The influence of flowmeters on rhinomanometry results and detection of nasal airflow asymmetry

<b><br>Introduction:</b> Rhinomanometry is an otolaryngological diagnostic method used to determine airflow as a function of the pressure drop through the left and right nasal cavities. Airflow is measured using orifice flowmeters that attenuate the flow.</br> <b><br>Aim:</b> This paper describes the results of a study into the effects of flowmeter design on rhinomanometry results and detection of nasal airflow asymmetry.</br> <b><br>Material and methods:</b> Four flowmeters were examined using a 3D printed model of a human nose.</br> <b><br>Conclusions:</b> Each flowmeter interfered with the rhinomanometry results.</br>.

Virtual rhinomanometry based on computed tomography of the paranasal sinuses in patients with nasal septum deviation a pilot study

AIM

The aim of the study was to compare the flow disturbances in computational fluid dynamics (CFD) technique based on computed tomography (CT) to the results of active anterior rhinomanometry (RMM), in patients with nasal septum deviation (NSD).

MATERIAL AND METHODS

In 24 patients with NSD, RMM and CT of the paranasal sinuses were performed as a part of typical clinical management. For each patient, 3D models of air-filled spaces in the nasal cavity were created, based on CT images, and air flow simulations during inhalation were performed using CFD technique. Correlations between RMM, both before and after anemization, during inspiration, and CFD were tested, independently for the left and right side.

RESULTS

The obtained correlation coefficients for the comparison of flow in RMM during inspiration and in CFD during simulated inspiration were: before anemization 0.46 for the left side and 0.52 for the right side, after anemization 0.65 for the left side and 0.61 for the right side (p &lt; 0.05).

CONCLUSIONS

Moderate correlation was found between the results of real and virtual rhinomanometry, with higher correlation coefficients obtained after anemization, compared to the values before anemization.

Rehabilitation after surgical treatment of retrobulbar tumors

The authors propose a set of rehabilitation exercises concerning the muscles which are responsible for movement of the eyeball. After surgical treatments of retrobulbar tumors, the function of the eyeball muscles is often inadequate. Some compensation should be created at the level of the central nervous system, which means trigging adaptation, substitution and habituation. The exercises should be started just after the patient is awakened: first in the horizontal position, then sitting position and finally standing position. The highest number of exercises should be done in the direction of extreme diplopia.

Otolaryngological symptoms in patients treated for tick-borne diseases

infections are borreliosis (Lyme disease) and tick-borne encephalitis (TBE). Lately there is growing incidence of Bartonella, Babesia, Anaplasma and Brucella co-infections. The similarity between the symptoms of tick-borne diseases and other pathologies causes serious diagnostic issues.

MATERIAL AND METHODS

216 patients aged 18-55, who presented to the outpatient clinic for tick-borne diseases in the years 2014-2016, were enrolled in the study. The patients had been diagnosed with Lyme disease and co-infections. The principal diagnostic tests to confirm the infections included ELISA, Western-Blot and circulating immune complexes (CIC).

RESULTS

In the group of 216 patients, 162 presented with otolaryngological symptoms. The most common complaint was tinnitus (76,5%) accompanied by vertigo and dizziness (53,7%), headache (39%), unilateral sensorineural hearing loss (16,7%). The patients also had tick-borne coinfections, among them the most common was Bartonella henselae (33,4%) and Bartonella quintana (13%).

CONCLUSIONS

Otolaryngological symptoms are a common manifestation of tick-borne diseases. They are most frequently observed in Lyme disease and Bartonella spp. infections. The symptoms in the head and neck region are usually occur in chronic Lyme disease with predominant IgG antibodies nad VlsE antigen.

[Squamous epithelium in the nasal cytology]

Nasal mucosa cytology is an additional examination useful to differentiate chronic rhinitis in allergological and laryngological diagnostics, including chronic sinusitis. The aim of the study was to estimate the cytological picture in a group of patients with the highest percentage of squamous epithelia, suggesting the atrophic rhinitis. The analysis was carried out on the basis of cytological results performed in 3055 patients diagnosed because of chronic rhinitis. Among these patients, in 31 individuals the higher percentage (30% - 76%) of squamous cells was found. In six patients, the clear predominance of squamous cells over ciliated and goblet cells (3:1) was reported. Only in three patients the increased percentage in eosinophils was stressed (3%, 5% and 9% respectively). No basic and metaplastic cells were observed in the studied cytograms. The squamous cells occurred probably as a result of normal mucosa damages during the different inflammatory changes, both allergic and non-allergic, the impact of toxic agents, irritants (including nasal drops). The higher percentage of squamous cells in the nasal cytogram could have explained the low effectiveness of local inflammatory treatment in these patients.

