ABSTRACT
- A case of a 37-year-old female patient is presented. The patient was admitted to the Surgical Emergency Unit after accidental fall on a metal rod when she had sustained stab injury of the right orbit with penetration into the right frontal brain lobe. Multi-slice computed tomography (MSCT) showed penetrating injury and fracture of the right orbital roof without eyeball damage and endocranial impressed bone fragments into the right frontal brain lobe. Urgent surgical intervention was performed by a maxillofacial surgeon and neurosurgeon, including reposition of bone fragments of the orbital roof and cranioplasty. Reconstruction of Tenon's capsule of the right eyeball was performed by an ophthalmologist. From the intraoperative wound swab of the orbit, Bacillus cereus was isolated, therefore the patient was administered ciprofloxacin and rifampicin as recommended by an infectious disease (ID) specialist. Follow up brain MSCT at 15 days and magnetic resonance imaging of the brain at 25 days showed brain edema in the right frontal area and signs of local brain abscess. Intravenous administration of the ciprofloxacin and metronidazole antibiotics with corticosteroids for edema suppression were ordered by the ID physician. Fourteen weeks after this therapy, brain MSCT showed complete abscess regression and no neurologic deficit with only mild psychomotor changes.
Subject(s)
Brain Abscess , Eye Injuries , Fracture Fixation , Neurosurgical Procedures , Ophthalmologic Surgical Procedures , Orbital Fractures , Postoperative Complications , Wounds, Penetrating , Adult , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/classification , Brain Abscess/diagnosis , Brain Abscess/drug therapy , Brain Abscess/etiology , Eye Injuries/diagnosis , Eye Injuries/etiology , Eye Injuries/surgery , Female , Fracture Fixation/adverse effects , Fracture Fixation/methods , Humans , Magnetic Resonance Imaging/methods , Neurosurgical Procedures/adverse effects , Neurosurgical Procedures/methods , Ophthalmologic Surgical Procedures/adverse effects , Ophthalmologic Surgical Procedures/methods , Orbit/injuries , Orbital Fractures/diagnosis , Orbital Fractures/surgery , Postoperative Complications/diagnosis , Postoperative Complications/drug therapy , Skull/injuries , Tomography, X-Ray Computed/methods , Treatment Outcome , Wounds, Penetrating/complications , Wounds, Penetrating/diagnosisABSTRACT
To assess the epidermal growth factor receptor (EGFR) correlation with histopathologic and clinical characteristics of laryngeal squamous cell carcinoma (SCC) and the impact of EGFR overexpression on patient survival. This retrospective study included 185 SCC patients treated at Clinical Department of ENT, Head and Neck Surgery, Split University Hospital Center between January 1, 2000 and December 31, 2009. A statistically significant correlation (p < 0.001) was recorded between the level of EGFR expression and SCC histopathologic grade, stage, metastasizing potential, relapsing potential, and patient survival. Kaplan-Meier survival curve yielded a statistically significant difference (χ(2) = 75.05; p < 0.001) among the four patient groups with different levels of EGFR expression. The higher the level of EGFR expression, the poorer is the patient prognosis and survival. In our study, expression of EGFR as a biomarker showed a potential predictive value in laryngeal SCC.
