PD-1 and PDL-1 gene expression in nasal polyp tissue from patients with asthma exacerbated by non-steroidal anti-inflammatory drugs correlates with the severity of the disease.

INTRODUCTION: The clinical syndrome that includes asthma, nasal polyps and hypersensitivity to nonsteroidal anti-inflammatory drugs is referred to as airway disease exacerbated by nonsteroidal anti-inflammatory drugs. Patients usually have the most severe form of nasal polyps. Asthma and chronic rhinosinusitis with nasal polyps share a common inflammatory profile, involving type 2 helper T lymphocytes. T-cell activity can be inhibited via the programmed death receptor, PD-1, leading to modulation of the immune response. Therefore, the purpose of this study is to evaluate the expression of genes encoding PD-1 and its ligand PD-L1 in nasal polyp tissue in patients with asthma exacerbated by non-steroidal anti-inflammatory drugs and to correlate the results with clinical data. MATERIAL AND METHODS: The material used for the study consisted of 54 tissue sections of nasal polyps. In the specimens, the expression of PD-1 and PD-L1 genes was determined at the mRNA level by qPCR. Statistical analysis was used to evaluate the results of the study. RESULTS: The expression of PD-1 and PD-L1 genes in the tissue of polyps was statistically significantly higher than in the nasal mucosa of patients in the control group. In addition, there was a correlation between the expression of both genes at the mRNA level and the severity of nasal polyps in the paranasal sinuses analyzed from computed tomography images of the paranasal sinuses and assessed using the Kennedy scale. CONCLUSIONS: Determining the expression of PD-1 and PD-L1 genes may provide a marker for the severity of polypoid lesions. In addition, learning more about the PD-1/PD-L signaling pathway and how it can be modulated may provide a potential therapeutic strategy for patients with inflammatory diseases.

Title Expression of FOXO3 and MAPK1 Genes in Patients with Benign Salivary Gland Tumors.

Pleomorphic adenomas (PAs) and Warthin tumors (WTs) are the most common benign tumors that occur in the salivary gland. PA has a tendency towards malignant transformation. Thus, searching for new methods to diagnose salivary gland tumors and treatment is important. The members of the class O forehead box transcription factor (FOXO3) and mitogen-activated protein kinase 1 (MAPK1) genes participate in the cellular processes, including in cell proliferation. The aim of this study was to analyze these genes' expression in the salivary gland tissues and in salivary gland tumors. The study group consisted of 50 patients treated for salivary gland tumors. For genetic tests, fresh samples of tissue collected during the surgery were used. The expression levels of the FOXO3 and MAPK1 genes were statistically significantly lower in PA tissue than in normal salivary gland tissue and WT tissue. This research revealed that the FOXO3 and MAPK1 genes are present in benign salivary gland tumors and also indicated a role of these genes in the development of benign salivary gland tumors. The cause of the development of pleomorphic adenomas may be apoptotic disorder and the activation of the inflammatory process. The examined genes may have potential to be new therapeutic targets for the treatment of pleomorphic adenomas.

Will the Use of Pharmacogenetics Improve Treatment Efficiency in COVID-19?

The COVID-19 pandemic is associated with a global health crisis and the greatest challenge for scientists and doctors. The virus causes severe acute respiratory syndrome with an outcome that is fatal in more vulnerable populations. Due to the need to find an efficient treatment in a short time, there were several drugs that were repurposed or repositioned for COVID-19. There are many types of available COVID-19 therapies, including antiviral agents (remdesivir, lopinavir/ritonavir, oseltamivir), antibiotics (azithromycin), antiparasitics (chloroquine, hydroxychloroquine, ivermectin), and corticosteroids (dexamethasone). A combination of antivirals with various mechanisms of action may be more efficient. However, the use of some of these medicines can be related to the occurrence of adverse effects. Some promising drug candidates have been found to be ineffective in clinical trials. The knowledge of pharmacogenetic issues, which translate into variability in drug conversion from prodrug into drug, metabolism as well as transport, could help to predict treatment efficiency and the occurrence of adverse effects in patients. However, many drugs used for the treatment of COVID-19 have not undergone pharmacogenetic studies, perhaps as a result of the lack of time.

Adjuvant radiotherapy in parotid gland pleomorphic adenoma - recommendations.