The measurement and analysis of surface geometric structure of ceramic femoral heads

The surface functionality of interacting components is determined by evaluating geometric surface structure. Hence, the ceramic femoral heads originated from precision machining were subject to measurement and analysis with regard to roughness, surface damages and deviation from roundness. A variety of measurement techniques were applied in order to thoroughly examine the product quality. The obtained results proved in accordance with the specification: Ra was not greater than 0.05 µm, whereas Δ was less than 10 µm (5 µm) when ceramic balls were used in conjunction with a polyethylene (ceramic) socket. Additionally, the surface damages which can affect the life of a friction pair were analyzed.

[Orbital tumors treated at the University Hospital Otolaryngology Clinic in Kraków between 1997 and 2011]

The main aim of the study was to establish the frequency of orbital tumor occurrence in the patients of the University Hospital Otolaryngology Clinic in Kraków as well as to analyze the clinical features, location in the orbit and to identify the group of patients with the highest risk of orbital tumor. The authors retrospectively analyzed 46 patients (29 women and 17 men) between the ages of 23 and 87. This group of patients was compared to a group of 80 patients who were surgically treated at the same clinic 10 years ago and to a group of 70 patients treated 15 years ago. We established that the tumors localized in the orbit were mainly benign. A variety of histological types of tumors arises in the orbit but it was significant that inflammatory pseudotumors were the most common cases in all three groups of patients treated in our clinic now, about 10 and about 15 years ago. Referring to the group of patients at the highest risk, we established that orbital tumors are definitely most common in women than men. It has turned out to be statistically significant that benign tumors were most common in younger patients and malignant in older people. That suggests the conclusion that being female is a risk factor for orbital tumors and age is a risk factor for them being malignant. Comparing different approaches for the resection of orbital tumors, we established that the lateral orbitotomy provides access to orbital tumors in the most common locations (intraconal and in the top corner of the orbit). Malignant and extensive tumors have to be treated by orbital exenteration.

[Cysts of the orbital bone and orbital sinus: clinical and morphological characteristics of the three cases]

BACKGROUND

Solitary bone cyst is rarely situated in facial bones.

AIM

We discuss clinical view, results of radiological examinations and differential histopathological diagnostics of cases.

RESULTS

We present 3 cases of patients: 51 year old man with cyst in frontal sinus; 29 year old man and 46 year old woman--both with changes in bones of the orbit. In all the cases results of histopathological examinations were similar. Cystic-shape pieces of vascularizated connective tissue were observed. Multiple cracks filled with cholesterol, macrophages with hemosiderin and occasionally multinuclear cells were noticed.

CONCLUSIONS

Solitary bone cyst may be located in the periorbital bone, especially frontal. Excellent laryngological, optic and cosmetic results are results of the surgery. Suspicious of the solitary bone cyst is possible due to MR or CT imaging, but final diagnosis must be confirm by histological examination.

[Necessity of chorda tympani cutting from data collected at Department of Otolaryngology at the Collegium Medicum of the Jagiellonian University]

BACKGROUND

Chorda tympani nerve is a branch of the facial nerve which enables perception of taste of 2/3 anterior part of tongue and it is responsible for unilateral parasymphatetic nerve supplying of the submandibular and sublinqual salivary glands.

MATERIAL AND METHODS

Prospective analysis of patients operated on middle ear in ENT Department Jagiellonian University of Krakow between 2004-2008 was performed. Nearly 650 operations were done in that period of time. Chorda tympani nerve was cut in 96 individuals. Most of them were treated for chronic otitis media.

RESULTS

When chorda tympani nerve was cut--the majority of cases did not complain of dysgeusia. Disturbance of taste was observed in ca. 2% of patients but it was transitory. The subject experienced sour/metallic taste.

CONCLUSIONS

Taste disturbance following unilateral injury to the chorda tympani nerve was usually the most intense in the first few weeks and improves with time.

[Analysis of oropharyngeal phase of swallowing in patients with amyotrophic lateral sclerosis]

BACKGROUND

Dysphagia is a common symptom of amyotrophic lateral sclerosis (ALS) and leads to increased risk of aspiration, malnutrition and dehydration. Swallowing mechanism in ALS patients has not been systematically studied.

MATERIAL AND METHODS

Based on the manometry analysis of upper investigate tract we have measured base of tongue contraction, resting pressure of the upper esophageal sphincter and average pharyngeal bolus velocity 10 ALS patients with slight dysphagia and have compared them to control group.

