Jejunal and ileocolic free flaps for digestive tract reconstruction following pharyngo-laryngo-oesophagectomy - 30 years of single-centre experience.

INTRODUCTION: Hypopharyngeal cancer accounts for 3-5% of all squamous-cell carcinoma (SCC) of the head and neck and has one of the worst prognoses. The aim of the study was to evaluate oncologic and functional treatment outcomes in patients with T3-T4a squamous cell hypopharyngeal and laryngeal cancer. MATERIAL AND METHODS: Retrospective analysis of the material from one treatment site included 90 patients (81 male, 9 female) who had undergone surgery between 1986 and 2010. Their mean age was 55.06 years (range 36-75). RESULTS: TNM (T - tumour, N - node, M - metastasis) staging assessment was feasible in 70 treatment-naïve patients (77.78%): 57 (63.33%) were classified to stage T4a, and 13 were classified to T3 (14.44%). Cervical lymphadenopathy was observed in 53 (63.3%) patients; in 44 patients (48.89%) postoperative histopathology confirmed metastatic disease. G2 or G3 SCC was detected in 80% of patients. All patients underwent laryngopharyngoesophagectomy (LPE). Digestive tract reconstruction was performed using one of two methods: jejunal autograft (JA) in 79 patients (87.78 %) - Group A or ileocolic autograft (IA) in 11 patients (12.22%) - Group B. Comparative statistical analysis of both groups showed statistically significant differences only for substitute speech production. The mean survival time of patients from both groups was 2.21 years after reconstruction surgery. CONCLUSIONS: JA or IA for digestive tract reconstruction in patients after LPE are burdened with high risk of complications but offer patients the chance of a normal oral diet shortly after surgery. Ileocolic autograft enables rapid production of substitute speech.

Oncological outcomes of CO2 laser cordectomies for glottic squamous cell carcinoma with respect to anterior commissure involvement and margin status.

BACKGROUND AND OBJECTIVES: Controversial prognostic factors of primary CO2 laser cordectomy are anterior commissure involvement (ACI) and status of margin. STUDY DESIGN/MATERIALS AND METHODS: Retrospective analysis of oncological outcomes in 102 patients with early glottic cancer undergoing laser cordectomy between 2013 and 2015. RESULTS: The T stages distribution included: 72.6% T1a, 14.7% T1b, and 12.7% T2. The ACI was diagnosed in 26 patients. The primary cordectomy was radical in 72 patients. The 2- and 5-year disease free survival (DFS) for all patients were, respectively, 83.3% and 77.3%.The 2-year DFS rates for T1a, T1b, T2 were, respectively, 91.7%, 66.7%, and 53.9% and the differences were statistically significant (P < 0.001). The 2-year DFS rates according to the ACI and free anterior commissure tumors were, respectively, 65.4% and 89.2%, and the ACI indicated worse prognosis (P = 0.057). The 2-year DFS rates according to margins status were higher for patients with close or positive margins, who had second resection (88.9%) compared with those of negative margins (80.9%) (P = 0.340). Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Evaluation of polymorphisms in microRNA biosynthesis genes and risk of laryngeal cancer in the Polish population.

MicroRNAs are the largest group of short regulatory RNAs. They regulate genes participating in many physiological and pathological processes. The role of micro RNAs in cancer development is also considerable. Therefore, the aim of this study was to evaluate the relationship between DROSHA (rs6877842) and DGCR8 (rs417309, rs1640299) gene polymorphisms with risk of occurrence of laryngeal cancer. The study included 100 patients and 100 healthy subjects. Genomic DNA was extracted from formalin-fixed, paraffin-embedded tissues. Analysis of the gene polymorphisms was performed using TaqMan SNP Genotyping Assay. The rs417309 AA genotype was found to be correlated with increased risk of larynx cancer. The rs1640299 TG and rs6877842 CG heterozygotes were significantly inversely associated with the presence of larynx cancer. Additionally, rs417309 AA genotype increased the risk of larynx cancer in the T1 stage, and the rs1640299 TG heterozygote occurred more frequently in the control group than those in the T3 and T4 stage. The rs417309 and rs1640299 polymorphisms of the DGCR8 gene as well as rs6877842 of the DROSHA gene might be associated with a risk of laryngeal cancer occurrence in the Polish population.

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland-Observations Based on 2192 Cases of the Polish Salivary Network Database.

