Biomedical subjects
Publications and source records attributed to M Kordylewska.
Cystic neck mass, enlarging for many years, as the first symptom of occult thyroid carcinoma was presented. On the basis of clinical and ultrasonographical examination the initial diagnosis was made: bronchiogenic neck cyst. The metastases of papillary carcinoma of thyroid gland were recognized in histological examination. The patient was admitted for surgical treatment.
UNLABELLED: The new diagnostic method, intraoperative ultrasound is presented. There are very few publications in the literature, but they mainly concern the application of transcutaneous ultrasound in localizing the abscesses, their puncture and drainage. Intraoperative imaging of tongue, tonsil, larynx tumors, submandibular and parotid glands and neck masses have been provided by means of a linear 7.5 MHz probe in Poznań ENT Dept. K. Marcinkowski University of Medical Sciences. The application of this method is pioneer and new. The aim of the study was to compare the sensitivity and the specificity of preoperative, transcutaneous ultrasound with the intraoperative one, to assess how the new method influences the extensiveness of the performed procedures and sonographic-surgical correlation of safety margins. MATERIAL: 5 patients with parotid tumors, 4 with tongue, 6 with tonsil and 6 with larynx cancers have been examined. In 13 of them, apart from primary site diagnostics, the neck masses have been assessed. The imaging documentation is presented and the preliminary conclusions concerning the usefulness of this method have been drown.
The purpose of this study was to prove the superiority of ultrasound (US) examination of the neck in comparison to palpation, to reveal unpalpable nodes (pN0) before surgery, and to allow for the early detection of nodal recurrences in patients with laryngeal cancers. In all, 1,120 patients with laryngeal cancers were operated on between 1990 and 1997. All underwent palpation and neck US before surgery. In the pN0 group US revealed enlarged lymph nodes in 261/505 cases, of which 63 (24.14%) were confirmed as metastatic by histology. All 1,120 patients underwent regular postoperative US follow-up. Nearly 5,000 US examinations were performed; 136 patients who developed nodal recurrences had surgical salvage procedures. In this group 61 patients had small, nonpalpable lesions, and 46 patients discrete and slight changes in scarred necks. In this latter group of 117 patients with nonpalpable lesions, 105 cases were histologically confirmed as metastatic. In postoperative check-ups, metastases were suspected in sonographically detected subclinical nodes, but the US scans obtained were difficult to interpret. In these cases, because of the dynamics of lesion changes, US was repeated two to three times at 10- to 14-day intervals. This reappraisal enabled us to exclude malignancy in regressing nodes, as well as to obtain the stable picture of scar, and support a diagnosis while the lesion grew larger or a central area of low attenuation or hypoechogenic echos appeared in the nodal capsule. Successful radical reoperation for tumor was done on110 patients; 78 patients underwent successful salvage surgery after an early US diagnosis. The sonographic-surgical correlation was nearly 95% and the sonographic-histological correlation was 90%. The follow-up period was 1-49 months. In all preoperative assessments US was found to be a valuable tool in the staging of laryngeal cancer and planning the extent of surgery. Close follow-up with US after radiotherapy and initial operation was essential for the early detection of tumor recurrences, making surgical salvage still feasible.
On the basis of cases of their own and the literature the authors review the etiology, pathophysiology and management of rhinophyma.
Assessment of neoplastic lesions situated inside palatinal tonsils and tongue may cause a lot of difficulties. Bringing into practice diagnostic tools such as: transcutaneous ultrasound, CT, MRI have met numerous limitations and obstacles. Apart from restrictions set by anatomical borders, other drawbacks of methods mentioned above are: high cost of single examination, expensive equipment and difficulties of access. In this paper the results of examination of 20 tongue tumors and 23 tonsil tumors carried out by means of endoral ultrasound are presented. Endoral ultrasound provided evaluation of size, localisation, extension and delimitation of and detect small nodules satellite to the predominant tumor mass. Evaluation of lesion echostructure enables to differentiate the tumor nature and advises to plan other diagnostic procedures.
The results obtained after the examination of 107 ultrasound cases of changed salivary glands were presented. The characteristic features for changes most often appearing in salivary glands were presented. In case of tumours and cysts the diagnosis was formed on the basis of the ultrasound character of the change (low homogenas, density in cysts, higher density, non homogenous character in tumours), the degree of separation from the surrounding tissue (clear capsule in cyst and benign tumours, lack of capsule, indistinctive image in change of malignant character, in case of infiltration of surrounding tissues). The diagnosis of inflammation was made depending on the character of the change of the parenchyma of salivary gland--the increase of the gland with the lowering of density characteristic for acute inflammation, the reduction of size, increased sonographic density, enlarged leading out (duct), the echo of concrement is characteristic together with the accompanying acoustic shade for bigger concrements.
Ultrasound examination is a fast, easy to carry out and relatively easily accessible one. This examination allows in the first stage to define the character of the change--cyst-like change, solid change, enlarged lymph nodes, and to establish topographic data, especially the relation to main blood vessels of the neck. The examination of 150 patients with neck changes of tumour type was carried out, the characteristic features of changes in case of solid tumours, benign and malignant ones, cyst-like changes, enlarged lymph nodes were presented. The comparison of the results of the ultrasound examination and the results of histopathological tests shows their substantial compliance.
The objective evaluation of the character of a change, localized in the area of palatine tonsil and tongue, especially in case of defining the extension of the change may cause many problems. So far the ultrasound examination of the tongue and tonsil was carried out by way of placing the endoscopic head on the skin in submandibular area or just behind the branch of mandibular, which in many cases didn't allow to achieve a satisfactory image of the changed tissues. This paper presents an attempt to use endoscopic head to examine changes localized in the area of tongue, palatine tonsil and nasopharynx and on soft palate. The paper also evaluates the usefulness of 2 types of endoscopic heads to carry out such examinations. The obtained initial results of the examinations point at substantial usefulness of this type of examination to the evaluation of changes localized in the area of tongue and palatine tonsil.
The authors report one case of the malignant external otitis treated with Ciprobay in 72-year-old diabetic female. They are calling attention to the diagnostic difficulties in the initial period of the disease due to similar clinical manifestations in the chronic otitis. The control examination after 7 months found no recurrence of the Pseudomonas aeruginosa infection.
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