RESULTS

All parameters measured were significantly changed in ALS patients indicting disturbances of oro-pharyngeal phase of swallowing even in ALS patients with slight dysphagia.

CONCLUSION

Early diagnosis of the swallowing disturbances is important for symptomatic therapy.

[Self-assessment of the effect of dysphagia on the quality of life in patients after partial laryngectomy for cancer initially located in the supraglottic area]

Dysphagia is frequent in patients after partial laryngectomy for cancer initially located in the supraglottic area. To ensure the best quality of life, establishing how the patient feels after treatment is necessary. Therefore, a self-administered questionnaire was designed to evaluate the dysphagia. 95 patients (75 male and 20 women) who were operated in ENT Department CMUJ between 1998-2004 participated in this study. The MDADI questionnaire in the Polish version was used. The subjective evaluation by the patient of dysphagia is directly related to the size of the tumor and the extent of the partial laryngectomy treatment. Patients, whose tumor was located in supraglottic-glottic area, had subtotal laryngectomy m. Miodoński. Their quality of life was significantly worse due to dysphagia than those with tumors located only in the supraglottic area. Swallowing dysfunctionality was significantly greater after the resection of the hyoid bone. Reconstruction of the base of a tongue by a graft of angiopedunculated submandibular gland diminished the difficulties in swallowing. Moreover, the longer the period after treatment, the higher the quality of life becomes because of the improvement in the swallowing functionality.

[Drug allergy among patients suffering from nasal polyps]

The study was performed in order to evaluate quantity and morphology of nasal polyps in patients with diagnosed drug allergy to aspirin, antibiotics, polocain, procain and other drugs. The study included 60 patients (27 females, 33 males aged between 18-69 years). Nasal polyp morphology was examined under electron microscope and light microscope. Morphological evaluation of epithelial and subepithelial structures was done under light microscope, taking not of inflammatory infiltration type, basal membrane, as well as degree of intestinal edema. Evaluation of epithelial cell type, their relative proportion, as well as area percentage covered by cilium, microvilli and squamous epithelium was done under electron microscope. Polyps in patients with idiosyncrasy to polish aspirin and sodium metamizole (12 patients) featured increased eosinophilic infiltration, thickened basal membrane, with elevated eosinophil percentage differential count. The epithelial percentage area was covered by squamous cells without villi. Polyps associated with idiosyncrasy to polish aspirin differed morphology compared to polyps originality from patients allergic to other medications. On the other hand polyps from patients allergic to other drugs, such as: penicillin, procainamide were morphologically (electron light microscope, light microscope) similar to those polyps caused by inflammatory factors.

[The efficacy of subterranean therapy in the salt chamber of Kinga Spa in Wieliczka for patients suffering from allergic rhinitis]

42 patients (27 women and 15 men aged 14-65 years) suffering from atopic and non atopic rhinitis were submitted for 24 days to the subterraneo-therapy in salt chambers of Kinga Spa in Wieliczka during the exacerbation of their illness. 20 patients suffered from pollen or dust mites allergy and the next 22 patients from non atopic rhinitis with recurrent nasal polyposis. In the first week and at the end of the therapy rhinoscopy, peak nasal inspiratory flow and smell were evaluated as well as daily symptoms score was noted in each treated patient. The results of performed observations indicate that unrelatively to the type of the rhinitis: 1. the nasal symptoms (running nose, sneezing, block of the nose) resolved directly during the stay of the patient in the salt chamber but the more constant effect was visible with the time of the therapy. 2. an increase in the peak nasal expiratory flow was connected with the decrease of nasal mucosal edema, 3. the smell disturbances disappeared in the patients together with the decrease of mucosal edema. The observed changes seem to be connected with the influence of the salt chambers' microclimate on the cells osmolarity disturbances in the nasal mucosa provoked by the non infectious chronic inflammation.

[Respiratory and skin diseases among school children in the industrial and rural regions]

The studies were done among the school-children in 3 grammar schools (2 in the industrial and 1 in rural regions). Allergological examination (anamnesis, physical exam and skin prick tests with inhalants) were performed among the pupils suspected of the allergic disorders on the basis of the questionnaire analysis made in all school-children. The results were compared to the environmental air pollution in the school region. The frequency (4.9-7%) and the type of the allergic diseases were similar in all 3 schools. The most frequent allergens were pollen, mites and animal epithelia. In rural region familial predisposition to allergy was 2 times higher in pupils suffering from allergy. 70% of pupils suffering from allergy in the industrial regions had no familial predisposition to allergy.