Health-related quality of life of parotid carcinoma patients-a comparative study with parotid adenoma patients and assessment of the influence of demographic, treatment, and pathological factors.

The aim of this study was to compare the health-related quality of life (HRQoL) of patients treated for parotid carcinoma (PC) and parotid adenoma (PA). The impact of demographic, treatment, and pathological factors was analyzed within the PC group. The EORTC QLQ-C30 and QLQ-H&N35 questionnaires were completed by 45 PC patients and 46 PA patients. A number of HRQoL domains were significantly worse in the PC group than in the PA group: global health status, pain, insomnia, loss of appetite, mouth opening, swallowing problems, dry mouth, sticky saliva, problems with senses and speech, social eating, and cognitive functioning (P<0.05). In the PC group, significantly worse scores were found for age >55years, radical parotidectomy, neck dissection, radiotherapy, recurrence of the disease, pT3/T4 stage, pN+ status, and high-grade tumour (P<0.05). Worse results were related to global health status, social contact, mouth opening, weight and appetite loss, physical, role, emotional, and social functioning, fatigue, speech problems, social eating, and financial difficulties. The study results demonstrate worse HRQoL in PC patients in comparison to PA patients. Older age, radical parotidectomy, neck dissection, radiotherapy, T3/T4 stage, pN+, high-grade tumours, and recurrence had a significant influence on HRQoL in PC patients.

An algorithm for preoperative differential diagnostics of parotid tumours on the basis of their dynamic and diffusion-weighted magnetic resonance images: a retrospective analysis of 158 cases.

BACKGROUND: To verify the usefulness of a new algorithm for preoperative differential diagnostics of parotid tumours on the basis of their dynamic and diffusion- -weighted magnetic resonance imaging (MRI). MATERIALS AND METHODS: The retrospective analysis included 158 consecutive surgical patients with parotid tumours. Aside from ultrasound-guided fine needle biopsy, the protocol of preoperative evaluation included dynamic and diffusion-weighted MRI. According to the new diagnostic algorithm, the result of fine needle biopsy was considered only in the case of lesions with time to peak enhancement (Tpeak) > 60 s and washout rate (WR) ≤ 30% on dynamic MRI and apparent diffusion coefficient (ADC) ≤ 1.7 × 103 mm/s2 on diffusion-weighted MRI, or those presenting with concomitant lymphadenopathy. The accuracy of this algorithm was verified against final histopathological diagnoses. RESULTS: The new algorithm gave 10 true positive and 2 false positive results, as well as 132 and 14 true and false negative results, respectively. Its sensitivity and specificity (41.7% and 98.5%, respectively) were the same as in the case of fine needle biopsy alone. None of the 59 tumours that were qualified as benign solely on the basis of preoperative MRI turned out to be malignant on postoperative histopathological examination. CONCLUSIONS: Interpreted together, dynamic and diffusion-weighted MRIs provide the same accuracy in preoperative differential diagnostics of parotid tumours as fine needle biopsy. This substantiates the use of diagnostic algorithms in which biopsy would serve mostly as a secondary test to verify selected ambiguous radiological diagnoses. (Folia Morphol 2018; 77, 1: 29-35).

Signs and symptoms of parotid gland carcinoma and their prognostic value.

The aim of this study was to analyse signs and symptoms present in patients with parotid gland carcinoma and to assess their prognostic value. A retrospective study of data from 131 patients who were treated surgically was performed. Evaluation of prognostic factors was possible in 109 patients who completed a minimum 5 year follow up. The most common sign and symptoms were parotid mass (96.9%), pain (40.4%), enlarged cervical lymph nodes (32.0%), facial nerve palsy (20.6%) and overlying skin infiltration (19.8%). In 20% of all cases there were no symptoms of tumour malignancy. The average duration of symptoms suggesting malignancy was 4 months. In univariate analysis, the strongest prognostic value was found for facial nerve palsy; it reduced nearly tenfold (9.7) the 5-year disease-free survival. The subsequent poor prognostic factors were: skin infiltration, enlarged cervical lymph nodes, tumour fixation and tumour size (>4 cm). Pain and the dynamics of tumour growth were not statistically significant for survival rate. Significant difference in 5-year disease free survival rate was found between the groups of patients, according to the number of symptoms suggesting malignancy. The multivariate analysis showed that only facial nerve palsy and skin infiltration were independent prognostic factors.

