Pub Date : 2022-10-04DOI: 10.5604/01.3001.0016.0259
M. Arcimowicz, T. Gotlib
Introduction: IgG4-related disease is a rare, immune disease with hyper-IgG4-gamma-globulinemia and fibro-inflammatory lesions that can occur in any organ. The diagnosis is made on the basis of clinical and histopathological criteria. In otolaryngological practice, the IgG4-related disease should be taken into account in the differential diagnosis of patients with salivary or lacrimal gland enlargement, with eyelid edema and chronic rhinosinusitis. Systemic glucocorticosteroids are the first line of treatment and can be combined with other immunosuppressants or biological treatment. The prognosis is favorable, but delay in diagnosis and therapy can lead to multiple organ failure and premature death. Case study: The paper presents a case report of patient initially treated for allergic rhinitis with asthma and eyelid edema, accompanied by rhinosinusitis, and history of numerous comorbidities (Hashimoto’s disease, parotid tumor, idopathic hepatitis, anemia and albinism). Imaging studies confirmed enlargement of the salivary and lacrimal glands with the upper eyelids edema and rhinosinusitis. The patient was qualified for sinus surgery. Postoperative histopathological examination enabled the diagnosis of IgG4- -related disease. For the next 5 years, the patient received prednisone and azathioprine, then prednisone and methotrexate, inhaled and nasal steroids, under constant specialist care, including otolaryngologist. Eyelid oedema resolved, asthma and allergic rhinitis were well controlled. Despite treatment, sinus symptoms gradually worsened, accompanied by headaches. The mucocele of the left frontal sinus was diagnosed and qualified for sinus reoperation. In the postoperative period, despite intensive treatment, mucocele of the right frontal sinus developed. Finally, another radical surgery on the frontal sinuses was performed (Draf III). The patient also showed other signs of progression of IgG4-related disease, including a twofold increase in serum IgG4 concentration. The lack of full control of the disease, manifested by difficult to treat rhinosinusitis, became the basis for qualification of the patient, now 44 years old, to biological treatment with rituximab.
{"title":"Difficult-to-treat rhinosinusitis in IgG4-related disease","authors":"M. Arcimowicz, T. Gotlib","doi":"10.5604/01.3001.0016.0259","DOIUrl":"https://doi.org/10.5604/01.3001.0016.0259","url":null,"abstract":"Introduction: IgG4-related disease is a rare, immune disease with hyper-IgG4-gamma-globulinemia and fibro-inflammatory lesions that can occur in any organ. The diagnosis is made on the basis of clinical and histopathological criteria. In otolaryngological practice, the IgG4-related disease should be taken into account in the differential diagnosis of patients with salivary or lacrimal gland enlargement, with eyelid edema and chronic rhinosinusitis. Systemic glucocorticosteroids are the first line of treatment and can be combined with other immunosuppressants or biological treatment. The prognosis is favorable, but delay in diagnosis and therapy can lead to multiple organ failure and premature death. Case study: The paper presents a case report of patient initially treated for allergic rhinitis with asthma and eyelid edema, accompanied by rhinosinusitis, and history of numerous comorbidities (Hashimoto’s disease, parotid tumor, idopathic hepatitis, anemia and albinism). Imaging studies confirmed enlargement of the salivary and lacrimal glands with the upper eyelids edema and rhinosinusitis. The patient was qualified for sinus surgery. Postoperative histopathological examination enabled the diagnosis of IgG4- -related disease. For the next 5 years, the patient received prednisone and azathioprine, then prednisone and methotrexate, inhaled and nasal steroids, under constant specialist care, including otolaryngologist. Eyelid oedema resolved, asthma and allergic rhinitis were well controlled. Despite treatment, sinus symptoms gradually worsened, accompanied by headaches. The mucocele of the left frontal sinus was diagnosed and qualified for sinus reoperation. In the postoperative period, despite intensive treatment, mucocele of the right frontal sinus developed. Finally, another radical surgery on the frontal sinuses was performed (Draf III). The patient also showed other signs of progression of IgG4-related disease, including a twofold increase in serum IgG4 concentration. The lack of full control of the disease, manifested by difficult to treat rhinosinusitis, became the basis for qualification of the patient, now 44 years old, to biological treatment with rituximab.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49478657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.5604/01.3001.0016.0723
P. Torchalla, J. Sokołowski, Wojciech Kimak, R. Bartoszewicz, K. Niemczyk
Introduction: Comparision of hearing outcomes in patients with conductive hearing loss after surgical treatment should be standardized. In 1995 the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology – Head and Neck Surgery published guidelines to standardize the reporting of treatment results in ossiculoplasty, stapes surgery, Meniere’s disease and schwannoma of the cerebellopontine angle. Despite the fact that the quality of presenting results significantly improved, some limitation remains. In 2012 Hearing Committee of the American Academy of Otolaryngology – Head and Neck Surgery published minimal standard of reporting hearing outcomes relating average pure-tone thresholds to word recognition score in scattegram. Aim: Authors present the results of surgical treatment of otosclerosis based on 46 cases treated at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland using the AAO-HNS guidelines from 1995 and 2012. The aim of the study was to evaluate the postoperative hearing results and to compare them with preoperative audiometric results and with similar reports published in the medical literature. Materials and methods: Retrospective analysis of medical history of patients with otosclerosis. Results: In this work the post-operative air bone gap ≤10 dB recognised as a very good result was obtained in 67.4% of patients. The post-operative air bone gap ≤20 dB, recognized as a good result was obtained in 89.1% patients. Conclusions: It is recommended to standardized the post-surgical audiometric data to compare the results among the different Departments.
