Deep neck infections (DNIs) are still emergency conditions in otorhinolaryngology. Due to rapid disease progression and life-threatening complications, the accurate surgical and medical treatment must be promptly applied. In the present study, we analyzed treatment protocols of 46 adults to assess efficacy of the treatment and search for prognostic factors of the outcomes. We performed retrospective analysis of medical data of 46 patients, who underwent surgical treatment in our department due to purulent DNI in the period from 2009 to 2017. Data investigated included age, sex, hospitalization time, duration of symptoms before drainage, comorbidities, selected laboratory tests results, location and the number of abscesses, results of microbiological cultures, and antibiotic treatment options. The study group consisted of 33 (71.7%) men and 13 (28.3%) women. Patients age ranged from 18 to 82 years. The mean duration of hospital stay was 13.2 ± 8.4 days. The most common site involved was submandibular space (43.5%), followed by parapharyngeal space (28.3%). The majority of patients had single abscess (81.2%), the multiple abscesses were revealed in 8 (18.8%) cases. The mean size of the abscesses was 42 mm. C-reactive protein level was increased in 96.7% patients (mean level 155.5  ±  146.7  mg/L), but the white blood cell count exceeded the normal in 60.9% cases (mean level 16.89  ±  5.59   ×  109/L). Staphylococcus aureus (20.7%) and Peptostreptococcus (20.7%) were the most common species cultured from swabs. The antibiotic treatment included most commonly a combined ceftriaxone and metronidazole (n = 23). Two patients died due to complications. The correlation between different variables and the duration of hospitalization revealed only the hemoglobin level below 12.5 g/dL, a significant predictor of longer hospitalization (16.23 days vs 12.09 days, P = .017). Patients with purulent DNIs and decreased hemoglobin level are predisposed to prolonged recovery following the surgical drainage.

Nonepithelial tumors of the larynx are relatively rare neoplasms of the head and neck. The chondrosarcoma, which develops commonly from cricoid and thyroid cartilage, stands for 0.2% of the laryngeal malignant neoplasms. The rhabdomyoma is even more uncommon benign tumor developing from the laryngeal striated muscles. The clinical manifestation and the treatment options depend on the histopathological evaluation, tumor localization, and its size. In presented case, the simultaneous occurrence of benign and malignant tumors of mesenchymal origin in the patient’s larynx was provoking hoarseness, globus sensation, and dysphagia. To the best of authors’ knowledge, no other case of the concomitance of rhabdomyoma and chondrosarcoma of the larynx have been reported in the literature.

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Despite multidirectional activities in the sphere of politics, health care and limiting direct interpersonal contacts to a minimum, the Covid-19 pandemic has covered the whole world and the number of new cases is rising exponentially. This demonstrates the considerable severity of the situation. The doctors and other health professionals are and will be at the forefront of the fight against the pandemic, being at the same time the group most at risk of infection. SARS-CoV-2 virus infection applies to patients of all ages, with a median age of 49–59 years. The most common complaints in patients with Covid-19 include fever, caught, dyspnea, general malaise and muscle aches. In the course of Covid-19 may occur pneumonia, which in about 20% of cases is moderately to severe and associated with respiratory distress. Important for otorhinolaryngologists are reports of smell and taste disorders. Post-infective loss of smell can make up about 30% of all patients with Covid-19. The confirmation of SARS-CoV-2 infection in patients with symptomatic or epidemiological suspicion of Covid-19 are genetic tests RT-PCR. Biological material is usually taken from the nose or nasopharynx. The management of Covid-19 is symptomatic because there is currently no specific cure drug. There is a particularly high risk of transmitting infection from a patient to the physicians, who are treating diseases of the respiratory tract or perform any interventions on the upper and lower respiratory tract. Low-symptomatic first stages of the disease with high viral load mean that during a pandemic, scheduled examinations and procedures should be limited. During the examination of patients or their treatment, adequate full PPE protection is indicated, reducing the risk of accidental infection of the treatment team. For the treatment of patients with confirmed SARS-CoV-2 infection or requiring immediate treatment without the possibility of determining epidemiological factors Covid-19, full protection in PPE is obligatory.

The 5p deletion syndrome (5p-, Cri-du-chat syndrome, CdCS) is a genetic disorder which results from a partial deletion of the short arm of chromosome 5. It was first described by Lejeune et al. in 1963. The incidence ranges from 1:15 000 to 1:50 000 live births. The 5p- is usually diagnosed in the first days of life because of the characteristic monotonous high pitched cat-like cry and relatively constant dysmorphic features. Other symptoms often present in the neonatal period include low birth weight, muscle hypotonia, asphyxia and feeding difficulties due to impaired suction and swallowing, which may all lead to failure to thrive. Organ malformations, with various larynx abnormalities, although not very frequent, can also be present. Symptoms that are prevalent in later life include severe motor delay and intellectual disability with significant speech impairment, as well as behavioral problems. The case report presents a female infant in her 5th month of life in whom, despite the typical symptoms of 5p-, stridor and episodes of choking were the main problems. Laryngotracheal endoscopy revealed the type I laryngeal cleft. Genetic analysis confirmed the diagnose of 5p- syndrome. The presented case shows that it is critically important to perform a further investigation and refer a child with laryngological problems coexisting with dysmorphic features to a clinical geneticist.