The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. The aim of the study was to analyse the epidemiological and histological differences of parotid tumours located in regions I-V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance, multicentre prospective studies conducted between 2017-2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men), were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, and facial nerve (FN) paresis were analysed for superficial (I_II) and deep (III_IV) lobes and with special regard to the tumours affecting region V. Twenty eight tumours were located exclusively in region V (1.45% total) and seventy-two tumours were found in region V exhibiting extensions to neighbouring regions (3.7% total), characterised as significantly younger and less frequent in retirees. In I-IV regions, approximately 90% of tumours were benign, with pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V, PA exceeded 75% but WT were casuistic (2/28). Incidences of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours > 4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy; however, 38% of patients showed false negative results both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumours located exclusively in region V vs. 1901 other patients and in 100 patients with V extension vs. 1829 other patients showed no clinical symptoms of malignancy binding with final malignant tumour histology as a single variable or in combination with other variables. The logistic regression models obtained in this study show strong linkage between tumour location and predictors (age, male gender, and tumour diameter) and also aimed to function as a good classifier. Our conclusion is that, despite the very clear image of the mid-cheek tumour which is easily accessible in palpation and ultrasound examination, it is necessary to improve oncological vigilance and preoperative patient preparation.

[The methodology of measurements of ossicular chain movability during tympanoplasty using Laser Doppler vibrometry]. / Metodologia pomiarów ruchomosci elementów ucha srodkowego za pomoca laserowej wibrometrii dopplerowskiej.

INTRODUCTION: Laser Doppler vibrometry can potentially be applied in the measurement of the acoustic conductivity of the middle ear during tympanoplasty. Its usefulness in estimating the accuracy of ossiculoplasty requires experimentally verified. AIM: The article presents the test procedure developed at the Department of Otolaryngology, Medical University of Warsaw for the displacement measurement of the conductive elements of the middle ear. MATERIALS AND METHOD: In the study were used 14 fresh-frozen temporal bones. In the initial stage was performed antrotomy with posterior tympanotomy. During the measurements, ER-2 speakers generated a signal with a frequency of 1000 Hz, 2000 Hz, 4000 Hz, 8000 Hz. Acoustic conductivity of the middle ear was measured on the back branch of the stapes, round window. Laser Doppler Vibrometer was used to measure velocity of each selected elements of the ear. In four experiments were assessed the intraoperative availability of measurement points, the impact of laser beam angle changes and the presence of reflective tape on the amplitude of vibration measured point, intra- and interindividual variability of the method. RESULTS: For all measured frequencies intra-individual differences were no statistically significant. There were observed large differences between the velocity values in various temporal bones. Changing the angle of the laser beam does not significantly affect the results. Mucosal surface of the tympanic cavity does not reflect the laser beam. CONCLUSION: Laser Doppler vibrometry can be used to measure motion of the middle ear sound conductivity with very good repeatability of measurements. Changing the angle of the laser beam should not vary amplitude of measurement during surgery. To maintain the sensitivity of response, it is necessary to use part of reflective tape.

Simultaneous Malignant and Benign Nonepithelial Neoplasms of the Larynx-A Case Report and Literature Review.

Nonepithelial tumors of the larynx are relatively rare neoplasms of the head and neck. The chondrosarcoma, which develops commonly from cricoid and thyroid cartilage, stands for 0.2% of the laryngeal malignant neoplasms. The rhabdomyoma is even more uncommon benign tumor developing from the laryngeal striated muscles. The clinical manifestation and the treatment options depend on the histopathological evaluation, tumor localization, and its size. In presented case, the simultaneous occurrence of benign and malignant tumors of mesenchymal origin in the patient's larynx was provoking hoarseness, globus sensation, and dysphagia. To the best of authors' knowledge, no other case of the concomitance of rhabdomyoma and chondrosarcoma of the larynx have been reported in the literature.

[Lateral petrosectomy in pathology of the temporal bone]. / Zastosowanie petrosektomii bocznej w patologii ucha i kosci skroniowej.

