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Biomedical subjects

B Mikaszewski

Publications and source records attributed to B Mikaszewski.

11 recordsLinked to original sources
PubMed2001

Intracranial complications of acute and chronic mastoiditis: report of two cases in children.

OBJECTIVE: The clinical picture of mastoiditis, sigmoid sinus thrombosis and brain abscess has changed with the advent of antibiotics. A delay in the recognition of intracranial complications in children and in the institution of appropriate therapy may result in morbidity and mortality. Increased mortality of the children has been correlated with the neurological status of the patient on admission to hospital. METHOD: A retrospective study was made of two children with acute mastoiditis and sigmoid sinus thrombosis and chronic mastoiditis with cerebellar abscess treated in 1997 in the ENT Department of the Medical University of Gdansk. RESULTS: We present two cases of intracranial complications in children (13 and 11 years old) originating from acute and chronic otitis media. The first case, of a 13-year-old boy with sigmoid sinus thrombosis as a complication of acute otitis media took its course as a typical Symonds Syndrome. Mastoidectomy, thrombectomy and jugular vein ligation associated with antibiotics and edema-reducing drugs and anticoagulants proved to be successful. The second case of an 11-year-old boy with exacerbated chronic otitis media with cholesteatoma and mastoiditis, was complicated by suppurative meningitis, cerebellar abscess, perisinual abscess and sigmoid sinus thrombophlebitis. Neurosurgical approach by suboccipital craniotomy and abscess drainage was ineffective. Otological treatments of modified radical mastoidectomy, thrombectomy, jugular vein ligation, perisinual and cerebellar abscess drainage associated with wide-spectrum antibiotics and edema-reducing drugs were performed with a very good outcome. After 3 years of follow-up the patients remain without any neurological and psychiatric consequences. CONCLUSION: The authors show different courses of both presented complications and imaging techniques and surgical procedures performed in these children. The sigmoid sinus trombosis with Symonds Syndrome may be difficult to diagnose due to previous antibiotics valuable in establishing the diagnosis and the extent of disease. The successful therapy is based on understanding of pathogenesis of the intracranial complication and the cooperation of an otolaryngologist, a neurologist, a neurosurgeon and an ophthalmologist.

Acute Disease↗
PubMed2000

[Bilateral neck dissections].

The structure of lymphatic system of the larynx causes that in some cases node metastases may occur bilaterally. In many patients bilateral neck dissection is indicated. In material of 252 patients with laryngeal carcinoma, treated in ENT Department in Gdańsk in 1976-1985, an assessment of frequency and indications to one-stage bilateral neck dissection was made. Among 252 patients, bilateral operations were performed in 50, i.e. 20%. We have found that in 29 patients of 50 were nodal metastases, in 12 unilateral and in 17 bilateral. The analysis of long-term results of treatment showed 23.5% of 5-year survivals in patients with bilateral metastases and 42.3% in patients with unilateral metastases. To base on these data we consider that bilateral one-stage neck dissection should be a standard treatment in many cases of laryngeal carcinoma.

Adult↗
PubMed2000

[Effectiveness of elective neck dissection in patients with laryngeal carcinoma].

The authors presented material of 711 patients with laryngeal cancer treated in Department of Otolaryngology Medical University of Gdańsk in the years 1976-1995 estimating effectiveness of elective neck dissection. 402 patients (56.6%) had N0 stage and in 162 of them elective neck dissection was performed. Occult metastases were found in 21% of N0 patients. Comparing treatment results in this group to inoperated N0 patients the authors found higher percentage of survival and lower incidence of failure after elective neck dissection.

Carcinoma, Squamous Cell↗
PubMed2000

[Long term result of treatment of laryngeal carcinoma (1981-1990)].

Long term results were evaluated on the basis of the epidemiological and clinical analysis of 386 patients treated surgically because of squamous cell carcinoma of the larynx in the ENT Department, Medical University of Gdańsk between 1981-1990. Full recovery was achieved in 52.3% of patients, failure was found in 26.9%. In the treatment evaluation the following factors were taken into account: the age of patients, T and N classification and clinical staging, primary location of the tumour. The treatment results, concerning the years 1981-1990 were compared to the ones obtained in our clinic in 1971-1980; it has been stated that the differences between the percentage of recoveries and the failures are statistically unimportant.

Adult↗
PubMed1996

A case of multiple post-anginal complications.

The paper presents an unusual case of multiple post-anginal complications in a 21-year old male patient that included a peritonsillar abscess, parapharyngeal space phlegmon, a deep intrafascial phlegmon of the neck, internal jugular vein thrombophlebitis, septicopyemia, lung abscess and pneumonia, and a pyothorax. The patient was cured surgically and with broad-spectrum antibiotics and antifungal medication. The unusual course of the disease with presumed mycotic etiology as a complication of antibiotic therapy is discussed.

Adult↗
PubMed1995

Benign neoplasms of the larynx.

In a 45-year period (from 1948 to 1992) 291 patients with histologically proved benign neoplasms of the larynx were observed and treated. The most frequently occurring tumors were papillomas, being 95.2% in whole material. In most cases of benign tumors of the larynx intralaryngeal excision of the tumor was used. Clinical data and results of treatment were presented and discussed.

Adolescent↗
PubMed1995

[Parapharyngeal space tumors].

The authors presented material of 52 parapharyngeal space tumors seen ENT Department Medical University of Gdańsk in year 1980-1994. Majority of these tumors -32 (61.5%)-were benign (adenoma pleomorphum-22, adenolymphoma-4, neurilemmoma-4, ganglioneuroma-2). The remaining 20 (38.5%) tumors were malignant (cystis branchiogenes carcinomatosa-4, carcinoma planoepitheliale-3, lymphoma malignum-3, adenoma pleomorphum maligum-2, tumor mucoepidermalis-2, and tumor acinocellularis, chemodectoma, meningeoma malignum, haemangiopericytoma, chordoma, chondrosarcoma one of each.

Adenolymphoma↗
PubMed1995

[Esthesioneuroblastoma. Personal opinion about diagnosis and treatment].

The authors present material of 6 cases esthesioneuroblastoma observed in ENT Department Medical University of Gdańsk. The tumors were seen in 3 children and 3 adults. According to Kadish staging there were one A, two B, two C and one D stage tumor. Investigation and treatment methods, and obtained results were discussed.

Adolescent↗
PubMed1995

[Extramedullary plasmacytomas of the larynx].

The authors present four cases of solitary extramedullary plasmocytoma of the larynx, a very rare laryngeal tumor, seen in ENT Department, Medical University of Gdańsk in years 1948-1994. They were 0.16% of all malignant laryngeal neoplasms and 23.5% of non-epithelial neoplasms of the larynx in this period. Characteristics for these tumors, epidemiological and clinical features were discussed.

Female↗
PubMed1994

Non-epithelial malignant neoplasms of the larynx.

From 1948 to 1992, 14 patients with non-epithelial malignant neoplasm of the larynx were seen in the ENT Department of the Gdańsk School of Medicine. During this period, 2,249 patients with malignant laryngeal neoplasms were treated. The choice of therapy (laryngectomy, total or partial, excision by thyrotomy, irradiation or chemotherapy) depended on the size and location of the tumor and its histopathological nature. Significant for these tumors were: unchanged mucosa covering the tumor, rare metastases to the cervical lymph nodes, difficulties in estimating a histopathological diagnosis and determination, in certain types their unifocal nature.

Adult↗