REEW ARCE 100 years of the Department of Otolaryngology

1DOI: 10.5604/01.3001.0014.6344

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POL OTORHINO REV 2020: 9 (4): 1-10

100 years of the Department of Otolaryngology, Head & Neck Surgery at the Medical University of WarsawStulecie Kliniki Otorynolaryngologii, Chirurgii Głowy i Szyi Warszawskiego Uniwersytetu Medycznego

Kazimierz Niemczyk, Antoni Bruzgielewicz, Ewa Osuch-Wójcikiewicz, Piotr Chęciński, Katarzyna Pierchała, Robert BartoszewiczChair and Clinic of Otorhinolaryngology, Head and Neck Surgery at the Medical University of Warsaw, Poland; Head: prof. Kazimierz Niemczyk MD PhD

Article history: Received: 03.11.2020 Accepted: 27.12.2020 Published: 05.01.2021

ABSTRACT: January 15, 2021 marks a hundred years from the establishment of the Clinic of Otorhinolaryngology, Head and Neck Surgery at the Medical University of Warsaw. The authors representing the oldest generations of the current Team present the history of the Clinic from the foundation until the present day. The main achievements throughout history and selected activities of the currently working Team are described.

KEYWORDS: Chair and Clinic of Otorhinolaryngology, clinic achievements, Development of Academic Otorhinolaryngology

STRESZCZENIE: 15 stycznia 2021 r. mija sto lat od założenia Kliniki Otorynolaryngologii, Chirurgii Głowy i Szyi Warszawskiego Uniwersytetu Medycznego. Autorzy reprezentujący najstarsze pokolenia aktualnego Zespołu przedstawiają losy Kliniki od jej założenia po dzisiejsze czasy. W niniejszej pracy opisane zostały najważniejsze osiągnięcia na przestrzeni dziejów oraz wybrane aktywności pracującego obecnie Zespołu.

SŁOWA KLUCZOWE: Katedra i Klinika Otorynolaryngologii, osiągnięcia kliniki, rozwój otorynolaryngologii akademickiej

The development of academic otorhinolaryngology in Warsaw is undoubtedly associated with the establishment of the Depart-ment of Ear, Nose and Throat Diseases (in later years the concept of the Department and Clinic was equivalent and in most cases the term “Clinic” prevailed). By the decision of the Ministry of Religious Denominations and Public Enlightenment of April 21, 1920, the Department was established on June 1, after awarding the title of associate professor of laryngology to Dr. Feliks Erbrich (1874–1938), head of the ENT outpatient clinic at the Hospital of the Holy Spirit in Warsaw (Fig. 1., 2.) [1, 2]. On October 1, Pro-fessor F. Erbrich began lecturing in otorhinolaryngology for stu-dents of the Faculty of Medicine at the University of Warsaw [3].

The grand opening of the Clinic and the official start of operation at Elektoralna 12 Street in Warsaw (Fig. 3.) took place on January 15, 1921; the event was honored with the inaugural lecture by Pro-fessor Feliks Antoni Erbrich [4, 5].

The newly established Clinic was most probably given the official name Laryngeo-Otiatric Clinic of the University of Warsaw (Fig. 4.).

Fig. 1. (A, B) The decision to confer the title of Professor Extraordinary upon Feliks Erbrich [2].

A

B

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WWW.OTORHINOLARYNGOLOGYPL.COM2

Since its inception, the Clinic was located together with the Eye Clinic in Pavilion IV on the ground floor in a site separated from the building complex of the Hospital of the Holy Spirit at Elekto-ralana 12 Street.

Initially, the Clinic consisted of: two patient rooms, one opera-ting room and three rooms for examining and admitting patients. Thanks to the expansion of the Clinic, the number of beds incre-ased over time – from 20 at the opening to 72 just before the war.

In March 1934, Professor F. Erbrich opened a counselling center at the Clinic for patients with speech disorders and hearing impa-irments, a scientific phoniatric facility, equipped with good equip-ment, and appointed Dr. Aleksandra Stępowska-Mitrynowicz as the head of the clinic. It was the first clinic of this type in Poland.

