Biomedical subjects

Józef Mierzwiński

Publications and source records attributed to Józef Mierzwiński.

8 recordsLinked to original sources

PubMed2006

[Rotation suction-knife (shaver) in otorhinolaryngological surgery].

INTRODUCTION: Rotation suction knife (shaver or microdebridor) was developed in beginning 1985 in orthopedic surgery. In the field of otolaryngology it was used in 1992-1994. Shaver is a combination of suction and cutting round knife working together. Knives of different shapes are put into handpiece. They have outer sheath with window, which protect the inner rotating blade. The blade is connected to suction and cutting tissue is removed from the operation field. In otolaryngology surgery we mostly used the oscillation cutting mode which is the most sufficient. Shaver surgery is precise in soft tissue resection, so the most advantages to powered the system is in rhinosurgery, polypectomy with extension to pansinus surgery. Microdebridor can be also used for nasopharynx-adenoidectomy, chonanal atresia surgery, turbinoplasty, dacryocystorhinostomy, sella turcica tumor resection or laryngeal surgery. MATERIAL AND METHODS: We used the Storz's shaver system with a handpiece with a motor in the vertical part of the T-shaped handle. Suction and transport of rejected material does not pass through the motor system. The suction channel is straight and clogging is minimized. We performed shaver surgery during functional endonasal endoscopic surgery (FESS) for polypectomy in 15 cases, medial antrostomy (uncinectomy for "swinging door" procedure) in 10 cases, nasopharyngeal-adenoidectomy in 3 cases and turbinoplasty (inferior turbinectomy) in 10 cases. RESULTS: In our material we did not observe any complications during and after surgery. The healing process is very good without obstruction and crusting. The shaver system has an excellent protection for surrounding tissue and minimalized the tissue destruction. CONCLUSIONS: Shaver is an excellent powered instruments for rhinosurgery especially massive polyps of nose and sinuses. It is very sufficient to prevent normal tissue and remove pathological one, this can be achieved in no bleeding area.

Adolescent↗

PubMed2006

[Cervical sympathetic chain neurilemmoma--a case report].

INTRODUCTION: Neurilemmoma is benign, slowly growing tumour that arise from nerves. Cervical sympathetic chain neurilemmoma is rare. The majority of neurilemmomas are asymptomatic at the time of presentation. The incidence of Horner's syndrome before excision has been reported only once. Surgical resection almost leaves the patient with a Horner's syndrome. MATERIAL AND METHODS: A 28 years old woman was admitted to Otolaryngology Department with left side neck mass. The tumor was first noticed 6 month later, and it was slowly growing. It was completely asymptomatic. She underwent excision of the tumor through an incision parallel with the anterior border of the strenomastoid muscle. RESULTS: Histology showed the tumour to be a neurilemmoma arising within the cervical sympathetic chain. During postoperative period in 2 day we observed a left side Horner's syndrome, completely asymptomatic. CONCLUSIONS: Neurilemmomas very rarely arise from the cervical sympathetic chain. They usually present as asymptomatic neck mass. The only complication encountered after surgery is Horner's syndrome, which required no treatment.

Adult↗

PubMed2006

[A simple-irrigating system for endoscopic sinus surgery].

INTRODUCTION: The most troublesome problem during endoscopic surgery is fouling of the endoscope lens (tip) with blood. Irrigating systems are available on the market but they are relatively very expensive. We present our own simple irrigating system, very effective and inexpensive. MATERIAL AND METHODS: The system consists of: polyethylene catheter No 6, sterile intravenous line with interposed stopcock, 500 ml saline solution, endoscope. The catheter is fixed to the endoscope with sterile sticks and connected to the bottle of saline solution with intravenous line. During the operation the irrigant solution flow is controlled with interposed stopcock. CONCLUSIONS: A simple irrigating system allows cleaning of blood from the endoscope obviating the need for frequent removal of the endoscope from the nose. This allows more rapid and safer endoscopic surgery. It is very simple and cheap.

Endoscopes↗

PubMed2006

[Functional endoscopic sinus surgery in children--our experience].

