Intranasal adhesions (synechiae) develop as a result of improper healing of the nasal mucosa. Their incidence ranges from 6.8% to 36% of rhinosurgical procedures. The aim of this study was to review the available publications and monographs dealing with intranasal adhesions—both in the context of formation and risk factors. The study used a review of the literature to determine the articles and studies available in the following medical databases: MEDLINE (National Library of Medicine’s), PubMed, and Google Scholar. The following search terms were used: synechiae nasal + synechial nasal + intranasal adhesions + nasal adhesions. The time criterion of available materials was not applied. Available filters in the search engines were used to narrow down the search results. Artificial intelligence was not applied. The review indicated that the risk of intranasal adhesions correlates with the type of surgery, the surgical technique, the dressing materials, and wound care in the postoperative period. Every case requires an individualized approach. Nasal septum separators, (self-)dissolving dressings and (in selected cases) Mitomycin C were investigated thoroughly. Further studies are required which may result in a universal classification system for intranasal adhesions.

Introduction: Intranasal adhesions (synechiae) are common complications of nasal surgery. This study aimed to analyze the factors influencing the development of synechiae, with particular emphasis on the use of nasal septal splints. We also propose a solution to reduce the incidence of this complication in the future. Methodology: This retrospective analysis of patients ( n = 243) who underwent septoplasty and septoconchoplasty between 2017 and 2022. Results: Iatrogenic intranasal synechiae occurred in 26.75% (65/243) of patients. Among patients who received nasal septal splints, synechiae occurred in 13.1%. Synechiae complicated 46.9% of the surgeries in the group without separators ( P < 0.001). There was no statistically significant relationship between increased risk of synechiae and concomitant conchoplasty (26% vs. 27.7%, P = 0.817). Patients with seton gauze dressings experienced synechiae significantly more often than those with nasal tampons or other gauze dressings ( P < 0.001). Conclusions: The use of nasal septal separators and tampons significantly reduces the risk of iatrogenic intranasal synechiae following septoplasty or septoconchoplasty, regardless of the degree of nasal septum deviation. Conversely, the use of seton gauze dressings is associated with a higher risk of developing synechiae.

Aim: The aim of this paper was to summarise the most common symptoms of head and neck malignancies, including their pathophysiology, based on current knowledge. Materials and methods: We analysed public databases (PubMed, Google Scholar) for the latest papers, mostly published between 2003 and 2023. These included reviews, systematic reviews, randomised controlled trials, and meta-analyses. Lack of access to full article and languages other than English or Polish were exclusion criteria. We did not use artificial intelligence. Results: The main symptoms of head and neck malignancies included difficult-to-heal wounds or ulcerations, lip pain, oral and pharyngeal pain, dysphagia, odynophagia, hoarseness, head or neck mass, otological problems, weight loss, asymmetrical obstruction of the nasal cavity, unilateral nasal bleeding, and paralysis or paresis of the facial nerve. While these symptoms are often attributed to non-malignant diseases, healthcare professionals should prioritise oncological considerations and interpret patient cases from a holistic perspective. Conclusions: Head and neck malignancies are often diagnosed already at advanced clinical stages. Patients presenting with the above-mentioned symptoms typically seek general practice or outpatient otorhinolaryngological consultation. It is crucial to acknowledge that these symptoms could be early signs of malignant diseases.

Introduction: The term “myiasis” refers to a group of parasitic diseases caused by fly larvae (maggots). Case report: The article presents a case study of a patient with myiasis within the metastatic cervical lymph nodes presenting with multiple necrotic foci in the course of squamous cell carcinoma of the palatine tonsil after chemotherapy. The patient was subjected to conservative treatment to achieve the maximum possible improvement. Due to the uncontrolled cancer, he was transferred to a stationary hospice. A review of the available literature on etiology, diagnosis, and treatment of myiasis is also presented. Conclusions: Myiases are a group of parasitic diseases developing, among others, in advanced cancer patients. The treatment should include mechanical removal of the larvae, disinfectants, and wound toilet