{"title":"The results of the surgical treatment of otosclerosis at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, based on the guidelines of the American Academy of Otolaryngology, Head and Neck Surgery","authors":"P. Torchalla, J. Sokołowski, Wojciech Kimak, R. Bartoszewicz, K. Niemczyk","doi":"10.5604/01.3001.0016.0723","DOIUrl":"https://doi.org/10.5604/01.3001.0016.0723","url":null,"abstract":"Introduction: Comparision of hearing outcomes in patients with conductive hearing loss after surgical treatment should\u0000be standardized. In 1995 the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology – Head\u0000and Neck Surgery published guidelines to standardize the reporting of treatment results in ossiculoplasty, stapes surgery,\u0000Meniere’s disease and schwannoma of the cerebellopontine angle. Despite the fact that the quality of presenting results\u0000significantly improved, some limitation remains. In 2012 Hearing Committee of the American Academy of Otolaryngology\u0000– Head and Neck Surgery published minimal standard of reporting hearing outcomes relating average pure-tone thresholds\u0000to word recognition score in scattegram.\u0000Aim: Authors present the results of surgical treatment of otosclerosis based on 46 cases treated at the Department of\u0000Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland using the AAO-HNS guidelines from\u00001995 and 2012. The aim of the study was to evaluate the postoperative hearing results and to compare them with preoperative\u0000audiometric results and with similar reports published in the medical literature.\u0000Materials and methods: Retrospective analysis of medical history of patients with otosclerosis.\u0000Results: In this work the post-operative air bone gap ≤10 dB recognised as a very good result was obtained in 67.4% of patients.\u0000The post-operative air bone gap ≤20 dB, recognized as a good result was obtained in 89.1% patients.\u0000Conclusions: It is recommended to standardized the post-surgical audiometric data to compare the results among the\u0000different Departments.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49627992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-26DOI: 10.5604/01.3001.0016.0057
P. Kołodziejczyk, T. Gotlib, M. Kuźmińska, K. Niemczyk
Introduction: Endoscopic surgery of the frontal recess and sinus proves to be a challenge due to the large anatomical variability of this area, the proximity of the olfactory groove and the orbit. These difficulties are often compounded by exacerbation of inflammation or intraoperative bleeding. Possible complications of endoscopic frontal sinus surgeries are cerebrospinal fluid leakage, orbital damage, bleeding from the anterior ethmoid artery, frontal recess disease – postoperative obstruction of the drainage pathway of the frontal sinus. For this reason, detailed knowledge of anatomy, a thorough preoperative radiological evaluation and appropriate surgical skills are crucial in performing this type of procedure. Aim: The aim of the study was to develop a checklist of elements that ought to be considered before endoscopic surgery of the frontal sinus. Methods: The study presents a review of the latest literature including 40 publications about radioanatomy of the frontal recess and sinus, complications of endoscopic surgery in this area and methods of their prevention. Results: The elements that ought to be assessed in computed tomography before frontal sinus endo-scopic surgery are the frontoethmoidal cells, the insertion of the uncinate process, the measurement of the angulation of the posterior wall of the frontal sinus and its dimensions, the anatomy of the olfactory groove, the location of the anterior ethmoid artery, the possible sinus aplasia. Conclusions: Proper use of the multiplanar computed tomography reconstruction technique enables the recognition of anatomical variabilities, the prediction of intraoperative difficulties and the selection of appropriate tools, which improve the surgical process and its safety.
