[Mechanisms smoothing deglutition disorders after oral cancer surgery]. / Mechanizmy lagodzace zaburzenia polykania po wycieciu nowotworu jamy ustnej.

Compensatory treatment for oropharyngeal dysphagia includes postural changes and reducing the risk of aspiration. Some of compensatory maneuvers are introduced spontaneously by the ill at first weeks after oral cavity tumour resection. On the basis of roentgenotelevision examination of deglutition in 82 patients we detected mechanisms with intention to minimize swallowing disturbances. Variability of their occurrence and differences in their efficiency should be emphasized, as well as essential synchronization of laryngeal closure with emptying of pharynx and opening upper oesophageal sphincter for swallowing efficiency. The valuation of compensatory maneuvers introduced spontaneously by the ill was defined as an important part of swallowing rehabilitation.

[Pedicled parietal bone grafts in the facial reconstruction surgery]. / Uszypulowane przeszczepy kosci ciemieniowej w operacjach odtwórczych twarzy.

Between years 1996 and 1997, pedunculated parietal bone graft for facial reconstruction after tumor excision was used in 8 patients. The defects comprised one side of maxilla with the orbit bottom, zygomatic bone and the orbit bottom, mandibular ramus, and the whole mandible: in 4, 1, 2, and 1 patient respectively. The reconstruction was done directly after tumor excision in 6 patients and later on in the other 2. The grafts were of full thickness in 6 and of outer table in 2. Functional and cosmetic effects were considered satisfactory in 6 patients. The whole mandible reconstruction ended up with a failure due to infection and tumor recurrence.

[Malignant tumors of mandible in children]. / Nowotwory zlosliwe zuchwy u dzieci.

Primary bone tumors represent about 7% of paediatric malignancies. Osteosarcoma and Ewing's tumor are the most frequent ones, however they are rare in facial bones. Mandibular localization is slightly more frequent and of better prognosis than maxillary one. Until 1995 there were only about 70 cases reported in the medical literature, mainly in the oncological or dental periodics. Our material consists of two children with Ewing's tumor of the mandible and one patient with osteosarcoma. The diagnosis was based on histopathological or cytological studies. The combined treatment--chemotherapy and radiotherapy--was performed in two patients with Ewing's tumor. The recommended resection of the mandible including the tumor mass has not been performed. No facial asymmetry is seen after termination of the radiotherapy. The boy with osteosarcoma underwent primary mandibular partial resection; a two-year chemotherapy was introduced only when metastases in the regional lymph nodes occurred (BLM, CTX, ACT-D, ADM, CDDP). The mandible was reconstructed surgically in 5 years after termination of radiotherapy and the anatomical relationship in the masticatory organ was restored. All children are now in good condition under our long-term observation. We present these cases of mandibular tumors regarding their rare occurrence and positive results of the introduced treatment.

[Functional reconstruction of the masticatory organ after combined therapy in a 9-year-old boy with osteosarcoma of the mandible]. / Funkcjonalne odtworzenie narzadu zucia po skojarzonym leczeniu osteosarcoma zuchwy u 9-letniego chlopca.

Resection of the considerable part of the arch of the mandible disturbs breathing, swallowing, speaking and alters the facial symmetry. One-staged reconstruction of the mandible is contraindicated in patients with malignant tumor and serious prognosis. The course of the combined treatment in 9-year-old boy with osteosarcoma of the mandible is presented (May 1987--resection of the anterior part of the body of the mandible and suprahyoid lymphadenectomy); the most severe postoperative functional disorders were treated immediately (tracheostomy, nasogastric tube for 3 weeks). The reconstruction of the mandible and restoration of the anatomical relationship in the masticatory organ were performed after 5 years. Because of the metastatic disease in the nuchal and cervical lymph nodes boy underwent chemotherapy (Jan 5th 1988-Feb 21st 1990) of the primary site of the tumor 7 months after surgery. The following cytostatic drugs were administered; BLM, CTX, ACT-D, ADM, CDDP. The functional rehabilitation, small correctional surgery and improvement in perception in the oral cavity facilitated the restoration of important functions of the masticatory organ (proved by the following studies: gustometric, manometric, logopedic, stereognostic, rentgenotelevision of the swallowing process). In addition, the self-perception and the boy's social status improved significantly after favourable change in patient's appearance.

[Craniomaxillofacial fibrous dysplasias]. / Zwyrodnienie wlókniste kosci twarzy i czaszki.

Thirty cranio-maxillofacial fibrous dysplasia patients were treated. There were 21 patients with monostotic and 9 patients with multiple lesions both jaws and bones of the skull. Most of the patients were under forty years of age. The lesions caused facial asymmetry in all patients, in two of them was visual disturbances and orbital dystopia, in one patient was hearing loss. The lesions were evaluated histologically that enabled appropriate diagnosis. The principles of surgical treatment were based on the zones of involvement. Treatment was aimed at correcting functional problems and achieving facial aesthetics. Conservative facial aesthetics. Conservative shaving was made in two patients. Radical excision of the dysplastic bone was made in lower parts of the face. In cases of the mandible and maxilla has been made reconstruction with free bone transplants. Tumors of the base of the skull were excised less radically and reconstruction has been made with alloplastic implants. No recurrence or invasion of the fibrous dysplasia into the grafted bone was seen.

[Thin-needle aspiration biopsy applied in the diagnosis of salivary gland tumours]. / Zastosowanie biopsji aspiracyjnej cienkoiglowej w diagnostyce guzów slinianek.

The diagnostic methods applied in the Department of Maxillofacial Surgery, Pomeranian Medical Academy used for preliminary diagnosis of salivary gland tumours and tumour-like lesions are described. The frequency of these methods and their usefulness in preoperative diagnosis are discussed. On the basis of own experiences the place of thin-needle aspiration biopsy is established among these methods. Advantages and limitations of this method are described, stressing the changes in the frequency of use of other diagnostic methods after the introduction of thin-needle aspiration biopsy. A model of diagnostic management is proposed for cases of salivary gland tumours and tumour-like lesions.

Coexpression of glial fibrillary acid protein, keratin and vimentin. A unique feature useful in the diagnosis of pleomorphic adenoma of the salivary gland in fine needle aspiration biopsy smears.

Positive staining for glial fibrillary acidic protein (GFAP) of tumor cells in fine needle aspirates of 11 of 12 pleomorphic adenomas of the parotid gland is reported. Tumor cells in these neoplasms also coexpressed keratin and vimentin to varying extents. Coexpression of GFAP, keratin and vimentin in tumor cells in aspirates is an unusual feature, so far demonstrated only in pleomorphic adenomas. Thus, intermediate filament typing may help to distinguish: (1) pleomorphic adenomas of the salivary glands from head and neck tumors of nonsalivary gland origin; (2) intracranial metastases of malignant mixed tumors of the salivary gland from gliomas; and (3) pleomorphic adenomas from extracranial gliomas.