14 research outputs found
Transoral Excision of a Parapharyngeal Space Tumor: Case Report
Tumors of the parapharyngeal space are rare tumors comprising less than 1% of all head and neck neoplasms. They are mainly salivary gland or neurogenic tumors. Clinical presentation is very variable. Surgical resection by different approaches remains to be the best possible treatment option. We present a case of 45 years old female patient admitted at the ENT Department due to the unilateral hearing loss and swallowing difficulties. Clinical examination revealed the
diagnosis of a pleomorphic adenoma of the parapharyngeal space. Tumor was surgical (transorally) excised. Two years following the surgery there is no recurrence of the initial symptoms and primary disease
Transoral Excision of a Parapharyngeal Space Tumor: Case Report
Tumors of the parapharyngeal space are rare tumors comprising less than 1% of all head and neck neoplasms. They are mainly salivary gland or neurogenic tumors. Clinical presentation is very variable. Surgical resection by different approaches remains to be the best possible treatment option. We present a case of 45 years old female patient admitted at the ENT Department due to the unilateral hearing loss and swallowing difficulties. Clinical examination revealed the
diagnosis of a pleomorphic adenoma of the parapharyngeal space. Tumor was surgical (transorally) excised. Two years following the surgery there is no recurrence of the initial symptoms and primary disease
Dermatoglyphs and Larynx Cancer
Cancer of the larynx is the seventh most common malignant disease among middle-aged men in Croatia. Morbidity ratio between men and women is 17:1. Etiology of disease is directly connected with the tobacco use while genetic influences have not yet been studied enough. Digito-palmar dermatoglyphs analysis has already been used in studying the genetic etiology of certain malignant diseases (lung, breast, cervical, colorectal, melanoma and gastric cancer). We have analyzed correlation of quantitative and qualitative traits between two groups (group of 40 men with larynx cancer versus control group of 100 phenotypically healthy men). Quantitative statistical analysis (descriptive statistics, multivariate and univariate analysis) has not shown statistically significant difference except for the latent structure using factor analysis. Qualitative analysis has shown statistically significant difference among two investigated groups thus suggesting the faster changes of the qualitative features under the influence of the ecological factors
Nefunkcio nalni karcinom paratiroidne žlijezde : prikaz sluÄaja
Parathyroid gland carcinoma is a rare malignancy. The tumor is mostly functioning, causing severe hyperparathyroidism, with high serum calcium level and severe bone disease. Non-functioning parathyroid carcinomas are extremely rare. We report on a 60-year-old male patient admitted to ENT Department due to a large neck tumor mass compressing the thyroid and trachea. Preoperatively, thyroid hormone, parathyroid hormone (PTH ) and calcium serum levels were normal. The following immunohistochemical markers (DAKO, Denmark) were used: bcl-2; CD- 10; Chromogranin-A; Cyclin-D1; EM A; Ki-67; Mdm-2; p-53; PGP-9,5; RCC; Synaptophysin; Thyroglobulin; and TTF -1. Immunohistochemical analysis indicated the diagnosis of a primary parathyroid gland carcinoma. Tumor cells showed diffusely positive immunohistochemical staining with chromogranin-A and PGP-9,5, positive staining of variable intensity with synaptophysin, and weakly positive reaction with EM A. Also, the cytoplasm of tumor cells was diffusely positively stained with bcl-2, while the nuclei showed positive reaction with p-53 oncogene and TTF -1. The remaining markers (CD-10, cyclin-D1, Ki-67, Mdm-2, RCC and thyroglobulin) were negative. Four years after the surgery, the patient died from renal carcinoma pulmonary metastases and liver cirrhosis complications. In conclusion, non-functioning parathyroid gland carcinoma is