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Introduction. Laryngeal cancer is a malignant degeneration, of epithelial or conjunctive nature, developed from the constitutive elements of the larynx. Larynx cancer represents between 1% and 3% of all malignant tumors and about 50% of the ENT sphere tumors, while squamous cell carcinoma represents around 95% of the malignant laryngeal tumors. The highest incidence is seen in males from southern and central Europe, Romania occupying one of the first places. Materials and method. The study analyses anatomoclinical, histological and immunohistochemical aspects of the treatment and prognosis of laryngeal cancer cases diagnosed in 2009- 2015. Results. The study includes a total of 490 patients diagnosed with cancer of the larynx, with a male/female ratio of 42.7/1. Most cases were from rural areas (67%), with an age predominance of 50-70 years old (72%). TNM staging reveals that 93.5% of patients presented in stages III and IV. Histological types were represented as follows: 35 carcinomas in situ, 19 microinvasive carcinomas, 202 carcinomas poorly differentiated, 144 moderately differentiated carcinomas, 68 well differentiated carcinomas, 8 papillary carcinomas, one leiomyosarcoma, one chondrosarcoma, one Kaposi sarcoma, eight bazaloide carcinomas, two verrucous carcinomas, one malignant melanoma. The type of surgery - diagnostic/ curative/ palliative; radical/partially - is associated with the histological type, grading of tumor differentiation, vascular and/or perineural invasion and, eventually, complementary immunohistochemical examinations. Genotyping with the identification and comparative evaluation of allelic frequency for genes included in the study, and the determination of gene expressions with detection and quantification of transcriptions of interest through Real Time PCR resulted in a quantitative comparative analysis of the expression of genes allegedly involved in laryngeal carcinogenesis with the designation of potential genetic markers that may be the targets of complex protocols for the screening/diagnosis or prognosis of laryngeal cancer. Conclusions. The study highlights the importance of knowing the histological type of laryngeal cancer, for a codification degree of the tumor invasion and the establishment of the appropriate oncologic and surgical treatment. [ABSTRACT FROM AUTHOR]

Epistaxis is a common presenting symptom either emergency condition or ambulatory in Otorhinolaryngology, affecting people of all ages. A multicentric retrospective descriptive study of 380 patients who were hospitalized with epistaxis over a 3.8 year period was carried out. Data collected was analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office/Word 2016. The current study showed that male adults after 60 years old are most affected by nasal bleeding. More than half of hospitalized patients have severe epistaxis at the time of hospitalization. However, further studies are necessary to be done in order to fully elucidate the epidemiology of nosebleeds requiring hospitalization. [ABSTRACT FROM AUTHOR]

Nosebleed or epistaxis is one of the most common forms of presenting an emergency in the ENT field. Since March 11, 2020, the World Health Organisation has proclaimed COVID-19 a global pandemic, and the world has been closed down. The main objective of the study is to analyse and compare the dynamics of epistaxis aetiology among the cases that required hospitalisation in the pre-pandemic period and the period of the COVID 19 pandemic. The study is multicenter retrospective from October 2018 to May 2022, including 380 cases of hospitalised epistaxis, with the mention that March 2020 is considered the beginning of the pandemic period. 60.8% of the patients enrolled in the study in the pre-pandemic period (60.8%) and 39.2% in the pandemic period. Differences between groups were not statistically significant between study entries (pre-pandemic vs. pandemic) and age (p=0.331), gender (p=0.916) or existence of local causes for epistaxis (p=0.895). Patients with general causes for epistaxis were more frequently enrolled in the pandemic period, while patients without general causes for epistaxis were more frequently enrolled in the pre-pandemic period. Patients with a hospitalisation period of more than 5 days were more frequently enrolled in the pre-pandemic period while patients with a hospitalisation period of 3 to 5 days were more frequently enrolled in the pandemic period. Also, patients with idiopathic epistaxis were more frequently enrolled in the pre-pandemic period. Based on the results presented in our study, the period of the Covid 19 pandemic directly influenced both the number of patients and the period of hospitalisation. [ABSTRACT FROM AUTHOR]