Intracranial complications of acute and chronic mastoiditis: report of two cases in children.

OBJECTIVE: The clinical picture of mastoiditis, sigmoid sinus thrombosis and brain abscess has changed with the advent of antibiotics. A delay in the recognition of intracranial complications in children and in the institution of appropriate therapy may result in morbidity and mortality. Increased mortality of the children has been correlated with the neurological status of the patient on admission to hospital. METHOD: A retrospective study was made of two children with acute mastoiditis and sigmoid sinus thrombosis and chronic mastoiditis with cerebellar abscess treated in 1997 in the ENT Department of the Medical University of Gdansk. RESULTS: We present two cases of intracranial complications in children (13 and 11 years old) originating from acute and chronic otitis media. The first case, of a 13-year-old boy with sigmoid sinus thrombosis as a complication of acute otitis media took its course as a typical Symonds Syndrome. Mastoidectomy, thrombectomy and jugular vein ligation associated with antibiotics and edema-reducing drugs and anticoagulants proved to be successful. The second case of an 11-year-old boy with exacerbated chronic otitis media with cholesteatoma and mastoiditis, was complicated by suppurative meningitis, cerebellar abscess, perisinual abscess and sigmoid sinus thrombophlebitis. Neurosurgical approach by suboccipital craniotomy and abscess drainage was ineffective. Otological treatments of modified radical mastoidectomy, thrombectomy, jugular vein ligation, perisinual and cerebellar abscess drainage associated with wide-spectrum antibiotics and edema-reducing drugs were performed with a very good outcome. After 3 years of follow-up the patients remain without any neurological and psychiatric consequences. CONCLUSION: The authors show different courses of both presented complications and imaging techniques and surgical procedures performed in these children. The sigmoid sinus trombosis with Symonds Syndrome may be difficult to diagnose due to previous antibiotics valuable in establishing the diagnosis and the extent of disease. The successful therapy is based on understanding of pathogenesis of the intracranial complication and the cooperation of an otolaryngologist, a neurologist, a neurosurgeon and an ophthalmologist.

[Bilateral neck dissections]. / Obustronne operacje wezlowe szyjne.

The structure of lymphatic system of the larynx causes that in some cases node metastases may occur bilaterally. In many patients bilateral neck dissection is indicated. In material of 252 patients with laryngeal carcinoma, treated in ENT Department in Gdansk in 1976-1985, an assessment of frequency and indications to one-stage bilateral neck dissection was made. Among 252 patients, bilateral operations were performed in 50, i.e. 20%. We have found that in 29 patients of 50 were nodal metastases, in 12 unilateral and in 17 bilateral. The analysis of long-term results of treatment showed 23.5% of 5-year survivals in patients with bilateral metastases and 42.3% in patients with unilateral metastases. To base on these data we consider that bilateral one-stage neck dissection should be a standard treatment in many cases of laryngeal carcinoma.

[Effectiveness of elective neck dissection in patients with laryngeal carcinoma]. / Ocena skutecznosci elektywnej operacji wezlowej na szyi u chorych na raka krtani.

The authors presented material of 711 patients with laryngeal cancer treated in Department of Otolaryngology Medical University of Gdansk in the years 1976-1995 estimating effectiveness of elective neck dissection. 402 patients (56.6%) had N0 stage and in 162 of them elective neck dissection was performed. Occult metastases were found in 21% of N0 patients. Comparing treatment results in this group to inoperated N0 patients the authors found higher percentage of survival and lower incidence of failure after elective neck dissection.

