The objective of this study was to assess the effectiveness and acceptability of fusafungine in the treatment of patients with community-acquired, upper respiratory tract infections. These infections, although frequently of viral origin, may be conducive to bacterial superinfection. Fusafungine, a combination of several enniatins, has been shown to display bacteriostatic activity against many micro-organisms responsible for infections of the respiratory tract, along with anti-inflammatory activity. This open, multi-centre study analysed data on 166 patients suffering from upper respiratory tract infections treated for 7 or 10 days with a fusafungine metered-dose spray. The incidence of upper respiratory tract symptoms was significantly reduced from baseline (p < or = 0.001) with the treatment evaluated as excellent or good by 92.1% of physicians. In 77.7% of the patients, no further treatment was necessary at the end of the seven-day therapeutic period. Out of the 37 patients who had the treatment prolonged for three more days, 78.4% had regression of their URTI at the end of therapy. In terms of tolerability, assessment by the investigators and the patients themselves demonstrated that fusafungine was extremely well tolerated. Acceptability of the treatment was considered poor by only one patient. Results of this study suggest that fusafungine, whatever the aetiology of the infection, gives rapid relief of nasal and pharyngeal symptoms and provides strong evidence of its efficacy and acceptability in treating URTIs.

PurposePrimary malignant melanoma of the nasal cavity and nasopharynx is rarely seen. Clinically, most patients display initial nonspecific symptoms of unilateral nasal obstruction or epistaxis. The prognosis is generally poor, with a mean survival time of 3.5 years.Material and methodsIn this paper, we have reported the case of malignant melanoma of the nasal cavity and nasopharynx. 79 years old man had presented with the swelling of the nose, nasal blockage and epistaxis during the six months before diagnosis. Functional endoscopic sinus surgery was performed to excised the nasal cavity tumor. Using positron emission tomography/computed tomography examination with 18-fluorodeoxyglucose, the patient was diagnosed with residual nasopharyngeal tumor after surgery.ResultsFollowing the diagnosis, intracavitary brachytherapy for nasopharynx was administered. Solitary cervical nodal involvement occurred 6 months after the diagnosis when had been completely removed. After that, external beam radiotherapy was performed on the submandibular area on the right side. Thereafter, the patient was given follow-up care in the Department of Radiation Oncology until the time of distant progression of the disease.ConclusionsWe have chosen to discuss this condition, because of its rarity and the possibility of using radiotherapy, even though the malignant melanoma had been regarded as a radioresistant disease, and also to emphasize the importance of a multidisciplinary approach to treatment of such patients.

Abstract:Objectives: Majority of patients that undergo total or partial removal of the hypopharynx and cervical oesophagus are oncologic patients. Optimal management of head and neck malignancies requires multimodal therapy including surgical ablation, reconstruction, and adjuvant oncologic therapy. Despite aggressive surgical and adjuvant therapy, a fi ve-year survival rate is achieved only in 25-35 %. Methods: In the presented retrospective study, the choice of reconstructive method was infl uenced by type, length and extent of the defect, and condition of patient. The fl ap was indicated when the defect not allowed for primary suture of the hypopharynx and/or cervical oesophagus. Two-team approach was used. Results: The study was based on the data of ten patients. Radial forearm fl ap was used in 8 cases; pectoralis major myocutaneous fl ap was used in 3 patients, and ALT perforator free fl ap in 1 case. A total of 12 fl aps were used for 10 patients. Two patients developed free fl ap necrosis. These necrotic fl aps were substituted with pedicled pectoralis major myocutaneous fl aps. Conclusions:The primary reconstruction of the pharyngo-oesophageal defects could be the method of choice. For the partial defects, the best choice could be a radial forearm free fl ap. For circumferential defects, jejunal fl ap could be the best. The pectoralis major pedicled fl ap could be a safe procedure for elderly patients with multiple medical problems ( Tab. 6, Fig. 2, Ref. 34). Full Text in PDF www.elis.sk. Key words: pharynx reconstruction, pharyngo-oesophageal reconstruction, ALT perforator fl ap, free radial forearm fl ap, pectoralis major fl ap. Surgical resection of the hypopharynx and cervical oesophagus may lead to severe functional defi cits, and it may prevent the patient's peroral intake of solid food and liquids. This usually applies to patients with locally advanced laryngeal or hypopharyngeal malignancy. The treatment of these patients involves resection and reconstruction followed by radiotherapy. Surgical resection and reconstruction of the hypopharynx in patients suffering from advanced oncological disease is a challenge for surgeons, anaesthesiologists, nurses, and represents serious stress for patient.Resection of a small part of the hypopharynx or cervical oesophagus allows for primary suture of the defect, and it results in only minimal and temporary changes. Extensive resections require diffi cult reconstructions, often associated with free transfer of tissues. Despite the extensive surgical therapy and aggressive adjuvant therapy, fi ve-year survival of patients in stage III or IV of head and neck malignancies is only 25-35 % (1-3).Nowadays, the most favoured method is that of one-stage reconstruction of gastrointestinal tract continuity. The reconstructions of hypopharynx and cervical oesophagus have progressed from multiple-stage procedures using pedicle skin fl aps (4-8) to the use of pedicle fasciocutaneous, myocutaneous and visceral fl aps (9-15). The advent of microsurgical free fl aps has allo...