Search results

1

A schwannoma of facial nerve in the extracranial segment – a case report

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Tarazewicz D., Wierzchowska M., Burduk P.

Polski Przegląd Otorynolaryngologiczny

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2019

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vol. 8(3)

44-49

EN

The report aims to present a rare case of facial nerve schwannoma within the parotid gland. Schwannomas are benign, welldefined tumours arising from Schwann cells that form the myelin sheaths of peripheral, cranial or spinal nerves. 25–45% of them are located within the head and neck, mainly in the parapharyngeal space. The intraparotid localisation is rare. The aetiology of cancer is unknown. Preoperative diagnosis, both radiological and cytological, is difficult and often does not give the correct diagnosis. Radiologically, a multiform adenoma is usually suspected, and fine needle aspiration biopsy is nondiagnostic. Due to the rarity and benign nature of the tumour, there has been debate over the need for surgical treatment.

2

Results of cystadenolymphoma treatment of superficial parotid gland

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Ślęzak A., Kaźmierczak W., Kaźmierczak H.

Otolaryngologia Polska

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2018

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vol. 72(6)

23-30

EN

Introduction: Warthin’s tumor is a non-malignant tumor that occurs in major salivary glands. Diagnostics include an interview and physical examination as well as additional tests – ultrasonography, magnetic resonance tomography, fine-needle aspiration biopsy. Surgical tumor resection remains the method of treatment, the scope of which includes techniques from extracapsular tumor resection to a full range of parotidectomy. Material and methods: A retrospective analysis was conducted for available medical records of 53 patients treated surgically at the Department of Otolaryngology and Laryngological Oncology at the Collegium Medicum of the Nicolaus Copernicus University in Toruń in 2009–2016. Each patient underwent an interview, physical examination and a routine ultrasound examination. Results of treatment of 57 tumors were analyzed. Results: The study showed that in the case of extracapsular tumor excision in 57 patients in the treatment of Warthin’s tumors of the lower pole of the parotid lobe, there were no complications in the form of: permanent paralysis or facial nerve palsy, mucocele, symptoms of Frey’s syndrome or cosmetic facial defect. Ultrasound examination performed in 8 (14%) patients revealed lesions requiring further diagnostics or periodic ultrasound monitoring. Conclusions: 1. Extracapsular tumor excision appears to be an accurate surgical technique in Warthin’s tumor of the lower pole of the parotid gland’s superficial lobe. 2. After removal of a cancerous lesion of the parotid gland, every patient requires periodic laryngological monitoring.

3

Evaluation of benign tumors of large salivary glands according to the new classification of the European Salivary Glands Society

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Olejniczak I., Leduchowska A., Kozłowski Z., Pietruszewska W.

Polish Journal of Otolaryngology

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2021

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vol. 75

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issue 4

7-13

EN

Introduction: Tumors of large salivary glands constitute about 2–3% of all head and neck tumors. Their incidence is statistically greater in males than in females, with the first symptoms usually appearing between the 4th and 7th decade of life. Aim: The aim of the study was to assess the usefulness of the new classification proposed by European Salivary Gland Society (ESGS) in comparison with the divisions of procedures previously valid in the literature, making a retrospective analysis of patients operated on due to benign tumors of large salivary glands in the Department of Otolaryngology, Head and Neck Oncology of the Medical University of Lodz in 2012–2020. Material and methods: The retrospective examination was based on the material consisting of: surgical protocols, histopathological results, imaging results and clinical observations. The material includes 283 patients (141 women and 142 men): 249 patients with parotid gland tumor and 34 patients with submandibular gland tumor. The most common histopathological diagnosis was pleomorphic adenoma, which was found in 105 patients (42.17%) and adenolymphoma diagnosed in 94 patients (37.75%). Results: The most common type of surgery was superficial parotidectomy including total superficial parotidectomy in 86 patients (34.54%) and partial superficial parotidectomy in 49 cases (19.68%). Then, according to the frequency of surgery, extracapsular tumor dissection (ECD) was performed (91 patients – 36.55%). According to the ESGS classification, in most cases parotidectomy I, II (37.34% of all parotidectomies) and parotidectomy II (28.49%) were performed. In case of ECD, all tumors were located at level II. Conclusions: In summary, the new classification is aimed at unifying, but also simplifying the current nomenclature, reducing the existing nomenclature errors. Determination of the exact location and extent of the tumor within the parotid gland facilitates postoperative monitoring of patients by ENT doctors and those of other specialties.

