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Laryngocele represents an abnormal invagination of the mucous membrane from the Morgagni laryngeal ventricle, being filled with air and communicating with the laryngeal inlet. The symptoms are intermittent, with recurrent episodes of dysphonia and airway insufficiency. Exceptionally, the wall of the cyst could become malignant. This case was reported given the association between laryngeal carcinoma and external laryngocele. [ABSTRACT FROM AUTHOR]

Background. Nowadays the newest method of nutrition in patients with head and neck carcinomas is the use of percutaneous endoscopic gastrostomy. Aim. Since 2012 we have actively implemented the use of Nutrison administered on PEG before and after the surgical removal of laryngeal or pharyngolaryngeal carcinomas.Material and method. We conducted a prospective descriptive study on 54 cases that benefited from prophylactic PEG placement. Results. Among the cases included in our study 28 underwent total laryngectomy with bilateral removal of lymph nodes, 23 patients required pharyngo-laryngectomy, 2 cases presented invading tonsilar carcinomas and 1 case with esophageal neoplasm received PEG for palliative purpose. Conclusions. The use of PEG is cost efficient lowering the number of in hospital stay days, permits the treatment of complex cases with multiple comorbidities and actively prevents the development of pharyngocutaneous fistulae. [ABSTRACT FROM AUTHOR]

Cinnamomum verum-functionalized Fe3O4 nanoparticles of 9.4 nm in size were laser transferred by matrix assisted pulsed laser evaporation (MAPLE) technique onto gastrostomy tubes (G-tubes) for antibacterial activity evaluation toward Gram positive and Gram negative microbial colonization. X-ray diffraction analysis of the nanoparticle powder showed a polycrystalline magnetite structure, whereas infrared mapping confirmed the integrity of C. verum (CV) functional groups after the laser transfer. The specific topography of the deposited films involved a uniform thin coating together with several aggregates of bio-functionalized magnetite particles covering the G-tubes. Cytotoxicity assays showed an increase of the G-tube surface biocompatibility after Fe3O4@CV treatment, allowing a normal development of endothelial cells up to five days of incubation. Microbiological assays on nanoparticle-modified G-tube surfaces have proved an improvement of anti-adherent properties, significantly reducing both Gram negative and Gram positive bacteria colonization. [ABSTRACT FROM AUTHOR]

Objectives: The study presents the experience of the Coltea ENT Clinic with the most common emergency in ENT pathology. Materials and methods: This a retrospective study including a group of 242 patients that were submitted in Coltea ENT Clinic during 2012 with anterior or posterior epistaxis. Results: The study group comprises 51.24% women and 48.76% men with 73.14% of patients (177) coming from urban areas and the remaining 26.86% (65) from rural areas. The total number of days of hospitalization is 1411, representing an average of 5.83 days / patient. Epistaxis was anterior in 80.17% of cases (194 patients) and antero-posterior in 19.83% (48 patients). 132 patients, representing 54.55% presented elevated blood pressure whereas liver and hematological disorders are uncommon etiologies. Therapeutic interventions are mostly non-surgical 207 (85.54%), the remaining 35 cases (14.46%), requiring surgery. Conclusions: Epistaxis associated with high blood pressure is found in 54.55% of the study group. In 38.02% of cases the etiology cannot be determined. Pluri-factorial etiology is common. The most difficult to control were the cases with epistaxis of hepatic etiology, in which cases the surgical solution was required. [ABSTRACT FROM AUTHOR]

Objectives: The study presents the experience of the Coltea ENT Clinic with the most common emergency in ENT pathology. Materials and methods: This a retrospective study including a group of 242 patients that were submitted in Coltea ENT Clinic during 2012 with anterior or posterior epistaxis. Results: The study group comprises 51.24% women and 48.76% men with 73.14% of patients (177) coming from urban areas and the remaining 26.86% (65) from rural areas. The total number of days of hospitalization is 1411, representing an average of 5.83 days / patient. Epistaxis was anterior in 80.17% of cases (194 patients) and antero-posterior in 19.83% (48 patients). 132 patients, representing 54.55% presented elevated blood pressure whereas liver and hematological disorders are uncommon etiologies. Therapeutic interventions are mostly non-surgical 207 (85.54%), the remaining 35 cases (14.46%), requiring surgery. Conclusions: Epistaxis associated with high blood pressure is found in 54.55% of the study group. In 38.02% of cases the etiology cannot be determined. Pluri-factorial etiology is common. The most difficult to control were the cases with epistaxis of hepatic etiology, in which cases the surgical solution was required. [ABSTRACT FROM AUTHOR]

