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1.
J Craniofac Surg ; 33(6): 1655-1658, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34907952

RESUMO

ABSTRACT: The restoration of large full-thickness lip defects still remains a formidable challenge for the reconstructive surgeons. Traumatic injuries, infections and tumors (primarily squamous cell carcinoma) are the most common source of the lip defects. Lower lips are more important in providing oral competence, unfortunately throughout the life-time they are significantly more exposed to ultraviolet radiation and thus are the most common site for the lip cancers (89%). This type of defect requires a complex reconstruction of an adequate sphincter function, defined vermilion, proper oral lining and sufficient mouth opening. To maintain the oral competence, it is of paramount importance to restore the function of orbicularis oris, which principally composes the body of the lip. Currently, the dynamic reconstructions are gaining considerable interest. They enables not only improvement of appearance but also a restoration of function and preservation of health-related quality of life. The use of the free gracilis muscle transfer to reconstruct the lower lip and its dynamic character in contrast to other, static reconstructions can provide the sufficient movement of the lower lip, which does not depend on function of other mimic muscles as it becomes an independent motor unit with its own neurotization. In our opinion the free functioning gracilis muscle flap, due to its anatomic and functional features as well as low-rate donor-site morbidity is the worth considering option for a lower lip reconstruction.


Assuntos
Músculo Grácil , Neoplasias Labiais , Procedimentos de Cirurgia Plástica , Músculo Grácil/cirurgia , Humanos , Lábio/cirurgia , Neoplasias Labiais/cirurgia , Qualidade de Vida , Raios Ultravioleta
2.
J Craniofac Surg ; 33(7): 1962-1970, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-35175985

RESUMO

ABSTRACT: Ameloblastoma (AM) is the most common, locally aggressive odontogenic tumor. It comprises about 1% of all head and neck neoplasms. It occurs mainly in young adults in their 3rd and 4th decade of life. It localizes in the mandible in about 80% of the cases. According to the 2017 WHO classification, 4 types of ameloblastoma can be distinguished: ameloblastoma (previously referred to as solid/multicystic-SMA; the "conventional type" AM), unicystic (AM-UA), extraosseous/peripheral (AM-PA), and malignant/metastatic (AM-MA). Solid, multicystic is the most common type. It is characteristic for its aggressiveness and high risk of recurrence. Radical resection with consecutive reconstruction is the treatment of choice of mandibular ameloblastomas.In this study, the authors present their experience in the surgical treatment of mandibular ameloblastomas with vascularized free flap reconstructions. They discuss new technological possibilities that could improve the precision of the reconstructive procedure and therefore result in the better aesthetic outcome.The retrospective study of a group of 21 patients suffering from mandibular ameloblastoma who underwent segmental man-dibulectomy with simultaneous microvascular free flap reconstruction was conducted. A thorough clinical analysis with various aspects was performed. Tumors resected before 2017 were double checked patomorphologically and assigned to the corrected subtype group.Seven patients were admitted to the department due to recurrent ameloblastoma. The most common localization of the tumor was the mandibular body ( n = 6) andbodywith ramus of the mandible ( n = 6). A total amount of 10 iliac crest free flaps and 12 fibular free flaps were performed. Complications were reported in 4 patients. A purulent oro-cutaneus fistula occurred in 3 patients. There was a flap failure in each reconstructive group. The virtual surgical planning with intraoperative cone-beam computed tomography was used in 3 patients. Dentition implantation was conducted in 4 patients (3 simultaneously, 1 postponed). The mean follow-up was 5 years and 8 months.Radical resection that covers radical segmental mandibulect-omy with immediate microvascular free flap reconstruction is a first-line and only effective treatment of mandibular ameloblas-tomas, that eliminates the risk of recurrence. The extent of surgical margins seems not to influence the recurrence rate, yet further investigation with statistical analysis should be performed. The choice of the adequate free flap must be adapted to dimensions and localization of the tumor and to each patient individually.New technologies such as virtual surgical planning with 3D models and intraoperative cone-beam computed tomography can make the reconstruction more accurate, improving patient's quality of life.


