[Cortisone treatment in prevention of pharyngocutaneous fistula after total laryngectomy]. / Tratamentul cortizonic în prevenirea fistulei faringo-cutanate postlaringectomie totala.

PURPOSE: To identify a method of prophylaxis in pharyngocutaneous fistula (PCF) after radical surgery for cancer of larynx and pyriform fossa. MATERIALS AND METHODS: A prospective longitudinal study on patients who were operated for cancer of larynx and pyriform fossa, in year 2007 in ENT Department of Clinic Emergency County Hospital Cluj-Napoca, with total laryngectomy and partial hypo-pharyngectomy. These patients were distributed in two lots: case (who received postoperative treatment with hemisuccinate of hydrocortisone or dexamethasone) and witness (they didn't received cortisone or other treatment except the standard therapy). We followed the detection of PCF at these 2 lots of patients and the time of resumption for naturally feeding and hospitalization. We performed the bi-variant analysis (Spearman). RESULTS: 23 patient were accomplished the inclusion and exclusion criteria. 4 of those patients developed postoperative pharyngo-cutaneous fistula, only one in the case lot. Statistically, cortisone administrated postoperative brought benefits: PCF was developed in a significant reduced proportion (p=0.02) and the resumption of naturally feeding was made in a significant shorter time (p=0.003) and hospitalization time was significantly reduced (p=0.001). CONCLUSION: Cortisone administration after total laryngectomy and partial hypo-pharyngectomy seems to be a prophylactic method for pharyngocutaneous fistula.

Results in brachial plexus palsy after biceps neuro-muscular neurotization associated with neuro-neural neurotization and teno-muscular transfer.

None of the currently used techniques for elbow flexion recovery in brachial plexus recovery offers enough strength for normal life activities. The association between several methods grants a better result by a summarizing effect compared to each method used separately. The paper reveals the improvement of the functional results in brachial plexus reconstruction by combining the techniques of nerve repair (nerve grafts, nerve transfers or direct muscular neurotization) with palliative muscular transfers. Of the 54 cases of microsurgical reconstruction of brachial plexus palsy, in 20 cases we associated a muscular transposition: 7 latissimus dorsi transfers (5 monopolar and 2 bipolar), 5 pectoralis major and 8 triceps transfers. The direct neuro-muscular neurotization of the biceps-EMG efficient - was associated with a muscular transfer in 8 cases: in 4 of the 7 latissimus dorsi transfers, in 3 cases of triceps transfer and in 2 case of pectoralis major transfer. The association of the 3 methods - direct neuromuscular neurotization, neuro-neuronal neurotization and muscular transfer - has a summarizing effect in the flexion restoration of the elbow flexion, which represents a major problem in the brachial plexus palsy.

[The indications and limits for echographic studies in pediatrics]. / Indicatiile si limitele investigatiei echografice în pediatrie.

Echography is an non-invasive investigation with many advantages, but also with its limits. It allows diagnosis in numerous diseases and in other illness may suggest the choice of the next investigations, thus shortening considerably the diagnosis steps. The information provided by the echographic examination must be correlated with the clinical findings and other data furnished by the laboratory tests or other imagistic investigations, to obtain an integrated holistic evaluation, able to give a complete and correct final diagnosis.