Extensive cut wound of the face - case report

We present a case report of a 57-year-old female with a 25 cm laceration on the left side of her face. The patient was cut with a knife and as a result the parotid gland, the parotid duct, the tongue, the corner of the mouth, the masseter muscle, the cartilaginous part of the external acoustic canal and the auricle were damaged. The facial nerve was not damaged. All of the injuries were managed, including end-to-end anastomosis of the Stenon duct and layered closure of the auricle. The cut wounds of the facial and ear area must be carefully assessed and adequately treated in order to assure proper healing and avoid complications. Key words: parotid gland, parotid duct, auricle, facial cut wound57-letnia pacjentka została przywieziona przez Zespół Ratownictwa Medycznego na Izbę Przyjęć z 25-centymetrową raną ciętą twarzy po stronie lewej. Uraz został zadany nożem. Uszkodzeniu uległ miąższ śliniaki, przewód wyprowadzający Stenona, język, lewy kącik ust, mięsień żwacz, część chrzęstna przewodu słuchowego zewnętrznego oraz małżowina uszna. Nerw twarzowy nie został uszkodzony. W artykule opisano sposób chirurgicznego zaopatrzenia uszkodzonych struktur twarzy. Na podstawie przeglądu literatury omówione zostały postępowanie oraz istotne aspekty zaopatrzenia tego typu urazów. Rany cięte okolicy twarzy i ucha wymagają dokładnej oceny i odpowiedniego zaopatrzenia, by uzyskać prawidłowe gojenie i uniknąć powikłań. Słowa kluczowe: ślinianka przyuszna, przewód wyprowadzający ślinianki, małżowina uszna, rana cięta twarz

Preoperative lymphocyte count, neutrophil to lymphocyte and platelet to lymphocyte ratio predict the recurrence with progression and cancerization in vocal fold lesions—retrospective study

Backgrounds This study explored the contribution of peripheral blood markers in diagnosis and prognosis estimation of different stages of laryngeal dysplasia and early glottic cancer. Methods Retrospective analysis of clinical, histopathological and laboratory data of 220 patients including hemoglobin, neutrophil, lymphocyte, monocyte and platelet counts, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR). Results The mean hemoglobin level and platelets count showed differences between histopathological stages of lesions (p = 0.041 and 0.046, respectively). In patients with recurrent lesions mean level of lymphocyte count, NLR and PLR were significant in assessing progression and cancerization (p = 0.005, 0.028 and 0.023, respectively). The univariate analysis recognized level of PLR ≥ 141.74 as significant risk factor of the recurrence of vocal fold hypertrophic lesions (OR = 1.963). Conclusions The levels of blood cells and their ratios seem to be effective in predicting the recurrence of lesion and even more their potential role in indicating malignant progression

Prognostic and predictive role of soluble programmed death ligand-1 in head and neck cancer

Objectives: The aim of the study was to investigate clinical significance of soluble PD-L1 (sPD-L1) serum level in head and neck cancer and to evaluate its role as a possible prognostic and predictive biomarker. Methods: A prospective analysis of sPD-L1 levels in 60 patients diagnosed and treated due to malignant and non-malignant lesions in the region of head and neck was performed in peripheral blood by an ELISA test. Results: The range of sPD-L1 in the study group was 0.16–1.63 ng/mL, mean 0.64 ± 0.32. There were no differences in the mean sPD-L1 regarding patients’ age, sex, and the localization of the lesion. Statistically significant difference was revealed in the average sPD-L1 level (p =  0.006) depending on the histopathological advancement of the lesions, 0.704 ± 0.349 and 0.512 ± 0.177 respectively in the malignant and benign group. The separate analysis of laryngeal lesions confirmed statistical difference in sPD-L1 (p =  0.002) for the malignant lesions (0.741 ± 0.353) compared with the benign (0.489 ± 0.175). The sPD-L1 level of 0.765 ng/mL or higher, revealed 35% sensitivity and 95.5% specificity for the diagnosis of head and neck malignant lesions (AUC = 0.664, 95% CI 0.529‒0.8, p-value = 0.039). The 1-year DFS was 83.3% in the group of patients with low sPD-L1 levels (< 0.765 ng/mL) and 53.8% in patients with high sPD-L1 (≥0.765 ng/mL). The 2-year OS were 68% and 69.2% respectively in both groups. The log-rank test confirmed statistically significant prognostic value of sPD-L1 level for 1-year DFS (p-value = 0.035). Conclusions: sPD-L1 is a promising prognostic and early recurrence predictive biomarker for head and neck cancers, most significantly for laryngeal lesions. Level of evidence: 3