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    Wyświetlanie 1-14 z 14
    Tytuł:
    Differences in the clinical course of acute appendicitis in the elderly in comparison to younger populati
    Autorzy:
    Zbierska, Katarzyna
    Kenig, Jakub
    Lasek, Anna
    Rubinkiewicz, Mateusz
    Wałęga, Piotr
    Powiązania:
    https://bibliotekanauki.pl/articles/1394163.pdf
    Data publikacji:
    2016
    Wydawca:
    Index Copernicus International
    Tematy:
    acute appendicitis
    elderly
    symptoms
    Opis:
    Acute appendicitis (AA) still remains the most common acute surgical abdominal emergency. Although 90% of cases occur in children and young adults, the incidence in the elderly amounts up to 10% and is constantly rising. The aim of the study was to assess the differences between clinical presentation in the elderly patients with AA compared to the younger patients. Additional aim was to assess the correlation between in-hospital time delays and patients’ outcomes. Material and methods. We conducted a retrospective analysis of medical data of 274 patients admitted to 3rd Department of General Surgery in Cracow between January 2011 and December 2013 due to AA. The elderly group comprised 23 patients aged 65 and above and the non-elderly group consisted of 251 patients. Results. The groups did not differ in symptoms and their duration, type of surgery and its duration. However, time from admission to ED to the beginning of the procedure was significantly lower in the elderly group (575.56 vs 858.9 min; p=0.03). The elderly had longer hospital stay (6.08 vs 4.69 days; p=0.004). In the elderly group the perforation rate was close to reaching statistical significance (26.1% vs 12.4%; p=0.06). No mortality was noted in both groups and morbidity was slightly higher in elderly group (17.4% vs 10%; p=0.26). Conclusions. There was no difference in the clinical presentation between elderly and non-elderly patients group. However, elderly patients presented with a more progressed inflammation of the appendix. The hospital stay was longer in the elderly group, without any mortality and with higher rate of morbidity in this group. The length of the preoperative phase was significantly shorter, confirming the awareness of importance of time in the elderly patients with acute abdomen.
    Źródło:
    Polish Journal of Surgery; 2016, 88, 3; 142-146
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Influence of Internal Carotid Endarterectomy on Patients Life Quality
    Autorzy:
    Kaźmierski, Piotr
    Kasielska, Anna
    Bogusiak, Katarzyna
    Łysakowski, Marek
    Stelągowski, Mirosław
    Powiązania:
    https://bibliotekanauki.pl/articles/1396589.pdf
    Data publikacji:
    2012-01-01
    Wydawca:
    Index Copernicus International
    Tematy:
    endarterectomy
    neurological symptoms
    questionnaire
    Opis:
    Appropriate treatment of symptomatic carotid artery stenosis can reduce ischemic cerebral strokes' risk and in some cases eliminate neurological symptoms. Endarterectomy is the most common surgical treatment.The aim of the study was to examine the influence of carotid endarterectomy on neurological symptoms and patients' life quality.Material and methods. The material comprised of 102 patients who underwent endarterectomy. All of the patients were given a questionnaire with a list of neurological symptoms (vertigos, headaches, left hemiparesis, right hemiparesis, numbness, acroparaesthesia, single syncope, recurrent syncopies, diplopia, tinnitus, concentration disturbances and aphasia) and with a numerical life quality scale to fill in before and a year after the surgery.Results. Vertigo, headache, single and recurrent syncopies and aphasia as well as cerebral stroke and amaurosis fugax were significantly more rarely observed after endarterectomy. The mean value of patients' life quality evaluated on a 10-point Likert scale after the surgery increased (3.9 vs 6.3).Conclusions. A year after carotid endarterectomy patients' life quality improves which is connected with neurological symptoms' regression and no further symptoms' occurrence due to a preventive role of the surgery.
