Biomedical subjects
Publications and source records attributed to M Pietniczka.
The authors report a case of cavernous sinus thrombosis of paranasal sinus origin. Such complication developed in a case of chronic exacerbated sinusitis and blockade of sinus orifices by polyps. Timely and effective surgical intervention combined with medical treatment achieved complete remission even of the complications of cavernous sinus thrombosis.
The authors showed diagnosis and treatment of parotid tumours.
The authors described the rare case of Malherbe calcifying epithelioma of the left preauricular area of the 10 years old girl from identical twins. The tumor was operated. The follow up without any sight of recurrence.
Removing of focus cancer in partial laryngectomy is going with the risk of local recurrence and the appearances of the next atypia cancer focus in the respiratory tract. Using of the new endoscopic methods can allow for total control in out patient department.
The neck cysts are the most common congenital malformation in the head and neck area. In these cases the diagnosis is established on clinical examination, the results of USG and the aspiration biopsy. The problem of malignancy was very rare, but nowadays there is much more in literature about these. The criteria of cancer diagnosis in the neck cysts metaplasia of ephitelium are mentioned. In the ENT Department in Warsaw between September 1989 until December 1994 were treated 29 patients with the neck cyst. Four of them had diagnosed as cancer in histopathological examination. Improvement of some non-invasive technique let us to use them more extensive, especially USG. The examination can be repeated many times, especially in cases when the primary neck tumor was treated using conservative methods.
This study is a review of 69 patients with tumours in the parotid glands who underwent diagnosis and surgery, at the ORL Clinic in Warsaw during the years 1990-1994. 20% of all tumours were malignant; the dominant type in this group was mucoepidermale carcinoma. Pleomorphic adenomas were the most common benign tumours. The role of thin needle aspiration biopsy in diagnosis of parotid tumours was performed. In 85%, of cases the results were confirmed by histopathology. Methods and results of treatment are presented.
We present 45 patients with laryngeal carcinoma after partial various type laryngectomy results in 1989-1995. Frequency occurrence complication was dependent on localisation and expations. The most often complications after operation are; dyspnea which needs tracheotomy done and nor radicality in histopathological example which press the surgeon to make total laryngectomy. Authors present the types of conservative and surgical treatment of anatomical and functional reconstruction of larynx.
Twenty-three patients with facial nerve paralysis following surgery for a cerebellopontine angle tumour had a facial-hypoglossal anastomosis and simultaneous anastomosis of the cervical ansa with the distal stump of the hypoglossal nerve. In 18 patients, simultaneously with the neural anastomoses, additional transpositions of the temporalis and masseter muscles were performed. At follow-up examination 3-87 months after reconstructive surgery, eight patients had House grade II, ten grade III and five grade IV outcome. The EMG evidence of reinnervation was observed 5-11 months after anastomosis. Combination of the facial-hypoglossal anastomosis with simultaneous myoplasty and with anastomosis of the distal hypoglossal nerve stump to the ansa cervicalis provides the advantage of immediate protection against ophthalmic complications, prevents hemiatrophy of the tongue and gives good functional results when reinnervation of the facial muscles takes place.
Explore the source record for details and available documents.
Surgery for extensive skull base lesions inevitably creates multiple tissue defects that require reconstruction. In this paper reconstruction methods applied in 41 skull base surgery procedures are presented. Anterior cranial fossa was involved in 13 operations (4 malignant and 9 non-malignant tumours), middle and posterior cranial fossa in 28 (9 malignant and 19 non-malignant). As a rule all the defects were reconstructed in one stage, immediately after tumour removal. Titanium mesh was the only alloplastic material used to cover bone defects in 7 patients. Otherwise only autografts were used. Postoperatively in all the patients in whom excision and repair of dura was necessary, continuous lumbar drainage of cerebrospinal fluid was maintained for 4-6 days. In anterior cranial fossa area large pediculated, vascularized periosteal flap allowed for reliable separation of upper airways from intracranial cavity. Titanium mesh was used to cover orbital wall defects. In the area of middle cranial fossa and temporal bone the most important aspects of reconstruction were watertight closure of the dura, separation of the surgical cavity from nasopharynx with rotated temporalis muscle, and facial nerve reconstruction (the nerve was reconstructed in 7 cases). Additionally in 1 patient hypoglossal nerve was sutured end-to-end. In 2 patients the invaded segment of internal carotid artery was excised and replaced with prosthesis. In 13 patients the surgical procedure was performed in an area that was previously operated upon and/or irradiated. Delayed healing was seen in 6 cases, but none required additional procedures and the wounds were completely healed with local treatment. Reconstruction methods presented in this paper are relatively simple and do not necessitate modern materials. Even in extensive procedures proper wound healing and satisfactory cosmetic result were obtained.