Intraoperative margins in oral and oropharyngeal cancer transoral surgery benefit from sampling method modifications.

OBJECTIVES: To investigate the impact on local relapse rate (LRR) and disease specific survival (DSS) of intraoperative margins (FS) obtained by circumferential sampling method, corresponding to the lesion shape and marked using clock-face orientation combined with narrow band imaging (NBI) in head and neck squamous cell carcinoma Materials and Methods: 147 consecutive patients who underwent primary surgery with radical intent for oral and oropharyngeal cancer between 2011 and 2016 were prospectively enrolled. Patients were assigned to 3 groups with different sampling methods. In group A (n=44) a classical FS sampling method was used. In group B (n=73), the clock-face orientation sampling method (FS oclock) was used, whereas in group C (n=30), the FS oclock method combined with NBI. The primary outcome measure was the interdependence between FS sampling methods and oncological outcomes measured by LRR and DSS. RESULTS: In total, 1534 FS samples were obtained with range of 3-24 FS taken per case, median 7.25 in group A, 8.15 in group B and 7.52 in group C. When compared FS histology and final histology in all groups the sensitivity, specificity and accuracy were 61.54%, 98.51% and 95.24%, respectively. The overall LRR equaled 8.8%. The lowest LRR was observed in FS oclock method combined with NBI (6.67%) followed by FS oclock (6.85%) and FS classic (13.64%). For all patients, DSS achieved 95.92% - 95.45% in FS classic, 95.89% in FS oclock and 96.67%. in FS oclock combined with NBI. CONCLUSION: The FS oclock sampling method combined with NBI increases the chance of achieving tumor-negative margins and in result improves the treatment outcome reflected by LRR and DSS.

[The cysts and fistulas of the neck in material of Otolaryngology Department of Rydygier District Hospital in Cracow]. / Torbiele i przetoki szyi w materiale oddzialu Otolaryngologii Wojewódzkiego Szpitala Specjalistycznego im L. Rydygiera w Krakowie w latach 1997-2007.

The retrospective study describes 118 patients treated for congenital cysts and fistulas of the neck between 1997 and 2007 in ORL Department of Rydygier District Hospital in Cracow. Malformation was divided into midline and laterocervical region anomalies. Malformation of midline included thyreoglossal duct and dermoid cyst. The most common malformation of laterocervical were cysts followed by fistulas. The theory of development, method of diagnosis and operative management were presented. Complication and recurrences were rare. Proper differential diagnosis and radical operation led to successful cure.

[A rare case of plasmocytoma of uvulae and carcinoma of larynx]. / Rzadki przypadek szpiczaka plazmocytowego jezyczka i raka krtani.

Plasmocytoma solitare is a rare disease of lymphoprolipherative origin. It is usually diagnosed occasionally on ORL departaments because of its close relation to head and neck localisation. Surgical treatment and/or radiotherapy is a treatment of choice. It becomes disseminated after years usually. Carcinoma of larynx is a squamos cell carcinoma of well known ethiology strongly corralated with alcohol and nicotin abuse. There is described a case of patient in this paper, who in a short time of few months developed two neoplasms of different histological origin, but localised in the same region of head and neck: Plasmocytoma solitary of uvulae and carcinoma of larynx. Due to early diagnoses the radical treatment (combined surgery and radiotherapy) was performed. However the extremly short time of follow up do not allow to make the observation of the DFS and OS of the patient.

[A rare case of schwannoma of the tongue]. / Rzadki przypadek nerwiaka oslonkowego jezyka.

Author described a rare case of lingual Schwannoma in 20 years old female. After complete surgical excision she has not shown recurrence during 2 years of follow-up. Schwannomas are peripheral nerve tumors of nerve sheath origin. Extracranial schwannoma in the head and neck region comprise 25-45% of all shwannomas, but only 1% are located intraoral and usually present as slow growing mass of long duration, producing few symptoms. The treatment is surgical excision.

[A case of giant pleomorphic adenoma of the parotid gland]. / Przypadek olbrzymiego gruczolaka wielopostaciowego przyusznicy.

INTRODUCTION: A case of pleomorphic adenoma of the parotid gland was reported. Pleomorphic adenoma is the most common benign tumor of the major salivary glands. A review of the literature confirms that this kind of tumor is less common in the minor salivary glands. We described statistic population, types of the diagnostic, treatment and clinical course of pleomorphic adenoma of the parotid gland. MATERIAL AND METHOD: We encountered such a tumor in a 55-year-old woman who was admitted to our Hospital. The only symptom was significant face deformation, growing for 30 years. RESULTS: The tumor was located under the right side of the face and was removed surgically. No complications were observed in the postoperative course but paresis of the facial nerve occurred. The patient was discharged from the hospital with the recommendation of facial muscles rehabilitation. After the two months from the surgery, paresis was diminished. Afterwards contact with the patient got lost. CONCLUSION: Pleomorphic adenoma is the most common benign tumor of the major salivary glands. Surgery is the main method of the treatment. The most common complication is paresis of the facial nerve.

[A gigant cystic lymphangioma of the neck]. / Olbrzymi naczyniak limfatyczny szyi.

The cystic lymphangiomas are congenital pathology of lymphatic system which concern 90% of children population, adults suffer very seldom. The authors present the case of giant cystic lymphangioma of the neck in the 37-year-old man with symptoms of tumor of the neck. The USG, CT and MRI confirm the presence of polycystic tumour with feature of bleeding into one of the cavities. Surgical treatment was performed. The patient is controlled without any relaps. The authors remind this rare pathology that should be considered in case of neck tumours.