<b>Introduction:</b> Standard treatment for pleomorhic adenoma (PA) of the parotid gland is complete surgical excision. Radiotherapy (RT) as a primary treatment method is controversial and generally is not applied. However, RT might be considered as an adjuvant therapy in some selected cases. </br></br> <b>Aim:</b> The aim of this work was to define recommendations for RT in patients with parotid gland PA after primary surgical treatment.</br></br> <b>Material and methods:</b> Based on the results currently published in the literature and the authors' own experiences from leading Polish laryngological and oncological clinical centers dealing with the treatment of salivary gland tumors, the indications for irradia- tion and its methods in patients with PA of the salivary glands were discussed. </br></br> <b>Results and discussion:</b> Authors recommend personalized treatment based on multidisciplinary panel decisions in each patient. Adjuvant RT should be considered in cases of suboptimal resection of primary PA (close margin, intraoperative tumor spillage, risk of recurrence based on clinical factors and histological features), and in cases of PA recurrence. Doses/ fractions and techniques of irradiation are recommended depending on the clinical extension of the primary or recurrent tumor. </br></br> <b> Conclusions:</b> Adjuvant RT in PA treatment should be a result of a personalized multidisciplinary decision after considering all possible risks of irradiation consequences. Recommendations for this treatment should be taken into consideration.

Evaluation of selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic surgery of the paranasal sinuses.

INTRODUCTION: The aim of the study was to evaluate selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic sinus surgery. MATERIAL AND METHODS: The study involved 121 patients: group I - 42 patients who did not receive anticoagulatory or antiplatelet medications, qualified for endoscopic sinus surgery under total intravenous anaesthesia (TIVA); group II - 40 patients who received in the perioperative period low-molecular-weight heparins, qualified for endoscopic sinus surgery under TIVA; group III - 39 patients diagnosed according to a schedule, due to vertigo or loss of hearing. All the patients received a full laryngological examination and detailed audiological and otoneurological diagnostics, and examination of selected haemostatic parameters before the surgery/diagnostics. RESULTS: The analysis of concentrations of coagulation parameters in groups I and II revealed a statistically significantly higher international normalized ratio value before surgery (I - 1.11; II - 1.08) and 48 h following surgery (I - 1.15; II - 1.10) in group I. The concentration of coagulation factor VII in the study patients was considerably higher in group I for all three measurements (481.93; 443.13; 486.02). The concentration of fibrinogen (coagulation factor I) was significantly lower in group I before surgery (3.2) and at 6 h after surgery (2.84). A significantly lower level of von Willebrand factor was found in group I before surgery (2.94). Comparing test results of groups I and III, who did not receive antiaggregants, statistically significant differences were observed in both tests for factors VII and VIII. CONCLUSIONS: Concentrations of von Willebrand factor and prothrombin revealed statistically significant differences in between groups.

Own experience in the treatment of major salivary gland tumors.

INTRODUCTION: The paper aims to demonstrate the Clinic's and own research in the treatment of major salivary gland tumors. MATERIAL AND METHOD: In the years 2013-2019, there were 95 salivary gland surgeries, including 45 performed in women (47.36%) aged between 24 and 82 and in 50 men (52.64%) aged 29 to 86. Diagnostics of major salivary glands included: patient history, otolaryngological examination, ultrasound and fine needle aspiration (BACC) (of tumor), laboratory tests (morphology, CRP) and computed tomography (CT) or magnetic resonance imaging (MRI) to accurately assess salivary glands, location of lesion and lymph nodes prior to elective surgery. Research results: In the analyzed material patients with major salivary gland tumors were most frequently operated on at the age of 61-70 (34.7%) and 51-60 years (23.2%). Most patients with tumors were hospitalized in the last 4 years between 2016-2019, which accounted for 77.8% of all operated cases. Among the operated lesions, benign neoplasms and tumors occurred in 93.7%, of which the most frequent findings in histopathological examination were Warthin tumor in 50.5%, and multiform adenoma in 26.3%. The remaining tumors and benign neoplasms constituted only 16.9% and were observed in isolated cases, including eosinophilic adenoma, lymphoepithelial cyst, myoepithelial adenoma, lipofibrosarcoma, congestive cyst, air cyst, tubular adenoma, basal cell carcinoma, cyst with squamous metaplasia features, vascular malformation. Malignant salivary gland tumors were found in 6.3%, including the following malignant tumors were revealed histopathologically: adenocarcinoma, mucoepidermal carcinoma, acinocellular carcinoma, epithelialmyoepithelial carcinoma, ductal carcinoma. CONCLUSIONS: The majority of operated salivary gland tumors were benign (93.7%), of which the most common histopathologically were: Warthin tumor (50.5%) and multiform adenoma (26.3%), while malignant tumors occurred in 6.3%. Tumors were localized mainly in the parotid gland in as many as 93.7% cases, of which the most common localization concerned the superficial lobe in 56.8%. The most frequent surgical technique used in the Clinic was extracapsular dissection of the tumor in 88.4%, and other methods were used rarely.

