No abstract

The main aim of this study was to analyse risk factors of postoperative morbidity after extended laryngeal surgery comparing patients with diabetes mellitus and non-diabetic patients. In retrospective study 69 patients (63 male and 6 female), who underwent partial laryngo-pharyngectomy and total laryngectomy between 2003 and 2004, were evaluated. 13 % of the total group of examined patients had concurrent diabetes, while 87% were nondiabetic patients. We performed partial laryngopharyngectomy in 39 out of 69 patients (56.5%) and total laryngectomy in 30 patients (43.5%). Secondary wound infections (88.9%) and pharyngocutaneus fistula (44.5%) had a significantly higher rate in diabetic patients (p<0.001). Among diabetics the cases with intraoperative or postoperative blood transfusions were more frequent--44.4%(p<0.001). Diabetic patients with laryngectomy procedures had more frequently prolonged postoperative anemia (55.5%, p<0.001) and electrolitic disbalance (66.6%, p<0.001). Our results have confirmed that diabetes mellitus is an important independent general clinical factor, which increases postoperative morbidity and hospitalization time in laryngeal surgery. Our data indicate the need to make a very serious plan and clinical assesment for laryngeal surgical therapy in diabetic patients.

Meningioma is a well-recognized tumor of the central nervous system, but it rarely appears as an extracranial tumor secondarily extended into the paranasal sinuses. Meningiomas arise from arachnoid cap cells that form the external membrane of the brain. Most meningiomas are slow growing and are usually not associated with substantial underlying brain edema; they cause symptoms by the compression of adjacent neural structures. An interesting natural history of a neglected meningioma with extracranial extension is described. The diagnosis of meningioma was established by CT imaging, finally based on the histopathology and immunochemistry. The meningioma cells in our male patient were positive for progesterone receptors. The patient underwent surgical treatment and recovered without complications. On follow-up 1 year later there were no signs of process expansion.

The advantage of the lateral pharyngotomy with tracheotomy for complete excision of a mass is demonstrated. It provides an excellent operative exposure and recovery without impairment of breathing and deglutition.