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Selektywna reinerwacja krtani jako metoda leczenia obustronnego porażenia fałdów głosowych

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Czesak M., Osuch-Wójcikiewicz E., Niemczyk K.
Polski Przegląd Otorynolaryngologiczny
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2021
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vol. 10(3)
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issue 3
1-5
EN
Laryngeal reinnervation is a dynamic method of treating bilateral vocal fold paralysis, which has been gaining more and more popularity for several years. Traditional surgical methods involve a permanent change in the anatomical structures of the larynx ensuring the restoration of its respiratory function, which further intensifies the disturbance of phonatory and defense functions of the lower respiratory tract. There is still no common protocol for the management of head and neck surgeons with a patient with bilateral recurrent laryngeal nerve injury. With this in mind, the current literature on laryngeal reinnervation techniques was reviewed.
PL
Reinerwacja krtani to dynamiczna metoda leczenia obustronnego porażenia fałdów głosowych, która od kilkunastu lat zdobywa coraz większą popularność. Tradycyjne metody chirurgiczne obejmują trwałą zmianę struktur anatomicznych krtani zapewniając przywrócenie jej funkcji oddechowej, co więcej nasilając zaburzenie funkcji fonacyjnej oraz obronnej dolnych dróg oddechowych. Wciąż brakuje wspólnego protokołu postępowania przyjętego przez chirurgów głowy i szyi z pacjentem z obustronnym uszkodzeniem nerwów krtaniowych wstecznych. Mając to na uwadze dokonano przeglądu obecnego stanu literatury na temat technik reinerwacji krtani.
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The influence of age and comorbidities on the outcomes of surgical treatment with free tissue transfer: a retrospective study

88%
Czesak M., Sobol M., Bruzgielewicz A., Niemczyk K., Osuch-Wójcikiewicz E.
Polish Journal of Otolaryngology
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2020
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vol. 74
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issue 4
8-12
EN
Introduction: Microvascular free tissue transfer enables the reconstruction of complex head and neck defects. The aim of the study was to assess the results of treatment of patients undergoing reconstructive surgery and to identify factors affecting these results, with particular reference to patient’s age. Materials and Methods: All patients who underwent free-flap head and neck reconstruction in our institution between 2010 and 2017 were included in this retrospective study. A series of 66 patients met the inclusion criteria and were divided into 2 age groups: group G1 aged <65 years (n = 41) and group G2 aged ≥65 years (n = 25). Minor local complications and general complications as well as comorbidities were analyzed. Results: No correlation was found between advanced age and the risk of free flap failure as well as the incidence of local minor complications. General complications were more frequent in the G2 group (32%) than in the G1 group (19.5%), although this is not a statistically significant difference. A statistically significant difference was found between the age and the patient’s health status according to ASA (P = 0.010). In the younger low-risk group, 12 patients (29.3%) had general and local complications, while in the older low-risk group only 1 (4%). General and local complications were found in 5 (12.2%) high-risk G1 patients and in 7 (28%) high-risk G2 patients. Conclusion(s): Patients with advanced head and neck malignant tumors should undergo reconstructive microsurgery regardless of age.
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