Otolaryngology (ORL) at the turn of the 19th century in Poland - an historical review.
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History, 19th Century↗
Biomedical subjects
Zygmunt Szmeja
Publications and source records attributed to Zygmunt Szmeja.
[Malignant tumours of the pharynx in the years 1992-2001].
All cases of malignant tumours of the pharynx (excluding tumours of the tongue) were analyzed based on the retrospective data from the 5 clinical centers in Poland from the years 1992-2001. A considerable--over 50% increase in morbidity was found out regarding particularly tumours of the oropharynx. In the analyzed material there is a predominance of males (3:1) and the peak of morbidity significantly falls. The subjects with advanced tumours of the pharynx made 26% of the studied group. The most common histopathological diagnosis was squamous cell carcinoma and the most common site--the oropharynx, in particularly the tonsil. The data the center in Katowice, where tumours of the hypopharynx have been predominant in the last few years, may point a similar tendency in the other centers in the future.
Adolescent↗
[Case of adenoid cystic carcinoma of the nose with rapid course].
A case of adenoid cystic carcinoma in 41-year old man, localised on nasal septum was described. The course of disease was very unsatisfactory--many local recurrences, lymph node metastases and in the last period generalisation of the neoplasms. The period between diagnosis and the time of death was only 8 months in spite of repeated operations of the tumours local recurrences and lymph nodes metastases as well as radio- and chemotherapy.
Adult↗
[Angiofibroma juvenile in the clinical material of Department of Otolaryngology in Poznan in the years 1977-2000 ].
30 patients suffering from angiofibroma juvenile were treated in the Department of Otolaryngology in Poznań in the years 1977-2000. The patients aged from 9-36 years. All the patients were treated surgically and the method of choice was Denker's surgery. 3 patients were reoperated because of local recurrence. On the base of own material good results of full recovery of patients with angiofibroma treated surgically are presented.
Adolescent↗
[Laser surgery in the treatment of bilateral vocal cord paralysis].
The introduction of surgical lasers into microsurgery of the larynx has made the resection of the posterior vocal cord with or without the arytenoid cartilage possible. This method of surgical treatment allows one to carry out a fast, non-open larynx procedure and practically bloodless operation with minimal postoperative trauma and edema of the surrounding tissues. Since November 1990 at the Clinic of Otolaryngology of the University School of Medical Sciences 48 arytenoidectomies (40 on the right side, 8 on the left side), 19 partial chordectomies and 25 Kashima operations. All surgical treatment were performed by means of CO2 laser in patients with bilateral paralysis of the vocal cords. In all patients postoperative recovery was correct and breathing difficulties were not observed after extubation. Laryngoscopic control examinations were performed a day after operation and a wide lumen of air through the operative field was observed. At the control examination, narrowing of the lumen of the larynx was not observed, the healing process of the operation area was without granulation. Laser arytenoidectomy allows good results of the breathing and phonation function. No changes of granulation proliferation were observed at the side of the CO2 laser treatment. Lack of reaction to laser beam there was possibility to use endoscopic procedures in patients who did not undergo a tracheotomy.
Adult↗
[Effect of ultrasonography on postoperative changes in treatment of neck lymph nodes and improvement of long term results in patients with laryngeal neoplasms].
Ultrasonography (US) is a well-known and valuable method of detecting lymph nodes in the neck. It is widely used in the preoperative neck assessment and in follow-up patients treated for head and neck cancer. The aim of the study was to compare the larynx cancer patients in two decades: the 80-ies and the 90-ies and the influence of a single diagnostic tool, i.e. ultrasonography, on therapeutic decisions and final results. Two groups of patients were selected: 737 patients treated between 1981-1985 (before the introduction of US) and 840 patients treated between 1991-1995 (routinely examined with the help of US) in ENT Dept. of Karol Marcinkowski University of Medical Sciences in Poznań. We aimed at analysing the percentages of neck metastases at the moment of diagnosis, the frequency of particular types of primary neck treatment, the percentages of neck recurrences, their advancement at the diagnosis and the methods of secondary treatment. Particular attention to feasibility of salvage was paid. Mean survival time in the group of patients with recurrence and the overall 5-year-long survival rates were analysed. No marked differences were stated between both groups as to epidemiological data, primary tumor advancement and types of the performed larynx surgery. Neck metastases occurred in both groups, 34% and 42%, respectively. Relapse rates were 12.9% and 12.6%, respectively. It was found that the number of elective neck dissections over the period given above became smaller, the number of radical neck dissections was stable, while the number of patients referred to wait and see policy increased. The number of successful neck salvage surgeries markedly increased while the number of patients not qualified for salvage decreased. For the both studied data, the curves on diagrams cross around the year 1992. The turning point situated in this time shows that ultrasound, introduced in 1991, gradually changed the types of primary treatment and possibilities of salvage neck treatment. The statistically significant differences in both groups were shown as to: types of the initial i.e. first neck treatment, relapse rate and the possibility of performing surgical salvage, while the only change was the introduction of a new diagnostic tool, i.e. neck ultrasonography. Survival rate was markedly better in the second group of patients. The methods of qualifying patients for the primary neck treatment and follow-up schedule have been changed since ultrasonography diagnostics was introduced in 1991 for routine assessment of the neck lymphatics in the larynx cancer patients. Strict follow-up schedule allow for early detection and successful treatment in high percentage of relapses.
Carcinoma↗
[Multiple primary neoplasms on the face].
A case of 74-year old woman with six separate cancers is presented. Four of them were nonmelanoma skin cancers (2 basal-cell carcinomas and 2 squamous-cell carcinomas), the remaining two were noncutaneous malignancies (invasive lobular carcinoma of the breast and squamous cell carcinoma of the parotid gland). Three lesions were present simultaneously on the head and neck region; basal-cell carcinoma on the cheek, squamous-cell carcinomas on the forehead, and in the parotid gland. All neoplasms were surgically removed, the region of affected parotid gland was additionally radiated. Extreme rarity of the multifocal primary malignancies is emphasized and the non-completely clear etiology, biology and pathology of these tumors is discussed.
Aged↗
[Ultrasonography in diagnosis of neck tumors].
Tumours of the neck are very important problem of the contemporary otolaryngology. In the study the use of sonography in evaluation of expansions of the neck was studied in 200 patients with histologically proven diagnosis. To carry out a detailed evaluation of the individual character of particular types of tumours, all basic features were analysed using the following criteria: echogenicity, echostructure, separation and contour. In this group developed 159 (78.5%) benign tumours and 41 (21.5%) malignant tumours. Malignant tumours were mainly: cystic or solid-cystic, with irregular contour, thickened separation and high echogenicity. Benign tumours were regular, smooth, with low echogenicity and clear separation.
Diagnosis, Differential↗