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Kazimierz Niemczyk

Publications and source records attributed to Kazimierz Niemczyk.

At least 19 recordsLinked to original sources
PubMed2006

A model of real time monitoring of the cochlear function during an induced local ischemia.

The aim of this study was to investigate the utility of distortion product otoacoustic emissions (DPOAEs) in intraoperative monitoring (IM) of cochlear ischemic episodes in animals during internal auditory artery (IAA) compression. The IAA was exposed using the posterior fossa approach and then compressed for 3 and 5 min intervals to effect ischemia. DPOAE amplitudes and phases were measured at 4, 8, and 12 kHz geometric mean frequency (GMF). In each monitored ear, laser-Doppler cochlear blood flow (CBF) was measured. All IAA compressions resulted in rapid decrease of DPOAE amplitude and CBF, with simultaneous DPOAE phase increase. DPOAE phase changes were found to increase consistently within several seconds of IAA compression, while corresponding DPOAE amplitudes changed more slowly, with up to 30-40 s delays. Following IAA release, DPOAEs at 12 kHz GMF were characterized by longer delays in returning to baseline than those measured at lower frequencies. In some cases, CBF did not return to baseline. In this animal model, DPOAEs were found to be sensitive measures of cochlear function during transient cochlear ischemic episodes, suggesting the utility of DPOAE monitoring of auditory function during surgery of cerebello-pontine angle tumors.

Animals↗
PubMed2005

[Long-term results of transtympanic gentamicin treatment in Meniere's disease].

OBJECTIVE: To determine the long-term hearing and vestibular outcomes in patients with intractable vertigo caused by unilateral Meniere's disease, who were treated with transtympanic injection of gentamicin. STUDY DESIGN: the study was a long-term analysis of hearing and control of vertigo in patients with unilateral Meniere's disease who received transtympanic gentamicin. METHODS: Pure-tone thresholds and ENG, along with the control of vertigo. Criteria described in 1995 by the American Academy of Otolaryngology - Head and Neck Surgery were used. Patients treated with transtympanic gentamicin had definite Meniere's disease and had intractable vertigo despite optimal medical therapy, no symptoms suggestive of Meniere's disease in the contralateral ear, and serviceable hearing in the contralateral ear. The study analyzed the outcomes of 9 patients for whom follow-up data were available for periods greater than 24 months after transtympanic gentamicin. RESULTS: Complete control of vertigo was obtained in all 9 patients. Profound sensorineural hearing loss occurred only in 1 patient. Hearing was improved in 6 patients, and in 2 was unchanged. CONCLUSIONS: Transtympanic gentamicin therapy is a good method of controlling vertigo and the risk of hearing loss is low.

Adult↗
PubMed2005

[Results of hearing perception after cochlear implantation in patients with auditory neuropathy].

INTRODUCTION: Results of hearing perception with patient with auditory and visual neuropathy combined with peripheral polyneuropathy one year after cochlear implantation are presented in this article. Visual problems and hearing loss were progressing during recent years leading to social problems and communication disability. Speech discrimination was much worse than could be suspected based on pure tone audiometry. Lack of benefit from hearing aids was also stated. METHODOLOGY: As the examination method free field speech audiometry was used based on Pruszewicz word tests and set of modified speech therapy tests TAPS II. Simple sentences, monosyllables and polysyllables words as well as logotoms perception and identification of music instruments sounds were estimated. MAIN RESULT: Progress of speech intelligibility in monosyllables test according to Pruszewicz in free field speech audiometry was stated, as well as better understanding of sentences, monosyllables and polysyllables words, and more precise recognition of music instruments sounds. MAIN CONCLUSION: In many sensory-neural profound hearing losses as well as auditory neuropathy cases good results may be obtained by cochlear implantation. Early diagnosis of auditory neuropathy is important because of proper management. Lack of benefit from hearing aids in such cases seems to be indication to cochlear implantation. In described case cochlear implantation improved hearing perception one year after using speech processor.

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↗
PubMed2005

[Sudden deafness as a presentation of acoustic neuroma].