Nasal polyposis is a chronic inflammatory condition characterized by hyperplasia of the sinus and/or pituitary mucosa, resulting in the appearance of benign polyposis. The aim of the study is to demonstrate the relation between nasal polyposis and other allergic pathologies of the respiratory system. The purpose of the paper is to highlight the changes in nostrils, paranasal sinuses and the bronchial tree in the context of the simultaneous involvement of the mucosa under the influence of allergic factors. Materials and method. The study analyzed a group of 373 patients admitted to the ENT clinic for a period of 5 years, diagnosed with nasal polyposis. Results. The clinical analysis of the patients diagnosed with nasal polyposis revealed that 28.41% of cases were associated with bronchial asthma, 23.32% with allergic rhinitis, and chronic allergic-infected rhinosinusitis in 26.27% of cases. The cases were analyzed from the anamnestic, rhinoscopic, endoscopic, functional, paraclinical and the allergic point of view. Conclusions. Proper and complete diagnosis leads to a correct surgical and medical treatment in order to improve patients' quality of life. [ABSTRACT FROM AUTHOR]

Endoscopic and imaging analysis of nasal polyposis is part of modern, specific methods of exploration. The objective of the study. To carry out an efficient description of the endoscopic and imaging characteristics in nasal polyposis cases. Purpose of the study. Trying to highlight the importance of complex examination for obtaining the correct diagnosis based on scales using a grading system. Materials and method. We evaluated a group of patients with bilateral nasal polyposis hospitalized in the ENT clinic of the County Emergency Clinical Hospital of Craiova over a period of 5 years, which underwent nasal endoscopy. A part of them also underwent cranial CT scan. Results. Using the Lildholdt grading system and the Lund-Kennedy scale, the nasal polyposis was graded in stages. The preoperative Lund-Kennedy scale had a minimum score of 3 and a maximum of 14, and postoperatively a minimum score of 0 and a maximum of 6. The Lund-Mackay score, analyzing patients with nasal polyposis associated with chronic allergic rhinosinusitis, obtained on the left side a mean score of 8 and on the right side an average score of 7. Conclusions. The analysis of the endoscopic and imaging parameters both preoperatively and postoperatively provided very valuable information for assessing the surgical treatment effects. [ABSTRACT FROM AUTHOR]

Chronic rhinosinusitis with nasal polyps of allergic etiology is one of the most common pathology in the ENT sphere that affect a significant percentage of population. The paper aims to establish the involvement of the allergic component in the genesis of nasal polyposis. The study included 150 nasal polyps from patients hospitalized and operated in the ENT Department of Craiova's Clinical Emergency County Hospital. The biological material was fixed in 10% buffered formalin, processed by classical paraffin embedding technique followed by hematoxylin-eosin staining and it was interpreted in the Pathology Department of the same hospital. We evaluated a number of histopathological parameters that were given severity scores. The most common changes at epithelial level were: basal layer hyperplasia observed in 87 cases (58%), goblet cell hyperplasia in 121 cases (80.66%), basal membrane thickening with values between 10-42µm corresponding to a number of 118 cases (78.66%). The most important stromal changes were edema in 88% and infiltration with eosinophils 100%, indicating the allergic nature of this disease. [ABSTRACT FROM AUTHOR]