Wstęp: Zrosty wewnątrznosowe (synechie) należą do najczęstszych powikłań po septoplastyce i septokonchoplastyce; mimo, iż nie są uznawane za powikłania o ciężkim charakterze, mogą prowadzić do pogorszenia drożności nosa, zmniejszenia satysfakcji pacjenta oraz utrzymywania się niedrożności nosa wygadającej dodatkowego leczenia. Cel: Przegląd aktualnego piśmiennictwa dotyczącego częstości występowania, czynników ryzyka, profilaktyki oraz leczenia zrostów po septoplastyce i septokonchoplastyce. Materiały i metody: Narracyjny przegląd piśmiennictwa z wykorzystaniem bazy PubMed. Zidentyfikowano dziewięć badań bezpośrednio dotyczących zrostów pooperacyjnych po septoplastyce lub septokonchoplastyce. Po przeprowadzeniu ręcznej analizy piśmiennictwa cytowanego w zakwalifikowanych pracach oraz włączeniu istotnych publikacji uzupełniających ostatecznie analizie poddano 21 artykułów. Uwzględniono prace oryginalne, badania porównawcze, badania randomizowane, kohortowe oraz istotne prace przeglądowe opublikowane w j. angielskim. Wyniki: raportowana częstość występowania zrostów wynosiła od 3,1% do 26,75%. Wartości wyższe, 36,2%, były opisywane zwłaszcza w kontekście chirurgii małżowin nosowych. Do głównych czynników związanych z powstawaniem zrostów należały: uszkodzenie błony śluzowej, kontakt przeciwległych powierzchni pozbawionych nabłonka, oraz sposób postępowania pooperacyjnego. Dane dotyczące rutynowego stosowania separatorów wewnątrznosowych pozostają niejednoznaczne, jednak w kilku badaniach wykazano zmniejszenie częstości występowania zrostów, szczególnie u pacjentów z grup podwyższonego ryzyka. Alternatywą dla tamponady nosa może być szew przezprzegrodowy; należy wskazać iż zastosowanie gazy setonowej zwiększa ryzyko zrostów.Techniki endoskopowe mogą ograniczać uszkodzenia błony śluzowej, a w rezultacie obniżyć ryzyko komplikacji. Zastosowanie mitomycyny C, może być opcją do rozważenia w niektórych przypadkach. Wnioski: Zrosty pozostają istotnym powikłaniem septo- bądź septokonchoplastyki. Podstawowe znaczenie w profilaktyce ich wystąpienia mają zabezpieczenie integralności błony śluzowej, minimalizowanie uszkodzeń nabłonka i odpowiednia pielęgnacja ran w okresie pooperacyjnym.

Introduction: The COVID-19 pandemic, which lasted from 2019 to 2023, caused a significant stagnation in the healthcare system, not only in our country but also worldwide. Data from the National Cancer Registry for 2020 confirms a decrease of approximately 15% for men and 14% for women in diagnosed cancers compared to 2019.Aim: The aim of this study was to examine the baseline clinical stage of laryngeal cancer (using the TNM scale) of the larynx in the population of patients diagnosed at the Multispecialty Regional Hospital in Gorzow Wielkopolski between 2017 and 2024.Materials and methods: The author conducted a retrospective analysis of the initial clinical stage according to the TNM scale in patients over 18 years of age diagnosed with laryngeal cancer. The division into groups, the study group (n = 65) and the control group (n = 76), was based on the date of histopathological diagnosis (31.01.2020). The analysis also included the necessity of performing a tracheostomy, the size of the primary lesion, and metastatic changes.Results: Squamous cell carcinomas were most frequently diagnosed in the middle part of the larynx (61.84% of the control population and 70.77% of the study population) on the right side (61.84% of the control population and 61.54% of the study cohort). The percentage of patients requiring tracheostomy increased by approximately 3%. There was also an increase in the percentage of patients with T4a (+11.15%) and N2c (+6.39%) features. An increase in the number of patients in stage IVa (+19.74%) was noted. Despite the observed differences between the populations, they were not statistically significant.Discussion: There was an increase in the number of tracheostomies performed due to sudden dyspnea, including those performed under local anesthesia. Data confirms an increase in the size of the diagnosed tumor and metastatic changes.Conclusions: After the outbreak of the SARS-CoV-2 pandemic, an increased percentage of patients requiring tracheostomy due to sudden dyspnea was noted. The size (in terms of dimension and extent of infiltration) of tumors in the primary location and metastases in the cervical lymphatic system also increased. A decrease in the number of patients with distant metastatic changes was observed. The observed differences were not statistically significant. It is necessary to conduct studies on a larger population.