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EN
Rhinophyma is the end-stage of rosacea. Nodular hypertrophy of the external nose is a chronic disease lasting for many years. The main problem in patients with rhinophyma apart from functional disorders are deformities of the nose regarding aesthetics. Therefore patients often isolate themselves and avoid interpersonal and social contacts. Majority of patients with symptoms of nodular hypertrophy are not aware of possibility of treatment which impoves functional disorders and aesthetic of the face. Surgical treatment still remains the basic method of treatment of rhinophyma. The long –term observations have proved satisfactory cosmetics and functional results.
EN
The aim of the study was intraoperative assessment of surgical treatment used for primary hyperparathyroidism (PH) basing on immediate histopathological findings and of parathormone (PTH) concentrations in blood serum, the latter being determined before and after removal of the affected parathyroid glands.Material and methods. The study group consisted of 110 patients: 85 women and 25 men aged 16-72 years (mean 49.3), treated surgically for PH or its recurrence. Each patient was operated together with bilateral neck exploration. The identified parathyroid glands were assessed. The operation was considered successful if the cause of PH could be confirmed by intraoperative histopathological examination, and PTH level was found lower than 50% of its preoperative value. Negative results of intraoperative tests were considered an indication for wider exploration of the neck or another full imaging diagnostics in order to decide about reoperation.Results. Parathyroid adenoma was detected in 85 (77.3%) patients, proliferation of the gland in 18 (16.4%) and parathyroid cancer in 7 (6.3%). Basing on intraoperative microscopic and immunochemical examinations, the surgical treatment was found successful in 107 (97.3%) patients. PTH concentration was found normal in 94 patients, and significantly lower in 13. The operation was assessed as unsuccessful in 3 (2.7%) patients (2x recurrence of parathyroid cancer, 1x proliferation of parathyroid glands). A non-significant PTH drop was noted in 1 patient, and PTH increase in 2. One patient died because of disseminated tumor disease, and 2 patients received another imaging diagnostics and reoperation with good result.Conclusions. 1. Positive result of intraoperative histopathological examination together with a significant drop in parathormone concentration in peripheral blood serum are essential for successful surgical treatment of PH. 2. Negative results of microscopic and immunochemical examinations are an indication for wider neck exploration. If further procedure is still unsuccessful, a more profound imaging diagnostics is necessary followed by reoperation.
EN
The aim of the study was evaluation of the results of surgical treatment of congenital blepharoptosis (CBP) using Mustarde’s modified method. Material and methods. Between 2005-2014 forty eight children with CBP underwent surgical correction of CBP by Mustarde’s modified method. Basing on the results of ophthalmic and orthoptic examination, and standard measurements, we estimated postoperative difference in the position and symmetry of the upper eyelids, and postoperative complications in our patients. Results. Very good results were obtained in all cases with mild, in 89.5% with moderate, and in 85.7% with severe unilateral CBP after correction by Mustarde’s modified method. Lagophthalmos was seen in 6.25%, and undercorrection in 12.5% of cases. Conclusions. 1. Mustarde’s modified method allows for obtaining very good functional and aesthetic results in CBP patients. 2. Mustarde’s modified method is a valuable supplemental surgical technique in CBP, and contributes to a low rate and small range of lagophthalmos.
EN
The aim of the study was the evaluation of the occurrence and type of nodular lesions of thyroid gland in the materials of the 1st Department of General and Endocrinological Surgery of Medical University in Białystok from 1993 to 2006.Material and methods. The clinical material was based on 3477 patients that underwent thyreoidectomy for nodular disease in above-mentioned period. Four periods and research groups were established with regard to the character of the goiter according to histopathological examination.Results. The number of thyroidectomies was significantly decreased. There was a increase in the percentage of patients operated for multinodular non-toxic goiter and a significant decrease in the number of patients with multinodular toxic goiter in the whole research group. The percentage of patients that underwent thyroidectomy for mononodular non-toxic goiter was increased as well in women as in men. Mononodular toxic goiter rarely occurred and there was no case of it in men. With a passage of time there was a significant increase in the number of patients operated for papillary cancer as well as for follicular cancer. Medullary cancer and non-differentiated cancer rarely occurred in analyzed material.Conclusions. There was a distinct decrease in the frequency of the occurrence of nodular lesions as well as in the number of thyroidectomies. The profile of thyroid nodules underwent changes in given periods pointing out the lower frequency of toxic goiter and the higher frequency of neoplasmatic lesions in the third and particularly in the fourth research period.