4

Pleomorphic adenoma - the results of a retrospective analysis of 104 patients treated at the Clinical Department of Cranio-Maxillofacial Surgery, Clinic of Otolaryngology and Laryngologic Oncology of the Military Institute of Medicine

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Korba M., Chloupek A., Dąbrowski J., Piętka T., Domański W., Biernacka B., Leśniak W.

Otolaryngologia Polska

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2017

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vol. 71(4)

34-36

EN

Pleomorphic adenoma, also known as tumor mixtus, is one of the most common types of benign neoplasm of the salivary gland, which presents as a slow growing, painless tumor. Major salivary glands are the typical localization of this neoplasm. It rarely undergoes malignant transformation, however may recur locally post resection. In this study, we present the results of a retrospective analysis of 104 patients treated at the Clinical Department of Cranio-Maxillofacial Surgery, Clinic of Otolaryngology and Laryngologic Oncology of the Military Institute of Medicine between 2004 and 2015 due to pleomorphic adenoma. The study confirmed the parotid gland as the most common location of tumor mixtus. In some cases, the large size of the tumor and its location were the cause of life-threatening complications.

5

Results of cystadenolymphoma treatment of superficial parotid gland

100%

Ślęzak A., Kaźmierczak W., Kaźmierczak H.

Polish Journal of Otolaryngology

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2018

|

vol. 72

|

issue 6

23-30

EN

Introduction: Warthin’s tumor is a non-malignant tumor that occurs in major salivary glands. Diagnostics include an interview and physical examination as well as additional tests – ultrasonography, magnetic resonance tomography, fine-needle aspiration biopsy. Surgical tumor resection remains the method of treatment, the scope of which includes techniques from extracapsular tumor resection to a full range of parotidectomy. Material and methods: A retrospective analysis was conducted for available medical records of 53 patients treated surgically at the Department of Otolaryngology and Laryngological Oncology at the Collegium Medicum of the Nicolaus Copernicus University in Toruń in 2009–2016. Each patient underwent an interview, physical examination and a routine ultrasound examination. Results of treatment of 57 tumors were analyzed. Results: The study showed that in the case of extracapsular tumor excision in 57 patients in the treatment of Warthin’s tumors of the lower pole of the parotid lobe, there were no complications in the form of: permanent paralysis or facial nerve palsy, mucocele, symptoms of Frey’s syndrome or cosmetic facial defect. Ultrasound examination performed in 8 (14%) patients revealed lesions requiring further diagnostics or periodic ultrasound monitoring. Conclusions: 1. Extracapsular tumor excision appears to be an accurate surgical technique in Warthin’s tumor of the lower pole of the parotid gland’s superficial lobe. 2. After removal of a cancerous lesion of the parotid gland, every patient requires periodic laryngological monitoring.

6

Pleomorphic adenoma - the results of a retrospective analysis of 104 patients treated at the Clinical Department of Cranio-Maxillofacial Surgery, Clinic of Otolaryngology and Laryngologic Oncology of the Military Institute of Medicine

100%

Korba M., Chloupek A., Dąbrowski J., Piętka T., Domański W., Biernacka B., Leśniak W.

Polish Journal of Otolaryngology

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2017

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vol. 71

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issue 4

34-36

EN

Pleomorphic adenoma, also known as tumor mixtus, is one of the most common types of benign neoplasm of the salivary gland, which presents as a slow growing, painless tumor. Major salivary glands are the typical localization of this neoplasm. It rarely undergoes malignant transformation, however may recur locally post resection. In this study, we present the results of a retrospective analysis of 104 patients treated at the Clinical Department of Cranio-Maxillofacial Surgery, Clinic of Otolaryngology and Laryngologic Oncology of the Military Institute of Medicine between 2004 and 2015 due to pleomorphic adenoma. The study confirmed the parotid gland as the most common location of tumor mixtus. In some cases, the large size of the tumor and its location were the cause of life-threatening complications.

