Etiology, Early Diagnosis and Proper Treatment of Silent Sinus Syndrome Based on Review of the Literature and Own Experience.

PURPOSE: The authors' aim was to review the literature in terms of the etiology of the syndrome, the frequency of Silent Sinus Syndrome (SSS) and surgical procedure, as well as to present their own experience. METHODS: The authors used PubMed, Medline, and Science Direct websites to find and review the most significant papers related to SSS. The case reports of SSS published between 2010 and 2020 were reviewed. A retrospective case review of 8 patients with SSS treated at the authors' departments was done. RESULTS: The silent sinus syndrome has been reported in both children and adults. It is relatively rare and should be differentiated from congenital sinus hypoplasia or atelectasis. It most often affects the maxillary sinus. SSS is usually diagnosed when facial asymmetry or vision problems occur. Late diagnosis requires endoscopic sinus surgery, involving orbital wall reconstruction. The etiology of the syndrome, including the role of bacterial flora found in the sinuses, is unclear. CONCLUSION: Early diagnosis of SSS enables avoiding orbital complications and limits surgical intervention to endoscopic surgery. Further research into bacteriology may help to understand the pathophysiology of the silent sinus syndrome.

Nutritional status at the moment of diagnosis in childhood cancer patients.

INTRODUCTION: Children with a neoplastic disease are highly susceptible to malnutrition. The main objective of the study was to assess the frequency of undernourishment and obesity at the time of the diagnosis of the neoplastic disease at children. MATERIALS AND METHODS: The study included 734 patients (58% males) at the age 1-20,25, with the diagnosis of neoplasm in the years 1986-2014. The patients were divided into groups depending on the type of the diagnosis: 1) ALL, 2) ANLL, 3) HL, 4) NHL, 5) NBL, 6) Wilms tumor, 7) mesenchymal malignant tumor. The BMI SDS and the height SDS were evaluated. The difference in the incidence of disorders in each group was examined. RESULTS: In the study group at the time of the diagnosis 21.5% of patients were undernourished while 13.8% presented were overweight. Patients in the ALL group were overweight more often than the rest of the study group (RR 1.82, CI 95%1.26-2.63, p=0.002) - 18.6% of them were overweight. However, children with mesenchymal malignant tumor were less susceptible to overweight than the rest of the patients (RR 0.36, CI 95%0.15-0.87, p=0.021) - only 5.4% of them were overweight. Girls with ALL were malnourished more often than other patients (RR 1.72, CI 95%1.08-2.75, p=0.03). There were no significant differences in the malnutrition/obesity frequency in other neoplasms groups. SUMMARY: ALL patients are less susceptible to underweight than the patients with the solid tumor. Moreover, the high incidence of overweight in children with ALL is noteworthy.