Assuntos
Ameloblastoma , Retalhos de Tecido Biológico , Neoplasias Mandibulares , Reconstrução Mandibular , Procedimentos de Cirurgia Plástica , Ameloblastoma/diagnóstico por imagem , Ameloblastoma/patologia , Ameloblastoma/cirurgia , Transplante Ósseo/métodos , Estética Dentária , Fíbula/cirurgia , Retalhos de Tecido Biológico/cirurgia , Humanos , Masculino , Mandíbula/cirurgia , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Reconstrução Mandibular/métodos , Qualidade de Vida , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Adulto Jovem
3.
Ann Surg ; 266(2): e19-e24, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28463895

RESUMO

OBJECTIVE: Evaluate the possibility of performing a complex vascular allotransplant of all neck organs including skin. SUMMARY BACKGROUND DATA: There are 2 previous attempts described in the literature, none of them being that complex. The first one is nonfunctional due to chronic rejection, the second one is viable yet considerably limited in complexity (no parathyroids, no skin). METHODS: The allotransplantation was performed simultaneously on 2 adjacent operating rooms, using microsurgical techniques. RESULTS: The patient's voice, breathing through mouth, swallowing, and endocrinal functions have been fully restored. CONCLUSIONS: Achieved results show clearly that such operations performed in selected patients can nearly fully restore functional and aesthetic effects in 1 single procedure.


Assuntos
Laringe/transplante , Glândulas Paratireoides/transplante , Faringe/cirurgia , Glândula Tireoide/transplante , Traqueia/transplante , Adulto , Carcinoma de Células Escamosas/cirurgia , Estética , Humanos , Neoplasias Laríngeas/cirurgia , Laringectomia/efeitos adversos , Masculino , Complicações Pós-Operatórias , Recuperação de Função Fisiológica , Transplante Homólogo
4.
J Clin Med ; 12(5)2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36902738

RESUMO

Non-squamous cell carcinoma-related malignant sinonasal tract tumors (non-SCC MSTT) are rare and diverse malignancies. In this study, we report our experience in the management of this group of patients. The treatment outcome has been presented, involving both primary treatment and salvage approaches. Data from 61 patients treated radically due to non-SCC MSTT between 2000 and 2016 at the National Cancer Research Institute, Gliwice branch, were analyzed. The group consisted of the following pathological subtypes of MSTT: adenoid cystic carcinoma (ACC), undifferentiated sinonasal carcinoma (USC), sarcoma, olfactory neuroblastoma (ONB), adenocarcinoma, small cell neuroendocrine carcinoma (SNC), mucoepidermic carcinoma (MEC), and acinic cell carcinoma, which were found in nineteen (31%), seventeen (28%), seven (11.5%), seven (11.5%), five (8%), three (5%), two (3%) and one (2%) of patients, respectively. There were 28 (46%) males and 33 (54%) females at the median age of 51 years. Maxilla was the primary tumor localization followed by the nasal cavity and ethmoid sinus in thirty-one (51%), twenty (32.5%), and seven (11.5%) patients, respectively. In 46 (74%) patients, an advanced tumor stage (T3 or T4) was diagnosed. Primary nodal involvement (N) was found in three (5%) cases, and all patients underwent radical treatment. The combined treatment consisted of surgery and radiotherapy (RT) and was given to 52 (85%) patients. The probabilities of overall survival (OS), locoregional control (LRC), metastases-free survival (MFS), and disease-free survival (DFS) were assessed in pathological subtypes and grouped together, along with the ratio and effectiveness of salvage. Locoregional treatment failure was seen in 21 (34%) patients. Salvage treatment was performed in fifteen (71%) patients and was effective in nine (60%) cases. There was a significant difference in OS between patients who underwent salvage and those who did not (median: 40 months vs. 7 months, p = 0.01). In the group of patients who underwent salvage, OS was significantly longer when the procedure was effective (median: 80.5 months) than if it failed (median: 20.5 months), p < 0.0001. OS in patients after effective salvage was the same as in patients who were primary cured (median: 80.5 months vs. 88 months, p = 0.8). Distant metastases developed in ten (16%) patients. Five and ten year LRC, MFS, DFS, and OS were 69%, 83%, 60%, 70%, and 58%, 83%, 47%, 49%, respectively. The best treatment results were observed for patients with adenocarcinoma and sarcoma, while USC gave the poorest results in our set of patients. In this study, we indicate that salvage is possible in most patients with non-SCC MSTT with locoregional failure and that it may significantly prolong their overall survival.

