[Indocyanine green angiography in assessment of parathyroid remnant perfusion after subtotal parathyroidectomy: a case report]. / Angiografiya s indotsianinom zelenym v otsenke perfuzii ostatka tkani parashchitovidnoi zhelezy pri subtotal'noi paratireoidektomii: klinicheskoe nablyudenie.

A 72-year-old female patient with chronic kidney disease stage presented with multiple parathyroid adenomas and tertiary hyperparathyroidism. SPECT/CT with 99mTc-MIBI revealed accumulation of radiopharmaceuticals in 2 out of 4 parathyroid glands. Ultrasound established localization of all parathyroid glands. Subtotal parathyroidectomy with excision of 3 glands and resection of half of the fourth gland was performed. Intraoperative indocyanine green angiography was performed to identify all parathyroid glands and remnant perfusion. There was normal parathyroid function after 6 months.

[Indocyanine green fluorescence angiography in transoral endoscopic thyroidectomy for papillary thyroid cancer]. / Primenenie fluorestsentnoi angiografii s indotsianinom zelenym v transoral'noi endoskopicheskoi tireoidektomii pri papillyarnom rake shchitovidnoi zhelezy.

OBJECTIVE: To evaluate the effectiveness of ICG angiography in patients with papillary thyroid cancer (PTC) undergoing transoral endoscopic thyroidectomy (TOETVA) and selective neck dissection (level VI). MATERIAL AND METHODS: A retrospective analysis included 20 patients with PTC who underwent TOETVA with selective neck dissection (level VI) between September and December 2022. ICG was administered intravenously (5 mg ´ 3 times). We analyzed parathyroid glands by visual examination and ICG angiography. Fluorescence of all glands was assessed. RESULTS: Twenty patients underwent ICG angiography during TOETVA. A total of 68 parathyroid glands were identified. Only 76.5% (52/68) of parathyroid glands were identified at initial visual examination. ICG angiography additionally localized 12 glands that improved detection to 94.1% (64/68). At least one well-vascularized parathyroid gland was demonstrated by ICG angiography in 16 patients. In all these patients, serum parathyroid hormone was normal in 1 and 10 days after surgery. Two out of four patients who failed to identify a well-vascularized parathyroid gland developed transient hypoparathyroidism. There were no intraoperative and postoperative complications associated with ICG angiography. CONCLUSION: ICG angiography was simple, safe and effective for better identification and preservation of parathyroid glands in patients with PTC undergoing TOETVA. This method was valuable for assessing the viability and function of parathyroid glands and predicting postoperative hypocalcemia.

[Vertical resections for larynx cancer with preservation of the thyroid cartridge plates]. / Vertikal'nye rezektsii pri rake gortani s sokhraneniem plastin shchitovidnogo khryashcha.

This article presents a method of organ-preserving surgical treatment of laryngeal cancer, which has been developed and used since 1991 at the Tsyba Medical Radiological Research Center, Branch of the National Medical Research Center of Radiology of the Ministry of Health of Russia. The indications for this method are tumors affecting the middle part of the larynx, limiting its mobility, extending to the anterior commissure, laryngeal ventricle, vestibular fold, lower larynx and one arytenoid cartilage, but retaining mobility in the scooper-cricoid articulation. OBJECTIVE: To increase the functional safety of the larynx and improve the quality of life of patients with laryngeal cancer by using the developed method of organ-preserving surgical intervention in combined treatment. MATERIAL AND METHODS: The study included 197 patients who were operated on by the same method for a primary tumor or in connection with a relapse of the disease. At the first stage, all primary patients underwent a course of radiation or chemoradiation therapy 40-50 Gy. In 78 patients with recurrent laryngeal cancer who underwent resection of the larynx, the previous treatment was carried out in the form of a full course of radiation or chemoradiation therapy with a above 60 Gy. RESULTS: Wound healing by primary intention in patients with preoperative irradiation was observed in 92.4% of cases. With resections for a primary tumor, restoration of functions was observed in 115 (96.6%) patients, and with resections of recurrent tumors - in 71 (91%) patients. Three-year disease-free survival in these patients was 74.4%. CONCLUSION: The presented data showed the high efficiency of the method. This is evidenced by the course of the postoperative period, functional and oncological results are comparable, and in some cases exceed those of other researchers.