7

Multiple sialoceles of the parotid gland in chronic parotid sialadenitis – a case report

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Molga-Magusiak M., Chęciński P., Nyckowska J.

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EN

Introduction: Chronic parotid sialadenitis is a disorder of multifactorial etiology. The main cause of this condition is usually a presence of deposits that narrow the parotid duct lumen. Obturative lesions and ongoing inflammation may lead to the development of retention cysts. Case report: In the reported case, a 56-year-old patient experienced a massive polycystic hyperplasia of the parotid gland secondary to chronic calculous sialadenitis, with total parotidectomy as the only effective method of treatment. The methods of treatment and procedural models in the management of chronic parotid sialadenitis are discussed.

8

Management of recurrent pleomorphic adenoma of the parotid gland: analysis of the material of Otolaryngology Department, Medical University of Warsaw between 1998 and 2008

100%

Szwedowicz P., Osuch-Wójcikiewicz E., Bruzgielewicz A., Chęciński P., Nyckowska J., Grotthuss M.

Otolaryngologia Polska

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2010

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vol. 64(7)

50-54

EN

Objectives: Treatment of patients with recurrent pleomorphic adenoma of the parotid gland is a challenge for a surgeon due to frequent problems with complete resection of all tumour foci while preserving continuity and function of the facial nerve. The aim of this study was to evaluate the clinical presentation and treatment results of patients with recurrent pleomorphic adenoma of the parotid gland. Materials and Methods: The medical records of 35 patients (25 women and 10 men) operated on (44 operations) for recurrent pleomorphic adenoma between the years 1988 and 2008 at the Otolaryngology Department, Medical University of Warsaw, were reviewed. These patients accounted for 8.9% of all patients treated for pleomorphic adenoma of the parotid gland (N=395). A retrospective analysis was performed to examine clinical features, surgical technique and facial nerve management. Results: All patients had palpable, nontender mass or masses in a parotid bed after 1 to 5 previous operations. Multifocal recurrences were present in 79.5% of cases. Median interval between initial treatment and commencement of recurrences was 6.1 (0.25-29) years. Patients with more than one recurrence were younger than patients who had only one. Malignant transformation of recurrent pleomorphic adenoma was observed in two patients (5.7%). Postoperative facial nerve paresis occurred in 15 cases. In two additional cases eradication of recurrent tumour required the facial nerve resection and reconstruction. Conclusions: Recurrent pleomorphic adenoma occurs more often in younger patients and women. The risk of the facial nerve injury increases with each successive operation. Surgical treatment should be individualized, taking into consideration the extent of the previous surgery and the type of recurrence.

9

Malignant tumor of the peripheral nerve sheaths in the parotid gland – a case report

88%

Movila A., Didora V., Zagacki D., Braun M., Morawiec-Sztandera A., Kaczmarczyk D.

Polski Przegląd Otorynolaryngologiczny

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2020

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vol. 9(1)

34-38

EN

Introduction: Neoplasms of the parotid glands constitute about 6% of head and neck tumours, the most common of which are: adenoma multiforme and Warthin’s tumor. Schwannoma is benign, encapsulated tumor of the nerve cells (lemocytes, Schwann cells), most often it occurs in the trunk, head, extremely rarely observed in the parotid gland. 9% Schwannomas derives from the facial nerve sheath, constituting from 0.5–1.2% of all salivary gland tumors. The literature describes 80 cases of intraparotid Schwannoma. Malignant Schwannoma (MPNST) account for 5% to 10% of all soft tissue sarcomas. Highgrade MPNST tumors are aggressive, with a tendency to relapse and metastasis. Case report: We present a case report of a 84-year-old female patient presented to the Head and Neck Oncology Clinic of the Medical University of Lodz, due to the painful tumor of the left parotid region. The tumor appeared six months before hospitalization. During the physical examination, there was a polycyclic tumor with reduced mobility, the skin on the tumor was slightly red, lymph nodes uninvolved, facial nerve function preserved. BACC revealed tumour tissue composed of sheets and spindle-shaped cells. The patient was qualified for surgical treatment. Under the general anesthesia the superficial lobe of the parotid gland along with the tumor was removed. After the procedure, no facial nerve palsy was found. The patient did well post-operatively and was discharged home on the 8th day after surgery. Immunohistochemical staining showed the tumour cells to be diffusely and strongly immunoreactive for S-100 protein and Ki67 40–50%. Strong and diffuse staining for S-100 protein were consistent with the malignant peripheral nerve sheath tumour (MPNST). The patient was referred for radiotherapy, due to the postoperative outcome and advanced age, no adjuvant treatment was proposed. The patient has been in observation for 1 year. No relapse was found in the follow-up studies.

