The role of the epiglottis in the swallow process after a partial or total glossectomy due to a neoplasm.

Repeatable epiglottic movement patterns were recorded during a videofluoroscopic swallow evaluation of 95 patients who had undergone a total or partial glossectomy due to a neoplasm. Because no epiglottic function assessment was performed preoperatively, for the purpose of this study it was assumed that epiglottic mobility was "normal" during this time and that all abnormalities found afterward resulted from the growth of the neoplasm and the glossectomy. It was noted that in the early postoperative period, absence of epiglottic movement was accompanied by aspiration and made swallowing incompetent in a majority of cases (9 of 10). A correlation of movement between the epiglottis and the extent of oral tissue excision was found. Epiglottic mobility was evaluated as "normal" in 72% of the patients, i.e., in 67 of 91 (74%) patients after a partial or nearly total glossectomy and in 1 of 4 people who underwent a total glossectomy. In the subgroup (16%) of patients who underwent a total or nearly total glossectomy and then had videofluoroscopic examinations, 60% of the cases had normal epiglottic movements and 40% had an immobile epiglottis. Compensatory mechanisms implemented by the patients on their own initiative, such as additional swallows and prolonged apnea during deglutition, enabled them to avoid aspiration. However, upward head movement and downward chin tilting during deglutition as compensatory mechanisms used by patients with no epiglottic movement did not reduce the aspiration risk in the early postoperative period and were found to accompany incompetent swallowing attempts.

Pleomorphic adenoma of salivary glands does not appear to be a BRCA-1-dependent tumour in a Polish cohort.

BACKGROUND: The aim of the study was to examine whether pleomorphic adenoma of salivary glands can occur on the basis of constitutional BRCA-1 mutations. MATERIALS AND METHODS: Two hundred and sixty-eight patients affected by mixed tumour of salivary glands were examined for occurrence of three BRCA-1 mutations dominating in Poland. RESULTS: BRCA-1 mutation was detected in only one of the patients, a female affected by breast cancer and pleomorphic adenoma of parotid gland. Parotid gland tumour showed clinical and histopathological features of typical pleomorphic adenoma with no morphological features of high-grade malignancy, which are characteristic of BRCA-1-dependent tumours. CONCLUSION: Considering the low frequency of BRCA-1 mutation in the examined group and also the absence of features characterizing BRCA-1-dependent tumours in the only BRCA-1-positive case, pleomorphic adenoma of salivary glands should not be recognized as a BRCA-1 dependent tumour.

Correction: Serum selenium levels and the risk of progression of laryngeal cancer.

[This corrects the article DOI: 10.1371/journal.pone.0184873.].

Serum selenium levels and the risk of progression of laryngeal cancer.

BACKGROUND: Observational studies have reported an inverse relationship between selenium status (blood or toenail) and the risk of laryngeal cancer; however, the impact of low serum selenium level on survival has not been evaluated. METHODS: We conducted a prospective study of 296 patients diagnosed with laryngeal cancer in Szczecin, Poland. Serum selenium was measured at diagnosis and prior to treatment. Patients were followed from the date of diagnosis to death at five years. Vital status was obtained by linkage to the Polish National Death Registry. RESULTS: The five-year survival after diagnosis was 82.0% (95% CI: 68% to 91%) for individuals in the highest quartile of serum selenium (> 66.8 µg/L) and was 28.6% (95% CI 19% to 42%) for individuals in the lowest quartile (<50.0 µg/L). In an age- and sex-adjusted analysis, the hazard ratio (HR) for death from all causes was 7.01 (95% CI 3.81 to 12.9) for patients in the lowest quartile of serum selenium, compared to those in the highest quartile. The corresponding multivariate HR was 3.07 (95% CI 1.59 to 5.94). CONCLUSIONS: This study suggests that a selenium level in excess of 70 µg/L is associated with improved outcome among patients undergoing treatment for laryngeal cancer. Further studies are needed to evaluate if selenium supplementation to achieve this level might improve overall prognosis.

[Using pedicled mandibular osteomuscular flap in orbital reconstruction]. / Rekonstrukcja dna oczodolu wyrostkiem dziobiastym zuchwy uszypulowanym na miesniu skroniowym.

Represented the way of orbital floor reconstruction using coronoid process of the mandible pedicled on temporal muscle. The clinical evaluation of vascularised bone graft from coronoid process confirmed their usefulness in the face recon struction surgery.

[Use of plate osteosynthesis as an effective method in surgical treatment of congenital cranial anomalies]. / Wykorzystanie osteosyntezy plytkowej jako skutecznej metody w chirurgicznym leczeniu wad wrodzonych twarzoczaszki.

Operative treatment of developmental anomalies were presented in actual work carried out in Maxillo-Facial Clinic PMA in Szczecin. Mesiocclusion was the most frequent anomaly, followed by microgenia, joint ankylosis of tempora mandibular, next laterogenia and first and second branchial arch syndrome. The operative treatment was finished by placing and fixing the bones in new changed position. The obtained results indicated that this type of management is the best effective in correction of visceral cranium development anomalies, it assure quick maintenance of good oral hygiene as well as stabilisation and functioning jaws.

[Nose reconstruction in material of Maxillofacial Surgery Department at the Pomeranian Academy of Medicine in Szczecin in 1975-2004]. / Rekonstrukcja nosa w materiale Kliniki Chirurgii Szczekowo-Twarzowej PAM w latach 1975-2004.

