Malignant eyelid tumors — results of surgical treatment and of the choice of reconstruction method

Cel pracy. Nowotwory powiek stanowią od 5 do 10% wszystkich złośliwych nowotworów skóry. Pojawiają się onegłównie u osób w starszym wieku, narażonych na przewlekłe działanie promieniowania słonecznego. Podstawowymleczeniem jest chirurgiczne wycięcie guza w całości. Celem pracy jest analiza kliniczna i histopatologiczna złośliwychnowotworów powiek u leczonych chorych, przedstawienie wybranych metod rekonstrukcji i ocena odległych wynikówchirurgicznego leczenia guzów powiek.Materiał i metoda. Badaniu poddano 92 chorych leczonych w Klinice Chirurgii Plastycznej Rekonstrukcyjnej i Estetycznejw latach 2000–2009 z powodu nowotworów złośliwych powiek. U wszystkich pacjentów wycięto guzz jednoczasową rekonstrukcją powieki. Wybór metody odtwórczej uzależniony był od wielkości i lokalizacji nowotworu.Przeprowadzono weryfikację preparatów histopatologicznych, określając typ nowotworu zgodnie z aktualnąklasyfikacją WHO i radykalność zabiegu operacyjnego. Na podstawie dokumentacji medycznej i badań kontrolnychpacjentów oceniono odległe wyniki leczenia.Wyniki. Nowotwory najczęściej zlokalizowane były w obrębie powieki dolnej — 67 (70,5%) i przyśrodkowego kąta oka— 17 (17,9%). Raka podstawnokomórkowego (BCC) stwierdzono w 83 (87,3%) przypadkach, natomiast u 12 (12,7%)rozpoznano inne, rzadziej występujące nowotwory złośliwe. Brak radykalnego wycięcia zmiany w badaniu histopatologicznymstwierdzono u 14 (14,7%) chorych. Reoperację z powodu wznowy nowotworu wykonano u 11 (15,6%)osób. Dobre odległe wyniki czynnościowo-estetyczne rekonstrukcji powiek stwierdzono w 84 (91,3%) przypadkach.Wnioski. Rak podstawnokomórkowy jest najczęstszym nowotworem złośliwym aparatu ochronnego oka i lokalizujesię głównie w obrębie powieki dolnej. Znacznie większe ryzyko wznowy istnieje w przypadku bardziej agresywnegopodtypu BCC — postaci naciekającej oraz guzów zlokalizowanych w obrębie przyśrodkowego kąta oka. Znajomośćwielu metod rekonstrukcyjnych umożliwia chirurgowi leczącemu nowotwory powiek wybór najodpowiedniejszejz nich, zależnie od wielkości i lokalizacji ubytku powstałego po wycięciu zmiany.Background. Eyelid tumors constitute 5–10% of all skin malignancies. They mostly affect the elderly and thosechronically exposed to sunlight. The primary treatment is radical surgical excision of the tumor. The aim of this studyis the clinical and microscopical analysis of malignant eyelid tumors in treated patients, the presentation of selectedreconstructive methods and the evaluation of long-term results of surgical treatment of eyelid tumours.Material and method. The study involved 92 patients treated in the Department of Plastic, Reconstructive andAesthetic Surgery in Łódź in 2000–2009 for malignant tumors of the eyelids. All patients underwent surgical excisionof the tumor with concurrent eyelid reconstruction. The choice of reconstructive method depended on the size andlocation of the tumor. Histopathological evaluation was carried out specifying the type of cancer and radical surgery.The long-term results were rated on the basis of medical records and patients’ examinations.Results. Tumors were located mostly within the lower eyelid 67 (70.5%) and the medial canthus 17 (17.9%). Basal cellcarcinoma was found in 83 (87.3%) cases, while in 12 (12.7%) diagnosed with other, less common cancers. Histopathological verification of tumor margins revealed incomplete excision in 14 specimens (14.7%). Re-operations due to recurrent tumor was performed in 11 (15.6%) cases. Good long-term results of functionally-aesthetic reconstruction of the eyelids was observed in 84 (91.3%) patients.Conclusion. 1. Basal cell carcinoma is the most common malignant tumor of the oculopalpebral region and originates mainly in the lower eyelid. 2. Significantly higher risk of recurrence exists with the more aggressive form of BCC (infiltrative basalcell carcinoma) and tumors located in medial canthus. 3. The knowledge of multiple reconstruction methods allows the surgeon to choose the most appropriate one, depending on the size and location of the defect formed after excision of the tumor

