Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons.The study is analysis of 531 patients with parotid gland tumours in patients treated in ENT Department during 1986-2006. We analysed surgical treatment and intraoperative tumour stage. The results of histological diagnosis were presented.The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma--75% and adenolymphoma--16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3-T4 was in 90%.
Küttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis of submandibular gland. This is an underrecognized entity in the surgical pathology and cytology literature. Most patients experience recurrent pain, discharge and swelling that is often associated with eating, but others only have asymptomatic hard swelling of the submandibular gland. Histologic examination of the excised submandibular glands revealed preserved lobular architecture, thickening of interlobular septa by sclerotic tissue, dense lymphoplasmacytic infiltrate, preservation of ducts with periductal fibrosis, and variable loss of acini. The morphologic appearance, in conjunction with the elevated IgG4 expression, distinguishes chronic sclerosing sialadenitis from other inflammatory diseases of the salivary glands. Chronic sclerosing sialadenitis belongs to the spectrum of IgG4-related diseases. We present a case of Küttner's tumor in a 62-year-old female treated by surgery. Although this disease was first described by Küttner in 1896, this clinical entity which masquerades as carcinoma is underdiagnosed by many surgeons. There is not enough evidence to support any diagnostic means that could help in the differential diagnosis of this benign condition. Given the high rate of malignancy in firm, painless lesions of the submandibular gland, surgical excision is often advocated and Küttner's tumor is usually diagnosed by the histopathologist.
Diffusion tensor imaging is unique in its ability to non-invasively visualize white matter fiber tracts in the human brain in vivo. White matter fiber bundles of the human brain form a spatial defined by the anatomical and functional architecture. Determination of axonal pathways provides an invaluable means to study the connectivity of human brain and its functional network. Comparison of fiber tract properties across subjects requires comparison at corresponding anatomical locations. In this paper, we present application of white matter tractography method based on incoherent motion of water molecules in fiber tissue, mainly in central nervous system. This motion is itself dependent on the micro-structural environment that restricts the movement of the water molecules. In white matter fibers there is a pronounced directional dependence on diffusion. With white matter fiber tracking or tractography, projections among brain regions can be detected in the three-dimentional diffusion tensor dataset according to the directionality of the fibers. The authors indicate diagnostic possibilities of MR tractography in otolaryngology for imaging the nervous tracts of sense of hearing, smell and taste with particular consideration of otoneurological evaluation of patients with cochlear implants and bone anchored hearing aid (BAHA). White matter tracts can be evaluated independently by using diffusion tensor tractography, which appears to be a promising technique for determining changes in white matter in degenerative disease. The authors also indicate that method as a beneficial in the surgical planning for patients with intrinsic brain tumors.
Summary Introduction In 2008 in Poland, there were over 2,200 cases of malignant melanomas. This tumor is characterized by considerable malice. Malignant melanoma of the head and neck region is a vast concept. Therefore it includes cutaneous, ocular, mucous membranes and metastatic melanomas. Methods A retrospective analysis of patients admitted to ENT Department of Silesian Medical University in Katowice with diagnosis of head and neck malignant melanoma. Results Between 1983 and 2009 10 cases of melanoma of head and neck were registered in our Department. Six patients presented ocular melanoma. They manifested disturbed vision and exophtalmus. All of them underwent orbital exenteration of affected eye. One case of melanoma arising from palatine tonsil was registered. Main symptom was tumor of the neck. One patient suffered from melanoma of nasal cavity, which manifested as reccurent epistaxis. Metastatic melanoma was found in 2 cases. One of them involved parotid gland tumor, another- supraclavicular nodes. Every patient underwent excision of tumor. Patient with supraclavicular nodes involvement – Crile operation. Discussion The most important diagnostic procedure in every form of melanoma is histopathological examination which reaveles atypical melanocytes. Radical excision of primary lesion has a great importance in long term prognosis. Radio-, chemo- and immunotherapy remain auxiliary treatment, often in advanced stage of disease.
Artykuł poświęcony jest kolekcji portretów fotograficznych wybitnych postaci polskiej kultury autorstwa fotografika Benedykta Jerzego Dorysa (1901-1990). Część jego spuścizny przechowuje Instytut Sztuki Polskiej Akademii Nauk w Warszawie (8370 negatywów), ale Autorka zajmuje się w swoim tekście częścią kolekcji fotografika przekazaną Działowi Ikonograficznemu Biblioteki Narodowej w Warszawie. Obejmuje ona ok. 7500 zdjęć – 2/3 tej kolekcji stanowią portrety fotograficzne artystów polskich. Większość z nich pochodzi z lat powojennych (do 1979 r.). Wykaz tych postaci Autorka zawarła w dalszej części artykułu zatytułowanej Postacie kultury w obiektywie Benedykta Jerzego Dorysa. Tekst uzupełnia Załącznik prezentujący przykłady opisu katalogowego spuścizny B.J. Dorysa przechowywanej w Bibliotece Narodowej.
Metastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland. The parotid gland and its lymph nodes are possible sites of metastases from head and neck cancers. However, metastasis from distant primary neoplasm below clavicle is possible, too. The authors presented the two cases of distant metastases to the parotid gland. The women with breast cancer and metastases to the parotid gland 11 years after surgery, radio- and chemotherapy of breast cancer. She died 7 months after parotid surgery of systemically advanced disease. The man with metastasis of malignant melanoma of unknown primary site. He underwent total parotid surgery with the tumor and lymph nodes. He died 7 months after surgery. In spite of intensive exam the primary location of the melanoma was unknown. The authors described pathophysiology of distant metastases to the parotid gland with special attention to possibilities of treatment and survival.
One of the problems in the stapes surgery is the floating footplate. The frequency of incidence of this complication is 2% to 5.8% of all operations. The authors present the results of stapes operations in a group of 28 cases (2.5%) from all the 1120 operations, in which the surgeon experienced a floating footplate. The hearing results were evaluated on the base of the average gain of air-conduction thresholds and air-bone gap levels at 500, 1000, 2000 and 3000 Hz. The improvement of hearing we observed in 24 patients, 4 patients heard worse.
Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. In one case we found coexistence foreign body (shot) and tumor--inflammation pseudotumor of the orbita. It is possible, that in this case long-time occupy foreign body in the orbita was a cause of that tumor. All foreign bodies were successfully removed, and postoperative course was uneventful. The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation.
It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009 estimately 9 million new cases were registered worldwide, mortality due tuberculosis reached 1.5 million. In Poland extrapulmonary tuberculosis is rare (7% of overall morbidity) and most commonly affects pleura, lymph nodes, bones, joints and genitourinary system. Head and neck tuberculosis is rare and causes many diagnostics problems. Retrospective analysis of case histories of patients admitted to ENT Department of Silesian Medical University in Katowice. Between 1993 and 2010 four cases of head and neck tuberculosis were diagnosed in our Clinic. Two of patients were admitted to the hospital with symptoms of laryngeal tumor such as difficulty in swallowing. During direct laryngoscopy tissue specimens were taken. Examination of the third patient showed tumor located below left angle of mandibule. During superficial parotidectomy tumor was removed. In the fourth registered case tuberculosis manifested as tumor of nasopharynx. In every case which is mentioned above pathology reports revealed epithelioid cell granulomas with caseous necrosis typical for tuberculosis. Patients underwent tuberculostatic treatment. Rare occurence and lack of characteristic symptoms of head and neck tuberculosis often lead to misdiagnosis. Histopathological examination is the most important diagnostic procedure. Microbiological examination is difficult in extrapulmonary tuberculosis, because of low concentration of pathogens in specimens. Tuberculostatic therapy is the leading method of treatment in every case of tuberculosis.
Summary Introduction The aim of this work was to reveal the problems of diagnostics and treatments of fungal rhinosinisitis. Material and methods Material includes 6 patients (4 women and 2 man, average age 55) treated between years 2005-2010 in the ENT Department of Silesian Medical University in Katowice. All patients were treated by surgery in general anesthesia. All patients had performed CT scan of paranasal sinus before surgical procedures. Removed materials were send to a histological and microbiological examination. Results In the studied material were 5 cases of noninvasive fungal rhinosinusitis (3 case of a fungal rhonosinusitis of the right and 2 of the left maxillary sinus) and 1 case of an invasive fungal rhinosinusitis that coused destroyment of apper and lower wall of the maxillary sinus and penetration to the right orbital. All patients underwent external approach surgery under general anesthesia. All of examinations the histological and microbiological confirmed fungal etiology (Aspergillus). A possible factor in the development of fungal sinusitis in one patient was previously treated pulmonary aspergillosis, but in a patient with invasive fungal sinusitis probably played a role in type 2 diabetes and old age. Pharmacotherapy included in a patient with invasive fungal sinusitis (Amphotericin B ® ) and in a patient with a history of lung Aspergillozie (Orungal ® ). The results of the control CT scan obtained full recovery. Conclusion Fungal infection of paranasal sinuses is a problem located at the intersection of many medical specialties. Force look at the patient in a multidisciplinary. Do not forget that it may be the final diagnosis as well as a symptom of immune deficiency, or metabolic disorders.
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