Comparison of two VHIT software programs in diagnostics of semicircular canals.

INTRODUCTION: The aim of this work was to assess SCC function in VHIT test, using both versions of VHIT ULMER. MATERIAL AND METHODS: The study was performed in 57 subjects aged 22-33 years (48 women and 9 men) without vertigo in anamnesis. Patients did not complain of any "vertigo" ailments or any balance disorder incidents in the past. All tests using either VHIT I or VHIT II were performed by the same person. The function of lateral SCC in VHIT ULMER II was examined similarly like in VHIT ULMER I. In both methods was used the same sensitivity threshold parameters for horizontal and vertical accelerations (horizontal - 2500, vertical - 1600). Each of these sequences enables a parameter, called represented GAIN, to be calculated in form of a point on the canalogram. RESULTS: GAIN represents the deviation of the gaze in comparison to the deviation of the head between the first (t - 0 ms) and the fourth image (t = 120 ms). The calculation formula is: GAIN (in %) =100 x DG/RH. DG is deviation of the gaze ("gaze velocity in space") and RH is rotation of the head ("head velocity or impulse canal paresis"). Normal GAIN value ranges 1-40%. CONCLUSIONS: The examination using VHIT ULMER II appears to be a more sensitive diagnostic method than VHIT ULMER I. Improved software with automated functions such as camera adjustments, examination surface arrangement, of VHIT ULMER II, enables technician to shorten the time of examination, simultaneously providing a range of new information about the condition of oculo-vestibular system.

Comparative evaluation of the diagnostic value of biopsy and NBI endoscopy in patients with cancer of the hypopharynx and larynx.

INTRODUCTION: Novel endoscopic technique - Narrow Band Imaging (NBI) seems to be a promising method for an early detection of neoplastic lesions of the upper aerodigestive tract. Compared to white light endoscopy, NBI improves the visualisation of the mucosal and submucosal microvascular patterns of observed pathologies. The aim of the study was to evaluate the diagnostic value of biopsy and NBI in patients with cancer of the larynx and hypopharynx. MATERIAL AND METHODS: The study was conducted in 100 adult subjects hospitalized in the Clinic of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics of Military Medical Academy University Teaching Hospital in Lodz, who were planned for surgical procedures for excision or surgical biopsy of pathological lesions of the hypopharynx or larynx. The following examinations were performed: subjective and objective, otorhinolaryngological, NBI endoscopy and histopathological assessment of suspicious lesions. The microvascular pattern of observed lesions was assessed according to the Ni scale criteria. The next stage of the study was to compare the endoscopic examination results (type of vascular pattern according to the Ni scale) with the histopathological result. The obtained results were subjected to statistical analysis. RESULTS: The sensitivity of NBI endoscopy in detection of malignant neoplasms in patients with hypopharynx and larynx lesions is 90.48%, specificity - 91.14%, positive predictive value - 73.08%, negative predictive value - 97.30%. C onclusions: NBI endoscopy is a modern imaging method, increasing the diagnostic potential of endoscopy in the early detection of malignant lesions within the hypopharynx and larynx.

[Narrow-band imaging endoscopy for diagnosis of adult laryngeal papillomatosis - case raports].