Professor Feliks Erbrich, Bronisław Grocholski, Stanisław Tuz, Jerzy Rogoziński were the first full-time employees of the Cli-nic. Over time, the Clinic’s team was joined by other employees who worked as academic teachers in different years. According to studies from various years of the publication “Composition of the University and List of Lectures at the University of Warsaw”, the teaching staff included, in addition to the above-mentioned: [6–31] Ludwik Abramowicz, Jan Marcin Godlewski, Henryk Le-wenfisz-Wojnarowki, Aleksandra Salomea Mitrynowicz (Mitri-novič) – Modrzejewska p.v. Stępowska, Jan Srebrny, Jan Duklan Szymański, Dionizy Jakub Zuberbier.

During this time, there were 119 papers published in Polish and foreign journals and conference materials, as well as 3 monogra-phs and scripts, and 4 chapters in textbooks.

In 1938, in the face of ill health of Professor Feliks Antoni Erbrich, the Council of the Faculty of Medicine instructed Dionizy Zuber-bier to lead the Clinic (1900–1940?). The announced competition for the position of the Head of the Clinic was won in April 1939 by Professor Antoni Dobrzański (1893–1953) [32].

Until September 25, 1939, the clinic was located in the building of the Hospital of the Holy Spirit at Elektoralana 12 Street. As a re-sult of military actions, on September 25 during Easter Monday, the Hospital of the Holy Spirit was destroyed (Fig. 5.).

At that time, the Clinic was headed by Dr. Jan Duklan Szy-mański, because its Head Professor Antoni Dobrzański was staying in Lviv (the clinic was to be taken over on October 1, 1939), while doc. Dionizy Zuberbier (carrying out the du-ties of Head of the Clinic) took up his duties with the service at the Polish Red Cross Hospital at the outbreak of World War II. On October 20, 1939, at its last session, the Medical Faculty Co-uncil of the University of Warsaw commissioned Dr. J. Szymański to run the Clinic for an indefinite period. Dr. J. Szymański was in charge of the Clinic during the shelling and bombardment, and with his team, he saved not just the sick, but also the set of instru-ments, book collection and documents of the Polish Otolaryngo-logical Society [35, 36].

Fig. 2. The bust of Professor F. Erbrich made by E. Wittig (from the historical archives of the Clinic).

Fig. 3. Hospital of the Holy spirit Elektoralna 12 Street, Warsaw, 1930s (from the archives of the Museum of Warsaw).

Fig. 4. Stamp of the clinic (from the historical archives of the Clinic).

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Fig. 5. Hospital of the Holy Spirit after bombing, Elektoralna 12 Street, Warsaw [38].

Fig. 6. Villa “Bożenka”, condition before World War II, Spacerowa 3 Street, Milanowek [38].

J. Szymański, F. Burska-Silver, J. Błeszyńska and L. Koenigstein, who was heroically killed at the Warsaw Uprising years later, and senior paramedics: S. Paśnik, J. Gastoł and Z. Staniszewska [33].

After the ghetto was formed in November 1940, at the beginning of 1941 the Clinic (municipal department) was transferred to the Infant Jesus Clinical Hospital; it was located in the superstructure of the pavilion of the II Clinic of Internal Medicine.

On August 25, 1944, the Clinic was evacuated to Tworki, and in October to Milanówek, from where the staff visited Warsaw three times in order to evacuate the remaining inventory of the Clinic. Initially, part of the clinical inventory, mainly the library and equ-ipment (walkie-talkie, “Sollux” quartz lamp, 2 ionization devices, long-wave diathermy, electric centrifuge, bronchoscopes and others) were evacuated to Tworki, and later to Milanówek [37]. Most li-kely, the Otolaryngology Clinic was located in Milanówek in the villa “Bożenka” at Spacerowa 3 Street (photograph 6), although the hospital had a subdivision in the primary school at Królewska 69 Street and in the villa “Kresy” [39]. The main participants in this move were: Jan Szymański, Antoni Dobrzański and student Henryk Czarnecki.

