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Cervical branchial cleft cysts are relatively common tumors of the neck that should be distinguished from an epidermoid cyst, hygroma, hemangioma, lymphangioma, lymphadenitis, and metastatic papillary carcinoma of the thyroid gland. Infected cysts might be misdiagnosed as a recurrent abscess. The aim of the study was to present current views concerning diagnosis and treatment of cervical branchial cleft cysts. Material and methods. Data and histopathological results obtained from 49 patients (18 women and 31 men) admitted to the Department of Cranio-Maxillofacial Surgery, due to lateral cervical cysts during the period between 2005 and 2009 were subject to retrospective analysis. Results. Most patients were in their third decade of life. The clinical examination showed a painless, slowly growing tumor on the lateral surface of the neck, more often on the right side, and in 30 cases with a concomitant infection. Initial diagnosis on the basis of the clinical examination, radiology and biopsy was confirmed in 48/49 cases (98%). All patients were subject to surgical treatment. During the 3 to 7 year follow-up period recurrence was not observed. Conclusions. Initial diagnosis of a cervical branchial cleft cyst on the basis of the clinical examination should always be confirmed by means of ultrasonography. In case of suspicion of a coexisting infection, fine-needle aspiration biopsy under ultrasound control is recommended. If there is concern that the lateral neck lesion is not a branchial cyst or its dimension is large, computed tomography of the neck or magnetic resonance should be performed. Complete excision of the tumor under general anesthesia is the treatment of choice, being associated with the low risk of local postoperative complications
EN
Tracheal secretion leakage might lead to ventilator-associated pneumonia. Standard tracheal tube cuffs are cylindrical in shape. Bronchial tree aspiration is observed in the presence of leakage past tracheal tube cuffs. The new TaperGuard tracheal tube has a cuff in the shape of a cone, preventing from the development of microtubules and microaspiration. The aim of the study was to compare standard tracheal tube cuffs with TaperGuard tubes, in terms of protection from microaspiration under general anesthesia. Material and methods. The observational study evaluated incidents of leakage during general anesthesia with intubation and mechanical ventilation in patients with significant obesity. The study group comprised 20 patients with the BMI >40 kg/m2 subjected to elective surgery under general anesthesia with intubation and mechanical ventilation, randomly divided into two subgroups: standard tracheal tube and TaperGuard tube. Results. In 4 of 10 patients with standard tracheal tubes we observed leakage around the cuff. In case of TaperGuard tubes no such leakage was observed. Conclusion. TaperGuard tubes protect against microaspirations, while standard tracheal tubes have no such properties.
EN
Noninvasive ventilation (NIV) is a technique of mechanical ventilation which does not require invasive airway management, i.e. intubation or tracheostomy. In emergency medicine Continuous Positive Airway Pressure (CPAP) is used often. A new method of NIV is Impedance Threshold Device (ITD). Breathing through an ITD is utilized to raise blood pressure in hypotensive patients. Aim of the study was to compare haemodynamic effects of NIV ITD and NIV CPAP. Material and methods. This study involved a group of 25 healthy volunteers. NIV was performed using ResQGARD ITD and CPAP Boussignac. Ventilation time was 25 minutes for each mask in each participant. Every three minutes parameters were collected: SpO2, BP and HR. There was a one hour interval in between ventilation with each mask. CPAP pressure was set at a level of 8 cm H2O and the mean inspiratory resistance of the ITD was 7cm H2O. Collected parameters were subjected to ANOVA statistical analysis. Results. Absolute comparison of BP, HR and SpO2 values did not reveal statistically significant differences between the masks. However considering blood pressure levels at entry, ventilation through an ITD significantly raised BP. Ventilation with NIV CPAP did not change significantly BP. Conclusion. Ventilation through an ITD device significantly improve haemodynamic function, whereas CPAP ventilation had no significant effect on it.
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