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    Wyświetlanie 1-6 z 6
    Tytuł:
    Virtual surgical planning and cone beam computed tomography in reconstruction of head and neck tumors – pilot study
    Autorzy:
    Krakowczyk, Łukasz
    Piotrowska-Seweryn, Agnieszka
    Szymczyk, Cezary
    Wierzgoń, Janusz
    Oleś, Krzysztof
    Ulczok, Rafał
    Donocik, Karolina
    Dowgierd, Krzysztof
    Maciejewski, Adam
    Powiązania:
    https://bibliotekanauki.pl/articles/1397270.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    cone beam computed tomography
    free flap
    head and neck
    reconstruction
    virtual surgical planning
    Opis:
    Introduction: The aim of the study was to prove that a combination of visual surgical planning (VSP) and cone beam computed tomography (CBCT) is an optimal technique in fibular free flap reconstructions after complex tumor resections in the head and neck region and that it leads to better functional and aesthetic outcomes. Material and method: Six patients (3 females, 3 males) with head and neck tumors were included in the study. The region concerned midface in 2 cases and mandible in 4 patients. On the basis of computed tomography of the head, fibular free flap (FFF) reconstruction was planned with the VSP technique. The 3D-printed models were prepared. At the beginning of the operation and a few minutes after the reconstruction, an xCAT CBCT by XORAN was performed. Minor corrections of the angles of the reconstructed bony parts were made where needed. The time of the operation was assessed for each case. Functional and cosmetic results were evaluated in a 1-year follow-up. Results: The mean time of operation was 6 hours and 48 minutes, which was approximately 1hour and 40 minutes less than standard reconstructive surgery. Functional recovery was achieved in all patients. Aesthetic result was unsatisfactory for 2 patients due to insufficient soft tissue masses of FFF. Conclusions: The authors claim that intraoperative CBCT imaging, regardless of the cost, improves the accuracy of aesthetic outcome of reconstructive surgeries based on VSP, especially in the region of the midface and the mandible. Further studies on a higher number of subjects are required.
    Źródło:
    Polish Journal of Otolaryngology; 2021, 75, 2; 28-33
    0030-6657
    2300-8423
    Pojawia się w:
    Polish Journal of Otolaryngology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Application of cone beam computed tomography in ENT and reconstructive head and neck surgery – literature review and own experience
    Autorzy:
    Piotrowska-Seweryn, Agnieszka
    Krakowczyk, Łukasz
    Maciejewski, Adam
    Kaniszewska-Dorsz, Żaneta
    Markowski, Jarosław
    Pietrauszka, Kornelia
    Goroszkiewicz, Karolina
    Powiązania:
    https://bibliotekanauki.pl/articles/1399645.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    computed tomography
    ENT
    free flap
    head and neck
    reconstruction
    Opis:
    CBCT is a relatively new diagnostic imaging method. It was first used in 1982 at the Mayo Clinic Biodynamics Research Laboratory [1], and has been commercially used in dentistry since 2001. It differs from multidetector computed tomography in terms of implementation technique and some parameters. A low dose of radiation is its greatest advantage, thanks to which many specialists, including ENT doctors and reconstructive surgeons, are more willing to use it. In otorhinolaryngology, CBCT is applied in pre- and perioperative diagnostics in both rhinology and otology. In reconstructive surgery, CBCT facilitates precise planning of the flap and intraoperatively allows a perfect match of the reconstructed tissue elements. In the article, the authors present current information on CBCT in ENT obtained on the basis of a review of Polish and foreign literature and share their own experience in its application in reconstructive surgery within the craniofacial region.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2019, 8, 3; 1-7
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Salvage surgery of hypopharyngeal cancer as a second malignancy post radiotherapy and the possibility of digestive track reconstruction – study of three cases and the literature review
    Autorzy:
    Rzepakowska, Anna
    Jasińska, Agnieszka
    Wolniewicz, Maria
    Baranek, Piotr
    Osuch-Wójcikiewicz, Ewa
    Bruzgielewicz, Antoni
    Niemczyk, Kazimierz
    Powiązania:
    https://bibliotekanauki.pl/articles/1399615.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    head and neck cancer
    second primary cancer
    hypopharyngeal cancer
    salvage surgery
    digestive tract reconstruction
    radial forearm free flap
    free autologous jejunal flap
    Opis:
