Carcinoma of unknown primary location are heterogeneous group of metastatic tumours where primary... more Carcinoma of unknown primary location are heterogeneous group of metastatic tumours where primary location could not be discovered with detail anamnesis, clinical examination and diagnostic procedures. Patients with metastasis carcinoma of unknown primary location in clinical oncology are represent with about 4% of total number of patients with solid tumours. The most frequent location carcinoma of unknown primary location, discovered with autopsy, are lungs, pancreas, colon, kidney, prostate and breast. Metastasis in cervical lymph nodes carcinoma of unknown primary location are represent between 3-9% of total number of patients with head and neck carcinoma. Patients with persistent cervical lymph node should be examined through diagnostical plan 'step by step' for identification carcinoma of unknown primary location.
Background/Aim: Numerous histopathological parameters, such as cartilage penetration, perineural ... more Background/Aim: Numerous histopathological parameters, such as cartilage penetration, perineural and lymphovascular invasion, presence of metastatic tissue in regional lymph nodes, extranodal extension of nodal metastases, as well as presence of cancer tissue on resection borders, are all important factors influencing survival in patients with laryngeal squamous cell carcinoma. A retrospective study was conducted in order to determine association between cancer surface area and these histopathological characteristics. Presence of extranodal extension of metastatic tissue in regional lymph nodes was also investigated. Methods: We revised 140 cases of laryngeal squamous cell carcinoma, processed after total laryngectomy, that were found in archives of Histopathology laboratory of Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia. Results: A significant difference in cancer surface area was found depending on penetration of thyroid cartilage, perineura...
Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizi... more Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnostic and treatment options. Case outline. A 66-year-old patient was admitted to the hospital due to recurrent and severe epistaxis. The patient underwent nephrectomy due to renal cell carcinoma, with no signs of relapse during a three-year follow-up. Nasal endoscopy and computed tomography revealed a large mass in nasal cavity, spreading to the anterior and posterior ethmoid cells, sphenoid sinus, orbit, and anterior cranial fossa. Definite diagnosis of renal cell carcinoma metastasis in sinonasal region was made by a pathologist after biopsy and further radiological examination showed no signs of malignant disease in the abdomen, thorax, or pelvis. Although the patient had received 50 Gy ...
Introduction/Objective. Total laryngectomy is a very mutilating operation and it leads to drastic... more Introduction/Objective. Total laryngectomy is a very mutilating operation and it leads to drastic changes in life quality. The purpose of this study was to examine factors of importance to the laryngectomized patients? quality of life and to evaluate characteristics of esophageal voice and speech. Methods. The study was conducted at the Clinic of Otorhinolaryngology and Maxillofacial Surgery, at the Clinical Center of Serbia (Belgrade, Serbia), during the period between March 2012?2015. The study included 223 patients diagnosed with laryngeal cancer, who underwent total laryngectomy. The total of 168 laryngectomized patients were provided with phoniatric rehabilitation. Results. The quality of life was significantly better for those laryngectomized patients who did undergo phoniatric rehabilitation. By means of intensive phoniatric rehabilitation the esophageal voice and speech was established in 86.3% of laryngectomized patients registered by objective acoustic analysis. Rehabilita...
SummaryLaryngeal granulomas present as contact and postintubation ulcers and granulomas. Essentia... more SummaryLaryngeal granulomas present as contact and postintubation ulcers and granulomas. Essentially, a contact granuloma is a pseudotumor of the lateral wall of the posterior glottis. The most common etiological factor is voice abuse, with predisponing factors such as reflux disease. Postintubation ulcers and granulomas, although of different etiology, according to all the other traits belong to this clinical entity. The therapy of choice is conservative treatment. Surgical laser excision is indicated for resistant cases and those whose size is causing respiratory distress. Treatment of laryngeal granulomas with zinc supplementation is reported in the literature as one of the forms of conservative treatment, and we wanted to consider it in this review. Zinc is an essential mineral that plays a vital role in many biochemical reactions and is considered very important for wound healing.
