New Medicine最新文献

{"title":"Indications for tympanostomy tube insertion in children","authors":"M. Wolniewicz, L. Zawadzka-Głos","doi":"10.25121/newmed.2019.23.2.49","DOIUrl":"https://doi.org/10.25121/newmed.2019.23.2.49","url":null,"abstract":"Introduction. Tympanostomy tube insertion is one of the basic paediatric otolaryngological procedures. Otitis media with effusion (OME) is the primary indication for elective qualification for this procedure. Currently, there are no recommendations suggesting pharmacotherapy for effusion. In cases of recurrent otitis media or acute complications of otitis media, tube insertion is a method of choice to support systemic antibiotic therapy. Aim. The main aim of this study was to evaluate indications for tympanostomy tube insertion. Secondary aims included characteristics of the study population and an intraoperative assessment of the tympanic membrane. Material and methods. We conducted a retrospective analysis of ear tube placement procedures performed in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw between January 1, 2018 and December 31, 2018. Results. A total of 213 children (aged between 2 months and 18 years) underwent tympanostomy tube insertion and a total of 368 tubes were placed due to otitis media with effusion in 2018 in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw. Elective tube insertion accounted for 69.48% of procedures. Recurrent otitis media (22.07%), complications of acute otitis media and, most of all, acute mastoiditis (23.33% of urgent procedures) came second. In a large majority of cases, Mikolow tympanostomy tubes were placed; in isolated cases, long-term tympanostomy tubes were used (14 T-tubes, 7 Paparella tubes). Mucous effusion dominated (62.44%). Ear tube placement alone was performed in more than half of cases (62.44%), while in 1/3 of patients the procedure was combined with adenoidectomy. Microscopically confirmed tympanic lesions indicative of advanced inflammation were found in 28 patients (13.14%). Conclusions. Although commonly accepted, tympanostomy tube insertion is not devoid of negative consequences. Possible complications include persistent tympanic perforation, tympanosclerosis, premature extrusion of an ear tube, ear discharge, tube obstruction and, in some cases, the need for surgical tube removal. Therefore, the procedure requires permanent and systematic otolaryngological care.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46319435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenoidectomy and adenotonsillotomy in patients treated in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018 – a retrospective analysis","authors":"Tomasz Lis, L. Zawadzka-Głos","doi":"10.25121/newmed.2019.23.2.43","DOIUrl":"https://doi.org/10.25121/newmed.2019.23.2.43","url":null,"abstract":"Introduction. Adenoidectomy and adenotonsillotomy are among the most common surgical procedures worldwide. Sleep-related breathing disorders and recurrent upper respiratory tract infections are two primary categories of indications for adenoidectomy and adenotonsillotomy. Aim. The aim of this study was to analyse selected adenoidectomy and adenotonsillotomy procedures performed in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018. Material and methods. A total of 474 patients aged between 11 months and 18 years, who underwent adenoidectomy and adenotonsillotomy in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018, were included in the study. Data on age, gender, length of hospital stay, as well as additional diagnoses in adenoid hypertrophy or adenoid and palatine tonsil hypertrophy were collected. Minor surgeries performed in addition to tonsillectomy were also evaluated. Results. A total of 472 patients underwent adenoidectomy and adenotonsillotomy in 2018. Adenotonsillotomy was almost twice more common. Tonsillar hypertrophy was accompanied by exudative otitis media in almost 1/3 of children, and ear ventilation tubes were needed in almost 1/5 of children. Mean hospital stay equaled 4.19 ± 1.44 days. Conclusions. We have shown that adenotonsillotomy was the most common procedure in the Department of Paediatric Otorhinolaryngology. Exudative otitis media was the most common concomitant diagnosis, and middle ear ventilation was the most common additional procedure. Hospital stay usually lasted 3 days.