Since the autumn of 1939, professors and assistants of the Facul-ty of Medicine at the University of Warsaw conducted undergro-und teaching and training; there were credits and examinations.

In November 1939, the Otolaryngology Clinic began to admit the first groups of students. Already in 1939, after a brief internship at the Clinic, medical graduates and 6th-year students were taking their final exams. By the end of the first half of 1940, 180 medical students and 30 graduates of the Dental Academy (formerly the State Institute of Dentistry) showed a satisfactory level of know-ledge in this subject.

In December 1941, with the consent of the secret University Au-thorities, the management of the Clinic and of the secret teaching of otorhinolaryngology in Warsaw was taken over by Professor A. Dobrzański from the hands of Dr. J. Szymański. As it was men-tioned above, the position of the head of the Clinic was supposed to be assumed by A. Dobrzańśki, but he was stopped by the war and the German-Soviet border in Lviv [36, 40]. From January 1942, after the Clinic had been taken over by Professor A. Dobrzański, there began regular and planned teaching of students who had completed their first years of medical studies at secret courses at the University of Warsaw, the University of the Western Lands and the Zaorski School.

The lectures and exercises were conducted by the entire team of professor Antoni Dobrzański’s assistants – Eugeniusz Błeszyń-ski, Jan Szymański, Aleksander Zakrzewski and volunteers Irena Cichocka, Leon Jastrzębski, Roman Karwowski, Stanisław Kmita, Zbigniew Kostuch, Edmund Mroczek, Jan Posmykiewicz. In the light of the limited number of places, the professor sent some of the groups for student exercises to other hospitals. The secret te-aching of otorhinolaryngology was attended at other institutions by – Stanisław Ankudowicz, Roman Cioch, Wacław Kafliński, Wacław Kuśnierczyk, Professor Jan Szmurło at the Ujazdowski

When the German army entered the lands of the Republic, the Department shared the fate of the University of Warsaw – it was liquidated, and the Clinic, as a department of the municipal ho-spital, was moved to the Law Courts Building in Leszno.

Rescued tools and apparatuses as well as the Clinic’s rescued libra-ry were moved there. This move was performed by the clinic’s do-ctors themselves, who saved the remains of the surviving property:

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Hospital, Tadeusz Gerwel, Kazimierz Królikiewicz at the Hospi-tal of the Holy Spirit and in the ghetto by Henryk Lewenfisz [41].

Since 1941, 9 major scientific projects have been completed, and in addition, the monograph “O twardzieli” (transl. “On scleroma”) and a textbook for doctors and students were published. All of it was burned down in the professor’s private apartment during the Uprising. Some of the works by Professor A. Dobrzański, A. Za-krzewski, Z. Kostuch and J. Kmita were recreated and published in later years. Professor Dobrzański also took part in the activities of the secret Council of the Faculty of Medicine [42, 43].

After the war, from April 1945 in Prague under the supervision of Professor A. Dobrzański and four assistants, the Clinic undertook systematic scholarly activities (Fig. 7.).

In August 1945, the branches of the Clinic from Milanówek and Grodzisk Mazowiecki began to be moved to prepared rooms and pavilions in the Hospital of the Infant Jesus at Nowogrodzka 59 Street. Although the transfer of the Clinic began in August 1945, and its operation began at the end of 1945, the opening ceremony took place on February 17, 1946. Also, an outpatient clinic was

opened with individual departments: 1. diseases of the ear, nose, throat and larynx 2. injuries, deformities and plastic surgery of the nose, ears and larynx, 3. speech and voice defects, and 4. tubercu-losis of the upper respiratory tract.

The clinic was located in pavilion I and had men’s and women’s departments. Initially, the Clinic had a total of 100 beds, but with time the number of beds was reduced to 76. There were 5 childre-n’s beds next to the women’s ward [44] (Fig. 8.).