{"title":"Radiological evaluation of the frontal recess area and the frontal sinus for the purpose of endoscopic sinus surgery","authors":"P. Kołodziejczyk, T. Gotlib, M. Kuźmińska, K. Niemczyk","doi":"10.5604/01.3001.0016.0057","DOIUrl":"https://doi.org/10.5604/01.3001.0016.0057","url":null,"abstract":"Introduction: Endoscopic surgery of the frontal recess and sinus proves to be a challenge due to the large anatomical variability of this area, the proximity of the olfactory groove and the orbit. These difficulties are often compounded by exacerbation of inflammation or intraoperative bleeding. Possible complications of endoscopic frontal sinus surgeries are cerebrospinal fluid leakage, orbital damage, bleeding from the anterior ethmoid artery, frontal recess disease – postoperative obstruction of the drainage pathway of the frontal sinus. For this reason, detailed knowledge of anatomy, a thorough preoperative radiological evaluation and appropriate surgical skills are crucial in performing this type of procedure. Aim: The aim of the study was to develop a checklist of elements that ought to be considered before endoscopic surgery of the frontal sinus. Methods: The study presents a review of the latest literature including 40 publications about radioanatomy of the frontal recess and sinus, complications of endoscopic surgery in this area and methods of their prevention. Results: The elements that ought to be assessed in computed tomography before frontal sinus endo-scopic surgery are the frontoethmoidal cells, the insertion of the uncinate process, the measurement of the angulation of the posterior wall of the frontal sinus and its dimensions, the anatomy of the olfactory groove, the location of the anterior ethmoid artery, the possible sinus aplasia. Conclusions: Proper use of the multiplanar computed tomography reconstruction technique enables the recognition of anatomical variabilities, the prediction of intraoperative difficulties and the selection of appropriate tools, which improve the surgical process and its safety.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49467681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-25DOI: 10.5604/01.3001.0016.0746
E. Szczepanek, Daniel Majszyk, Agata Szleper, A. Bruzgielewicz, J. Sokołowski, E. Osuch-Wójcikiewicz, K. Niemczyk
Introduction: Laryngeal cancer is the most frequent neoplasm of the head and neck region. Despite advances in chemo-radiotherapy (CRT), surgery still remains an important role in the management of laryngeal cancer. Laryngeal preservation techniques, including endoscopic laser resection, are becoming more popular nowadays. However, total laryngectomy (TL) remains a reasonable option for advanced disease in selected patients. The main aim of this study was to perform general characteristics of patients with advanced laryngeal and hypopharyngeal cancer treated with TL as well as to perform a detailed analysis of the disease, treatment modalities and complications. Material and methods: This is a retrospective single-centre analysis. Baseline characteristics and preoperative clinical variables were collected. The study group consisted of 42 patients with advanced-stage carcinoma of the larynx and hypopharynx treated with TL between January 2020 and December 2021 at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland. Preoperative and postoperative clinical variables were collected. Statistical analysis was performed using R software (R version 4.0.3). Results: The mean age of patients at diagnosis was 63.6 +/- 9.2 years, 32 (76.2%) patients were male. The most common symptoms at diagnosis were: hoarseness (78.6%) and dyspnea (47.6%). There was no statistically significant association between symptoms present at diagnosis and the stage of diagnosed laryngeal cancer according to the TNM classification (T3, T4a, T4b). Stage III was observed in 33 (78.6%) patients, IVa in 8 (19%) and IVb in 1 (2.4%) patient. Of the 42 included patients, total laryngectomy was performed in 39 (92.9%) patients and pharyngolaryngectomy in 3 (7.1%) patients. Tracheoesophageal voice prosthesis was implanted in all patients. Complications after surgery were observed in 5 (11.9%) patients. Squamous cell carcinoma was diagnosed in 100% of patients. Complementary therapy was performed in 36 (85.7%) patients. Conclusions: Our study population confirmed that patients suffering from advanced laryngeal and hypopharyngeal cancer are mostly men aged over 60 years with the most common variant of smoking history of over 20 cigarettes per day for a period over 5 years. Symptoms at diagnosis and TNM classification staging of laryngeal cancer are not related parameters.