The laryngeal papillomas belong to the group of non-malignant tumours. The risk of getting sick increases with the number of contingent sexual contacts, smoking, alcohol abuse and untreated gastro-oesophageal reflux. This paper describes five cases presenting different levels of exposure to the risk factors and variable course of adult laryngeal papillomatosis. These people, in addition to routine diagnostics, were examined using endoscopy with the use of narrow beam of light, which turns out to be a useful diagnostic tool in the case of laryngeal papillomatosis.

Concurrent ENG and VNG recording in healthy people - preliminary report.

INTRODUCTION: The aim of the study was to evaluate concurrent recording of ENG and VNG measurements in selected diagnostic tests in healthy subjects so as to explore potential sensitivity and applicability of this kind of testing in the diagnostics of vertigo. MATERIAL AND METHODS: The study was carried out in 50 healthy subjects including 24 women and 26 men aged 20-22 (mean age of 20.5 years) reporting no otorhinolaryngological organ-related complaints and no history of any balance disorders or vertigo. Every patient underwent subjective and objective otoneurological tests, electronystagmographic (ENG) examination including calibration, head-tracking test, optokinetic nystagmus test, rotatory chair test, positional tests according to Cawthorne and Rosen, and Hallpike caloric test as well as videonystagmographic (VNG) examination which included calibration, spontaneous nystagmus evaluation, head-tracking test, positional tests according to Cawthorne and Rosen with neck rotation test, and Hallpike caloric test. At first, ENG and VNG examinations were carried out separately at a 24-hour interval. Concurrent ENG and VNG recording was carried out 48 hours following the last test, with calibration being performed again before both evaluations. The concurrent recording included the spontaneous nystagmus evaluation, positional tests according to Cawthrone and Rose with the neck rotation test, and Hallpike caloric test. RESULTS: No negative mutual interference of the conducted tests has been observed. Both in the concurrent and in the separate recordings, the caloric test revealed lower values of the mean velocity of the nystagmus free phase in the ENG test as compared to the VNG test. No signs of spontaneous nystagmus, as well as no signs of optokinetic and positional nystagmus, were detected in any case. CONCLUSIONS: The conducted tests did not reveal any mutual excludability between the selected ENG and VNG diagnostic tests upon concurrent recording. However, the concurrent use of both examinations in the diagnostics of balance disorders and vertigo requires further studies.

Diagnosis and treatment of nasal and paranasal inverted papillomas - epidemiology and own experience.

INTRODUCTION: The aim of this study was to analyse the occurrence of inverted papillomas of the nose and paranasal sinuses in patients that underwent endoscopic sinus surgery in our department. MATERIAL AND METHODS: Between 2006 and 2016, 3,574 patients underwent surgery due to paranasal sinus diseases. Patients were qualified for surgery based on medical history, computed tomography, and laboratory tests. Data were gathered from medical files, and they included age, sex, and histopathological diagnosis. RESULTS: Among 3,574 patients that underwent surgery due to chronic inflammatory changes, on histopathology, inverted papillomas were diagnosed in 80 patients, including 31 women (38.75%) and 49 men (61.25%). Most patients were aged 60-70 years (women, 12.5%; men, 15%) or 50-60 years (women, 5%; men, 21.25%). Between 2006 and 2016, the number of surgeries ranged from 264 (7.38%) in 2013 to 355 (9.93%) in 2016, and the number of inverted papillomas ranged from 4 in 2007 and 2015 (1.23%) to 12 in 2014 (3.87%). Over the last 4 years of the study period, the incidence of inverted papillomas increased. CONCLUSIONS: Among 3,574 patients operated on due to chronic inflammatory changes, on histopathology, inverted papillomas were diagnosed in 80 cases (2.23%); thus, all patients qualified for endoscopic surgery due to inflammatory or hypertrophic changes should undergo rhino-fiberoscopy. Recurrence of inverted papillomas was observed in 17.50%, typically in patients with nasal polyps that co-occurred with inverted papillomas. We regard rhino-fiberoscopy as the most valuable method for detecting tumour recurrence in patients after surgery for inverted papillomas.

The evaluation of the neck torsion test in subjective examinations of patients with vertigo and/or hearing loss.