Purpose of the paper. To highlight the benefits of endoscopic diagnostic and therapeutic exploration in laryngeal pathology. Objective of the paper. To facilitate clinical diagnosis and endoscopic therapy. Materials and method. A 5-year (2013- 2017) study of patients with dysphonic laryngeal, dyspneic and dysphagic laryngeal pathology with telescope-suspended laryngoscope, a camera connected to the monitor under general anesthesia. Endoscopically, 644 patients, aged between 16 and 81 years old, were treated with 818 diagnostic, therapeutic and exploratory-evolutionary laryngoscopies. Results and discussions. The benign princeps pathology was represented by laryngeal polyps (19.56%), followed by myxomas. Malignant tumors were diagnosed in 28.41% of the study group. The excision of benign tumors or biopsy of presumed malignant tumors was performed under the Kantor Berci II telescopic laryngoscope. The advantage of the optical device connected to the video camera and implicitly to the monitor by augmenting the image was that it elucidated the diagnosis and allowed the optimal functional treatment to be applied. Conclusions. Modern telescopic laryngoscopes producing a well-defined peripheral image and a depth of endoscopic focus, alongside the finest instrumentation, allow for accurate excisions and targeted sampling. [ABSTRACT FROM AUTHOR]

The paper presents a retrospective statistical study on a sample of patients with hypopharyngeal cancer, admitted to the ENT clinic of the County Emergency Hospital of Craiova in the period 2008-2012. Over the few last years, this disease has been the center of attention for the oncologists, having the tendency of an increasing morbidity( 1,2). This type of cancer presents a special risk due to its lymphophilic character and the potential to increase rapidly its size. Few symptoms and the presence of only the cervical adenopathy makes the patients to ask for medical help often only in the advanced stages of the disease. Considering the given advanced staging, the tumor extension and the existence of the adenopathy with rapid metastasis, the prognosis of hypopharynx cancer is poor. Due to the specific gravity of the disease, an extensive statistical study presents interest from the point of view of highlighting the risk factors, the distribution of the disease according to various factors (sex, environment of origin etc.), the applied treatments (surgical and oncology) and their importance, and the correlations between the various parameters involved. [ABSTRACT FROM AUTHOR]

The purpose of the paper work. To highlight the severe suppurative cervicomediastinal complications after perforating the cervical esophagus with a sharp foreign body. Objectives of the paper work. To underline the importance of clinical and imagistic diagnosis and the treatment of the cervical medial topographic region with multidisciplinary surgical team: ENT, thoracic surgeon, general surgeon and AIT physician. Materials and method. A 72-year-old patient swallowed a fish bone while eating, with the immediate appearance of a cervical pain with stinging, dysphagia and sore odynophagia. Results and discussion. The patient was hospitalized in emergency 24 hours after the ingestion of the sharp foreign body, presenting with cervical emphysema and leukocytosis 18.000/mm³. CT showed retroesophageal cervical and postero-superior mediastinal collection. The emergency surgical intervention under general anesthesia, with a mixed surgical team, evacuated the purulent collection by antero-inferior cervicotomy, with a drainage aspiration Redon tube, gastrostomy and massive antibiotic treatment for Klebsiella pneumoniae. Daily antiseptic lavage was performed on the aspiration tube for 4 weeks, which led to the suppression of gastrostomy after 6 weeks. Conclusions. The emergency surgery, performed with a multidisciplinary, competent and professional team, has been associated with massive and targeted antibiotic treatment and cervical dressings, performed under septic conditions, and leading to the heal of the cervical mediastinal suppuration. [ABSTRACT FROM AUTHOR]