A 7-person team led by Professor Antoni Dobrzański started wor-king at the Clinic at the Hospital of the Infant Jesus: Irena Cichoc-ka-Szumilin, Henryk Czarnecki, Stanisław Czernic, Witold Woj-ciech Gadomski, Leon Jastrzębski, Irena Ratajska, Roman Józef Karwowski. In 1946, Dr. Aleksandra Mitrinowicz-Modrzejewska returns to the country and re-organizes a clinical phoniatric faci-lity, which would be the only one in the country for many years. Next, she establishes a Polyclinic Phoniatric Ward at the Clinic and receives a separate room for its organization at Wojciecha Oczki 6 Street.

After his return in 1948 from scientific guards in England, the USA and Sweden, Professor Antoni Dobrzański expanded the operating profile at the Clinic to include the department of facial plastic surgery, nose and ear reconstruction operations, cartilage transplants in plastic surgeries and ozena; he developed otosur-gery and introduced ear operations into practice using J. Lemper-t’s method and surgical treatment of otosclerosis [45]. As one of the first in Poland, the clinic began broad use of penicillin in dise-ases of the ears, pharynx and nose, especially in brain abscesses, while developing its own remarks on the dosage, administration methods and interaction of this antibiotic with other drugs [46]. A method of treating laryngeal papillomas using diathermic over-heating was also developed [47].

In 1951, professor A. Dobrzański started his efforts to create a Science and Research Center in Ciechocinek. The center, focu-sed on the treatment of diseases of the upper respiratory tract, was intended to treat primarily workers in the weaving industry, mills

Fig. 7. Professor A. Dobrzański, nn, Professor F. Czubalski, nn, Professor J. Melanowski, Pro-fessor A. Czyżewicz (from the left) – defense of the doctoral MD I. Cichocka-Szumilin, Warsaw, 1949 (from the historical archives of the Clinic).

Fig. 9. Professor H. Lewenfisz-Wojnarowski and dr. hab. I. Cichocka-Szumilin (in the first row, third and fourth from the left) among the students, Nowogrodzka 59 Street, Warsaw, 1954. Nowogrodzka 59 Street, Warsaw, 1954 (from the historical archives of the Clinic).

Fig. 8. Pavilion No. I at Nowogrodzka 59 Street, where the Otolaryngology Clinic was loca-ted in the 1970s (from the historical archives of the Clinic).


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activities of the Clinic for the period 1946–1962, J. Szymański states that there were 28,656 patients present at the Clinic at that time, 21,936 operations were performed, and 15,000 out-patient procedures were done. At that time, the clinics admit-ted 100,000 patients.

Professor Jan Szymański headed the Clinic until the fall of 1969, when he fell ill. In the period of grave illness, the management of the Clinic was handed over to Professor Zbigniew Bochenek (1923–1977), who was appointed the Head of the Clinic on September 1, 1969. After his return to health, J. Szymański worked in the Clinic until 1973 as the so-called professor “at the Department” (Fig. 11.).

Under the leadership of professor Z. Bochenek, in 1969 the clinic underwent a comprehensive renovation – operating rooms were modernized, sanitary facilities were added, and the basement was used for auxiliary rooms. In 1972, after renovation, the Clinic had 73 beds, including: an Oncology Department with 30 beds (esta-blished on May 29, 1972), a postoperative room with 3 beds (or-ganized in May 1972), 2 operating rooms and 1 treatment room (1st floor). The clinic included the following medical centers: au-diology, phoniatrics, otoneurology (it was the first clinic of this type in Poland), oncology, facial plastic surgery, allergology, and laboratories: audiology (in the basement a laboratory for classical audiology, and then electrophysiology), phoniatrics, otoneurolo-gy (the first laboratory of electronystagmography in Poland was opened as part of the studio), histopathology, transplantology, and photographic documentation.

The clinic’s audiology center was the first in Poland to introduce electrocochleographic tests with the use of the Polish production “ANOPS” averaging computer, impedance testing of the middle ear and sonomotor reflex tests for the auricular muscles. The Cli-nic saw the development of:

• otological surgery – as the first in Poland and one of the first in Europe, it introduced into practice homogeneous transplants of preserved eardrum and ossicles as material in ear reconstructive surgeries,

and mines. The commenced efforts of Professor A. Dobrzański were successfully completed in 1954 by dr. hab. I. Cichocka-Szumilin.

