Biomedical subjects

Jarosław Balcerzak

Publications and source records attributed to Jarosław Balcerzak.

9 recordsLinked to original sources

PubMed2005

[Nasal polyps is not a homogenous pathology].

UNLABELLED: Nasal polyposis is still a disease of unknown etiology. Looking at its clinical course it seems to be not homogenous pathology. Inflammation of the mucosa, mainly eosinophilic is probably the most important factor, which leads to the development of nasal polyps. THE AIM OF STUDY: To analyze and compare the history data and eosinophilic inflammation parameters in patients with nasal polyps. MATERIAL AND METHODS: 67 patients with nasal polyposis were included into the study. They were divided into three groups: PP-primary nasal polyps (n = 33-49.2%); A-polyps and bronchial asthma without aspirin intolerance (n = 19-28.4%); ASA-polyps and aspirin-induced asthma (n = 15-22.4%). The history data were taken using patient's questionnaire. To assess the eosinophilic inflammation intensity the blood and nasal eosinophilia and serum eosinophilic cationic protein (ECP) concentration were measured. RESULTS: The average age of all patients was 55 +/- 1.5 (range 32-76), the age distribution was comparable in all groups. The ratio males:females--1.5:1 (PP--2.7:1; A--1.1:1; ASA--0.7:1. The females with nasal polyps much more often suffer from asthma than males (p = 0.036). The age when polyps were first seen was 45.1. The duration of nasal polyps was 10 +/- 10 years (range 0.5-30 years): PP-- 10 +/- 9; A-- 14 +/- 11; ASA-- 7 +/- 7 (A/ASA-- p = 0.045). Period of 6.6 years of rhinitis had preceded the diagnosis of nasal polyposis (PP--7.3; A--7.1; ASA--4.5). Age when asthma was developed (A+ASA groups)--45.5; the duration of asthma was 11 +/- 9 years. 58% of patients had polypectomy/ethmoidectomy (PP--45%; A--60%; ASA--80%). The number of operations per one patient: 1.3 (PP--1.0; A--1.2; ASA--2.0), the most often performed in ASA group (PP/ASA-- p = 0.01 and A/ASA-- p =0.045). The mean interval between polypectomies in all patients--9.1 years (PP--10; A--12, ASA--3.5). Blood eosinophilia: 5.6 +/- 0.4% (PP-- 4.6 +/- 0.5; A-- 6.2 +/- 0.9; ASA-- 7.2 +/- 0.9% and PP/ASA-- p = 0.019; PP/A+ASA-- p = 0.03). Nasal eosinophilia: 18.5 +/- 3% (PP-- 15.0 +/- 4; A-- 15.5 +/- 6; ASA-- 30.0 +/- 8% and PP/ASA-- p = 0.01; A/ASA-- p = 0.02). Serum ECP concentration: 24 +/- 2 microg/l. CONCLUSIONS: The patient's history and the intensity of eosinophilic inflammation are not similar in all nasal polyposis patients, that support the classification into PP, A and ASA groups. The most severe clinical picture and the highest values of eosinophilic parameters are observed in ASA group. Aspirin intolerance seems to be unfavourable prognostic factor in nasal polyposis.

Adult↗

PubMed2005

[Effect of nasal obstruction on subjective assessment of sleep quality by the patients with obstructive sleep apnea].

In 52 patients with Obstructive Sleep Apnea Syndrome (OSAS) and nasal obstruction due to nasal septum deformation, hypertrophy of inferior nasal concha or posttraumatic external nose deformity the evaluation of the day somnolence using the Epworth Scale was carried out. The patients were randomly divided in to two groups. The first group consisted of 40 patients who were subjected to appropriate corrective surgery of the nasal obstruction. The remaining 12 patients constituted the control group. After 3 month each of the patients was asked to fill in the same questionnaire. Among the patients who underwent the surgical procedure day somnolence intensity was decreased approximately 2 times whereas in the control group no significant changes were observed. Results of this study could be crucial for the discussion concerning the complex influence of the nasal obstruction on the pathomechanism and symptomatology of obstructive breathing disorders during sleep.

Adult↗

PubMed2004

[Frontal sinus mucocele].

Between 1995 and 2000 twenty-two patients were treated for frontal sinus mucocele in the Department of Otorhinolaryngology of Medical University of Warsaw. History and physical examination revealed several-year-old chronic rhinosinusitis (CRS) in all but one cases. Thirteen patients had been previously operated on for this reason at least once. Conservative management, mainly in periods of symptom deterioration, was applied in other patients. The only patient with negative history of CRS had undergone in the past head injury with fracture and dislocation of the anterior wall of the frontal sinus, in the past. All patients were treated surgically with use of the intranasal endoscopic approach in 15 cases, osteoplastic surgery of the frontal sinus in 5 cases and combination of both in 2 cases. Diagnostic and management protocol is discussed and compared with data presented in the literature.