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41685200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-induced pneumoparotitis – a rare case report","authors":"Karolina Raczkowska-Łabuda, Monika Jabłońska-Jesionowska, Jolanta Jadczyszyn, M. Frąckiewicz, M. Pilch, L. Zawadzka-Głos","doi":"10.25121/NEWMED.2019.23.2.60","DOIUrl":"https://doi.org/10.25121/NEWMED.2019.23.2.60","url":null,"abstract":"Pneumoparotitis (pneumoparotiditis, pneumosialoadenitis) is a rare and frequently misdiagnosed condition. Signs of subcutaneous emphysema in parotid gland, the neck or the mediastinum are alarming symptoms that should be promptly addressed. Computed tomography, which is the gold diagnostic standard, may be successfully replaced with ultrasonography in the paediatric population. Sialography has a complementary role in the imaging of the gland, and allows for parotid duct irrigation to remove deposits and prevent recurrent inflammation. The paper presents a case of a 12-year-old boy who deliberately inflated his both parotid glands for about 6 months, and thus developed parotid pneumatocele with a diameter of about 25 mm. Diagnostic imaging was extended to include autoimmune diseases. Detailed family history was obtained. Conservative treatment, including dexamethasone irrigation of the Stensen’s duct, was used and the symptoms fully resolved. A 3-month follow-up showed no increase in the size of pneumatocele or episodes of parotiditis.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42352549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faciocranial complications of sinusitis","authors":"M. Michalik, Adrianna Podbielska-Kubera","doi":"10.25121/newmed.2019.23.1.23","DOIUrl":"https://doi.org/10.25121/newmed.2019.23.1.23","url":null,"abstract":"Sinusitis is one of the most common conditions. The aetiology of sinusitis has not been fully discovered; however, viruses and bacteria are usually the dominant causes. The chief symptoms include nasal congestion, profuse nasal discharge and a compromised sense of smell. Inflammation of any sinus can be the source of complications. Complications develop usually as a result of exacerbation of chronic sinusitis. Sinusitis may result in inflammation spreading inside the cranium and to the orbital area and in the development of osteomyelitis or superior sagittal sinus thrombosis. Due to the anatomical location and proximity of important structures, sphenoid sinusitis may lead to meningitis or subdural empyemas, temporal lobe abscesses and cavernous sinus thrombosis. Fungal sinusitis is very dangerous since it is characterised by a rapid course often complicated by intracranial and orbital spread. Invasive fungal paranasal sinusitis with orbital complications is a life-threatening emergency. If there is concern about possible orbital or intracranial complications of sinusitis or if there is no improvement after initial empirical therapy, the use of diagnostic imaging is necessary, including computed tomography and magnetic resonance imaging. Early diagnosis of sinusitis and multidisciplinary management involving a combination of antibiotic therapy and surgical treatment, including neurosurgery and maxillofacial procedures can be effective in the prevention of complications and may significantly reduce morbidity and mortality.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44730722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of paediatric patient with nasal bone fracture","authors":"Małgorzata Palac-Siczek, M. Pilch, L. Zawadzka-Głos","doi":"10.25121/newmed.2019.23.1.14","DOIUrl":"https://doi.org/10.25121/newmed.2019.23.1.14","url":null,"abstract":"Introduction. The nose is one of the most frequently injured areas on the face both in children and adults. The evaluation of paediatric patients with nasal injury is a challenge, and it often requires repeated physical examinations before referring the patient for surgical treatment. Nasal bone injury can either be isolated (prevalent type) or constitute an element of multiple-site facial injury. Essential aspects associated with the surgical treatment of nasal bone injuries include the timing of surgical intervention and adherence to meticulous surgical technique. Both factors are often implicated in treatment outcome and hence determine the final appearance of the nose and its function. Aim. The aim of study is to analyse the relation of patients age and sex compared to mechanism of trauma with paediatric patients. This study also analysed the length of period from injury to surgical intervention and time of hospitalization needed. Material and methods. The present paper contains an analysis of a total of 54 cases of children aged 2 to 17 years, who were operated on because of nasal bone injury in the Department of Paediatric Otolaryngology, University Clinical Centre in Warsaw, in the period from 1.01.2018 until 31.03.2018. The analysis is based on the medical records of the study patients. Results. The majority of cases were boys (65%). With respect to age, 4- and 5-year-olds, and 14-year-olds, were the predominant subgroups (13% of all cases, respectively). The dominant mechanisms of injury included falls (41%), beating (24%) and sports activities (26%). The patients typically underwent a surgical procedure on days 6-8 after the injury (65%), and the period of hospitalization was 2 days (69%). Conclusions. The most common nasal trauma of pediatric patient, majority boys, is the isolated fracture of nasal bone related to sports injury and beating. The fracture can be resettled mostly within one week after trauma and hospitalization takes one to two days.