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Biomedical subjects

J Pietruski

Publications and source records attributed to J Pietruski.

At least 19 recordsLinked to original sources

[Samuel Rosen (1897-1981): the originator of stapes mobilization].

Samuel Rosen originator of the surgical procedure so called mobilization, was second only to Juliusz Lempert as one of the great modern discoverers of new surgical techniques in the treatment of otosclerosis. This was the result of a chance discovery during routine stapes mobility test of the ossiculat chain before fenestration. Rosen having had excellent scientific training and knowledge was well prepared to interpret accidental stapes mobility and so design a new surgical technique. This operation enabled thousands of patients with otosclerosis to regain their hearing. However, he did not receive widespread acclaim in his own country. He received many invitations from abroad, travelled to several countries around the world where he taught stapes mobility testing and demonstrated his surgical procedure. In 1957 he also visited Poland, where he was born. He did not however limit himself to microsurgery of the ear. He created a group of international scientists who on the basis of investigations carried out by some of them, in the quiet noiseless African bush demonstrated that not only hearing is protected and the ageing process of this sensory organ delayed but also the development of arteriosclerosis is slowed down that which is the root cause of more and more cases of heart disease which among other factors can be attributed to the noisy stress ridden world we live in. After much success and fame which he achieved throughout the world, the American Medical Association awarded Sam Rosen a gold medal in 1967. But this too was not widely accepted by all his colleagues in his own country. He died in 1981 in China.

History, 20th Century↗

[Juliusz Lempert (1890-1959): the author of the fenestration technique].

Juliusz Lempert was born in 1890 in Poland. A few years later the poor Jewish family emigrated to the United States. Lempert obtained his MD degree at Long Island Medical College, and soon after that established a small hospital of his own in Manhattan. Later he bought an old five-storey building and converted it into a new otological medical center, which he called Endaural Hospital. His life was rather difficult with the wave of antisemitism in the United States and the adversity which he encountered so many times. However his contribution to the microsurgical treatment of conductive deafness is immense. He elaborated and introduced a new method of mastoidectomy and, first of all, fenestration--a new one-stage surgical technique to be applied in cases of otosclerosis. This precise, sophisticated operation revolutionized surgical treatment. With a dentist's drill Lempert created a new window on the horizontal canal, in this way the sound wave could stimulate the inner ear. He was to call it "fenestration nov-ovalis". Lempert was never a member of any ENT society and worked in his hospital alone. When suddenly his only son was stricken with leukemia and died, Lempert was completely broken, and never returned to this work. The next blows were new operative methods of otosclerosis: stapes mobilisation introduced by Rosen and stapedectomy by Shea. He never accepted these new techniques. It was a painful experience for a surgical genius who had at so many times been hurt during his life. He could not believe that his fenestration was definitely gone. Lempert quickly deteriorated physically and mentally, and died in 1958.

Fenestration, Labyrinth↗

[Errors in surgical techniques: a cause of complications in tympanoplasty. Part I].

The analysis of follow-ups shows, that the lack of success in tympanoplasty is often due to errors in operative technique and insufficient postoperative analysis of our failures. The failures has to be analysed in any case, always with exactly operative report comprises the dynamics factors of the operation and written immediately after surgery.

Humans↗

[Therapeutic issues in the case of one hearing ear].

The paper presents some important facts relating to the dangerous cases with one remaining functional ill ear. What should one do when a patient presents with a potentially dangerous chronic otitis media and the other ear is absent? The analysis of such dangerous cases with cholesteatoma, more especially those with a labyrinhine fistula and a cases with sudden deafness contralaterally shows that caution and responsibility has to be taken.

Cholesteatoma↗

[The errors of the operative technique as a cause of unsuccessful tympanoplasty. Part II].