Are animal-related injuries in rural areas a social problem? A survey from Poland

Objective The aim of this study was to analyze the mechanisms of animal-related injuries in Polish rural areas, and to evaluate the effects of such injuries on subjects’ health and social life Material and Methods Data concerning animal-related injuries were collected from 102 patients (45 females and 57 males, mean age 45.01±11.4 years) on the basis of a questionnaire. The study was conducted in the rural area of central Poland. Moreover, to assess the severity of injuries to the head and neck region, the Facial Injury Severity Scale (FISS) was applied. Results The most commonly affected body areas are the upper and lower limbs, which explains the fact that most subjects do not recognize the injury-related deformity as an aesthetic defect.Statistical correlations were observed in several aspects, amongst others: – women were significantly more likely than men to consider undergoing surgical procedures to eliminate/reduce post-traumatic deformities and scars (p<0.05); – injury-related deterioration in appearance resulted in limitations of patients’ social life (p<0.0001)

Influence of ethnicity on aesthetic preferences for lip characteristics in Caucasian male and female faces

Background: In an era where globalization and social media significantly reshape beauty standards, it is imperative to delve into the subjectivity of beauty and attractiveness. The lips, a key element in facial aesthetics, contribute significantly to the perception of attractiveness, and also have a profound impact on an individual's self-esteem. Objective: To analyze the influence of ethnicity on the aesthetic preferences for lip characteristics, among male and female faces. Materials and methods: This study encompassed a sample of 231 study participants (153 women and 78 men) with an average age of 23.2 ± 2.8 years, representing ethnicities such as African, Caucasian, Middle Eastern, and South Asian. Participants were asked to rate a series of images showcasing various lip variants, providing insights into their aesthetic preferences. Results: Demographic analysis revealed gender and ethnic variations in aesthetic preferences for all the investigated lip parameters. Women were 2.42 times more likely than men to prefer no Cupid's indentation on a female model (p = 0.0019). Conclusions: The study underscores the importance of understanding cultural influences on beauty standards and challenges the notion of a universal beauty ideal. The evolving role of social media trends, such as Cupid's bow indentation elimination, raises questions about the dynamic nature of aesthetic preferences among different ethnicities.</p

Influence of ethnicity on aesthetic preferences for lip characteristics in Caucasian male and female faces

Background: In an era where globalization and social media significantly reshape beauty standards, it is imperative to delve into the subjectivity of beauty and attractiveness. The lips, a key element in facial aesthetics, contribute significantly to the perception of attractiveness, and also have a profound impact on an individual's self-esteem. Objective: To analyze the influence of ethnicity on the aesthetic preferences for lip characteristics, among male and female faces. Materials and methods: This study encompassed a sample of 231 study participants (153 women and 78 men) with an average age of 23.2 ± 2.8 years, representing ethnicities such as African, Caucasian, Middle Eastern, and South Asian. Participants were asked to rate a series of images showcasing various lip variants, providing insights into their aesthetic preferences. Results: Demographic analysis revealed gender and ethnic variations in aesthetic preferences for all the investigated lip parameters. Women were 2.42 times more likely than men to prefer no Cupid's indentation on a female model (p = 0.0019). Conclusions: The study underscores the importance of understanding cultural influences on beauty standards and challenges the notion of a universal beauty ideal. The evolving role of social media trends, such as Cupid's bow indentation elimination, raises questions about the dynamic nature of aesthetic preferences among different ethnicities.</p