5.
Med Sci Monit ; 18(4): CS31-6, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22460099

RESUMO

BACKGROUND: Reconstruction of the pharynx and cervical esophagus has significantly progressed in the last 2 decades. A revolution in microvascular surgery has provided numerous choices for primary restoration, or in secondary reconstructions necessary for recurrences or complications of primary surgery. The goals of reconstruction after laryngopharyngoesophagectomy are to provide continuity of the alimentary tract, to protect major blood vessels, to heal the primary wound, and to restore the swallowing and breathing functions with minimal donor site and neck morbidity and deformation. CASE REPORT: We present 3 cases with complex defects of the laryngopharynx, cervical esophagus and trachea and anterior neck skin following central neck exenteration safely reconstructed with a single anterolateral thigh flap. No postoperative complications occurred in any of the 3 cases of reconstructions, each using a single anterolateral thigh flap. CONCLUSIONS: This approach significantly simplified the reconstruction, with quick recovery, short hospital stay and excellent functional and aesthetic results.


Assuntos
Retalhos de Tecido Biológico , Laringectomia/métodos , Laringe/cirurgia , Terapia de Salvação , Idoso , Humanos , Laringe/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Recidiva
6.
Contemp Oncol (Pozn) ; 16(6): 546-50, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23788942

RESUMO

AIM OF THE STUDY: The aim of the study was to develop standards for the prefabrication of free microvascular flaps in an animal model, followed by their application in clinical practice, and quantitative/qualitative microscopic assessment of the extent of development of a new microvascular network. MATERIAL AND METHODS: The study was carried out in 10 experimental pigs. As the first stage, a total of 20 prefabricated flaps were created using polytetrafluoroethylene (PTFE) as a support material, placed horizontally over an isolated and distally closed vascular pedicle based on superficial abdominal vessels. After completing the animal model study, one patient was selected for the grafting of the prefabricated free flap. RESULTS: All 20 free flaps prefabricated in the animal model were analyzed microscopically, exhibiting connective tissue rich in fibroblasts and small blood vessels in the porous areas across the entire thickness of the PTFE element. CONCLUSIONS: Flap prefabrication is a new and fast developing reconstruction technique. The usefulness of prefabrication techniques and their status in reconstructive surgery still needs to be investigated experimentally and clinically. The method based on prefabricated free flaps is the first step towards anatomical bioengineering that will make it possible to replace missing organs with their anatomically perfect equivalents.

10.
Strahlenther Onkol ; 186(9): 496-501, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20803185

RESUMO

PURPOSE: To evaluate the feasibility and preliminary results of intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy. PATIENTS AND METHODS: Between 2003 and 2006, 16 patients with early-stage cancer of mobile tongue (n = 10 [63%]) or floor of the mouth (n = 6 [37%]) treated at Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were evaluated for IORT boost with the INTRABEAM®System (Carl Zeiss Surgical GmbH; IORT-PRS) because of the high risk of local recurrence due to positive margins on frozen pathologic section. After tumor resection, the applicator was positioned in the tumor bed. The applicator's diameter (range: 1.5-5 cm) was selected to encompass high-risk area of tumor recurrence. The dose (5 Gy, 7 Gy, or 7.5 Gy) was applied according to tumor volume and bone proximity. External-beam radiotherapy (EBRT) was provided to the tumor bed in all patients (50 Gy) and to the nodal area, when needed. Toxicity and local tumor control were assessed. RESULTS: Median follow-up was 36 months. IORT did not increase acute mucosal reaction. Local tumor control was found in all cases. Early mucosal reaction did not exceed 3 according to the RTOG scale and healed in median time of 35 days after completion of EBRT. No late adverse effects were observed. CONCLUSION: This preliminary report has demonstrated the feasibility of IORT-PRS for patients with early oral cancer with the indications for postoperative radiotherapy. This method may be considered an alternative boost technique, although additional studies are needed to establish long-term results in a larger group of patients.


Assuntos
Neoplasias Bucais/radioterapia , Neoplasias Bucais/cirurgia , Neoplasias da Língua/radioterapia , Neoplasias da Língua/cirurgia , Idoso , Terapia Combinada , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Período Pós-Operatório , Fatores de Tempo , Neoplasias da Língua/patologia
11.
Neurol Neurochir Pol ; 44(2): 148-58, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20496285

