Silicone prosthetics and anti-thyroid autoimmunity.

INTRODUCTION: In esthetic surgery, the use of silicone implants is a topic of hot discussion. MATERIAL AND METHODS: An analysis of 119 esthetic surgical interventions on the mammary gland was performed. A study of the immune and endocrine parameters after mammoplasty was carried out. RESULTS: The phenomenon of an increase in the levels of autoantibodies to the TSH receptor was revealed. The phenomenon of pre-operative growth of prolactin and TSH levels has been confirmed. An increase in thyroid autoimmunity after silicone mammoplasty is interpreted as a result of a silicone adjuvant action. An increase in the incidence of ASIA syndrome in patients who underwent breast surgery was registered. However, it was observed in both patients with silicone and non-silicone breast surgeries and therefore could not be solely explained by the use of silicone. Within 12 months following silicone mammoplasty, the patients with an increase of anti-TSH receptor autoimmunity nevertheless did not show any clinical and laboratory signs of overt thyroid disease, thus staying in a pre-nosological state. PRACTICAL RECOMMENDATIONS: Based on these results, we recommend the following for esthetic surgery: (a) all patients planned for silicone implant surgery should be examined for autoantibodies to the TSH receptor and (b) patients who have undergone breast endoprosthesis, starting 6 months after the operation, need long-term follow-up for thyroid status with mandatory testing for the level of these autoantibodies.

[Results of surgical treatment of oral cavity cancer T1-2N0M0].

The article shows the results of treatment of 20 patients (aged from 46 to 85 years old) with early oral cavity squamous cell carcinoma at the period from April 2009 to January 2011. The surgery included the resection of primary tumor and neck dissection in all the patients. The primary tumor was removed by mouth access in 10 patients and combined method was used in 10 cases. The selective neck dissection was carried out in 22 cases. The oral cavity wounds were closed primarily by local flaps in 10 patients, some small residual defects were left open in 3 cases. The reconstructions with remote skin-muscular infrahyoid flap were performed in 7 patients. The free revascularized radial skin-fascia flap was used in 3 cases. A follow-up period was from 24 to 44 months. The primary local regional control consisted of 85% in given group of patients. The rate of recurrence of the second primary metachronous tumor was 15%. Tumors were located in the oral cavity. Overall 3-year survival was 90% (18 out of 20 patients).

[Microsurgical autografting for reconstruction of head and neck oncological defects. An analysis of 60 cases].

The authors analyzed results of the free flap transfer in surgery of head and neck. 60 operations were performed since October 2006 till May 2012. Indications for using them were reconstruction of the mucosa of the oral cavity and the pharynx in 48 cases, the extensive defects of skin and soft tissues of the head and neck in 12 cases. All cases except 2 had the initial reconstruction. First 18 operations were performed with the binocular loupes, followed by using operating microscope. During the operations 42 radial skin-fascia flaps, 10 anterolateral femoral flaps, 5 thoracodorsal flaps, 1 anteromedial femoral flap, 1 scapular skin bone flap and 1 jejunal flap were used. During the early postoperative period one of the patients died (postoperative lethality 1.7%). Necrosis of flaps took place in 6 cases (5 radial skin-fascia flaps, 1 thoracodorsal flap). The causes of failures were assessed as arterial thrombosis (1 case), venous thrombosis (2 cases), postoperative infection (1 case). The exact cause in 2 cases couldn't be determined. Thus, the total success in the given series of surgery was 88.9%.