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.

Evaluation of benign tumors of large salivary glands according to the new classification of the European Salivary Glands Society.

<b>Introduction:</b> Tumors of large salivary glands constitute about 2-3% of all head and neck tumors. Their incidence is statistically greater in males than in females, with the first symptoms usually appearing between the 4th and 7th decade of life. <br/><b>Aim:</b> The aim of the study was to assess the usefulness of the new classification proposed by European Salivary Gland Society (ESGS) in comparison with the divisions of procedures previously valid in the literature, making a retrospective analysis of patients operated on due to benign tumors of large salivary glands in the Department of Otolaryngology, Head and Neck Oncology of the Medical University of Lodz in 2012-2020. <br/><b>Material and methods:</b> The retrospective examination was based on the material consisting of: surgical protocols, histopathological results, imaging results and clinical observations. The material includes 283 patients (141 women and 142 men): 249 patients with parotid gland tumor and 34 patients with submandibular gland tumor. The most common histopathological diagnosis was pleomorphic adenoma, which was found in 105 patients (42.17%) and adenolymphoma diagnosed in 94 patients (37.75%). <br/><b>Results:</b> The most common type of surgery was superficial parotidectomy including total superficial parotidectomy in 86 patients (34.54%) and partial superficial parotidectomy in 49 cases (19.68%). Then, according to the frequency of surgery, extracapsular tumor dissection (ECD) was performed (91 patients - 36.55%). According to the ESGS classification, in most cases parotidectomy I, II (37.34% of all parotidectomies) and parotidectomy II (28.49%) were performed. In case of ECD, all tumors were located at level II. <br/><b>Conclusions:</b> In summary, the new classification is aimed at unifying, but also simplifying the current nomenclature, reducing the existing nomenclature errors. Determination of the exact location and extent of the tumor within the parotid gland facilitates postoperative monitoring of patients by ENT doctors and those of other specialties.

[Tumors of the parotid gland--management and results of surgical treatment]. / Guzy slinianki przyusznej-obraz kliniczny, sposób postEpowania i wyniki leczenia.

INTRODUCTION: Tumors of the salivary glands are uncommon and represent 2-4% of head and neck neoplasms. Most tumors originate in the parotid gland, from which 10 to 15% are found to be malignant. Different methods of surgical treatment can be performed depending on the type, localization and size of tumor. MATERIAL AND METHODS: Retrospective analysis of the medical data of 138 patients with parotid gland tumors who where treated in our departament between 1997-2007 was done. RESULTS: There were 74 women and 64 men. Benign tumors were found in 104 patients with the pleomorphic adenoma as the most common (53 cases). The rest histological type were Whartin's tumor, myoepithelial and basal cell adenoma respectively. Malignant neoplasms were diagnosed in 16 patients, most commonly mucoepidermoid carcinoma. The most frequent localization of the tumor after dividing the parotid gland into four parts was postero-inferior pole. 68 patients (49.27%) had superficial parotidectomy, extracapsular dissection was performed in 65 cases (47.1%). CONCLUSIONS: Frequency of tumors of the parotid gland, their histological types and methods of surgical treatment in our data support other studies. Ultrasonography is the key procedure in the diagnosis of tumors of the parotid gland, qualification into surgical treatment and postoperative observation. In extracapsular dissection the risk of the facial nerve paralysis is lower than in other technics.

[Role of IFN-gamma and TNF-alpha in etiology of nasal polyps--initial studies]. / Udzial IFN-gamma i TNF-alfa w etiopatogenezie polipów nosa--badania wstepne.

OBJECTIVE: Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of interferon gamma and TNF-alpha secreted by Th1 lymphocytes and to analyze their role in the etiology of nasal polyps. METHODS: 12 patients with nasal polyposis were selected - 6 of them allergic and 6 non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Blood sample was obtained from patients and examined for the expression of IFN-gamma and TNF-alpha by intracellular staining procedure after stimulation with PMA/ionomycin and allergen. RESULTS: Negative correlation was found between expression of IFN-gamma and TNF-alpha after PMA/ionomycin stimulation and allergen stimulation (p > 0,05). Statistical analysis of two groups of patients demonstrated that no significant differences in the cytokine expression in allergic versus non-allergic patients were observed although mean value of IFN-gamma and TNF-alpha were lower in allergic patients in comparison to non-allergic (p > 0,05). We didn't observed any correlation between expression of INF-gamma and TNF-alpha and: coexistence of bronchial asthma, allergy to aspirin and local corticosteroid treatment. In patients with recurrent polyposis the expression of INF-gamma was significantly lower (p = 0,05). CONCLUSION: This research suggests that IFN-gamma and TNF-alpha play a role in the pathogenesis of nasal polyps but the allergic mechanism may not play a fundamental role in this process. It needs further investigations.

