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In this article, we present the case of a 57-yearold man with cervical and mediastinal tumor mass, normal blood count as well as virusological status. Cervical tumor tissue biopsy revealed cells positive for CD34, CD13, LCA, CD33, and CD163 but negative for T-cell and B-cell markers, NK-cell markers, plasmacytic markers and anaplastic large cell lymphoma markers. These features were consistent with myeloid sarcoma of the neck with involvement of the mediastinum. We discussed differential diagnosis and therapy of isolated myeloid sarcoma and suggest that clinical presentation, cell morphology, complete immunophenotype, and specific genotypic lesions in some cases, must be evaluated.
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Objectives: In patients hospitalized due to deep neck infections (DNIs), to investigate the association between demographic parameters, etiology, and localization of abscesses and/or phlegmons, complications, comorbidities, treatment, and bacterial cultures. Methods: We analyzed data of 263 patients that were hospitalized from January 1, 2012, to December 31, 2015, due to deep neck space phlegmons and/or abscesses. We performed statistical analysis with the SPSS 22.0 software; statistical significance was set p<0.05. Results: Among the analyzed patients, dental infections were the most frequent, followed by acute phlegmonous pharyngitis. Submandibular space abscesses or phlegmons of the neck were the most frequent complications of these infections. Re-operation was performed in 19.8% of cases, and complications developed in 11% (mostly airway obstruction). DNI complications were less common in smokers than in non-smokers (OR=0.038, p=0.025). Discussion: In our study, dental infections accounted for 70.6% of DNI cases. Thus, our study explains why odontogenic DNIs are the most common DNI type studied in the literature. Poor oral health and odontogenic infections should not be underestimated because they can lead to uncommon but lethal diseases such as descending necrotizing mediastinitis, which requires aggressive surgical treatment and is associated with a mortality rate of 10%-40% despite treatment. The complication developed in 11.4% of cases. In conclusion, oral health and hygiene contribute to DNI development.
EN
Introduction: Postoperative injury of the marginal mandibular branch of the facial nerve is considered a complication in neck dissection and can be related to different factors including traction, devascularisation or conduction block due to diathermy. Material and Methods: A prospective, crossover study including patients treated via bilateral selective neck dissection level IIa during a 12-month period, was performed to evaluate efficacy of the Hayes-Martin manoeuvre to prevent nerve injury during use of cold or monopolar diathermy dissection. Results: 20 patients met the inclusion criteria (40 neck dissections). Just one case of right temporal MMN weakness in the postoperative period was observed (1/40 = 2.5%). There were no cases of permanent marginal mandibular nerve weakness when using the Hayes-Martin manoeuvre. Conclusion: he Hayes-Martin manoeuvre is a safe method to preserve MMN during neck dissection level IIa, regardless of the type of dissection.
EN
Introduction: Postoperative injury of the marginal mandibular branch of the facial nerve is considered a complication in neck dissection and can be related to different factors including traction, devascularisation or conduction block due to diathermy. Material and Methods: A prospective, crossover study including patients treated via bilateral selective neck dissection level IIa during a 12-month period, was performed to evaluate efficacy of the Hayes-Martin manoeuvre to prevent nerve injury during use of cold or monopolar diathermy dissection. Results: 20 patients met the inclusion criteria (40 neck dissections). Just one case of right temporal MMN weakness in the postoperative period was observed (1/40 = 2.5%). There were no cases of permanent marginal mandibular nerve weakness when using the Hayes-Martin manoeuvre. Conclusion: he Hayes-Martin manoeuvre is a safe method to preserve MMN during neck dissection level IIa, regardless of the type of dissection.
5
88%
EN
Objectives: In patients hospitalized due to deep neck infections (DNIs), to investigate the association between demographic parameters, etiology, and localization of abscesses and/or phlegmons, complications, comorbidities, treatment, and bacterial cultures. Methods: We analyzed data of 263 patients that were hospitalized from January 1, 2012, to December 31, 2015, due to deep neck space phlegmons and/or abscesses. We performed statistical analysis with the SPSS 22.0 software; statistical significance was set p<0.05. Results: Among the analyzed patients, dental infections were the most frequent, followed by acute phlegmonous pharyngitis. Submandibular space abscesses or phlegmons of the neck were the most frequent complications of these infections. Re-operation was performed in 19.8% of cases, and complications developed in 11% (mostly airway obstruction). DNI complications were less common in smokers than in non-smokers (OR=0.038, p=0.025). Discussion: In our study, dental infections accounted for 70.6% of DNI cases. Thus, our study explains why odontogenic DNIs are the most common DNI type studied in the literature. Poor oral health and odontogenic infections should not be underestimated because they can lead to uncommon but lethal diseases such as descending necrotizing mediastinitis, which requires aggressive surgical treatment and is associated with a mortality rate of 10%-40% despite treatment. The complication developed in 11.4% of cases. In conclusion, oral health and hygiene contribute to DNI development.
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