Voice rehabilitation after surgery for oral and oropharyngeal cancer

The purpose of our study was to improve the quality of life of patients after surgery for oral and oropharyngeal cancer.Material and methods. Voice rehabilitation outcomes in 50 patients with stage II-III oral and oropharyngeal cancer were studied. All patients underwent resection of V> of the tongue. The patients were aged between 33 and 70 years, 70 % of them were up to 60 years. All patients received combined modality treatment and postoperative voice rehabilitation in Cancer Research Institute of Tomsk National Research Medical Center of RAS. The technique of voice rehabilitation included breathing exercises, articulation gymnastics for the muscles of the cheeks, lips, tongue, lower jaw and correc of disturbances in sound pronunciation. A speech function was assessed before and after rehabilitation using speech material that contained a text with semantic load, individual words, syllables and a meaningless set of sounds.Results and discussion. In the postoperative period, all patients experienced a sharp restriction of the mobility of the stump of the tongue, very low speech intelligibility, violation of the pronunciation of sounds, complete or partial absence of intonation pattern, and slowdown in the rate of speech. Postoperative voice rehabilitation aimed at increasing the mobility of tongue stump and correcting sound pronunciation made it possible to improve speech function in the period from 5 to 30 days (median 22.1) by restoring the pronunciation of the velar sounds [K, G] in 78-94 % of cases, alveolar sounds [T, D] in 74-80    I [C] in 56 % of cases. Based on the study, the authors conclude that speech rehabilitation is required for all patients, who underwent surgery for oral and oropharyngeal cancer, taking into account the extent of surgery and individual characteristics of the patients

Calcium phosphate coatings produced by radiofrequency magnetron sputtering method

Calcium phosphate coatings on titanium implants surface, produced by radio frequency (RF) magnetron sputtering method with hydroxyapatite solid target were investigated. It was found that produced coatings are calcium deficient compared to stoichiometric hydroxyapatite. The surface of the coatings is highly rough at the nanoscale and highly elastic. In vivo experiments on rats revealed that titanium implants with the calcium phosphate coatings do not cause negative tissue reaction after 6 months incubation period

The Fabrication of Bioresorbable Implants for Bone Defects Replacement Using Computer Tomogram and 3D Printing

The present work demonstrates the possibility of production of personalized implants from bioresorbable polymers designed for replacement of bone defects. The stages of creating a personalized implant are described, which include the obtaining of 3D model from a computer tomogram, development of the model with respect to shape of bone fitment bore using Autodesk Meshmixer software, and 3D printing process from bioresorbable polymers. The results of bioresorbable polymer scaffolds implantation in pre-clinical tests on laboratory animals are shown. The biological properties of new bioresorbable polymers based on poly(lactic acid) were studied during their subcutaneous, intramuscular, bone and intraosseous implantation in laboratory animals. In all cases, there was a lack of a fibrous capsule formation around the bioresorbable polymer over time. Also, during the performed study, conclusions were made on osteogenesis intensity depending on the initial state of bone tissue

The Fabrication of Bioresorbable Implants for Bone Defects Replacement Using Computer Tomogram and 3D Printing

The present work demonstrates the possibility of production of personalized implants from bioresorbable polymers designed for replacement of bone defects. The stages of creating a personalized implant are described, which include the obtaining of 3D model from a computer tomogram, development of the model with respect to shape of bone fitment bore using Autodesk Meshmixer software, and 3D printing process from bioresorbable polymers. The results of bioresorbable polymer scaffolds implantation in pre-clinical tests on laboratory animals are shown. The biological properties of new bioresorbable polymers based on poly(lactic acid) were studied during their subcutaneous, intramuscular, bone and intraosseous implantation in laboratory animals. In all cases, there was a lack of a fibrous capsule formation around the bioresorbable polymer over time. Also, during the performed study, conclusions were made on osteogenesis intensity depending on the initial state of bone tissue

Composite implants coated with biodegradable polymers prevent stimulating tumor progression