Introduction: In everyday phoniatrician practice there are problems in finding adequate coding in... more Introduction: In everyday phoniatrician practice there are problems in finding adequate coding in current version of International Classification of Diseases. There is grey area for additional explanation under the official diagnosis and its code in Computer program window, but that has bad consequences on efficacy in writing the final medical report. Objective Suggestions for solving this problem that can contribute in next Revision are presented. Method The comparation between diagnoses in 7 years period of Phoniatric Department everyday practice and given diagnoses in current version of International Classification of Diseases. Results Certain percent of diagnoses that are overviewed during last 7 years in our Phoniatric Department has no adequate expression in given diagnoses in Tenth Revision. One can say that there is some kind of communication disorder. Conclusion This is the moment for Communication Disorders Care Center experts to participate in constitution of widespread a...
Background/Aim. Nasal polyps are inflammatory hyper-trophic proliferations of the sinonasal mucos... more Background/Aim. Nasal polyps are inflammatory hyper-trophic proliferations of the sinonasal mucosa composed of both epithelial and stromal elements. The aim of this study was to determine histopathological hallmarks of nasal polyposis via semiquantitative morphometric study. Methods. The study comprised 77 patients with chronic rhinosinusitis and nasal polyposis (CRSwNP) that underwent functional endoscopic sinonasal surgery performed by the same surgeon. The control group consisted of 9 different nasal mucosal samples that were taken from patients without CRSwNP that underwent functional and esthetic surgery. Morphometric analysis included gradation of tissue edema within polyps, thickening of epithelial basal membrane, degree of inflammation, presence/absence of metaplasia with-in epithelium, degree of fibrosis within polyps, and percentage of inflammatory cells within inflammatory infiltrate (lymphocytes, macrophages, plasma cells, neutrophils and eosinophils). Results. As expect...
Introduction. Primary sarcomas are uncommonly seen in larynx and comprise around 1% of all laryng... more Introduction. Primary sarcomas are uncommonly seen in larynx and comprise around 1% of all laryngeal malignant tumors. We present three cases of patients with different types of laryngeal sarcomas and discuss about diagnostic and treatment difficulties. Case outline. Each patient presented with hoarseness and shortness of breath. Computed tomography scans showed large transglottic tumors of the larynx with no signs of cervical lymphadenopathy and definitive diagnoses of sarcomas were made by pathologists. Each patient underwent total laryngectomy with clear resection margins. Patient with laryngeal leiomyosarcoma developed large locoregional relapse of malignant disease and pulmonary metastasis four months after surgery and patient with laryngeal osteosarcoma was diagnosed with inoperative locoregional relapse of malignant disease three months after surgery. Both patients died within six months after surgery. On the other hand, patient with laryngeal chondrosarcoma was disease-free ...
Objectives: The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical... more Objectives: The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical treatment of headache caused by contact points (CPs) between the nasal septum and inferior or middle turbinate. Methods: The research was designed as a prospective clinical case-series study. The patients with CP headaches were offered to choose between 2 treatment options, surgery and medical treatment. Two groups of surgically treated patients (surgery groups 1 and 2, depending on whether there is a contact between nasal septum and inferior turbinate or middle turbinate) were evaluated and compared for headache intensity and frequency. Headache intensity was measured using a visual analog scale value from 0 to 10; the frequency of headache was expressed as the number of days during 1 month with a headache (before surgery, 1 month, and 6 months after surgery). A comparison was also made between surgically and nonsurgically treated patients. Results: We found more intensive and frequent...
Introduction/Objective. New World Health Organization Classification of Head and Neck Tumors from... more Introduction/Objective. New World Health Organization Classification of Head and Neck Tumors from 2017 has introduced significant changes, mainly considering tumors in the oropharyngeal region. New entities of HPV-positive and -negative squamous cell carcinomas have been acknowledged, not only based on the presence of an active viral infection and different tumor markers expression, but also because of their different histopathology, staging assessment, and prognosis. A retrospective study has been conducted, in order to determine p16 positivity in squamous cell carcinomas in oropharynx and in the oral cavity, and to see whether they differ in sex and age distribution. Methods. The presence of viral infection was verified based on p16 immunochemistry staining, p16 being the surrogate marker for HPV infection. A total of 177 cases of squamous cell carcinomas in the oropharynx and the oral cavity, found in the archives of the Histopathology Laboratory of the Clinic for Otorhinolaryngo...
