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Biomedical subjects

M Kossowski

Publications and source records attributed to M Kossowski.

18 recordsLinked to original sources
PubMed2004

[Laryngeal disorder revealing unrecognized pulmonary tuberculosis].

Laryngeal tuberculosis is exceptional and identification in this localization can reveal clinically unrecognized pulmonary tuberculosis. We report two cases illustrating this situation. The pseudo-tumor aspect observed at endoscopy may be wrongly suggestive of neoplasia. Bacteriological examination provides the diagnosis. New methods of genomic diagnosis (Gen-Probe) and culture now allow particularly rapid diagnosis. Outcome is always favorable with standard anti-tuberculosis treatment.

Adult↗
PubMed2003

[Susac syndrome or microangiopathy of the cochlea, brain and retina].

OBJECTIVES: Susac syndrome, also called SICRET syndrome (small infarction of cochlear, retinal, and encephalic tissue) is a rare condition difficult to diagnose. Sudden deafness may be the inaugural sign. MATERIAL AND METHODS: A female patient developed subacute encephalopathy, bilateral sensorineural hearing loss, and ischemic retinopathy. The patient was given cyclophosphamid and methylprednisolone for six months, followed by prednisone for eight months. RESULTS: Signs of encephalopathy had totally regressed by month 14 and retinal arteries were free of obstruction. Deafness remained unchanged. CONCLUSION: Diagnosis of this microangiopathy involving the inner ear, the brain, and the retina is suggested by the clinical triad and established on the basis of tonal audiometry, fundus examination, fluorescein angiography, examination of the cerebrospinal fluid, magnetic resonance imaging. Multiple sclerosis is the main differential diagnosis. The pathogenesis remains unknown. We observed transient-evoked otoacoustic emissions. There is no consensus concerning treatment. Many advocate combining corticosteroids and immunosuppressors. Otolaryngologists should be aware that an ophthalmological examination is required for patients with central or visual disorders associated with hearing loss.

Adult↗
PubMed2002

[Current aspects of laryngeal tuberculosis: a report of four cases].

OBJECTIVE: Laryngeal tuberculosis is a rare condition. This new clinical pattern of tuberculosis should be recognized by clinicians. METHODS: We report our experience with four cases of laryngeal tuberculosis. RESULTS: The principal differences in the disease pattern are an increase in the number of cases of primary laryngeal tuberculosis without any evident pulmonary involvement and the declining number of pseudotumor forms with an larger number of nonspecific laryngeal localizations. CONCLUSION: Tuberculosis should be entertained as a possible diagnosis in patients with nonspecific laryngeal disease. The diagnosis is confirmed by identification of granulomatous inflammation and acid-fast bacilli. New culture techniques and molecular biology methods such as polymerase chain reaction allow early identification of Mycobacterium tuberculosis.

Adult↗
PubMed2001

[Positron emission tomography in head and neck oncology: five cases].

FDG-PET (18-fluoro-desoxyglucose positron emission tomography) is a fonctionnal imaging method based on the high rate of glycolysis in different types of cancer-cells. We report the first five cases where FDG-PET was used in France for head and neck cancers. The results were analyzed on the basis of data reported to date in the literature, leading to a proposal for rational use of this diagnostic available in only a few centers in France. For primary assessment of cervicofacial carcinomas, different imaging techniques such as CT and MRI have improved tumor staging. Although 18-FDG-PET cannot replace these techniques used to monitor size and structural changes in tumors and lymph nodes, it will be helpful in following their metabolic activity. This diagnostic tool consequently is greatly helpful for detection and post-therapeutic evaluation of head and neck carcinomas and their recurrence. 18-FDG-PET is currently under evaluation as a tool for detecting cervical lymph nodes and early assessment of response to chemotherapy.

Fluorodeoxyglucose F18↗
PubMed2001

[Positron emission tomography in head and neck oncology].

