Could MMP3 and MMP9 Serve as Biomarkers in EBV-Related Oropharyngeal Cancer.

The high incidence of, and mortality from, head and neck cancers (HNCs), including those related to Epstein-Barr virus (EBV), constitute a major challenge for modern medicine, both in terms of diagnosis and treatment. Therefore, many researchers have made efforts to identify diagnostic and prognostic factors. The aim of this study was to evaluate the diagnostic usefulness of matrix metalloproteinase 3 (MMP 3) and matrix metalloproteinase 9 (MMP 9) in EBV positive oropharyngeal squamous cell carcinoma (OPSCC) patients. For this purpose, the level of these MMPs in the serum of patients with EBV-positive OPSCC was analyzed in relation to the degree of histological differentiation and TNM classification. Our research team's results indicate that the level of both MMPs is much higher in the EBV positive OPSCC patients compared to the EBV negative and control groups. Moreover, their levels were higher in more advanced clinical stages. Considering the possible correlation between the level of MMP 3, MMP 9 and anti-EBV antibodies, and also viral load, after statistical analysis using multiple linear regression, their high correlation was demonstrated. The obtained results confirm the diagnostic accuracy for MMP 3 and MMP 9. Both MMPs may be useful in the diagnosis of EBV positive OPSCC patients.

Serum and Saliva Level of miR-31-5p and miR-let 7a in EBV Associated Oropharyngeal Cancer.

Epstein-Barr virus (EBV) has a well-documented association with head and neck neoplasms, including nasopharyngeal carcinoma (NPC). In the last few years, research aimed at elucidating the role of the miRs in the pathogenesis of head and neck cancer (HNC) has gained importance. The study of miRs expression has set new directions in the search for biomarkers with diagnostic and prognostic value, and even in the search for new therapeutic targets for various tumors, including HNC. The aim of current study was to approximate the importance of miR-31-5p and miR-let 7a in the pathogenesis of EBV associated oropharyngeal cancer. For this purpose, experiments were carried out to determine the level of mentioned miRs in serum among patients diagnosed with oropharyngeal cancer linked to EBV infection, depending on histological differentiation-grading (G1-G3) and TNM classification. All clinical specimens stratified by HPV status were HPV negative. The level of antibodies EBNA and EBVCA was also assessed. The obtained results showed a significantly increased serum level of miR-31-5p but decreased level of miR-let 7a in EBV positive oropharyngeal cancer patients. We demonstrated association between the level of tested miRs and clinical stage. Our findings showed that miR-31-5p and miR-let-7a may be involved in development and progression of EBV associated oropharyngeal cancer. Therefore, it seems important to further study these molecules, as well as to determine whether they could be important biomarkers in the diagnosis of oropharyngeal cancer associated with EBV infection.

Bioelectrical impedance phase angle and subjective global assessment in detecting malnutrition among newly diagnosed head and neck cancer patients.

Malnutrition, which can be determined by subjective and objective methods, has a high prevalence in head and neck cancer patients. Subjective Global Assessment is a subjective method of nutritional status evaluation. Phase angle, determined by bioelectrical impedance analysis, is proposed as an objective nutritional marker in various disease conditions. The study was conducted to investigate the association between phase angle and Subjective Global Assessment to validate the determination of the nutrition status in adult patients with head and neck cancer. In a prospective cohort study, patients were classified as either well-nourished or malnourished using the Subjective Global Assessment. Phase angle measured by bioelectrical impedance analysis was planned in 75 naive patients with histologically confirmed head and neck cancer. Receiver operating characteristic curves were estimated using the non-parametric method to determine the optimal cut-off level of phase angle. The study was conducted on a cohort population of 75 patients. Well-nourished patients (n = 45) had a statistically significantly higher (p = 0.005) median phase angle score (5.25º) as compared to those who were malnourished (4.73º) (n = 30). A phase angle cut-off of 4.73 was 80 % sensitive and 56.7 % specific in detecting malnutrition diagnosed by SGA in these populations. Phase angle is considered to be a nutritional indicator in patients with head and neck cancer in detecting malnutrition. Further observations are needed to calculate survival, and validate the prognostic significance of phase angle. For future studies, it is important to indicate the specificity of the PA in comparison to SGA measurement.

Prevalence of Polyoma BK Virus (BKPyV), Epstein-Barr Virus (EBV) and Human Papilloma Virus (HPV) in Oropharyngeal Cancer.