Sudden deafness (SD) is thought to be a heterogenic group of disorders as to etiopathogenesis. Acoustic neuroma should always be considered in the differential diagnosis. The authors analysed symptoms occurring in the group of 89 patients, diagnosed with acoustic neuroma. A special attention was paid to the role of sudden deafness as a clinical manifestation of the VIIIth nerve pathology. Progressive hearing loss, tinnitus, headache and sudden deafness were the most common complaints. Sudden deafness was developed by approximately 1 of the investigated patients (24.7%). Progressive hearing loss, tinnitus and sudden deafness were also dominating initial signs. The sudden deafness onset was preceded by the period of progressive hearing loss in 3 patients. In one case episode of SD occurred twice.

Adolescent↗
PubMed2005

[Natural history of otosclerosis--from tinnitus to deafness].

Authors review the most important data about natural history, signs and symptoms and clinical stages of otosclerosis. Development of otosclerosis is long-lasting and involves several decades of lives. First symptoms already appear in teenagers in about 20% of cases. In advanced cases there are irreversible sensorineural hearing loss. When total deafness occurs cochlear implantation is nowadays the treatment of choice.

Adolescent↗
PubMed2005

[Bilateral neck tumor as the clinical manifestation of neurofibromatosis type I (NF I)].

A case of the 17-years old girl with bilateral tumors of the neck due to neurofibromatosis type I has been described. Patient has been unsuccessfully treated conservatively for over two years prior to the admission to our department. The principles of diagnostics and surgical treatment of the patients with neurofibromatosis type I have been presented.

Adolescent↗
PubMed2005

[Auditory neuropathy--new disease].

Auditory neuropathy, a disorder of neural synchrony, is a retrocochlear hearing disorder identified by absence of auditory brainstem responses (ABR) and presence of evoked acoustic otoemissions (EOA). Registration of emissions shows normal function of external cilliary cells. Patients with auditory neuropathy have difficulties to understand speech especially in presence of beckground noise. Normal conversation requires the support of orofacial reading. The authors presents electrophysiological and behavioral tests useful in diagnostic process. An option in treatment of auditory neuropathy is cochlear implantation. Such treatment is indicated when conventional hearing aids doe not help to improve speech understanding.

Cochlear Implantation↗
PubMed2004

[Evaluation of the inner ear fluorescence].

Searching for the methods, which may improve the visualisation of the membranous labyrinth, authors decided to evaluate autofluorescence of the membranous structures of the inner ear. The analysis of the inner ear autofluorescence parameters was performed. We assessed, whether the detected differences in autofluorescence between the bony elements and the membranous structures, allows the practical apply, owning to increased contrast in the operating microscope. The optimal wave length inducing autofluorescence of membranous labyrinth amounts to 465 nm. Obtained in these circumstances contrast of the membranous structures don't cause a significant improvement in their visualisation, comparing with the picture received in the traditional optical microscope.

Ear, Inner↗
PubMed2004

The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery.

The treatment of total deafness using a cochlear implant has now become a routine medical procedure. The tendency to expand the audiological indications for cochlear stimulation and to preserve the remnants of hearing has brought new problems. The authors have studied the topographical anatomy of the internal structures of the ear in the area where cochleostomy is usually performed and an implant electrode inserted. Ten human temporal bones were obtained from cadavers and prepared in a formalin stain. After dissection of the bone in the area of round and oval windows, the following diameters were measured using a microscope with a scale: the transverse diameters of the cochlear and vestibular scalae at the level of the centre of the round window and 0.5 mm anteriorly to the round window, the distance between the windows and the distances from the end of the spiral lamina to the centre of the round window and to its anterior margin. The width of the cochlear scala at the level of the round window was 1.23 mm, and 0.5 mm anteriorly to the round window membrane it was 1.24 mm. The corresponding diameters for the vestibular scala are 1.34 and 1.27 mm. The distances from the end of the spiral lamina to the centre of the round window and to its anterior margin are 1.26 and 2.06 respectively. The authors noted that the two methods of electrode insertion show a difference of 2 mm in the length of the stimulated spiral lamina. The average total length of the unstimulated lamina is 2.06 and 4.06 in the two situations respectively.

Cochlear Implantation↗
PubMed2004

[Treatment of petrosal cholesteatoma with intracranial extention].