a very rare disease. Detailed immunohistochemical analysis is needed to distinguish it from other thyroid and parathyroid neoplasms and metastatic carcinoma. Surgical treatment is presently the best mode of therapy.Karcinom paratiroidne žlijezde je rijedak maligni tumor. Tumor je najÄeÅ”Äe hormonski aktivan i uzrokuje teÅ”ki oblik hiperparatiroidizma s visokom serumskom razinom kalcija, poremeÄajima koÅ”tane gustoÄe i bubrežnim kamencima. Nefunkcionalni paratiroidni karcinom je iznimno rijedak. Prikazuje se sluÄaj 60-godiÅ”njeg bolesnika koji je primljen na Odjel otorinolaringologije zbog velikog tumora vrata koji je komprimirao grkljan i duÅ”nik. Prijeoperacijski su serumske vrijednosti hormona Å”titnjaÄe, paratiroidnog hormona i kalcija bile unutar referentnih vrijednosti. KoriÅ”teni su slijedeÄi imunohistokemijski biljezi: (DAKO, Danska): bcl-2; CD-10; Chromogranin-A; Cyclin-D1; Ki-67; Mdm-2; p-53; RCC; Synaptophysin; Thyroglobulin i TTF -1. Imunohistokemijskom analizom tumora postavljena je dijagnoza primarnog karcinoma paratiroidne žlijezde. Tumorske stanice su pokazale difuzno pozitivnu imunoreakciju s kromograninom i PGP- 9,5, pozitivnu reakciju razliÄitog intenziteta sa sinaptofizinom, te slabo pozitivnu reakciju na EM A. U citoplazmi je naÄena umjereno pozitivna reakcija na bcl-2, a jezgre su bile pozitivne na p-53 i TTF -1, dok su ostali biljezi bili nereaktivni. Äetiri godine nakon operacije bolesnik je umro od posljedica pluÄnih metastaza karcinoma bubrega i dekompenzirane jetrene ciroze. U zakljuÄku, nefunkcionalni karcinom paratiroidne žlijezde je vrlo rijedak i težak za dijagnosticiranje. Detaljnim imunohistokemijskim metodama potrebno ga je diferencirati od ostalih tumora Å”titne i paratiroidne žlijezde i metastatskog karcinoma. KirurÅ”ko lijeÄenje danas predstavlja optimalan oblik terapije
Nefunkcio nalni karcinom paratiroidne žlijezde : prikaz sluÄaja
Parathyroid gland carcinoma is a rare malignancy. The tumor is mostly functioning, causing severe hyperparathyroidism, with high serum calcium level and severe bone disease. Non-functioning parathyroid carcinomas are extremely rare. We report on a 60-year-old male patient admitted to ENT Department due to a large neck tumor mass compressing the thyroid and trachea. Preoperatively, thyroid hormone, parathyroid hormone (PTH ) and calcium serum levels were normal. The following immunohistochemical markers (DAKO, Denmark) were used: bcl-2; CD- 10; Chromogranin-A; Cyclin-D1; EM A; Ki-67; Mdm-2; p-53; PGP-9,5; RCC; Synaptophysin; Thyroglobulin; and TTF -1. Immunohistochemical analysis indicated the diagnosis of a primary parathyroid gland carcinoma. Tumor cells showed diffusely positive immunohistochemical staining with chromogranin-A and PGP-9,5, positive staining of variable intensity with synaptophysin, and weakly positive reaction with EM A. Also, the cytoplasm of tumor cells was diffusely positively stained with bcl-2, while the nuclei showed positive reaction with p-53 oncogene and TTF -1. The remaining markers (CD-10, cyclin-D1, Ki-67, Mdm-2, RCC and thyroglobulin) were negative. Four years after the surgery, the patient died from renal carcinoma pulmonary metastases and liver cirrhosis complications. In conclusion, non-functioning parathyroid gland carcinoma is a very rare disease. Detailed immunohistochemical analysis is needed to distinguish it from other thyroid and parathyroid neoplasms and metastatic carcinoma. Surgical treatment is presently the best mode of therapy.Karcinom paratiroidne žlijezde je rijedak maligni tumor. Tumor je najÄeÅ”Äe hormonski aktivan i uzrokuje teÅ”ki oblik hiperparatiroidizma s visokom serumskom razinom kalcija, poremeÄajima koÅ”tane gustoÄe i bubrežnim kamencima. Nefunkcionalni paratiroidni karcinom je iznimno rijedak. Prikazuje se sluÄaj 60-godiÅ”njeg bolesnika koji je primljen na Odjel otorinolaringologije zbog velikog tumora vrata koji je komprimirao grkljan i duÅ”nik. Prijeoperacijski su serumske vrijednosti hormona Å”titnjaÄe, paratiroidnog hormona i kalcija