Injury of the Hyoid Bone as a Rare Complication in Cervical Spine Rehabilitation: A Case Report.

Neck pain is a common reason for primary care visits, and its differential diagnosis should consider various conditions. The reported incidence of hyoid bone fractures is extremely low, accounting for only 0.002% of all fractures. The most common causes of hyoid bone fractures include strangulation attempts and motor vehicle accidents. We report a case of an uncommon complication of manual therapy of the cervical spine. A 76-year-old woman complained of neck pain that worsened during speaking and swallowing, originating from a neck physiotherapy session. The otolaryngological examination revealed tenderness on the right side of the neck. Flexible nasal endoscopy demonstrated a shallow right piriform recess and asymmetry of the arytenoid cartilages. Computer tomography scan of the neck showed an isolated fracture of the right greater horn (cornu major) of the hyoid bone. The treatment was nonsurgical, with the use of a Schantz collar and pain relief drugs. Reported symptoms of hyoid bone fractures include dysphagia, odynophagia, and neck pain. In most cases of hyoid fractures, conservative management suffices, involving rest, analgesic and anti-inflammatory treatment, and neck immobilization. Surgical treatment is often necessary in the cases of fractures accompanying other injuries.

Assessment of the effect of inflammatory changes and allergic reaction on TAS2R38 receptor expression in patients with chronic sinusitis (CRS).

<b>Background:</b> Chronic rhinosinusitis (CRS) is one of the most common health complaints affecting 15% of the world's population. Recent reports confirm the participation of sensory organs in the defense process against pathogenic microorganisms. The bitter taste receptor TAS2R38 is described to play a role in the upper airway defense system. <br><b>Purpose:</b> The purpose of this study was to assess the function of the bitter taste receptor in correlation with the severity of CRS, sensory organ disorders and allergic reaction. <br><b>Material and method: </b>The study contained 100 patients undergoing nasal surgery, divided into two groups: CRS with and without nasal polyps. The control group consisted of patients undergoing septoplasty after excluding rhinosinusitis. Sinus mucosa samples obtained during surgery were used to assess TAS2R38 expression using immunohistochemistry. The IgE level was indicated from blood samples collected from patients. The Sniffin' Sticks Test was performed. <br><b>Results:</b> CRS patients had higher expression of TAS2R38 receptor compared to controls (p = 0.0175). A statistically significantly higher TAS2R38 H-score in nasal mucosa was found among patients with a higher inflammation process in CT scan (p = 0.001), higher IgE level (p = 0,04) and an abnormal result of the Sniffin' Sticks Test. <br><b>Conclusions: </b>Patients with CRS had significant TAS2R38 receptor overexpression correlating with the severity of inflammatory changes in CT scans, abnormal perception of smells and higher IgE level. A cumulative impact was found between the inflammatory changes, smell disfunction and the severity of subjective symptoms of CRS (according to EPOS) and the intensity of cell staining (index H-score).

Analysis of implementiation of 4th Head and Neck Cancer Awareness Week in Department of Otolaryngology in Miedzyleski Hospital in Warsaw.

INTRODUCTION: The aim of the study was to analyze the profile of patients applying for free preventive examinations within The Forth European Head an Neck Cancer (HNC) Awareness Week in the Department of Otorhynolaryngology in Miedzyleski Hospital in Warsaw (ORL MSS). MATERIAL AND METHODS: A media campaign was designed to inform HNC risk patients about the opportunity to receive free preventive examinations in ORL MSS. 225 patients were enrolled to the study. Patient age ranged from 26 to 92 (average 63 years). Women accounted for 66% (149) and males 34% (76). Each patient completed a questionnaire assessing risk factors for HNC, including reported symptoms and lifestyle. ENT examination was performed. Some patients were referred for further diagnostics and treatment. RESULTS: The following HNC risk factors connected with lifestyle were found: nicotine in 22%, alcohol in more than once a week in 12%, oral sex in 17%, multiple sexual partners in 10%, rare dental tests in 24%, prosthetic restorations in 45%. The symptom that most often prompted patients to participate in the HNC prevention week was chronic hoarseness (64%) of people, dry mouth (39%), swallowing (37%), nasal obstruction (6%), neck tumour (5%). One per every five patients was referred to further diagnostics: imaging screening 7% (15 persons), fiber optic examination 11% (25 persons), the excision of the lesion 8% (18 persons). 17 patients were referred for further oncological treatment, of which 13 had benign tumors and 4 had malignant tumors. CONCLUSIONS: The HNC Awareness Program increases public consciousness and should systematically includes people with risk factors. The introduction of the Program in the ORL Department has made possible to detect and treat cancer in early stages in 7.5% of those who applied for the program. The use of adequate diagnostics and treatment requires, however, adequate financial resources and systemic solutions.

Parotid gland tumours in the ENT Department in Miedzyleski Hospital in Warsaw between 2007 and 2014.

INTRODUCTION: Parotid gland tumours comprise 3% of all head and neck tumours. Although uncommon they are a histologically diverse group of tumors. The WHO classification of salivary gland tumours from 2005 recognizes 24 different malignant subtypes. They present different clinical courses and varying prognoses. Nearly 80% of salivary gland tumours are located in the parotid gland. MATERIAL AND METHODS: Our study evaluated retrospectively 445 patients with parotid gland tumours treated in our hospital in the period between 2007 and 2014. We analyzed surgical treatment and histological diagnosis. RESULTS: There were 253 (56.9%) women and 192 (43.1%) men. The incidence of benign neoplasms was 90%. The most frequent benign tumour was pleomorphic adenoma (46%) and Whartin's tumour (35%). The most commonly found malignant tumour was acinic cell carcinoma (23%) and adenocarcinoma (13%). Non-Hodgin lymphoma in the parotid gland constituted nearly 17% of all malignant lesions. Hybrid tumours were diagnosed in 5 cases. Each patient underwent surgical procedure. Temporary facial nerve paralysis after surgery was diagnosed among 10 patients. Additionally, among 4 patients permanent facial nerve paralysis was diagnosed, which appeared before surgery or during surgical resection of the infiltrated facial nerve. DISCUSSION: In this study the frequency of benign neoplasms was higher and its histopathology was different than in the literature. The most common malignant parotid gland neoplasm was acinic cell carcinoma. The study presents 5 cases of hybrid neoplasms which are very uncommon and cause difficulties with prognostic evaluation and treatment selection.