Biomedical subjects
Publications and source records attributed to Z Szlenk.
There was presented a case of advanced recurrence of the oral cavity and mandible cancer after partial glossectomy. The authors stress the possibility of extensive surgery and next postoperative defect reconstruction. The Pectoralis Mayor osteomyocutaneous island flap of rib was used to reconstruction of the fundi oral cavity, the mandible and the pharynx.
We present the technique and results of endoscopic neodymium-yttrium aluminum garnet laser treatment of benign tracheal stenoses. This therapy was used in 15 patients with tracheal stenoses. Benign tracheal granulomas were caused by prolonged tracheal intubation in eight patients, permanent maintenance of tracheostomy tube in five patients, and nonspecific inflammatory process of the trachea in two patients. The clinical picture was dominated by dyspnea and stridor. The achievement of normal tracheal patency required several laser therapy sessions, repeated at 5- to 7-day intervals. In 30% of patients additional laser vaporization was required as well. The immediate and short-term results were encouraging; in all cases the normal tracheal lumen was restored, resulting in alleviation of patients' symptoms.
The authors present the technique and results of endoscopic Nd:YAG laser treatment of inflammatory tracheal stenoses. This kind of therapy was employed in 10 patients with tracheal stenosis, resulting from long-term nastotracheal intubation (6 cases), tracheostomy tube after radical laryngectomy (3 cases) and tracheal trauma. The laser fiber was introduced into trachea by the operative channel of a flexible bronchoscope and vaporization of obstructing tissues carried out using contact method in continuous mode of light emission (power 7-20 Watts). The achievement of normal tracheal patency usually required several laser therapy sessions (3-5), repeated in 3-5 days intervals. The short-term results are encouraging: in all cases the normal tracheal was lumen was restored, resulting in alleviation of patients' symptoms. In 3 cases a recurrent tracheal stenosis, requiring additional laser treatment was observed.
In 21 patients with T3, T4 pharyngo-laryngeal cancer circumferential resection with immediate reconstruction using a free revascularized jejunal autograft was performed. In 13 cases the jejunal reconstruction was successful. In patients previously not irradiated the rate of success was 75% and in irradiated ones 37.5%. Five patients survived more than 5 years: one more than 7, two more than 6 and one more than 5. One patient with an unsuccessful jejunal graft and with subsequent skin reconstruction survived more than 6 years. The causes of failure were:-irreversible spasm of the arteries in 2 cases, skinking of the vessels resulting in flap necrosis in flap necrosis in 2 cases, -necrosis due to widespread atherosclerosis of the cervical arteries in 3 cases and of an unknown cause in 1 case. The cause of death was: widespread metastases in 12 cases, C.V.A. in 1 case, road traffic accident in 1 case, complications of the ileus in 1 case and carotid artery haemorrhage in 1 case. One of the successful patients was irradiated postoperatively, because the pathology report stated there was incomplete resection, and survived more than 6 years with no disturbance of swallowing. In general 10 patients died in the first year, 4 in the second, 1 in the third and 1 in the fourth--without any signs of recurrence. The five year survival of 24% in the presented group is relatively high in comparison with the generally accessible data for T3, T4 hypopharyngeal carcinoma treated by any of the usual methods.
The kidney carcinoma is the commonest tumour to metastasize to the head and neck. The majority of renal metastases occur in the nose and paranasal sinuses. This paper presents four cases of metastatic tumour in the nasal cavities, paranasal sinuses, frontal bone and piriform fossa. The difficulties in diagnosis and management was also presented.
The authors described the clinical signs and consequences of suffocations during sleep apnea. They presented the results of the surgical intervention of nasal obstruction in patients with sleep apnea. The during-all-night examinations of these patients proved the possibility of positive effects of surgical intervention of nasal obstruction in patients with sleep apnea.
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