The purpose of this paper. The importance of total dysphagia caused by esophageal foreign bodies with an impact upon the esophageal walls. The objectives of this paper. Clinical and imagistic diagnosis in determining the technique that must be used for the extraction of foreign bodies: rigid esophagoscope or external cervicotomy. Materials and method. Patients hospitalized in the ENT Clinic over a period of 5 years (2012-2016) with ingested foreign bodies, dysphagia and esophageal affectation. Results and discussions. After an analysis of the 155 hospitalised patients, it could be noticed that enclavation was conducted on a normal esophagus in 58% of cases and on a pathological esophagus in 42% of cases. The foreign bodies enclaved on the normal esophagus were large-sized food items (meat, cartilages, pointed bones), dentures, usually stagnating, and were prevented from swallowing at the mouth of esophagus. On a stenosed post-caustic esophagus there have been small-sized food items (peas, beans, cherry stones), depending on whether it was a case of simple or multi-levelled stenosis. In children, the ingested foreign bodies were metallic (coins) or plastic (buttons, LEGO toys) stucked in cervical esophagus. It was not difficult to set the diagnosis of esophageal foreign body, as patients or relatives described how the foreign body was ingested. Radiological examination was compulsory in order to emphasise any potential parietal changes with mediastinal disorder of the pointed foreign bodies, and it was conducted urgently, consisting in esophagoscopy (the diagnosis method) and the extraction of the foreign body in a secure, painless manner. Conclusions. The manoeuvres for the natural extraction of the foreign body by means of endoscopic control or external cervicotomy must be conducted as soon as possible after ingestion, with 24-hour hospital observation after the extraction of the foreign body. [ABSTRACT FROM AUTHOR]

The purpose of this paper. The importance of total dysphagia caused by esophageal foreign bodies with an impact upon the esophageal walls. The objectives of this paper. Clinical and imagistic diagnosis in determining the technique that must be used for the extraction of foreign bodies: rigid esophagoscope or external cervicotomy. Materials and method. Patients hospitalized in the ENT Clinic over a period of 5 years (2012-2016) with ingested foreign bodies, dysphagia and esophageal affectation. Results and discussions. After an analysis of the 155 hospitalised patients, it could be noticed that enclavation was conducted on a normal esophagus in 58% of cases and on a pathological esophagus in 42% of cases. The foreign bodies enclaved on the normal esophagus were large-sized food items (meat, cartilages, pointed bones), dentures, usually stagnating, and were prevented from swallowing at the mouth of esophagus. On a stenosed post-caustic esophagus there have been small-sized food items (peas, beans, cherry stones), depending on whether it was a case of simple or multi-levelled stenosis. In children, the ingested foreign bodies were metallic (coins) or plastic (buttons, LEGO toys) stucked in cervical esophagus(2). It was not difficult to set the diagnosis of esophageal foreign body, as patients or relatives described how the foreign body was ingested. Radiological examination was compulsory in order to emphasise any potential parietal changes with mediastinal disorder of the pointed foreign bodies, and it was conducted urgently, consisting in esophagoscopy (the diagnosis method) and the extraction of the foreign body in a secure, painless manner. Conclusions. The manoeuvres for the natural extraction of the foreign body by means of endoscopic control or external cervicotomy must be conducted as soon as possible after ingestion, with 24-hour hospital observation after the extraction of the foreign body. [ABSTRACT FROM AUTHOR]

Objective. Thrombosis and thrombophlebitis of the lateral venous sinus (LST) is one of the complications of otic suppurations in children. The paper traced the defining diagnostic features and also the actual treatment and its controversy. Material and method. The paper aims to present the case of LST secondary to mastoiditis in the ENT Department between 2009 and 2015. Results. A total of 8 cases, out of which 3 were children, had LST secondary to otic suppurations. All patients underwent radical mastoidectomy with exclusion of lateral venous sinus (LS) on 7 patients. After mastoidectomy one child was followed-up for over three years by repeated MRI examinations that asserted the repermeabilization of the LS. Routine ligation of the internal jugular vein (IJV) is recommended when the thrombus exceeds the mastoid area, when the IJV is interested or when sepsis and pulmonary complications persist. There is also controversy regarding anticoagulation treatment. Conclusions. The therapeutic attitude regarding lateral venous sinus is differentiated depending on the extension of the thrombus, the degree of lumenal narrowing and general septic phenomena, radical mastoidectomy accompanied or not by exclusion of lateral sinus or ligation of the internal jugular vein. [ABSTRACT FROM AUTHOR]