Adolescent↗

PubMed2004

[Functional nasal surgery in the treatment of obstructive sleep apnea].

UNLABELLED: The study included 22 males with significant decrease in nasal patency, at age of 44+/-7 yrs with body mass index 28.9+/-3.8 kg/m2, diagnosed with obstructive sleep apnea syndrome (OSAS) by polysomnography. All patients underwent functional, corrective nasal surgery. In one patient an infection in the wound occurred. Postoperatively 19 (86%) patients reported significant subjective improvement. With regard to polysomnography, one patient was cured and in another one a decrease of AHI to more than 50% of baseline was found. In 6 (27.3%) patients AHI rose from 33.2+/-13 to 53.6+/-21.2. CONCLUSION: Nasal surgery in OSAS shows limited effectiveness. Because of multilevel decrease in airway patency, some of the patients may need a step-wise approach to surgical treatment.

Adult↗

PubMed2003

[Labyrinthine fistulas: surgical management].

The authors presented management rules and the results of surgical treatment in perilymphatic fistulas. Materials comprise 7 cases of cholesteatoma and 6 cases after previously performed so called conservative modified operation of the ear. In 3 cases cholesteatomas were destroying the membranous structures or were being adherent to them. In these cases labyrinthectomy was performed with partial conservation of hearing in one patient. In the remained 10 cases the fistulas were cleaned and sealed with 3 layers of tissues--fascia, cartilage and fascia. After the ossicular chain was reconstructed in one stage. Discharge, and vertigo were stabilised in all cases. It was stated that cleaning of the labyrinthine fistula during cholesteatoma removal does not influence on bone conduction thresholds.

Adolescent↗

PubMed2002

[Clinical effects of surgical treatment of obstructive sleep apnea syndrome].

Aim of this study was to estimate the efficiency of surgical interventions in the treatment of obstructive sleep apnea (OSAS). Inclusion criteria for treatment were: presence of anatomical abnormalities within upper airways, a will to undergo surgical procedure and no medical contraindication for this treatment. Study group consisted of 43 men at age 42.8 +/- 6.8 year with mean pretreatment value of AHI: 49.5 +/- 21.5. Nasal surgery was performed in 26 cases interventions improving patency of nose were performed, uvulopalatopharyngoplasty in 17 and in two the tonsillectomy. Diagnosis of OSAS was made on the basis of typical complains and symptoms and results of nocturnal polysomnography. During follow-up, subjective improvement was reported by 35 (81%) of patients. Polysomnography revealed a significant decrease of AHI to below 15 in 10 (23%) cases; a lowering over 50% of AHI was obtained in 6 (14%) cases: in another 7 (16%) an increase in post-surgery AHI value was noticed. Efficiency of each intervention is presented as follows: tonsillectomy: 100%, uvulopalatopharyngoplasty: 41% and nasal surgery: 4.2%. Deterioration of OSAS in 7 cases was most probably due to more sleep on back during the follow-up.

Adult↗

PubMed2002

[Uvulopalatopharyngoplasty and laser assisted uvulopalatoplasty in treatment of patients with sleep related breathing disorders].

In the years 1996-1999 in the Department of Otolaryngology of Medical Academy in Warsaw 58 patients with respiratory disorders during sleep were treated using uvulopalatoplasty in 35 cases and laser uvulopalatoplasty in 23 cases. The authors describes operation technique, qualification criteria and results assessed on the basis of basic values of polysomnographic study as well as subjective feelings of patients.

Adult↗

PubMed2002

[Midfacial degloving approach in the surgical treatment of angiofibroma juvenile].

From 1996 through 2001 8 male with a diagnosis of juvenile angiofibroma were managed at the ENT Department of Medical University in Warsaw using midfacial degloving approach. Surgical technique as well as pre- and postoperative management of these patients were described. According to authors' experience midfacial degloving approach enables the broad exposition of the operating field.

Adolescent↗

PubMed2002

[Tracheobronchopathia osteochondroplastica].

Tracheobronchopathia osteochondroplastica (TO) is a rare disease of unknown etiology affecting mainly the trachea and large bronchi. It is characterized by the presence of multiple submucosal osseus and/or cartilaginous nodules. The authors report a case of 74-year-old woman in whom fiberoptic bronchoscopy, performed because of hemoptysis, revealed typical feature of TO. Besides the typical nodules protruding into the lumen of trachea and main bronchi, a small soft nodule in the larynx was found. On histological examination it was showed to be polyp with regions of inflammation and necrosis. The direct relation between such a laryngeal polyp and TO seems to be very unlikely.

Aged↗