RESUMO

BACKGROUND AND PURPOSE: The aim of the study was to present our results of the surgical treatment of subtemporal fossa tumours and surrounding regions using the extended subtemporal approach. MATERIAL AND METHODS: Twenty-five patients (10 women, 15 men) with subtemporal fossa tumours were included in the study. The neurological and performance status of the patients were assessed before and after surgery as well as at the conclu-sion of treatment. The approximate volume of the operated tumour, its relation to large blood vessels and cranial nerves, as well as consistency and vascularisation were assessed. RESULTS: The symptom duration ranged from 2 to 80 months (mean: 14 months). In 44% of patients, headache was the predominant symptom. Less frequent symptoms were: paralysis of the abducent nerve and disturbances of the trigeminal nerve. Approximate volume of the tumours ranged from 13 to 169 cm3 (mean: 66 cm3). The most frequent histological diagnosis was meningioma (16%), followed by angiofibroma, neurinoma and adenocystic carcinoma (12%). Total or subtotal resection was achieved in 80% of patients. CONCLUSIONS: The extended subtemporal approach allows for the removal of tumours of the subtemporal fossa and surrounding regions. This approach also allows one to remove tumours expanding in the regions surrounding the subtemporal fossa only. In such cases the subtemporal fossa constitutes the way of the surgical approach.


Assuntos
Procedimentos Neurocirúrgicos/estatística & dados numéricos , Neoplasias da Base do Crânio/cirurgia , Adolescente , Adulto , Idoso , Angiofibroma/patologia , Angiofibroma/cirurgia , Carcinoma/patologia , Carcinoma/cirurgia , Criança , Cordoma/patologia , Cordoma/cirurgia , Feminino , Fibroma/patologia , Fibroma/cirurgia , Seguimentos , Humanos , Masculino , Meningioma/cirurgia , Pessoa de Meia-Idade , Neurilemoma/patologia , Neurilemoma/cirurgia , Exame Neurológico , Polônia , Base do Crânio , Neoplasias da Base do Crânio/patologia , Resultado do Tratamento , Adulto Jovem
12.
Otolaryngol Pol ; 75(2): 28-33, 2020 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-33949315

RESUMO

<b>Introduction:</b> 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. <br><b>Material and method:</b> 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. <br><b>Results:</b> 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. <br><b>Conclusions:</b> 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.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço , Cirurgia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Projetos Piloto , Tomografia Computadorizada por Raios X
13.
Pol Przegl Chir ; 92(5): 1-7, 2020 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-33028725

RESUMO

<b>Introduction:</b> The nose is the central and probably the most important organ of the face. In view of the three-dimensional shape and variety of tissues, reconstructive surgery after tumor resection in this anatomical region requires the surgeon's knowledge of anatomy. <br><b>Materials and Method:</b> In the years 2010-2019, 48 patients were treated in the Oncological and Reconstructive Surgery Clinic for extended nasal tumors, which required the use of free microvascular flaps after resection for functional and aesthetic supply of anatomical structures of the nose. <br><b>Results:</b> In 48 patients, a total of 92 free microvascular flaps were used for nasal reconstruction including: radial forearm free flap in 24 patients, radial forearm free flap with radial bone in 14 patients, auricular free flap in 16 patients, radial forearm free flap in combination with auricle free flap in 7 patients, double auricular free flap in 6 patients, radial forearm free flap in combination with double auricular free flap in 4 patients. Total necrosis of the free flap was noted in 4 cases, partial in 6 patients. <br><b>Conclusions:</b> The presented surgical techniques using microvascular free flaps constitute a recognized method of treatment and should be used in everyday surgeon practice. The results demonstrated in this article allow to obtain optimal functional and aesthetic effects.


Assuntos
Neoplasias Nasais/cirurgia , Nariz/cirurgia , Rinoplastia/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Expansão de Tecido/métodos , Adulto , Feminino , Antebraço , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nariz/patologia , Neoplasias Nasais/patologia , Procedimentos de Cirurgia Plástica/métodos
14.
Otolaryngol Pol ; 62(3): 316-20, 2008.
Artigo em Polonês | MEDLINE | ID: mdl-18652157

RESUMO

BACKGROUND: Extended supraomohyoid neck nodes dissection (ESOHND) involves surgical resection of nodal levels from I to IV. The incidence of occult metastases in level V is rare and mainly depends of the location and size of the primary tumour in oral cavity and oropharynx squamous cell cancer. AIM: The aim of this study was to present the results of treatment with extended supraomohyoid neck dissection. METHODS: The records of 72 patients with cancer of the oral cavity undergoing extended supraomohyoid neck dissection (ESOHND) during the period 15.12.2003 - 13.06.2005 were reviewed. RESULTS: Tumor and nodal stage were: T2-9(13%), T3-39(54%), T4-24(33%), N0-14(19%), N1-31(43%), N2-25(35%), N3-2(3%). 64 patients were treated with surgery and postoperative adjuvant radiotherapy. The follow-up period ranged from 11 to 27 months. The surgical failure rate was 8% (occurred in 6 of 72 patients). CONCLUSIONS: Preliminary analysis suggests extended supraomohyoid neck nodes dissection to be considered as a therapeutic and diagnostic procedure in patients with squamous cell cancer of oral cavity and oropharynx.