Defining a therapeutic strategy in oncology requires a substantial amount of imaging data provided by modern techniques. While the description of the lesions and their environment has become very precise, there remains a certain degree of uncertainty concerning tissue typing. Positron emission tomography is a scintigraphy technique which can produce quantitative images of metabolic characteristics. 18F-fluorodeoxyglucose is a tracer allowing an analysis of glucose metabolism known to be highly increased in malignant tissues. Increased uptake is an indication of malignancy with an established correlation with proliferative capacity. The only limitation of the method is the generally weak uptake observed in benign hypermetabolic inflammatory or infectious areas. All stages of the disease are concerned for head and neck cancer patients. Clinical experience to date indicates that PET can be applied most usefully to search or residual disease with a possible differentiation between post-therapeutic fibrosis and viable tumor tissue as well as the identification of early relapse. Study of early response to chemotherapy is also an interesting application. Search for extension can also be improved with this technique allowing both regional and whole body explorations. Positron emission tomography is not widely available in France at the present time so all patients cannot be examined with this technique. Positron emission tomography is an evolving technique with improvements being proposed both in the technique and in tracer elements. Further information will be available with new developments in this non-invasive exploration tool.

Carcinoma, Squamous Cell↗
PubMed2001

[Value of positron-emission tomography in the post-treatment follow-up of epidermoid carcinoma of the head and neck].

UNLABELLED: This study aimed at pointing out the supply of the positron emission tomography (PET) in the posttherapeutic follow-up of the head and neck squamous cell carcinomas and to determine the best period to perform this test. PATIENTS AND METHODS: Twenty patients have been included in this series, 16 men and 4 women. The PET was performed between 3 and 6 months after the end of all therapy. It systematically included radiation therapy. The results of the PET have been compared with those obtained by histology. The average distance of the follow-up of the patients after the achievement of the test was 11 months. RESULTS: They divided up according to the presence or not of an abnormal fixation on the PET imaging. Negative PETs: eight cases. Among those, a patient showed a metastatic cervical adenopathy at five months. Positive PETs: twelve cases which can be divided into three groups according to the area of the fixation. Primary site: 8 cases, 4 of which false-positive. Cervical lymph nodes: one case. Other sites: three cases. In our series PET had a sensitivity of 87% and a specificity of 67%. CONCLUSION: The PET is an original imaging as it allows a corporal metabolic study at one go. It seems to be very useful in the follow-up of patients who show a head and neck squamous cell carcinoma. The best period to perform it is the third or fourth posttherapeutic month. The high sensitivity is interesting within the context of an early detection of a residual tumour, for it allows to think of a suitable therapy quicker.

Aged↗
PubMed2000

[Traumatic and occupational deafness].

The frequency of accidental, traumatic hearing loss is increasing due to a sometimes violently noisy environment and to the development of sports as leisure activities. The diagnosis is based on knowledge of the circumstances of the trauma and on otoscopic examination. Total audiometry localises the damage. Occupational hearing loss forms a special subset of traumatic deafness. This trauma is usually due to intense noise occurring at the work-place. It is of insidious onset, irreversibly progressive and without treatment once under way; Prevention is based on knowledge of the deleterious effects of noise and on the individual factors of the subject at risk.

Athletic Injuries↗
PubMed2000

[Lyme disease: a case report].

A male patient aged 38 was complaining from severe musculo-arthral pains and high body temperature of 39 degrees C. He was admitted to the clinical hospital after long and detailed diagnostic procedures--conducted during previous hospitalization, which focused on Plasmocytoma. Serological examinations relating to Lyme disease were undertaken in the clinical hospital and the results appeared positive. The patient received Vibramicin for a prolonged treatment lasting 30 days. Radiological findings showed distraction in both hip joints (especially the right one), with areas of bone erosion, severe osteoporosis and calcifications in periarthral soft tissues. After pharmacological treatment the body temperature normalized and the pain became less severe. The state of the patient's health improved from subjective and objective point of view.

Adult↗
PubMed1997

[Internal ear injuries in diving: apropos of 16 cases].