The aim of this study was to analyze the prevalence of BK virus, Human Papillomavirus and Epstein-Barr virus in oropharyngeal cancer, and to test our hypothesis that BKV/HPV/EBV co-infection plays a role in oropharyngeal squamous cell carcinoma. The correlation between viral infection, OSCC, anatomic location, pre-treatment staging, evidence of metastases to lymph nodes, and grading was also investigated. The examination samples were collected from 62 patients from paraffin tissue blocks. Males (90.3%) with, smoking (83.9%) and alcohol abuse (67.7%) problems prevailed in the studied group. G2 histological type was recognized in 80.6% cases. T4 (77.4%) and N2 (56.5%) traits occurred in the majority of patients. No cases of metastasis were observed (M0 100%). HPV - 24.2%, EBV - 27.4% and BKV 17.7% were detected in the studied samples. We observed co-infection EBV/BKV in 8% of cases, HPV/BKV in 4.8%, and HPV/EBV in 9% cases. Only in two cases co-infection of all three viruses was found.

Body composition analysis in head and neck squamous cell carcinoma.

Direct bioimpedance measures [resistance, reactance, phase angle] determined by bioelectrical impedance analysis (BIA) detect changes in tissue electrical properties. Bioelectrical impedance analysis vector (BIVA) technique is a promising tool, using the pure data obtained by BIA evaluation for the screening and monitoring of nutrition and hydration status. BIVA has the potential to be used as a routine method in the clinical setting for the assessment and management of body fluids. The study was conducted to evaluate soft tissue hydration and mass through pattern analysis of vector plots as height, normalized resistance, and reactance measurements by bioelectric impedance vector analysis in patients with head and neck cancer. Whole body measurements were made with ImpediMed bioimpedance analysis in 134 adult, white, male subjects 22-87 years old: 67 patients with head and neck cancer (H&NC) and 67 healthy volunteers matched by sex, age and BMI as a control group. All patients were previously untreated and without active nutritional interventions. Mean vectors of H&NC group versus the control group were characterized by an increased normalized resistance component with a reduced reactance component (separate 95% confidence limits, P < 0.05). BIVA may offer objective measures to improve clinical decision-making and predict outcomes. In patients with H&NC to reduce post-operational complications monitoring bioimpedance vector trajectory may support therapy planning of individual patients before surgery.

Serum NF-κB in Epstein-Barr Virus-Related Oropharyngeal Carcinoma Diagnostic Usability.

Early diagnosis and effective therapy are the fundamental challenge for modern oncology. Hence, many researchers focus on the search for new or improved biomarkers. Due to the great importance of nuclear factor kappa B (NF-κB) in physiological and pathological processes, we focused on assessing its usefulness as a biomarker in OPSCC. The purpose of the research presented here was to evaluate the prevalence and the level of NF-κB in the serum of OPSCC patients (ELISA). Serum NF-κB levels were also assessed depending on the degree of histological differentiation of the tumor and TN classification. Additionally, we considered the existence of a correlation between the concentration of NF-κB and EBV antibody titers, viral load and selected MMPs-MMP3 and MMP9. Taken together, the obtained results demonstrated that NF-κB level was significantly higher among patients with EBV-related OPSCC than among those without EBV. In addition, the level of NF-κB was significantly higher in more advanced clinical stages. Moreover, a positive correlation was found between the concentration of NF-κB and the level of selected EBV antibodies, viral load and both tested MMPs. The diagnostic accuracy of NF-κB was confirmed by ROC analysis.

Serum Anti-Zta and Anti-LMP1 Antibodies in Oropharyngeal Cancer Related to Epstein-Barr Virus-Diagnostic Usefulness.

BACKGROUND: The role of the Epstein-Barr virus (EBV), the first known human oncogenic virus, in the development of nasopharyngeal cancer (NPC) is already well documented. There are few studies in the available scientific literature on oropharyngeal cancer associated with EBV infection. Due to the lack of an effective vaccine against EBV, it is necessary to search for new markers for the early diagnosis and prognosis of this disease. The aim of current study was to determine the usefulness of anti-Zta and anti-LMP1 antibodies as diagnostic and prognostic markers in EBV positive OPSCC patients. METHODS: For this purpose, experiments were carried out to determine both the prevalence and level of EBVCA, EBNA1, EA, Zta, and LMP1 antibodies in serum patients depending on histological differentiation-grading and TNM classification (ELISA assay). RESULTS: Based on the obtained results, we showed that OPSCC EBV positive patients are characterized by a higher level of anti-Zta antibodies than in the EBV negative group. Their level depended on the clinical stage. Moreover, a ROC analysis confirmed the diagnostic accuracy of anti-Zta antibodies. CONCLUSIONS: Anti-Zta and anti-LMP1 antibodies may be useful in the diagnosis of OPSCC. It seems that combined antibody testing should be performed to increase diagnostic accuracy.