This study reports the fabrication of nanostructured coatings based on magnetite, polyethyleneglycol, and biologically active molecule (polymyxin B-PM) for producing biofilm-resistant surfaces (voice prosthesis). Magnetite nanoparticles (MNPs) have been synthesized and functionalized using a co-precipitation method and were further deposited into thin coatings using the matrix-assisted pulsed laser evaporation (MAPLE) technique. The obtained nanoparticles and coatings were characterized by X-ray diffraction (XRD), thermogravimetric analysis with differential scanning calorimetry (TGA-DSC), scanning electron microscopy (SEM), transmission electron microscopy with selected area electron diffraction (TEM-SAED), Fourier-transform infrared spectroscopy (FT-IR), and infrared microscopy (IRM). Their antibiofilm activity was tested against relevant Staphylococcus aureus and Pseudomonas aeruginosa bacterial strains. The Fe3O4@PEG/PM surface of modified voice prosthesis sections reduced the number of CFU/mL up to four orders of magnitude in the case of S. aureus biofilm. A more significant inhibitory effect is noticed in the case of P. aeruginosa up to five folds. These results highlight the importance of new Fe3O4@PEG/PM in the biomedical field. [ABSTRACT FROM AUTHOR]

Cutaneous wounds are often superinfected during the healing process and this leads to prolonged convalescence and discomfort. Usage of suitable wound dressings is very important for an appropriate wound care leading to a correct healing. The aim of this study was to demonstrate the influence of a nano-coated wound dressing (WD) on Candida albicans colonization rate and biofilm formation. The modified WD was achieved by submerging the dressing pieces into a nanofluid composed of functionalized magnetite nanoparticles and Satureja hortensis (SO) essential oil (EO). Chemical composition of the EO was established by GC-MS. The fabricated nanostructure was characterized by X-ray Diffraction (XRD), Transmission Electron Microscopy (TEM), Differential Thermal Analysis (DTA) and Fourier Transform-Infrared Spectroscopy (FT-IR). The analysis of the colonized surfaces using (Scanning Electron Microscopy) SEM revealed that C. albicans adherence and subsequent biofilm development are strongly inhibited on the surface of wound dressing fibers coated with the obtained nanofluid, comparing with regular uncoated materials. The results were also confirmed by the assay of the viable fungal cells embedded in the biofilm. Our data demonstrate that the obtained phytonanocoating improve the resistance of wound dressing surface to C. albicans colonization, which is often an etiological cause of local infections, impairing the appropriate wound healing. [ABSTRACT FROM AUTHOR]

Introduction: We describe the management of a-75 year old patient with chronic obstructive pulmonary disease (COPD), II New York Heart Association (NYHA) class heart failure, mitral stenosis and hypertension who presented with mild respiratory distress and dysphagia secondary to compression from a multinodular goiter. In order to properly manage this case, we reviewed the current State of the Art on multinodular goiter in patients with multiple associated pathologies. Results: A multidisciplinary team was assembled including anesthesiology, cardiology and otolaryngology specialists. The patient underwent a cervicotomy with the removal of the compressive thyroid goiter. Conclusions: Airway obstruction and swallowing problems from extra-tracheal compression in a patient with coexistent morbidity represent a unique management dilemma. Therefore, we relied on surgeon-performed ultrasound exam to ascertain all the risks and the possibility of surgical removal of the thyroid mass. The ultrasound exam enabled the correct and complex surgical planning along with an improved resident training concerning the procedure. [ABSTRACT FROM AUTHOR]

Tonsillitis and adenoiditis represent the inflammation of the tonsils, pharynx and Waldeyer'stonsillar ring (adenoid tonsil, lingual tonsil, palatine tonsil and tubal tonsil). The common causes are represented by the infection with adenovirus, Streptococcus sp., Haemophilus influenzae airborne through Pflugge drops and not so often through digestive tract or by contact. Surgery is indicated if chronicity or failure of antibiotic and anti-inflammatory treatment using traditional tonsillectomy procedure or by performing radiofrequency tonsil reduction or coablation. Traditional tonsillectomy under general anesthesia implies excision of the tonsil using the scalpel and electrocauterisation and traditional adenoidectomy using Beckman Adenoid Curette with hemostasis. This procedure has disadvantages as longer recovery time, intraoperative bleeding and also possible bleeding in the recovery time. Radiofrequency tonsil reduction uses Surgiton with high-frequency and low temperature and it has a lot of advantages compared with the traditional procedure. Among this advantages, there are: short operation time, absence of intraoperative bleeding, lower infection rate, shorter recovery time and lower postoperative pain. This procedure cannot be used for treating hypertrophic tonsils and also a variety of adenoiditis and these are treated using the traditional method. This presentation aims at exposing the advantages and disadvantages of both surgical technics at the current level of knowledge. [ABSTRACT FROM AUTHOR]