After the study of 16 observations of inner ear injuries in diving, the authors remind us to the different mechanisms of inner ear's lesions. The principle of treatment depends of these mechanisms. Emergency is to recognize a decompression injury. So, all vestibular disorders must be considered as a decompression injury, as soon as, it was a saturating diving. Hyperbaric oxygenotherapy must be undertaken immediately. Though the symptomatology suggestive of fistula for 4 patients, no surgical exploration was done. The follow-up was marked by spontaneous amelioration, that make think of possible spontaneous cicatrization.

Adult↗
PubMed1997

[Incidence of vertigo in diving].

Vertigo is relatively common after diving. Although it may be the result of the changes in pressure, it can also be a feature of decompression accidents, of clinical toxicity, simply be a manifestation of altered physiology resulting from immersion in a weightless environment in which all the organs involved in maintaining equilibrium (vestibular system, proprioception and vision) are affected. It seemed to us to be of interest to study the incidence of vertigo in naval divers by means of an anonymous questionnaire. The responses were elicited over a 3 month period from 333 divers. 45 divers reported clinical sensations of vertigo, an incidence of 13.5%. If this figure is related to the number of dives, the incidence falls to 0.06%. No decompression accidents were reported. The main aetiology was barotrauma, 42% being of alternobaric and 36% of pressure type. The remaining aetiologies were sensory illusions in 6% of cases, and other non-ENT causes in 16%. After a review of the physiopatholgy and study of the case hisotries, there is a discussion of the features which allow the aetiology to be determined and treatment planned.

Adult↗
PubMed1997

[Traumatic perilymphatic fistula and sports].

In the past ten years four sportsmen with a traumatic perilymphatic fistula were treated. Three of these four patients were surgically treated: two of them underwent a labyrinthectomy and with one of them, the oval window was grafted. After the analysis of these cases, we have made a study of the literature. Careful attention to the patient history and accurate review of the recurrent vestibulocochlear symptomatology isolate a clinical "audiovestibular syndrome of perilymphatic fistule". There is lack of precise preoperatoire diagnostic test. Nevertheless, entire positionnal audiometric test is a reliable and easy to perform test. The medical management is based on bed rest during a reasonable period. Only patients with significant suggestive symptomatology are surgically explored . They sometimes need destruction of vestibular function without preservation of hearing.

Adult↗
PubMed1993

[Reoperation of tumors of the parotid gland. Technical approach and consequences for the 7th cranial nerve. Apropos of 22 cases].

Second or more surgical procedures on parotid are usually difficult and may induce injury on the facial nerve. The authors report their experience about 42 patients. The choice between a total parotidectomy or a surgical excision of a tumor depends of the number of surgical procedure, the type of initial procedure and the histological type of the tumor. Second surgical procedures for a wrong initial histological diagnosis (11 cases) were always a total parotidectomy with facial nerve preservation. The risk of a partial or total facial palsy is higher after several recurrences (3 of 8 cases). The facial nerve had to be resected in 3 of 9 cases of malignant tumors recurrences. The initial treatment of a tumor of the parotid must be radical so it can prevent for further surgical procedures and then avoid a facial nerve injury.

Adult↗
PubMed1992

[Petrous surgical approaches in tumors of the cerebellopontine angle].

Three petrous incisions, performed by an ENT-neurosurgery team, can be used for the resection of tumours of the cerebellopontine angle: transpetrosal incisions (posterior translabyrinthine and transcochlear) which provide large access to the IAM and the posterior surface of the petrous bone, but they sacrifice hearing. The suprapetrosal incision (reserved for tumours in the meatus) and the mastoidoretrosigmoid incision (for tumours less than or equal to 20 mm) preserve the labyrinth in an attempt to preserve hearing. The principal objectives of surgical resection of tumours of the cerebellopontine angle (85% of which are acoustic neuromas) are total resection (to preserve the vital prognosis) and preservation of facial nerve function. Attempts to preserve hearing must be confined to cases selected by a complete clinical otological and audiometric examination.