EN
Adrenal tumors are common neoplasms and majority of them are small, benign, hormonally inactive adrenocortical adenomas. Whereas adrenal cancer (ACC) is a rarely occurring (5% of adrenal tumors) but highly aggressive neoplasm. The early diagnosis and complete surgical resection is the only effective treatment option. Laparoscopic adrenalectomy is the gold standard for small and medium tumors. Whereas for large tumors classic adrenalectomy is considered a procedure of choice with a proven better oncological outcome. We herein report a case of a 57-year-old female diagnosed with a large, advanced left adrenal tumor with invasion of vena cava. It was diagnosed in CT and proven in core biopsy. Open adrenalectomy with thoracotomy was conducted to completely resect the tumor by an interdisciplinary team.
EN
Face skeletal deformities have been confusing both doctors and patients for ages. The harmony of the face exerts huge influence not only on one’s psyche but also the behavior and the individual’s social and professional status. In this study we present a procedure of treating skeletal malocclusion. It was performed using various orthodontic methods, like the alteration of the growth of jaws and camouflage applied in appropriate age groups. We paid special attention to the close cooperation between the orthodontist and the surgeon, which hugely facilitates curing the most complex, multi-dimensional deformities. In this study, we present our own materials concerning the effects of cooperation between two departments of Medical University of Lublin, namely the Chair and Clinic of Maxillofacial Surgery and Department of Jaw Orthopedics.
EN
Poland's syndrome is characterized by variable clinical picture. Classic deformity consists of unilateral hypoplasia or aplasia of the sternocostal head of the pectoralis major muscle and ipsilateral hand malformations. Additionally on the affected side hypoplasia or aplasia of the breast in women is observed. Variable malformations in Poland's syndrome cause that there is no uniform treatment schedule.The aim of the study was to analyze surgical treatment conducted in patients with Poland's syndrome in Plastic, Reconstructive and Aesthetic Surgery Clinic.Material and methods. A retrospective analysis of surgical treatment was carried out in the group of 66 patients with Poland's syndrome on the basis of their medical documentation.Results. The most common operation performed in women was breast reconstruction with silicone implant. Two men had their chest symmetrized by fat grafting. Syndactyly observed in patients with complete Poland's syndrome was surgically removed in early childhood.Conclusions. Treatment of patients with Poland's syndrome, mainly due to variable clinical picture, is individual and depends on age, sex and degree of deformity. In children with complete Poland's syndrome operations include surgical removing of syndactyly. Breast reconstruction in women with Poland's syndrome with silicone implants is known and safe method. Such procedures are performed after 18 years of age.
EN
The aim of the study was to determine the prevalence of adrenal tumours and their types based on the analysis of material from university surgical centres participating in a 5-year study between the years 2001 and 2005.Material and methods. A total of 178 patients, 169 (94.9%) adults and 9 (5.1%) children, with adrenal tumours were treated during the study period. Amongst the operated upon patients, there were 111 (62.4%) females (106 adults and 5 girls) and 67 (37.6%) males (63 adults and 4 boys). The age of patients ranged from 7 months to 82 years (mean 55.4 ± 11.8 years). For children, ages ranged from 7 months to 17 years, while for adults ages ranged from 24 to 82 years.Results. Incidentalomas were detected in 36 (21.3%) of 169 adults, and seven (19.4%) of them were found to be hormonally active in biochemical tests.The patients underwent surgery after the preparation depending on the general state, type of tumour, its functioning, and concomitant diseases. Adrenalectomy was performed using a classical open technique through the lumbal access in 146 (86.4%) adults, and a laparoscopic technique through the retro- or transperitoneal access in 23 (13.6%) adults. In the videolaparoscopic operations, retroperitoneal access was preferred. All children were operated upon by means of the classical technique with trans-abdominal access.Adrenal tumours were most frequent in the 6th decade of life (33.2% of all tumours). In the adult group, 143 (84.6%) cases of histologically diagnosed benign tumours and 26 (15.4%) cases of malignant neoplasms were found. Sixteen (9.5% of all tumours and 61.5% of malignancies) of them appeared to be secondary metastatic tumours. Moreover, six (66.7%) children had primary malignant adrenal tumours.In three adult patients whose tumours were up to 3 cm in size in the remaining adrenal gland (after previous adrenalectomy on the other side), enucleation was carried out in one patient and partial resection of the only adrenal gland in two patients. The follow-up cortisol levels in the blood sera of these patients appeared to be normal.Conclusions. 1. Adrenal tumours most commonly occur in the 6th and 7th decades of patients' lives; an increase in the incidence rate is affected by the percentage of metastases to adrenal glands. 2. Adrenal incidentalomas reveal subclinical hormonal activity in a significant percentage of patients and require adequate preparation prior to surgery. 3. Operations preserving the cortex of the only adrenal gland allow the patients to avoid hormonal substitution therapy. 4. Tumours in children are a separate phenomenon with specific tumour characteristics and origin.