    Źródło:
    Polish Journal of Surgery; 2012, 84, 1; 17-22
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Otolaryngological manifestations of leishmaniosis
    Autorzy:
    Kurnatowski, Piotr
    Moroz, Jakub
    Powiązania:
    https://bibliotekanauki.pl/articles/1398590.pdf
    Data publikacji:
    2016
    Wydawca:
    Index Copernicus International
    Tematy:
    leishmaniosis
    treatment
    otolaryngologic
    clinical symptoms
    Opis:
    Travel to developing countries is associated with possibility to acquire different, also parasitic, diseases which have become a diagnostic and therapeutic problem. The ENT specialist is one of the medical officers who may make initial contact with a patient with a suspected parasitic disease. One of them is leishmaniosis: a parasitic disease classified as Neglected Tropical Diseases (NTD), which occurs in the tropics, subtropics and southern Europe. While asymptomatic invasion is observed in some cases, three forms of symptomatic leishmaniosis can be distinguished: cutaneous leishmaniosis (CL), visceral leishmaniosis (VL), and mucosal leishmaniosis (ML). Signs and symptoms of these forms, as well as the differential diagnosis, diagnostic procedures and treatment are presented in the paper.
    Źródło:
    Polish Journal of Otolaryngology; 2016, 70, 5; 2-6
    0030-6657
    2300-8423
    Pojawia się w:
    Polish Journal of Otolaryngology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Otorhinolaryngological manifestations of COVID-19
    Otorynolaryngologiczne manifestacje COVID-19
    Autorzy:
    Wysocki, Jarosław
    Powiązania:
    https://bibliotekanauki.pl/articles/1399025.pdf
    Data publikacji:
    2021-04-26
    Wydawca:
    Index Copernicus International
    Tematy:
    COVID-19
    otorhinolaryngology
    symptoms
    otorynolaryngologia
    objawy
    Opis:
    COVID-19 manifests itself in a wide spectrum of clinical symptoms, both in terms of their variety and severity. It can be asymptomatic or abortive, mild, moderate, severe and lightning, as septic with multiple organ failure and shock Typical leading symptoms of COVID-19 are: high fever poorly responding to drugs, severe loss of strength, chest pain, dyspnoea, pain headaches, bone and joint pain and muscle pain, until the onset of acute respiratory distress syndrome (ARDS). However, many publications mention among the possible symptoms also others, not related to the involvement of the lower respiratory tract. These are gastrointestinal disorders, damage to the central and peripheral nervous system, catarrh of the upper respiratory tract and dysfunctions of the sensory organs. The aim of this literature review was to determine the frequency of various head and neck dysfunctions that are part of COVID-19. Symptoms of conjunctivitis, nasal mucosa, pharynx and larynx are reported by about of patients, but they do not always occur at the same time, as in infections caused, for example, by rhinoviruses. Anosmi / hyposmia or ageusia / hypogeusia occur with a similar frequency. Symptoms of damage to the equilibrium system, such as dizziness, are reported by approx. 1/3, vertigo and hearing loss approx. 5-6%, tinnitus approx. 10% of patients. Reports of coexistence with COVID-19 of peripheral paresis of the facial nerve are so far relatively few and often included in the neurological disorders, the frequency of which is also about 1/3 of COVID-19 cases. Importantly, both catarrhal symptoms and the others listed here may precede, co-occur or follow the appearance of the leading symptoms of COVID-19. They can also be the only symptoms of this disease. This should prompt otorhinolaryngologists to be particularly vigilant in this regard
    COVID-19 manifestuje się szerokim spektrum objawów klinicznych, tak pod względem ich różnorodności, jak natężenia. Może przebiegać bezobjawowo lub poronnie, lekko, średnio, ciężko oraz piorunująco, jako stan septyczny z niewydolnością wielonarządową i wstrząsem Typowymi wiodącymi objawami COVID-19 są: wysoka gorączka słabo reagująca na leki, mocno odczuwalna utrata sił, ból w klatce piersiowej, duszność, ból głowy, bóle kostno-stawowe i mięśniowe, aż do wystąpienia zespołu ostrej niewydolności oddechowej ARDS (acute respiratory distress syndrome). Jednakże wiele publikacji wymienia wśród możliwych objawów także inne, nie związane z zajęciem dolnych dróg oddechowych. Są to zaburzenia żołądkowo-jelitowe, uszkodzenia ośrodkowego i obwodowego układu nerwowego, nieżyt górnych dróg oddechowych i dysfunkcje narządów zmysłów. Celem niniejszego przeglądu piśmiennictwa było określenie częstości różnych dysfunkcji w obrębie głowy i szyi, będących elementami COVID-19. Objawy nieżytu spojówek, błony śluzowej nosa, gardła i krtani podaje ok. ¾ chorych, jednak nie zawsze występują one wszystkie i jednoczasowo, jak w infekcjach wywoływanych np. przez rhinowirusy. Z podobną częstością występują Anosmi/hyposmia lub ageusia/hypogeusia. Objawy uszkodzeń układu równowagi, w postaci dizziness zgłasza ok. 1/3, vertigo i niedosłuch ok. 5-6%, szum uszny ok. 10%, pacjentów. Doniesienia o współwystępowaniu z COVID-19 obwodowego niedowładu nerwu twarzowego są na razie stosunkowo nieliczne i często zaliczane do zaburzeń neurologicznych, których częstość wynosi również ok. 1/3 przypadków COVID-19. Co ważne, tak objawy nieżytowe, jak i pozostałe tu wymienione mogą poprzedzać, współwystępować lub następować po wystąpieniu wiodących objawów COVID-19. Mogą być także jedynymi objawami tej choroby. Powinno to skłaniać otorynolaryngologów do szczególnej czujności w tym zakresie.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2021, 10, 2; 18-24
