Purpose of the study. Improvement of surgical treatment outcomes in patients with advanced cancer of the tongue and the mouth floor providing radical surgery with preservation of the organ functions.Materials and methods. Two patients with advanced cancer of the tongue and the mouth floor with metastases to lymph nodes in the neck (St.4 (IVA, рT4a N2b M0), clinical group 2, were operated on according to our special technique. The surgery was performed under endotracheal anesthesia. After cervical lymph node dissection, the tongue and the mouth floor tissues were resected intraorally. The incisions were made through their entire thickness along healthy tissues. Smears were taken from the dissected tissues for intraoperative pathology consultation control for the presence of cancer cells. The tissues of the mouth floor affected by the tumor were completely removed without going beyond the hyoglossus muscle, since the lingual and hypoglossal nerves go along its outer surface. This allowed radical tumor removal with preservation of the tongue functions.Results. Patients operated on according to our special technique have been observed for more than 9 months without continued tumor growth and recurrences tumor with preservation of the tongue and the mouth floor functions.Conclusion. In such patients, ablastics principles are combined with the preservation of the tongue functions. This can be achieved because after removal of the tongue tumor, resection of the mouth floor is performed without going beyond the hyoglossus muscle not affected by the tumor, since the lingual and hypoglossal nerves go along its outer surface. Complying with ablastics, it preserves the tongue functions: chewing, swallowing, articulate speech, taste perception.

Malignant tumors of the head and neck are still one of the most challenging problems of treatment in modern oncology. The disease affects mainly the capable people (from 30 to 60 years old). Tumor lesions of the paranasal sinuses lead to disability and have a high mortality rate. Head and neck tumors comprise of 20–30 % of all cancer cases. People with early paranasal sinus cancer have minor complaints, their general condition doesn’t get affected so they don’t seek for medical care in a while. As a result, patients start on treatment at tumor grades III–IV. This article provides the most complete information about the causes, frequency and special features of the course of paranasal sinus cancer, as well as about modern methods of it’s diagnosis and combination treatment. Despite the great advances in the treatment of these malignant tumors the three and five year survival rates remain unsatisfactory, which requires a research for new effective treatments. Currently the main treatment methods for these malignant tumors are combination and complex (involving surgery, radiotherapy and chemotherapy) treatments. The standard treatment approach includes radical surgical removal of the primary tumor and metastatic lymph nodes followed by radiation or chemoradiation therapy. Chemotherapy as monotherapy is administered in non-resectable primary or recurrent tumors, distant metastases or when a patient refuses the radical surgery. Improvement of existing treatment methods and development of new ones are an essential need. Earlier detection of the disease requires primary care physicians to be trained to diagnose tumor lesions of the paranasal sinuses, and highly specialized physicians (dentists, otorhinolaryngologists, maxillofacial surgeons, dermatologists) to express their cancer alertness.

Background. Infectious complications are the most frequent and severe among all complications in cancer patients. The development of fungal-bacterial infections is particularly difficult. The aim was to develop an etiological description for the causative agents of infectious complications in oncological patients. Materials and methods. The study was conducted from January, 2020 to December (inclusive both dates), 2021. 3662 hospitalized patients (men and women) aged from 1 to 85 years with clinical manifestations of an infection were examined. The traditional microbiological method was used to clarify the etiology of the infectious process and to verify the pathogen. Phenotypic and real-time PCR methods were used for detection of carbapenemase and ESBL production. Results. The organs of the respiratory system, skin, soft tissues, and blood are most susceptible to infectious complications. In the etiology of infectious complications, the leading place is occupied by gram-negative bacteria. The conducted microbiological study made it possible to establish that resistance to cephalosporins and carbapenems in enterobacteria is realized through various resistance mechanisms. Extended-spectrum β-lactamases and carbapenemases are particularly relevant and concerning. Monitoring revealed the growth of carbapenemase-producing isolates of Klebsiella pneumoniae (34.9%), the spread of carbapenemase among Escherichia coli strains (5.1%), the increase in the spread of Acinetobacter baumannii strains with the production of NDM groups (32.6%). Conclusion. Prescription of antibacterial drugs should be based only on the results of microbiological diagnostics. The current situation requires modern methods of microbiological diagnostics: the use of only up-to-date (periodically updated) criteria for determining sensitivity to antimicrobial drugs, as well as the introduction of phenotypic tests that provide reliable information without molecular genetic methods.