Proliferation activity and apoptosis in granulation tissue and cholesteatoma in middle ear reoperations

The aim of the study was to find out the potential prognostic value of proliferation activity and apoptosis in cholesteatoma and granulation tissue removed during middle ear reoperation in recurrent middle ear inflammation. Granulation tissues and recurrent cholesteatoma were analysed after being surgically removed from the middle ear in a group of 25 patients qualified for middle ear reoperation procedure. Paraffin sections were stained with haematoxylin and eosin according to Mallory’s method. Immunohistochemical reaction Anti-PCNA was performed. Apoptosis was evaluated using the TUNEL method. The percentage of PCNA-positive cells was 42–95% in the matrix of the cholesteatoma and 29–81% in the perimatrix. In the granulation tissue it was 35–75%. The percentage of apoptotic cells was 12–73% in the matrix of the cholesteatoma, 5–72% in the perimatrix and 1–65 % in the granulation tissue. The prognostic value of the parameters studied in the recurrent middle ear inflammatory process is questionable, probably due to the small number of cases under examination

The controversial role of superoxide radicals in living organisms

The destructive role of reactive oxygen species (ROS) in cell and tissue damage is well documented. However, so far a very little is known about their role as a regulating factor in the cellular metabolism. At present, we cannot judge out whether the superoxide radicals are beneficial or harmful to the organisms. Their positive or negative influence each time is determined by a numerous factors (e.g. site and time of radicals generation as well as their concentration). This may lay down a t the bottom of some conflicting observations in free radical biology. The controversial role of the superoxide radicals in the vital metabolic processes (inflammation, proliferation, malignant transformation, apoptosis and lipid peroxidation) is discussed.Zadanie pt. „Digitalizacja i udostępnienie w Cyfrowym Repozytorium Uniwersytetu Łódzkiego kolekcji czasopism naukowych wydawanych przez Uniwersytet Łódzki” nr 885/P-DUN/2014 dofinansowane zostało ze środków MNiSW w ramach działalności upowszechniającej naukę

Wyniki rekonstrukcji muszli małżowiny usznej wyspowym płatem z okolicy zamałżowinowej u pacjentów po wycięciu raka

Celem pracy było przedstawienie naszego doświadczenia z zastosowania wyspowego płata zamałżowinowego (pif) do rekonstrukcji muszli małżowiny usznej oraz kliniczna analiza wyników operacji tą metodą u pacjentów po wycięciu raka tej okolicy. Materiał i metodyka. Analizą objęto 13 chorych, których poddano rekonstrukcji muszli ucha z zastosowaniem pif, w latach 2000-2013. Podczas wizyt kontrolnych oceniono wczesne i odległe wyniki leczenia. Porównano opinię chirurga i pacjenta. Na podstawie badań kontrolnych u pacjentów oceniono, przez co najmniej 2 lata, wczesne i odległe wyniki rekonstrukcji uwzględniające opinie chirurga plastycznego i pacjentów. Wyniki. Zmiany wycięto w całości u wszystkich badanych, nie stwierdzając wznowy w ciągu 2 lat. Przekrwienie bierne wystąpiło u 2 osób (15,3%), a nadmierne przyleganie małżowiny usznej też u 2 chorych (15,3 %). Wyniki pooperacyjne były bardzo dobre u 11 pacjentów zarówno w ocenie chirurga, jak i chorych, natomiast u 2 pacjentów satysfakcjonujące z powodu nadmiernego przylegania małżowiny usznej. Wnioski. 1. Operacje połączone z rekonstrukcją po wycięciu guza muszli małżowiny usznej wyspowym płatem zza małżowiny usznej pozwoliły na doszczętne wycięcie zmian (bez oznak wznów), a jednocze- śnie zachowanie właściwego konturu muszli operowanej małżowiny usznej. 2. Użycie zamałżowinowych płatów wyspowych w chirurgicznym leczeniu ubytków muszli małżowiny usznej zapewniło bardzo dobre wyniki pooperacyjne, co potwierdza skuteczność tej metody. 3. Wyniki zabiegów rekonstruujących muszlę wyspowym płatem zza małżowiny usznej przyczyniły się do bardzo dobrych ocen zastosowanego leczenia zarówno w opinii pacjentów, jak i chirurgów

Results of auricular conchal bowl reconstructions following cancer resections with postauricular island flap

