ISRCTN registry: Registration number ISRCTN19016626, registered 23 January 2013.

No abstract

The Eagle's syndrome is a disease is caused by irritation of the nervous, vascular and muscular structures the surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deep part of the lateral region of the face, which irradiates in to the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are founding various otolaryngological, dental, neurological diseases. Aim: due to the lack of information on the development and course of the stylohyoid syndrome, conservative treatment and the complexity of diagnosis, the anatomical features of the hypertrophied styloid process, their length and angles of deviation and the need for local impact on the process, the stylohyoid ligament and the neurovascular bundle, to varying degrees presenting to the styloid process, it becomes necessary to develop the most effective and simple method for diagnosis a hypertrophied styloid process and to optimize the need for CT examination with contrasting of the great vessels of the neck and performing functional tests. Materials and methods: Over the past 9 years, we examined and treated 184 patients. The appeals were random, with no specific focus. Of these, there were 133 women (72.3%), men – 51 (27.7%); age – from 25 to 70 years old: 25-30 years old – 15 people (8.1%), 30-45 years old – 116 (63%), 45-60 years old – 38 (20.6%), 60-70 years old – 15 (8.1%); the duration of the disease is from 1 to 10-15 years. Our work was aimed at improving and simplifying the diagnosis of the hypertrophied styloid process during the initial treatment of the patient in an outpatient and polyclinic conditions using functional tests, determining the need to refer patients to CT examination to visualize the relationship of the elongated styloid process with the main vessels of the neck, the possibility of pressure of the append age on the vessels and nerves of the neck, both at rest and in the movement of the head and neck, the development of impaired blood circulation in the brain due to impaired blood flow through the arteries and impaired out flow through the veins, and the development of corresponding symptoms in addition to those described in the literature. Due to the difficulty of diagnosing hypertrophy of the styloid process of the temporal bone in an outpatient and polyclinic conditions and the lack of awareness of practical otolaryngologists about this problem, we proposed a scheme for examining patients with suspicion of this problem.

Topicality: The Eagle's syndrome is a disease that is caused by irritation of the nervous, vascular and muscular structures that surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deep part of the lateral region of the face, which irradiates into the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are found in various otolaryngological, dental, neurological diseases. Purpose of the study: determine and evaluate the most significant and distinctive X-ray signs of hypertrophied styloid processes of the temporal bone; reveal differences in growth options and X-ray structure of the styloid processes of the temporal bone in accordance with histological data; eEvaluate the effect of conservative treatment of stylohyoid syndrome depending on different growth options for the styloid process of the temporal bone, according of the data of computed tomography. Materials and methods of research: at the process of our work based on diagnostics and treatment of stylohyoid syndrome, we analyzed 86 clinical cases: 61 women and 25 men. Patients age varies from 35 till 70 years. CT images with contrasting of the great vessels of the neck and functional tests. Based on the analysis, we developed a scheme for determining the variants of the styloid process growth, based on the CT data, in relation to the data of the histological examination of the styloid processes of the patients we operated on. Results: The analysis of CT images and histological studies allows us to divide the lengthening of the styloid processes of the temporal bone into two groups, which we give the name "ossification", that is, the actual growth of the styloid process and "calcification", that is, dystrophic changes and deposits of calcium salts in the ligament. Accordingly, we are developing approaches to conservative or to surgical treatment of this pathology, taking into account the CT data, depending on the growth options of the styloid process of the temporal bone.

Diagnosis and treatment of malignant neoplasms of the head and neck is an urgent modern problem of oncology, as there is a steady increasing of this pathology. At the same time are untimely diagnosis and frequent recurrences take place. The purpose is to test the method of excision of the tumor of the skin of the external nose and assess its feasibility in radical surgical removal by using anemic Klein solution. Material and methods of research: 64 patients were examined with skin neoplasms that received surgical treatment options using Klein’s anematize solution at the ENT department from 2015 to 2020 years. Patients ranged in age from 28 to 65 years, 15 women and 49 men. Patients are divided into two groups depending on the morphology of the tumor. The first group — 50 (78.2%) patients with malignant skin lesions. From this sample, 17 (34%) with basal cell carcinoma of the nasal skin and 33 (66%) with squamous cell carcinoma (G1) of the nasal skin. The second group consists of 14 (21.8%) patients with melanoma of the skin of the nose and torso. Metastasis in the deep jugular chain were diagnosed in 6 (16.7%) patients from the group of patients with melanoma. Results of the study and discussion: observations of patients for 5 years showed a satisfactory quality of life of all patients with malignant skin tumors. No recurrence of nasal cancer in the first group was registered during the follow-up of patients. Among a group of patients with melanoma, 1 (7.1%) patient was diagnosed with recurrence in the visual organ and brain. Conclusions: 1. Clinically, skin cancer was non-aggressive, had a relatively slow growth and 100% of patients had no recurrence of cancer after surgery for 5 years (p<0.05). 2. Melanoma of the skin was aggressive in a year — 1 (7.1%) patient was diagnosed recurrence in the visual organ and brain. 3. The use of Klein’s solution 5 minutes before the surgery under the base of the tumor provided a pronounced hemostasis due to vasospasm and contributed to the prevention of intraoperative recurrence in 63 (98.4%) patients (p<0.05). Key words: malignant tumors, skin of the external nose, surgical treatment, recurrences.