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1.  Auditory cortical activation and plasticity after cochlear implantation measured by PET using fluorodeoxyglucose 
Functional Neurology  2014;29(2):121-125.
The purpose of this study was to evaluate possible relationships between duration of cochlear implant use and results of positron emission tomography (PET) measurements in the temporal lobes performed while subjects listened to speech stimuli. Other aspects investigated were whether implantation side impacts significantly on cortical representations of functions related to understanding speech (ipsi- or contralateral to the implanted side) and whether any correlation exists between cortical activation and speech therapy results. Objective cortical responses to acoustic stimulation were measured, using PET, in nine cochlear implant patients (age range: 15 to 50 years). All the patients suffered from bilateral deafness, were right-handed, and had no additional neurological deficits. They underwent PET imaging three times: immediately after the first fitting of the speech processor (activation of the cochlear implant), and one and two years later.
A tendency towards increasing levels of activation in areas of the primary and secondary auditory cortex on the left side of the brain was observed. There was no clear effect of the side of implantation (left or right) on the degree of cortical activation in the temporal lobe. However, the PET results showed a correlation between degree of cortical activation and speech therapy results.
PMCID: PMC4198160  PMID: 25306122
central nervous system; cochlear implant; neural plasticity; positron emission tomography
2.  Kimura's Disease in a Caucasian Female: A Very Rare Cause of Lymphadenopathy 
Case Reports in Otolaryngology  2014;2014:415865.
Introduction. Kimura's disease is a rare chronic inflammatory disorder characterized by the head and neck lymphadenopathy often accompanied by eosinophilia and elevated serum IgE. It is benign condition with unknown etiology usually affecting young men of Asian race. Affected Caucasians are very rare. Case Presentation. We report a clinically and histopathologically typical case of this disease in a 40-year-old Caucasian female. In differential diagnosis particular attention has been paid to angiolymphoid hyperplasia with eosinophilia and neoplasms. Conclusion. The diagnosis of Kimura's disease can be very difficult and misleading; it is important not to ignore histopathological features. The presented patient has been under follow-up with no more symptoms of the disease for the last 1.5 years.
PMCID: PMC4052045  PMID: 24955268
3.  Clinical Use of Skull Tap Vestibular Evoked Myogenic Potentials for the Diagnoses of the Cerebellopontine Angle Tumor Patients 
BioMed Research International  2014;2014:135457.
Objective. To document our experiences using a new skull tapping induced Vestibular Evoked Myogenic Potentials (tap VEMPs) technique combined with standard Auditory Vestibular Evoked Myogenic Potentials (AC VEMPs) for advanced clinical assessment of cerebellopontine angle tumor (CPAT) patients. Design and Study Sample. Three patients were selected in order to highlight observations shown in a larger patient population and to show the variability of the findings. Both tap VEMPs and AC VEMPs were acquired from the sternocleidomastoid muscle (SCM) with EMG-based biofeedback and monitoring. Results. The usefulness of VEMPs was demonstrated, indicating the presence of a tumor and contributing additional information as to the involved nerve bundles in two out of the three cases. Conclusion. Due to the sensory organ dependency and related innervations differences, acquiring both AC VEMPs and tap VEMPs is likely to increase the probability of diagnosing CPATs and provide more information on the involved vestibular nerve bundles. This study demonstrates the feasibility of the possible expansion and combination of tap VEMPs and AC VEMPs techniques into a clinical diagnostic battery for advanced assessment of CPAT patients and its contribution as a guideline for the use of tap VEMPs in general.
PMCID: PMC3996892  PMID: 24804198
4.  Is cochlear implantation a good treatment method for profoundly deafened elderly? 
To assess the benefits of cochlear implantation in the elderly.
Patients and methods
A retrospective analysis of 31 postlingually deafened elderly (≥60 years of age) with unilateral cochlear implants was conducted. Audiological testing included preoperative and postoperative pure-tone audiometry and a monosyllabic word recognition test presented from recorded material in free field. Speech perception tests included Ling’s six sound test (sound detection, discrimination, and identification), syllable discrimination, and monosyllabic and multisyllabic word recognition (open set) without lip-reading. Everyday life benefits from cochlear implantation were also evaluated.