Feather holes and flight performance in the barn swallow Hirundo rustica.

Feather holes are small (0.5-1 mm in diameter) deformities that appear on the vanes of flight feathers. Such deformities were found in many bird species, including galliforms and passerines. Holey flight feathers may be more permeable to air, which could have a negative effect on their ability to generate aerodynamic forces. However, to date the effects of feather holes on flight performance in birds remained unclear. In this study we investigated the relationship between the number of feather holes occurring in the wing or tail feathers and short term flight performance traits - aerial manoeuvrability, maximum velocity and maximum acceleration - in barns swallows, which are long distance migrating aerial foragers. We measured short-term flight performance of barn swallows in a standardized manner in flight tunnels. We found that acceleration and velocity were significantly negatively associated with the number of holes in the wing flight feathers, but not with those in the tail feathers. In the case of acceleration the negative relationship was sex specific - while acceleration significantly decreased with the number of feather holes in females, there was no such significant association in males. Manoeuvrability was not significantly associated with the number of feather holes. These results are consistent with the hypothesis that feather holes are costly in terms of impaired flight. We discuss alternative scenarios that could explain the observed relationships. We also suggest directions for future studies that could investigate the exact mechanism behind the negative association between the number of feather holes and flight characteristics.

[Expression of adhesion molecule ICAM-1 in patients with nasal polyps]. / Ekspresja czastki adhezyjnej ICAM-1 u chorych z polipami nosa.

INTRODUCTION: Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The prevalence of nasal polyps seems to vary between 1 and 4% of the population. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of adhesion molecule ICAM-1 in patients with nasal polyps. MATERIALS AND METHODS: 53 patients with nasal polyposis were selected and divided into two groups--allergic and non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Immunohistochemical studies with monoclonal antibody against ICAM-1 antigen (NCL-CD54, Novocastra) using immunoperoxidase method were performed to evaluate expression of ICAM-1. RESULTS: Immunoexpression of ICAM-1 was present on some epithelial cells and on fibroblast, inflammatory cells and endothelium in the submucosa. The mean +/-SD values of the immunoexpression of ICAM-1 were significantly increased in dust-sensitive patients compared with dust-tolerant patients (1.93 +/- 0.83 vs 0.83 +/- 0.73 (p < 0.001). CONCLUSIONS: This research suggests that ICAM-1 plays an important role in the pathogenesis of nasal polyps and the allergic mechanism may play a fundamental role in this process. However, further examinations to confirm this need to be undertaken.

[Etiology of nasal polyps: an update]. / Badania nad etiopatogeneza polipów nosa.

Nasal polyps are the results of chronic inflammation of nasal mucosa. Ethiopathology of nasal polyposis is still unclear and investigated. The main aim of this study was the assessment of interleukin 2 (IL-2), 4 (IL-4) and 13 (IL-13) and interferon gamma (IFN-gamma) expressions in two groups of patients with nasal polyps: non-allergic and allergic to dust. Twelve patients with nasal polyposis were selected, six of them allergic and six non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Blood sample was obtained from patients and examined for the expression of Interleukin 2, 4, and 13 and IFN-gamma by intracellular staining procedure after stimulation with PMA/ionomycin (phorbol 12-myristate 13-acetate) and allergen (D. pteronyssimus, Allergopharma). Negative correlation was found between expression of Interleukin 2, 4, 13 after PMA/ionomycin and allergen stimulation (p > 0.05) into two groups. Although mean expression of IFN-gamma and IL-2 were lower in allergic patients with nasal polyps. Mean value of IL-4 and IL-13 were higher in allergic patients in comparison to non-allergic, but the correlations were not significant. We did not find correlations between expression of investigated interleukins and bronchial asthma and ASA-intolerance existed in patients (p > 0.05). We found that expression of IFN-gamma was significantly lower in patients with polyps recurrences followed by polypectiomies (p = 0.05). In patients who used intranasal local steroid before treatment we observed significant decrease of 11-2 and 11-13 levels after allergen stimulation (p = 0.,034, p = 0.023). No specific differences of expression of investigated cytokines between allergic versus non-allergic patients suggests that the allergic mechanism may not play an fundamental role in the aetiology and formation of nasal polyps. Furthermore local steroids seem to be used in every patient after polypectomy because of their anti-inflammatory stimulation.

