Design, clinical applications and post-surgical assessment of bioresorbable 3D-printed craniofacial composite implants.

This study details the design, fabrication, clinical trials' evaluation, and analysis after the clinical application of 3D-printed bone reconstruction implants made of nHAp@PLDLLA [nanohydroxyapatite@poly(L-lactide-co-D,L-lactide)] biomaterial. The 3D-printed formulations have been tested as bone reconstruction Cranioimplants in 3 different medical cases, including frontal lobe, mandibular bone, and cleft palate reconstructions. Replacing one of the implants after 6 months provided a unique opportunity to evaluate the post-surgical implant obtained from a human patient. This allowed us to quantify physicochemical changes and develop a spatial map of osseointegration and material degradation kinetics as a function of specific locations. To the best of our knowledge, hydrolytic degradation and variability in the physicochemical and mechanical properties of the biomimetic, 3D-printed implants have not been quantified in the literature after permanent placement in the human body. Such analysis has revealed the constantly changing properties of the implant, which should be considered to optimize the design of patient-specific bone substitutes. Moreover, it has been proven that the obtained composition can produce biomimetic, bioresorbable and bone-forming alloplastic substitutes tailored to each patient, allowing for shorter surgery times and faster patient recovery than currently available methods.

Analysis of the Validity of Perioperative Antibiotic Prophylaxis in Maxillofacial Surgery.

Perioperative antibiotic prophylaxis is the standard in surgical departments. The type of operation, the duration of the procedure, the degree of microbiological purity of the operating field and the current clinical condition of the patient determine its administration. The aim of this study was to validate the antibiotic prophylaxis used in a Maxillofacial Surgery Department for a group of trauma and non-trauma patients. To that end, an observational prospective cohort study was carried out. The study was conducted on a group of 83 patients of the Department of Cranio-Maxillo-Facial Surgery who were divided into a group of trauma patients (n = 43) and one of non-trauma patients (n = 40). In both groups, the classic microbiological tests were carried out, and the results were analyzed in relation to: the study group, age, sex, duration of surgery, type of surgical access. Most bacterial strains were isolated at the initial stage of the operation. Gram (+) cocci were isolated more often in the trauma group and Gram (-) rods in the non-trauma group. Significantly more often, strains of fungi were noted in the initial stage of the procedure in the trauma group. We conclude that the use of perioperative antibiotic prophylaxis in the Maxillofacial Surgery Departments is justified.

Analysis of laryngeal brush biopsy-based cytology results in patients of the 4th Military Teaching Hospital and Polyclinic in Wroclaw in years 2019-2020.

<b>Introduction:</b> Cytological examination of exfoliated epithelial cells of the uterine cervix, oral cavity, or rectum has been successfully used in the diagnostics of pathological conditions of these organs for many years. In these cases, the test material is collected from the available regions. </br></br> <b>Aim:</b> The aim of the study consisted in the analysis of cytological smears of laryngeal epithelial cells from patients hospitalized at the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital and Polyclinic in Wroclaw in years 2019-2020. The analysis was aimed at demonstrating whether representative laryngeal epithelial material could be obtained from brush biopsies. </br></br> <b>Material and methods:</b> The study was carried out in 92 subjects aged between 26 and 85 years, including 34 women (37.0%), from whom material for cytological examination had been collected from the larynx in the course of microsurgical procedures carried out using the Kleinsasser laryngeal instrument set in 2019-2020. </br></br> <b>Results: </b>Analysis was performed on 90 out of 92 cell smears (97.8%). Two smears were not qualified for analysis due to ille-gibility. The smears were assessed using a proprietary scale consisting in a modification of the Bethesda system. Abnormal results of cytological examinations were obtained in a majority of cases. HSILs with invasive features were the most common abnormal results of cytological examinations. </br></br> <b>Conclusions:</b> Laryngeal epithelial cells can be successfully evaluated by means of cytological examination. Abnormal presen-tation of cytological smear is frequently hypercellular, with inflammatory cells being observed less frequently. No statistically significant relationship was observed between the results of the cytological examination and the overall quality of the smear, number of cells, number of erythrocytes, or the severity of inflammation.

[The parotid glands neoplasms in material of the otolaryngology clinical ward of 4(th) Military Clinical Hospital with the Polyclinic in Wroclaw in the years 1992-2010]. / Nowotwory slinianek przyusznych w materiale Klinicznego Oddzialu Otolaryngologicznego 4. Wojskowego Szpitala Klinicznego z Poliklinika we Wroclawiu w latach 1992-2010.

AIM: The aim of the study is the analyses of parotid glands neoplasms on 105 patients who underwent surgery at the Otolaryngology Clinical Ward of 4(th) Military Clinical Hospital with the Policlinic in Wroclaw in the years 1992-2010. MATERIAL AND METHODS: In the group of patients with parotid glands tumor there were 52 women and 53 men. The following data: age, sex, time between appearing first symptoms and operation, the kind of the executed operation and the result of histopathological examination were taken into account in this study. RESULTS AND CONCLUSIONS: The most common of tumors are benign neoplasms (88%), the malignant ones are in 12% of patients. The most frequent tumor is pleomorphic adenoma (53%), the second one is lympho-adenoma (26%). In parotid gland tumors are often located on the left side (60%). Authors noticed significant development of the quantity operated parotid salivary gland tumors in the last three years.