Background/Aim. Laryngeal carcinomas make 1%?3% of all head and neck malignancies.Treatment outco... more Background/Aim. Laryngeal carcinomas make 1%?3% of all head and neck malignancies.Treatment outcome and survival rates depend greatly on established stage of the disease. The purpose of this study was to examine the survival of the patients with advanced laryngeal carcinoma depending on gender, age, common risk factors (tobacco and alcohol use), primary tumor localization, histopathological tumor grade, clinical TNM (tumor, node and metastasis) stage and surgical treatment of the disease. Methods. Retrospective study included 252 patients treated surgically for advanced squamocellular carcinoma of the larynx in a threeyear period with five-year follow-up. Patients included in the study were treated primary with surgery, with postoperative radiotherapy and chemotherapy depending on the stage of the disease, intraoperative findings and tumor resection borders. Overall survival and disease-specific five-year survival of patients was calculated for demographical and clinical characteris...
We provided preliminary psychometric data for the European Organization for Research and Treatmen... more We provided preliminary psychometric data for the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Head and Neck Module, updated version (QLQ-H&N43) from a group of Serbian laryngectomized patients. The study included 170 subjects. The QLQ-H&N43 is a 43-item questionnaire, with 12 multi-item scales and 7 single-item symptom scales. All subjects also completed the Quality of Life Questionnaire-Core 30-questions (QLQ-C30). Good internal consistency (Cronbach's α of above 0.7) was found for 5 of the 7 scales. All QLQ-H&N43 scales correlated negatively as predicted with all QLQ-C30 functioning scales. The correlations with the QLQ-C30 symptoms supported discriminant validity, with only one exception: the head and neck social eating scale overlapped with the QLQ-C30 pain scale. For 14 of 19 QLQ-H&N43 scale scores, significant known-group differences were observed between those who differ in type of laryngectomy, adjuvant therapy, or 5-y...
Early stage glottic cancer can be successfully treated with open surgery, LASER surgery or radiot... more Early stage glottic cancer can be successfully treated with open surgery, LASER surgery or radiotherapy. During this treatment the physician obviously has to bear in mind principles of oncological radicality, but also, none the less, the preservation of all the functions of the larynx, and especially the preservation of voice quality. The aim of the study is to compare, in a specifically designed prospective study, the method of treatment with the functional results of basic characteristics of spoken voice of patients with early stage cancer of the glottis region. Then, based on the analysis of the results, to try and determine the most successful method of treatment. The first study group consisted of 72 patients operated using transoral laser microsurgery; the second study group consisted of 75 patients operated using open surgery; and the third study group consisted of 74 patients treated with radiotherapy. The voice quality is much better after laser chordectomy compared to open...
Objective In emergency airway management, the occurrence of surgical tracheotomy complications is... more Objective In emergency airway management, the occurrence of surgical tracheotomy complications is increased and may be fatal for the patient. However, the factors that play a role in complication occurrence and lead to lethal outcome are not known. The objective of this study was to determine predictors associated with the occurrence of complications and mortality after emergency surgical tracheostomy. Study Design Retrospective study with a systematic review of the literature. Setting Tertiary medical academic center. Subjects and Methods We included 402 adult patients who underwent emergency surgical tracheostomy under local anesthesia due to upper airway obstruction. Demographic, clinical, complication occurrence, and mortality data were collected. For statistical analysis, univariable and multivariable logistic regression methods were used. Results In multivariable analysis, significant positive predictors of complication occurrence were previously performed tracheotomy (odds ra...
The purpose of the present study is to report our experience in the diagnosis and treatment of ma... more The purpose of the present study is to report our experience in the diagnosis and treatment of mastoiditis in adults. Five patients with an active chronic otitis and mastoiditis were presented. All of them had a history of chronic ear discharge for long period of time and have been diagnozed and treated sufficiently. All relevant data were analyzed from the medical records. The most common symptoms of the disease were otalgia, otorrhea and hearing loss, but the physical signs of mastoiditis (swelling, erithema and tenderness of the retroauricular region) were presented in all cases. Localization and enlargement of the pathological process within the middle ear spaces was determined by CT. All patients were treated surgically and with intravenous antibiotics. In one patient the other treatment was applied due to a specific (TBC) process in the ear. Early diagnosis and adequate treatment (surgery combined with an effective antibiotics therapy) is most important to prevent a serious complications of mastoiditis (extracranial and/or intracranial).