The authors describe various methods of surgical treatment of extensive petrous pyramid cholesteatoma. The surgical technics were selected to each individual patient. The approach depended on the disease's course, the lesion extention and the ear functional state. Total removing of cholesteatoma were possible by the lateral petrosectomy or by the middle fossa approach. The authors underline that petrous cholesteatoma can develop after previous radical mastoidectomy. The origin of this type of cholesteatoma is usually supratubal recess.

Aged↗
PubMed2004

[Chondroma of the skull base].

Summary Chondromas of the skull base are extremely rare cartilaginous tumors. Etiology of chondromas remains unknown. The clinical presentation and radiological findings are not unique and cannot reliably distinguish from other similar lesions in this area. The low frequency of patients with chondromas of the skull base makes it impossible to draw definitive treatment conclusions. Chondromas are benign tumors and have good clinical outcomes. However, follow-up depends on localization of the tumor and neighboring vital structures within a small area. The authors present a case of 16-year-old patient with chondroma of the skull base, followed by a diagnostic evaluation and surgical management. Clinical characteristics of the neoplasm was presented on the basis of literature.

Adolescent↗
PubMed2004

[Merkel cell carcinoma of the head and neck].

Merkel cell carcinoma (MCC) is a skin cancer arising from neurosecretory cells which take part in APUD system. In most cases it is locally growing tumor with significant tendency to local recurrences after surgery. The authors have described four cases MCC localised on the skin of the middle angle of the eye, lower eyelid, auricle and cheek, without nodal metastases. All patients have been surgery treated, in two cases reconstructive surgery was performed. Radiotherapy followed surgery was used for two patients. The authors have reported 5-year survival rate in 2 cases, 2-year disease-free rate and 18 month in other cases.

Aged↗
PubMed2003

[Sinus tympani in surgery of the middle ear and skull base].

Tympanic sinus is located at the medial wall of the tympanic cavity. It's visualisation is difficult from most of approaches. Tympanic sinus is often filled with cholesteatoma in course of chronic otitis. Intraoperative assessment of tympanic sinus was performed in 29 patients with facial recess cholesteatoma, and in 20 patients with acoustic neuroma operated with translabyrinthine approach. In the group of patients with cholesteatoma four patients underwent canal wall up tympanoplasty with posterior tympanotomy, 25 underwent canal wall down tympanoplasty. Tympanic sinus was assessed during surgery with 30 degrees endoscope. In all cases depth of the sinus was measured with the use of calibrated hook. In 11 patients depth of the sinus exceeded 4 mm. In 6 among these features of bone destruction was found.

Cholesteatoma, Middle Ear↗
PubMed2003

[Anatomy of sinus tympani].

30 temporal bones from adult cadavers of both sexes were examined. After the tympanic sinus was identified, its morphologic features were evaluated. Minimum distance from adjacent structures: lateral and posterior semicircular canal, facial nerve canal and jugular fossa were taken. Measurements were taken under operative microscope with eye-piece graduation of 0.05 mm accuracy. Four main morphologic types of entrance to the sinus and two main developmental forms--deep and shallow sinus were distinguished. Deep sinus coexisted with absence of bridge and conversely if bridge was seen sinus was shallow. Deep sinuses were located close to the facial canal, in some cases penetrating around the canal up to 2/3 of canal's circumference. This anatomical variation increase the risk of the facial nerve damage during the surgery. In most of cases tympanic sinus is oval in shape. It's long diameter lies in vertical plane. The mean distance between the sinus and adjacent structures were as following: facial nerve canal--1.5 mm, lateral semicircular canal--2.1 mm, posterior semicircular canal--1.59 mm, jugular fossa--5.5 mm. No differences dependent from gender and side were found.

Adult↗
PubMed2003

[Transtympanic steroid application in sudden deafness].

The paper presents the results of transtympanic steroid therapy for sadden sensorineural hearing loss in 20 patients. All patients previously underwent a full conventional treatment, without the beneficial effect. Patients were classified into two groups: the first one consisted of 16 patients who received intratympanic Dexaven application just after termination of conventional treatment. The second group received intratympanic treatment 1 or more months after the conventional therapy had been finished. The pattern of intratympanic Dexaven application is presented. The results of treatment are promising (hearing improvement in 7 cases) and the method is both minimally invasive and inexpensive.

Administration, Topical↗