INTRODUCTION: The focus of this paper is the evaluation of usability of various nose skin reconstruction methods applied after removal of a skin cancer in the Teaching Hospital of Maxillofacial Surgery at the Pomeranian Academy of Medicine in Szczecin in 1975-2004. MATERIAL AND METHODS: The research material consisted of 285 patients who underwent a surgical treatment of nose skin cancers located in various skin areas. In 67 cases, the tumour was situated on a nostril flare, in 42--on the nose tip, in 98--on the bridge and in 68--on one of its sides, most frequently, near the corner of the eye. Said tumours often covered more than one of the above-mentioned areas or even all of them. Reconstruction planning and performance was an integral part of the surgical treatment. The tumour amputation was preceded by an assessment of the quantity and quality of tissues necessary for filling in the lesions. Lesions located on the nose surface were covered by free skin grafts. In the case of nostril flare tumours, they were filled in with grafts composed of skin and cartilaginous tissue from the ear. Lesions including all nose layers were most frequently (in 136 cases) covered with various types of axially vascularised frontal skin flaps i.e. by the middle or temporal part of the frontal flap. In the case of elderly people the nasolabial flaps were used. RESULTS: In most cases, both the aesthetic and functional effects were very good. What appeared to be the most difficult reconstruction case was the restoration of the nasal bone structures after their complete amputation. CONCLUSION: Due to the thickness, colour and easiness of preparation of the middle frontal flap, it is considered to be the best material for reconstruction of the nose.

[Treatment of cranial fractures, evaluation of osteosynthesis plates, complications and results]. / Leczenie zlaman kosci twarzoczaszki, ocena osteosyntezy plytkowej, wyniki, powiklania.

In recent years, the osteosynthesis plate has became very popular due to its quality during treatment of visceral cranium bone fractures. It is recommended to be used for stabile fusion of multi segment fractures. In the Maxillo-Facial Surgery Clinic of PMA Szczecin the presented method is applied from the mid-80-ies of the last century. Experience and obtained results permit as to state that osteosynthesis plate of visceral cranium posttraumatic fractures provides most efficient method in their treatment. It allows to establish one-time anatomical functional bone fusion, soon return to correct stomatognathic system, shortens hospitalizations time, thus securing speedy return to normal life. Analyzing the complications it was found out that in the majority of cases the decisive significance referred to: the condition of patients, time of reporting after trauma, biomechanical fusion features as wall as skill of the operator. Not always the complications were the results of the applied method.

[Breathing disorders after resection of structures in the oral cavity, throat and neck studied by pulse oximetry examinations]. / Zaburzenia oddychania po rozlegllych zabiegach operacyjnych w jamie ustnej, gardle i szyi na podstawie wyników badán pulsoksymetrycznych.

INTRODUCTION: Surgical treatment of oral cavity neoplasms consists of the resection of tumor surrounded by a healthy tissue margin. This study is aimed at an objective, qualitative and quantitative evaluation of breathing disturbances and dyspnoea after the resection of oral cavity structures, throat structures and muscles of the neck. For the purpose of evaluating the above-mentioned disturbances an attempt was made to carry out pulse oximetry examination. MATERIAL AND METHODS: We have examined 50 persons after the resection of oral cavity structures, throat structures and muscles of the neck in Maxillofacial Clinic of Pomeranian Medical Academy in Szczecin. The examinations were performed by pulse oximetry set during sleep before and after operations. The patients were divided into three groups according to the type of removed structures which included: lateral part of the mandible; mental part of the mandible; part of the tongue. RESULTS: The results of examinations obtained gave rise results as: pulse oximetry examination revealed an increased incidence of blood desaturation episodes and a decrease in minimum saturation level. CONCLUSIONS: Surgical treatment of oral cavity neoplasms leads to breathing disturbances. Apnoea episodes cause a drop in the arterial blood saturation with oxygen.

A low selenium level is associated with lung and laryngeal cancers.

PURPOSE: It has been suggested that selenium deficiency is a risk factor for several cancer types. We conducted a case-control study in Szczecin, a region of northwestern Poland, on 95 cases of lung cancer, 113 cases of laryngeal cancer and corresponding healthy controls. METHODS: We measured the serum level of selenium and established genotypes for four variants in four selenoprotein genes (GPX1, GPX4, TXNRD2 and SEP15). Selenium levels in the cases were measured after diagnosis but before treatment. We calculated the odds of being diagnosed with lung or laryngeal cancer, conditional on selenium level and genotype. RESULTS: Among lung cancer cases, the mean selenium level was 63.2 µg/l, compared to a mean level of 74.6 µg/l for their matched controls (p<0.0001). Among laryngeal cancer cases, the mean selenium level was 64.8 µg/l, compared to a mean level of 77.1 µg/l for their matched controls (p<0.0001). Compared to a serum selenium value below 60 µg/l, a selenium level above 80 µg/l was associated with an odds ratio of 0.10 (95% CI 0.03 to 0.34; p = 0.0002) for lung cancer and 0.23 (95% CI 0. 09 to 0.56; p = 0.001) for laryngeal cancer. In analysis of four selenoprotein genes we found a modest evidence of association of genetic variant in GPX1 with the risk of lung and laryngeal cancers. CONCLUSION: A selenium level below 60 µg/l is associated with a high risk of both lung and laryngeal cancer.