INTRODUCTION: The aim of this work was to evaluate the diagnostic value of the neck torsion test in VNG, Doppler ultrasonography and brainstem auditory evoked potentials in patients with vertigo and/or hearing loss due to intracranial vascular malformations. MATERIAL AND METHODS: The study covered 47 patients, 30 female and 17 male (mean age, 55.5 years; range, 19-74 years) with vertigo and/or hearing disorders and the asymmetry of vertebral arteries. Each patient underwent a subjective examination, an otolaryngological examination, otoneurological diagnostics, VNG with gaze tracking in the straight ahead position and in the 600 left and right neck torsion, the neck torsion test, audiological diagnostics including I-, III- and V-wave latency of the brainstem evoked potentials in the straight ahead position and the right ear stimulation in the 600 right neck torsion and the left ear stimulation in the neck torsion to the left, Doppler ultrasonography with measuring the diameter of vertebral arteries and the velocity of the blood flow in these vessels with the use of the neck torsion test. RESULTS: In own study, in VNG, the positive neck torsion test was observed in 76.5% of the study patients, while square waves in both directions were found in 46.5% and in one direction in 10.6%. Cervical nystagmus was noticed in 19.1% of these patients. In the auditory evoked potentials test, the differences in I-, III- and V-wave latency time were not statistically significant, either at rest or in the neck torsion. In the Doppler ultrasound examination, the asymmetry of vertebral arteries were present (below 25%) in 7 women (14.9%) and 4 men (8.5%), whereas large asymmetries (above 25%) were observed in 23 women (48.9%) and 13 (27.7%) men (range, 25% - 215%) and was statistically insignificant. The resting blood flow velocity in vertebral arteries of large asymmetries, both in systole and diastole heart phases, was significantly higher in the artery with larger asymmetry. CONCLUSION: The neck torsion test can be diagnostically useful in monitoring the vertebrobasilar system as well as qualify for microsurgical procedures if the vertebrobasilar insufficiency has been diagnosed.

Expression of POSTN, IL-4, and IL-13 in Chronic Rhinosinusitis with Nasal Polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is one of the most frequently encountered chronic nasal diseases with a significant impact on patient quality of life. The aim of our study was therefore to investigate the association between the POSTN, IL-4, and IL-13 gene expression and the nasal polyp development. The objective of this study was to determine differential expression of POSTN, IL-4, and IL-13 genes in the mucosa and polyps of 63 patients with CRSwNP and 23 chronic rhinosinusitis (CRS) without nasal polyps (CRSsNP) when compared with patients with nasal septum deviation (n=18) who were used as controls. The expression level was investigated using reverse transcription-polymerase chain reaction assays in the polyp tissue and the mucosa of paranasal sinus collected while undergoing functional endoscopic sinus surgery. Expression of the mRNAs of all three genes, IL-4, IL-13, and POSTN, was significantly greater in the paired tissues of CRS patients with NPs or without NPs than in control subjects, with highest levels of POSTN and IL-13 seen in CRSwNP. An increased level of POSTN, IL-4, and IL-13 gene expression may be related to the development of chronic rhinosinusitis with nasal polyps, but polyp formation seemed to be associated especially with POSTN and IL-13 expression.

Significance of CYCLOOXYGENASE-2(COX-2), PERIOSTIN (POSTN) and INTERLEUKIN-4(IL-4) gene expression in the pathogenesis of chronic rhinosinusitis with nasal polyps.

The purpose of this paper was to evaluate the level of Cyclooxygenase-2 (COX-2), Periostin (POSTN) and Interleukin-4(IL-4) gene expression in patients with chronic rhinosinusitis with nasal polyps, without polyps and with a nasal septum deviation. The tests were performed on 63 patients (24 women and 39 men) with chronic rhinosinusitis and polyps (CRSwP-study group I), with determination of the COX-2, POSTN and IL-4 gene expression; an allergy was diagnosed in 38 cases. The reference groups were patients with chronic rhinosinusitis without polyps--CRS (n = 23, including 14 women and 9 men) and patients with nasal septum deviation--DSN (n = 18, including 9 women and 9 men). The expression level was determined in the polyp tissue and the mucosa of paranasal sinus collected during an FESS. The expression level of studied genes was also evaluated in the material. Immediately after being collected, the tissue fragments were placed in test tubes with 1 ml of RNAlater (Qiagen, Hilden, Germany) preventing the degradation of RNA and frozen at -70 °C. The studies revealed an increased level of POSTN, IL-4 gene expression and a decreased level of COX-2 gene expression that may be associated with the development of chronic rhinosinusitis with nasal polyps. An analysis of the expression level indicates the participation of POSTN and IL-4 in the development of chronic rhinosinusitis with nasal polyps in patients with atopy.