喉癌是头颈部最常见的肿瘤。尽管放化疗(CRT)有了进步，手术仍然是喉癌治疗的重要手段。喉保存技术，包括内镜下激光切除，现在越来越受欢迎。然而，全喉切除术(TL)仍然是一个合理的选择，对于晚期疾病的选定患者。本研究的主要目的是了解接受TL治疗的晚期喉癌和下咽癌患者的一般特征，并对疾病、治疗方式和并发症进行详细分析。材料和方法:这是一项回顾性单中心分析。收集基线特征和术前临床变量。该研究组包括42名晚期喉癌和下咽癌患者，于2020年1月至2021年12月在波兰华沙医科大学耳鼻喉科、头颈外科接受TL治疗。收集术前和术后临床变量。采用R软件(R version 4.0.3)进行统计学分析。结果:确诊患者平均年龄63.6±9.2岁，男性32例(76.2%)。诊断时最常见的症状是:声音嘶哑(78.6%)和呼吸困难(47.6%)。根据TNM分级(T3、T4a、T4b)，诊断时出现的症状与诊断喉癌的分期无统计学意义。III期33例(78.6%)，IVa期8例(19%)，IVb期1例(2.4%)。42例患者中，39例(92.9%)患者行全喉切除术，3例(7.1%)患者行咽切除术。所有患者均行气管食管义齿植入术。术后出现并发症5例(11.9%)。100%的患者被诊断为鳞状细胞癌。36例(85.7%)患者接受了辅助治疗。结论:我们的研究人群证实，晚期喉癌和下咽癌的患者多为60岁以上的男性，最常见的吸烟史为每天20支以上，持续5年以上。喉癌诊断时的症状与TNM分型分期无相关性。
{"title":"The management of advanced laryngeal and hypopharyngeal cancers between years 2020–2021 – single-centre experience","authors":"E. Szczepanek, Daniel Majszyk, Agata Szleper, A. Bruzgielewicz, J. Sokołowski, E. Osuch-Wójcikiewicz, K. Niemczyk","doi":"10.5604/01.3001.0016.0746","DOIUrl":"https://doi.org/10.5604/01.3001.0016.0746","url":null,"abstract":"Introduction: Laryngeal cancer is the most frequent neoplasm of the head and neck region. Despite advances in chemo-radiotherapy (CRT), surgery still remains an important role in the management of laryngeal cancer. Laryngeal preservation techniques, including endoscopic laser resection, are becoming more popular nowadays. However, total laryngectomy (TL) remains a reasonable option for advanced disease in selected patients. The main aim of this study was to perform general characteristics of patients with advanced laryngeal and hypopharyngeal cancer treated with TL as well as to perform a detailed analysis of the disease, treatment modalities and complications. Material and methods: This is a retrospective single-centre analysis. Baseline characteristics and preoperative clinical variables were collected. The study group consisted of 42 patients with advanced-stage carcinoma of the larynx and hypopharynx treated with TL between January 2020 and December 2021 at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland. Preoperative and postoperative clinical variables were collected. Statistical analysis was performed using R software (R version 4.0.3). Results: The mean age of patients at diagnosis was 63.6 +/- 9.2 years, 32 (76.2%) patients were male. The most common symptoms at diagnosis were: hoarseness (78.6%) and dyspnea (47.6%). There was no statistically significant association between symptoms present at diagnosis and the stage of diagnosed laryngeal cancer according to the TNM classification (T3, T4a, T4b). Stage III was observed in 33 (78.6%) patients, IVa in 8 (19%) and IVb in 1 (2.4%) patient. Of the 42 included patients, total laryngectomy was performed in 39 (92.9%) patients and pharyngolaryngectomy in 3 (7.1%) patients. Tracheoesophageal voice prosthesis was implanted in all patients. Complications after surgery were observed in 5 (11.9%) patients. Squamous cell carcinoma was diagnosed in 100% of patients. Complementary therapy was performed in 36 (85.7%) patients. Conclusions: Our study population confirmed that patients suffering from advanced laryngeal and hypopharyngeal cancer are mostly men aged over 60 years with the most common variant of smoking history of over 20 cigarettes per day for a period over 5 years. Symptoms at diagnosis and TNM classification staging of laryngeal cancer are not related parameters.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71286779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-22DOI: 10.5604/01.3001.0016.0174
Anna Długosz-Karbowska, W. Smółka, J. Markowski
Cervical necrotizing fasciitis (CNF) is uncommon, difficult to diagnose and rapidly progressive severe infection causing necrosis of subcutaneous tissue and fascial compartments, associated with high mortality; early recognition and surgical intervention are crucial. In most cases of nercrotizing fasciitis in head and neck region the origin is odontogenic or pharyngolaryngeal; predominantingly identified bacteria are Streptococci and Staphylococci. Characteristic CT finding is gas demonstration, main complication is descending necrotizing mediastinitis (DNM), unfrequently vascular entities: internal jugular vein thrombosis, carotid sheath necrosis, carotid artery aneurysm and rupture and other arterial hemorrhage. A fulminant CNF course requires timely implementation of appropriate treatment. Broad-spectrum antibiotic therapy and repeated surgical interventions with the removal of necrotic tissues is most common treatment. Open wound treatment increases the risk of additional coinfection and sepsis; modern approach is usage of negative pressure wound therapy or percutaneous catheter drainage. Tracheostomy may be helpful in need of further, repetitive debridement. Loss of soft tissues and skin of the neck may require reconstruction with full or split thickness free flap, local flap or biodegradable dermal substitute. Authors describe case of patient with CNF complicated by sepsis. The necrosis resulted in a 10x20 cm defect in the front of the neck, which was covered with a split thickness graft harvested from the anterolateral surface of the thigh. No complications occurred during healing of the graft.
