RESUMEN
The parotid gland is the largest salivary gland. Tumors of the salivary gland account for 5% in the structure of oncological morbidity, and up to 80% of tumors affect the large salivary glands with tumor localization in 20% of cases in the pharyngeal process of the parotid salivary gland. The main clinical sign of a tumor of the parotid salivary gland is the presence of a slowly growing mass in the area of the gland. Often, underestimation of the clinical symptoms of salivary gland tumors is the reason for the late diagnosis of this disease and the initial manifestations of the process remain unnoticed for a long time. In order to increase the efficiency of clinical diagnostics of salivary gland tumors, the staff of the Department of Maxillofacial Surgery, Otorhinolaryngology and Topographic Anatomy with Operative Surgery of the Burdenko Voronezh State Medical University studied the clinical and anatomical parallels of changes in the ENT organs in lesions of the pharyngeal process of the parotid salivary gland. Using the previously obtained results of interdisciplinary interaction of otorhinolaryngologists and maxillofacial surgeons made it possible to increase the efficiency of diagnosis and treatment of patients with tumors of the pharyngeal process of the parotid salivary gland.
Asunto(s)
Adenoma Pleomórfico , Neoplasias de la Parótida , Neoplasias Faríngeas , Neoplasias de las Glándulas Salivales , Humanos , Neoplasias de la Parótida/diagnóstico , Neoplasias de la Parótida/cirugía , Neoplasias de la Parótida/patología , Saliva , Neoplasias de las Glándulas Salivales/patología , Faringe , Neoplasias Faríngeas/diagnóstico , Neoplasias Faríngeas/cirugía , Adenoma Pleomórfico/patología , Glándula Parótida/cirugía , Glándula Parótida/patologíaRESUMEN
A rare observation of ossifying fibromyxoid tumor of the larynx in a 23-year-old young man is presented. Surgical intervention, performed in two stages, provided a positive result. With dynamic observation of this patient for three years, continued growth and tumor recurrence were not observed. Due to the fact that ossifying fibromyxoid tumor is rare, differs in the complexity of differential diagnosis and an uncertain prognosis of the course of the disease, registration and dispensary observation of patients with this pathology is necessary.
Asunto(s)
Fibroma Osificante , Fibroma , Neoplasias de los Tejidos Blandos , Adulto , Diagnóstico Diferencial , Fibroma/diagnóstico , Fibroma Osificante/diagnóstico por imagen , Fibroma Osificante/cirugía , Humanos , Masculino , Recurrencia Local de Neoplasia , Neoplasias de los Tejidos Blandos/diagnóstico , Adulto JovenRESUMEN
The article is dedicated to the 100th anniversary of the Department of Otorhinolaryngology of Burdenko Voronezh State Medical University.
Asunto(s)
Aniversarios y Eventos Especiales , Otolaringología , Historia del Siglo XX , UniversidadesRESUMEN
The dynamics of indicators of free-radical oxidation in various purulent-inflammatory diseases of the middle ear in 280 patients was studied. Significant violations of the processes of free radical oxidation in the serum of blood were taken for the patients, the degree of which depends entirely on the severity and nature of the inflammation. A complex treatment with the use of antioxidant therapy in 280 patients was carried out. Positive results were obtained, confirmed by clinical and laboratory indicators. The pathogenetic significance and dependence of the course of purulent-inflammatory diseases of the middle ear on the processes of free radical oxidation was established, which was reflected in the determination of the duration of treatment of various forms of both acute and chronic otitis media.
Asunto(s)
Radicales Libres , Otitis Media Supurativa , Enfermedad Crónica , Oído Medio , Radicales Libres/metabolismo , Humanos , Otitis Media Supurativa/metabolismo , Oxidación-ReducciónRESUMEN
The present study was designed to investigate the clinical. laboratory, and morphological characteristics of the nasal obstruction process. It included 87 patients presenting with polypous rhinosinusitis. The dynamics of the serum leukotriene C4 (LTC4) level in the patients and the morphological changes in their polypous tissue suggested the existence of the pronounced exudative phase of allergic inflammation and provided a basis for the use of the leukotriene receptor antagonist in the form of the sodium montelucast tablets for the treatment of nasal obstruction.