Cerebellar Neoplasms↗
PubMed1991

[Surgery of the parotid gland. Indications. Review of the anatomy].

The surgical division of the parotid gland in three parts or "lobes" in relation to facial nerve is a practical custom. After revising the surgical anatomy, the indications and operative technique of total parotidectomy with preservation of the facial nerve (TPP) are described. The discussion is open for pleomorphic adenomas of the superficial lobe, between some authors in favour of a superficial parotidectomy and others who perform a systematic TPP. Other surgical operations are total parotidectomy (TP) without preservation of the facial nerve, TP associated with a neck dissection, at lastly extensive or partial parotidectomies. Trans-parotid surgery uses the parotid region as an approach to neighbouring structures or regions.

Humans↗
PubMed1990

[Focal infection? Did you say focal infection ... focal infection and uveitis].

A chronic seat of infection more often than not situated in the E.N.T. area is responsible for remote pathological symptoms commonly called focal infection. The eye may be a target organ, where focal infection appears in the form of a uveitis. Four clinical observations are reported as demonstration. The transmission mechanism operates through an immune phenomenon from bacterial antigens which engender reactions of hypersensitivity. The E.N.T. specialist must be aware of these symptoms and seek a pharyngeal, sinusal or latent buccodental infection.

Adult↗
PubMedDate not supplied

Fine alterations of distortion-product otoacoustic emissions after moderate acoustic overexposure in guinea pigs.

Guinea pigs were exposed to a pure tone at 6 kHz and 80 dB SPL for 30 minutes in order to induce mild reversible auditory fatigue over the 4 hours following exposure. Cochlear monitoring aimed to compare the shifts in round-window compound action potentials (CAP) thresholds to those of 2f1-f2 distortion-product otoacoustic emissions (DPOAE, frequency of stimuli f1 and f2). Both responses were evaluated every 1/10th octave between 6 and 12 kHz for CAP thresholds, and from 4 to about 14 kHz for DPOAEs in response to 50- and 70-dB SPL stimuli. The auditory fatigue turned out to be sufficiently mild that DPOAEs remained present, so that their microstructure could be followed up while the stimulus frequency ratio f2/f1 was swept from 1.06 to 1.30 (fixed f2) so as to derive DPOAE level profiles against f2/f1 and group latencies. CAP thresholds decreased by about 10 dB above 7.2 kHz, whereas DPOAE amplitudes decreased at most f2 frequencies from 6.6 kHz to 15.2 kHz, with the range of decrease being slightly narrower at higher stimulus intensities. While the mean DPOAE shift after 1 hour was around 5 dB irrespective of stimulus intensity, it tended to increase slightly after 2 hours despite stable CAP thresholds. DPOAE profiles against f2/f1 were slightly modified by the auditory fatigue, so that the maximum tended to be reached at lower ratio. No significant variation of DPOAE latencies was found after acoustic overstimulation. These experiments show that complex DPOAE changes were induced by auditory fatigue and their relationship to CAP threshold changes does not seem to be straight-forward. Nonetheless, fine DPOAE recordings might be useful to detect early changes in cochlear mechanics.

Acoustic Stimulation↗
PubMedDate not supplied

[Reoperation of tumors of the parotid gland, surgical approach and consequences for the 7th cranial nerve. Apropos of 42 cases].

Second or more surgical procedures on parotid are usually difficult and may induce injury on the facial nerve. The authors report their experience about 42 patients. The choice between a total parotidectomy or a surgical excision of a tumor depends on the number of surgical procedure, the type of initial procedure and the histological type of the tumor. Second surgical procedures for a wrong initial diagnosis (11 cases) were always a total parotidectomy with facial nerve preservation. The risk of a partial or total facial palsy is higher after several recurrences (3 of 8 cases). The facial nerve had to be resected in 3 of 9 cases of malignant tumors recurrences. The initial treatment of a tumor of the parotid must be radical so it can prevent for further surgical procedures and then avoid a facial nerve injury.

Adenocarcinoma↗