{"title":"Cervical necrotizing fasciitis complicated by sepsis – case report","authors":"Anna Długosz-Karbowska, W. Smółka, J. Markowski","doi":"10.5604/01.3001.0016.0174","DOIUrl":"https://doi.org/10.5604/01.3001.0016.0174","url":null,"abstract":"Cervical necrotizing fasciitis (CNF) is uncommon, difficult to diagnose and rapidly progressive severe infection causing necrosis of subcutaneous tissue and fascial compartments, associated with high mortality; early recognition and surgical intervention are crucial. In most cases of nercrotizing fasciitis in head and neck region the origin is odontogenic or pharyngolaryngeal; predominantingly identified bacteria are Streptococci and Staphylococci. Characteristic CT finding is gas demonstration, main complication is descending necrotizing mediastinitis (DNM), unfrequently vascular entities: internal jugular vein thrombosis, carotid sheath necrosis, carotid artery aneurysm and rupture and other arterial hemorrhage. A fulminant CNF course requires timely implementation of appropriate treatment. Broad-spectrum antibiotic therapy and repeated surgical interventions with the removal of necrotic tissues is most common treatment. Open wound treatment increases the risk of additional coinfection and sepsis; modern approach is usage of negative pressure wound therapy or percutaneous catheter drainage. Tracheostomy may be helpful in need of further, repetitive debridement. Loss of soft tissues and skin of the neck may require reconstruction with full or split thickness free flap, local flap or biodegradable dermal substitute. Authors describe case of patient with CNF complicated by sepsis. The necrosis resulted in a 10x20 cm defect in the front of the neck, which was covered with a split thickness graft harvested from the anterolateral surface of the thigh. No complications occurred during healing of the graft.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48002251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.5604/01.3001.0015.9782
Wojciech Kimak, A. Bruzgielewicz, D. Kaczmarczyk, Daniel Majszyk, K. Niemczyk
Desmoid tumor or deep fibromatosis (ICD O – 8821/1) is rare neoplasm from fibroblasts and myofibroblasts constituting approx. 3% of all soft tissue tumors.The morbidity is estimated at 2.4 to 4.5 cases per 1 million annually.The abdominal cavity is affected in the majority of cases,while only 7–15% of cases are diagnosed with head and neck tumors.The autors present a case of 41-year old woman in whom the final histopathological diagnosis was extremely difficult.The clinical presentation,imaging work-up and tumor location in the present case report were suggestive of the parotid gland as the primary location of the lesion. Contrast-enchanced CT,sonography and fine needle aspiration biopsy were sugestive of a mixed tumor (tumor mixtus), in MRI suggested that other benign and malignant lesions should also be considered. Histopathological examination of the removed tumor was suggestive of nodular fasciitis.It was suggested that a reference center should be consulted in order to rule out spindle cell sarcoma with low-grade malignancy potential. Result of the examination after consultation-desmoid fibromatosis. The treatment of desmoid tumor includes a surgery, adjuvant radiotherapy and systemic treatment including hormone therapy, chemotherapy and non-steroidal anti-inflammatory drugs.