[Salivary tumors in the material of the Otolaryngology Clinical Ward of 4th Military Clinical Hospital with the Polyclinic in Wroclaw in the years 1992- 2008]. / Guzy slinianek w materiale Klinicznego Oddzialu Otolaryngologicznego 4 Wojskowego Szpitala Klinicznego z Poliklinika we Wroclawiu w latach 1992-2008.

AIM: The aim of the study is the analyses of salivary gland tumors on 193 patients who underwent surgery at the Otolaryngology Clinical Ward of 4th Military Clinical Hospital with the Polyclinic in Wroclaw in the years 1992-2008. MATERIAL AND METHODS: In the group of patients with salivary gland tumors, which were analysed, there were 106 woman (54.9%) and 87 men (45.1%). The following data: age, sex, time between appearing first symptoms and operation, objective and subjective symptom, the kind of the executed operation and the result of histopathological examination were taken into account in this study. RESULTS AND CONCLUSIONS: Tumors located in 48.7% in parotid gland, 49.7% in submandibular salivary gland and 1.6% in hypoglossal salivary gland. Tumor--like lesions constituted 56%, adenoma 38.9% and malignat tumors 4.7% of all glands tumors. Tumors salivary glands both benign and malignat occur at women about the average age of 50.9 more often. Pleomorphic adenoma was the most common neoplasm. Tumors located in parotid salivary glands are often on the left side.

[A rare case of multiple primary benign neoplasm of parotid gland: oncocytoma and adenolimphoma]. / Rzadki przypadek pierwotnego mnogiego niezlosliwego nowotworu slinianki przyusznej: gruczolaka kwasochlonnego i gruczolaka limfatycznego.

AIM OF THE WORK: The authors present unusually rare case primary multiple synchronicus benign tumor of the ipsilateral parotid gland: oncocytoma and Warthin's tumor, which is rare among occasionally occurred multiple tumors with different histology in the salivary glands. MATERIAL AND METHOD: A 71-year-old man presented with the tumor in the right parotid gland. We performed excision of the superficial lobe of the parotid gland. The preoperative ultrasonography and macroscopic analysis of the removed parotid gland tissue revealed only one tumor recognised histopathologically as adenolimphoma, but upon histopathological examination Warthin's tumor proved to coexist with oncocytoma. RESULTS AND CONCLUSIONS: In the ultrasonography examination some salivary glands tumors may not be recognised. The histopathological examination is the ultimate method in recognising tumors, which are not detected in the preoperative diagnosis. The superficial parotidectomy protects from the recrudescence of the superficial lobe of the parotid gland tumors. The coexistence of the oncocytoma and Warthin's in one parotid gland is extremely rare. Only a few cases were described in the English literature and in the available Polish literature there is none of such reports.

[Endoscopic surgical treatment of isolated inverted papilloma of the sphenoid sinus complicated by cerebrospinal fluid (CSF) rhinorrhea--case report]. / Endoskopowa operacja izolowanego brodawczaka odwróconego zatoki klinowej powiklana plynotokiem nosowym--opis przypadku.

This report presents a case of isolated inverted papilloma of the sphenoid sinus in 48-year old patients diagnosed and treated in ENT Departament of Military Hospital in Wroclaw. Post operative course complicated by cerebrospinal fluid (CSF) rhinorrhea. We used Surgicel, lyophylized dura and TachoComb with Tissucol to close dural fistula. Using of this in reconstructive surgery to treat post operative CSF leak was effective. In last CT three years after operation, we observe the bone decline in sphenoid sinus and recurrence of the leasion in sphenoid sinus.

[Maxillary artery embolisation as a method of treatment of hemorrhages in Rendu-Osler-Weber Syndrome--our experience]. / Obserwacje wlasne leczenia krwawien w chorobie Rendu-Oslera-Webera za pomoca selektywnej embolizacji tetnicy szczekowej.

The authors have described case of patient suffering from Rendu-Osler-Weber Syndrome for many years, after many unsuccessful attempts to treat massive hemorrhages from the nose. This was what made them use maxillary artery embolisation method. It was done using Seldinger technique. Radiologic visualisation of blood vessels was obtained by use of C-arm. The use of this method in that case has been successful so far. According to authors opinion embolisation of maxillary arteries is an effective alternative in treating recurring hemorrhages in patients with Rendu-Osler-Weber Syndrome.

[A case of para-cerebral abscess as a complication of middle ear purulent inflammation]. / Przypadek ropnia przymózgowego jako powiklanie ropnego zapalenia ucha srodkowego.

We reported the case of para-cerebral abscess in the left temporal region, being a complication of exacerbation of chronic middle ear inflammation with cholesteatoma. Computed tomography was performed, which helped in the diagnosis. The patient was treated conservatively by aimed antibiotic therapy. We performed surgery of the middle ear, with abscess removal through trepan apertura attaining good results. We have presented principles of diagnostic and therapeutic procedures which help in prevention of intracranial complications in ear diseases.