Despite the hard daily service work for open health care, the Clinic maintained a high level of education for students. To meet the urgent concerns in the field of academic textbooks, in the post-war period the Clinic published one of the first post-war textbooks for teaching otorhinolaryngology for students and doctors “Diseases of the ears, nose, pharynx and larynx” (1951) edited by Professor A. Dobrzań-ski and the textbook “Diseases of the mouth, pharynx and nose” (1952) for students of dentistry, prepared by dr. hab. J. Szymański.

After the sudden death of professor Antoni Dobrzański on Febru-ary 13, 1953, doc. I. Cichocka-Szumilin (1910–2011) remained the Head of the Clinic until this function was taken over by Professor Henryk Lewenfisz-Wojnarowski (1894–1956) (Fig. 9.).

Professor H. Lewenfisz-Wojnarowki modernized the Clinic in the years 1955–1956 – large patient rooms (26 beds) were converted into 3-person rooms, the operating theater was modernized, and a soundproofed room was built. The clinic was equipped with a modern microscope for ear surgery. Professor Henryk Lewen-fisz-Wojnarowski continued to develop diagnostic and treatment methods at the Department of Hearing Disorders: he developed and introduced his own method of testing the mobility of the sta-pes, a number of modifications for complete conservative surgery, fenestration and tympanoplasty [49].

The sudden death of professor Henryk Lewenfisz-Wojnarowski on September 27, 1956 was followed by the appointment on Octo-ber 1, 1956 of Professor Jan Szymański (1903–1984) as the Head of the Clinic on the basis of the resolution of the Medical Faculty Council of the Medical Academy in Warsaw and the appointment of the Minister of Health and Social Welfare (Fig. 10.). Before ap-pointing him to this position, dr. hab. I. Cichocka-Szumilin once again acted as Head of the Clinic at the turn of 1956/1957.

In addition to scholarly and training work, the Clinic’s employ-ees conducted large-scale medical activities. In the report on the

Fig. 10. Professor B. Dylewski, Professor J. Szymański, Professor A. Zakrzewski, Professor J. Hybasek, Professor S. Podvinec, nn, Professor W. Jankowski, Professor J. Taniewski, Professor J. Iwaszkiewicz (first row from the left, sitting), dr. Z. Witwicka (standing), dr. J. Biskupska, dr. hab. I. Cichocka-Szumilin, dr. hab. T. Bystrzanowska (2nd row from the left, sitting), 24th PTOL Congress, Gdańsk, 1958 (from the historical archives of the Clinic).

Fig. 11. Professor Zbigniew Bochenek in the office at Nowogrodzka 59 Street, Warsaw 1970s (from the historical archives of the Clinic).

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• otoneurosurgery – as the first in Poland, it began to perform microsurgical operations on the internal auditory canal in patients with dizziness and a tumor of the auditory nerve from access through the middle cranial fossa and translabirynthine approach,

• head and neck surgery – surgical techniques have been developed for diseases of the salivary glands and larynx,

• plastic surgery – experimental and clinical activities with the use of plastics in operations of congenital ear defects, nasal deformities and after extensive cancer surgery were started,

• phoniatrics – equipment for phonospectroscopic examinations of voice and speech was developed and clinical methods of research in this field were established [50].

In 1975, the Clinic’s team led by Professor Zbigniew Bochenek mo-ved from the old building of pavilion No. I of the State Teaching Hospital No. 1 to the newly built Central Clinical Hospital of the Medical Academy at Banacha 1 Street (Fig. 12.).

Professor Zbigniew Bochenek soon enjoyed moving to the new premises of the Clinic. After many years of coronary heart disease, he died of a heart attack on July 14, 1977. For several months, Pro-fessor I. Szumilin-Cichocka (Fig. 13.) was the Head of the Clinic.

From October 1, 1977, the Senate of the Medical Academy in War-saw entrusted the management of the Clinic to dr. hab. n. med. Grzegorz Janczewski (1935–2016) (Fig. 14.).