[Long term result of treatment of laryngeal carcinoma (1981-1990)]. / Odlegle wyniki leczenia raka krtani (1981-1990).

Long term results were evaluated on the basis of the epidemiological and clinical analysis of 386 patients treated surgically because of squamous cell carcinoma of the larynx in the ENT Department, Medical University of Gdansk between 1981-1990. Full recovery was achieved in 52.3% of patients, failure was found in 26.9%. In the treatment evaluation the following factors were taken into account: the age of patients, T and N classification and clinical staging, primary location of the tumour. The treatment results, concerning the years 1981-1990 were compared to the ones obtained in our clinic in 1971-1980; it has been stated that the differences between the percentage of recoveries and the failures are statistically unimportant.

A case of multiple post-anginal complications.

The paper presents an unusual case of multiple post-anginal complications in a 21-year old male patient that included a peritonsillar abscess, parapharyngeal space phlegmon, a deep intrafascial phlegmon of the neck, internal jugular vein thrombophlebitis, septicopyemia, lung abscess and pneumonia, and a pyothorax. The patient was cured surgically and with broad-spectrum antibiotics and antifungal medication. The unusual course of the disease with presumed mycotic etiology as a complication of antibiotic therapy is discussed.

Benign neoplasms of the larynx.

In a 45-year period (from 1948 to 1992) 291 patients with histologically proved benign neoplasms of the larynx were observed and treated. The most frequently occurring tumors were papillomas, being 95.2% in whole material. In most cases of benign tumors of the larynx intralaryngeal excision of the tumor was used. Clinical data and results of treatment were presented and discussed.

[Parapharyngeal space tumors]. / Nowotwory przestrzeni przygardlowej.

The authors presented material of 52 parapharyngeal space tumors seen ENT Department Medical University of Gdansk in year 1980-1994. Majority of these tumors -32 (61.5%)-were benign (adenoma pleomorphum-22, adenolymphoma-4, neurilemmoma-4, ganglioneuroma-2). The remaining 20 (38.5%) tumors were malignant (cystis branchiogenes carcinomatosa-4, carcinoma planoepitheliale-3, lymphoma malignum-3, adenoma pleomorphum maligum-2, tumor mucoepidermalis-2, and tumor acinocellularis, chemodectoma, meningeoma malignum, haemangiopericytoma, chordoma, chondrosarcoma one of each.

[Esthesioneuroblastoma. Personal opinion about diagnosis and treatment]. / Nerwiak wechowy. Obecne poglady na diagnostyke i leczenie.

The authors present material of 6 cases esthesioneuroblastoma observed in ENT Department Medical University of Gdansk. The tumors were seen in 3 children and 3 adults. According to Kadish staging there were one A, two B, two C and one D stage tumor. Investigation and treatment methods, and obtained results were discussed.

[Extramedullary plasmacytomas of the larynx]. / Odosobnione pozaszpikowe guzy plazmatycznokomórkowe krtani.

The authors present four cases of solitary extramedullary plasmocytoma of the larynx, a very rare laryngeal tumor, seen in ENT Department, Medical University of Gdansk in years 1948-1994. They were 0.16% of all malignant laryngeal neoplasms and 23.5% of non-epithelial neoplasms of the larynx in this period. Characteristics for these tumors, epidemiological and clinical features were discussed.

Non-epithelial malignant neoplasms of the larynx.

From 1948 to 1992, 14 patients with non-epithelial malignant neoplasm of the larynx were seen in the ENT Department of the Gdansk School of Medicine. During this period, 2,249 patients with malignant laryngeal neoplasms were treated. The choice of therapy (laryngectomy, total or partial, excision by thyrotomy, irradiation or chemotherapy) depended on the size and location of the tumor and its histopathological nature. Significant for these tumors were: unchanged mucosa covering the tumor, rare metastases to the cervical lymph nodes, difficulties in estimating a histopathological diagnosis and determination, in certain types their unifocal nature.