Carcinoma of unknown primary location are heterogeneous group of metastatic tumours where primary... more Carcinoma of unknown primary location are heterogeneous group of metastatic tumours where primary location could not be discovered with detail anamnesis, clinical examination and diagnostic procedures. Patients with metastasis carcinoma of unknown primary location in clinical oncology are represent with about 4% of total number of patients with solid tumours. The most frequent location carcinoma of unknown primary location, discovered with autopsy, are lungs, pancreas, colon, kidney, prostate and breast. Metastasis in cervical lymph nodes carcinoma of unknown primary location are represent between 3-9% of total number of patients with head and neck carcinoma. Patients with persistent cervical lymph node should be examined through diagnostical plan 'step by step' for identification carcinoma of unknown primary location.
Background/Aim: Numerous histopathological parameters, such as cartilage penetration, perineural ... more Background/Aim: Numerous histopathological parameters, such as cartilage penetration, perineural and lymphovascular invasion, presence of metastatic tissue in regional lymph nodes, extranodal extension of nodal metastases, as well as presence of cancer tissue on resection borders, are all important factors influencing survival in patients with laryngeal squamous cell carcinoma. A retrospective study was conducted in order to determine association between cancer surface area and these histopathological characteristics. Presence of extranodal extension of metastatic tissue in regional lymph nodes was also investigated. Methods: We revised 140 cases of laryngeal squamous cell carcinoma, processed after total laryngectomy, that were found in archives of Histopathology laboratory of Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia. Results: A significant difference in cancer surface area was found depending on penetration of thyroid cartilage, perineura...
Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizi... more Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnostic and treatment options. Case outline. A 66-year-old patient was admitted to the hospital due to recurrent and severe epistaxis. The patient underwent nephrectomy due to renal cell carcinoma, with no signs of relapse during a three-year follow-up. Nasal endoscopy and computed tomography revealed a large mass in nasal cavity, spreading to the anterior and posterior ethmoid cells, sphenoid sinus, orbit, and anterior cranial fossa. Definite diagnosis of renal cell carcinoma metastasis in sinonasal region was made by a pathologist after biopsy and further radiological examination showed no signs of malignant disease in the abdomen, thorax, or pelvis. Although the patient had received 50 Gy ...
Introduction/Objective. Total laryngectomy is a very mutilating operation and it leads to drastic... more Introduction/Objective. Total laryngectomy is a very mutilating operation and it leads to drastic changes in life quality. The purpose of this study was to examine factors of importance to the laryngectomized patients? quality of life and to evaluate characteristics of esophageal voice and speech. Methods. The study was conducted at the Clinic of Otorhinolaryngology and Maxillofacial Surgery, at the Clinical Center of Serbia (Belgrade, Serbia), during the period between March 2012?2015. The study included 223 patients diagnosed with laryngeal cancer, who underwent total laryngectomy. The total of 168 laryngectomized patients were provided with phoniatric rehabilitation. Results. The quality of life was significantly better for those laryngectomized patients who did undergo phoniatric rehabilitation. By means of intensive phoniatric rehabilitation the esophageal voice and speech was established in 86.3% of laryngectomized patients registered by objective acoustic analysis. Rehabilita...
SummaryLaryngeal granulomas present as contact and postintubation ulcers and granulomas. Essentia... more SummaryLaryngeal granulomas present as contact and postintubation ulcers and granulomas. Essentially, a contact granuloma is a pseudotumor of the lateral wall of the posterior glottis. The most common etiological factor is voice abuse, with predisponing factors such as reflux disease. Postintubation ulcers and granulomas, although of different etiology, according to all the other traits belong to this clinical entity. The therapy of choice is conservative treatment. Surgical laser excision is indicated for resistant cases and those whose size is causing respiratory distress. Treatment of laryngeal granulomas with zinc supplementation is reported in the literature as one of the forms of conservative treatment, and we wanted to consider it in this review. Zinc is an essential mineral that plays a vital role in many biochemical reactions and is considered very important for wound healing.