Deep neck infections - still important diagnostic and therapeutic problem.

Deep neck infections (DNI) are serious problem because of variable clinical manifestations. This condition affects fascial compartments of the head and neck and organs that they contain. Nowadays the incidence of DNI have decreased because of antibiotics use and improvements in oral hygiene. But it may still lead to many life-threatening complications due to numerous portals of entry and proximity to vital structures. Furthermore, the inappropriate use of antibiotics, steroids, and nonsteroidal anti-inflammatory drugs may mask signs of infection and change the clinical presentation, and also lead to a different courses of disease. In the literature, especially in complicated cases, the mortality may range up to 42%.

[The role of chosen cytokines in etiology of nasal polyps]. / Rola wybranych cytokin w powstawaniu polipów nosa.

UNLABELLED: Nasal polyposis is a chronic inflammatory disease of the nasal mucus. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of interleukins 2 and 4 in patients with nasal polyps and to compare cytokine profile of patients with allergy versus patients without allergy. MATERIAL AND METHODS: Twelve patients with nasal polyps were selected, six of them allergic to dust and six non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin test to dust and the serum levels of IgE. Blood sample was obtained from patients and examined for the expression of Interleukin 2 and 4 by intracellular staining procedure, after stimulation with PMA (phorbol 12-myristate 13-acetate) and allergen (D. pteronyssimus, Allergopharma). RESULTS: Statistical analysis of 2 groups of patients demonstrated that no significant difference in the interleukins expression in allergic versus non-allergic patients was observed (p > 0.05). In patients who used intranasal local steroid before treatment we observed significant decrease of 11-2 level after allergen stimulation (p = 0.034). CONCLUSION: No differences of expression of Interleukin-4 between allergic versus non-allergic patients suggests that the allergic mechanism does not play an important role in the aetiology and formation of nasal polyps. To confirm this, further research needs to be undertaken.

[Polymorphism of metalloproteinases MMP-1 and MMP-2 in risk of laryngeal cancer]. / Polimorfizm genów metaloproteinaz MMP-1 i MMP-2 w ocenie predyspozycji do zachorowania na raka krtani.

INTRODUCTION: The laryngeal cancer is the most common malignancy of the head and neck squamous cell carcinoma. Recent studies have revealed the role of genetic variations in the risk for laryngeal cancer. Polymorphic genes of matrix metalloproteinases may affect an individual genetic predisposition to the occurrence and clinical implications of the disease. THE AIM OF THE PRESENT STUDY: was to evaluate the role of polymorphic variants of MMP-1 and MMP-2 genes in the development of laryngeal carcinoma. MATERIAL AND METHODS: DNA was extracted from 633 individuals including 261 patients with laryngeal carcinoma and 372 healthy volunteers. Genotyping was carried out using TaqMan(®) SNP Genotyping Assays (Applied Biosystems, USA). The distribution of polymorphisms of metalloproteinases were analysed: -1607 1G/2G MMP-1 and -1306 C/T MMP-2 gene. RESULTS: The distribution of genotypes of -1607 1G/2G MMP-1 polymorphism was significantly different in controls vs patients (χ(2) 15.05, p<0.001). The 2G allele carriers of MMP-1 -1607 1G/2G polymorphism were at higher risk for laryngeal carcinoma development (p<0.001). In the present study, 2G/2G polymorphic variant was the independent factor of cancer development (p=0.0015). CONCLUSION: Presented data suggest an implication of MMP-1 polymorphisms in the laryngeal carcinoma susceptibility. The presence of the MMP-1 2G allele seemed to be associated with increased risk for the disease. In summary, the current study have provided the evidence that an individual's risk for carcinoma of larynx is modulated by genetic factors.