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Pathological Fractures of the Mandible in the Department of Cranio-Maxillofacial Surgery Medical University in Łódź

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Tyndorf M., Manowska B., Arkuszewski P., Gaszyńska E.
Polish Journal of Surgery
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2010
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vol. 82
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issue 11
615-620
EN
Pathological fractures of the mandible are rare, comprising 1-2% of this injuries.The aim of the study was to analyse demographic data, etiology, site and treatment procedures of pathological mandible fractures.Material and methods. The retrospective study comprised 17 patients (10 males and 7 females) with pathological mandible fracture. Upon the basis of the medical documentation, demographic data, such as age and sex, were recorded, and so were clinical data: mechanism of the fracture, its cause (pathology, causing lowering the mechanical resistibility of the mandible), location and manner of the treatment.Results. Most common cause of the fracture was presence of odontogenic cyst and mandibular atrophy. Most common mechanism of injury were chewing and falls. Regardless of the causes, the majority of the fractures occurred in the body of mandible.Conclusion. Treatment of the mandibular pathological fractures differs according to etiology.
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Methicillin Resistant Staphylococcus Aureus Infections of Soft Issues of the Oral Cavity, Face and Neck in Patients Hospitalized at the Cranio-maxillofacial Surgery Department

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Gaszyńska E., Tyndorf M., Manowska B., Arkuszewski P.
Polish Journal of Surgery
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2011
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vol. 83
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issue 4
212-215
EN
The aim of the study was to identify a group of patients at high risk of methicillin resistant Staphylococcus aureus (MRSA) infection following surgical procedures involving oral cavity, head and neck.Material and methods. A retrospective analysis of demographic, clinical and laboratory data was performed. A manual search of laboratory records for a five years period (2005-2009) was performed for specimens submitted to the diagnostic microbiology laboratory from patients admitted to the Cranio-Maxillofacial and Oncologic Surgery Department.Results. Methicillin resistant Staphylococcus aureus was identified in 26 cases. Most commonly it was isolated from tongue swabs in patients following extensive oncological surgical procedures involving oral cavity. Most common risk factors were: age above 65 years, neoplasms, multisite trauma with loss of consciousness, cigarette smoking, alcohol abuse, tobacco addiction, antibiotic therapy immediately before hospitalization. More than half of patients with MRSA infection required surgical treatment except for pharmacological treatment.Conclusions. Monitoring of postoperative wounds is of great importance with regard to he risk of MRSA infection.
3
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Blindness After Midface Injuries - Data From the Department of Cranio-Maxillofacial and Oncological Surgery, Medical University in Łódź

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Gaszyńska E., Krawczyk M., Tyndorf M., Arkuszewski P.
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EN
One of the most serious consequences of eye globe injury is loss of vision. Direct trauma to the eyeball is extremely rare, in comparison to the incidence of orbital fractures.The aim of the study was to determine the frequency and characteristics of post-traumatic amaurosis in patients subject to midfacial injuries.Material and methods. Retrospective analysis comprised 6677 records of patients admitted to the Department of Cranio-Maxillofacial and Oncological Surgery, Medical University in Łódź during the period between 2004 and 2009.Results. Post-traumatic amaurosis was diagnosed in seven patients. The most common cause of post-traumatic blindness was attributed to fighting and road traffic accidents. All patients with midface fractures were thoroughly examined by an ophthalmologist. Six patients were subject to pharmacological therapy, while two were qualified towards surgical treatment (optic nerve decompression).Conclusions. It is necessary to conduct an accurate examination of the visual organ in all patients after midfacial trauma, in order to confirm or exclude organ of vision injuries. Pharmacological and surgical treatment should be immediately initiated, as a consequence of optic nerve neuropathy.
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Diagnosis and Treatment of Cervical Branchial Cleft Cysts Based on the Material from the Department of Cranio-Maxillofacial Surgery, Medical University in Łódź and Literature Review

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Gaszyńska E., Gaszyński T., Arkuszewski P.
Polish Journal of Surgery
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2012
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vol. 84
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issue 11
547-550
EN
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
5
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Comparison of Microaspiration Around Taperguard Tube Cuffs and Standard Tracheal Tubes in Obese Patients Subjected to Surgery Under General Anesthesia

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Gaszyńska E., Ratajczyk P., Wieczorek A., Szewczyk T., Gaszyński T.
Polish Journal of Surgery
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2015
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vol. 86
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issue 3
107-110
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.
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Comparison of haemodynamic effects of noninvasive ventilation delivered via ResQGARD and CPAP boussignac masks

88%
Gaszyńska E., Roguszka K., Stankiewicz- Rudnicki M., Wieczorek A., Gaszyński T.
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vol. 85
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issue 3
129-132
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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