Introducere. Simptomatologia clinică în cancerul de amigdală palatină a fost ştearsă şi confundată în primele stadii ale afecţiunii cu o simptomatologie de tip inflamator, motiv pentru care majoritatea pacienţilor s-au prezentat tardiv la medic, în stadiile III şi IV, conform clasificării TNM. Acuzele subiective au fost de tipul disfagiei şi odinofagiei unilaterale, otalgie reflexă, expectoraţii serosanghinolente, scădere ponderală marcată, halenă fetidă şi tulburări fonatorii de tipul stomatolaliei. Material şi metodă. Studiul s-a efectuat pe 132 de cazuri de tumori maligne amigdaliene (98,2% carcinoame scuamoase şi 1,8% limfoame), diagnosticate în clinica ORL prin biopsie excizională la Spitalul Clinic Judeţean de Urgenţă Craiova, între anii 2010 şi 2014. Piesele prelevate au fost supuse prelucrării în tehnici histologice clasice, respectiv imunohistochimice, utilizând ca markeri de proliferare celulară ate PCNA şi p53. Rezultate. Studiul histologic a evidenţiat faptul că numai 10% au fost carcinoame scuamoase bine diferenţiate, 37,27% carcinoame moderat diferenţiate, iar 52,7% slab diferenţiate. Carcinoamele epidermoide bine diferenţiate au apărut ca fiind formate din celule de aspect epitelial, poliedrice, joncţionate între ele prin desmozomi, amintind de celulele epiteliale ale stratului spinos. Celulele neoplazice au prezentat dimensiuni variate, cu nudei mari, cu inversarea raportului nucleu/citoplasmă. Nucleii celulelor carcinomatoase au apărut cel mai adesea hipercromi, cu contur neregulat, cu invaginări, lobulări sau înmuguriri nucleare, cu cromatină dispusă inegal, determinând astfel o coloraţie neomogenă a nucleului. Frecvent s-au înregistrat monstruozităţi nucleare sau celule poliploide. Nucleii au apărut cel mai adesea voluminoşi, multipli, bine evidenţiaţi. Frecvent s-a observat mitoze atipice, asimetrice, bipolare sau chiar'tripolare. Variaţiile celulare şi nucleare au determinat un aspect pleomorf al parenchimului tumoral, celulele superficiale carcinomatoase formând adesea perle cheratozice. Studiul imunohistochimic al factorilor de proliferare celulară PCNA şi p53 a arătat o imunomarcare intensă a celulelor din stratul profund şi absenţa imunomarcajului în perlele cheratozice. Imunocolorarea cu PCNA a marcat neuniform celulele carcinomatoase, inclusiv pe cele cu nudei monstruoşi, dovedind că acestea se găsesc în diverse stadii ale ciclului celular. Concluzii. Carcinoamele epidermoide bine diferenţiate au reprezentat doar 10% din studiul cancerelor de amigdală palatină. Parenchimul tumoral s-a caracterizat prin variat pleomorfism celular şi nuclear. Imunomarcarea PCNA şi p53 a fost intens pozitivă în celulele tumorale, inclusivîn celulele cu nudei monstruoşi, dovedind capacitatea proliferativă mare a celulelor carcinomatoase. [ABSTRACT FROM AUTHOR]

