Bacteriological analysis of isolated chronic sinusitis without polyps

Introduction: Chronic sinusitis (CRS) is phenotypically divided into inflammation with polyps (CRSwNP) or without polyps (CRSsNP). Aim: To try to explain the reasons for isolated sinusitis by analysing medical history as well as anatomical and bacteriological data. Material and methods: In 2016, endoscopic surgery was performed in 103 patients with CRSsNP within 6 months. The authors evaluated 28 patients with lesions in one sinus. Results: The patients did not report any previous facial trauma, dental procedures, there were no odontogenic causes of the disease. They had not been treated with antibiotics within 30 days prior to admission to hospital. Ninety-seven bacterial strains were grown, of which 32 in patients with isolated nasal sinusitis. Statistical analysis has shown that there is a trend toward a statistically significant (p = 0.0868) relationship between the presence of Staphylococcus aureus and the type of inflammation. Conclusions: There is an indication that the presence of Staphylococcus aureus is associated with isolated sinusitis, especially in women

Increase in the incidence of parotid gland tumors in the years 2005-2014

Introduction: Salivary gland tumours account for 3-6% of tumours of the head and neck. About 80% of salivary gland tumors occur in parotid glands, 10-17% of which are malignant The aim of the study was to assess whether there is an upward trend in cancer incidence within the parotid glands, with particular emphasis on cancers. Materials and methods: 322 patients underwent surgery and 328 parotid gland tumours were removed in the years 2005-2014 at the Department of Laryngology and Laryngological Oncology of the Upper Silesian Medical Centre in Katowice-Ochojec. Clinical, histopathological and statistical analyses of the removed parotid gland tumours were performed. Results and discussion: A significant increase in the incidence of benign tumours, especially mixed and Warthin tumours, was demonstrated. There was no significant increase in the number of malignant tumours over the analysed period of time

Olfactory neuroblastoma – a rare tumour under the guise of chronic rhinosinusitis

Olfactory neuroblastoma (ONB), also called esthesioneuroblastoma, is a rare tumour that occurs in the nasal cavity and paranasal sinuses. The symptoms that patients report are similar to chronic rhinosinusitis (CRS). The authors present the case of a patient referred to hospital due to nasal obstruction on the left side. The performed endoscopic surgery revealed within the left middle nasal concha a tumour penetrating into the anterior ethmoid and frontal recess. ONB was diagnosed in the histopathological examination. The patient was qualified for complementary radiotherapy. The patient has been under medical supervision for 24 months. There have been no signs of recurrence. It was decided to present the above case due to the lack of deviations in the ENT endoscopy and minor ailments reported by the patient, which in combination with advanced age could lead to discontinuation of surgical treatment

Giant fronto-ethmoidal osteoma - selection of an optimal surgical procedure

Osteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator. Objective: Determine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature. Methods: Group of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied. Results: The authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p = 0.2691) and the frontal sinuses (p = 0.5891). Conclusion: The choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques

Allergies, asthma or hypersensitivity to NSAIDs - are they an equally important risk factor for the development of a specific CRS phenotype?

Introduction: CRS is a complex systemic disease affecting more than 10% of the population. There are two main types of CRS phenotypes: CRSwNP and CRSsNP. In the Caucasian population, the prevalence of inflammation markers typical of the Th1 profile is observed in CRSsNP, whereas Th2 and Th17 in CRSwNP. Th2 inflammation is observed in the CRSwNP phenotype with concomitant allergies, asthma or hypersensitivity to NSAIDs. Objectives: The aim of the study was to evaluate, based on the authors’ own material, whether allergies, asthma or hypersensitivity to NSAIDs were a risk factor for the development of a specific CRS phenotype. An attempt was also made to investigate the influence of comorbidities on the extent of sinus endoscopic procedures, which depended on the severity of inflammation. Methods: In the years 2006–2015, ESS was performed on 2217 patients with different CRS phenotypes. Patients with an allergy, bronchial asthma and hypersensitivity to NSAIDs were subjected to analysis. Results: Based on logistic regression, it was found that among the mentioned comorbidities, only asthma (P < 0.0001) and hypersensitivity to NSAIDs (P = 0.0007) significantly affect the occurrence of the phenotype with polyps, whereas the impact of allergies is statistically insignificant (P = 0.1909). The relationship between the type of ESS and CRS phenotypes is statistically significant (P < 0.0001). Conclusions: Bronchial asthma and hypersensitivity to NSAIDs have a statistically significant effect on the occurrence of the CRSwNP phenotype. This effect was not observed in allergies. The impact of allergies, asthma and hypersensitivity on the phenotype was observed in the group of patients subjected to the most extensive surgery (ESS 4)

Head and neck lymphomas - a retrospective ten-year observation

Aim of the study: Lymphomas are a heterogeneous group of tumours of lymphoid tissue in which there is an abnormal proliferation of cells of the lymphatic system. The literature notes a gradual increase in the incidence of this type of cancer in the whole population. The aim of the study was to evaluate whether the above tendency occurs in the head and neck area. Material and methods: In the years 2005-2014, at the Otolaryngology and Laryngological Oncology Department of the Upper Silesian Medical Centre in Katowice, 77 cases of lymphoma were recorded, 58 of which were analysed in terms of location, histological type, age and sex of the patient, and the presence of risk factors. Results: The vast majority of them were non-Hodgkin's lymphomas (NHL) - 67.53%. Hodgkin's lymphomas (HL) accounted for only a small fraction of diagnoses (7.79%). In terms of histopathological types, in most cases of NHL, there occurred diffuse large B-cell lymphomas (DLBCL) - 51.92%. The most common location was the lymph nodes, representing the location of the primary lesion in more than half of the cases. As regards the extranodal location, the Waldeyer ring dominated (54.54%) along with the palatal tonsil (40.90%). There has been a significant upward trend, especially in the incidence of NHL