The clinic at the new hospital at Banacha Street initially had 91 beds (in the 1990s, after renovation, the number of beds was re-duced to 81); it occupied the entire floor in block B and was di-vided into three sections with 1-, 2- and 4-person patient rooms. The operating theater in block C was centralized and consisted of 14 operating theaters, of which the Clinic had 2 operating rooms, and from the 1980s one small, so-called laser room.

The clinic conducted scientific and training activities on a large sca-le – it organized meetings and courses. Between May 29 and June 1, 1986 it was the organizer of the XXXIII Congress of the Polish Society of Otorhinolaryngologists. Professor Grzegorz Janczewski never limited the scientific and professional development of his associates, he even encouraged them for training trips abroad, and writing doctoral and postdoctoral theses. The professor’s favora-bleness towards this direction was so advanced that he agreed that the employees of the Clinic set up “their own organizations” that would conduct courses, symposia, conferences and conventions. As a result, after some time the Clinic became not just the orga-nizer, but the co-organizer of many important events in which the employees of the Clinic participated. At the time when Professor Grzegorz Janczewski was on sick leave, i.e. from October 1, 2002 to July 31, 2003, the function of Head of the Clinic was assumed by Professor Antoni Krzeski.

On August 1, 2003, after the decision of the Medical Faculty Co-uncil and the Senate, the Rector of the Medical University of War-saw handed over the management of the Otolaryngology Clinic to Professor Kazimierz Niemczyk (Fig. 15.).

Fig. 12. Block of the Institute of Surgery CSK, Banacha 1 Street, Warsaw, the 1980s [51].

Fig. 13. Professor Irena Cichocka-Szumilin, Nowogrodzka 59 Street, Warsaw, 1973 (from the archives of the Clinic).

Fig. 14. Welcome of dr. hab. med. Grzegorz Janczewski as the Head of the Clinic. A. Kraska, A. Osóbka-Morawska, J. Biskupska-Więcko, A. Jachowska, D. Danikiewicz-Więcko, G. Janczewski (from the left) Banacha 1 Street, Warsaw, 1977 (from the collection of Professor E. Osuch-Wójcikiewicz).


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On January 9, 1998 the Clinic saw the first in Poland brainstem implantation to treat deafness in the course of neurofibromato-sis type 2 in cooperation with a neurosurgeon, Professor Robert Behr from Würzburg, who excised the tumor and placed the im-plant electrode into the lateral recess of the fourth ventricle. Al-ready on April 17, 1999 such an operation was performed entirely by doctors from Poland.

Since 1997 surgery of the base of the skull begins to develop in-tensively; started in the 1970s by Professor Z. Bochenek, thanks to

After taking up the duties of the Head of the Clinic on August 1, 2003 Professor Kazimierz Niemczyk set ambitious plans for him-self and the team. He introduced new diagnostic and surgical tech-niques, developed previously started areas, and modernized the Clinic. From 1980 to 2020, the Clinic achieved a lot in the field of otorhinolaryngology. Many diagnostic and operational methods were introduced for the first time in Poland and in Europe.

The Clinic’s team still values the principle that the historical events that have taken place here will forever remain the history of the Clinic, and do not follow the authors of the success else-where. The position of each team member results from his de-velopment at the Clinic. The conditions for this development, ethos and traditional values of the Clinic’s team have been de-veloped over the years of work of their predecessors. None of us should forget about it.

In 1980, the Clinic was the first in Poland to introduce electrophy-siological tests of the hearing organ to everyday diagnostics, and on April 28, 1983 for the first time in Poland, a CO2 laser was used here as a “surgical knife” in laryngeal surgery.

Extensive resections of laryngeal and laryngopharyngeal tumors required reconstructive surgeries. The first reconstruction of pha-rynx and cervical esophagus with a revascularized small intestine transplantation was performed on July 16, 1984.

On July 16, 1992, the first cochlear implantation surgery in Poland and Eastern Europe was performed at the Clinic.

In 1993, endoscopic sinus surgery was introduced at the Clinic.

