Search

The authors present current opinions about anatomy and physiology of the stapedius muscle and its role of the hearing process. The stapedius muscle is the smallest striped muscle of the human body and contracts reflexive in response to acoustic stimulation. The stapedius muscle puls the neck of the stapes in the direction of the stapedius tendon. This movement causes stiffening of the incus and the malleus and also changes the pressure of the perilymph in the inner ear. This is the protective inner ear action of the stapedius reflex against hearing damage by noise. The stapedius reflex shows bilateral interactions and its center is located in the brainstem. The binaural interaction of the stapedius reflex plays an important role in the maintaining of the sound direction. The stapedius tendon also plays role in the vascularization of the long process of the incus.

To collect and analyze epidemiological and demographical data of patients qualified for and implanted with the Baha® system in Poland.17 out of 28 otolaryngology departments performing Baha® implantation in Poland participated in the study. Up to date there were 286 patients registered in database. Data were obtained from the preoperative questionnaires including information such as age and gender, indications for the implantation, previous hearing aid use as well as data regarding the surgical technique.The most frequent indication for the Baha® system was bilateral mixed hearing loss (51%), followed by SSD (18%), bilateral conductive hearing loss (17%), unilateral mixed (8%) and conductive (6%) hearing loss. In 11% of subjects hearing impairment was congenital versus 89% cases of acquired. The mean age was 44 years with the slight prevalence of women (52%). 63% of patients did not have previous experience with hearing aids. The most frequent surgical technique was classic dermatome single stage procedure performed under general anesthesia (65%).Data gather in this multicentre research serve as a valuable source of information on qualifications for the Baha®, shows demographic spectrum of adult recipients in Poland. It also presents the preferences of surgical procedures. Outcomes of the study may constitute a reference for each centre participating in this research as well as for new centers starting the Baha® procedure.

The measure of efficaciency of screening test is specificality and sensitivity. The validation of the screening test by using Program "Słysze" in Silesia in year 2002 was done.The Program consisted of two parts: 1. The screening test in schools: a) pure-tone test, b) speech audiometry in noice, and 2. Audiometric verifying of "positive results" of the test. 8885 children were tested in Silesia in 2002. 919 schoolchildren (10.3%) had "positive results". 465 pupils reported to a verifying examination. The hearing loss was confirmed in 191 children. 6 months after the end of Program the control audiometric examinations to validate the Program "Słysze" were done in 100 children, who gained "negative results" in screening test.Program "Słysze" had a high specificality--0.93, sensitivity--0.70, ability to identify--0.92. A positive predictive value was--0.40, and negative predictive value was--0.98.

Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons.The study is analysis of 531 patients with parotid gland tumours in patients treated in ENT Department during 1986-2006. We analysed surgical treatment and intraoperative tumour stage. The results of histological diagnosis were presented.The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma--75% and adenolymphoma--16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3-T4 was in 90%.

Paralysis of the facial nerve reveales some symptoms which are very unfavourable for esthetic point of view (deformity of the face with incompetence of the palpebal function). It is recognized as the one of the most invalidity for humane life. There are many surgical techniques to reconstructive facial nerve such as: decompression, end to end or side to end anastomosis with hypoglosal, glosopharyngeal, axesorius or mandibular nerves. Reconstruction technique depends upon the extent of injury, the availability of the proximal stump and time since injury and duration of muscle denervation. In the presence of facial paralysis electrodiagnostic tests should be performed before surgery and every 3 mounts after, during rehabilitation, which play also the most important role in recovery.The authors present the outcome of the surgical treatment of the facial nerve paresis in 31 patients cured in the Silesian Department of Laryngology in Katowice from 1991 to 2002. The reasons of the paresis were otitis media with cholesteatoma and granuloma in 18 cases, head trauma in 2 patients and iatrogenic impairment after ear operations in 11 cases. The decompression of the facial nerve was done in 20 patients, anastomosis end to end in 3, crossover anastomoses between the facial nerve and the hypoglossal nerve was done in 1 case, and transplantation of auricular major nerve in 7 cases.The outcome was good in 20 patients (64.5%), satisfactory in 10 patients (32.3%) and non satisfactory in one case (3.2%).In our material the most of cases was caused by otitis media with cholesteatoma. The best outcome was obtained after decompression of the facial nerve. The rehabilitation before and after surgery play the very important role in the recovery.

