to determine the changes of selected voice parameters for persons after such a treatment and also to elaborate work out some premises for prediction of potential voice modifications for persons who have not yet decided to undergo such a treatment. In order to achieve the goal, analyses have been carried out for voice utterances of persons before the tonsillectomy surgery and after the treatment. The first voice recordings took place between one and three days before the surgery. The post-treatment recordings have been carried out about 6 weeks after the surgery, as a procedure accompanying the follow-up examinations. In the present paper, an analysis has been carried out concerning phonemes /a/, /e/, /i/, and /u/ with prolonged phonation. The completed research shows that for evaluation of voice modification in the aspect of changes resulting from tonsillectomy, the most useful parameters are some of the mel-cepstral coefficients, the formant frequencies, and also the relative power coefficients

    Cat scratch disease : an underestimated diagnosis

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    Introduction: Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellular bacilli Bartonella, transmitted by domestic animals. Aim: We present a case report of a patient treated in the Department of Otolaryngology UJ CM in Krakow. The patient presented with a neck tumor. Due to unclear clinical manifestation he underwent surgical treatment. The postoperative histopathological examination suggested cat scratch disease. In detailed anamnesis the patient admitted contact with cats and dogs in his household. No posoperative complications were observed. Conclusions: In every case of neck tumor it is advisable to consider cat scratch disease, remembering that exclusion of a neoplastic process remains a priority

    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
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