Introduction. In 1972, in Poland, Professor Erwin Mozolewski presented a pioneering thesis concerning the creation of intubated voice fistula in a group of 24 patients. It was undoubtedly the prototype of today’s voice prosthesis. Materials and method. The study involved 33 men after total laryngectomy due to advanced squamous cell carcinoma, treated in the Otolaryngology Ward of the District Hospital in Skarżysko-Kamienna between the years 2012–2017, who were implanted with a voice prosthesis Provox II and Provox Vega. Results. During the analyzed period, 127 voice prosthesis were replaced in 33 patients. This paper focuses on complications connected with the implantation of voice prosthesis. The most common reason for replacement of a voice prosthesis was fluid leakage through the voice prosthesis channel – 95 cases. Spontaneous prolapse of the voice prosthesis occurred in 11 patients, and after re-insertion of the prosthesis, the correct fistula voice was obtained. The voice prosthesis was replaced due to difficulty in creating the prosthetic speech in 8 patients. A much more serious complication is the occurrence of leakage around the voice prosthesis. In the examined group, leakage around the prosthesis occurred in 5 patients. An inflammatory plaque was formed around the prosthesis, which was removed in case of significant prosthetic cover or at the request of an alarmed patient – in 4 patients. The prosthesis protruded and rotated in the trachea and hung on a fragment of mucous membrane of the trachea in 1 patient.
Introduction. Ramsay Hunt syndrome is a clinical manifestation of varicella zoster virus reactivation. It is characterized by an erythematous vesicular rash in the external auditory canal and pinna with otalgia, vertigo and ipsilesional facial palsy. Symptoms develop over a few days with prodromal signs of facial weakness, tingling, facial numbness. Usually, cranial nerves VII and VIII are involved in the inflammatory process. Possible consequences of Ramsay Hunt syndrome are hearing loss, encephalitis and meningitis. Description of the case report. The authors present the case of a 63-year-old woman with a vesicular rash, earache, vertigo and left-sided facial paralysis who was treated with antiviral drugs and analgesics. These symptoms were complicated by conductive hearing loss in the left ear and meningitis. After treatment facial paralysis decreased. Unfortunately, hearing loss was permanent. Discussion. Rapid administration of antivirals and corticosteroids limited facial paralysis and improved facial expression. The prognosis for facial palsy is poorer in Ramsay Hunt syndrome than in idiopathic forms. Conclusions. A past history of vertigo and hypertension could been a predisposing factor for the severe manifestation of Ramsay Hunt syndrome and subsequent complications
Introduction. Combined aplasia of multiple sinuses is extremely rare. Agenesis of the paranasal sinuses is an uncommon clinical condition that appears mainly in the frontal (12%) and maxillary (5-6%) sinuses. Case report. In this paper, we present the case of a 74-year-old woman with combined frontal and shenoid sinus aplasia accompanied by unilateral maxillary sinus hypoplasia. The findings were confirmed by a computed tomography scan of paranasal sinuses. The reason for admission was persistent headache, numbness of the left cheek and left alveolar process, and occasional nasal blockage. Discussion. The uniqueness of our case is that the patient is an elderly female with combined aplasia of the frontal and sphenoid sinus with hypoplastic maxillary sinuses, whereas previously reported cases were found in children and in young adults. Summary and conclusions. These anomalies can be misdiagnosed as chronic sinusitis or neoplasm. All potential sinus anomalies will have clinical implications and will hinder conventional and functional endoscopic sinus surgery
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