Introduction: In everyday phoniatrician practice there are problems in finding adequate coding in... more Introduction: In everyday phoniatrician practice there are problems in finding adequate coding in current version of International Classification of Diseases. There is grey area for additional explanation under the official diagnosis and its code in Computer program window, but that has bad consequences on efficacy in writing the final medical report. Objective Suggestions for solving this problem that can contribute in next Revision are presented. Method The comparation between diagnoses in 7 years period of Phoniatric Department everyday practice and given diagnoses in current version of International Classification of Diseases. Results Certain percent of diagnoses that are overviewed during last 7 years in our Phoniatric Department has no adequate expression in given diagnoses in Tenth Revision. One can say that there is some kind of communication disorder. Conclusion This is the moment for Communication Disorders Care Center experts to participate in constitution of widespread a...
Background/Aim. Nasal polyps are inflammatory hyper-trophic proliferations of the sinonasal mucos... more Background/Aim. Nasal polyps are inflammatory hyper-trophic proliferations of the sinonasal mucosa composed of both epithelial and stromal elements. The aim of this study was to determine histopathological hallmarks of nasal polyposis via semiquantitative morphometric study. Methods. The study comprised 77 patients with chronic rhinosinusitis and nasal polyposis (CRSwNP) that underwent functional endoscopic sinonasal surgery performed by the same surgeon. The control group consisted of 9 different nasal mucosal samples that were taken from patients without CRSwNP that underwent functional and esthetic surgery. Morphometric analysis included gradation of tissue edema within polyps, thickening of epithelial basal membrane, degree of inflammation, presence/absence of metaplasia with-in epithelium, degree of fibrosis within polyps, and percentage of inflammatory cells within inflammatory infiltrate (lymphocytes, macrophages, plasma cells, neutrophils and eosinophils). Results. As expect...
Introduction. Primary sarcomas are uncommonly seen in larynx and comprise around 1% of all laryng... more Introduction. Primary sarcomas are uncommonly seen in larynx and comprise around 1% of all laryngeal malignant tumors. We present three cases of patients with different types of laryngeal sarcomas and discuss about diagnostic and treatment difficulties. Case outline. Each patient presented with hoarseness and shortness of breath. Computed tomography scans showed large transglottic tumors of the larynx with no signs of cervical lymphadenopathy and definitive diagnoses of sarcomas were made by pathologists. Each patient underwent total laryngectomy with clear resection margins. Patient with laryngeal leiomyosarcoma developed large locoregional relapse of malignant disease and pulmonary metastasis four months after surgery and patient with laryngeal osteosarcoma was diagnosed with inoperative locoregional relapse of malignant disease three months after surgery. Both patients died within six months after surgery. On the other hand, patient with laryngeal chondrosarcoma was disease-free ...
Objectives: The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical... more Objectives: The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical treatment of headache caused by contact points (CPs) between the nasal septum and inferior or middle turbinate. Methods: The research was designed as a prospective clinical case-series study. The patients with CP headaches were offered to choose between 2 treatment options, surgery and medical treatment. Two groups of surgically treated patients (surgery groups 1 and 2, depending on whether there is a contact between nasal septum and inferior turbinate or middle turbinate) were evaluated and compared for headache intensity and frequency. Headache intensity was measured using a visual analog scale value from 0 to 10; the frequency of headache was expressed as the number of days during 1 month with a headache (before surgery, 1 month, and 6 months after surgery). A comparison was also made between surgically and nonsurgically treated patients. Results: We found more intensive and frequent...
Introduction/Objective. New World Health Organization Classification of Head and Neck Tumors from... more Introduction/Objective. New World Health Organization Classification of Head and Neck Tumors from 2017 has introduced significant changes, mainly considering tumors in the oropharyngeal region. New entities of HPV-positive and -negative squamous cell carcinomas have been acknowledged, not only based on the presence of an active viral infection and different tumor markers expression, but also because of their different histopathology, staging assessment, and prognosis. A retrospective study has been conducted, in order to determine p16 positivity in squamous cell carcinomas in oropharynx and in the oral cavity, and to see whether they differ in sex and age distribution. Methods. The presence of viral infection was verified based on p16 immunochemistry staining, p16 being the surrogate marker for HPV infection. A total of 177 cases of squamous cell carcinomas in the oropharynx and the oral cavity, found in the archives of the Histopathology Laboratory of the Clinic for Otorhinolaryngo...