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Persistence of Non-Vertigo Symptoms in Meniere Disease During Remission – A Preliminary Report
    Autorzy:
    Olusesi, Abiodun
    Oyeniran, Olubukola
    Powiązania:
    https://bibliotekanauki.pl/articles/1397442.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    Meniere disease
    Non-Vertigo Symptoms
    remission
    Opis:
    Background: Though the absence of vertigo in Meniere disease is often interpreted as remission, patient-centered subjective assessment of quality of life remains the best indicator of such remission. Study Objective: To assess the presence and severity of aural pressure/tinnitus, hearing loss, unsteadiness, nausea and vomiting in MD patients during remission. Setting: Urban tertiary care referral hospital in a developing country. Methodology: Consecutive patients with diagnosis of Definite Meniere were selected from the Balance and Dizziness Clinic of National Hospital Abuja for the study. Quality of life assessment was carried out using 3 validated tools – Modified MD-POSI, Vertigo Symptom Scale and Tinnitus Handicap Inventory (THI). Patients were included only when they have been vertigo free for at least 4 weeks. Pure tone audiometry was carried out in those with subjective hearing loss at recruitment and 4 weeks later. Results: A total of 26 patients completed the study. All had cinnarizine for acute vertigo control and Betahistine for maintenance of vertigo control. There was female preponderance (17:9). The age range was 32–56 years. The duration of MD ranges from 4 months to 12 years. The total and subscale MD-POSI scores for “between attacks” significantly correlated with hearing, unsteadiness and tinnitus/pressure when compared to during attack. 69.2 per cent of participants experienced symptoms of unsteadiness during remission. 13/26 of participants reported persistent, though less annoying tinnitus that poorly correlated with THI score during remission. Conclusion: Our study showed that significant non-vertigo symptoms affect the quality of life during remission. Perhaps there is need to properly define, in future studies, what constitutes remission in patients with MD.
    Źródło:
    Polish Journal of Otolaryngology; 2020, 74, 4; 31-36
    0030-6657
    2300-8423
    Pojawia się w:
    Polish Journal of Otolaryngology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The Value of Scoring Systems for the Diagnosis of Acute Appendicitis
    Autorzy:
    Walczak, Dominik A.
    Pawełczak, Dariusz
    Żółtaszek, Agata
    Jaguścik, Rajmund
    Fałek, Wojciech
    Czerwińska, Monika
    Ptasińska, Karolina
    Trzeciak, Piotr W.
    Pasieka, Zbigniew
    Powiązania:
    https://bibliotekanauki.pl/articles/1395540.pdf
    Data publikacji:
    2015-02-01
    Wydawca:
    Index Copernicus International
    Tematy:
    acute appendicitis
    scoring systems
    diagnosis
    appendectomy
    symptoms
    signs
    Opis:
    Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis. Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results. Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively). Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis
    Źródło:
    Polish Journal of Surgery; 2015, 87, 2; 65-70
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Applicability of RSI and RFS questionnaires in the Polish language version
    Autorzy:
    Włodarczyk, Elżbieta
    Miaśkiewicz, Beata
    Szkiełkowska, Agata
    Skarzyński, Piotr
    Skarżyński, Henryk
    Powiązania:
    https://bibliotekanauki.pl/articles/1397786.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    – LPR
    laryngopharyngeal reflux
    Reflux Symptoms Index
    Reflux Finding Score
    Opis:
    RSI and RFS questionnaires are a basic and common method used for initial diagnosis of laryngopharyngeal reflux (LPR). However, they only measure symptoms which may or may not be concurrent with LPR. The severity of these symptoms is assessed either by the patients themselves (with the use of the Reflux Symptoms Index – RSI) or by the doctor specialising in the field (with the use of the Reflux Finding Score – RFS). Therefore, the findings of the questionnaire may to a large extent depend on the study population – its demographic and cultural characteristics; the extent to which the medical terms used in the questionnaires are understood; and on the linguistic aspects and translation choices. As for the Polish language versions of these questionnaires, there is no reliable analysis of their consistency and if they reach the assumed goal. The studies we have conducted on a group of 84 patients show that we encounter at least one of the above-mentioned problems. Therefore, to make the questionnaires reliable and useful for diagnosis, it is necessary to conduct a formal validation of their translation and to conduct studies on reference groups.