硬纤维瘤或深纤维瘤病(ICD O - 8821/1)是一种罕见的肿瘤，由成纤维细胞和肌成纤维细胞组成。占所有软组织肿瘤的3%发病率估计为每年每100万人2.4至4.5例。在大多数病例中，腹腔受到影响，而只有7-15%的病例被诊断为头颈部肿瘤。作者提出了一个41岁的女性病例，最终的组织病理学诊断是非常困难的。本病例的临床表现、影像学检查和肿瘤位置提示腮腺为病变的原发部位。CT增强、超声及细针穿刺活检提示混合性肿瘤(tumor mixtus)， MRI提示其他良恶性病变也需考虑。切除肿瘤的组织病理学检查提示结节性筋膜炎。我们建议咨询一个参考中心以排除有低级别恶性潜能的梭形细胞肉瘤。会诊后检查结果:硬纤维瘤病。硬纤维瘤的治疗包括手术、辅助放疗和全身治疗，包括激素治疗、化疗和非甾体抗炎药。
{"title":"Desmoid Tumor of the Neck – Case Study","authors":"Wojciech Kimak, A. Bruzgielewicz, D. Kaczmarczyk, Daniel Majszyk, K. Niemczyk","doi":"10.5604/01.3001.0015.9782","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9782","url":null,"abstract":"Desmoid tumor or deep fibromatosis (ICD O – 8821/1) is rare neoplasm from fibroblasts and myofibroblasts constituting approx. 3% of all soft tissue tumors.The morbidity is estimated at 2.4 to 4.5 cases per 1 million annually.The abdominal cavity is affected in the majority of cases,while only 7–15% of cases are diagnosed with head and neck tumors.The autors present a case of 41-year old woman in whom the final histopathological diagnosis was extremely difficult.The clinical presentation,imaging work-up and tumor location in the present case report were suggestive of the parotid gland as the primary location of the lesion. Contrast-enchanced CT,sonography and fine needle aspiration biopsy were sugestive of a mixed tumor (tumor mixtus), in MRI suggested that other benign and malignant lesions should also be considered. Histopathological examination of the removed tumor was suggestive of nodular fasciitis.It was suggested that a reference center should be consulted in order to rule out spindle cell sarcoma with low-grade malignancy potential. Result of the examination after consultation-desmoid fibromatosis. The treatment of desmoid tumor includes a surgery, adjuvant radiotherapy and systemic treatment including hormone therapy, chemotherapy and non-steroidal anti-inflammatory drugs.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.5604/01.3001.0015.9953
Małgorzata Gwóźdź-Jezierska, I. Bielecki
Introduction: The topic of tongue tie causes a lot of discussion among specialists in areas of interest. The term ankyloglossia has been defined as a state of the lingual frenulum hindering its motor function. Aim: The aim of the study is to present the current views on the short lingual frenulum. Material and methods: The literature from 2019–2021 on this topic was searched for in PubMed and Google Scholar using keywords. Results: Ankyloglossia is a congenital abnormality that can cause difficulties in breastfeeding newborns and infants and that is the most important problem of this structure. Discussion: The affected sucking reflex generates further dysfunctions in the area of the oropharyngeal space, which may lead to malocclusion and speech impediments. The procedure of frenotomy is primarily aimed at achieving the correct tongue motility. High individual variability in the structure of the frenulum and the occurrence of compensation mechanisms among newborns who suck the breast incorrectly, make it difficult to develop a universal classification for assessing the indications for surgery. The current state of knowledge justifies the need for further, extensive interdisciplinary research and reaching a consensus regarding the procedure.
{"title":"The current knowledge about ankyloglossia","authors":"Małgorzata Gwóźdź-Jezierska, I. Bielecki","doi":"10.5604/01.3001.0015.9953","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9953","url":null,"abstract":"Introduction: The topic of tongue tie causes a lot of discussion among specialists in areas of interest. The term ankyloglossia has been defined as a state of the lingual frenulum hindering its motor function. Aim: The aim of the study is to present the current views on the short lingual frenulum. Material and methods: The literature from 2019–2021 on this topic was searched for in PubMed and Google Scholar using keywords. Results: Ankyloglossia is a congenital abnormality that can cause difficulties in breastfeeding newborns and infants and that is the most important problem of this structure. Discussion: The affected sucking reflex generates further dysfunctions in the area of the oropharyngeal space, which may lead to malocclusion and speech impediments. The procedure of frenotomy is primarily aimed at achieving the correct tongue motility. High individual variability in the structure of the frenulum and the occurrence of compensation mechanisms among newborns who suck the breast incorrectly, make it difficult to develop a universal classification for assessing the indications for surgery. The current state of knowledge justifies the need for further, extensive interdisciplinary research and reaching a consensus regarding the procedure.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71286766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.5604/01.3001.0016.0567
Ada Kantczak, I. Bielecki
Gastroesophageal reflux disease (GERD) is diagnosed when the reflux of the stomach contents causes complications or troublesome symptoms. This disease can present with esophageal or extraesophageal symptoms. Laryngopharyngeal reflux (LPR) occurs when gastric contents reflux beyond the oesophagus to laryngopharynx, oropharynx or nasopharynx and it can cause symptoms such as: globus, hoarseness, chronic cough, regurgitations, vomiting or failure to thrive in infants. LPR can influence clinical course of many diseases i.a laryngomalacia, subglottic stenosis, chronic hoarseness and/or recurrent respiratory papillomatosis. LPR is also believed to be a factor leading to formation of laryngeal granulomas, ulcerations, Reinke’s edema, functional voice disorders, sinusitis, otitis media or even life threatening events in neonates. The main diagnostic methods currently used are laryngoscopy, 24-hours pH-metry and esophageal multichannel intraluminal impedance testing. Treatment consist of lifestyle changes and pharmacologic treatment.The use of antireflux medications is not recommended in patients with extraesophageal symptoms in absence of typical GERD symptoms. Surgical treatment can be considered in children with severe LPR symptoms refractory to pharmacological treatment. Controversies regarding diagnosis and treatment of LPR still exists. Further investigations are needed to establish guidelines for the diagnosis and management of LPR.