INTRODUCTION: Certain problems in ear surgery are caused by temporal bone cholestetoma and chronic otitis media complicated by deafness, facial nerve dysfunction, vertigo or meningcephalocele. Lateral petrosectomy offers possibility of radical treatment and prevention of temporal bone destruction and following complications. AIM OF STUDY: It is an analysis of indications for lateral petrosectomy and it's results as a treatment of otitis media and temporal bone cholesteatoma. The possibility of synchronous cochlear implantation is noted. MATERIAL: Retrospective analysis of 62 patients after lateral petrosectomy, operated in the Department of Otolaryngology at the Medical University of Warsaw in 2001-2009. The group consisted of thirty one men and thirty one women. RESULTS: Thirty two patients suffered from chronic granuloma or chronic choleateatoma otitis media or temporal bone cholesteatoma. Seventeen patients suffered from deafness prior surgery. Cochlear implantation was possible in five patients: two of them after cranium fracture, two with deafness caused by chronic otitis media and one with deafness caused by osteoradionecrosis. Intraoperative CSF leak was observed of eight patients. In one case lateral perosectomy was used as a treatment of CSF leak after removal of cerebellopontine tumor. There was no evidence of CSF leak after surgery. Facial nerve dysfunction was observed in fifteen cases. CONCLUSIONS: Lateral petrosectomy offers possibility of radical treatment in same patients with chronic otorrhea. The total removal of cholesteatoma prevents intracranial and intratemporal complications in case of chronic otitis media. Patients after lateral petrosectomy require systematic ENT and radiological (CT, NMR) examination.

[Management of recurrent pleomorphic adenoma of the parotid gland: analysis of the material of Otolaryngology Department, Medical University of Warsaw between 1998 and 2008]. / Postepowanie z nawrotowym gruczolakiem wielopostaciowym slinianek przyusznych: analiza materialu Kliniki Otolaryngologii WUM od 1988 do 2008 roku.

OBJECTIVES: Treatment of patients with recurrent pleomorphic adenoma of the parotid gland is a challenge for a surgeon due to frequent problems with complete resection of all tumour foci while preserving continuity and function of the facial nerve. The aim of this study was to evaluate the clinical presentation and treatment results of patients with recurrent pleomorphic adenoma of the parotid gland. MATERIALS AND METHODS: The medical records of 35 patients (25 women and 10 men) operated on (44 operations) for recurrent pleomorphic adenoma between the years 1988 and 2008 at the Otolaryngology Department, Medical University of Warsaw, were reviewed. These patients accounted for 8.9% of all patients treated for pleomorphic adenoma of the parotid gland (N=395). A retrospective analysis was performed to examine clinical features, surgical technique and facial nerve management. RESULTS: All patients had palpable, nontender mass or masses in a parotid bed after 1 to 5 previous operations. Multifocal recurrences were present in 79.5% of cases. Median interval between initial treatment and commencement of recurrences was 6.1 (0.25-29) years. Patients with more than one recurrence were younger than patients who had only one. Malignant transformation of recurrent pleomorphic adenoma was observed in two patients (5.7%). Postoperative facial nerve paresis occurred in 15 cases. In two additional cases eradication of recurrent tumour required the facial nerve resection and reconstruction. CONCLUSIONS: Recurrent pleomorphic adenoma occurs more often in younger patients and women. The risk of the facial nerve injury increases with each successive operation. Surgical treatment should be individualized, taking into consideration the extent of the previous surgery and the type of recurrence.

[Paragangliomas of the neck--a 10-year experience of the Department of Otolaryngology of Warsaw Medical University]. / Przyzwojaki szyi w materiale Kliniki Otolaryngologii Warszawskiego Uniwersytetu Medycznego w latach 2001-2010.