Introducere. Starea precanceroasă laringiană presupune leziuni cu o probabilitate crescută de a dezvolta cancer. în 1923, Jakson a introdus conceptul de leziuni laringiene premaligne, iar Kleinsasser (1963) realizează prima clasificare. Mai sunt cunoscute ca: stări precanceroase, leziuni premaligne, stări de graniţă (frontieră), stări precursoare, iar clinic: laringita cronică, leucoplazia*laringiană, erythroplakia. Material şi metodă. în cadrul lucrării sunt evaluate principalele gene implicate, împreună cu aspectele histologice şi imunohistochimice definitorii. Rezultate şi concluzii. Clasificările actuale presupun împărţirea în 4 grade evolutive (displazie uşoară, moderată, severă şi carcinom in situ). Tranziţia de la epiteliul normal la carcinomul scuamocelular laringian se realizează în cadrul unui multistadial, cu acumularea progresivă de alterări genetice, care implică pierderea funcţiilor supresoare tumorale, activarea oncogenelor şi rearanjarea expresiei moleculelor de adeziune cu modularea producerii de enzime proteolitice. Tratamentul acestor leziuni precanceroase ale laringelui este de principiu chirurgical, prin microchirurgie laringiană, unii autori recomandând şi un tratament medical cu vitamina A şi retinoizi, inhibitori de ciclo-oxigenază 2 sau terapie fotodinamică. Supravegherea în dinamică a procesului patologic în leziuni cu risc de degenerare malignă este obligatorie. [ABSTRACT FROM AUTHOR]

Introducere. Tromboza şi tromboflebita sinusului venos lateral (TSL) reprezintă complicaţiile unui proces supurativ otic sau otomastoidian. Sunt întâlnite în situaţiile de infecţie acută, dar predomină în cazurile de otomastoidită cronică. Incidenţa şi mortalitatea au scăzut drastic în urma apariţiei antibioterapiei. Material şi metodă. Studiul retrospectiv a fost efectuat pe o perioadă de 10*ani (2004-2013) în Clinica ORL Craiova şi a cuprins toţi pacienţii diagnosticaţi cu tromboză sau tromboflebită de sinus venos lateral. Rezultate. Âu fost identificate 10 cazuri cu TSL secundare otomastoiditei cronice şi două secundare otomastoiditei acute. Cele mai frecvente simptome’au fost otoreea şi febra. Evaluarea pacienţilor a presupus efectuarea preoperatorie a tomografiei computerizate pentru confirmarea diagnosticului. Majoritatea pacienţilor au avut complicaţii multiple supurative. La toate cazurile s-a practicat mastoidectomie radicală, cu excluderea sinusului venos interesat şi ligatura jugularei interne. Bacilii gram-negativi au fost cel mai frecvent depistaţi la examenul bacteriologic. Concluzii. Deşi este o complicaţie rară a otomastoiditei, este însoţită frecvent de alte complicaţii intrâcraniene. Tratamentul trombozei de sinus venos lateral este controversat, mastoidectomia radicală cu excluderea sinusului a permis vindecarea tuturor pacienţilor. [ABSTRACT FROM AUTHOR]