In 1994, the Clinic was the first in Poland to routinely introdu-ce the method of examining the hearing organ with the use of otoacoustic emission, and in 1996 – comprehensive diagnosis and treatment of sleep apnea syndrome.

Fig. 15. The Clinic’s team in 2003. In the first row: A. Krzeski, E. Osuch-Wójcikiewicz, M. Gu-zewicz, K. Niemczyk, J. Nyckowska, J. Balcerzak, K. Pierchała, E. Orkan-Łęcka. In the second row: M. Rezaei, T. Gotlib, A. Bruzgielewicz, N. Górski, R. Zawadzka, M. Held- Ziółkowska, P. Podogrodzki, M. Hamera-Słynarska, L. Mikołajewska, O. Korolkowa--Wojas, J. Piotrowski, A. Tuszyńska, B. Jaśkiewicz, J. Popowski, O. Stanisławek-Sut, E. Witkowska, I. Gromek, H. Soczówka, P. Szwedowicz. (from the left) Banacha 1a Street, Warsaw, 2003 (from the archives of A. Bruzgielewicz).

B

C

A

Fig. 16. (A, B, C) Clinic after the renovation, Banacha 1a Street, Warsaw, 2020.

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reconstructed tissue defect. Also, there was the first surgical tre-atment for cholesterol granuloma through the sphenoid sinus in endoscopic optics in Poland. The use of the endoscopic technique allowed to reduce the invasiveness of the pathology of the skull base during surgery.

In 2013, a world-unique method of hearing monitoring during tympanoplastic surgery (simultaneous laser and electrophysiolo-gical measurements) was introduced. This allowed for more preci-se reconstructive operations of the middle ear conduction system. Progress was also made in developing the principles of diagnostics and rehabilitation of patients with balance disorders leading to falls.

In 2014, a universal technique for the reconstruction of the tym-panic membrane was developed and introduced. The applied method allowed for greater stability of the grafts used for the reconstruction. Advancement was also made in developing the principles of endoscopic surgery of the middle ear. This new method allowed for a more radical excision of lesions from the middle ear space and better control of the reconstructed tissu-es, as well as improved control of the spaces inaccessible to mi-croscopic examination.

In 2015, the modern Narrow Band Imaging (NBI) technique was introduced for the early detection of laryngeal cancers. There was also a considerable development of phonosurgery owing to the introduction of injection laryngoplasty and medialization thyro-plasty (medial displacement of the vocal fold), and in 2016, recon-struction of the recurrent laryngeal nerves and decompression of the recurrent laryngeal nerves after stapedectomies complicated with vocal fold paralysis. This is the most physiological method for restoring the voice and upper airway patency, giving the best functional results if applied early after the onset of injury.

In 2017, the monitoring of the hearing organ during tympano-plasty operations was introduced using the prototype of the pa-tented OSSILAIOM device, manufactured with the Intelligent Hearing System that enables measurements of Auditory Steady State Responses – ASSR and of oscillations of the auditory ossic-les by means of laser Doppler vibrometry (LDV) conducted si-multaneously.

Professor Kazimierz Niemczyk surgery of auditory nerve tumors became a common procedure at the Clinic. Currently, the Clinic has performed over 9000 operations to remove auditory nerve tu-mors. Such a number of performed surgeries can be boasted by individual centers in the world. This period also saw the large-scale implementation of surgeries to remove glomus tumors involving the skull base and cervical angioleiomyoma.

Owing to the great commitment and work of Professor Kazimierz Niemczyk, in 2001 the Clinic recreated the program of deafness treatment with the use of cochlear implants. By the end of 2020, over 1,000 cochlear implants and nearly 30 stem implants had been implanted.

In 2004, the method of treating Ménière’s disease was reintrodu-ced which consisted in cutting along the vestibular nerve through the medial fossa of the skull. To this day, the operation from this approach is performed only at the Clinic. Since then, more than 300 operations have been completed. In terms of the number of such operations, the Clinic remains among the world leaders. Par-ticularly noteworthy is the introduction of intraoperative elec-trophysiological monitoring of the hearing organ (simultaneous measurement of ABR, ECoch, and direct measurement from the auditory nerve) in patients operated on due to pathology of the posterior cranial fossa. Intraoperative measurements have impro-ved the functional results of surgery through the middle cranial fossa in terms of hearing preservation.