{"title":"Laryngopharyngeal reflux in children- a current Otolaryngologist’s perspective","authors":"Ada Kantczak, I. Bielecki","doi":"10.5604/01.3001.0016.0567","DOIUrl":"https://doi.org/10.5604/01.3001.0016.0567","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is diagnosed when the reflux of the stomach contents causes complications or troublesome symptoms. This disease can present with esophageal or extraesophageal symptoms. Laryngopharyngeal reflux (LPR) occurs when gastric contents reflux beyond the oesophagus to laryngopharynx, oropharynx or nasopharynx and it can cause symptoms such as: globus, hoarseness, chronic cough, regurgitations, vomiting or failure to thrive in infants. LPR can influence clinical course of many diseases \u2028i.a laryngomalacia, subglottic stenosis, chronic hoarseness and/or recurrent respiratory papillomatosis. LPR is also believed to be a factor leading to formation of laryngeal granulomas, ulcerations, Reinke’s edema, functional voice disorders, sinusitis, otitis media or even life threatening events in neonates. The main diagnostic methods currently used are laryngoscopy, 24-hours pH-metry and esophageal multichannel intraluminal impedance testing. Treatment consist of lifestyle changes and pharmacologic treatment.The use of antireflux medications is not recommended in patients with extraesophageal symptoms in absence of typical GERD symptoms. Surgical treatment can be considered in children with severe LPR symptoms refractory to pharmacological treatment. Controversies regarding diagnosis and treatment of LPR still exists. Further investigations are needed to establish guidelines for the diagnosis and management of LPR.","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48095726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-09DOI: 10.5604/01.3001.0015.9837
Diana Dołomisiewicz, Marta Lipiec, Katarzyna Mielniczek, A. Rzepakowska
Background: Botulinum toxin (BT) is primarily known for its aesthetic applications, but there are many opportunities to use the toxin for the prevention and treatment of various other conditions. BT is not very widespread in otolaryngology practice, but can be effective in many diseases. The TB mechanism is related to the blockade of the muscular plate or the glandular one and is therefore effective in various muscular disorders and autonomic secretory disorders. Aim: The purpose of this work is to review the applications of botulinum toxin in otolaryngology. Material and methods: Scientific publications on the Pubmed platform were reviewed using the keywords: „botulinum toxin” and „otolaryngology”, and time descriptors were set for 2012–2022. Results: Botulinum toxin is an effective and safe treatment that causes minor and transient side effects, and its duration of action varies depending on the condition for which it is used (from 3–6 months on average, up to several years in Lucia Frey syndrome). This is the first-line treatment in Lucia Frey syndrome, laryngeal dystonia and synkinesis. The most common otorhinolaryngological indications, discussed in the following paper, in which botulinum toxin is one component of treatment include Lucia Frey syndrome, salivary fistulas, excessive salivation syndromes, laryngeal dystonia, vocal tremor, vocal granuloma, synkinesis in facial nerve palsy, dysphagia, and an interesting new indication for the use of the toxin in the treatment of resistant rhinitis. The following paper reviews the treatment protocols with botulinum toxin for the aforementioned indications and includes information such as management, dosage, injection sites. The study provides an introduction for ENTs interested in introducing botulinum toxin into their practice, as well as updates practical information for those already practicing. Conclusions: Botulinum toxin is a safe and effective treatment for a wide range of non-aesthetic indications in otorhinolaryngology.