    Patients with head and neck cancers have an increased risk of second malignant neoplasm occurrence (25% in long-term follow-up, 4% yearly). Most patients with a primary tumor can be treated with organ-preserving strategies including radiotherapy (RT) or chemoradiotherapy (CRT). Very often after radical surgical excision there are indications for adjuvant radiotherapy. However, if recurrence or second malignancy will develop after definitive primary RT, there are limitation to use therapeutic dose of radiation again for the same area. Salvage surgery is regarded as the only curative option in those cases. In our study we analysed 3 patients, who presented with head and neck second cancer in the area of hypopharynx, within 10-25 years after primary radiotherapy due to oropharyngeal and laryngeal cancer. A total pharyngectomy with larynx preservation and bilateral neck dissection were performed in the first case and the radial forearm free flap (RFFF) was used for reconstruction of the pharynx. Second patient, due to perilaryngeal invasion in radiological images, underwent total pharyngolaryngectomy with selective bilateral cervical lymph nodes dissection and digestive track was restored also with RFFF. The third patient had previously undergone laryngectomy and after total pharyngectomy the free autologous jejunal flap (FAJF) was used for reconstruction. The main goal of reconstruction after salvage surgery due to hypopharyngeal cancer is to reconstruct the digestive tract. The other important aspect is to optimize the anatomy for voice rehabilitation and swallowing. Unfortunately, radiation and chemotherapy impair wound healing, which indicates increased risk of postoperative complications and makes salvage surgery results unpredictable.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2019, 8, 1; 33-39
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Surgical treatment and reconstruction of central giant cell granuloma (CGCG) of the mandible of the aggressive type – case report and literature review
    Leczenie chirurgiczne i rekonstrukcyjne centralnego ziarniniaka olbrzymiokomórkowego żuchwy o agresywnym przebiegu – opis przypadku i przegląd piśmiennictwa
    Autorzy:
    Piotrowska-Seweryn, Agnieszka
    Oleś, Krzysztof
    Grajek, Maciej
    Chekan, Mykola
    Maciejewski, Adam
    Lange, Dariusz
    Powiązania:
    https://bibliotekanauki.pl/articles/1399684.pdf
    Data publikacji:
    2019-10-04
    Wydawca:
    Index Copernicus International
    Tematy:
    fibular free flap
    giant cells
    granuloma
    mandible
    reconstruction
    komórki olbrzymie
    rekonstrukcja
    wolny płat strzałkowy
    ziarniniak
    żuchwa
    Opis:
    Introduction: Central giant cell granuloma (CGCG) is a benign tumor-like lesion of a bone, mainly localized in the mandible. It usually occurs in children and young adults under 30 y/o., predominantly in females. The etiology of the disease remains unknown. Clinically, two types of CGCG have been distinguished – a non-aggressive one, in which the granuloma grows slowly, often asymptomatically, and aggressive type for which the following features are characteristic: increased bone destruction, severe pain, large size, rapid growth, high recurrence rate and complications such as root resorption, tooth displacement or cortical bone perforation. The treatment of CGCG depends on its type. In cases of granulomas of the aggressive type, the following therapeutic procedures have been proposed: intralesional corticosteroid injections, interferon and calcitonin therapy as well as immunotherapy with anti-bone resorptive human monoclonal antibody like denosumab. However, in most cases nonsurgical treatment is insufficient. Local curettage of the lesion also entails a high risk of relapse. Therefore, radical surgical resection, often combined with bone reconstruction, is the recommended way of treatment for aggressive CGCG. Case report: The authors present a case of a 31-year-old female patient treated for central giant cell granuloma of the mandible at the Department of Oncological and Reconstructive Surgery, Maria Sklodowska Curie Memorial Cancer Centre and Institute of Oncology in Gliwice. The resection of CGCG localized in the mandible on the right side together with fibular free flap reconstruction has been performed, with satisfactory aesthetic effect. The immunohistochemical examination indicated a positive stain reaction for CD68 and CD31 and expression of Ki67 marker was 13%. No complications were reported in the postoperative period. The six-month follow up revealed no relapse. Conclusions: The authors claim that radical surgical management should be performed in all patients with CGCG of the aggressive type. Fibular free flap is recommended for reconstruction in large bone defects. This allows tumor-free margins at the resection and satisfactory cosmetic outcome. Quality of life and facial appearance can be improved with dental implantation after a certain period of remission. A regular follow-up is essential as an element of holistic oncological process.