10

Parotid gland tumors in Northern Greece: a 7-year retrospective study of 207 patients

88%

Poutoglidis A., Tsetsos N., Sotiroudi S., Fyrmpas G., Poutoglidou F., Vlachtsis K.

Polish Journal of Otolaryngology

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2020

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vol. 75

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issue 5

39-43

EN

Introduction: Parotid gland neoplasms represent a heterogenous group of tumors, either benign or malignant. The diagnosis and management of parotid gland tumors is complicated by their relative infrequency and their diverse biologic behavior. Aim: The aim of this study is to investigate the epidemiological characteristics, the recurrence rates and the surgical approach employed for parotid gland tumors in Northern Greece. Material and methods: This is a single-center retrospective study. All patients admitted to the ENT department of “G. Papanikolaou” General Hospital of Thessaloniki from January 2012 to June 2019 with the diagnosis of parotid gland tumor were included in the study. Patients with incomplete charts and patients that underwent revision surgeries were excluded. Chi-squared tests were used to assess the associations between variables. Results: A total of 207 patients with a mean age of 54.97 (range 16–91) were included in the study. Benign neoplasms accounted for 87.9% of the cases. Warthin’s tumor was the most common neoplasm encountered, with an incidence of 46.8%, followed by pleomorphic adenoma (31.9%). There was a higher incidence of parotid gland tumors in males and smokers (P = 0.025, P = 0.001 respectively). The majority of the patients were treated with an extracapsular resection (60.4%) or with a partial superficial parotidectomy (22.6%). In 12 cases (5.7%), there was a recurrence of the lesion. The most common complications encountered were facial nerve injury, Frey’s syndrome and hematoma formation. Conclusions: Parotid gland tumors are typically benign, non-aggressive tumors, more frequently seen in men than women. There is a positive association between smoking and parotid gland tumor development. Comprehensive information regarding recurrence and complication rates is presented.

11

Przydatność ultrasonografii w diagnostyce zespołu Sjögrena

63%

Saied F., Włodkowska‑Korytkowska M., Maślińska M., Kwiatkowska B., Kunisz W., Smorawińska P., Sudoł‑Szopińska I.

Journal of Ultrasonography

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2013

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vol. 13

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issue 53

202-211

EN

Sjögren’s syndrome is an autoimmune exocrinopathy which manifests itself with dryness of the eyes and the oral cavity. These symptoms comprise a so-called sicca syndrome (xerostomia and xerophthalmia). Two forms of this disease may be distinguished: primary Sjögren’s syndrome which affects salivary glands and secondary Sjögren’s syndrome with other autoimmune diseases present such as rheumatoid arthritis, systemic lupus erythematosus or systemic scleroderma. The diagnosis is based on the classification criteria established in 2002 by a group of American and European scientists (American-European Consensus Group), which involve the interview and physical examination as well as serological, histopathological and radiological tests. Most of these examinations show some limitations such as invasiveness, expensiveness or limited accessibility. The latest research suggests that ultrasound examination may appear promising in the diagnostics of the main salivary glands: submandibular and parotid glands. It is an accessible and relatively cheap examination with high sensitivity and specificity values which are comparable to those obtained via conventional means used in the diagnostics of this disease, i.e. biopsy of the minor salivary glands, sialography and scintigraphy, as well as superior to those obtained in sialometry and Schirmer’s test. Additionally, ultrasonography correlates with the results of magnetic resonance imaging. Therefore, a number of authors claim that US examination should be included in the classification criteria of Sjögren’s syndrome. The aim of this article is to present the diagnostic capacity of the US examination in Sjögren’s syndrome using the current ultrasound classification systems based on the grey-scale, Doppler and contrast-enhanced examinations. The latest research confirms that the most valuable diagnostic criterion in Sjögren’s syndrome is the heterogeneity of the glandular parenchyma. The outcome of the examination greatly depends on the examiner’s experience.