INTRODUCTION: Pediatric functional endoscopic sinus surgery (FESS) is now commonly performed for chronic rhinosinusitis therapy. The surgery is necessary when symptoms of sinusitis persist after maximal medical treatment. Apart from anatomic and technical issues the main difference between adult and pediatric FESS is related to postoperative care. In earlier reports a second-look endoscopy in general anaesthesia was recommended to inspect, debride and clean the operative site in young patients. MATERIAL AND METHODS: The aim of the study was to estimate the results of FESS surgery in children and to propose a relevant way for postoperative care. FESS surgery was performed in 64 children (mean age 13, 2 years) and postoperative follow-up was available in 47 children (33 girls, 14 boys). The protocol for postoperative follow-up based on our notes and literature is suggested. All patients after surgery were instructed to use saline solution or Ringer solution for nose cleaning. Seven days after surgery nasal steroids were implemented. Second look endoscopy with wound debridement in general anaesthesis was necessary in 8 children (13%) after major procedures, where a lot of crust and blood clots in postoperative site were noted. RESULTS: It is suggested that formation of synechiae and granulation tissue in the early postoperative period is one of the adverse prognostic factors in FESS outcome. In spite of not aggresive approach to follow-up, wound inspection and postoperative site cleaning the synechiae were found in 2 (3%) patients only. 30 children (64%) were symptoms--free after surgery. CONCLUSIONS: Functional endoscopic sinus surgery (FESS) is efficient treatment for chronic rhinosinusitis in children. Aggresive post operative site debridement is rarely necessary. Postoperative general anaesthesia "second-look procedure" is indispensable in a few patients only but it needs an individual approach for each child.

Adolescent↗

PubMed2006

[The use of Nd-Yag laser in the treatment of tracheal tumor in 14 years old child with mukopolisacharydosis type II].

Hunter's Syndrome (MPS II) is a class of hereditary disorder characterized by a deficiency of specific enzyme--iduronate sulphatase required to break down mucopolisacharides and occurs in Poland in one of 100-150 thousand male live births. MPS II may be lethal in the second decade of life as a result of infiltrativ cardiomiopathy leading to irreversible heart failure or upper airway obstruction caused by infiltration, granulation and deformation in trachea or larynx. We report a case of 14-year-old male with Hunter Syndrome who developed tracheal obstruction and was treated with Nd-Yag laser. We discuss the possibility of treatment and our results--improvement in patient's symptomatic and functional status.

Adolescent↗

PubMed2005

[Tympanoplasty decision making in a child with HIV contamination--case report].

Otologic problems are infrequent in HIV patients. Authors present the case of chronic otitis media in the HIV infected child. The patient with significant hearing loss, and prolonged aural discharge, resistant to local and systemic antibiotic treatment was treated surgically. Mastoidectomy with myringoplasty was performed. The substantial hearing improvement has been obtained, ear discharge never returned. However due to episodes of chronic otitis media with effusion ear drainage with tympanostomy tubes, after initial surgery have been performed two times. The controversies regarding surgery decision-making in this group of patients are discussed.

AIDS-Related Opportunistic Infections↗

PubMed2004

[Additional diagnostic methods for recording of adenoid hypertrophy in children with allergic rhinitis].

The role of enlarged adenoids and tonsils in upper airway obstruction has become well-established earlier, thus, adenoidectomy with or without tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population. Direct assessment of adenoidal size is difficult and no definitive method is so far available to complement clinical assessment. The most important diagnostic techniques are recording of obstructive symptoms, transoral posterior rhinoscopic examination, radiological evaluation, such as lateral radiography of the adenoid and nasopharyngeal magnetic resonance imaging, transnasal fiberoscopic examination, acoustic rhinometry and others. In this study we compare acoustic rhinometry, fiberoscopy and Cohen and Konac radiological method. Spearman's correlation test was used to evaluate the degree of correlation between these three methods. We concluded that acoustic rhinometry and radiology are good and objective methods for measuring adenoid sizes in allergic children.

Adenoids↗

PubMed2004

[The occurrence of food allergy and bacteria allergy in chiidren with tonsilar hypertrophy].

The diagnosis of food allergy is difficult because it is a multifaceted problem and is incompletely understood. Both upper and lower respiratory tracts can be affected by food allergy. The importance of bacterial allergy of the upper respiratory tract is however one of the most controversial problems in allergology. The palatine tonsils play an important role in immunologic surveillance and resistance to infection in the upper aerodigestive tract. The role of enlarged adenoids and tonsils in upper airway obstruction has become well-established earlier, thus, adenoidectomy with, or without, tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population. Research done in respect to Waldeyer's ring on people dealing at the same time with allergy, is seldom the subject of dissertation in Polish as well as world wide medical literature. To examine the influence of food and bacterial allergy on the tonsilar hypertrophy (TH) we studied 136 children ages 3 to 7 years, who had TH. On the basis of allergic and immunological examinations, in 28.6% food allergy was confirmed as the main cause of the complaints. We conclude that large tonsillar tissues sometimes with upper airway obstruction may by caused or aggravated by food allergies, therefore, early prevention of exposure to them may help reduce occurence of TH.

Bacteria↗