Bacteriological analysis of selected phenotypes of chronic rhinosinusitis with co-existing asthma, allergy and hypersensitivity to non-steroidal anti-inflammatory drugs

Introduction: Chronic rhinosinusitis (CRS) is one of the commonest chronic diseases. It is a systemic disease caused by many factors, including bacterial infections. There are two main types of CRS phenotypes: with polyps (CRSwNP) and without polyps (CRSsNP). Aim: Analysis of sinus mucosal microbiome in patients with CRS depending on the phenotype. Investigating a possible link between the type of bacterial flora and the coexistence of diseases present in the CRS (asthma, allergy or hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) as well as the number of performed operations. Material and methods: The authors conducted a retrospective study of the bacterial flora of the nasal cavity in patients with CRS operated endoscopically from March 2016 to June 2017. The study consisted od 222 women and 248 men. On the basis of an endoscopic examination, patients were qualified for the phenotype with or without polyps. Based on the medical interview patients were divided into group with asthma, allergy, NSAID hypersensitivity, first and repeated operations. The statistical analysis was made. Results: There is no statistically significant relationship (p = 0.8519) between the CRS penotypes. In the group with CRSsNP, a statistically significant relationship was found between the observed flora and the coexistence of asthma (p = 0.0409), a trend towards significance was also noticed in the case of allergy (p = 0.0947). There was no relationship between the flora and NSAID hypersensitivity (p = 0.7356). In the group of CRSwNP patients, no statistically significant relationship was found between the observed bacterial flora and the presence of asthma (p = 0.7393), hypersensitivity to drugs (p = 0.1509) or allergy (p = 0.7427). There is no statistical significance between the occurrence of particular flora and the multiplicity of operations in both the CRSwNP (p = 0.4609) and CRSsNP phenotypes (p = 0.2469). Conclusions: Gram-positive cocci were equally common in CRSwNP and CRSsNP. In the CRSsNP, there was a correlation between the coexistence of asthma and allergy, and the presence of Gram-positive cocci. There was no statistical significance between the occurrence of particular flora and the multiplicity of operations in both CRS phenotypes

Rzadki przypadek nowotworów mnogich neurogennych przestrzeni przygardłowej

Parapharyngeal space tumours are rare and represent less than 1% of head and neck tumours. Approximately 20% of them are neurogenic tumours, of which the most common are schwannomas and paragangliomas. The authors present the case of a 64-year-old female patient during diagnosis of cervical spine disorders, in whom the presence of a parapharyngeal space tumour reaching the ostium of the internal carotid artery was accidently revealed. After surgical removal of the lesion, two different tumours of different origin, from the vagus nerve and the cervical portion of the sympathetic nervous system, were detected by histopathological examination.Guzy przestrzeni przygardłowej występują rzadko i stanowią mniej niż 1% guzów głowy i szyi. W ok. 20% to guzy neurogenne, z czego najczęściej są to nerwiaki osłonkowe i paraganglioma. Autorzy prezentują przypadek 64-letniej chorej, u której w trakcie diagnostyki schorzeń kręgosłupa szyjnego przypadkowo stwierdzono obecność guza w przestrzeni przygardłowej, sięgającego otworu tętnicy szyjnej wewnętrznej. Po usunięciu chirurgicznym zmiany, badanie histopatologiczne zidentyfikowało dwa różne guzy o odmiennym pochodzeniu, z nerwu błędnego i części szyjnej układu współczulnego

Tumour of palatine tonsil as a medical and social problem &#8212; a case report

Hyperplastic lesions of oral cavity and throat, despite being relatively accessible in the objective examination, are often discovered accidentally, at the level of considerable clinical advances. The majority of hyperplastic lesions in this area has its source in palatal tonsils, and mostly applies to smokers or people abusing alcohol. The authors present a clinical case of a patient who admitted extreme sanitary neglects and draw attention to the problems of prophylaxis, diagnosis, and treatment, as well as to widely understood social aspects. Worth emphasizing are: the role of a family physician, organization and efficiency of a general medical care, social care and the availability of palliative care. Adv. Pall. Med. 2010; 9, 2: 61&#8211;64Hyperplastic lesions of oral cavity and throat, despite being relatively accessible in the objective examination, are often discovered accidentally, at the level of considerable clinical advances. The majority of hyperplastic lesions in this area has its source in palatal tonsils, and mostly applies to smokers or people abusing alcohol. The authors present a clinical case of a patient who admitted extreme sanitary neglects and draw attention to the problems of prophylaxis, diagnosis, and treatment, as well as to widely understood social aspects. Worth emphasizing are: the role of a family physician, organization and efficiency of a general medical care, social care and the availability of palliative care. Adv. Pall. Med. 2010; 9, 2: 61&#8211;6