The aim of the study was to present our experience with the postauricular island flap (pif) and clinical evaluation of the results following auricular conchal bowl reconstructions with the pif in patients after carcinoma resections. Material and methods. We analyzed results in 13 patients who underwent auricular conchal bowl reconstructions with pif following malignant tumor resection between 2000-2013. The patients were followed-up. We estimated early and long-term results after surgery including plastic surgeon’s and patient’s opinion. Results. The malignancies were completely excised in all patients, and there were no recurrences within 2 years of follow-up. Observed complications of conchal bowl reconstructions were venous congestion in two cases (15.3 %), and pinning of the operated ear in two patients (15.3%). Postoperative result was very good in 11 cases (both in the opinion of plastic surgeon and patients), whereas in two patients with pinning of the operated ear was satisfied. Conclusions. 1. Postauricular island flap reconstructions after auricular conchal bowl resections allowed for complete removal of malignant tumors with no evidence of recurrence, and also preserved proper conchal shape in the reconstructed ear. 2. Reconstructions of auricular conchal bowl with the postauricular island flap resulted in very good postoperative results, which confirms the efficiency of the applied technique. 3. Reconstructive surgery with postauricular island flap of individuals with partial auricular conchal bowl defects contributed to postoperative satisfaction in both patients and doctors’ estimation

External auditory meatus and/or conchal bowl reconstruction with postauricular island flap in patients with Basal Cell Carcinoma or Squamous Cell Carcinoma

Aims. Presenting our clinical experience with the postauricular island flap (pif) and estimation of the results following partial external auditory canal (eac) and/or auricular conchal bowl reconstructions with the pif in patients after carcinoma resections. Methods. We have analyzed postoperative results of 19 patients after auricular conchal bowl (11), or auricular conchal bowl and eac (8) reconstructions with pif, following malignant tumor resections, between 2000-2015. The patients were followed-up and evaluated in respect of early and long-term results after surgical treatment considering plastic surgeon’s and patient’s opinion. Results. The cancers were completely excised in all patients, and there were no recurrences within at least 2 years of follow-up. The observed complications after reconstructions comprised venous congestion in five cases (26.3 %), pinning of the operated ear in four patients (21 %), prominent earlobe in three (15.8 %), and eac constriction in three cases (15.8 %). Postoperative result was very good in all cases (both in the opinion of plastic surgeon and patients), except patients with pinning of the operated ear, prominent earlobe (moderately satisfied). Conclusions 1. Combined operations involving postauricular island flap reconstructions after partial (external auditory meatus and/or auricular conchal bowl) resections allowed for complete removal of malignant tumors with no evidence of recurrence, and also preservation of proper conchal shape in the reconstructed ear. 2. Retroauricular approach in cases with cancer involvement of the external auditory meatus allowed for proper visualization and estimation of lesions extent, as well as adequate surgical access. </jats:p

Diagnostic imaging in chronic otitis media: does CT and MRI fusion aid therapeutic decision making? – a pilot study

Introduction: Despite the recent advances in otosurgery diagnosis of cholesteatoma and qualification for surgery remains an issue in contemporary laryngology. In cases of cholesteatoma recidivism, it is of utmost importance to properly locate the pathology in the middle ear to plan surgical approach. Magnetic Resonance imaging in diffusion-weighted non-echoplanar sequences (non-EPI DWI) enables cholesteatoma detection as small as 2 mm and could potentially prevent unnecessary second-look surgery. Computed Tomography of the temporal bone allows precise visualization of bony structures and topographical landmarks of the middle ear. A fusion of both imaging modalities combines the advantages of these techniques. Material and methods: Five patients treated in the Department of Otolaryngology, the Medical University of Lodz for probable cholesteatoma recidivism were included in this study. A high-resolution CT scan of the temporal bone and an MRI scan including non-EPI sequences was obtained in all patients. A fusion of CT and MRI studies was conducted using OsirixMD software. Fist, CT studies were fused with MRI BFFE sequences, then non-EPI sequences were added. Finally, if the patient qualified for surgical treatment histopathological diagnosis was compared with MRI results. Results: CT scans were analyzed to establish the extent of previous surgical interventions and anatomical landmarks preservation. In all cases, MRI results were suspicious of cholesteatoma recidivism. Four cases were confirmed in postoperative histopathological evaluation, there was one false positive case when intraoperatively scar tissue was identified, which was later confirmed as connective tissue upon histopathological evaluation. Conclusions: CT and MRI fusion provides a helpful diagnostic tool in preparation for surgery in patients with suspected cholesteatoma recidivism

External auditory meatus and/or conchal bowl reconstruction with postauricular island flap in patients with Basal Cell Carcinoma or Squamous Cell Carcinoma