Evaluation of oxidative DNA damage and antioxidant defense in patients with nasal polyps.

OBJECTIVES: The presence of inflammatory cells indicates the development of epithelial cell injury in nasal polyposis (NP) and the potential for production of high levels of reactive oxygen and nitrogen species. The aim of our study was to clarify the role of oxidative stress and antioxidant status in the deterioration accompanying NP. METHODS: Twenty patients (11 men) aged 47.2 ± 17.0 years with nasal polyps were included in the study. Twenty healthy subjects (7 men) aged 48.2 ± 15.3 years formed the control group. The erythrocyte activities of antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), and plasma nitric oxide (NO) concentrations were measured. An alkaline comet assay was used to determine the extent of blood lymphocyte DNA damage of oxidized purines as glicosylo-formamidoglicosylase (Fpg) sites, and oxidized pyrimidines as endonuclease III (Nth) sites. RESULTS: A significant increase of NO (P < 0.05) and non-significant decreases of SOD (P > 0.05), CAT (P > 0.05), and GPx (P > 0.05) were seen in NP patients compared to healthy controls. The level of blood lymphocyte oxidative DNA damage in NP patients was significantly higher compared to the control group (P = 0.01). DISCUSSION: The blood lymphocyte DNA damage level increased in patients with NP. Elevated DNA damage may be related to overproduction of reactive oxygen and nitrogen species and/or decreased antioxidant protection.

DNA damage and oxidant-antioxidant status in blood of patients with head and neck cancer.

Oxidative stress induces a cellular redox imbalance that has been found to be present in various cancer cells, and overproduction of free radicals may be related to oncogenic stimulation. We investigated the activity of the following antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) concentrations in blood of patients with head and neck squamous cell carcinoma (HNSCC) compared with the control group. A comet assay was used to assess DNA damage. A nonsignificant increase of MDA and a decrease of SOD, CAT, and GPx (p>0.05) were seen in HNSCC patients compared with controls. It was found that the level of oxidative DNA damage in HNSCC patients was significantly higher compared with the control group (p ≤ 0.001). Our observations suggest that HNSSC patients may represent an impaired antioxidant defense system, resulting in DNA damage and genome instability. It has to be also considered that an oxidant/antioxidant imbalance may be connected to the complex mechanism leading to the DNA damage indicated in the blood of patients with head and neck cancer.

Effects of oral contraceptives on selected parameters of the homeostatic control system in young women having a sudden disorder of the auditory and/or balance system.

The purpose of the paper was to assess the effects of oral contraceptives on selected parameters of the homeostatic control system in women having a sudden disorder of the auditory and/or balance system. The study included 105 young women divided into two groups: Group I--52 women with the disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 20-49; and Group II--53 women without any disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 18-40. The patients included in the study underwent a full otoneurological evaluation, detailed laryngological diagnostics and an evaluation of selected parameters of the homeostatic control system--fibrinogen level, D-dimer level, evaluation of APTT and PT indicator, plasma estradiol and progesterone with the Roche Cobas analyser by means of chemiluminescence. The vertigo occurring in the study group was most often central (59.6% of cases), mixed with compensation in 36.6% of cases, and peripheral only in 3.8% of cases, indicating labyrinth damage in 40.4% of cases. An analysis of the progesterone level, considering the menstrual cycle phase in the group, showed that its value was abnormal in 51.0% of women in the study group and 47.1% in the control group. In their own studies, the authors observed that the estradiol level in the plasma, considering the menstrual cycle phase in the study group, was abnormal in 41.2% of women and that the differences in its concentration were statistically significant in the study and control groups (p = 0.005), which may have a negative impact on the possibility of a thromboembolic episode.

[Neoplastic tumors in patients with unilateral inflammations qualified for endoscopic surgery]. / Guzy nowotworowe u chorych z jednostronnymi zmianami zapalnymi zakwalifikowanymi do operacji endoskopowych.

