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© Borgis - New Medicine 3/1999, s. 52-53
Cezary Ranocha, Mieczysław Chmielik, Iwona Jakubczyk
Polish Paediatric ENT surgery in the XIX-th century
From Children´s ENT Clinic, Warsaw, Poland
Head of Clinic: Prof. Mieczysław Chmielik, M.D. Ph.D
Key words: pediatric, ent.
In the last years of the XIX-th century Paediatric ENT surgery was separated from general ENT, because the course of the disease, management and prognosis in paediatric group is different from those observed in adults. The first Paediatric ENT ward was established in Poland in the 1895. In Warsaw Children Hospital on Kopernik street 7-beds ward for children suffering on ear, nose and throat diseases was created as a part of General Surgery Ward. The head of this ward was M.D.Z. Dobrowolski.
The greatest development of this specialisation in Poland has happened after World War II owing to Assistant Professor Jan Danielewicz. In 1947 he came to Warsaw from Lwow. He worked in close cooperation with Professors: Michałowicz, Barański and Groer. In 1953 he became a head of of Paediatric ENT Clinic in Mother and Child Institute. In 1956 in Paediatric Clinic at Litewska 16 street in Warsaw another Paediatric ENT Clinic was established. Assistant Professor Jan Danielewicz become a head of this 32-beds ward. He was responsible for creation of Paediatric ENT as a medical specialisation in the 1959. First examines were performed in 1961. From 1964 until now Paediatric ENT is a second-degree specialisation and can be performed after examinations of first degree. No less then 3 years practice in Paediatric ENT ward is a minimal requirement. The programme of this specialisation includes achieving fluency in the surgery of the larynx, ear, nose and paranasal sinuses (long list of adequate procedures is counted), courses such like neurology, oncology, stomatological surgery, audiology and phoniatry, allergology, exams in 2 foreign languages, and 2 final examines: practical (skill in surgery) and theoretical.
After Jan Danielewicz has retired in 1973, the head of Clinic became Professor Ewa Kossowska. From 1993 the head of the Warsaw Paediatric ENT Clinic is professor Mieczysław Chmielik. The Assistant Professors in this Clinic were such superb ENT surgeons like M. Góralówna and Professor T. Zaleski.The main interests and greatest achievements of the Clinic was: lymphoid tissue problems at children, internal oesophagotomy as the method of treatment the oesophageal strictures after chemical burns, acoustic analysis of laryngeal sounds, laryngeal cicatrixes surgery, surgery of the nose and paranasal sinuses endoscopic surgery.
Five departments of Paediatric ENT in the Academy Centers were created in Poland after World War II due to great devotion and hard work of Assistant Professor Jan Danielewicz and group of other scientists and practicing doctors. In 1958 in Paediatric Clinic in Łód 30 - beds ENT ward was created. The head of this ward was Assistant Professor S. Kmita; from 1966 - to 1986 Professor H. Brzezińska. In 1970 this ward become Children´s ENT Clinic. From 1986 the head of this Clinic is Professor D. Gryczyńska.The greatest achievements of the Clinic was: ear diseases diagnostics and treatment, treatment of papillomas of the larynx at children, alergology problems, glue ear treatment at children, laryngeal cicatrixes surgery, paranasal sinuses, nose and larynx endoscopic surgery.
In 1970 Children´s ENT Clinic in Poznań was created. The head of this Clinic was Assistant Professor R. Rafiński, then Professor A. Soboczyński (professor from 1982). From 1994 the head of this Clinic is Professor M. Grzegorowski. The greatest achievements of the Clinic and main research studies are: bronchology problemsand foreign bodies and malformations in the respiratory tract, immunology of the tonsills and treatment of papillomas of the larynx at children.
In Lublin, ENT ward was created on 1935. From 1984 it is known as the ENT Paediatric Clinic - and from 1995 as the ENT Paediatric Clinic of Phoniatry and Audiology. The head of this ward was Professor M. Brennenstuhl - Pliszczyńska and from 1993 - Professor G. Niedzielska. The main research studies performed in thic Clinic are: diagnostics and treatment of children with laryngeal cicatrixes and congenital deafness treatment and rehabilitation.