    Źródło:
    Polish Journal of Otolaryngology; 2019, 73, 1; 17-21
    0030-6657
    2300-8423
    Pojawia się w:
    Polish Journal of Otolaryngology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Selected issues about diagnosis and treatment of the oral mucose membrane
    Autorzy:
    Górska, Renata
    Nowak, Maciej
    Powiązania:
    https://bibliotekanauki.pl/articles/1400242.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    mucous membrane
    oral cavity
    systemic diseases
    changes
    oral symptoms
    Opis:
    Authors, based on current literature and their own clinical practice, have reported the most common oral mucosal lesions, with their clinical presentation, diagnosis and treatment.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2017, 6, 2; 15-24
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    COVID-19 – current clinical data and review of recommendations for otolaryngologists and dentists
    Autorzy:
    Niemczyk, Kazimierz
    Jasińska, Agnieszka
    Krawczyk, Przemysław
    Bilińska, Małgorzata
    Powiązania:
    https://bibliotekanauki.pl/articles/1399175.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    Covid-19
    Dentists
    diagnosis
    Otorynolaryngologists
    prevention
    SARS CoV-19
    symptoms
    Opis:
    Despite multidirectional activities in the sphere of politics, health care and limiting direct interpersonal contacts to a minimum, the Covid-19 pandemic has covered the whole world and the number of new cases is rising exponentially. This demonstrates the considerable severity of the situation. The doctors and other health professionals are and will be at the forefront of the fight against the pandemic, being at the same time the group most at risk of infection. SARS-CoV-2 virus infection applies to patients of all ages, with a median age of 49–59 years. The most common complaints in patients with Covid-19 include fever, caught, dyspnea, general malaise and muscle aches. In the course of Covid-19 may occur pneumonia, which in about 20% of cases is moderately to severe and associated with respiratory distress. Important for otorhinolaryngologists are reports of smell and taste disorders. Post-infective loss of smell can make up about 30% of all patients with Covid-19. The confirmation of SARS-CoV-2 infection in patients with symptomatic or epidemiological suspicion of Covid-19 are genetic tests RT-PCR. Biological material is usually taken from the nose or nasopharynx. The management of Covid-19 is symptomatic because there is currently no specific cure drug. There is a particularly high risk of transmitting infection from a patient to the physicians, who are treating diseases of the respiratory tract or perform any interventions on the upper and lower respiratory tract. Low-symptomatic first stages of the disease with high viral load mean that during a pandemic, scheduled examinations and procedures should be limited. During the examination of patients or their treatment, adequate full PPE protection is indicated, reducing the risk of accidental infection of the treatment team. For the treatment of patients with confirmed SARS-CoV-2 infection or requiring immediate treatment without the possibility of determining epidemiological factors Covid-19, full protection in PPE is obligatory.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2020, 9, 1; 19-27
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Brain metastasis as the first symptom of gastric cancer – case report and literature review
    Autorzy:
    Murawa, Dawid
    Nowaczyk, Piotr
    Szymkowiak, Małgorzata
    Karaszewska, Bogusława
    Powiązania:
    https://bibliotekanauki.pl/articles/1396242.pdf
    Data publikacji:
    2013-07-01
    Wydawca:
    Index Copernicus International
    Tematy:
    gastric cancer
    gastric cancer symptoms
    gastric cancer metastases
    brain metastases
    Opis:
    The study presented a patient with asymptomatic gastric cancer, in whom the first symptom was metastasis to the brain. The patient was initially diagnosed by a neurologist and subject to surgical intervention in the area of residence, where he underwent craniotomy with the excision of the metastatic lesions located in the occipital lobe. The histopathological examination revealed the presence of adenocarcinoma metastases. Following complex diagnostics the patient was diagnosed with cardial carcinoma, being subject to cerebral radiotherapy and chemotherapy. The patient was then referred to surgery at the Wielkopolska Cancer Center in Poznań. After final exclusion of disease dissemination (by means of PET-CT) the patient underwent total gastrectomy with D2 lymphadenectomy, and gastrointestinal tract reconstruction by means of the Roux-en-Y method. The histopathological examination result was as follows: tubular-papillary G2 adenocarcinoma (intestinal type), pT2 pN0 (23 evaluated lymph nodes without cancer metastasis), vascular neoplastic emboli, and positive HER2 protein expression. After surgery the patient was subject to adjuvant chemotherapy. Control brain CT examinations revealed the presence of 4 recurrent metastatic lesions-the patient was disqualified from stereotactic radiation therapy and was subject to palliative chemotherapy. The discussion presented the problem of treating patients with stage IV gastric cancer, including current management guidelines, as well as literature review concerning the treatment of patients with diagnosed gastric cancer and brain metastases.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 7; 401-406
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Laryngological symptoms of gastroesophageal reflux disease
    Autorzy:
    Mierzwa, Grażyna
    Sinkiewicz, Anna
    Powiązania:
    https://bibliotekanauki.pl/articles/1400277.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    gastroesophageal reflux disease
    laryngopharyngeal reflux
    extraesophageal symptoms
    proton pump inhibitors
    treatment
    Opis:
    The artical presents a case of a 32 years old men with extraoesophagal symptoms of gastroesohagal reflux disease and laryngopharyngeal reflux. He was by ph-impedance monitoring, stroboskopy and gastrointestinal endoscopy with biopsy diagnosed. PPI therapy with dexlansoprasole was most efficient.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2017, 6, 2; 70-75
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Vertigo in cerebellopontine angle tumor Patients
    Autorzy:
    Zarębska-Karpieszuk, Paulina
    Bartoszewicz, Robert
    Pierchała, Katarzyna
    Niemczyk, Kazimierz
    Powiązania:
    https://bibliotekanauki.pl/articles/1401828.pdf
    Data publikacji:
    2015
    Wydawca:
    Index Copernicus International
    Tematy:
    acoustic neuroma
    vestibular schwannoma
    vertigo
    imbalance;cerebellopontine angle tumor;symptoms T
    Opis:
    Cerebellopontine angle tumors are a group of tumors that originate from the posterior cranial fossa. Most of them are acoustic neuromas arising from the Schwann cell sheath of the vestibular branch of VIII cranial nerve. Those benign tumors usually present with unilateral hearing loss (53–57%), tinnitus (79–82%), and vertigo/imbalance (18–50%). The objective of this study was documentation-based evaluation of 53 out of 96 patients that received surgical treatment in the ENT Department of Medical University in Warsaw during the period from May 2012 to May 2014, with special consideration of vertigo/imbalance in relation to other symptoms. Statictical analysis has shown larger frequency of vertigo/imbalance in patients with mild to moderate hearing loss and positive corelation between the largest diameter of the tumor and the vestibular deficit in VNG (videonystagmography). The corelation of vestibular deficit in VNG and imbalance symptoms was only estabilished in the group with intrameatal localization of the tumor (T1).