Purpose. The verification of the presumption of cervical lymphadenopathy as a metastasis of a nasopharyngeal neoplasm. Objectives. The investigation of macroscopic features of high cervical lymphadenopathy; the detailed, clinical, imaging, histological examination of the ENT trap area (epipharynx). Materials and method. From the Craiova County Emergency Clinical Hospital archive, we present the case of a patient admitted to the ENT clinic for the presence of a giant laterocervical tumor block. Results and discussion. The patient D.G., aged 47 years old, was admitted to the ENT Clinic of Craiova for the presence of a right laterocervical tumor block, evolving for 5 months, associating intense local pain for two weeks. Objective: giant tumor formation, straight laterocervical, round-ovalar, with a diameter of 10/8/7 cm, relatively well delimited, with firm consistency, easily adherent to deep planes, with the presence of a central fluctuating area. Posterior rhinoscopy: infiltrative, asymmetrical deformation of the mucosa of the right lateral wall of the cavity. Cervical ultrasound: giant tumor formation, difficult to measure, with intensely inhomogeneous structure, inside multiple transsonic areas, which seemed well encapsulated, without cleavage space with the jugular vascular bundle. Cervical CT scan: deformation of the right postero-lateral wall of the cavity, by the presence of a tissue tumor formation, iodophilic, with minimal area of necrosis inside. Right jugulocarotid adenopathic block, 8.4 cm in diameter, with necrosis inside and the erasure of the cleavage plane from the large vessels of the neck; lymphadenopathy with a diameter between 1 cm and 1.5 cm, deep and superficial right cervical jugulocarotid, right spinal; lymphadenopathy with a diameter of 1.4 cm right intraparotid. Guided cavity biopsy – extemporaneous exam: microscopic structure of multilayered squamous epithelium, with areas of aggravated dysplasia, in situ carcinoma and areas of microcarcinoma, underlying lymphoid tissue with reactive lymph follicles (lymphoepithelioma?). Surgery: right jugulocarotid lymphadenectomy, right spinal chain and parotid. Evolution: favorable, with healing per primam and the suppression of sutures at 7 days after surgery. HP paraffin exam – adenopathic block: lymph node with undifferentiated carcinoma metastasis. HP paraffin exam – cavum tumor fragment: undifferentiated nasopharyngeal carcinoma, underlying lymphoid tissue with reactive lymphatic follicles. External radiotherapy: external irradiation (particle accelerator – Betatron) on the primary tumor and the cervical region, 70 Gy in fractions of 2 Gy. Surveillance after treatment: locoregional evaluation at 3 months and at 6 months – fibroscopy with no tumors; in-depth annual assessment for 5 years (fibroscopy, cervicothoracic CT scan, liver ultrasound, alkaline phosphatase) – tumor-free. Conclusions. Because cervical lymph node metastases are often the first and for a long time the only early symptom in nasopharyngeal carcinoma, the rigorous endoscopic examination and nasopharyngeal biopsy are imperative in every case of pathological interest of the cervical lymph nodes, even when there are no suspected findings. [ABSTRACT FROM AUTHOR]

Purpose of the paper. To highlight the complication of otic mastoid infection with venous lateral sinus thrombophlebitis, and to present the emergency therapeutic involvement. Objectives of the paper. The correlation of clinical signs, laboratory and imaging paraclinics for the diagnosis of otic mastoiditis and venous lateral sinus thrombophlebitis necessitated emergency medical and surgical treatment for the suppression of the infection. Materials and method. Patients admitted to the ENT clinic during 2009-2015 and diagnosed with thrombophlebitis (nine cases, of which three were children). Results and discussion. Out of the 196 cases of chronic cholesteatoma otic mastoiditis, only nine patients had venous lateral sinus thrombophlebitis (4.5%). Fetid otorrhea, hemicrania and false hyperleukocytosis led to CT scanning to detect the venous lateral thrombophlebitis in eight cases. In one case - a 3-year-old child, feverish, with severegeneral condition, with unaffected eardrums - the MRI exam established the venous lateral thrombosis and mastoid suppuration. The treatment of all patients was represented by antibiotics and corticosteroid therapy, and emergency surgical intervention on the mastoid and sinus outbreaks (thrombus removal, permeabilization, exclusion plugging). All patients evolved favorably. Conclusions. Even though rarely, venous lateral sinus thrombophlebitis from suppurative otic mastoiditis is a serious disease, and the diagnosis and emergency surgical treatment are beneficial to patients in most cases. [ABSTRACT FROM AUTHOR]

