The aim of the paper is to present the surgical methods applied in a 76 year old patient treated for carcinoma of the larynx. As an effect of the carried out total laryngectomy, extensive pharyngeal ...fistula occurred. The fistula was closed with myocutaneous flap which was pedunculated on double reversed pectoral major muscle. Due to lymphatic metastases surgical dissection of lymphatic system of the left side of the neck was performed 2 years after laryngectomy. During this operation the left common cervical artery was removed (Goretex graft). Next-cobaltotherapy was applied. After following 2 years the skin necrosis just over the flap occurred. It was caused by shirt collar pressure. Because of the major bleeding common cervical artery was oligated. During this procedure the frontal wall of the oesophagus was damaged and again pharyngeal fistula appeared. Attempts at closing it with flaps pedunculated on pectoral major muscle and trapezius muscle did not succeed. Finally fistula was closed with cylindric flap from the abdomen connected with the cutaneous flap from surrounding fistula tissues. Following recognition of this illness the patient had undergo nine consecutive, extensive operations. Ten years after diagnosis he is still alive and leads a life appropriate to his age.
Twenty one patients with advanced malignant tumors of the orbit have been treated in the Department of Otolaryngology, Medical Academy in Warsaw, between 1980 and 1995. There were two groups of ...patients: five with primary orbital tumors and sixteen with secondary tumors that penetrated from sinuses. In all cases surgical treatment with orbital exenteration has been performed, as well as postoperative radiotherapy. The local cutaneus flaps and temporalis muscle flap have been used for reconstruction of the orbitomaxillary defects. The authors suggest that one-stage reconstruction of maxillo-facial region after surgery decreases facial deformation and allows to apply ocular prothesis guickly.
During 1980-1992 twelve patients with malignant melanoma of the head and neck were treated in the Department of Otolaryngology of Medical Academy in Warsaw. The largest group (eight patients) ...consisted of the cases with melanoma localized on the nasal mucosa. In next four patients the tumor localized on the skin of the head. The clinical course of the melanoma was discussed and its methods of cure in dependence on the degree of progression.
The cytologic examination of nasal mucosa before and after the operation of ozaena were described. Significant changing of cytological images was found. In preoperative examinations the squamous ...metaplasia was seen, the postoperative examinations the squamous metaplasia was seen, the postoperative findings were various. From the prognostic point of view most positive was the recovery of the cylindric epithelium. The worst in the prognosis was the persisting of squamous metaplasia in all postoperative smears.
Multiple primary neoplasm has developed in 70 patients with head and neck cancer who were treated in Otorhinolaryngology Department Medical Academy in Warsaw. Two primary neoplasm has been recognised ...in 63 patients, three independent tumors in 7 patients. The most common site for a first tumor was laryngeal carcinoma, for a second - lung, skin and tongue. The squamous cell carcinoma was the most common in the first as well as in the second malignancies.
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.
The case of the extensive laryngeal cancer recurrence after radiotherapy was described. The authors were discussed treatment surgery it with reconstruction of the tissue defect. The skin defect was ...reconstructed with the pectoralis mayor myocutaneous island flap, the pharyngeal secondary fistula was reconstructed with the Trapezius myocutaneous flap.
Forty-seven patients were treated in the Department of Laryngology, Medical Academy in Warsaw between 1980 and 1989. Twenty-seven patients had squamous cell carcinoma. All cases were advanced. The ...patients were treated by combination of surgery and postoperative radiotherapy. Nineteen patients (40.4%) survived five years.
The use of myocutaneous island flaps for the reconstruction of the extensive postoperative defects, enlarged possibilities of surgery treatment of malignant tumors. The report presented a case of ...recurrence of the tongue cancer after radiotherapy. There was performed an extensive surgery in result of which the tongue, the oral cavity floor, the pharynx and the larynx were excised. The defect was reconstructed with the latissimus dorsi myocutaneous island flap. The authors present the vascularization of the flap and the technique of its formation. The latissimus dorsi myocutaneous island flap is often used in the reconstruction of the oral cavity and the pharynx due to its long pedicle and rich vascularization.
Atypical fibroxanthoma is an uncommon mesenchymal neoplasm. It is cytologically malignant but usually clinically being tumor which typically arises in sundamaged skin of the head and neck region. The ...principal differential diagnoses are spindle cell squamous carcinoma, melanoma and leiomyosarcoma. Immunohistochemistry plays a key role in diagnosis. We report a patient with atypical fibroxanthoma of the maxilla and the neck.