UNLABELLED: Paragangliomas are rare neoplasms of neurological origin and account for 0.012% of all tumors. Only 10% of them have extraadrenal localization. Head and neck paragangliomas account for 0.33% neoplasms of that localization. Typically paragangliomas are benign tumors, but even 19% cases may have malignant potential. On the neck they are located typically closely to carotid artery bifurcation, jugular bulb and along the course of vagus nerve. Laryngeal localization is very rare. Nonspecific manifestation and wide spectrum of symptoms cause difficulty in diagnosis of paragangliomas. AIM: Presentation of the diagnostic process, performed treatment and obtained results of neck paragangliomas in the material of the Department of Otolaryngology of Warsaw Medical University in years 2001-2010. MATERIAL AND METHODS: There was performed retrospective analysis, based on the medical documentation of 14 patients with neck paragangliomas (9 women and 5 men), age range 25-62 years, hospitalized in the Department of Otolaryngology of Warsaw Medical University during the last 10 years. The date from the history, physical examination, radiological evaluation and the method of performed treatment and post-treatment complications were studied. RESULTS: Out of 14 patients with neck paragangliomas, there were 9 cases of isolated tumors and 5 cases of synchronic, multicentric neoplasms. The most common and single symptom was nonspecific neck mass. Doppler ultrasonography was adequate diagnostic tool in carotid artery paragangliomas. To diagnose mulicentric paraganglioma, vagal or laryngeal paraganglioma more thorough radiological examination was necessary, including computed tomography, magnetic resonance and angiography. All patients had performed surgical treatment. There were observed very good results in patients with isolated paragangiomas of carotid artery or larynx. Surgical management of multicentric and vagal paragangliomas was exposed to higher risk of cranial nerve paresis. CONCLUSIONS: (1) Paragangliomas are rare tumors of nonspecific clinical manifestation, making the early diagnosis very difficult. (2) Precise radiological evaluation is necessary taking into consideration quite high incidence of multicentric paragangliomas. (3) There is higher risk of cranial nerve paresis after surgical treatment of multicentric paragangliomas, neoplasms larger then 5 centimeters in diameter and vagal paragangliomas then in isolated carotid artery paragangliomas.

[Round window's movability measurements with helping of LDV in evaluation of ossicular chain functioning]. / Przydatnosc badania ruchomosci okienka okraglego za pomoca laser Doppler Vibrometer w ocenie rekonstrukcji lancucha kosteczek sluchowych w tympanoplastykach typu zamknietego.

UNLABELLED: Round window's movability measurements with helping of LDV in evaluation of ossicular chain functioning. AIM OF STUDY: Quantitive evaluation of round window movability in normal conditions and after malleus stapes assembly reconstruction were aims of the study. METHODS AND MATERIALS: In the experiment there were taken 10 non-frozen temporal bones harvested within 48 hours. Temporal bones specimens were prepared like in closed technique with antromastoidectomy and large posterior tympanotomy. Hearing system before and after MSA reconstruction were evaluated by measurement of round window movement. Measurements were performed at four frequencies: 1000 Hz, 2000 Hz, 4000 Hz, 8000 Hz. RESULTS: In the normal ossicular chain the biggest movability were stated at frequency of 1 kHz. After reconstruction at all frequencies measurements were significantly worse. In reconstructed ears the highest movabilities were stated at frequencies 2000 Hz and 4000 Hz. CONCLUSIONS: Round window movability could be measured by Laser Doppler Vibrometry in posterior tympanotomy approach. Before reconstruction the biggest movability were evaluated at 1000 Hz and after MSA at 2000 Hz

[Management of recurrent sinonasal inverted papilloma in the experience of ENT Department Medical University of Warsaw]. / Postepowanie w przypadkach wznowy brodawczaka odwróconego nosa i zatok przynosowych po leczeniu operacyjnym w materiale Kliniki Otolaryngologii Warszawskiego Uniwersytetu Medycznego.

INTRODUCTION: Inverted papilloma is benign epidermal neoplasm of not recognized etiology. The lesion is estimated to represent 0.5-4% of sinonasal tumors. Generally inverted papilloma is unilateral, arises from the lateral nasal wall and characterizes with local destruction and rapid growth. The tumor can possibly undergo malignant transformation. The treatment of choice is surgery, recently endoscopic approach is considered to be superior to the open approach. THE AIM OF STUDY: was evaluation of recurrent inverted papilloma treatment results in the experience of Otolaryngology Department, Medical University of Warsaw, from 1982 to 2009. MATERIAL: The group of 124 patient (66 men and 58 women) aged from 26 to 79 with inverted papilloma operated between 1982 and 2009 were enrolled in the study. Follow up was from 6 months to 27 years. RESULTS: Most common primary localization of the tumor was combined lateral nasal wall and maxillary sinus (42%). In 37% the lesion involved unilaterally the lateral nasal wall, maxillary sinus and ethmoid sinuses, rarely it was localized only in the lateral nasal wall (16.1%) and exclusively in the nasal septum (4.8%). All the patients were treated surgically, 46% of patients underwent endoscopic procedure, 37.1% lateral rhinotomy, 15% Denker rhinotomy and 1.6% midfacial degloving. Recurrence was observed in 15.3% including 57.9% after endoscopic surgery, 26% after Denker operation and 15.8% after lateral rhinotomy. Malignant transformation was observed in 5 patient (4%). All the patients with recurrent inverted papilloma were treated surgically, 5.3% of patient underwent midfacial degloving, 5.3% Caldwell-Luc operation, 10.5% endoscopic procedure, 26.3% Denker operation and 52.6% lateral rhinotomy. CONCLUSIONS: 1. Endonasal and open approach should be considered in the surgical treatment of recurrent inverted papilloma. 2. Endoscopic approach is preferred in the recent years but qualification for each method should depend on lesion localization, extent and volume. 3. Regular follow-up enables early recurrence diagnosis and treatment.