Assuntos
Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/cirurgia , Neoplasias Bucais/cirurgia , Esvaziamento Cervical/métodos , Neoplasias Orofaríngeas/cirurgia , Adulto , Carcinoma de Células Escamosas/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Polônia , Estudos Retrospectivos , Resultado do Tratamento
15.
Otolaryngol Pol ; 61(2): 142-6, 2007.
Artigo em Polonês | MEDLINE | ID: mdl-17668799

RESUMO

82 patients with adenolymphoma of parotid gland treated with surgery in Department of Oncological Surgery Cancer Center, Gliwice in the period of 1986-2004 were retrospectively analyzed. They were about 22% of all patients with parotid gland tumors operated in that period. In almost 70% of cases partial parotidectomy with facial nerve preservation was performed as a treatment of choice. In that group DFS was over 95%. Local recurrence occurred in less then 5%, only in cases with multiple tumor in histopathological examinations. Quality of life parameters were also analyzed. In the analysis complications rate increased with the extension of surgical treatment. It revealed in the postoperative cosmetic defect evaluation. Partial resection of the parotid gland could be useful method of surgical treatment of adenolymphoma selected cases. It allows to achieve the same results as classic parotidectomy with lower risk of significant complications. In analyzed group the local recurrence was always combined with multi lesional growth of the tumor.


Assuntos
Adenolinfoma/cirurgia , Neoplasias Parotídeas/cirurgia , Adenolinfoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Nervo Facial/fisiopatologia , Paralisia Facial/etiologia , Paralisia Facial/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Neoplasias Parotídeas/patologia , Complicações Pós-Operatórias/mortalidade , Qualidade de Vida , Estudos Retrospectivos , Procedimentos Cirúrgicos Operatórios/métodos , Taxa de Sobrevida , Resultado do Tratamento
16.
Ann Transplant ; 22: 53-57, 2017 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-28138125

RESUMO

BACKGROUND The human face is a one-of-a-kind structure with unique morphology, complexity, and function, in which different subunits are not even similar to other parts of the body. Therefore, extended complex deficits of the face are usually difficult to reconstruct, and autologous tissue restoration is generally not able to give a satisfactory aesthetic and functional outcome. The main goal of face allotransplantation is to restore symmetry, contour, and appearance as well as function of the face, especially control of orbicularis oculi and oris muscle physiology. We present the case of a total face transplant in an advanced neurofibromatosis type 1 patient - the second face transplant in Poland. CASE REPORT The recipient was a 28-year-old female with neurofibromatosis type I limited to the head region. During 24 years she underwent more than 35 surgical procedures, but for the last 3 years a significant decrease of her functionality and appearance was observed, including serious problems with speech, eating, and vision. In December 2013 she was qualified for a face transplant procedure. When the donor was found, she was matched on several clinical and biochemical characteristics including negative T and B cell cross-matching. Similarly, the transplantation procedure was done using two connected operating rooms; in the first, the donor's face was harvested, and in the second, the recipient's face was prepared - the tumor mass was resected and vascular and nervous structures were prepared. Due to the extension and complexity of the potential defect, more than 75% of head soft tissues were harvested including both auriculae, left and right eyelids, and scalp down to the occipital lower line. CONCLUSIONS Our case showed that neurofibromatosis is a real indication for a face transplantation procedure. Also, the results of rehabilitation, quality of life, motor and sensory recovery, and physiological status were comparable, showing that face transplantation based on careful selection of recipients and procedure planning is a real alternative, allowing achievement of excellent results that are far away from the outcomes of conventional reconstructions.