Extranasopharyngeal angiofibroma: clinical and radiological presentation.

Nasopharyngeal angiofibroma (NA) is a rare, vascular tumor affecting adolescent males. Due to aggressive local growth, skull base location and risk of profound hemorrhage, NA is a challenge for surgeons. Angiofibromas have been sporadically described in extanasopharyngeal locations. We review ten cases of extranasopharyngeal angiofibroma (ENA) and discuss the incidence, clinical presentation and management of this pathology. The group consisted of 4 males and 5 females aged 8-49. There were 7 patients with nasal angiofibroma, 1 patient with laryngeal angiofibroma, 1 patient with oral angiofibroma and another patient with infratemporal fossa tumor. In patients with nasal angiofibroma most common presenting symptoms were nasal obstruction and epistaxis. Patients with laryngeal angiofibroma suffered from mild dysphagia and patients with the infratemporal fossa tumor had painless cheek swelling. In four patients with nasal tumor computed tomography (CT) demonstrated mass with strong to intermediate contrast enhancement. In one patient with nasal tumor carotid angiography demonstrated pathological vessels without intensive tumor blush. Infratemporal fossa tumor showed intensive contrast enhancement on CT and magnetic resonance imaging (MRI) scans, and abundant vascularity on angiography. Laryngeal and oral angiofibroma required no radiological imaging. Three nasal tumors were evaluated before introduction of CT to clinical practice. All patients underwent surgery. No recurrences developed. ENAs differ significantly from NAs regarding clinical and radiological presentations. They lack typical clinical and radiological features as they develop in all age groups and in females, may be less vascularised, arise from various sites and produce a variety of symptoms.

Application of bioelectrical impedance analysis in monitoring patients with head and neck cancer after surgical intervention.

INTRODUCTION: It is estimated that about 60% of patients with head and neck cancer (HNC) show poor nutritional status, and approximately 80% lose weight during treatment. The impact of surgical procedures on the risk of further weight loss, severe malnutrition and cachexia is a significant clinical problem that determines the higher incidence of postoperative complications, reduced effectiveness of the treatment used, longer hospitalization time, poor quality of life and higher mortality among patients. Bioelectrical impedance analysis (BIA) is currently recognized as a useful method of assessing the body composition and therefore the nutritional status of cancer patients. The aim of this study is to investigate whether measured and calculated parameters of BIA change shortly after surgery and could reflect the health of cells and body composition changes. MATERIALS AND METHODS: We enrolled 54 patients (males) with advanced HNC in this observational study. We collected detailed anthropometric and BIA derived data. The Subjective Global Assessment (SGA) was used to assess the nutrition. RESULTS: In the assessment performed one week after the surgery, compared to the condition on the day of surgery, the patients had significantly lower values of nutritional status (weight; body mass index - BMI; SGA), body composition (free fat mass - FFM; intracellular fluid - ICF; total body water - TBW). Other changes include a significant increase in fat mass (FM) or extracellular fluid (ECF). Moreover, a significant reduction of phase angle (PA, one of the most important BIA derived prognostic factors) was also noted. CONCLUSIONS: Apart from the baseline assessment of the body composition and diagnosing nutritional disorders, it seems, that BIA should be considered also in the monitoring of HNC patients undergoing surgery.

Vibrations in the human middle ear.

BACKGROUND: Middle ear surgery techniques can improve hearing destroyed by disease, but results of treatment are difficult to predict. Therefore, researchers use a Laser Doppler Vibrometer to measure vibrations of human middle ear ossicles. MATERIAL/METHODS: Measurements of ossicular chain vibrations are performed on fresh human temporal bone specimens using Laser Doppler Vibrometer. Vibrations of stapes are recorded in 3 cases: 1) for intact ossicular chain, 2) when incus long process is removed, and 3) after long process reconstruction with bone cement. A typical analysis of transfer function is completed by other methods applied in dynamics. RESULTS: Measurements and analysis of stapes vibrations in case of intact and damaged ossicular chain show regular and irregular behavior which can be recognize with the help of phase portraits, recurrence plots, correlation dimension, and Hurst and Lyapunov exponents. The long process reconstruction with bone cement gives good results in improving hearing. CONCLUSIONS: Recurrence plots, and Lyapunov and Hurst exponents used in the study complete information obtained from transfer function and can be employed to enrich the classical approach to ossicular chain vibrations.