The influence of age and comorbidities on the outcomes of surgical treatment with free tissue transfer: a retrospective study.

<b>Introduction:</b> Microvascular free tissue transfer enables the reconstruction of complex head and neck defects. The aim of the study was to assess the results of treatment of patients undergoing reconstructive surgery and to identify factors affecting these results, with particular reference to patient's age. <br><b>Materials and Methods:</b> All patients who underwent free-flap head and neck reconstruction in our institution between 2010 and 2017 were included in this retrospective study. A series of 66 patients met the inclusion criteria and were divided into 2 age groups: group G1 aged <65 years (n = 41) and group G2 aged ≥65 years (n = 25). Minor local complications and general complications as well as comorbidities were analyzed. <br> <b>Results:</b> No correlation was found between advanced age and the risk of free flap failure as well as the incidence of local minor complications. General complications were more frequent in the G2 group (32%) than in the G1 group (19.5%), although this is not a statistically significant difference. A statistically significant difference was found between the age and the patient's health status according to ASA (P = 0.010). In the younger low-risk group, 12 patients (29.3%) had general and local complications, while in the older low-risk group only 1 (4%). General and local complications were found in 5 (12.2%) high-risk G1 patients and in 7 (28%) high-risk G2 patients. <br><b>Conclusion(s):</b> Patients with advanced head and neck malignant tumors should undergo reconstructive microsurgery regardless of age.

[Nutritional status of patients with cancer of larynx and hypopharyx]. / Stan odzywienia chorych z rakiem krtani i gardla dolnego.

THE AIM OF THE STUDY: The meaning of proper nutritional state in the group of cancer patients in preoperative period was noticed already over 40 years ago. In spite, that treatment of malnutrition is easy, many patients are not diagnosed and not treated, what has obvious consequences. The aim of this study was to evaluate nutritional status of patients with cancer of larynx and hypopharynx before the treatment. MATERIAL AND METHOD: 223 men and 29 women with diagnosed squamous cell cancer of larynx and hypopharynx, who were classified to surgical treatment, were included into study. The evaluated population was divided into groups depending on location and local extend of the tumor. The nutritional state was assessed using: body mass index (BMI) and total lymphocyte count (TCL). RESULTS: Using BMI the malnutrition was diagnosed in 41% of all patients. The level of malnutrition increases while increases stage of local extend of tumor. The least numerous group of malnutritioned patients were those with tumor of glottis, but also in this group was the largest percentage of patients with local extend of tumor: T1 and T2. The state of considerable malnutrition was diagnosed in 34% patients with tumor of the piriform recess. Using TLC the malnutrition characterized 37% of all patients. In the group with tumor of glottis and epiglottis the level of malnutrition increases while increases stage of local extend of tumor. All the patients with tumor T4 with unclassified origin location were classified to the group of malnutritioned. CONCLUSIONS: The malnutrition is diagnosed in considerable percentage of patients with cancer of larynx and hypopharynx. The diagnosis of poor nutritional state will permit to apply suitable, controlled nutrition before surgical treatment. This will contribute in decrease of complication frequency and improve the tolerance of treatment.

[Method of ossicular chain valuation. Experimental measurement and clinical application]. / Metoda oceny ruchomosci kosteczek sluchowych badanie eksperymentalne i mozliwe zastosowanie kliniczne.