The aim of this study was analysis of results of audiologic evaluation in the group of 191 children with hearing loss. Children were selected from the group of 8885 pupils of primary schools in Silesia by screening test "Słysze" in 2002. Universal Screening Program of Hearing in Children and Teenage "Słysze" was created and introduced in to the clinic practice by Institute of Physiology and Pathology of Hearing in Warsaw in 1999. The screening program consists of: pure tone examination and speech audiometry in noise. Children with hearing loss detected by this test in 2002 were followed laryngological and audiological examination. Special attention was paid on articulation disturbances, communicational and educational problems in children with hearing loss. The authors focused also attention on "discreet signs of hearing deficiency" (not reacting to commands, turning up a TV-set, loud speech). The validation of screening test "Słysze" was also conducted. In the selected population of primary schoolchildren in Silesia hypoacusis occurred in 6% of examined children, in "city" schools the percentage proved to be higher than in "village" schools. In the group aged 6 to 10 the conductive hearing loss occurred considerable more frequently. Eustachian tube dysfunctions in children with conductive hearing loss occurred more frequently in the group of the younger ones. Older than 10 years old in most cases proved to have perceptive-type of hearing loss. The hearing loss hinders a child's psycho-intellectual development, it is important to detect it as early as possible. The evaluations showed that despite frequent occurrence of "discreet symptoms of hypoacusis", only 17.8% of parents suspected hearing loss in their own child. According to the frequency of parents' signals of "discreet symptoms of hypoacusis" it was found that the fact of turning up TV sound was the most powerful sign indicating the probability of hearing loss (45.5%). The most common risk factors of hearing loss in schoolchildren were also estimated. A characteristic, homogenous group of 34 children (17.8%) was the group with MSHL minimal sensorineral hearing loss of high frequencies (6-8 kHz). Results obtained give evidence of low level of awareness in the society concerning the problem of hypoacusis, which confirms the necessity to screening of hearing in schoolchildren and improving of health care in this respect. Diagnosing hypoacusis in case of children is an interdisciplinary problem, requiring cooperation of medical circles but also teachers, speech therapists and parents.

The authors present current opinions about anatomy and physiology of the stapedius muscle and its role of the hearing process. The stapedius muscle is the smallest striped muscle of the human body and contracts reflexive in response to acoustic stimulation. The stapedius muscle puls the neck of the stapes in the direction of the stapedius tendon. This movement causes stiffening of the incus and the malleus and also changes the pressure of the perilymph in the inner ear. This is the protective inner ear action of the stapedius reflex against hearing damage by noise. The stapedius reflex shows bilateral interactions and its center is located in the brainstem. The binaural interaction of the stapedius reflex plays an important role in the maintaining of the sound direction. The stapedius tendon also plays role in the vascularization of the long process of the incus.

Since the publication of Miodoński, Zollner and Wullstein different methods and grafting materials have been promoted in tympanoplasty. The purpose of this study was to demonstrate the anatomical and functional results of tympanoplasty in comparison with the material used. The studies included a selected group of 142 patients who were operated on because of perforation of tympanic membrane. The analysed group consisted of 112 patients when perichondrium and cartilage were used to reconstruct the tympanic membrane. The comparison group consisted of 30 patients when fascia of the musculus temporalis was used to close a defect of the eardrum. In all cases before and after operation there was made tonal audiometry with indication for air and bone conduction within range from 500 to 4000 Hz, verbal audiometry after operation with indication of speech detection and speech reception threshold using mono-syllable NLA-93 test, tympanometry after operation and evaluation of anatomical results after surgery. The comparison of operation results showed that there was no significant difference between the two groups.

Since the publication of Miodoński, Zollner and Wullstein different methods and grafting materials have been promoted in tympanoplastic surgery. The purpose of this study was to demonstrate the anatomical and functional results of tympanoplastic surgery with the use of cartilage and perichondrium grafts. The studies included a selected group of 112 patients who were operated on because of perforation of tympanic membrane. The analysed group consisted of 112 patients when perichondrium and cartilage were used to reconstruct the tympanic membrane. In all cases before and after operation there was made tonal audiometry with indication for air and bone conduction within range from 500 to 4000 Hz, verbal audiometry after operation with indication of speech detection and speech reception threshold using mono-syllable NLA-93 test, tympanometry after operation and evaluation of anatomical results after surgery.

Authors described an extremely rare case of primary lipoma of the middle ear in 8-years old girl. A histological structure, localisation and occurrence of this tumor in the temporal bone was discussed on the basis of the literature. Authors have presented symptomatology, diagnosis difficulties and treatment of primary lipoma of the middle ear. They have paid attention to the course of disease and non-characteristic symptoms, which imitated the symptoms of the chronic otitis media.

Authors have described a rare case of split of the thyroid tissue in the right carotid triangle in 41 years-old-man. They lay stress on difficulty with making right preoperative diagnosis. A growth in the right carotid triangle was surgically excised, and the microscopic examination of the specimen revealed thyroid tissue with collide goiter. Because this entity cannot be clinically distinguished from the others neck tumors, split of the thyroid tissue should be considered in the differential diagnosis.

Authors have described prothesis to reconstruction of transmissive system in middle ear, which has received using patent no PL 54142 Y1.

Author present four cases of mixed laryngocoele. Planocellular carcinoma of larynx was recognized at one of the four patients after 17 months from the operation of laryngocoele. A rare case of bilateral laryngocoele described by the authors was found in a woman, who was operated on in 1981 because of the internal laryngocoele at the left side. She was reoperated in 1995 a mixed laryngocoele at the right side was removed.