Background/Aim. Laryngeal carcinomas make 1%?3% of all head and neck malignancies.Treatment outco... more Background/Aim. Laryngeal carcinomas make 1%?3% of all head and neck malignancies.Treatment outcome and survival rates depend greatly on established stage of the disease. The purpose of this study was to examine the survival of the patients with advanced laryngeal carcinoma depending on gender, age, common risk factors (tobacco and alcohol use), primary tumor localization, histopathological tumor grade, clinical TNM (tumor, node and metastasis) stage and surgical treatment of the disease. Methods. Retrospective study included 252 patients treated surgically for advanced squamocellular carcinoma of the larynx in a threeyear period with five-year follow-up. Patients included in the study were treated primary with surgery, with postoperative radiotherapy and chemotherapy depending on the stage of the disease, intraoperative findings and tumor resection borders. Overall survival and disease-specific five-year survival of patients was calculated for demographical and clinical characteris...
We provided preliminary psychometric data for the European Organization for Research and Treatmen... more We provided preliminary psychometric data for the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Head and Neck Module, updated version (QLQ-H&N43) from a group of Serbian laryngectomized patients. The study included 170 subjects. The QLQ-H&N43 is a 43-item questionnaire, with 12 multi-item scales and 7 single-item symptom scales. All subjects also completed the Quality of Life Questionnaire-Core 30-questions (QLQ-C30). Good internal consistency (Cronbach's α of above 0.7) was found for 5 of the 7 scales. All QLQ-H&N43 scales correlated negatively as predicted with all QLQ-C30 functioning scales. The correlations with the QLQ-C30 symptoms supported discriminant validity, with only one exception: the head and neck social eating scale overlapped with the QLQ-C30 pain scale. For 14 of 19 QLQ-H&N43 scale scores, significant known-group differences were observed between those who differ in type of laryngectomy, adjuvant therapy, or 5-y...
Early stage glottic cancer can be successfully treated with open surgery, LASER surgery or radiot... more Early stage glottic cancer can be successfully treated with open surgery, LASER surgery or radiotherapy. During this treatment the physician obviously has to bear in mind principles of oncological radicality, but also, none the less, the preservation of all the functions of the larynx, and especially the preservation of voice quality. The aim of the study is to compare, in a specifically designed prospective study, the method of treatment with the functional results of basic characteristics of spoken voice of patients with early stage cancer of the glottis region. Then, based on the analysis of the results, to try and determine the most successful method of treatment. The first study group consisted of 72 patients operated using transoral laser microsurgery; the second study group consisted of 75 patients operated using open surgery; and the third study group consisted of 74 patients treated with radiotherapy. The voice quality is much better after laser chordectomy compared to open...
Objective In emergency airway management, the occurrence of surgical tracheotomy complications is... more Objective In emergency airway management, the occurrence of surgical tracheotomy complications is increased and may be fatal for the patient. However, the factors that play a role in complication occurrence and lead to lethal outcome are not known. The objective of this study was to determine predictors associated with the occurrence of complications and mortality after emergency surgical tracheostomy. Study Design Retrospective study with a systematic review of the literature. Setting Tertiary medical academic center. Subjects and Methods We included 402 adult patients who underwent emergency surgical tracheostomy under local anesthesia due to upper airway obstruction. Demographic, clinical, complication occurrence, and mortality data were collected. For statistical analysis, univariable and multivariable logistic regression methods were used. Results In multivariable analysis, significant positive predictors of complication occurrence were previously performed tracheotomy (odds ra...
The purpose of the present study is to report our experience in the diagnosis and treatment of ma... more The purpose of the present study is to report our experience in the diagnosis and treatment of mastoiditis in adults. Five patients with an active chronic otitis and mastoiditis were presented. All of them had a history of chronic ear discharge for long period of time and have been diagnozed and treated sufficiently. All relevant data were analyzed from the medical records. The most common symptoms of the disease were otalgia, otorrhea and hearing loss, but the physical signs of mastoiditis (swelling, erithema and tenderness of the retroauricular region) were presented in all cases. Localization and enlargement of the pathological process within the middle ear spaces was determined by CT. All patients were treated surgically and with intravenous antibiotics. In one patient the other treatment was applied due to a specific (TBC) process in the ear. Early diagnosis and adequate treatment (surgery combined with an effective antibiotics therapy) is most important to prevent a serious complications of mastoiditis (extracranial and/or intracranial).
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