EN
Endogenic hyperinsulinism is mainly caused by neuroendocrine tumors (insulinomas) which autonomously secrete insulin. Because the symptoms are often aspecific, a considerably delay in diagnosis occurs. The treatment consists of operative removal of the tumor from the pancreas, preceded by pre-operative localization. In this article we describe our experience with surgical removal of insulinomasMaterial and methods. We retrospectively analyzed all patients with insulinoma which were treated in our center. Definitive diagnosis was made using a 72-hours glucoses fasting test. We describe the symptoms, localization techniques and the outcomes after surgery.Results. Between January 2002 and May 2011, 45 patients (35.6% men and 64.4% female) were treated in our center. The most prevalent symptoms were altered consciousness and general malaise. The combination of CT-scan and endoscopic ultrasound had the highest (90%) sensitivity to localize tumors pre-operatively. During surgery, in 40 patients (89%) the tumor could be removed by enucleation. In the other five patients partial pancreas resection was required. In 22 patients (49%) we used intra-operative insulin level measurements to confirm complete tumor resection. Within the first month after surgery, two patients (4.4%) developed acute pancreatitis, four patients (8.8%) developed a pancreatic fistula. One patient died of multi-organ-failure. All patients were free from symptoms of hyperinsulinism after the surgery and after a median follow-up of 4.5 years.Conclusions. Based on the experience with 45 patients, surgical removal, aided by pre-operative localization with CT and endoscopic ultrasonography, is an effective and safe treatment for insulinomas.
EN
Enterovesical fistulas (EF) are a relatively uncommon complications of colorectal and pelvic malignancies, diverticulitis, inflammatory bowel disease, radiotherapy and traumas. Authors reviewed material of 24 patients hospitalized in the Jesus Infant Hospital Medical University of Warsaw from 1995 to 2006.Material and methods. A total of 24 symptomatic fistulas were recorded in a 13 of women and 11 of men. In all cases of persistent fistulas were treated by surgical and/or urological interventions. The origin of the fistulas were: colorectal malignancies 16 of patients (67%), pelvic malignancies 2 patients (8%), vesical malignancies 3 patients (12.5%) and other 3 patients (12.5%). The most common anatomical anastomoses were as follows: vesicosigmoidal fistula in 12 patients (50%), vesicorectal fistula in 4 patients (16.5%), vesicoenteral fistula in 2 patients (8.5%), urogenitoenteral fistula in 3 patients (12.5%), other in 3 patients (12.5%).Results. Surgical treatment of fistulas were: colostomy in 15 patients (50%), enteral resections and anastomoses in 6 patients (20%), transversostomy 3 patients (10%), jejunostomy 1 patient (3%), other in 5 patients (17%). To the end of 2006 from 24 patients underwent of treatment : 9 patients are alive (37.5%), 8 patients death (33.3%), 7 unknown (29.2%). The median period of life were 12 months (from 1 to 84 months) after.Conclusions. 1. The most common etiological factors of enterovesical fistulas were colorectal malignancies 67% of patients. 2. Only 20% of patients were underwent completly surgical treatment because of advenced malignancies. 3. The most common method of surgical treatment was colostomy in 63% of patients.
EN
Introduction: Certain problems in ear surgery are caused by temporal bone cholestetoma and chronic otitis media complicated by deafness, facial nerve dysfunction, vertigo or meningcephalocele. Lateral petrosectomy offers possibility of radical treatment and prevention of temporal bone destruction and following complications. Aim of study: It is an analysis of indications for lateral petrosectomy and it's results as a treatment of otitis media and temporal bone cholesteatoma. The possibility of synchronous cochlear implantation is noted. Material: Retrospective analysis of 62 patients after lateral petrosectomy, operated in the Department of Otolaryngology at the Medical University of Warsaw in 2001-2009. The group consisted of thirty one men and thirty one women. Results: Thirty two patients suffered from chronic granuloma or chronic choleateatoma otitis media or temporal bone cholesteatoma. Seventeen patients suffered from deafness prior surgery. Cochlear implantation was possible in fi ve patients: two of them after cranium fracture, two with deafness caused by chronic otitis media and one with deafness caused by osteoradionecrosis. Intraoperative CSF leak was observed of eight patients. In one case lateral perosectomy was used as a treatment of CSF leak after removal of cerebellopontine tumor. There was no evidence of CSF leak after surgery. Facial nerve dysfunction was observed in fi fteen cases. Conclusions: Lateral petrosectomy offers possibility of radical treatment in same patients with chronic otorrhea. The total removal of cholesteatoma prevents intracranial and intratemporal complications in case of chronic otitis media. Patients after lateral petrosectomy require systematic ENT and radiological (CT, NMR) examination.