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41577625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic evaluation of congenital respiratory stridor in children","authors":"Monika Jabłońska-Jesionowska, L. Zawadzka-Głos","doi":"10.25121/newmed.2019.23.1.3","DOIUrl":"https://doi.org/10.25121/newmed.2019.23.1.3","url":null,"abstract":"Introduction. Congenital respiratory stridor in children is the result of respiratory tract pathology located at various anatomical levels. There is an ongoing debate on whether every case of stridor requires diagnostic evaluation and which method is the most effective for determining the final diagnosis. Aim. The aim of the present study is to answer the question which procedure should be performed to diagnose the casuse of congenital stridor in children and why, and what the most common cause of the stridor is. Material and methods. A group of 110 children examined due to congenital respiratory stridor was analysed. The children’s general condition was assessed and imaging studies and lower respiratory tract endoscopy were performed under general anaesthesia. In some children cardiac ultrasound and contrast-enhanced radiographic examination of the oesophagus or contrast-enhanced computed tomography scan of the chest were performed. Results. Children aged 3 days to 11 years were analysed. The most common cause of stridor was congenital laryngeal hypotonia found in 50% of children and the second most common was abnormalities of the great arteries in 28% of children. Biphasic stridor, which may be a sign of multiple respiratory abnormalities, was diagnosed most frequently. It was only lower respiratory tract endoscopy performed under general anaesthesia that made it possible to make the right diagnosis. Conclusions. The most useful diagnostic method for congenital respiratory stridor is lower respiratory tract endoscopy under general anaesthesia, which is used to evaluate both the larynx and the trachea since defects may coexist at various respiratory levels. It is also for this reason that the type of stridor is not tantamount to the level at which the pathology is located in the respiratory tract. One needs to bear in mind that abnormalities of the great arteries may also be the cause of congenital respiratory stridor.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48491095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corynebacterium pseudodiptheriticum – a dangerous respiratory pathogen. A case report","authors":"M. Michalik, Adrianna Podbielska-Kubera, A. Samet, A. Dmowska-Koroblewska, M. Broda","doi":"10.25121/newmed.2018.22.4.147","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.4.147","url":null,"abstract":"We believe that an insufficient role is attributed to bacteria belonging to the genus Corynebacterium in the pathogenesis of chronic sinusitis. These strains are treated as contaminants in most cases. Meanwhile, Corynebacterium strains may be a clinically significant pathogenic agent, especially in cases where samples are collected from the lower respiratory tract in symptomatic patients. Corynebacterium strains can survive in the form of biofilms in hospitals and cause multi-resistant infections. We present a rare case of Corynebacterium pseudodiptheriticum infection. The patient was a 10-year-old girl who complained of recurrent rhinitis and sinusitis. Adenoidectomy and functional endoscopic sinus surgery were performed. The patient returned for a consultation after six months due to exacerbation of the disease symptoms lasting for 2 weeks (inflow of thick secretions difficult to expectorate). Corynebacterium pseudodiptheriticum and Staphylococcus epidermidis were cultured from swabs. The patient was treated with ciprofloxacin, and her condition improved. The described case points to the need to identify strains of a given species and to pay attention to species commonly considered as commensals that may contribute to serious complications.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48531554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral antrochoanal polyp: case report, literature review and clinical guidelines","authors":"A. Wasilewska, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.4.155","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.4.155","url":null,"abstract":"Antrochoanal polyps are unilateral benign lesions that arise within the maxillary sinus antrum. The purpose of this study was to review the clinical characteristics and treatment of antrochoanal polyp (ACP). A retrospective analysis was performed to investigate the case of one patient with an extremely rare bilateral polyp with a high incidence of recurrence. ACPs account for approximately one-third of polyps occurring in children. Most of them are unilateral. The recurrent course of ACP is more prevalent in the paediatric population than in adults. ACPs require differential diagnosis with malignancies. The mainstay of treatment is surgery. The gold standard is endoscopic sinus surgery with complete removal of polyp mass under endoscopic control and widening of the maxillary sinus ostium via the middle meatus. Postoperative follow-up of at least 2 years is very important to monitor patients for recurrence.