PL

Zespół Sjögrena jest autoimmunologiczną egzokrynopatią, manifestującą się objawami suchości oka i jamy ustnej, składającymi się na tzw. zespół suchości (kserostomia i kseroftalmia). Można wyróżnić dwie postaci choroby: pierwotny zespół Sjögrena, zajmujący głównie gruczoły ślinowe, oraz wtórny zespół Sjögrena, z towarzyszącymi innymi chorobami autoimmunologicznymi, tj. reumatoidalnym zapaleniem stawów, toczniem układowym rumieniowym czy twardziną układową. Rozpoznanie choroby opiera się na kryteriach klasyfikacyjnych opracowanych w 2002 roku przez grupę naukowców z Ameryki i Europy (American‑European Consensus Group), które bazują na badaniach przedmiotowych i podmiotowych, serologicznych, histopatologicznych i radiologicznych. Większość tych badań wykazuje pewne ograniczenia, takie jak inwazyjność, wysoki koszt czy mała dostępność. Ostatnie prace wskazują, że obiecującą metodą w diagnostyce choroby jest badanie ultrasonograficzne głównych gruczołów ślinowych: ślinianek podżuchwowych i przyusznych. Jest to badanie dostępne, stosunkowo niedrogie, wykazujące wysoką czułość i swoistość, na poziomie porównywalnym do konwencjonalnych metod stosowanych w rozpoznawaniu tej choroby, tj. biopsji gruczołów ślinowych mniejszych, sialografii i scyntygrafii, i przewyższającym sialometrię i test Schirmera. Dodatkowo koreluje z wynikami rezonansu magnetycznego. Wielu autorów postuluje zatem włączenie badania ultrasonograficznego do kryteriów klasyfikacyjnych zespołu Sjögrena. Celem pracy jest przedstawienie możliwości diagnostycznych badania ultrasonograficznego w rozpoznawaniu zespołu Sjögrena, z uwzględnieniem dotychczas stosowanych ultrasonograficznych systemów klasyfikacyjnych, opierających się na badaniu w skali szarości, w opcji dopplerowskiej oraz z zastosowaniem środków kontrastujących. Najnowsze badania potwierdzają, że najcenniejszym diagnostycznie kryterium w rozpoznawaniu zespołu Sjögrena jest niejednorodność miąższu gruczołów. Wynik badania w dużej mierze zależy od doświadczenia badającego.

12

Standards for the assessment of salivary glands – an update

63%

Zajkowski P., Ochal-Choińska A.

Journal of Ultrasonography

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2016

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vol. 16

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issue 65

175-190

EN

The paper is an update of 2011 Standards for Ultrasound Assessment of Salivary Glands, which were developed by the Polish Ultrasound Society. We have described current ultrasound technical requirements, assessment and measurement techniques as well as guidelines for ultrasound description. We have also discussed an ultrasound image of normal salivary glands as well as the most important pathologies, such as inflammation, sialosis, collagenosis, injuries and proliferative processes, with particular emphasis on lesions indicating high risk of malignancy. In acute bacterial inflammation, the salivary glands appear as hypoechoic, enlarged or normal-sized, with increased parenchymal flow. The echogenicity is significantly increased in viral infections. Degenerative lesions may be seen in chronic inflammations. Hyperechoic deposits with acoustic shadowing can be visualized in lithiasis. Parenchymal fibrosis is a dominant feature of sialosis. Sjögren syndrome produces different pictures of salivary gland parenchymal lesions at different stages of the disease. Pleomorphic adenomas are usually hypoechoic, well-defined and polycyclic in most cases. Warthin tumor usually presents as a hypoechoic, oval-shaped lesion with anechoic cystic spaces. Malignancies are characterized by blurred outlines, irregular shape, usually heterogeneous echogenicity and pathological neovascularization. The accompanying metastatic lesions are another indicator of malignancy, however, final diagnosis should be based on biopsy findings.