In 1995 in Białystok another ENT Paediatric Clinic was established. The head of this Clinic is Professor E. Hassmann - Poznańska. The main research studies are: tympanoplastic surgery,
ear diseases diagnostics and treatment and laryngeal cicatrixes surgery.
The first „Days of Paediatric ENT” were performed at Zakopane in 1959 due to Assistant Professor Jan Danielewicz and dr. Borkowska - Gaertig. Another Days of Paediatric ENT were celebrated every 3- or 4- years. This year´s XII-th Days of Paediatric ENT in Warsaw, 03-05. Jun. 1999 are crowning achievement of 40 - years tradition of our Congressses.
Between 6-th and 7-th Days of Paediatric ENT in 1979 Professor Ewa Kossowska has organized in Warsaw the first European Congress of Paediatric ENT. In an Victoria Hotel in Warsaw over 400 participans, between them many great scientist and specialists.
A large number of problems were the topics of the Congress, e. g. sinubronchitis, laryngo-tracheal stenoses, adenoid problems, tracheotomy, allergic rhinitis, neoplastic tumors at children, glue ear, ear reconstruction surgery. This Congress was the last one for Assistant Professor Jan Danielewicz. He died in NOV, 1982. It was a great loss for polish Paediatric ENT surgery. In this remembrance about Assistant Professor Jan Danielewicz it´s worth to remember about his great scientific intuition. He was especially interested in reactions of tissues and organs on pathogens and difference in the sort of reaction in corelation in patient´s age. His clinical observations were ahead in comparison to experimental immunology. Today´s immunology has proved his rights concerning lymphoid tisssue of the nasal and pharyngeal region and properties of mucous membrane of the nose, middle ear, sinuses and pharynx. His theories changed people´s minds and become a base for a new medical specialisation - Paediatric ENT. Many of his scientific works were published in „Pediatria Polska”, „Polski Tygodnik Lekarski”, „Grulicy”, „Polski Przegląd Chirurgiczny” and others.
His clinical observations changed method of BCG vaccination at neonates.
PAEDIATRIC ENT DIVISION AND IT´S WORK
Paediatric ENT surgeons serve much for local societies. Emergency servises for children in Warsaw, Łód, Poznań, Lublin and Silesia were organised. Many Paediatric ENT Outpatient´s Clinic serve for young patient´s. From 1956 due to Assistant Professor Jan Danielewicz every wednesday scientific meetings of practicing doctors were organised. During 15 years the chairman of the Paediatric Division was Jan Danielewicz, in the years 1977-1985 Professor Ewa Kossowska from Warsaw, and in the years 1985-1989 Professor Andrzej Soboczyński from Poznań. From 1989 until present time the chairman of the Paediatric Division in Professor D. Gryczyńska - head of Children´s ENT Clinic in Łódź./div>
The scientific work of members of Paediatric ENT Division is known Worldwide. Many polish paediatric ENT surgeons took part in International Congresses and Conferences.
In 1977 during Congress of Paediatric ENT in Sirmione and San Felice del Benaco European Council for Paediatric ENT was founded - Assistant Professor Jan Danielewicz contributes in this work. His follower - Professor Ewa Kossowska become a member of Group Management in 1979 year. In redaction of International Journal od Pediatric Otorhinolaryngology has worked as an experts - Assistant Professor Maria Góralówna and Professor Ewa Kossowska - just from 1980. During 40-years history of Paediatric ENT in Poland following books were introduced: - St.Kmita - „Pediatric Otorhinolaryngology.” PZWL 1976 - E. Kossowska - „Otolaryngology at growing age.” PZWL, wyd. I, 1979. wyd. II, E. Kossowska, B. Moszyński - Nursing in Ear, Nose and throat diseases PZWL 1981. The newest book is „Pediatric Otorhinolaryngology.” for medical students - M. Chmielik, Medical Academy, Warsaw.
Piśmiennictwo
1. Góralówna M., Kossowska E.: Otolaryngologia Diecięca - rys his-toryczny; Pediatria Polska Nr 11-12, 1990,str 113-127. 2. Gryczyńska D.: Laryngologia Dziecięca; Zarys historii otolaryngologii polskiej 1879-1995; pod red. B. Latkowskiego, 133-141.
New Medicine 3/1999
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