The mean age at the time of cochlear implantation was 72.4 years old. The mean postimplantation follow-up time was 2.34 years. All patients significantly improved their audiological and speech understanding performances. The preoperative mean pure-tone average threshold for 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz was 110.17 dB HL. Before cochlear implantation, all patients scored 0% on the monosyllabic word recognition test in free field at 70 dB SPL intensity level. The postoperative pure-tone average was 37.14 dB HL (the best mean threshold was 17.50 dB HL, the worst was 58.75 dB HL). After the surgery, mean monosyllabic word recognition reached 47.25%. Speech perception tests showed statistically significant improvement in speech recognition.
The results of this study showed that cochlear implantation is indeed a successful treatment for improving speech recognition and offers a great help in everyday life to deafened elderly patients. Therefore, they can be good candidates for cochlear implantation and their age alone should not be a relevant or excluding factor when choosing candidates for cochlear implantation.
PMCID: PMC3794868  PMID: 24124356
cochlear implantation; elderly; audiometry; speech perception; speech recognition; hearing loss; hearing aid
6.  Voice evaluation following endoscopic laser CO2 cordectomy and conventional cordectomy  
An analysis of long term voice quality outcomes of two different types of surgical intervention for Tis and T1 glottic carcinoma: laryngofissure conventional cordectomy and endoscopic laser CO2 cordectomy, with or without additional radiation therapy.
Material and methods
Total of 46 patients with Tis and T1 glottic carcinoma served as subjects. All have been treated surgically with laryngofissure conventional cordectomy (32.61%) or endoscopic laser CO2 cordectomy (67.39%). The surgeries were performed in the Department of Otolaryngology at the Medical University of Warsaw (1990-2004). The presented voice assessments were made at least 3 years following the surgery, in between January 2006 and February 2007.
In patients after the endoscopic laser CO2 cordectomy the following findings are more often observed: the unrestrained voice production, wider range of Fo in a spoken sentence, longer maximum phonation time, better intensity of phonation for normal and loud speaking, lower degree of hoarseness based on the Yanagihara’s classification, and the lower VHI. No significant influence of the performed additional radiotherapy on voice parameters was found.
Patients after endoscopic laser CO2 cordectomy, compared to laryngofissure conventional cordectomy, present better voice quality. The amount of the excised vocal fold tissue, which in our study was slightly larger in case of the conventional cordectomy, could account for the results mentioned above. This may also be explained by the necessity of the anterior thyrotomy, which is required for conventional cordectomy via external approach, and often results in anterior synechia and level difference between the neocord and the contralateral vocal fold.
PMCID: PMC3258680  PMID: 22291748
glottic carcinoma; voice quality; spectrography; acoustic analysis of voice
7.  Videolaryngoscopic and videostroboscopic evaluation following laser CO2 and conventional cordectomy of Tis and T1 glottic carcinoma 
This paper is an analysis of long-term functional results, observed on videolaryngoscopic and videostroboscopic examination, of two different types of surgical intervention for Tis and T1 glottic carcinoma: laryngofissure conventional cordectomy and endoscopic laser CO2 cordectomy, with or without additional radiation therapy (using 60Co).
Material and methods
A total of 46 patients with Tis and T1 glottic carcinoma, 43 men (93.48%) and 3 women (6.52%), served as subjects. All were treated surgically with laryngofissure conventional cordectomy (15 patients, 32.61%) or endoscopic laser CO2 cordectomy (31 patients, 67.39%). The procedures were performed in the Department of Otolaryngology at the Medical University of Warsaw between November 1990 and February 2004. Videolaryngoscopic and videostroboscopic examinations were conducted a minimum of 3 years after the surgery, between January 2006 and February 2007. The appearance of the neocord (the scar after cordectomy), scar or synechia formation in the anterior commissure, movements of the vocal folds on respiration and phonation, difference in level between the neocord and the normal vocal fold, glottic closure, phonation type, and ventricular folds hyperfunction were examined. The symmetry of vocal fold vibrations, regularity of vibrations, glottic closure, amplitude of vibrations, and mucosal wave were also evaluated.
In our study, the videolaryngoscopic and videolaryngostroboscopic examination showed a significantly higher occurrence of the following findings in patients after endoscopic laser cordectomy: phonation at the glottic level, complete glottic closure, and a tendency to vibration of the neocord on phonation.
Ventricular hyperfunction on phonation and scar or synechia formation in the anterior commissure were observed statistically more frequently in patients after laryngofissure conventional cordectomy.
PMCID: PMC3284081  PMID: 22371810
glottic closure; ventricular hyperfunction; anterior commissure; vocal fold vibrations; mucosal wave

Results 1-7 (7)