bile unutar referentnih vrijednosti. KoriÅ”teni su slijedeÄi imunohistokemijski biljezi: (DAKO, Danska): bcl-2; CD-10; Chromogranin-A; Cyclin-D1; Ki-67; Mdm-2; p-53; RCC; Synaptophysin; Thyroglobulin i TTF -1. Imunohistokemijskom analizom tumora postavljena je dijagnoza primarnog karcinoma paratiroidne žlijezde. Tumorske stanice su pokazale difuzno pozitivnu imunoreakciju s kromograninom i PGP- 9,5, pozitivnu reakciju razliÄitog intenziteta sa sinaptofizinom, te slabo pozitivnu reakciju na EM A. U citoplazmi je naÄena umjereno pozitivna reakcija na bcl-2, a jezgre su bile pozitivne na p-53 i TTF -1, dok su ostali biljezi bili nereaktivni. Äetiri godine nakon operacije bolesnik je umro od posljedica pluÄnih metastaza karcinoma bubrega i dekompenzirane jetrene ciroze. U zakljuÄku, nefunkcionalni karcinom paratiroidne žlijezde je vrlo rijedak i težak za dijagnosticiranje. Detaljnim imunohistokemijskim metodama potrebno ga je diferencirati od ostalih tumora Å”titne i paratiroidne žlijezde i metastatskog karcinoma. KirurÅ”ko lijeÄenje danas predstavlja optimalan oblik terapije
Metastaza karcinoma bubrega u nosno-sinusnoj Ŕupljini
Renal cell carcinoma accounts for 3% of all adult malignant tumors. Common sites of metastases are lungs, bone, liver, brain and adrenal glands. Metastatic disease to the head and neck ranges from 15% to 30%. The 5-year survival rate after nephrectomy is 60%-75%, but with multiorgan metastases the 5-year survival rate is significantly lower, 0-7%. A case is presented of a female patient diagnosed with renal cell carcinoma metastases to the paranasal sinuses, diagnosed and treated at the Department of ENT and Head and Neck Surgery, Zadar General Hospital, Zadar, Croatia. The tumor was surgically removed. Unfortunately, the patient died one year after the procedure due to multiorgan failure. Although metastases of renal cell carcinoma to the head and neck are very rare, it should be first suspected when investigating a metastatic tumor in this region. Surgical excision offers the best hope for long term survival. In case of unresectable tumor, other treatment options should be considered such as radiotherapy, immunotherapy and chemotherapy.Od svih malignih tumora ljudskog organizma tumor bubrega je zastupljen u oko 3% sluÄajeva. Äesta mjesta metastaziranja su pluÄa, kosti, jetra, mozak i nadbubrežna žlijezda. Pojava metastaza ovoga karcinoma u podruÄju glave i vrata kreÄe se oko 15%-30%. Postotak petogodiÅ”njeg preživljenja nakon nefrektomije je 60%-75%, dok je istovjetno preživljenje s prisutnim metastazama znatno kraÄe, 0-7%. U ovom radu prikazuje se bolesnica kojoj je dijagnosticiran karcinom bubrega s metastazom u nosnoj Å”upljini i paranazalnim sinusima. DijagnostiÄki postupak i kirurÅ”ko lijeÄenje obavljeno je u OpÄoj bolnici Zadar, Odjel otorinolaringologije i kirugije glave i vrata. Tumor je uspjeÅ”no kirurÅ”ki odstranjen, ali je bolesnica preminula nakon godinu dana zbog viÅ”eorganskih metastaza. Metastaza bubrežnog karcinoma u podruÄju glave i vrata je vrlo rijetka. KirurÅ”ka ekscizija je metoda izbora, a u sluÄaju neresektabilnog tumora moguÄe je primijeniti radioterapiju, imunoterapiju i kemoterapiju
A view of the first BAHA system implant in Zadar General Hospital
Bone Anchored Hearing Aid ili BAHA sistem danas predstavlja novi i moderan naÄin sluÅ”ne rehabilitacije i alternativu konvencionalnim sluÅ”nim pomagalima. Od prve proizvodnje 1977. godine u
Å vedskoj (Entific Medical Systems, Goteborg), u Å”irokoj je primjeni i do sada je ukupno u svijetu implantirano oko 100.000 bolesnika. U radu prikazujemo prvi sluÄaj implanatacije BAHA sistema na Odjelu
otorinolaringologije, OpÄe bolnice Zadar. Ugradnja BAHA sistema uÄinjena je kod bolesnika s dugogodiÅ”njom kroniÄnom upalom srednjega uha i kroniÄnim mastoiditisom, Å”to je dovelo do teÅ”koga
