Chronic rhinosinusitis (CRS) is a very common disorder that remains poorly understood from a pathogenic standpoint. Recent research on the pathogenesis of CRS has been focused on the potential role of biofilms in this chronic infection. The aim of this study was to assess the sinuses’ microflora and biofilm formation on the sino-nasal mucosa in patients with CRS. Paranasal sinus mucosa specimens were harvested at the time of functional endoscopic sinus surgery (FESS). Classical microbiology techniques for the isolation and identification of sinus mucosa microbial flora were used. Scanning electron microscopy (SEM) was used to detect biofilm on the surface of mucosa. A microtiter plate assay for in vitro biofilm formation was employed, divided into three aliquots. One part was assessed for bacterial presence, utilizing an API manual system and the Vitek® 2 Compact system. The two remaining aliquots were tested by in vitro conventional microbiological assay with the use of the Infinite M200 (Tecan) microtiter plate reader, and also by scanning electron microscopy (SEM). A microbiological examination of mucosal specimens had taken during FESS operation revealed the presence of various types of bacteria in 29 out of 30 tested samples. Out of 62 different strains isolated from patients with CRS, 23 strains of coagulase-negative Staphylococcus epidermidis and 6 strains of Escherichia coli were the most frequently isolated microorganisms, accounting for 37.1 and 9.7 %, respectively. Among the 62 isolated strains, 58 were used to assess biofilm formation. From the total of 58 isolates, 8.6 % were strong biofilm producers, 20.7 % were moderate, and 70.7 % of isolates were considered to be non- or weak biofilm producers. SEM of the 30 nasal concha mucosal samples taken from patients with CRS revealed biofilm in 23 specimens. A marked destruction of the epithelium was observed, with variation in degrees of severity, from disarrayed cilia to complete absence of cilia. The vast majority of nasal concha mucosal samples of patients affected by chronic sinusitis presented with biofilm formation. Our study showed that 76.7 % of patients having FESS for CRS had evidence of biofilms on SEM micrographs. Although certain detection methods could lead to various discrepancies in the amount of biofilm produced, the consistent demonstration of biofilms in patients with CRS suggests that this convoluted three-dimensional structures might play a significant role in either the pathogenesis or persistence of chronic rhinosinusitis.

The aim of the study was to compare two types of mandible reconstructive operations with scapula and fibula free flaps: procedures with 3-D models from thermoplastic materials and conventional planning surgeries. 8 patients were treated due to an advanced oral cavity squamous cell carcinoma. In four patients with a mandibular defect, a physical 3-D model consisting of the reconstructed and unaffected sites was prepared for a reconstruction protocol. The 3-D models were designed based to high resolution CT scans. Assessment of comparative functionality (stability of junction, mobility, mastication ability) and cosmetics was examined in both groups, following a 8 weeks healing period with better results in group with 3D model. 3-D models for mandible and donor bones allow to obtain better functionality of restored mandible in comparison to the traditional method also significantly decreases time of the operation and allows to achieve the desired shape and esthetic effect within the 1/3 of the lower face.

The aim of the study was to analyze the efficacy of treatment of closure of cutaneopharyngeal fistulas, following total laryngectomy, using a fasciocutaneous flap. In the group of 6 patients treated in years 2013-2014, in 4 (67%) patients the healing process was successful, in one patient complete flap necrosis was noted on the 6th day, in another patient a small cutaneopharyngeal fistula was recognized, which closed secondarily with no intervention. Flaps of this type, having a small risk of local complications at donor site and satisfactory functional and aesthetic results, may be an alternative form of flap to others used in the reconstruction of superficial deficits in the head and neck areas.

Our goal was to describe a laryngeal-preserving single-stage procedure for the treatment of low-grade chondrosarcomas of the larynx: a total cricoidectomy with medial femoral condyle flap reconstruction. The study was designed as a case series of three consecutive patients with low-grade chondrosarcomas of the cricoid cartilage lamina, diameter 4.4, 5.2, 3.8 cm, respectively, who underwent total cricoidectomy in 2012. Single-staged reconstruction of the defect with medial femoral condyle flap including the periosteum and thin underlying cortical layer of the bone was conducted. Oncologic and functional results were observed during 3 years of follow-up. No evidence of tumor recurrence was detected during follow-up. One month after surgery, all patients were able to tolerate a soft diet and to speak satisfactorily. None of the patients reported aspiration after surgery nor experienced aspiration-related problems, which was confirmed by means of the Leipzig-Pearson scale. The speech ability was good, maximum phonation time was 14, 18, 21 s, respectively, and the voice handicap index scores ranged from 24 to 36 and had improved noticeably at 1, 3 and 6 months follow-up. Two patients were ultimately decannulated, and one female still has a tracheostomy; however, she is able to keep the tracheostoma closed for most of the time, maintaining good phonatory and swallowing functions. Total cricoidectomy with reconstruction by means of medial femoral condyle flap may replace the total laryngectomy in large low-grade chondrosarcomas of the cricoid cartilage.

No abstract

The larynx is a complicated organ with very important functions. Reconstructive operations of the larynx often result in some function reduction caused by scars and stenoses. The aim of this report is to present the results of the one-stage reconstructive operation after a large excision of the chondrosarcoma of the larynx. The patient was male, aged 48 with the history of the operation of the highly mature cartilaginous sarcoma of the thyroid on the right side with tumor recurrence. The one-stage reconstructive surgery using medial condyle femur corticoperiosteal free flap which reshaped the cartilage scaffold and restored an inner layer as the mucosa was made. The flap survived without local and systemic complications. Six months follow-up revealed no local recurrence and good breathing results. There was no restriction of movement of the lower limbs. The patient returned to work previously performed. Results were shown in endoscopic examinations and computer tomography. The medial condyle femur corticoperiosteal free flap may be an option for reconstruction of large laryngeal defect with restoring its shape and inner layers.

No abstract

The laser surgery is an effective and non-invasive treatment of early glottic cancer but the strict follow-up regimen is demanded.