PL

W publikacji przedstawiono aktualizację standardów Polskiego Towarzystwa Ultrasonograficznego dotyczących badania ultrasonograficznego gruczołów ślinowych, wydanych w 2011 roku. Opisano w niej obecne wymogi techniczne dotyczące aparatów ultrasonograficznych, technikę przeprowadzania badania i pomiarów oraz zasady wykonywania opisu badania. Omówiono zarówno prawidłowy obraz ultrasonograficzny ślinianek, jak i najważniejsze patologie w obrębie tych gruczołów, takie jak: stany zapalne, sialozy, kolagenozy, urazy oraz procesy rozrostowe, ze szczególnym podkreśleniem cech zmian o wysokim ryzyku złośliwości. W przypadku ostrych, bakteryjnych zapaleń ślinianki są hipoechogeniczne, powiększone bądź normalnego rozmiaru, ze zwiększonym przepływem miąższowym. W zapaleniach wirusowych echogeniczność jest wyraźnie podwyższona. W zapaleniach przewlekłych widoczne są zmiany degeneracyjne. W kamicy uwidocznić można hiperechogeniczne złogi z towarzyszącym cieniem akustycznym. W sialozach do minują cechy zwłóknienia miąższu. Zespół Sjögrena daje różne obrazy zmian w miąższu ślinianek na różnych etapach choroby. Gruczolaki wielopostaciowe to zwykle zmiany hipoechogeniczne, dobrze odgraniczone i najczęściej policykliczne. Guz Warthina jest zazwyczaj zmianą hipoechogeniczną, owalną, z torbielowatymi przestrzeniami bezechowymi. Zmiany złośliwe cechują się zatartymi granicami, nieregularnym kształtem, zwykle niejednorodną echogenicznością i patologicznym unaczynieniem. Towarzyszące zmianie przerzutowe węzły chłonne są dodatkowym aspektem świadczącym o złośliwym jej charakterze, jednak ostateczne rozpoznanie można postawić na podstawie wyniku biopsji.

13

Mistakes in ultrasound examination of salivary glands

63%

Białek E. J., Jakubowski W.

Journal of Ultrasonography

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2016

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vol. 16

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issue 65

191-203

EN

Ultrasonography is the first imaging method applied in the case of diseases of the salivary glands. The article discusses basic mistakes that can be made during an ultrasound examination of these structures. The reasons for these mistakes may be examiner-dependent or may be beyond their control. The latter may include, inter alia, difficult conditions during examination (technical or patient-related), similarity of ultrasound images in different diseases, the lack of clinical and laboratory data as well as the lack of results of other examinations, their insufficient number or incorrectness. Doctor-related mistakes include: the lack of knowledge of normal anatomy, characteristics of ultrasound images in various salivary gland diseases and statistical incidence of diseases, but also attaching excessive importance to such statistical data. The complex anatomical structures of the floor of the oral cavity may be mistaken for benign or malignant tumors. Fragments of correct anatomical structures (bones, arterial wall fibrosis, air bubbles in the mouth) can be wrongly interpreted as deposits in the salivary gland or in its excretory duct. Correct lymph nodes in the parotid glands may be treated as pathologic structures. Lesions not being a simple cyst, e.g. lymphoma, benign or malignant tumors of the salivary glands or metastatic lymph nodes, can be mistaken for one. The image of disseminated focal changes, both anechoic and solid, is not pathognomonic for specific diseases in the salivary glands. However, in part, it occurs typically and requires an extended differential diagnosis. Small focal changes and infiltrative lesions pose a diagnostic problem because their etiology cannot be safely suggested on the basis of an ultrasound examination itself. The safest approach is to refer patients with abnormal focal changes for an ultrasoundguided fine-needle aspiration biopsy.