Digit ratio (2D:4D), laryngeal cancer and vocal fold leukoplakia

Background - To date, there are no studies that have analyzed the possible influence of exposure to prenatal sex hormones on the risk of laryngeal cancer (LC) and premalignant laryngeal lesion—vocal fold leukoplakia (VFL). Digit ratio (2D:4D) is suggested to be a proxy of prenatal sex hormone exposure. Objective - To examine 2D:4D in patients with LC and clarify if it could add to the verified risk factors in estimating the overall risk of LC. Methods - 511 subjects participated in the study. The study group included 269 patients: with LC (N = 114, 64 men) and VFL (N = 155, 116 men). Controls included 242 healthy individuals (66.40 ± 4.50 years (106 men)). Results - Predictive models estimating the risk of VFL and LC in women, based solely on predictors like smoking and alcohol consumption had a lower area under the ROC curve (AUC) than the model with left 2D:4D. AUC for the model estimating the likelihood of VFL increased from 0.83 to 0.85, and for LC from 0.76 to 0.79. Conclusions - Low left 2D:4D may be associated with an increased risk of developing leukoplakia and laryngeal cancer in women. In the case of laryngeal cancer, left 2D:4D may serve as additional variable (to other known risk factors, such as smoking and/or alcohol consumption), which can improve cancer risk prediction

Charakterystyka rozkładów poszczególnych typów rozszczepów wargi i podniebienia wśród dzieci łódzkich w latach 1981-2015

Wprowadzenie: Rozszczepy wargi i/lub podniebienia są najczęstszą wadą wrodzoną w obrębie twarzy. Obraz kliniczny tych zaburzeń jest bardzo różnorodny. Rozszczep może obejmować samą wargę, wargę i wyrostek zębodołowy, dotyczyć samego podniebienia lub obejmować wszystkie te struktury. Cel: Celem pracy było scharakteryzowanie – w materiale własnym, wśród dzieci urodzonych w Łodzi w latach 1981–2015 – poszczególnych postaci rozszczepów oraz ich rozkładów zależnych od płci i strony ciała objętej wadą,. Materiał i metody: Badaniem objęto grupę 434 pacjentów z rozszczepem wargi i/lub podniebienia (218 chłopców oraz 216 dziewczynek) w wieku od 4 tygodni do 18 lat, które urodziły się w Łodzi w latach 1981–2015. Wyniki: W analizowanym materiale największą grupę stanowiły izolowane rozszczepy podniebienia (181 pacjentów; 41,7%), następnie rozszczepy wargi i podniebienia (156 chorych; 36%), a najmniejszą – rozszczepy samej wargi (97 dzieci; 22,3%). Szczegółowa analiza typów tej wady pokazuje, że izolowane rozszczepy podniebienia są zdecydowanie częstsze u płci żeńskiej niż męskiej (112 vs 69), podczas gdy rozszczepy wargi i podniebienia odwrotnie (96 chłopców vs 60 dziewczynek. Wady lewostronne są częstsze niż prawostronne. Wnioski: Na przestrzeni 35 lat wśród dzieci urodzonych w Łodzi najczęściej obserwowane były izolowane rozszczepy podniebienia, następnie wady wargi i podniebienia, a najrzadsze rozszczepy samej wargi. Rozszczepy podniebienia występują częściej u dziewczynek, natomiast wargi i podniebienia u chłopców. W przypadku zaburzeń jednostronnych wady lewostronne są dwukrotnie częstsze niż prawostronne

Rare facial clefts

In 1976 Dr. Paul Tessier described numeric classification for rare craniofacial clefts. He first emphasized that a fissure of the soft tissue corresponds, as a general rule, to a cleft of the bony structure. The classification, easy to understand, became widely accepted because the recording of the malformations was simple and facilitated communication between observers. The aim of this study was to present our own experience with treatment of patients with rare facial clefts. Material and methods. Our Department has 11 patients with rare craniofacial clefts under its care. This group includes 8 boys and 3 girls. The patients aged from 2 months to 18 years at the time of the first consultation. Results. In two patients the cleft was median, in seven patients it was one-sided and in two – bilateral. The most common type of cleft was number 6, and the rarest were 2, 3, and 7. All patients underwent surgical treatment. Conclusions. Atypical facial clefts are rare congenital anomalies, however because of functional and aesthetic disturbances they constitute a serious medical and therapeutic problem. Facial clefts are characterized by variable clinical presentation and require individualized treatment plan

Satisfaction from surgical treatment and its influence on the wellbeing of patients with Recklinghausen disease – preliminary report