This study is based on the author's personal experience in a middle ear reconstructions. Errors can occur at each surgical stage--tympanic membrane and chain reconstructions, mobilisation of the footplate. At any moment the surgeon can gain or loose the dB. The operating technique is the main factor. A proper operative technic includes a good operating approach and excellent hemostasis. The tympanic membrane, should be as thin as possible, exactly and carefully dissected. Care should be taken to avoid any damage to the fascia graft fibers. Bad or unsure material should be discarded. The graft should not be too large because if it overlaps the EAC wall, it narrows the canal. If the graft is too small, secondary edge performation can occur. The shallow placement of the graft risk a bad contact. Opposite--too deep--poor ventilation of the middle ear and may lead to adhesions. The annulus should be well prepared, free of epithelial remnants. If not cholesteatoma could develop and discontinuity between the neotympanium and the ossicular chain abolish the transmission effect. The mechanical and lever principles during reconstruction of the sound transmission should be kept in mind at all times. The reconstructed system must be delicate and light. The round window reflex is the most important indice of good performed reconstruction, and should be used similar to the modern monitoring system. Try to prevent the natural structures. They are the most valuable material for the future reconstruction.

Ear Ossicles↗

[Magnetic stimulation of the facial nerve: a new testing method].

Magnetic stimulation (MST) is the new method electrodiagnostic testing. The motor nerves are contrally stimulated proximally to the pathology. This technique enables to evaluate the function of the facial nerve immediately after onset. It can also be used to evaluate the function of the facial nerve in Bell's palsy. The technique is absolutely painless. The results suggest that MST provides a sensitive data of evaluation of facial palsy and will be a very valuable prognostical test.

Equipment Design↗

[Some remarks concerning the treatment of the conductive hearing loss].

The author points out a decrease tendency in using middle ear reconstruction surgery due to the development and the accessibility of hearing aids. Such an attitude inevitably leads to ordering hearing aids especially air conductive ones in cases which ought to be operated. The author thus wants to underline the fact that bone conductive hearing aids are very rarely recommended, even though the should be used more often. He also recommends a precise analysis of one's unsuccessful surgical results as a method of gaining skills and proficiency. The author also points out the fact that one should never neglect quoting native bibliography.

Bone Conduction↗

[Facial palsy in Equatorial Africa].

The author presents the analysis of 29 cases of facial palsy collected in Shaba, Zaire (former Katanga, Belgian Congo) between 1984-1988 in the region called Copperbelt. Because to date there has been no work done on these problems in this part of Africa, it would be interesting to present a short report. Patients with facial palsy came to the ENT Department mostly for other reasons, and very late. Only 5 patients came before 3 mos after the onset. The different etiologies were as follows: 2--post traumatic, 7--otogenic, 9--tumors, 4--iatrogenic, 6--Bells palsy, 1--other. The assessment, comparison and the treatment of such cases in an underdeveloped country is very difficult or almost impossible. The small number of cases is insufficient for any conclusions, but the author tried to get some data, which would be a starting point in the future researches.

Adolescent↗

[Lucja Frey (1889-1943) in the 50th anniversary of her tragic death and 70th anniversary of the auriculotemporal syndrome].

Lucja Frey was a Polish neurologist born and lived in Lwów, former east Polish town, and died during the war in Lwów's ghetto. In 1923 she described the auriculo-temporalis syndrome, at present well known all over the world. But personality and history of the extraordinary Polish scientist remains obscure. The aim of this paper is to present her silhouette. Because a great number of Polish scientists are also not known abroad, the authors tried to explain the causes of their absence in the world bibliography.

History, 19th Century↗

[Treatment of facial spasm with botulinum toxin].

Facialis spasmus (FS) is a chronic hyperkinesia primarily affecting patients in the 5th and 6th decades. Only muscles innervated by the facial nerve (FN) are involved. In the beginning there are only slight jerks, mostly in the region of the eyelid. In due course all facial muscles get involved. Spasms are worse when the patient is anxious, watching TV, working, driving and then restrict social activities. Because the etiology has not been known, a lot of methods of surgical and medical treatment were unsuccessful. Recently the cause has been clarified: FS is though to be caused by an irritation of this nerve by a blood vessel. The condition can be cured by an operation to separate the nerve and blood vessel. If an operation is thought to be inappropriate, treatment of FS may be with botulinum toxin (BT). BT is used in very small doses (nanograms), and is injected in the area of the muscle that is affected. This weakens the muscle and helps to prevent a spasm.

Blepharospasm↗