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49322578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial flora in chronic sinusitis in children","authors":"M. Michalik, Adrianna Podbielska-Kubera, M. Pawlowska, Jolanta Miazga","doi":"10.25121/newmed.2018.22.4.135","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.4.135","url":null,"abstract":"Chronic rhinosinusitis is one of the main causes of morbidity in the paediatric population. The aetiology of chronic sinusitis (CS) is still investigated. Most cases of chronic sinusitis develop from unresolved acute sinusitis. Acute sinusitis is usually associated with one species of bacteria (most often aerobic), whereas chronic sinusitis is dominated by a mixed bacterial flora including 2-3 bacterial strains. The most common pathogens in chronic sinusitis are S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, coagulase-negative staphylococci, as well as Gram-negative bacteria, such as Pseudomonas aeruginosa, Proteus spp., Klebsiella spp., Enterobacter spp., Escherichia coli and anaerobic bacteria. Staphylococci predominated in the study group of patients: 36 strains of S. aureus and 31 strains of S. epidermidis were isolated. Typical respiratory pathogens were practically absent, and constituted only a small percentage of all isolated microorganisms. Full diagnosis and treatment of patients with chronic sinusitis should include laryngological, microbiological, allergological, biochemical, and histopathological consultations as well as diagnostic imaging. Isolation of materials with high diagnostic value (aspirates, tissues) is very important. The selection of appropriate antibiotic therapy, in addition to assessing bacterial resistance to antibiotics, may require the determination of virulence traits of cultured strains.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42068972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreign bodies in the oesophagus on the example of patients of the Department of Paediatric Otolaryngology at the Medical University of Warsaw","authors":"Małgorzata Badełek-Izdebska, L. Zawadzka-Głos","doi":"10.25121/newmed.2018.22.4.119","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.4.119","url":null,"abstract":"Introduction. Foreign bodies in the oesophagus are one of the more frequent non-infectious reasons for a child’s visit to the hospital emergency room. Most often, children swallow items accidentally while having fun, learning about the world with the help of their senses, as well as when eating meals. It is coins, plastic or metal fragments of objects that are usually swallowed. Also, hard pieces of food may stick to the oesophagus. Aim. The aim of the study was to analyse clinical symptoms as well as diagnostic and therapeutic procedures in patients with suspicion of the presence of a foreign body in the oesophagus. Material and methods. The authors analysed clinical data of 49 patients hospitalized in the Department of Paediatric Otolaryngology at the Medical University of Warsaw due to the suspicion or presence of a foreign body in the oesophagus. What was also analysed, was the diagnostic and therapeutic process during which the initial diagnosis was confirmed or excluded. Results. The authors analysed the symptoms with which patients came to the hospital, the diagnostic and therapeutic procedures used and the results of treatment. Attention was paid to diagnostic difficulties that may be encountered by a physician in the Admission Room, and then an otolaryngologist qualifying the patient for interventional treatment or deciding on conservative procedures. Possible complications that may occur during ezophagoscopy are described. Conclusions. Foreign bodies in the oesophagus are a common problem in the paediatric population. The most common foreign objects are coins, metal or plastic items or food. The most dangerous foreign objects are disc batteries and sharp, large objects. Diagnostic imaging includes chest and neck X-ray, and in the case of non-contrasting bodies – X-ray with barium or a cotton ball soaked in contrast. The presence of clinical symptoms and/or imaging results suggesting the presence of a foreign body in the oesophagus is an indication for oesophageal endoscopy under general anaesthesia. Both rigid esophagoscopy and the use of a flexible fiberscope are burdened with a certain degree of risk, of which the parents should be informed before those are performer.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49151257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}