AIM OF STUDY: Evaluation of usefulness new non-contact method--Laser Doppler vibrometry (LDV) in measurements of movability of ossicular chain during second look operation was aim of the study. We would like answer to questions: 1. Is LDV helpful in intraoperative conditions? 2. Which measurements points have the largest practical value? 3. Which measured parameters could be used to determination of effectiveness ossicular chain reconstruction? METHODS AND MATERIALS: In experiment there were taken 3 fresh temporal bones kept in 0,9% NaCl. In first stage were executed: antromastoidectomy with wide tympanotomy. The ossicular chain movability investigation was conducted on: back branch of stapes, front branch of stapes, round window, umbo of eardrum. Laser Doppler Vibrometer was used to measurement ossicular chain's movability. ER-2 loudspeakers were generated wave: 1000 Hz, 2000 Hz, 4000Hz. In second stage were executed: Malleus-Stapes Assembly (MSA) ossicular chain's reconstruction and repeated investigation in measured points. RESULTS: The most convenient points to measurement were respectively: back branch of stapes, front branch of stapes, umbo of eardrum. In two cases round window was placed in deep niche and was partly covered by facial nerve. MSA performance didn't influence accessibility of measuring points. Theresholds of measured point's movability was useful to evaluation of reconstruction. CONCLUSIONS: Back branch of stapes, front branch of stapes and umbo of eardrum are useful to intraoperatve measurements ossicular chain movability. Delimitation thresholds of ossicular chain movability can help in reconstruction's evaluation. After next experiments LDV can be use in practice-intraoperative.

[Complications of percutaneous dilational tracheotomy--case report]. / Powiklania tracheotomii przezskórnej--opis przypadku.

INTRODUCTION: Tracheotomy is one of the most oldest operations in surgery. Percutaneous dilational tracheotomy has become increasingly popular as an alternative to standard tracheotomy over the last 30 years. It is particularly useful in patients who require prolonged mechanical ventilation, in the intensive care units. Percutaneous tracheotomy is a technique that can be performed at the bedside. It is cost effective, minimally invasive and can be done rapidly. CASE REPORT: We report a case of subglottic stenosis after percutaneous tracheotomy. A 56- year old obese man with chronic obstructive lung disease, insulin-independent diabetes, arterial hypertention and atrial fibrillation was admitted to the ENT Department because of stridor. 3 months earlier he had undergone percutaneous dilational tracheotomy due to respiratory failure. Laryngostroboscopy and a CT scan were performed, and showed 25 mm subglottic airway obstruction of the trachea. DISCUSSION: The incidence of asymptomatic subglottic tracheal stenosis after decannulation of percutaneous tracheotomy patients has been reported in over 25% with to 2% case reports of symptomatic stenosis. Although percutaneous dilational tracheotomy is considered as a safe procedure, there is a high incidence of tracheal stenosis.

[Reconstruction of the nose after oncological operations]. / Rekonstrukcje ubytków nosa po operacjach onkologicznych w materiale Kliniki Otolaryngologii Warszawskiego Uniwersytetu Medycznego w latach 1998-2007.

INTRODUCTION: Skin cancer (basal cell carcinoma, squamous cell carcinoma) and melanoma are the most frequent malignancy appearing in a human begin. The treatment of choice is surgical excision of tumor with margins of healthy tissue. An extent of resection determines the method of reconstruction. MATERIAL: The authors present reconstructive methods of nasal skin cancer defects performed in 61 patients treated in the Department of Otolaryngology of Medical University of Warsaw between 1998 and 2007. Basal cell carcinoma, squamous cell carcinoma and melanoma were diagnosed in 49, 10 and 2 patients respectively. Depending on the extend of tumor resection different reconstructive techniques were performed. RESULTS: In 9 patient tumor recurrence was detected during 1-2 years of follow-up. Among them, in 7 patients another reconstruction procedure was required, and 1 patient underwent several surgical procedures due to subsequent recurrences. CONCLUSIONS: Surgical wounds after resection of skin cancer of the nose can be closed primarily or by means of variety of reconstructive techniques that in some cases may be combined depending on the extent of a defect.

[Abscess of the parotid gland]. / Ropien slinianki przyusznej.

Inflammatory processes developing in the region of parotid gland can be specific or non-specific. Non-specific inflammation of bacterial or viral origin, which almost always are secondary to inflammatory processes in the region of oral cavity and pharynx, can be caused by presence of sialoliths in parotid gland or in the excretory duct. In the paper we presented 11 patients treated for the reason of parotid gland abscesses. Etiology, the course of the disease, and the method of treatment were analyzed.

Gender-related incidence, risk factors exposure and survival rates of laryngeal cancers - the 10-years analysis of trends from one institution.