Background: Neurofibromatosis type 1 (NF-1) is one of the most common autosomal dominant disorders. Multiple benign dermal neurofibromas, café au lait spots, axillary and inguinal freckling are the hallmarks of NF-1. Aim: The aim of this paper is to verify if surgical treatment performed in patients with NF-1 is satisfactory to them and to describe demographic factors characteristic for patients with Recklinghausen disease. Methods: A special questionnaire was prepared for the study, which contained 45 questions. Seventeen patients with neurofibromatosis type 1 agreed to fill in the questionnaire aged from 22 to 61 years. Results: Surgical treatment in patients was started between 6 and 45 years of age. All patients declared their will to continue surgical treatment. After treatment patients felt more comfortable, more self-confident and sociable. The first symptoms of neurofibromatosis were seen at about 13 years of life in most patients. All women who gave birth noticed progression of the disease during pregnancy. Conclusions: Performed surgical treatment raises life comfort and increases self-confidence in patients with neurofibromatosis type 1. Due to visible skin changes in neurofibromas it is worth referring patients to Plastic Surgery Departments. Doctors dealing with patients with NF-1 should inform them about the potential heredity of the disease and that puberty and pregnancy intensify the process of skin neurofibroma development

Treatment of Patients with Giant Tumors in the Course of Recklinghausen Disease – Own Experience

Neurofibromatosis type 1 (NF-1, von Recklinghausen disease) is included in the group of diseases known as phacomatosis. Clinical diagnosis of Recklinghausen disease is based on the presence of 2 from 7 criteria developed by a panel of expert. So far effective strategy of treatment of patients with NF-1 is not developed. One method of treatment are surgical excisions. The aim of the study was to present own experience of treatment of patients with giant tumors in the course of Recklinghausen disease. Material and methods. The Department of Plastic, Reconstructive and Aesthetic Surgery of Medical University in Łódź has under care 34 patients with NF-1. Fifteen patients (8 females and 7 males) with giant tumors were included in this analysis. The patients age was from 6 to 57 years. In analyzed group a retrospective review of surgical treatment was carried out on the basis of patients’ medical documentation. Results. Ten from 15 analyzed patients were operated on in our Department and performed surgeries were aimed to partially reduce the tumors mass. Only one patient had his tumor excised in one-stage procedure, in rest of the patients the lesions were too extensive. Most patients in histopathological examinations were diagnosed with neurofibroma (8 patients), 1 - neurofibromaplexiforme and 1 - neurofibrolipoma. Conclusions. Unpredictable course of Recklinghausen disease causes that follow-up examinations are necessary. Treatment of such patients is particularly indicated when the tumor mass causes difficulty in patients daily habits or is life-threatening. Also it is worth to remember that delayed decision of surgical treatment unable excision of the whole tumor in one-stage procedure. This in turn causes the risk of tumor re-growing and/or developing of malignanc

Częstość występowania różnych typów rozszczepów czaszkowo-twarzowych w jednym ośrodku w okresie 34 lat

Wstęp: Rozszczepy ustno-twarzowe są najczęstszą wadą wrodzoną w obrębie głowy i szyi. Cel: Celem niniejszej pracy jest przedstawienie i usystematyzowanie własnej grupy pacjentów z różnymi typami izolowanych rozszczepów ustno-twarzowych. Materiał i metody: Wykonano retrospektywne badanie w grupie 473 łódzkich pacjentów z rozszczepami ustno-twarzowymi. Wyniki: W analizowanej grupie było: 434 osób z rozszczepem wargi i/lub podniebienia, 28 z rozszczepem nosa i 11 z rzadkimi rozszczepami twarzy, według klasyfikacji Tessiera. Wnioski: W badanej grupie większość pacjentów to dzieci z typowymi rozszczepami wargi i/lub podniebienia. Rozszczepy nosa nie są tylko składową rozszczepów czaszkowo-twarzowych, ale mogą występować w formie izolowanej, jako wada pośrodkowa lub dotycząca skrzydła nosa. Przydatna może okazać się prosta obrazowa klasyfikacja, która przybliży podstawy patologii oraz ułatwi chirurgowi podjęcie decyzji co do planu operacyjnego