Objectives. The paper aims to study the factors influencing diagnostic decision-making in tracheobronchial foreign body suspicion in children, all in order to establish an accurate indication for tracheobronchial exploration. Material and method. The retrospective study was performed on 106 cases with suspected tracheobronchial foreign body (TFB) in children, hospitalized and treated in the ENT department of the County Clinical Emergency Hospital of Craiova within 5 years. Results. Following history, clinical examination, laboratory findings and traheobronhoscopy the diagnosis was confirmed in 72.64% of cases and in 22.92% the diagnosis was denied. The high percentage of denied cases is due, on one hand, to exploring those cases where history is suggestive for the diagnosis (the presence of the aspiration episode), in which case the tracheobronchial exploration is mandatory, and on the other hand, to those cases of pneumonia and bronchopneumonia with prolonged evolution and without positive answer to treatment. Analyzing the age group affected and confirmation of diagnosis for the age group 0-1 years, there were no errors in diagnosis. For the age group 1-3 years, the ratio of 15/49 (30.6%) of denied and confirmed is much lower than for the 4-7 years age group (7/9 - 77.77%). Over the age of 7, the ratio 4/11 of denied and confirmed (36.36%) falls within the general margins. Emphysema was the frequent radiological feature found in children. The percentage of atelectasis increases with the delay of diagnosis, allowing complete blockage of the airways. 20% of X-rays were normal. Conclusions. The high percentage of cases discarded after tracheobronchial exploration is given, on the one hand, to the imperative exploration upon reasonable suspicion of foreign body and, on the other hand, to the confusion generated by pre-existing pulmonary pathology. Greater prevalence of denied cases encountered in the age group 4-7 years, compared to the other age groups, is probably secondary to a greater degree of freedom given to the children and less attentive supervision. [ABSTRACT FROM AUTHOR]

Scopul lucrării. Urmărirea manifestărilor subiective și obiective ale supurațiilor endocraniene secundare otitelor medii. Material și metodă. Sunt analizaţi bolnavii internați în Clinica ORL Craiova pe o perioadă de 10 ani, în 21 de cazuri: complicaţii endocraniene post-otită supurată cronică în 17 cazuri și post-otită medie acută în 4 cazuri. Am întâlnit tromboflebită de sinus sigmoid cu tromboză de venă jugulară în 14 cazuri, abces cerebelos la 1 caz, abces cerebral în 4 cazuri, meningită otogenă în 2 cazuri. Rezultate. Simptomatologia subiectivă și obiectivă a fost dominată de hemicranie, inapetență, febră în dinți de ferăstrău, stare generală alterată, dureri la palparea punctelor mastoidiene, grețuri, vărsături, dezechilibru cu baza largă de susținere, redoare de ceafă, fotofobie. Suspiciunea clinică de complicație endocraniană a fost confirmată de imagistica computer-tomogafică. Asanarea focarului otic după rezolvarea supurației endocraniene a abcesului cerebral sau cerebelos a dus la diminuarea până la dispariție a simptomatologiei. Tromboflebita sinusului venos lateral a beneficiat de excluderea sa concomitent cu ligatura venei jugulare interne. Concluzii. Apariția hemicraniei, a stării generale alterate la un bolnav cu supurație auriculară trebuie să îndrepte atenția către o complicație endocraniană. Persistența durerii de cap, a vărsăturilor implică investigarea CT craniană pentru diagnostic de certitudine. [ABSTRACT FROM AUTHOR]

Scopul lucrării. Prezentarea complicaţiilor endocraniene ale supuraţiilor auriculare din punctul de vedere al atitudinii terapeutice, cu exemplificarea unor cazuri clinice edificatoare. Material şi metodă. Se exemplifică cazurile clinice ale unor bolnavi internaţi în Clinica ORL Craiova care au prezentat complicaţii endocraniene şi exocraniene după supuraţii otice îndelungate, confirmaţi prin examinare computer-tomografică sau rezonanţă magnetică nucleară. Rezultate. Metodele terapeutice au constat în intervenţii chirurgicale de urgenţă de asanare a focarelor mastoidiene şi a complicaţiilor supurative exocraniene şi endocraniene, concomitent cu tratamentul neurochirurgical şi tratamentul antibiotic specific, condus de medicul infecţionist. Evoluţia a fost favorabilă la toate cazurile prezentate, cu vindecarea complicaţiilor prin asanarea focarului supurativ otic. Concluzii. Supuraţia auriculară veche, colesteatomatoasă, este sursă de complicaţii atât endotemporale, exocraniene, cât şi endocraniene. Rezolvarea chirurgicală de urgenţă a complicaţiilor supurative asigură succesul terapeutic. [ABSTRACT FROM AUTHOR]