Aims. Presenting our clinical experience with the postauricular island flap (pif) and estimation of the results following partial external auditory canal (eac) and/or auricular conchal bowl reconstructions with pif in patients after carcinoma resections. Methods. We have analyzed postoperative results of 19 patients after auricular conchal bowl (11), or auricular conchal bowl and eac (8) reconstructions with pif, following malignant tumor resections, between 2000-2015. The patients were reexamined and evaluated in respect of early and long-term results after surgical treatment considering both the plastic surgeon’s and the patient’s opinion. Results. The cancers were completely excised in all patients, and there were no recurrences within at least 2 years of follow-up. The observed complications after reconstructions comprised venous congestion in five cases (26.3%), pinning of the operated ear in four patients (21%), prominent earlobe in three (15.8%), and eac constriction in three cases (15.8%). The postoperative result was very good in all cases (both in the opinion of the plastic surgeon and the patients), except for patients with pinning of the operated ear, with a prominent earlobe (moderately satisfied). Conclusions. 1. Combined operations involving postauricular island flap reconstructions after partial (external auditory meatus and/or auricular conchal bowl) resections allowed for complete removal of malignant tumors with no evidence of recurrence, and for the preservation of a proper conchal shape in the reconstructed ear. 2. A retroauricular approach in cases with cancer involvement of the external auditory meatus allowed for proper visualization and estimation of lesions extent, as well as adequate surgical access

Rekonstrukcja przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej wyspowym płatem zamałżowinowym u chorych z rakiem podstawnokomórkowym lub kolczystokomórkowym

Cel: Przedstawienie klinicznego doświadczenia z zastosowania wyspowego płata zamałżowinowego (Postauricular Island Flap; PIF) oraz ocena wyników rekonstrukcji przewodu słuchowego zewnętrznego (External Auditory Canal; EAC) i/lub muszli małżowiny usznej tą metodą u pacjentów po wycięciu złośliwej zmiany nowotworowej tej okolicy. Materiał i metody: Analizie poddano łącznie 19 chorych po wycięciu raka z zastosowaniem PIF (2000–2015) – 11 pacjentów po rekonstrukcji muszli małżowiny usznej, 8 pacjentów po rekonstrukcji muszli wraz z EAC. Oceniono wczesne i odległe wyniki leczenia operacyjnego. Porównano opinie chirurga i pacjenta. Wyniki: U wszystkich badanych zmiany wycięto w całości, nie stwierdzając wznowy w ciągu min. 2 lat obserwacji. Przekrwienie bierne wystąpiło u 5 chorych (26,3%), nadmierne przyleganie małżowiny usznej u 4 pacjentów (21%), u 3 chorych (15,8 %) zauważono odstawanie płatka, a u 3 osób (15,8%) zwężenie EAC. Wyniki pooperacyjne były bardzo dobre u wszystkich pacjentów (tak w ocenie chirurga, jak i chorych), za wyjątkiem pacjentów z nadmiernym przyleganiem małżowiny usznej i z odstawaniem płatka, u których oceny były satysfakcjonujące. Wnioski: 1) Operacje po wycięciu guza przewodu słuchowego zewnętrznego i/lub muszli małżowiny usznej połączone z rekonstrukcją wyspowym płatem zza małżowiny usznej pozwoliły na doszczętne wycięcie zmian (bez oznak wznów) oraz zachowanie właściwego konturu muszli operowanej małżowiny usznej. 2) Zastosowanie dostępu w okolicy zamałżowinowej u chorych z rakiem umiejscowionym w obrębie przewodu słuchowego zewnętrznego pozwoliło nie tylko na właściwą wizualizację i ocenę rozległości tych zmian, ale także stworzyło dobre dojście do pola operacyjnego

Multicenter experiences in temporal bone cancer surgery based on 89 cases.

OBJECTIVE:To present outcomes of extensive surgery: lateral, subtotal, total petrosectomies in patients with temporal bone invasion resulting from specific primary cancers. STUDY DESIGN:Retrospective case review. SETTING:Four tertiary referral centers. MATERIAL:89 patients with cancer of the temporal bone treated between January 2006 and December 2010. INTERVENTION:Multidisciplinary team approach including surgical resection, reconstruction, and postoperative radiotherapy. MAIN OUTCOME MEASURE:Disease-specific survival, overall survival. RESULTS:In 27.0% of the patients, relapse was reported, with an average of 6.3 months after surgery; 31 patients (34.8%) died during the follow-up. The average mortality was 22.1 months. Fifty-four patients (58.7%) stayed alive during the time of observation. The average survival time was 42.0 months. The median time of survival with relapse was 12 months (range: 1-51 months). The three-year disease-free rate was 38.0% and the overall survival rate was 58.7%. CONCLUSIONS:Petrosectomy is an effective treatment for malignant temporal bone invasion. The probability of a good outcome was statistically decreased with a high T grade, positive margins, and salvage surgery. Younger age is connected with better prognosis. One of the major tasks remains to improve detection and to shorten the time to diagnosis, keeping in mind that symptoms are insidious and in younger people, the time before diagnosis was longer