EN
Background: Neurofibromatosis type 1 (NF-1) is one of the most common autosomal dominant disorders. Multiple benign dermal neurofibromas, café au lait spots, axillary and inguinal freckling are the hallmarks of NF-1. Aim: The aim of this paper is to verify if surgical treatment performed in patients with NF-1 is satisfactory to them and to describe demographic factors characteristic for patients with Recklinghausen disease. Methods: A special questionnaire was prepared for the study, which contained 45 questions. Seventeen patients with neurofibromatosis type 1 agreed to fill in the questionnaire aged from 22 to 61 years. Results: Surgical treatment in patients was started between 6 and 45 years of age. All patients declared their will to continue surgical treatment. After treatment patients felt more comfortable, more self-confident and sociable. The first symptoms of neurofibromatosis were seen at about 13 years of life in most patients. All women who gave birth noticed progression of the disease during pregnancy. Conclusions: Performed surgical treatment raises life comfort and increases self-confidence in patients with neurofibromatosis type 1. Due to visible skin changes in neurofibromas it is worth referring patients to Plastic Surgery Departments. Doctors dealing with patients with NF-1 should inform them about the potential heredity of the disease and that puberty and pregnancy intensify the process of skin neurofibroma development.
EN
The aim of the study was to review the clinical characteristics of operated patients with respect to pulmonary sequestration and analyze diagnostic and therapeutic problems connected with this anomaly.Material and methods. We performed a retrospective analysis of 23 patients operated on because of pulmonary sequestration between 1963 and 2004 in the Departments of Thoracic Surgery in Zakopane (10 patients) and Szczecin-Zdunowo (13 patients).Results. The study group comprised 8 men and 15 women and the mean age was 28 years. 15 patients (65.2%) presented with clinical symptoms such as coughing, fever and chest pain. Preoperatively, pulmonary sequestration was suspected in 5 patients. Amongst the remaining patients, the preoperative diagnosis was lung cancer (9 patients), metastasis from testicular neoplasms (n=1), emphysematous bullae (n=2), pulmonary cyst (n=4), bronchiectasis (n=1) and lung abscess (n=1). None of the patients were subjected to arteriography and 6 patients underwent contrast-enhanced computer tomography examination, although it did not lead to a proper diagnosis. We found 20 intralobar sequestrations and 3 extralobar sequestrations, which were situated above the diaphragm. There were 11 sequestrations on the right side and 12 on the left side. The operations performed included: lobectomy (14 patients), segmentectomy 1+2 (n=1), wedge resection (n=3), sequestrectomy (n=3), lower bilobectomy (n=1), and middle lobectomy (n=1). Blood supply from the thoracic aorta was found in 17 patients and the abdominal aorta in the remaining 6 patients. In 5 patients, the pulmonary sequestration was supplied by more than one artery. Complications included hemorrhage from supplying arteries in 8 patients and phrenic nerve palsy in one patient. One patient required mechanical ventilation after the operation. There was no further morbidity and mortality. Distant surgical results were good.Conclusions. 1. Pulmonary sequestration in adults is difficult to diagnose before the operation, even with a detailed computer tomography examination. 2. Intralobar sequestration is much more common (87%) than extralobar and is often situated in the basal segments with comparable incidence on the right and left sides. 3. The greatest danger during the operation is major bleeding from the supplying artery. 4. Prognosis after the operation is favorable.