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2015, 4, 4; 27-31
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Acute dyspnea as a manifestation of Forestiers disease. A case report
    Autorzy:
    Kuryłowicz, Jagoda
    Stodulski, Dominik
    Garsta, Ewa
    Mikaszewski, Bogusław
    Powiązania:
    https://bibliotekanauki.pl/articles/1398952.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    acute laryngeal dyspnea
    diffuse idiopathic skeletal hyperostosis
    dysphagia
    Forestier’s disease
    laryngeal oedema
    otolaryngological symptoms
    stridor
    tracheotomy
    Opis:
    Introduction: Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a noninflammatory disease and is characterized by ossification of the anterolateral aspect of vertebral bodies, mostly in thoracic part of the spine. Although, usually, DISH is asymptomatic, in rare cases osteophytes located in the cervical part of the spine can cause otolaryngological manifestations, such as dysphagia (most common), hoarseness and stridor Case report: In differential diagnosis of upper respiratory tract symptoms, we should consider DISH. We present case of 82-years old male patient with acute dyspnea, who was diagnosed with osteophytes of C4–C7 vertebral bodies. In this case conservative therapy was not efficient, therefore successful surgical treatment was performed. BMI – Body Mass IndexCRP – C Reactive Protein CT – computed tomography DISH – diffuse idiopathic skeletal hyperostosis GERD – gastro-esophageal reflux disease MRI – magnetic resonance imaging NSAIDs – nonsteroidal anti-inflammatory drugs ORL PPI – proton pump inhibitors Diffuse idiopathic skeletal hypMRerostosis (DISH), also known as Forestier’s disease, was first described under the name “senile ankylosing hyperostisis of the spine” by Jacques Forestier in 1950 [1]. It is a noninflammatory disease, characterized by ossification of the anterolateral aspect of vertebral bodies, mostly in thoracic part of the spine. It may also involve enthesopathy of the extremities. Forestier’s disease is a rather common condition, which affects approximately 40% of older (>65 years old) male patients. Prevalence of DISH increases with age (56% for age >80 years old), BMI and blood pressure [2] and is associated with diabetes mellitus, elevated insulin-like growth factor and hyperuricemia [3].Although usually DISH is asymptomatic, in rare cases osteophytes located in the cervical part of the spine can cause otolaryngological manifestations, such as dysphagia (most common), hoarseness and stridor [4–10]. null null null null An 82-years old man was admitted to the Department of Otolaryngology due to acute dyspnea with stridor at rest. Respiratory disorder was progressing for 2 months. Moreover, patient complained of dysphagia and hoarseness, which were present for a year. The patient was diagnosed with GERD and treatment was administrated. Medical history was significant of duodenal ulcer with perforation and prostate cancer treated with hormonal therapy for 13 months. Flexible nasopharyngoscopy revealed large mass protruding from the posterior wall of hypopharynx and oedema, which concealed interarytenoid notch and partly rima glottis (Fig. 1.). No other abnormalities in ORL examination were present. Increased CRP level and impaired fasting glucose were found in laboratory tests during hospitalization. CT (Fig. 2.) and MRI (Fig. 3.) revealed massive osteophytes on the anterior part of vertebral bodies C4–C7 without intervertebral disc space narrowing, thickened vestibular folds and peri-arytenoid region. X-ray revealed no changes in sacro-iliac joints. Hypopharyngoscopy and microlaryngoscopy were performed in due to rule out neoplastic changes. Antibiotis, steroids and high doses of PPI (proton pump inhibitors) were administered, resulting in oedema decrease and resolution of the symptoms. After 7 months patient was hospitalized again, due to acute dyspnea and stridor. Increased CRP level was found in laboratory tests. Despite conservative therapy (corticosteroids, antibiotics and PPI) no significant respiratory improvement was achieved, therefore decision on surgical treatment was made. Patient was referred to the Department of Neurosurgery where, after elective tracheotomy, cervical osteophytes (C2–C5) were removed, using an anterolateral transcervical approach, without any complications (Fig. 4.). Because of postoperative laryngeal and hypopharyngeal oedema, steroid therapy was maintained. Decannulation was performed on 7th postoperative day, although patient complained of more severe dysphagia with aspiration while swallowing. Nasogastric feeding tube was inserted for 3 weeks. At the 6-month follow up dyspnea and dysphagia are absent, patient successfully swallows solid food and liquids. Endoscopic examination revealed only small protrusion and minor oedema on posterior wall of hypopharynx on the level of arytenoids (Fig. 5., 6.). null null Forestier’s disease otolaryngological manifestations are extremely rare. The most common symptom is dysphagia, aside from it aspiration [11], dyspnea (with or without stridor) and hoarseness [4].Our patient’s main complaint and reason of hospitalization was dyspnea, while