In this experiment we studied oncologic safety of model implants created using the solution blow spinning method with the use of the PURASORB PL-38 polylactic acid polymer and organic mineral filler which was obtained via laser ablation of a solid target made of dibasic calcium phosphate dihydrate. For this purpose the implant was introduced into the area of Wistar rats’ iliums, and on day 17 after the surgery the Walker sarcoma was transplanted into the area of the implant. We evaluated the implant’s influence on the primary tumor growth, hematogenous and lymphogenous metastasis of the Walker sarcoma. In comparison with sham operated animals the implant group demonstrated significant inhibition of hematogenous metastasis on day 34 after the surgery. The metastasis inhibition index (MII) equaled 94% and the metastases growth inhibition index (MGII) equaled 83%. The metastasis frequency of the Walker sarcoma in para aortic lymph nodes in the implant group was not statistically different from the control frequency; there was also no influence of the implant on the primary tumor growth noted. In case of the Walker sarcoma transplantation into the calf and the palmar pad of the ipsilateral limb to the one with the implant in the ilium, we could not note any attraction of tumor cells to the implant area, i.e. stimulation of the Walker sarcoma relapse by the implant. Thus, the research concluded that the studied implant meets the requirements of oncologic safety

Composite implants coated with biodegradable polymers prevent stimulating tumor progression

In this experiment we studied oncologic safety of model implants created using the solution blow spinning method with the use of the PURASORB PL-38 polylactic acid polymer and organic mineral filler which was obtained via laser ablation of a solid target made of dibasic calcium phosphate dihydrate. For this purpose the implant was introduced into the area of Wistar rats’ iliums, and on day 17 after the surgery the Walker sarcoma was transplanted into the area of the implant. We evaluated the implant’s influence on the primary tumor growth, hematogenous and lymphogenous metastasis of the Walker sarcoma. In comparison with sham operated animals the implant group demonstrated significant inhibition of hematogenous metastasis on day 34 after the surgery. The metastasis inhibition index (MII) equaled 94% and the metastases growth inhibition index (MGII) equaled 83%. The metastasis frequency of the Walker sarcoma in para aortic lymph nodes in the implant group was not statistically different from the control frequency; there was also no influence of the implant on the primary tumor growth noted. In case of the Walker sarcoma transplantation into the calf and the palmar pad of the ipsilateral limb to the one with the implant in the ilium, we could not note any attraction of tumor cells to the implant area, i.e. stimulation of the Walker sarcoma relapse by the implant. Thus, the research concluded that the studied implant meets the requirements of oncologic safety

Development of personalized approach to the reconstruction of bone tissue defects using porous ceramic osteoimplants

A fundamentally new complex technique for preoperative planning and creation of individual implants from ceramics for the reconstruction of the maxillofacial region is clinically applicable and in demand in modern trends of reconstructive surgery were developed and approved. The developed method implies using of alumina based ceramic material, which meets the requirements for medical materials used in reconstructive surgery. It was shown that by varying the initial composition of the ceramic powder material, it is possible to achieve structural and mechanical affinity with the surrounding bone tissue. Building a 3D model of an osteoimplant on the basis of a computed tomography of the patient avoids the need for additional resection of the bone tissue and ensures complete geometric conformity of the osteoimplant to the prosthetic area. The method was approved by the reconstruction of the patient's skull-orbital complex using a three-dimensional personalized ceramic implant. The complete absence of the inflammatory reaction after surgery was observed

Efficiency of radiotherapy during local hyperthermia in the treatment of laryngeal and laryngopharyngeal cancer

Cancer of the larynx and laryngopharynx, which is accessible to visual and instrumental examination, remains the most relevant and complicated problem among head and neck malignances as before. Investigations show that the incidence of cancer at these sites in Russia in the last decade has risen from 4.5 to 9.67 %. This is a severe and poor prognostic form of cancer, which is characterized by its nonspecific early clinical manifestations, complex anatomic and topographic structure, and a high rate of regional metastases. The mainstay of treatment for head and neck cancer involves 3 components: surgery, chemotherapy, and radiotherapy (RT), which are performed alone or in combination. The most commonly used technique is combined, frequently crippling due to organ-removing operations. The clinical introduction of current radio modifiers, local and deep hyperthermia systems, is a promising approach to improving the results of treatment, to enhancing the radiation damage of RT, and to achieving the tumor regression sufficient for surgical intervention without augmenting the early and late toxicity inherent in chemoradiation treatment. The results of the performed study of 35 patients with T2–3N0–2M0 laryngeal and laryngopharyngeal cancer proved the high efficiency of local hyperthermia in treating malignancies in this region during both preoperative (grades III– IV therapeutic pathomorphism) and radical beam RT