EN
Introduction: Parapharyngeal space (PPS) is the anatomical area lateral to the upper pharynx and clinically important due to PPS tumors. They account for less than 1% of head and neck neoplasms. Both benign and malignant neoplasms may arise there and typical for this localization is diversity of histological origin. Complete surgical excision is still the basis of treatment. Aim of the study: Evaluation of the results of surgical treatment of PPS tumors in the Department of Otolaryngology at the Medical University over the period 2015–2017. Material and methods: A retrospective analysis of medical records including complaints, physical examination, results of imaging studies, surgical approach, postoperative complication and histopathological results in 22 patients with a diagnosis of a PPS tumors. Results: The most frequent complaints reported by the patients were: discomfort in the throat, dysphagia, hearing disorders and a palpable tumor on the neck. Asymptomatic course of the disease was demonstrated in 4 cases. All patients were treated surgically: 2 with transoral approach, 9 with transparotid-transcervical approach, 11 with transcervical approach. In most cases the tumor was removed radically. In 2 patients intracapsular tumor resection was performed. Based on histopathological examination the benign lesions dominated (18/22). In 4 cases malignant neoplasms were diagnosed: carcinoma ex pleomorphic adenoma, adenoid cystic carcinoma and two cases of squamous cell carcinoma. The most common origin of PPS tumors was deep lobe of parotid gland and for this group 11 patients had diagnosis of pleomorphic adenoma. Other diagnosis included: paraganglioma, neurofibroma, hemangioma, lymphangioma and rhabdomyoma. Postoperative complications occurred in 9 patients and presented as hoarseness and dysphagia due to paresis of the lower group of cranial nerves (IX, X, XII). Significant intraoperative bleeding during surgery occurred in 2 cases and ligation of the external carotid artery was necessary. Conclusion: Due to the anatomical topography of PPS and its content with the essential vessels and the lower group of cranial nerves, the surgical treatment of pathology of this area is still a challenge for head and neck surgeons. The decrease of voice quality and impaired speech and swallowing should always be considered as complications post the surgical resection in PPS.
EN
Introduction: Parapharyngeal space (PPS) is the anatomical area lateral to the upper pharynx and clinically important due to PPS tumors. They account for less than 1% of head and neck neoplasms. Both benign and malignant neoplasms may arise there and typical for this localization is diversity of histological origin. Complete surgical excision is still the basis of treatment. Aim of the study: Evaluation of the results of surgical treatment of PPS tumors in the Department of Otolaryngology at the Medical University over the period 2015–2017. Material and methods: A retrospective analysis of medical records including complaints, physical examination, results of imaging studies, surgical approach, postoperative complication and histopathological results in 22 patients with a diagnosis of a PPS tumors. Results: The most frequent complaints reported by the patients were: discomfort in the throat, dysphagia, hearing disorders and a palpable tumor on the neck. Asymptomatic course of the disease was demonstrated in 4 cases. All patients were treated surgically: 2 with transoral approach, 9 with transparotid-transcervical approach, 11 with transcervical approach. In most cases the tumor was removed radically. In 2 patients intracapsular tumor resection was performed. Based on histopathological examination the benign lesions dominated (18/22). In 4 cases malignant neoplasms were diagnosed: carcinoma ex pleomorphic adenoma, adenoid cystic carcinoma and two cases of squamous cell carcinoma. The most common origin of PPS tumors was deep lobe of parotid gland and for this group 11 patients had diagnosis of pleomorphic adenoma. Other diagnosis included: paraganglioma, neurofibroma, hemangioma, lymphangioma and rhabdomyoma. Postoperative complications occurred in 9 patients and presented as hoarseness and dysphagia due to paresis of the lower group of cranial nerves (IX, X, XII). Significant intraoperative bleeding during surgery occurred in 2 cases and ligation of the external carotid artery was necessary. Conclusion: Due to the anatomical topography of PPS and its content with the essential vessels and the lower group of cranial nerves, the surgical treatment of pathology of this area is still a challenge for head and neck surgeons. The decrease of voice quality and impaired speech and swallowing should always be considered as complications post the surgical resection in PPS.
EN
Introduction: Juvenile nasopharyngeal angiofibroma is a rare, benign tumor; however, it shows local aggression and leads to profuse nosebleeds. Aim: The aim of the study is to present 20 years of experience in endoscopic treatment of this tumor. Material and methods: The material covers 71 patients treated in the years 1985–2019 at the Department of Otolaryngology and Laryngological Oncology in Poznań. In these patients, either the classic external approach, or the double approach – external with the use of endoscopes, or only the endoscopic approach was used. In the entire population, external surgeries were performed in 37 patients, double access in 8 and endoscopic access in 26 patients. Results: Complete resection of the tumor was achieved in 51 patients (72%). The remaining 20 patients (28%) had a residual or recurrent tumor and all of these patients underwent reoperation. Conclusions: The endoscopic approach with the use of various optics and navigation allows for the removal of not only small tumors but also much more advanced ones. Pre-operative evaluation of imaging results is extremely important to avoid incomplete tumor removal. Individual development of an operating strategy, a wide range of optics and various surgical methods, and especially endoscopic ones, are the guarantee of therapeutic success.
