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4 European Journal of Clinical and Experimental Medicine

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Labial salivary gland biopsy in the diagnosis of Sjögren’s syndrome

100%

Katarzyna Błochowiak K. , Jerzy Sokalski J.

European Journal of Clinical and Experimental Medicine

2019

nr 2

162-168

Introduction. Labial salivary gland biopsy is used for diagnosis of Sjögren’s syndrome (SS) and lymphoma accompanying SS. Aim. The aim of this study was to present the main techniques used for taking labial salivary gland biopsies in the diagnosis of SS with respect to their advantages, histologic criteria, validation, complications, and their usefulness for diagnostic procedures, monitoring disease progression, and treatment evaluation. Material and methods. This study is based on analysis of literature. Results. The microscopic confirmation of SS is based on the presence of focal lymphocytic sialadenitis (FLS) with a focus score ≥1 per 4 mm2 of glandular tissue. A lymphocytic focus is defined as a dense aggregate of 50 or more lymphocytes adjacent to normal-appearing mucous acini in salivary gland lobules that lacked ductal dilatation. Other histopathological features of SS are lymphoepithelial lesions and a relative decrease of <70% IgA + plasma cells. Labial salivary gland biopsy is characterized by high specificity, a positive predictive value, and an average sensitivity of 79% in SS. Conclusion. It can be also valuable in diagnosing B-cell mucosa-associated lymphoid tissue (MALT) lymphomas but it is not recommended for the monitoring of SS progression and the effectiveness of the treatment. Persistent lower lip hypoesthesia is the most severe complication of labial salivary gland biopsy.

Ramsay Hunt syndrome with deep hearing loss and meningitis

100%

Katarzyna Błochowiak K. , Bartłomiej Kamiński B.

nr 1

60-62

Introduction. Ramsay Hunt syndrome is a clinical manifestation of varicella zoster virus reactivation. It is characterized by an erythematous vesicular rash in the external auditory canal and pinna with otalgia, vertigo and ipsilesional facial palsy. Symptoms develop over a few days with prodromal signs of facial weakness, tingling, facial numbness. Usually, cranial nerves VII and VIII are involved in the inflammatory process. Possible consequences of Ramsay Hunt syndrome are hearing loss, encephalitis and meningitis. Description of the case report. The authors present the case of a 63-year-old woman with a vesicular rash, earache, vertigo and left-sided facial paralysis who was treated with antiviral drugs and analgesics. These symptoms were complicated by conductive hearing loss in the left ear and meningitis. After treatment facial paralysis decreased. Unfortunately, hearing loss was permanent. Discussion. Rapid administration of antivirals and corticosteroids limited facial paralysis and improved facial expression. The prognosis for facial palsy is poorer in Ramsay Hunt syndrome than in idiopathic forms. Conclusions. A past history of vertigo and hypertension could been a predisposing factor for the severe manifestation of Ramsay Hunt syndrome and subsequent complications

Current recommendations for treatment and diagnosing of xerostomia in Sjögren’s syndrome

80%

Oleh Zablotskyy O. , Martyna Tomczyk M. , Katarzyna Błochowiak K.

nr 4

356-363

Introduction. Xerostomia is one of the most common and disturbing adverse effects of systemic diseases and their therapies. This complication markedly increases the risk for dental caries, difficulties with chewing, swallowing and sleep disorders with a significant impact on the patient’s quality of life. Sjögren’s syndrome (SS) is a systemic autoimmune disease that primarily affects the exocrine glands, resulting in dryness of the mouth due to lymphocytic infiltration of the salivary glands. Aim. The aim of this paper is to present the current recommendations in diagnosing and treating SS-related xerostomia. Material and methods. Analysis of literature Results. For the assessment of SS-related xerostomia, only an unstimulated salivary flow with rates of 0.1 mL/min is included in the current SS classification criteria. Saxon test, sialography, ultrasonography of salivary glands play supporting function. Treatment of SS -related xerostomia includes an application of secretagogues and the implementation of specific dental prophylaxis measures. Adjuvant therapies include herbal remedies, photobiomodulation, and acupuncture. Conclusion. Treatment of SS requires multidisciplinary care. There is no fully effective treatment of xerostomia that provides immediate and long-lasting results.

Extraction of asymptomatic impacted third molars – a review

61%

Katarzyna Błochowiak K. , Paweł Aleksandrzak P. , Kropielnicki , Jakub Handschuh J. , Patrycja Pawlik P. , Anna Stanek A.

nr 1

71-78

Introduction. The prophylactic extraction of asymptomatic wisdom teeth is defined as the surgical removal of wisdom teeth in the absence of local disease. Early extraction of asymptomatic third molars is considered beneficial to patients to prevent the risk of future pathology, and to minimize operative and postoperative risks. The second concept is watchful monitoring of asymptomatic wisdom teeth, adhering to specific indicators for their extraction. Aim. The aim of this paper is to present and evaluate the indications and effects of prophylactic extraction of asymptomatic impacted third molars in adolescents and adults, compared with their retention and watchful monitoring. Material and methods. This study is based on analysis of literature. Conclusion. There exist clear indications for the extraction of third molars which are associated with pathology. Prophylactic extractions of asymptomatic impacted third molars should be performed only before 20 years of age. In older age, asymptomatic third molars should be retained and watchfully monitored, and removed only in cases of evident clinical or radiological symptoms