Assuntos
Transplante de Face , Neurofibromatose 1/cirurgia , Qualidade de Vida , Adulto , Feminino , Humanos , Imunossupressores/uso terapêutico , Resultado do Tratamento
17.
Adv Med Sci ; 61(2): 293-299, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27136187

RESUMO

PURPOSE: The analysis of gene expression, especially those involved in cell cycle control, can help to discover mechanisms determining the outcome of radiation treatment. The main purpose of this study was to examine the expression level of genes responsible for cell cycle regulation in samples of the head and neck cancer, obtained during surgery. METHODS: Postsurgical samples of SCC of head and neck region were collected. Over 80 genes were analysed using cell cycle quantitative real-time RT-PCR Array method. Presence of 14 high-risk HPV types DNA in frozen or paraffin-embedded tumour pathological samples was also assessed. To correlate gene expression with selected pathological features and clinical outcome we used different hierarchical clustering method. RESULTS: Hierarchical clustering demonstrated the association between gene expression within certain clusters and gender, tumour site, T stage, N stage, grade, pathological subtype or tumour recurrence. CONCLUSIONS: Despite some limitations we were able to identify gene clusters that allowed to classify patients according to selected clinical features and occurrence of tumour recurrence. The results of the analysis also confirm that the incidence of HPV infection among the patients from Upper Silesia is relatively low, whereas HPV negative tumours, likely associated with smoking, appeared dominant.


Assuntos
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Proteínas de Ciclo Celular/genética , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/patologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/virologia , Proteínas de Ciclo Celular/metabolismo , Feminino , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/virologia , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Papillomaviridae/fisiologia
18.
Pol Przegl Chir ; 87(8): 384-8, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26495913

RESUMO

UNLABELLED: 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.


Assuntos
Qualidade de Vida , Retalhos Cirúrgicos/irrigação sanguínea , Coxa da Perna/cirurgia , Coleta de Tecidos e Órgãos/métodos , Neoplasias da Língua/psicologia , Neoplasias da Língua/cirurgia , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Glossectomia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Coleta de Tecidos e Órgãos/psicologia , Língua/cirurgia , Neoplasias da Língua/reabilitação
19.
J Craniomaxillofac Surg ; 30(1): 59-61, 2002 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12064885

RESUMO

INTRODUCTION: Adenoid cystic carcinoma is an uncommon malignant epithelial tumour of salivary glands. The treatment of choice for these tumours is considered by some to be radical surgery, combined in many centres with postoperative radiotherapy. The goal of such treatment is local control and preservation of function. AIMS: The aim of the retrospective study was to analyse the results of surgery for patients with adenoid cystic carcinoma treated at the Institute of Oncology in Gliwice during the period of 1970-1989. MATERIAL: The analysed group includes 47 patients with adenoid cystic carcinoma. All patients underwent macro- and microscopically proven radical resection of the primary lesion located in major or minor salivary glands. RESULTS: Five- and 10-year survival rate was 85% and 47%, respectively, and 5-year disease-free survival rate was 79%. As the group of patients treated with surgery and radiotherapy was too small (nine cases), the results of combined treatment were not analysed. Local recurrence after surgery occurred in 21% of patients in different time intervals (even as long as 10 years after completion of treatment). CONCLUSION: High risk of local recurrence after surgery suggests that postoperative radiotherapy should always be given. Late development of local recurrences suggests that follow-up should be for a minimum of 10 years.


Assuntos
Carcinoma Adenoide Cístico/cirurgia , Neoplasias das Glândulas Salivares/cirurgia , Adolescente , Adulto , Idoso , Carcinoma Adenoide Cístico/radioterapia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/radioterapia , Falha de Tratamento
20.
Otolaryngol Pol ; 58(5): 927-31, 2004.
Artigo em Polonês | MEDLINE | ID: mdl-15732778

RESUMO

In 1974 Karapandzic described reconstruction technique of the lower lip resection defects by using neuro-vascular flap of the upper lip. In this paper authors present six cases of this reconstruction, were defect after resection was in the range of 50-80% of lower lip. In all cases the result was excellent, comparing to other plastic techniques. Based on the authors scale, functional and aesthetic result was scored. Authors suggest that this reconstruction can be an alternative to other methods using rotation flaps in particular cases of lower lip cancer.


Assuntos
Neoplasias Labiais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Complicações Pós-Operatórias , Idoso , Humanos , Neoplasias Labiais/patologia , Masculino , Mandíbula , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Reoperação , Retalhos Cirúrgicos , Fatores de Tempo , Resultado do Tratamento
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