The respiratory pathology during sleep includes a number of diseases of the superior airways, from snoring to obstructive sleep apnea syndrome (OSAS). In adults, undiagnosed and untreated OSAS is associated with hypertension and other cardiovascular associated diseases; in children, respiratory pathology during sleep may result in serious consequences. Obstructive sleep apnea syndrome in children, left untreated for a long period of time, may result in behavior, cognitive and physiological deficits. In the past years, a lot of progress has been made in sleep medicine in children, but a lot of problems concerning the factors involved in fenotipical variability and pathogenic mechanisms of OSAS remain misunderstood. OSAS can cause a large number of nocturnal symptoms (snoring, increase of respiration effort, nocturnal sweating, agitated sleep, enuresis), and daylight symptoms (mouth respiration, nasal obstruction, nasal voice, attention and behavior deficits). OSAS diagnosis, and also assessing the severity of the condition are realized through the use of polysomnography, and early treatment will determine the severity of this entity. In children, tonsil hyperplasia plays a key role in compromising the permeability of the superior airways during sleep, tonsillectomy being the right treatment path. Children with complex forms of OSAS associated with cranio-facial or neurological anomalies can be treated with different types of surgical procedures or other types of non-surgical therapies. This presentation tries to sum up our current level of knowledge regarding the etiology and mechanism of OSAS in children, the risk factors, as well as the current methods of diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Adenoiditis is an affection of the superior airways, especially in newborns and small children (rare occasions of adult occurrence) and is produced by an allergen, or bacterial, or viral infection of the pharynx adenoid tissue Luschka. Acute adenoiditis has a sudden offset, mild fever/no fever, nasal obstruction, loud respiration, pus secretions, coughing, especially at night. Untreated or treated incorrectly, adenoiditis can cause severe complications such as otitis media, adenitis, acute erythematous or erythemato-papulous angina, laryngitis, tracheitis, bronchitis, pneumonia, or gastrointestinal disorders. Chronic adenoiditis is the consequence of hypertrophy of the adenoidal vegetation and has a chronical evolution that can determine serious complications. Symptoms are similar to the acute form, except the fact that they are permanent and represent the core that increases the frequency of the respiratory infections. In the chronical form, simptoms persist, the most important being nasal obstruction, mouth respiration, nasal voice, sleep apnea, adenoidal face, ear diseases and recurrent superior airways infections. In many cases, distinction between the symptoms and the complications of adenoiditis is unclear or arbitrary, because of this reason we try to use our current level of understanding regarding the physiopathological mechanisms involved in this affliction and try to sketch a fair difference. [ABSTRACT FROM AUTHOR]

Introducere. Atât rinoplastia deschisă, cât şi cea închisă presupun manevre comune, dar şi procese influenţate de însăşi calea de abord aleasă. O analiză preoperatorie atentă este necesară pentru a înţelege cum fiecare abordare afectează percepţia chirurgului asupra anatomiei, limitele sau oportunităţile chirurgicale, precum şi gradul de control asupra rezultatului final. Un specialist care se axează numai pe una dintre tehnici evident face un compromis în cazul unora dintre pacienţi. Material şi metodă. Vom prezenta o serie de cazuri pornind de la simplu lâ complex ce au beneficiat de rinoplastie estetică şi funcţională. Vor fi subliniate avantajele şi dezavantajele utilizării tehnicii închise sau deschise. De mare importanţă este natura funcţională a rinoplastiei, fapt ce păzeşte chirurgul de iminenţa complicaţiilor şi malpraxisului. Este controversată abordarea pacienţilor ce pot suferi de tulburări de dismorfism corporal şi care din anamneză se adresează chirurgului estetician pentru diverse proceduri în diferite regiuni anatomice. Rezultate şi concluzii. Recent, comparaţia dintre cele două tehnici a început s'ă dispară, prin formarea unei mase critice de specialişti ce stăpânesc în egală măsură ambele tehnici, fapt ce le permite sa le combine sau chiar să transforme o procedură în alta. însă rămâne ca axiomă că procedura deschisă este utilizată mai ales de tânărul specialist în perioada de acumulare a experienţei şi încrederii necesare abordării tehnicii închise. [ABSTRACT FROM AUTHOR]