dysphagia was secondary problem. Foregoing symptoms can occur not only due to osteophytes compression on larynx and esophagus, but also because of chronic inflammation and chronic or recurrent edema caused by mechanic irritation. Other symptoms, such as aspiration while swallowing, can be caused by impaired movability of epiglottis or vocal chords [8, 11].In presented case symptoms (especially dyspnoe) were increasing during upper respiratory tract infections and due to exacerbation of GERD.In literature authors described similar cases, where inflammation led to oedema, chronic or remitting during infection, which worsened patient’s condition [12, 13] and caused respiratory decompensation, necessitating even urgent tracheotomy [10].During diagnosis of DISH with otolaryngologic manifestations, mirror laryngoscopy and fiberoscopy should be performed. It can reveal fine, firm protrusion on the posterior wall of pharynx, accompanied by oedema and impaired movability of larynx [8].In differential diagnosis of protrusion on the posterior wall of pharynx we should consider retropharyngeal pathologies, such as malignant tumors (including lymphoma), benign tumors, metastases, congenital defects (e.g. vascular malformations), lymphadenopathy, retropharyngeal abscess or massive oedema. Imaging (CT, MRI) can rule out these diseases [14].Forestier’s disease should also be distinguished from other pathologies, which involve vertebral bodies, including ankylosing spondylitis, osteophytes in osteoarthritis or osteomas [3]. Differential diagnosis can be based on Resnick’s radiological classification criteria of DISH [15]: presence of flowing calcification and ossification along with the anterolateral aspects of at least four contiguous vertebral bodies, relative preservation of intervertebral disc height in the involved vertebral segments and absence of apophyseal joint bony ankylosis and sacro-iliac joint erosion, sclerosis or bony fusion.In cases with dysphagia being the main patient’s complaint, esophagogram with barium swallowing should be performed [5, 9, 11]. Elective panendoscopy with biopsy should always be considered to rule out neoplasm [5, 16].If DISH is diagnosed accidently in imaging, we can assume an expectant attitude. Conservative treatment with NSAIDs, steroids and dietary measures can be introduced in cases without weight loss and with minor respiratory symptoms. Gastroesophageal reflux can be symptom-worsening factor, therefore PPI treatment should be considered. If conservative treatment is not effective, osteophytes’ surgical removal is recommended, preferably using anterolateral approach [16].In our case, conservative therapy was not sufficient. Massive hypopharyngeal oedema and stridor were present in spite of high doses of corticosteroids. Due to the pre-operative oedema we decided to perform an elective tracheotomy before neurosurgical intervention, to avoid possible complications [13].It is remarkable, that after surgery dyspnea resolved after few days, whilst dysphagia and aspiration worsened in post-operative time and nasogastric tube insertion was necessary.Authors present this case in aim to draw attention to Forestier’s disease as possible reason for respiratory and gastrointestinal symptoms among elderly people.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2021, 10, 1; 49-52
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Zastosowanie techniki szybkiego filmu w sekwencji cyfrowej (HSDI) w diagnostyce postaci klinicznej dysfonii u chorych z refluksem krtaniowo-gardłowym (LPR)
    Autorzy:
    Kosztyła-Hojna, Bożena
    Zdrojkowski, Maciej
    Duchnowska, Emilia
    Powiązania:
    https://bibliotekanauki.pl/articles/1397261.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    chrypka
    dysfonia hiperfunkcjonalna
    High Speed Digital Imaging (HSDI)
    obrzęk krtani
    refluks krtaniowo-gardłowy (LPR)
    Reflux Finding Score (RFS)
    Reflux Symptoms Index (RSI)
    Opis:
    Wstęp: Choroba refluksowa przełyku (GERD) może powodować występowanie powikłań pozaprzełykowych, do których należy refluks krtaniowo-gardłowy (LPR). Jest on spowodowany zmianami morfologicznymi w krtani z powodu wstecznego zarzucania treści żołądkowej. LPR ma bardzo bogatą symptomatologię. Nie ma patognomonicznego obrazu krtani dla LPR. W diagnostyce LPR wykorzystywana jest subiektywna skala RSI, oceniająca symptomy w połączeniu z laryngoskopową oceną krtani w skali RFS. Cel: Celem pracy była diagnostyka postaci klinicznej dysfonii u chorych z LPR z wykorzystaniem techniki HSDI. Materiał i metody: Badaniem objęto grupę 72 pacjentów osiągających wynik > 13 w skali RSI i > 7 w skali RFS. Wyniki: Szczegółowa diagnostyka obrazowa techniką HSDI z wykorzystaniem kamery w trybie wysokiej szybkości (HS) i wysokiej rozdzielczości (HR) pozwoliła na precyzyjną obiektywną diagnostykę zaburzeń jakości głosu (dysfonii) o typie organicznym i czynnościowym o charakterze hiperfunkcjonalnym.
    Źródło:
    Polish Journal of Otolaryngology; 2021, 75, 3; 14-20
    0030-6657
    2300-8423
    Pojawia się w:
    Polish Journal of Otolaryngology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
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