Asunto(s)
Acetatos , Leucotrieno C4/sangre , Obstrucción Nasal , Pólipos Nasales , Quinolinas , Rinitis , Sinusitis , Acetatos/farmacología , Acetatos/uso terapéutico , Adulto , Ciclopropanos , Femenino , Humanos , Inflamación/tratamiento farmacológico , Inflamación/inmunología , Antagonistas de Leucotrieno/farmacología , Antagonistas de Leucotrieno/uso terapéutico , Masculino , Obstrucción Nasal/diagnóstico , Obstrucción Nasal/tratamiento farmacológico , Obstrucción Nasal/inmunología , Pólipos Nasales/complicaciones , Pólipos Nasales/inmunología , Pólipos Nasales/patología , Quinolinas/farmacología , Quinolinas/uso terapéutico , Rinitis/complicaciones , Rinitis/inmunología , Sinusitis/complicaciones , Sinusitis/inmunología , Sulfuros , Resultado del TratamientoRESUMEN
The objective of the present work was to improve the quality of diagnostics and treatment of hypervascular masses in ENT structures based on the multidisciplinary approach. The study involved 51 patients presenting with hypervascular masses in ENT structures. All of them underwent comprehensive medical examination including fibrolaringoscopy, multispiral computed tomography, magnetic resonance tomography, ultrasound dopplerography, selective carotid angiography, and/or various combinations of these techniques. The patients were given surgical, endovascular, and combined treatments. The study has demonstrated the advantages of application of the multidisciplinary approach to combined diagnostics and treatment of hypervascular masses in ENT structures as exemplified by neck hemangioma.
Asunto(s)
Angiografía/métodos , Endoscopía/métodos , Hemangioma/diagnóstico , Tomografía Computarizada Multidetector/métodos , Neoplasias Nasales/diagnóstico , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Diagnóstico Diferencial , Femenino , Hemangioma/cirugía , Humanos , Persona de Mediana Edad , Neoplasias Nasales/cirugíaRESUMEN
The objective of the present study was to estimate the possibilities and prospects for the use of regional intra-arterial chemotherapy in the combined treatment of locally advanced laryngeal cancer. The results of the chemoradiotherapeutic treatment of 26 patients presenting with locally advanced laryngeal cancer were analysed. The chemical agents were selectively administered intra-arterially three times from the right-hand femoral access by the standard procedure at a total focal dose (TFD) of 26 and 50 gram prior to the onset of and during of radiotherapy. The very first administration of the chemical agent resulted in the 30% decrease the tumour size. It further decreased by 70% on the average after the TFD of 50 gram was achieved. It made possible the continuation of gamma-therapy up to the total therapeutic dose. As a result, complete regression of the tumour was documented. The dynamic endoscopic control study and CT of the larynx revealed recurrent laryngeal cancer in 1 of the 26 patients (3.8%). The remaining patients did not develop metastases during the 18 month follow-up period. It is concluded that the results of the present study confirm high (96.2%) effectiveness of the method employed in this study which allows it to be recommended for the organ-preserving treatment of locally advanced laryngeal cancer.
Asunto(s)
Antineoplásicos/administración & dosificación , Neoplasias Laríngeas/tratamiento farmacológico , Anciano , Angiografía , Relación Dosis-Respuesta a Droga , Estudios de Seguimiento , Humanos , Infusiones Intraarteriales , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/radioterapia , Masculino , Persona de Mediana Edad , Radioterapia Adyuvante , Resultado del TratamientoRESUMEN
The authors describe the previously unknown morphological structure, bulla ethmoidalis uncinata, located at the medial plate of ethmoidal labyrinth that forms the upper part of the lateral wall of the nasal cavity in the region of middle nasal meatus. It was shown that the absence of semilunar hiatus in the nasal cavity may be responsible for fronto-nasal communication through the infundibular opening or the crooked fronto-nasal duct. The discovery of bulla ethmoidalis uncinata substantially extends our knowledge of the structure of human nasal cavity.
Asunto(s)
Hueso Etmoides/anatomía & histología , Tabique Nasal/anatomía & histología , Adulto , Anciano , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The present work is based on the examination of 37 sagittal sawcut sections through the heads of human corpses of either gender. Evacuation paths for the contents of frontal sinuses were studied experimentally in different types of fronto-nasal communication. Two variants of infundibular fronto-nasal communication are described, lateral and medial, formed by the bony septum between uncinate process and bulla ethmoidalis uncinata. It was shown that the direction of evacuation of the contents of a frontal sinusis and the possibility of their rhinoscopic identification are directly dependent on the type of the naso-frontal communication. Cannulas have been developed that optimally match the shape of the naso-frontal communication. An approach is proposed to the choice of the most adequate instrument for endonasal probing frontal sinuses.