EN
The aim of the study was analysis of the number of resection and palliative procedures in patients operated on for colorectal cancer in Poland. We also analyzed the number of sphincter-sparing surgery in patients with rectal cancer.Material and methods. Statistical data about surgical procedures performed in patients with colorectal cancer were obtained from the National Institute of Hygiene in Warsaw. The procedures were divided into palliations and resections. The analysis was performed for the period from 2005 to 2008. We analyzed the data including women and men.Results. We observed an increase in the number of resections from 3381 to 3768 (85.6-88% of all treatments) (2005-2008) in patients with colon cancer. A similar regularity was observed in patients who underwent surgery for rectal cancer from 2335 to 2712, respectively (76.4 to 81.4% of all treatments). Similarly, the number of sphincter-sparing surgery over the course of the period has increased from 1502 to 1916 operations.Conclusions. The increase in the percentage of resections and sphincter-sparing surgery may indicate the progress in the earlier detection of colorectal cancer. Another reason for this increase may be improving the level of education of surgeons due to the better availability of workshops and training. However, analysis is based on too short period of time and these conclusions cannot be regarded as final.
EN
The breast cancer is the most common cancer in women, both in Poland and in the world. Consequences entail a disruption in the physical, psychological and social functioning. The aim of the study was to assess the acceptance of illness by patients treated for breast cancer in the early postoperative period. Material and methods. The research was conducted on the group of 100 consecutive patients aged 32‑80 years (median 56 years) who underwent surgery for breast cancer in the Centre of Oncology in Bydgoszcz w 2014 roku. 68 of women had mastectomy, 32 of women had conservative surgery. Polling was conducted in the early period after surgery. The original questionnaire containing closed questions the scale of acceptance of the disease (AIS) as well as mental adaptation to cancer (Mini-Mac) was used in the study. Results. 38% of patients had high acceptance of the disease, 48% averageand 14% had low acceptance. Patients after conservative surgery had a higher average values for the mental strategies to cope with the disease, for the fighting spirit (23.1), helplessness and hopelessness (13.5), positive revaluation (23), the patients had a lower average (16.5) in the strategy to absorb anxiety. Patients after conservative surgery had a higher average for constructive style (2.6) but lower for destructive style (1.5). High level of mental coping with the disease was observed in 53%of patients with constructive style and 4% of patients with destructive style. While, a low level of mental coping with the dosease was observed in 5% of patients with constructive style and 46% of patients with destructive style. Conclusions. Almost half of women after mastectomy or conservative surgery had an average acceptance of the disease. The disease was accepted best by educated women living in the cities, whitecollar workers with a good economic situation. The following factors were affected the better management of the disease, in order: age, education, current occupation and economic situation, while the type of surgery did not affect better management. More than half of women, regardless of the type of surgery reflected the high level of constructive style.
EN
The aim of the study was the estimation of the results of surgical correction in pronation or supination forearm deformity.Material and methods. Clinical material comprised 19 patients, both sexes, in age from 2 years 3 months to 14 years who were treated in years 2001-2007 because of forearm deformation due to perinatal brachial plexus palsy. Evaluation of the results of surgical treatment has been performed in all cases with using Al-Qattan's scale.Results. As a result of performed tenomioplastic operations in all operated patients functional position of forearm has been achieved (grade 3 in Al-Qattan's scale)., and in 8 cases additionally good range of pronation and supination (grade 4 in Al-Qattan's scale).Conclusions. The necessity of forearm deformity correction in perinatal brachial plexus palsy may concern patients who have been treated microsurgically in very early childhood, and also patients who haven't been qualified to primary surgical treatment because of significant improvement of upper limb function as a result of rehabilitation. Tenomioplastic operations used in forearm position correction should be reserved for patients without fixed contracture who have possibility of forearm passive rotation moves. These procedures are burdened by low risk of complications and with proper qualification they can provide significant improvement of upper limb functional efficiency.
EN
Eagle's syndrome is a rare cause of chronic cervical and throat pain connected with styloid process elongation. The etiology of this disorder remains unclear. The authors presented four cases of symptomatic, one-sided and both-sided elongation of the styloid process. Moreover, the study presented aspects of diagnosis and treatment of Eagle's syndrome. The Authors especially focused on surgical techniques.
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