Evaluation of tracheal stenosis: comparison between computed tomography virtual tracheobronchoscopy with multiplanar reformatting, flexible tracheofiberoscopy and intra-operative findings.

The aim of the study was to evaluate and compare various helical CT display modes [virtual endoscopy (VE)] and multiplanar reformations (MPR), conventional flexible tracheobronchoscopy (FT) and intra-operative (IO) findings in patients with tracheal stenosis and to analyze the advantage of MPR and VE in diagnosis and treatment planning and in postoperative follow-up. Thirty-seven patients with tracheal stenosis underwent standard neck and chest CT followed by MPR and VE. Results were correlated with the results of FT and IO findings. Thirty-three of the 37 stenoses were correctly graded and measured adequately using VE. Complete correlation among CT, fiberoptic tracheoscopy, and surgery of stenosis grading, stenosis length and length of planned resection segment of the trachea was noted between 33 of 37 patients with tracheal stenosis. Correlation between VE and IO was noted in 35 of 37 patients and between FT and VE was noted in 33 of 37 patients with tracheal stenosis. The sensitivity of VE was 94-97%, specificity was 100% with comparison to IO findings. The sensitivity and accuracy of MPR was 86-89% and specificity was 100% with comparison to FT findings. The results of the study indicate that VE is an excellent, consistent, and objective technique. VE with MPR is very useful in diagnostic evaluation and treatment planning in patients with tracheal stenosis.

Association between human papillomavirus infection and laryngeal squamous cell carcinoma.

The aim of this study was to compare the prevalence of human papillomavirus (HPV) infection in laryngeal squamous cell carcinoma using two methods: PCR-DNA enzyme immunoassay (PCR/DEIA) and immunohistochemistry (IHC) for detection of HPV in specimens of laryngeal squamous cell carcinoma and to correlate the presence of HPV with the epidemiological and clinicopathological features of recurrence and survival. HPV DNA was amplified from 93 paraffin-embedded laryngeal squamous cell carcinoma tissue specimens by the short PCR fragment (SPF 10) primer set using PCR/DNA method. HPV detection using monoclonal anti-human papilloma virus antibodies Clone K1H8 for IHC reaction was performed on 130 specimens. HPV was identified in 35.5% of patients with laryngeal squamous cell carcinoma using PCR/DEIA and 27.7% using IHC. There was no statistically significant association between the presence of HPV and the epidemiological and clinicopathological features and recurrence. There was no statistically significant association between the presence of HPV and overall survival nor disease specific survival. Statistically significant correlation between HPV detection using PCR/DEIA technique and IHC technique was found. The presence of HPV infection in 27.7% and 38.9% of the patients suggests a possible role in the etiology of laryngeal squamous cell carcinoma. The SPF(10) PCR/DEIA technique is the most accurate method for detection of HPV in laryngeal squamous cell carcinoma.

[Vibrations of the human tympanic membrane measured with Laser Doppler Vibrometer]. / Drgania blony bebenkowej oceniane Dopplerowskim wibrometrem laserowym.

The knowledge of the physiology of the normal ear is important to understand the function of the ear. It is especially crucial in the reconstruction of the destroyed ear to apply the knowledge of the normal ear. We present results of tympanic membrane vibrations measurements using Laser Doppler Vibrometer in human temporal bone specimens. Six temporal bone specimens were harvested within 48 hours of death and stored cooled until preparation. The preparation included mastoidectomy with posterior tympanotomy and partial resection of the facial nerve to visualize the stapes with its footplate. We measured velocity and displacement of each quadrant of the tympanic membrane and the umbo with the laser Vibrometer equipped with velocity and displacement decoders. The sensor head OFV-534 produced and read the reflected laser beam directed at a measured point with a dedicated micromanipulator attached to an operating microscope. A retro-reflective tape was used to enhance the reflection of the laser beam. Vibrations were induced by a acoustic stimulation at the tympanic membrane. The results of the measurements were corrected to a sound pressure in the external ear canal. Laser Doppler Vibrometer system allows an undisturbed measurement of vibrations in the middle ear. Posterior quadrants of the tympanic membrane have greater velocity and displacement than anterior quadrants in lower frequencies up to 2 kHz.