{"title":"Botulinum toxin - an overview of applications in otorhinolaryngology","authors":"Diana Dołomisiewicz, Marta Lipiec, Katarzyna Mielniczek, A. Rzepakowska","doi":"10.5604/01.3001.0015.9837","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9837","url":null,"abstract":"Background: Botulinum toxin (BT) is primarily known for its aesthetic applications, but there are many opportunities to use the toxin for the prevention and treatment of various other conditions. BT is not very widespread in otolaryngology practice, but can be effective in many diseases. The TB mechanism is related to the blockade of the muscular plate or the glandular one and is therefore effective in various muscular disorders and autonomic secretory disorders. Aim: The purpose of this work is to review the applications of botulinum toxin in otolaryngology. Material and methods: Scientific publications on the Pubmed platform were reviewed using the keywords: „botulinum toxin” and „otolaryngology”, and time descriptors were set for 2012–2022. Results: Botulinum toxin is an effective and safe treatment that causes minor and transient side effects, and its duration of action varies depending on the condition for which it is used (from 3–6 months on average, up to several years in Lucia Frey syndrome). This is the first-line treatment in Lucia Frey syndrome, laryngeal dystonia and synkinesis. The most common otorhinolaryngological indications, discussed in the following paper, in which botulinum toxin is one component of treatment include Lucia Frey syndrome, salivary fistulas, excessive salivation syndromes, laryngeal dystonia, vocal tremor, vocal granuloma, synkinesis in facial nerve palsy, dysphagia, and an interesting new indication for the use of the toxin in the treatment of resistant rhinitis. The following paper reviews the treatment protocols with botulinum toxin for the aforementioned indications and includes information such as management, dosage, injection sites. The study provides an introduction for ENTs interested in introducing botulinum toxin into their practice, as well as updates practical information for those already practicing. Conclusions: Botulinum toxin is a safe and effective treatment for a wide range of non-aesthetic indications in otorhinolaryngology.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-09DOI: 10.5604/01.3001.0015.9788
Katarzyna Biegun, Łukasz Ścibik, Agnieszka Krawczyk, M. Brzychczy-Wloch
Background: In recent years, a dynamic increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been observed, especially in highly developed countries. As in the case of anal and genital cancers, a significant proportion of OPSCC (about 60%) is due to sexually acquired HPV infection, and the increase in OPSCC is attributed to changes in sexual behavior in Western countries. EBV and CMV viruses are also characterized by carcinogenesis, but the literature data on their participation in the development of neoplasms of the middle throat are still very limited. Objective: The aim of this article is to review the latest scientific reports on the impact of infections with latent viruses (HPV, EBV, CMV) on the oncogenesis process in the middle pharynx and to summarize the prophylactic options using the available multivalent vaccines against HPV infections. Conclusions: HPV-positive oropharyngeal squamous cell carcinoma of the middle pharynx is a significant clinical problem due to the increase in the number of cases, especially in young people, who lack classic risk factors, such as exposure to tobacco and alcohol. HPV-dependent neoplasms are characterized by a better prognosis and less invasive oncological therapy (radiotherapy and chemotherapy). Of central importance in the prevention of HPV-positive OPSCC in both women and men is prophylaxis with multivalent vaccination. Due to the lack of sufficient data on the participation of EBV and CMV viruses in the development of OPSCC, as well as the lack of prophylaxis, intensive research in this area is necessary.
{"title":"The role of HPV CMV and EBV latent viruses of the development of Oropharyngeal squamous cell carcinoma (OPSCC)","authors":"Katarzyna Biegun, Łukasz Ścibik, Agnieszka Krawczyk, M. Brzychczy-Wloch","doi":"10.5604/01.3001.0015.9788","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9788","url":null,"abstract":"Background:\u0000In recent years, a dynamic increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been observed, especially in highly developed countries. As in the case of anal and genital cancers, a significant proportion of OPSCC (about 60%) is due to sexually acquired HPV infection, and the increase in OPSCC is attributed to changes in sexual behavior in Western countries. EBV and CMV viruses are also characterized by carcinogenesis, but the literature data on their participation in the development of neoplasms of the middle throat are still very limited.\u0000Objective:\u0000The aim of this article is to review the latest scientific reports on the impact of infections with latent viruses (HPV, EBV, CMV) on the oncogenesis process in the middle pharynx and to summarize the prophylactic options using the available multivalent vaccines against HPV infections.\u0000Conclusions:\u0000HPV-positive oropharyngeal squamous cell carcinoma of the middle pharynx is a significant clinical problem due to the increase in the number of cases, especially in young people, who lack classic risk factors, such as exposure to tobacco and alcohol. HPV-dependent neoplasms are characterized by a better prognosis and less invasive oncological therapy (radiotherapy and chemotherapy). Of central importance in the prevention of HPV-positive OPSCC in both women and men is prophylaxis with multivalent vaccination. Due to the lack of sufficient data on the participation of EBV and CMV viruses in the development of OPSCC, as well as the lack of prophylaxis, intensive research in this area is necessary.\u0000\u0000","PeriodicalId":52362,"journal":{"name":"Polish Otorhinolaryngology Review","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48674205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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