Asunto(s)
Senos Etmoidales/anatomía & histología , Exudados y Transudados , Seno Frontal/anatomía & histología , Sinusitis Frontal/diagnóstico , Sinusitis Frontal/cirugía , Cadáver , Catéteres , Endoscopía , Senos Etmoidales/patología , Femenino , Seno Frontal/patología , Sinusitis Frontal/patología , Humanos , MasculinoRESUMEN
The objective of the present study was to evaluate the immune status of patients with chronically recurring polypous rhinosinusitis (CRPS) for the identification of the key markers of immune disorders. Assessment of the efficiency of traditional therapy during the postoperative period demonstrated that it was very low in terms of beneficial effect on the major components of the immune system, T and B lymphocytes. Determination of the frequency of immune disorders during irradiation of autoblood with ultraviolet light and plasmapheresis in the postoperative period and evaluation of "true" effects of these treatments revealed their significant quantitative immunostimulating action. Integral evaluation (rank-sum analysis) demonstrated similar therapeutic efficiency of the two methods.
Asunto(s)
Transfusión de Sangre Autóloga/métodos , Sangre/efectos de la radiación , Inmunoterapia/métodos , Pólipos Nasales/terapia , Plasmaféresis/métodos , Rinitis/terapia , Sinusitis/terapia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pólipos Nasales/inmunología , Rinitis/inmunología , Sinusitis/inmunología , Resultado del Tratamiento , Rayos UltravioletaRESUMEN
The objective of the present study was to evaluate effectiveness of secretolytic, secreto-stimulating therapy in 40 patients presenting with acute rhinosinusitis. It was confirmed that acute inflammation results in suppression of local protective mechanisms acting in nasal cavity mucosa. Secretolytic and anti-inflammatory activity of Sinuforte was shown to induce these mechanisms; there is correlation between this effect and clinical picture of the disease. Parallel analysis of the results of traditional treatment of sinusitis and secretolytic, secretion-stimulating therapy has demonstrated high efficiency of the latter modality in patients suffering acute rhinosinusitis.
Asunto(s)
Antiinflamatorios/uso terapéutico , Exudados y Transudados/efectos de los fármacos , Rinitis/tratamiento farmacológico , Sinusitis/tratamiento farmacológico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucosa Nasal/efectos de los fármacos , Mucosa Nasal/metabolismo , Radiografía , Rinitis/diagnóstico por imagen , Rinitis/parasitología , Rinitis/patología , Sinusitis/diagnóstico por imagen , Sinusitis/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
The objective of the present study was to analyse results of fibrolaryngoscopic examination of pretumorous and tumorous laryngeal structures in 75 patients aged from 17 to 78 years who underwent repeated laryngeal biopsies to confirm suspected diagnosis of cancer. Vital staining of affected mucosal areas with a 1% methylene blue solution was used for the purpose. It was found that malignant tumours coloured violet as they readily absorbed the dye while its fixation by dysplastic tissue produced all shades of blue depending on the degree of dysplasia. It is concluded that the method employed in this study increases the informative value of clinical and histological diagnosis and thereby permits to avoid the use of additional diagnostic procedures.
Asunto(s)
Neoplasias Laríngeas/diagnóstico , Laringoscopía/métodos , Lesiones Precancerosas/diagnóstico , Adolescente , Adulto , Anciano , Femenino , Humanos , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Lesiones Precancerosas/patología , Adulto JovenRESUMEN
Results of examination and treatment of 111 patients were used to evaluate the severity of chronic decompensated tonsillitis based on the following parameters of endotoxicosis: leukocytic intoxication index, content of medium molecular-weight peptides in blood, and erythrocyte sorption capacity. These results provided additional information about the functional state of palatine tonsils and severity of tonsillogenic intoxication; moreover they made it possible to evaluate efficiency of conservative treatment and determine indications for surgical intervention. Taken together, these data may be used to avoid subjective conclusions as regards the degree of decompensation in patients with chronic tonsillitis.