    Wstęp: CGCG jest łagodną, guzopodobną zmianą kości, najczęściej lokalizującą się w obrębie żuchwy. Występuje ona głównie u dzieci i młodych dorosłych poniżej 30 r.ż., z przewagą płci żeńskiej. Etiologia schorzenia nie została do końca poznana. Klinicznie wyróżnia się dwie postacie CGCG: (1) nieagresywną, kiedy ziarniniak rośnie powoli, często bezobjawowo, oraz (2) agresywną, charakteryzującą się: nasilonym niszczeniem kości, dolegliwościami bólowymi, większymi rozmiarami guza, jego gwałtownym wzrostem i powikłaniami, takimi jak: resorpcja korzeni czy perforacja blaszki kostnej, oraz wysoką tendencją do nawrotów. Leczenie ziarniniaka zależy od jego postaci. W przypadkach CGCG o agresywnym przebiegu zastosowanie znajduje leczenie zachowawcze pod postacią sterydoterapii w infekcjach miejscowych, aplikacji interferonu, kalcytoniny czy denosumabu. Jednak w większości przypadków ta forma terapii bywa nieskuteczna. Również wyłyżeczkowanie zmiany niesie wysokie ryzyko nawrotu choroby. Stąd najlepszym sposobem postępowania jest radykalne chirurgiczne usunięcie zmiany, często wymagające operacji rekonstrukcyjnej ubytków kostnych. Opis przypadku: W niniejszej pracy autorzy przedstawiają przypadek 31-letniej chorej, leczonej w Klinice Chirurgii Onkologicznej i Rekonstrukcyjnej Centrum Onkologii – Instytutu im. Marii Curie-Skłodowskiej Oddziału w Gliwicach z powodu centralnego ziarniniaka olbrzymiokomórkowego żuchwy. U pacjentki wykonano operację resekcji fragmentu żuchwy po stronie prawej wraz z guzem z następową rekonstrukcją wolnym płatem strzałkowym, uzyskując zadowalający efekt kosmetyczny. Przebieg pooperacyjny był niepowikłany. W badaniu immunohistochemicznym wykazano dodatnią reakcję z przeciwciałami CD68 i CD31, a współczynnik Ki67 wyniósł 13%. W półrocznym okresie obserwacji nie odnotowano wznowy ziarniniaka. Wnioski: Autorzy uważają, że radykalne leczenie chirurgiczne powinno być stosowane u wszystkich pacjentów z agresywną postacią centralnego ziarniniaka olbrzymiokomórkowego. Z uwagi na częste naciekanie kości w tych przypadkach, zalecają rekonstrukcję wolnymi płatami kostnymi z mikrozespoleniem naczyniowym. Pozwala to na uzyskanie radykalności onkologicznej w połączeniu z dobrym efektem kosmetycznym. Jakość życia i estetyka twarzy może być udoskonalona dzięki implantom zębowym, zastosowanym po odpowiednim czasie remisji choroby. W całościowym leczeniu onkologicznym ogromną rolę odgrywa ścisła, regularna kontrola w ośrodku prowadzącym.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2019, 8, 4; 30-37
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Instrumental evaluation of dysphagia after oropharyngeal cancer surgery with free flap reconstruction
    Autorzy:
    Jamróz, Barbra
    Chmielewska, Joanna
    Milewska, Magdalena
    Niemczyk, Kazimierz
    Powiązania:
    https://bibliotekanauki.pl/articles/1401527.pdf
    Data publikacji:
    2016
    Wydawca:
    Index Copernicus International
    Tematy:
    FEES
    VFS
    dysphagia
    head and neck cancer
    free flap reconstruction
    Opis:
    Introduction: Assessment of usefulness of instrumental method of evaluation of dysphagia in creating a therapeutic plan among patients after oropharyngeal cancer surgery with free flap reconstruction. Material and Method: Seven patients after oropharyngeal cancer surgery with free flap reconstruction hospitalized from January to September 2016 in the ENT Department of Warsaw Medical University were included in this study. All patients underwent few times after surgery: clinical swallowing examination, water swallowing screening test and fiberoptic endoscopic evaluation of swallowing and/or videofluoroscopy. Results: All patients were diagnosed with dysphagia and had unitentional weight loss (average 5,9% of initial weight during 3 months). In water swallowing test only three participant achieved negative score for 5 ml, and two for 10 ml, 20 ml and 90 ml of water. Fiberoptic endoscopic evaluation of swallowing was analyzed for swallowing patterns and laryngeal pathology. FEES showed following abnormalities: aspiration (saliva, liquid), penetration (puree, liquid), premature swallowing (liquid, puree) and multiswallowing (liquid, puree, solid food), retention (saliva, puree, liquid, solid food). Videofluroscopy showed on the first place problems with oral phase of swallowing: difficulty forming and propeling bolus, tongue pumping movements, oral cavity residue, premature spillage and delayed oral onset. During the pharyngeal phase we observed: residue in valleculae and piriform sinuses, reduced laryngeal elevation, penetration and aspiration, multiple swallows. Conclusion: Instrumental assessment of swallowing helps during diagnostic and therapeutic process of patients with dysphagia after oncological treatment. a.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2016, 5, 4; 22-28
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The use of anterolateral thigh flap (ALTF) for functional tongue reconstruction with postoperative quality of live evaluati
    Autorzy:
    Krakowczyk, Łukasz
    Maciejewski, Adam
    Szymczyk, Cezary
    Wierzgoń, Janusz
    Półtorak, Stanisław
    Powiązania:
    https://bibliotekanauki.pl/articles/1394335.pdf
    Data publikacji:
    2015
    Wydawca:
    Index Copernicus International
    Tematy:
    free flap
    reconstructive surgery
    anterolateral thigh flap
    Opis:
    The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live. Material and methods. Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status. Results. The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points. Conclusions. Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.
    Źródło:
    Polish Journal of Surgery; 2015, 87, 8; 384-388
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-6 z 6

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