oÅ”teÄenja sluha. Zahvat je uÄinjen u lokalnoj anesteziji u jednom aktu. Po uredno zavrÅ”enoj osteointegraciji nakon osam tjedana postavljen je i aktiviran BAHA govorni procesor BP110. Tri mjeseca od aktivacije govornoga procesora bolesnik je iznimno zadovoljan postignutom razinom sluÅ”ne rehabilitacije. BAHA sistem danas je postao opÄe prihvaÄen i suvremen naÄin rehabilitacije sluha. Uz adekvatan odabir kandidata i uz pravilno izveden kirurÅ”ki zahvat, daje znaÄajno bolje rezultate u rehabilitaciji sluha od konvencionalnih
sluŔnih pomagala.Bone Anchored Hearing Aid (BAHA) today presents a new and modern way of hearing rehabilitation and an alternative to the conventional hearing aids. Since its first manufacture in 1977 in Sweden (Entific Medical Systems, Goteborg), it has been widely used and up to now around 100,000 BAHA systems have been implanted worldwide. In the present case we report on a first BAHA system implantation at the ENT Department of Zadar General Hospital. The BAHA system implantation was performed in a patient with a long term history of chronic suppurative otitis that resulted in severe hearing loss. The procedure was done under local anesthesia as a single act. Upon proper osteointegration after eight weeks, the speech processor BP110 was added and activated. Three months following the activation of the speech processor, the patient is highly satisfied with the level of the achieved hearing rehabilitation. Presently, the BAHA system was a universally accepted procedure of hearing rehabilitation, and with the proper candidate selection and
meticulous surgical intervention, it gives significantly better hearing rehabilitation when compared to the conventional hearing device
The Effect of Propofol and Fentanyl as Compared with Sevoflurane on Postoperative Vomiting in Children after Adenotonsillectomy
Postoperative vomiting (PV) after adenotonsillectomy in children is a common problem with an incidence as high as 40ā80%. Only few studies in the recent literature compared the effect of different anesthetic techniques concerning PV in children. The aim of this study was to compare the incidence of PV in two groups of children who underwent two different general anesthesia techniques in order to determine what type of anesthetic technique is more related to less PV. The clinical trial included 50 children (physical status ASA I, 3ā12 years old) divided into 2 groups and monitored for PV 24 hours following the surgery. Group one (G1) consisted of 25 children who underwent general anesthesia with gas mixture 60% nitrous oxide and 40% oxygen and anesthetic propofol, opioid fentanyl and muscle relaxant vecuronium intravenously and group two (G2) included 25 children to whom volatile anesthesia with sevoflurane in the same gas mixture was given. Demographic characteristics (gender, age, weight, history of motion sickness and earlier PV) as well as surgical data (length of surgery and anesthesia, intraoperative blood loss) were recorded. There were no significant differences considering demographic characteristics and surgical data between the investigated groups. The incidence of PV was relatively low 3 children (12%) in G1 group and 5 children (20%) in G2 group. Statistically there was no significant difference between the groups regarding the incidence of PV and both anesthetic techniques can be used equally safe regarded to PV
Giant Basal Cell Carcinoma of the Forehead: A Case Report
Giant basal cell carcinoma (GBCC) is defined as a tumor 5cm or greater in diameter. They present less than 1% of all basal cell carcinomas. We present a case of an 85-year-old male patient with a giant ulcerating tumor of the left forehead (measuring 7x6cm). Under local anesthesia tumor was surgically excised. No involvement of the underlying periostal or bone structure was noted. Pathohystological exam revealed the giant basal cell carcinoma, with free surgical margins. Giant basal cell carcinomas are rare tumors and are usually result of a long duration and patient neglect. In comparison to the ordinary basal cell carcinoma these tumors have a higher metastatic potential. Surgical resection with negative surgical margin is the best possible treatment option