Ocena chirurgicznego leczenia chorych z zespołem Eagle’a

Wstęp: Celem badania była ocena skuteczności chirurgicznego leczenia pacjentów z zespołem przedłużonego wyrostka rylcowatego (zespołem Eagle’a), biorąc pod uwagę zarówno wczesne, jak i późne jego wyniki. Materiał i metody: Grupę badawczą stanowiło 15 pacjentów, którzy przebyli zabieg resekcji wyrostka rylcowatego z powodu wystąpienia objawów zespołu Eagle’a w latach 2005–2017. Podczas wizyty kontrolnej pacjenci zostali poproszeni o wypełnienie pooperacyjnej ankiety, która porównywała objawy występujące przed zabiegiem oraz ich stopień nasilenia z obecnym stanem zdrowia. Do oceny każdego z objawów oddzielnie zastosowano skalę bólu VAS, a do określenia jakości życia skalę Laitinena. Uwzględniono również dane z dokumentacji medycznych pacjentów. Wyniki ankiet poddano analizie statystycznej. Wyniki: Badanie wykazało, że 11 spośród 15 operowanych osób zanotowało znaczną poprawę w poziomie odczuwanych dolegliwości bólowych (średnio o 70,5%) oraz polepszenie się jakości życia (średnio o 65%) w stosunku do stanu sprzed zabiegu. W wykonanej analizie statystycznej wykorzystano: test Wilcoxona dla par wiązanych, test Manna-Whitneya, test Kruskala-Wallisa oraz współczynnik korelacji Spearmana. Stwierdzono występowanie istotnych statystycznie zależności pomiędzy odnotowanym stopniem poprawy a długością resekowanego wyrostka rylcowatego oraz jego ustawieniem. Dyskusja: W badaniu udowodniono, że chirurgiczne leczenie metodą resekcji wydłużonego wyrostka rylcowatego wykonywane z dostępu zewnątrzustnego w większości przypadków jest skutecznym sposobem leczenia zespołu Eagle’a, obarczonym niskim ryzykiem powikłań pozabiegowych.Introduction: The aim of the study was to assess the effectiveness of surgical treatment of patients with Eagle’s syndrome, taking into account both early and late results. Material and methods: The study group consisted of 15 patients who underwent resection of the styloid process due to Eagle syndrome in the period of 2005–2017. During the follow-up visit, the patients were asked to fill in a post-operative questionnaire that compared the pre-operative symptoms and their severity with the patients’ current health condition. The VAS pain scale was used to assess each symptom, and the Laitinen scale was used to assess the quality of life. Data from patients’ medical records were also included. The results of the surveys were subjected to statistical analysis. Results: The study showed that in 11 out of 15 cases there was a significant improvement in the level of pain (70.5% on average) and an improvement in quality of life (on average 65%) comparing to the pre-operative condition. The Wilcoxon test for binding pairs, the Mann-Whitney test, the Kruskal-Wallis test and the Spearman correlation coefficient were used in the statistical analysis. There were statistically significant correlations between the recorded improvement rate and the length of the resected styloid process and its setting. Discussion: The study proved that resection of prolonged styloid process from extraoral approach in most cases is an effective method of treatment of Eagle syndrome, that carries low risk of complications

Minor Salivary Gland Tumours of Upper Aerodigestive Tract: A Clinicopathological Study

The aim of this retrospective study of 56 patients with minor salivary gland tumours (MSGTs) of the upper aerodigestive tract is to present demographic features, distribution of tumours as well as methods and results of treatment performed in our institution over a 10-year period. Of 221 patients with salivary gland tumours, 56 patients with MSGT were selected. There were 36 female and 20 male patients aged from 8 to 81 years. Male-to-female ratio was 1 : 2 in the group of benign MSGT and 1 : 1.7 in the group of malignant tumours. The palate was the most frequent site of MSGT (45.6%), followed by buccal mucosa (19.3%). Of all MSGTs 63.2% were malignant, and 36.8% were benign. Adenoid cystic carcinoma was the most common neoplasm (31.6%), followed by pleomorphic adenoma (29.8%). Surgery was the method of choice in the treatment of patients with MSGT. Postoperative defects were reconstructed by prosthetic obturators, local flaps, and free radial forearm flap. Relative survival for patients with malignant MSGT was 88% at three years and 71.5% at five years. MSGTs are more frequent in females and predominantly affect the palate. Malignant MSGTs are more common than benign

Enophthalmos as a prognostic factor in blow-out fracture of the orbit. Retrospective study of over 700 cases

The aim of the study was to determine the influence of posttraumatic enophthalmos in orbital blow-out fracture on the treatment results. The relationship between time from injury to treatment, type of surgical reconstruction, bone graft site, type of diplopia and treatment results were evaluated. The relationship between the location of the fracture and the degree of enophthalmos was also analyzed. The study included 730 patients, 128 women and 602 men, aged 4 to 77 years, average 28 years, treated because of orbital blow-out fracture in our Department between 1975 and 2015. The study included only patients with an isolated orbital floor or medial wall fracture, so-called "pure blow-out" or "internal blowout". Fractures of the lower rim, roof or lateral wall of the orbit, as well as the coexistence of other fractures of the facial part of the skull, were excluding citeria from the study. Complete recovery in surgically treated patients was achieved in 405 (58.8%) patients, improvement in 179 (26%) and no improvement in 105 (15.2%) patients. The degree of post-traumatic enophthalmos affects the result of the treatment. The location of the orbital fracture affects the enophthalmos, in our group of patients the largest incidence occurred in the fracture located in the orbital floor combined with medial wall. Patients who underwent surgical treatment up to 14 days after the injury achieved better results than those postponed

IgG4-related disease in the head and neck region : report of two cases and review of the literature

IgG4-related disease (IgG4-RD) is a rare immune-mediated condition characterized by extensive tissue fibrosis and infiltration by immunoglobulin G4 positive plasma cells in a single organ or systemic appearance. Two cases are presented including an unusual case of a 30-year-old man with IgG4-RD appearing simultaneously in the cervical lymph nodes, ethmoid, maxillary sinuses, and upper gingiva, with spontaneous loss of teeth. According to the literature, this is the first case with loss of teeth occurring in the course of the disease. The second case is a 46-year-old man suffering from IgG4-related chronic sclerosing sialadenitis of the right submandibular gland