[Isolated neurofibroma of the tongue]. / Izolirovannaya neirofibroma yazyka.

A clinical case of successful treatment of isolated tongue neurofibroma presented patient K., 64 years old, referred to the clinic complaining of a feeling of «discomfort¼ on swallowing. With a comprehensive examination, a diagnosis of an isolated tongue neurofibroma was established. Surgical treatment was performed. The diagnosis was confirmed morphologically. The presented clinical case of isolated tongue neurofibroma in an elderly patient is casuistic in nature, of scientific and practical interest due to the rarity and unusualness of the disease.

[Individual-specific symptoms of malignant neoplasms of the oropharynx occurring in otolaryngologist's practice]. / Individualizatsiya simptomov zlokachestvennykh novoobrazovanii rotoglotki v praktike otorinolaringologa.

According to statistical data given in the article the incidence of oropharyngeal cancer increases, despite the ease of access to the maxillofacial area and the possibility to make visual and manual examination of this site. It should be stressed that locally advanced oropharyngeal cancer of the III-IV stages was the first diagnosis in 82.9% of patients. It may be due to low level suspicion of primary care physicians. The paper considers risk factors for development of oropharyngeal cancer and presents the list of compulsory diagnostic tests. The authors suggest that recommended diagnostic algorithm will be helpful to a timely detection of precancer and cancer abnormalities in the oropharynx in order to minimize the time and to define the optimal scheduling of examination of a patient in specialized health care centers for early detection of cancer.

TREATMENT OF LOCAL RADIATION LESIONS IN BREAST CANCER PATIENTS.

The purpose of this paper is the demonstration and analysis of the effectiveness of spinal cord stimulation in treatment of chronic drug-resistant neuropathy pain in a patient with radiation-induced plexopathy. She underwent radiation therapy for cancer of the right breast in 2000. Ten years later she complained with pain and weakness her right arm. After physical examination and investigation right-side brachial plexopathy was diagnosed. Antidepressant and anticonvulsant had positive effect during one year but then pain appeared again. That is why the patient has been implanted the system of epidural electrostimulation of thickening of the cervical spinal cord. During the post-operative period significant improvement of pain relief was noted. The doses of analgesics were decreased. Spinal cord stimulation efficacy for treatment of chronic pain was repeatedly proved in clinical investigation and meta-analyses. Nevertheless spinal cord stimulation effects on radiation-induced neurological disorders and possible pathophysiological mechanisms are not enough examined. All these facts require further investigation.

[Prognostic value of hemoglobin concentration in the course of chemoradiotherapy of patients with oropharyngeal squamous cell carcinoma].

There was performed a comparative analysis of the indicators of immediate and long-term results of chemoradiotherapy in 342 patients with squamous cell oropharyngeal carcinoma depending on hemoglobin level before and after treatment. In patients with normal level of hemoglobin a rate of response to treatment was almost two times higher than that of patients with anemia (75,3% vs. 23,5%) and complete regression of tumors was detected by more than three times often (65,4% vs. 17,6%). The overall five-year survival of patients with anemia was significantly worse than that of patients who had normal hemoglobin level (50,7% vs. 67,7%). Patients who had normal hemoglobin level at the time of discharge demonstrated a five-year overall survival of 75,7%, while those with a hemoglobin level below normal, but more than 80 g/l,--only 57,8%. Hemoglobin concentration was a significant prognostic factor for survival of patients with squamous cell carcinoma of the oral cavity and oropharynx. Low baseline of hemoglobin was also a negative prognostic factor for tumor response to treatment, especially to chemotherapy.