The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. ...Mucosal samples from maxillary sinus in 40 ACP patients who underwent endoscopic sinus surgery were analyzed histopathologically and by scanning electron microscopy. Results were compared with maxillary mucosa samples of 40 patients without endoscopic and radiological signs of sinus disease. The existence of biofilm and its relation to the degree of histopathological changes according to Terrier classification of chronic mucosal inflammation of maxillary sinus were statistically analyzed. Biofilm was detected in 23 of 40 (57.5%) ACP patients; the incidence was significantly lower in the control group (2/40, 5%). Biofilm was not found in type 1 mucosa according to Terrier classification. In conclusion, biofilm showed a significant incidence in the maxillary sinus mucosa of ACP patients (57.5%). Occasionally, biofilm can be found in patients with no signs of sinus disease, but not on histologically normal mucosa. Results of this study support the theory that biofilm formation does not represent the initial stage of the inflammatory process.
The most obvious indication for thyroid surgery is malignancy, but other indications are also not rare. As with any other surgical procedure, those surgeries also carry risks which can be classified ...as minor or major.
In this overview, we present minor (seroma, scarring) and major complications of thyroid surgery (recurrent nerve injury, hypoparathyroidism, and bleeding). We discuss the possibilities of prevention and treatment of each of those complications.
In recent years, thyroid surgery is becoming safer due to the development of new surgical, hemostatic, and other techniques such as intraoperative monitoring of the recurrent laryngeal nerve and parathyroid gland detection.
SAŽETAK
Cilj istraživanjaUtvrditi incidenciju i definirati moguće komplikacije laringoskopije ultrabrzom kamerom te utvrditi incidenciju nemogućnosti cjelovitog prikaza glasnica tijekom pregleda.
...Materijali i metodeProspektivna analiza 113 ispitanika kojima je učinjena laringoskopija ultrabrzom kamerom u dva uzastopna dana, s primjenom topikalnog anestetika i bez njega. Zabilježen je razvoj komplikacija i nemogućnost prikaza cijele duljine glasnica pri pregledu.
RezultatiUkupno je zabilježeno 7 komplikacija (3,09% snimanja) u 6 ispitanika (5,3% ispitanika). Sve su komplikacije bile kratkotrajne i blagog oblika te nisu ostavile dugoročne posljedice. Nemogućnost prikaza cijele duljine glasnice tijekom pregleda opažena je u 3 ispitanika (2,65% ispitanika). Uslijed izraženog refleksa nadražaja na povraćanje pri pregledu u 7 ispitanika (6,19%) grkljan uopće nije bilo moguće prikazati. Primjenom topikalnog anestetika pri pregledu u navedenoj skupini u njih 4 (57,14%) uspjela se postići cjelovita vizualizacija glasnica.
ZaključciRezultati naše studije pokazuju da je laringoskopija ultrabrzom kamerom sigurna metoda vizualizacije glasnica, uz rijetku pojavnost blagih, ograničenih komplikacija te u malom broju bolesnika nije primjenjiva zbog nemogućnosti prikazivanja cijele duljine glasnica. Potrebna su daljnja istraživanja za razvijanje preciznog algoritma pregleda, koji bi optimizirao i standardizirao laringoskopiju ultrabrzom kamerom te poboljšao toleriranje i olakšao izvođenje pretrage.
Najočitija indikacija za kirurški zahvat na štitnjači je zloćudna novotvorina, ali nisu rijetke ni druge indikacije. Kao
kod svake druge operacije i ovdje su mogući određeni rizici, koji se mogu ...podijeliti na blaže i teže. Rasprava: u ovom pregledu
predstavljamo blaže (serom, ožiljke i disfagiju) i teže komplikacije kirurgije štitnjače (krvarenje, ozljeda povratnog živca i
hipoparatiroidizam). Opisane su mogućnosti prevencije te liječenja svake pojedine komplikacije. Zaključak: u posljednje
vrijeme kirurgija štitnjače postaje sve sigurnija, uz uvođenje novijih metoda hemostaze, kao i ostalih metoda poput intraoperativnog
monitoringa povratnog živca i detekcije paratiroidnih žlijezda.
To establish whether covering the tympanic membrane perforation after war blast injury with silicon foil can enhance the ear drum healing rate and to determine the appropriate timing of silicon ...patching.
We retrospectively analyzed the charts of 210 patients wounded during the Homeland War in Croatia 1991-1995, with 315 blast tympanic membrane perforations. In 44 patients (61 perforations), the eardrum perforation was covered by silicon foil, whereas in 166 patients (254 perforations) it was left to heal spontaneously. The patients who underwent the patching procedure were divided in two groups according to the time period between the blast injury and the procedure: 38 perforations were treated within 3 days and 23 perforations were treated 4 to 6 days after the blast injury.
The rate of tympanic membrane healing in the silicon foil patching group was significantly higher (91.8%) than that in the group of perforations left to heal spontaneously (79.9%, P=0.029). The healing rate was significantly higher in the group treated within 3 days after the blast injury (97.4%) than in the group treated 4 to 6 days after the injury (82.6%, P=0.042).
Covering the perforation after the war blast injury with silicon foil significantly improves the rate of tympanic membrane healing. To obtain the best healing outcome, the procedure should be performed within the first 72 hours after the trauma.