introducere. Complicaţia cea mai redutabilă în cadrul evoluţiei postoperatorii a pacientului laringectomizat este reprezentată de dezvoltarea unei fistule faringo-cutanate, evident exceptând scenariul recidivei tumorale. Povara dezvoltării unei astfel de fistule este dublă: a pacientului prin faptul că nu se mai poate alimenta corespunzător şi îi scade calitatea vieţii, dar şi a sistemului medical prin faptul că pacientul nu îşi mai poate continuă programul de tratament oncologic, anulând eforturile deja depuse în vederea vindecării lui şi solicitând resurse materiale suplimentare până la rezoluţia fistulei. Material şi metodă. Am implementat activ utilizarea gastrostomei endoscopice p'ercutanate (PEG) ca modalitate de alimentare postoperatorie a pacienţilor laringectomizaţi în plus faţă de metodele deja utilizate în examenul clinic (sonda nazogastrică şi gastrostoma clasică). Pentru a putea oferi pacienţilor opţiunea utilizării preoperatorii a PEG sunt necesare colaborarea directă cu o secţie de chirurgie generală şi un serviciu de endoscopie digestivă cu personal experimentat şi supraspecializat. Rezultate şi concluzii. Utilizarea PEG a prevenit activ prelungirea duratei de spitalizare a pacienţilor, a prevenit apariţia fistulelor faringo-cutanate prin excluderea sondei nazogastrice cu efect iritativ la nivelul anastomozei faringo-esofagiene. Montarea preoperatorie a PEG s-a dovedit cost-eficientă prin faptul că a prevenit apelarea la resortul chirurgiei generale în vederea efectuării unei gastrostome clasice. Gradul de fistulizare în cadrul sublotului de pacienţi ce a beneficiat de sondă nazogastrică a fost de 19,46%, pe când în cazul sublotului de pacienţi ce a beneficiat de PEG s-a dovedit a fi mult mai mică, de 7,40%. [ABSTRACT FROM AUTHOR]

Introducere. Patologia tumorală nazo-facială necesită utilizarea unor procedee de reconstrucţie ce implică colaborarea unor echipe interdisciplinare ce reunesc specialişti de chirurgie plastică, otorinolaringologie şi chirurgie oro-maxilo-facială. Material si metodă. Vom ilustra prin cazuistica proprie toate procedurife de reconstrucţie pornind de la simplu la complex: de la sutura în „Z" la lamboul migrat bilobat etc. Trebuie respectate unităţile morfo-funcţionale de la nivelul regiunii nazo-faringiene prin prisma densităţii specifice de elemente anatomice. Cazurile cele mai complexe necesită reconstrucţii cu lambouri libere migrate locoregionale, precum şi substrat de rezistenţă prin montarea de materiale protetice. în fiecare caz se vor sublinia avantajele şi dezavantajele diferitelor tehnici de reconstrucţie, cu atât mai mult cu cât nu există o reţetă standard şi rezultatul final este direct dependent de experinţa echipei chirurgicale. Rezultate şi concluzii. Pacientul cu patologie tumorală nazo-facială este, de cele mai multe ori, victima pasării responsabilităţii între diferite specialităţi, când de fapt acestea ar trebui să conlucreze în vederea oferirii unui rezultat rezecţional în primul rând funcţional şi în limita unei calităţi a vieţii corespunzătoare şi a unui aspect estetic necesar integrării sociale complete. [ABSTRACT FROM AUTHOR]