Asunto(s)
Endotoxemia/diagnóstico , Tonsila Palatina/fisiopatología , Índice de Severidad de la Enfermedad , Tonsilitis/diagnóstico , Tonsilitis/fisiopatología , Adolescente , Adulto , Enfermedad Crónica , Eritrocitos/fisiología , Femenino , Humanos , Leucocitos/fisiología , Masculino , Persona de Mediana Edad , Tonsila Palatina/cirugía , Péptidos/sangre , Tonsilectomía , Tonsilitis/cirugía , Adulto JovenRESUMEN
Peculiarities of thyroid gland linear dimensions, volume, shape, and topographical features were investigated using the morphological material obtained from 426 human corpses of either gender with a view to using this information for planning and performing tracheostomy in residents of the Central Chernozem region, Russia. The study yielded new data on surgical anatomy of additional muscles of the subhyoid region, thyroid isthmus and pyramidal lobe. Rare and previously unknown variants of anatomical structure of the anterior cervical area are described that may play the role of risk factors of postoperative complications of tracheostomy. Relevant recommendations are provided for practicing otorhinolaryngologists.
Asunto(s)
Cuello/anatomía & histología , Glándula Tiroides/anatomía & histología , Tráquea/anatomía & histología , Tráquea/cirugía , Traqueostomía , HumanosRESUMEN
This study had the objective of evaluating intraoperative characteristics of sanation surgery for the correction of structural elements of ethmoid bone in 131 patients presenting with frontitis. Moreover, it included histological examination of the resected tissues. It was shown that chronic frontitis is associated not only with serious morphological changes in mucous membrane of the respective frontal sinusis and along the entire length of ethmoidal labyrinth but also with necrobiotic processes in the ethmoid bone plates, depending on the state of the ostiomeatal complex. It is supposed that these findings may account for irregular or low effect of conservative therapy of chronic frontitis and confirm the necessity of surgical sanation of ethmoidal labyrinth with due regard for the state of the ostiomeatal complex.
Asunto(s)
Hueso Etmoides/patología , Hueso Etmoides/cirugía , Sinusitis Frontal/patología , Sinusitis Frontal/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Resultado del Tratamiento , Adulto JovenRESUMEN
A total of 118 children with exudative otitis media were available for observation in this study. Pneumatization of the mastoid process was evaluated by the roentgenoplanimetric technique. A large fraction of patients (48%) with acute exudatived otitis media showed pneumatic type of pneumatization whereas sclerotic pneumatization predominated in children with chronic exudative otitis media (68%). Retractions significantly more frequently developed in ears with the sclerotic type of pneumatization of the mastoid process (91%) than in case of pneumatic pneumatization. Based on these data, the children were divided into two groups, one comprising 25 patients with acute exudative otitis, the other 35 ones with recurrent disease. It is concluded that children with the symptomocomplex characterized by low level of pneumatization of the mastoid process, conductive or mixed hearing loss with a bone-air interval of 30-50 dB, and type B tympanogram are in need of early surgical intervention.
Asunto(s)
Otitis Media con Derrame/diagnóstico por imagen , Otitis Media con Derrame/cirugía , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Apófisis Mastoides/diagnóstico por imagen , NeumorradiografíaRESUMEN
This study included analysis of the results of treatment of 136 patients at the age from 19 to 92 years presenting with pathological changes in the frontal sinuses. 126 of them had undergone surgery for the treatment of inflammatory diseases, osteomas, and injuries to the frontal sinuses in the preceding period. 62.7% of the patients in the latter group developed relapses of the disease; therefore, 44.1% of them needed the second operation. In order to improve the efficiency of treatment of chronic recurrent and postoperative frontitis, radical operation on the frontal sinuses in 56 patients was completed by obliteration of the sinus using the osteoplastic composite material MK-9M. Dynamic observations during the three subsequent years demonstrated stable recovery in all the 56 patients.
Asunto(s)
Adhesivos/administración & dosificación , Seno Frontal/lesiones , Seno Frontal/cirugía , Sinusitis Frontal/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Seno Frontal/patología , Sinusitis Frontal/patología , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Morphological methods were employed to prognosticate the clinical course of abscesses in deep-lying perimandibular and pharyngeal soft tissues. It was shown that soft tissues surrounding the suppurative focus in patients presenting with the long-standing inflammatory process contain cells with nuclei of relatively low ploidy. This finding provides a rationale for the inclusion in the combined treatment of abscesses of an additional range of medicines normalizing reparative processes in the soft tissue.