OBJECTIVES: The aim of the study was the analysis of the epidemiology of laryngeal cancer over 10 years in relation to known risk factors and to assess the current survival rates in this group of patients. METHODS: The data were retrospectively collected from patients' medical records, then entered in the database using dedicated software and a statistical analysis was performed. RESULTS: 512 subjects - 443 men (86.5%) and 69 women (13.5%) were enrolled into the study. The male-to-female ratio was 6.4:1. There were 97.1% smoking women and 98% smoking men, however the history of more than 20 cigarettes per day smoking admitted 81.1 % of women and 94.6% of men. Heavy alcohol consumption was the case in 14 (20.3%) women and in 307 (69.3%) men. For both the size of heavy alcohol consumption and the size of excessive tobacco use, there was found statistically significant difference between women and men with laryngeal cancer (p<0.05). In the majority of male and female subjects, the tumour was located in the supraglottis/glottis area. Apparently this tumour location was much more common among women, accounting for 60.9% of cases , while in men was confirmed in 39.3% of cases. The stages of the laryngeal cancer were similarly of high advancement for both the men and women - stages III and IV were confirmed in 82.6% of women and in 77.6% of men. The over 5-year survival rate was 39.1% among women and 37.2% among men. Conclusions Contradictory to decreased exposure to risk factors and the shorter period for diagnosis, the higher stages of cancer were observed in women. Although in women the advancement was higher and the majority of cases were located in unfavourable supraglottic area, the survival rates were higher. Key words: laryngeal cancer, epidemiology, men and women, risk factors.

[Follicular (nodular) non Hodgkin's lymphoma of tonsil--case report]. / Chloniak grudkowy migdalka podniebiennego--opis przypadku.

INTRODUCTION: Non Hodgkin's lymphomas quite often present in the head and neck region and after squamous cell carcinoma are the second most common neoplasm of this area. The most predominant localization for extranodal NHL in the head and neck region is the tonsil. The vast majority of NHL at this site are B-cell lymphomas, including diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, extranodal marginal zone B-cell of MALT type. MATERIAL AND METHODS: The authors presented the case of primary extranodal non Hodgkin's lymphoma of the right tonsil in patient with the long history of chronic tonsillitis and after bilateral tonsillectomy. The affected tonsil together with enlarged lymph node was surgically removed. The histologic examination detected follicular (nodular) non Hodgkin's lymphoma, grade 3. The patient was refered to the Hematology and Oncology Department for additional treatment. RESULTS: In the Hematology and Oncology Department staging was conducted recognizing lymphoma--clinical stage I according to Ann Arbor. The patient was treated with R-COP regiment (six cycles rituximab + COP- cyclophosphamid, vincristin, prednisolon). The complete remission was achieved. The patient is in observation period both in Otolaryngology and Hematology Department. CONCLUSION: Recurrent, non-typical chronic tonsillitis with enlarged neck nodes may be follicular lymphoma's symptom, especially in older patients.

Altered Expression of miRNAs Is Related to Larynx Cancer TNM Stage and Patients' Smoking Status.

It has been reported that microRNAs (miRNAs) are responsible for acquiring all the hallmarks of cancer cells, as well as have a significant impact on the clinical management of cancers at every stage, including prognosis, remission, relapse, and metastasis. In this study, we investigated the association of miR-29a-3p, miR-202-3p, miR-3713, miR-4768-3p, and miR-548aa expression with clinicopathologic features in patients suffering from laryngeal cancer (LC) and determined the potential role of studied miRNAs in the progression of LC. The study group consisted of 48 patients with untreated primary tumors of head and neck cancer localized in the larynx. Expression of the selected miRNAs was verified by the qRT-PCR technique. We showed that the expression of miR-29a as well as miR-548aa was positively correlated with tumor stage and lymph node metastasis, whereas the expression of miR-4768-3p was negatively correlated with lymph node metastasis. Furthermore, we investigated that exposure to cigarette smoke altered miRNA expression profile in LC. The expression level of miR-202-3p was significantly increased in smoking patients compared with nonsmokers, whereas the miR-4768-3p, miR-548aa, and miR-3713 were markedly decreased. Our research contributed toward better elucidating the mechanisms underlying the progression of LC as well as the use of miRNAs inhibitors as novel agents against progression and metastasis of LC.