Introducere. Cel mai des folosite modalităţi de reabilitare fonatorie disponibile pentru pacientul român sunt laringofonul si butonul fonator. Deşi au fost dezvoltate instrumente de analiză a calităţii vieţii pre- şi postoperator, în ceea ce priveşte funcţia fonatorie nu există algoritme clare pentru aplicarea uneia dintre cele două metode de reabilitare, fiind de cele mai multe ori o problemă de disponibilitate sau de preferinţă a pacientului. Material şi metodă. Am analizat un grup de 50 de pacienţi care au beneficiat de reabilitare fonatorie post-laringectomie totală prin inserţie de buton fonator de tip Provox Vega. Baza de date a cuprins vârsta, sexul, mediul de provenienţă, statutul social, nivelul educaţional, gradul şi perioada de utilizare a protezei. Toate cazurile au suferit montarea butonului fonator per secundam, şi nu simultam laringectomiei totale. Există pacienţi care nu folosesc maximal proteza vocală sau chiar abandonează' acest dispozitiv uneori în favoarea laringofonului. Am încercat să analizăm care sunt factorii ce duc la acest scenariu. Rezultate şi concluzii. Dintre aceştia, un număr de 6 pacienţi nu au utilizat maximal proteza vocală sau chiar au solicitat extragerea butonului fonator şi ulterior au adoptat folosirea laringofonului. Nici unul nu a fost de sex feminin şi to ţi proveneau din mediu rural. Patru dintre ei aveau studii medii, iar doi nu beneficiau de sprijin familial activ. Propunem un algoritm de selecţie a pacienţilor care ar beneficia maximal din inserţia butonului fonator sau care altfel ar utiliza mai degrabă laringofonul. [ABSTRACT FROM AUTHOR]

Introduction. Rhinoseptoplasty is considered the most challenging operation because many techniques have to be taken into consideration to achieve an optimal aesthetic and functional results. Rhinoseptoplasty techniques have been perfected over time, following two main surgical approaches: structural rhinoplasty (resection/ reconstruction) and conservative (preservation rhinoplasty). Methods. The authors present the risks and complications in a comparative study of 100 cases with patients in primary rhinoseptoplastyplasty performed between 2019-2021: 50 cases in Structural Rhinoplsty and 50 cases in Preservation Rhinoplasty. The study presents two surgical concepts of rhinoplasty regarding the main advantages, disadvantages and indications of each type of rhinoseptoplasty surgery. Results and conclusions. Complications post-rhinoseptoplasty can be considered as perioperative, functional, anatomic (aesthetic) and psyhological. In this study 10 cases (10%) of primary rhinoplasty required revision surgery. The most frequent postoperative deformity is the "pollybeak" when a deep naso-frontal angle, cartilaginous hump and reduced tip projection are present preoperatively. The pollybeak was the indication in 4 cases (40%) of all revision rhinoplasties. Other frequent postoperative deformities are: wide nasal tip, retractions of the columella base and irregularities of the nasal dorsum. These deformities are very often combined and caused by a loss of septal support. Septorhinoplasy is a difficult procedure and the surgeon must have accurate anatomical knowledge and rich clinical experience. The risks for rhinoplasty-complications can be reduced with increasing experience. It is very important to make distinction between complication and mistake. [ABSTRACT FROM AUTHOR]

The nasal pyramid is an essential structure in the physiognomy of the individual, and the external appearance of the nose is very important in the modern society in which we find ourselves. That is why the anatomical diversity of the nasal pyramids has led to the development of various surgical technique for reshaping the nasal structures. Rhinoseptoplsty has changed considerably in recent decades, from a standardized reduction procedure to a procedure focused on very differentiated problems, reductions, relocations and augmentations of frequently combined tissues Most surgeons around the world have agreed on a new concept of surgery, that of preserving different structures of the nose given the fact that the principle of preservation is better than that of resection, with a more natural result. Material and method. Review of the two surgical concept of rhinoplasty regarding the main advantages and disadvantages of each type of rhinoseptoplasty surgery. Results and conclusions. Proper patient selection is important for good results. Before surgery, nasal analysis should perfomed clinically and photographically to determine the necessary corrections. Rhinoplasty is still one of the most challenging procedures in facial plastic surgery. With the right surgical experience and proper surgical techniques the results are most often good and the patients are satisfied. [ABSTRACT FROM AUTHOR]

Cinnamomum verum-functionalized Fe3O4 nanoparticles of 9.4 nm in size were laser transferred by matrix assisted pulsed laser evaporation (MAPLE) technique onto gastrostomy tubes (G-tubes) for antibacterial activity evaluation toward Gram positive and Gram negative microbial colonization. X-ray diffraction analysis of the nanoparticle powder showed a polycrystalline magnetite structure, whereas infrared mapping confirmed the integrity of C. verum (CV) functional groups after the laser transfer. The specific topography of the deposited films involved a uniform thin coating together with several aggregates of bio-functionalized magnetite particles covering the G-tubes. Cytotoxicity assays showed an increase of the G-tube surface biocompatibility after Fe3O4@CV treatment, allowing a normal development of endothelial cells up to five days of incubation. Microbiological assays on nanoparticle-modified G-tube surfaces have proved an improvement of anti-adherent properties, significantly reducing both Gram negative and Gram positive bacteria colonization.