Patients with head and neck squamous cell carcinoma (HNSCC) can develop lung squamous cell carcinoma (LuSCC), which could be the second primary tumor or HNSCC metastasis. Morphologically it is ...difficult to distinguish metastatic HNSCC from a second primary tumor which presents a significant diagnostic challenge. Differentiation of those two malignancies is important because the recommended treatments for metastatic HNSCC and primary LuSCC differ significantly. We investigated if the quantification of the promotor methylation status in HNSCC and LuSCC differs.
Primary HNSCC (N = 36) and LuSCC (N = 17) were included in this study. Methylation status in the ASC/TMS1/PYCARD (apoptosis-associated speck-like protein containing a caspase recruitment domain; 8 CpG sites) and MyD88 (Myeloid differentiation primary response protein 88; 10 CpG sites) promoters was analyzed. Bisulfite converted DNA, isolated from tumor tissue was quantified using pyrosequencing. Results of pyrosequencing analysis were expressed as a percentage for each tested CpG site. Receiver-operating characteristic (ROC) curve analysis was used for the evaluation of the diagnostic properties of selected biomarkers.
CpG sites located in the promoters of ASC/TMS1/PYCARD_CpG8 (- 65 upstream) and MyD88_CpG4 (- 278 upstream) are significantly hypermethylated in the HNSCC when compared with LuSCC (p ≤ 0.0001). By performing ROC curve analysis we showed that corresponding areas under the curve (AUC) were 85-95%, indicating that selected CpG sites are useful for a distinction between primary LuSCC and primary HNSCC.
Results of the present study indicate that there is a significant difference in the methylation status of tested genes between primary HNSCC and LuSCC. However, to prove this approach as a useful tool for distinguishing second primary LuSCC from HNSCC metastasis, it would be necessary to include a larger number of samples, and most importantly, metastatic samples.
Laryngeal carcinoma is one of the most common tumors of the head and neck, just after skin cancer. Alongside open surgery, transoral endoscopic laser surgery (TOLS) has become widespread as a ...treatment method. Our aim was to assess the efficacy of transoral laser cordectomy in a group of patients with early glottic carcinoma. We retrospectively analyzed data on 131 patients who underwent TOLS in the 2017-2021 period. We divided patients into groups according to tumor stage and type of cordectomy performed, and compared outcomes between the groups. Our results revealed a higher number of patients in the group with Tis and T1a than in those with T1b and T2 who underwent type III cordectomy, and also a higher number of those for whom outpatient follow-ups were sufficient after surgery in the same group. We did not observe significant difference in outcomes according to cordectomy type except for type V (a-d), where a higher number of patients had to undergo radiotherapy. This study underlines the importance of careful patient selection for TOLS, as well as the need for close cooperation with pathology and radiology specialists to ensure optimal approach and extent of surgery for each individual patient. It also displayed TOLS as a sound therapeutic option for early stages of glottic carcinoma but also indicated the need for similar studies in a larger number of patients to elucidate the effectiveness in certain glottis areas.
The aim of the study was to analyze clinical characteristics, surgical treatment, complications, and prognosis related to thyroid surgery in children and adolescents in a 10-year study at a single ...institution.
Retrospective study.
We performed a retrospective analysis of clinical data of children and adolescents who underwent thyroid surgery due to benign thyroid disease and thyroid cancer from January 2011 to May 2020. We presented the clinical characteristics and type of surgical treatment for different thyroid diseases.
We present data on surgical procedures and complication rates following surgery, which was comparable to other published data. We emphasize the importance of radioiodine and hormone replacement postoperative therapy in cancer patients and our opinion on total thyroidectomy and neck dissection in thyroid cancer surgery.
This study demonstrated that thyroid surgery in children and adolescents is a safe and efficient procedure in the hands of experienced surgeon for adult thyroid surgery. For children and adolescents with thyroid carcinoma, our method of choice is total thyroidectomy with occasionally paratracheal neck dissection, whereas lateral cervical lymph node dissection is only necessary in fine needle aspiration positive lymph nodes. Our results according to postoperative outcomes and complications are comparable to other recently published data.
Laryngeal squamous cell carcinoma (LSCC) is the most common form of malignant disease in the head and neck region characterized by frequent occurrence of metastases in the neck lymph nodes early in ...the disease onset. In the presented study, we performed quantitative proteomic profiling of patient-matched primary tumor and adjacent non-tumorous tissues derived from metastatic LSCC as to identify new protein candidates with potential diagnostic and therapeutic significance. Obtained results revealed for the first time involvement of the basement membrane protein ladinin-1 in laryngeal cancer metastases. Alterations in the cellular microenvironment that propel metastatic events in laryngeal cancer include activation of MIF-CD44-β1 integrin signal transduction pathway and induction of downstream signaling mediated by NF-κB and Src tyrosine kinase, which ultimately impinge on cytoskeletal dynamics and architecture resulting in increased cellular motility and invasiveness. In this context, particularly interesting finding is upregulation of several actin-binding proteins novel to laryngeal cancer pathogenesis including coronin-1C and plastin-2, whose functional significance in laryngeal carcinogenesis has yet to be established. We also detected for the first time a complete loss of afamin in metastatic laryngeal cancer tissues, which warrants further studies into its use as a possible marker for monitoring disease progression and/or treatment outcome.
•Ladinin-1, afamin, CD-14, and TUBA4A were assessed in laryngeal metastatic tumors.•MIF-CD44-β1 integrin signaling is important in metastatic laryngeal cancer.•Complete loss of afamin was observed in metastatic laryngeal cancer.