INTRODUCTION: The aim of this work was to analyze the occurrence and type of neoplasm in unilateral pathological lesions within the nose and paranasal sinuses in patients who underwent endoscopic surgery, in own material. MATERIAL AND METHODS: Between 2006 and 2012 2295 patients, including 1006 women aged 15-84 and 1289 men aged 17-87, were operated on due to diseases of paranasal sinuses in the Department of Otolaryngology and Laryngological Oncology. The patients underwent surgery after a medical interview, physical examination, 3D CT of paranasal sinuses and laboratory tests. The removed lesions were histopathologically investigated. The studied group included the patients with only unilateral lesions and histopathologically recognized neoplastic lesion. RESULTS: In the studied material, neoplastic lesions occurred in 9.8% cases, out of which 5.4% were inverted papillomas, 3.1% osteomas, and 1.5% malignant tumors. However, in the patients who were operated due to hypertrophic changes within paranasal sinuses, neoplasm was found in 1.3% cases, while inverted papilloma in 0.7%, osteoma in 0.4% and malignant tumors in 0.1%, which altogether amounts to 8 times higher occurrence of neoplastic lesions in unilateral changes. RESULTS: Unilateral changes within paranasal sinuses require highly inquisitive pre-operative diagnostics, peri-operative analysis and histopathological evaluation.

[Internal and external chordectomy via laryngofissure with the use of CO2 laser]. / Chordektomia wewnetrzna i zewnetrzna poprzez rozszczepienie krtani i zastosowaniem lasera CO2.

INTRODUCTION: The aim of this work was to evaluate the therapy results of patients with glottic carcinoma in the T1NoMo advanced clinical stage on internal or external chordectomy via the thyroid cartilage with the use of CO2 laser. MATERIAL AND METHODS: The study was conducted in 110 patients, including 7 women aged 52-68 and 103 men aged 52-73, who were treated in the Department of Otolaryngology and Laryngological Oncology, Military Medical Academy Teaching Hospital in Lodz, during the years 2010-2012, due to laryngeal carcinoma (T1N0M0). RESULTS: The studied material was subjected to external chordectomy via laryngofissure in 51 men (46.4%), and internal chordectomy with the use of CO2 laser in 52 men (47.2%) and 7 women (6.4%). In the patients operated via laryngofissure, the following types of external chordectomy were performed: IV - in 25 cases (49.0%), Vc - in 12 cases (23.6%), and Vb and Vd - in 7 cases each (13.7% each). Internal chordectomy was conducted with the use of the following types: III - in 31 cases (52.5%), IV - in 15 cases (25.4%) and Vd - in 13 cases (22.1%). During the post-operative follow-up of 1-3 years, no recurrence of carcinoma was observed. CONCLUSIONS: The place and size of carcinoma are often dependent on the type of internal and external chordectomy, which is preceded by tracheotomy and is usually dependent on a patient's consent. Too short post-operative follow-up does not allow for the comparison of effective therapies of the two surgical methods.

Inflammation of the frontal intersinus septal air cell as a cause of headaches.

INTRODUCTION: The aim of this paper is to present a rare case of frontal intersinus septal air cell inflammation as a cause of headaches. PRESENTATION OF CASE: A 23-year-old patient was admitted to the Department of Otolaryngology and Laryngological Oncology for severe headaches during an upper respiratory tract infection. After neurological consultation including brain MRI and CT scanning of the paranasal sinuses, the inflammation of the frontal intersinus septal air cell was diagnosed. After examination, the patient was qualified for external osteoplasty. Under general endotracheal anaesthesia, the frontal intersinus septal air cell was intraoperatively opened from the side of the right frontal sinus, the mucoid content was aspirated and a plate of bone was removed. The patient reported complete relief from headaches on the second day after surgery. DISCUSSION: According to the previous studies, the frontal intersinus septal cell is more frequent in patients with frontal sinus inflammation than in the patients without inflammatory changes. Further, the conducted research indicates that its occurrence does not result in significant disorders in the drainage and ventilation of the frontal sinuses, and as such is not likely to be the cause of inflammation. CONCLUSION: In the case of inflammatory changes in the frontal intersinus septal air cell without concomitant frontal or ethmoid sinusitis, surgery via the external approach appears to be an effective method for the radical removal of pathological changes.