Biomedical subjects
Publications and source records attributed to P Wójtowicz.
Authors present multistage surgical treatment of cancer disease with its radical dissection and anatomical reconstruction of risected tissue diminution and consecutive functional reconstruction of organs and tissue elements in later stage.
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.
Papilloma of the nose requires radical, surgical procedure, because may occur of the recurrences and metaplasia. The lateral rhinotomy is the most recommended technique as good total and radical for excision of the tumor. We present 25 cases of papilloma treated in the Otolaryngological Department in Warsaw. The new methods of the pre-, intra- and post-operative evaluation using endoscopy, especially microscope endoscopy has been used. Endoscopy is also very valid methods for post-operative monitoring follow-up.
Partial laryngectomy of larynx cancer are limited by difficulties in reconstruction at the same time the anatomical way of the upper respiratory tract with secure maintenances defence and phonation functions. Authors present their own way of reconstructive surgery which can allow to make good condition for the comfortable life.
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.
Authors present the case of carcinoma adenoides cysticum, which was located in small salivary glands of palatum. After surgical treatment and radiotherapy during 3 years observation of the patient two new ca adenoides cysticum focus were noticed. It can give evidence of cancer multifocus of cancer recurrents.
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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.