Mariola Popko

Comparison of positron emission tomography/computed tomography imaging and ultrasound in surveillance of head and neck cancer - The 3-year experience of the ENT Department in Poznan.

BACKGROUND Posttreatment surveillance for the local and regional recurrence of the head and neck squamous cell carcinoma often requires a multimodality techniques that include PET combined with CT, MRI, US. AIM The purpose of this study is to compare the diagnostic performance of two imaging techniques (PET/CT and US), and their combined use for the detection of a subclinical regional recurrence in patients after HNSCC treatment. MATERIALS AND METHODS 83 patients after completion of the HNSCC treatment underwent both US and PET/CT on the mean follow-up of 14 months after initial treatment. RESULTS The sensitivity and specificity of PET/CT were 86% and 82%, respectively; US values reached 81% and 87%, respectively. PPV was 79% for PET/CT, and 83% for US. NPV was 89% for PET/CT, and 85% for US. The overall accuracy for PET/CT and US was 84% for both methods. CONCLUSION US could be regarded as complementary to PET/CT as the procedures with highest sensitivity, specificity and NPV for detecting subclinical regional recurrences after HNSCC treatment.

Presurgical evaluation of retroauricular subcutaneous tissue thickness in BAHA surgery.

Objective A growing population of implanted patients benefit from the Bone-Anchored Hearing Aid (BAHA). An important step in the surgery is subcutaneous tissue reduction. The proper preparation of the implant site depends on relevant tissue removal, which is combined with incision, surgical technique, and preliminary retroauricular tissue thickness. Study Design Prospective analysis. Setting Authors attempt to measure the retroauricular subcutaneous tissue thickness and try to trace the correlation between retroauricular subcutaneous tissue thickness with objective parameters such as sex, height, weight, and age. Patients Group of hundred randomly selected patients were enrolled in the study. Intervention(s) Standard ultrasound with liner transducer probe was applied to measure the tissue thickness. Main Outcome Measures Sex, weight, height, and age were correlated with retroauricular tissue thickness; results also were calculated for body mass index. Results The retroauricular subcutaneous tissue thickness ranged between 2.0 and 11.0 mm with the mean value of 5.25 mm. Statistical validation revealed strong correlation with weight and body mass index. Statistical difference was found between retroauricular subcutaneous tissue thickness and sex, confirming women to have thinner subcutaneous tissue than men. The age of the patient also was predictive but without the linear correlation. Conducted measurements revealed no association between retroauricular subcutaneous tissue thickness and height of the patients enrolled in the study. Conclusion Our results provide a predictive value during preoperative counseling of patients and planning the surgery. Basic information obtained during the examination can help choose the optimal implantation technique. The ultrasound examination applied in the study turned to be an easy and reliable method to assess the retroauricular tissue thickness before the surgery.

Przyczyny zwężeń krtaniowo-tchawiczych na podstawie przeglądu literatury i doświadczeń własnych

Summary Laryngo-tracheal stenosis (LTS) is a relatively rare disease, caused usually by iatrogenic reasons (intubation, tracheotomy, radiotherapy and surgery of the larynx and trachea) or by trauma. However they may be caused by another rare diseases effecting the wall of the larynx and trachea (primary stenosis) or by compression of pathological process near by (secondary stenosis). Among the primary stenosis except iatrogenic and posttraumatic there are also: congenital, postinfective (tuberculosis, syphilis, scleroma, diphtheria, histoplasmosis and the other), in connective tissue diseases (Wegeners granulomatosis, relapsing polychondritis), in blister diseases (pemphigoid cicarticans, epidermolysis bullosa hereditaria), in amyloidosis, in sarcoidosis and tracheobronchopathia osteochondroplastica. Secondary stenosis may be effected by thyroid diseases, diseases of the big blood vessels of the thorax, hypertrophic thymus, enlargement of the lymph nodes near by the trachea, tumors and cysts of the neck and mediastinium, retrotracheal abscess and cold abscess in vertebral column tuberculosis. If the reason of stenosis is unknown, the stenosis is called idiopathic. In this publication basing on the literature review the reasons of LTS were described in details. We also present our clinical experience concerning 124 patients. The authors underline, that in most of patients the reason of LTS can be find after taking the history of a patient. However, in the cases, when the reason is not clear, a lot of specific examination should be done to find another rare reason, and only after exclusion it the diagnosis of idiopathic LTS can be established.

Systemy klasyfikacji zwężeń krtaniowo-tchawiczych

Summary Laryngo-tracheal stenosis (LTS) is a relatively rare disease, which develops in very heterogenous group of patients. Careful diagnostics and classification are essential for planning the following treatment and assessing its results. To classify and treat LTS, endoscopic and imaging techniques are required. In this publication basing on the literature review different systems of LTS classifications are described in details. Additionally basing on our clinical experience the probe of choosing the best classification for Polish ENT and thoracosurgery departments was undertaken. In our opinion the use of complex grading systems is unreal in everyday work by Polish ENT surgeons and thoracosurgeons. We suggest to implement the Cottons system and Medical Research Council dyspnea scale as the optimal way to classify and asses the outcomes of LTS treatment. The former system is well known and widely advocated in Poland, the latter requires a modicum of time from the physician. Both scales, as a combination of subjective and objective parameters show a strong correlation and therefore complement each other.Laryngo-tracheal stenosis (LTS) is a relatively rare disease, which develops in very heterogenous group of patients. Careful diagnostics and classification are essential for planning the following treatment and assessing its results. To classify and treat LTS, endoscopic and imaging techniques are required. In this publication basing on the literature review different systems of LTS classifications are described in details. Additionally basing on our clinical experience the probe of choosing the best classification for Polish ENT and thoracosurgery departments was undertaken. In our opinion the use of complex grading systems is unreal in everyday work by Polish ENT surgeons and thoracosurgeons. We suggest to implement the Cottons system and Medical Research Council dyspnea scale as the optimal way to classify and asses the outcomes of LTS treatment. The former system is well known and widely advocated in Poland, the latter requires a modicum of time from the physician. Both scales, as a combination of subjective and objective parameters show a strong correlation and therefore complement each other.

Zastosowanie PET/CT w diagnostyce nowotworów głowy i szyi – doniesienie wstępne w oparciu o prezentację przypadków

18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) offers advantages over PET alone, which is limited by poor anatomic localization and CT alone, which provides morphologic data only. Fusion of PET and CT images allows for precise target delineation for head and neck cancer compared with CT alone. The aim of this article is to evaluate the effect of the use of PET/CT in patients with head and neck cancer. We present four patients whose management was influenced by the implementation of combined PET/CT imaging. We conclude that PET/CT allows detection of recurrent neoplasm, carcinoma of unknown origin, second primary sites, distant metastases, tumor surveillance, staging, and planning radiation therapy.