PL

Badanie ultrasonograficzne jest pierwszą metodą obrazową stosowaną w przypadku chorób ślinianek. W artykule omówiono podstawowe pomyłki, które można popełnić podczas badania ultrasonograficznego tych gruczołów. Przyczyny błędów mogą być zależne i niezależne od lekarza badającego. Do przyczyn niezależnych należą m.in. trudne warunki badania (techniczne lub ze strony osoby badanej), podobieństwo obrazów ultrasonograficznych w różnych jednostkach chorobowych oraz brak danych klinicznych, laboratoryjnych i wyników innych badań lub ich zbyt mała liczba czy nieprawidłowość. Wśród przyczyn pomyłek zależnych od lekarza wykonującego badanie ultrasonograficzne należy wymienić nieznajomość: anatomii prawidłowej, cech obrazów ultrasonograficznych w różnych chorobach ślinianek, statystycznej częstości występowania chorób, ale również zbytnie sugerowanie się nią. Skomplikowane struktury anatomiczne okolicy dna jamy ustnej mogą być mylone z łagodnymi lub złośliwymi nowotworami. Fragmenty prawidłowych struktur anatomicznych (kości, zwłókniałe ściany tętnic, pęcherzyki powietrza w jamie ustnej) mogą zostać nieprawidłowo zinterpretowane jako złogi w śliniance lub jej przewodzie wyprowadzającym. Prawidłowe węzły chłonne obecne w śliniankach przyusznych można potraktować jako struktury patologiczne. Zmiany niebędące torbielą prostą mogą zostać z nią pomylone, np. chłoniak, niezłośliwe i złośliwe nowotwory ślinianek, węzły chłonne przerzutowe. Obraz rozsianych zmian ogniskowych, zarówno bezechowych, jak i litych, nie jest w śliniankach patognomoniczny dla konkretnych jednostek chorobowych, chociaż w części występuje typowo i wymaga poszerzonej diagnostyki różnicowej. Problem diagnostyczny stanowią małe zmiany ogniskowe oraz zmiany naciekowe, ponieważ na podstawie samego badania ultrasonograficznego nie można bezpiecznie sugerować ich etiologii. Najbezpieczniejszym sposobem postępowania jest kierowanie pacjentów z obecnością nieprawidłowych zmian ogniskowych na biopsję aspiracyjną cienkoigłową celowaną, monitorowaną ultrasonograficznie.

14

Rozległa rana cięta twarzy – opis przypadku

63%

Woźniczko K., Molga-Magusiak M., Rzepakowska A., Bartoszewicz R.

Polski Przegląd Otorynolaryngologiczny

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2021

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vol. 10(3)

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issue 3

1-5

PL

57-letnia pacjentka została przywieziona przez Zespół Ratownictwa Medycznego na Izbę Przyjęć z 25-centymetrową raną ciętą twarzy po stronie lewej. Uraz został zadany nożem. Uszkodzeniu uległ miąższ śliniaki, przewód wyprowadzający Stenona, język, lewy kącik ust, mięsień żwacz, część chrzęstna przewodu słuchowego zewnętrznego oraz małżowina uszna. Nerw twarzowy nie został uszkodzony. W artykule opisano sposób chirurgicznego zaopatrzenia uszkodzonych struktur twarzy. Na podstawie przeglądu literatury omówione zostały postępowanie oraz istotne aspekty zaopatrzenia tego typu urazów. Rany cięte okolicy twarzy i ucha wymagają dokładnej oceny i odpowiedniego zaopatrzenia, by uzyskać prawidłowe gojenie i uniknąć powikłań. Słowa kluczowe: ślinianka przyuszna, przewód wyprowadzający ślinianki, małżowina uszna, rana cięta twarzy

EN

We present a case report of a 57-year-old female with a 25 cm laceration on the left side of her face. The patient was cut with a knife and as a result the parotid gland, the parotid duct, the tongue, the corner of the mouth, the masseter muscle, the cartilaginous part of the external acoustic canal and the auricle were damaged. The facial nerve was not damaged. All of the injuries were managed, including end-to-end anastomosis of the Stenon duct and layered closure of the auricle. The cut wounds of the facial and ear area must be carefully assessed and adequately treated in order to assure proper healing and avoid complications. Key words: parotid gland, parotid duct, auricle, facial cut wound

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