In 2005, a new method of testing called the auditory steady state response (ASSR) was introduced to the diagnosis of hearing im-pairment.

In 2010, the world’s first placement of a bilateral, simultaneous, ful-ly implantable middle ear implant was performed. The use of this method allowed to expand the possibilities of hearing restoration.

In 2013, the scope of reconstructive surgery was considerably expanded by introducing the reconstruction of tissue defects using various flaps with microvascular anastomoses. It gave an oppor-tunity to obtain a good functional and aesthetic effect, and allo-wed to precisely adjust the size and morphology of the flap to the

Fig 17. (A, B) Museum of Otorhinolaryngology – Head and Neck Surgery, Banacha 1a Street, Warsaw, 2020.

BA


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Over the twenty-year period, the clinic underwent a comple-te modernization both on the 7th floor of block B (rooms for patient rooms and staff ) in 2011 (department A) and in 2015 (department B and research laboratories on the second floor) (Fig. 16.). A complete modernization of the clinic’s outpatient rooms is planned for 2021.

Guided by many years of tradition, in 2015 we opened the Mu-seum of Otorhinolaryngology – Head and Neck Surgery at the Clinic (Fig. 17.). The collection of the museum includes exhibits owned by the Clinic and ones donated by its former and current employees, as well as by private individuals or acquired by the As-sociation for the Support of Laryngology.

The 100 years of its existence saw the establishment of 37 degre-es of habilitated doctor (1921–2020) and 110 degrees of doctor (1946–2020) at the Department and Clinic of Otorhinolaryngo-logy, Head and Neck (1921–2020), the publishing of 78 books and monographs, as well as thousands of papers in both Polish and fo-reign magazines and conference materials.

Further work for our “Alma Mater” and the Republic of Poland as well as care for continuous development, while maintaining the tradition and mission of the Clinic, is and will be the contribution of the current Team and future generations.

Year 2018 saw the first visualization and recording in vivo of vi-brations of the round window membrane during ear stimulation via bone. There was also a development of endoscopic operations in the field of benign and malignant tumors of the base of the an-terior and middle cranial fossa, including the pituitary gland, in cooperation with the Department of Neurosurgery (doc. T. Gotlib, T. Dziedzic MD PhD). From 2019, a new diagnostic technique is introduced using magnetic resonance imaging with contrast to vi-sualize changes in the inner ear characteristic of Ménière’s disease.

Fig. 18. Clinic Team, Banacha 1a Street, Warsaw, 2019.

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Word count: 5620 Tables: – Figures: 18 References: 51

Access the article online: DOI: 10.5604/01.3001.0014.6344 Table of content: https://otorhinolaryngologypl.com/issue/13438

Some right reserved: Polish Society of Otorhinolaryngologists Head and Neck Surgeons. Published by Index Copernicus Sp. z o.o.

Competing interests: The authors declare that they have no competing interests.

The content of the journal „Polish Society of Otorhinolaryngologists Head and Neck Surgeons” is circulated on the basis of the Open Access which means free and limitless access to scientific data.

This material is available under the Creative Commons – Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). The full terms of this license are available on: https://creativecommons.org/licenses/by-nc/4.0/legalcode

Corresponding author: prof. Kazimierz Niemczyk MD PhD; Chair and Clinic of Otorhinolaryngology, Head and Neck Surgery at the Medical University of Warsaw, Poland; Banacha street 1a, 02-097 Warsaw, Poland; Phone: +48 22 599 25 21; E-mail: [email protected]

Cite this article as: Niemczyk K., Bruzgielewicz A., Osuch-Wojcikiewicz E., Checinski P., Pierchala K., Bartoszewicz R.: 100 years of Otorhinolaryngology, Head Neck Surgery Department of Medical University of Warsaw; Pol Otorhino Rev 2020; 9 (4): 1-10

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REEW ARCE 100 years of the Department of Otolaryngology