[Recurrence in operated patients with laryngeal squamous cell carcinoma]. / Wznowy u pacjentów leczonych operacyjnie z powodu raka krtani.

PURPOSE: The aim of the present study was to investigate the recurrence prevalence in patients with laryngeal squamous cell carcinoma (LSCC) underwent surgery as primary treatment. MATERIAL: The assessed group consisted of 148 patients with operable LSCC underwent surgery as primary treatment between 1999-2002. Surgery was performed in all cases. Total laryngectomy was performed in 107 (72.3%) patients and laser endoscopic tumor resection was performed in 41 (27.7%) patients. RESULTS: Local recurrence occurred in 18 (12.2%) patients, nodal recurrence in 12 (8.1%) and both and/or remote metastases in 6 (4%) patients. Altogether, recurrence was present in 36 (24.3%) patients and 111 (75.7%) patients had no symptoms of recurrence. Recurrence prevalence in 3-year follow-up--prevalence of recurrence significantly increased with tumor's T feature (p=0.04), N feature (p=0.03), progression of clinical stage (p=0.008) and histological malignancy G stage (p=0.01). Recurrence prevalence in 5-year follow-up--prevalence of recurrence significantly increased with tumor's T feature (p=0.02), N feature (p=0.01), progression of clinical stage (p=0.003) and histological malignancy G stage (p=0.002). Tumors localized in glottic area had less recurrences than those localized in supraglottic area (p=0.05). There were no significant dependence between recurrence type (local or nodal) and tumor's clinicopathological features. Multiple factor analysis with logistic regression model did not revealed simultaneous influence of many variables on recurrence's presence and type. Using multiple factor analysis with Cox's regression model it was proved that recurrence presence (p<0.00001) is a significant independent prognostic factor in the analyzed group of patients with laryngeal carcinoma in 3-year follow-up. CONCLUSIONS: Recurrence prevalence depends on localization, systemic progression stage, clinical progression stage, cervical lymph nodes state and histological malignancy stage of tumor. Patients with local recurrence have statistically significantly worse prognosis than patients with no recurrence. Recurrence presence is significant independent prognostic factor in 3-year follow-up.

Laryngeal cancer in farmers from Lublin region of Poland.

The aim of the study was to analyse if work related risk factor had any influence on stage, localisation and histology of type of malignant tumour. Demographic and risk factors and results of treatment of farmers with patients working outside farming were compared. The group included 148 patients with primary laryngeal squamous cell carcinoma (LSCC) diagnosed and treated in our institution in the years 1999-2002. 84 (56.8%) of 148 patients were farmers and 64 (42.2%) patients worked outside farming. The univariate analysis of demographical and clinicopathological features of the farmers' group versus the other professions group with LSCC showed a statistical significance for sex, age and G stage. Nearly statistical significance was observed for the N stage (p=0.06) and for primary localisation of the tumour (p=0.05). The difference in 3 and 5-year survival rates between the group of farmers in comparison with the group of patients working outside farming and with LSCC was not significant for most of the demographical and clinicopathological features. Local, nodal or local plus nodal recurrence occurred in 15 (21.1%) of 84 farmers during 3 years follow-up. Distant metastases were observed in 7 (8.3%) of 84 farmers with LSCC, 6 to the lungs and one to the liver. Farmers with larynx cancer had different presentation pattern than other profession patients. The incidence of glottic cancer and well differentiated cancer was higher in farmers than in other professions. The prevalence of larynx cancer in women was significantly lower among farmers than in other professions. There were older patients in the group of farmers and relatively less women than in the group of patients with other professions.

Transnasal microscopic approach for juvenile nasopharyngeal angiofibroma.

INTRODUCTION: Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, vascular tumor originating in the nasopharynx. The treatment of choice for JNA is surgical excision. In recent years, surgical management has been greatly influenced by the use of the transnasal endoscopic technique. THE AIM: The aim of the study was to present our experience with the transnasal microscopic removal of JNA. MATERIAL AND METHODS: Ten patients with JNA aged 12-17 underwent diagnostics imaging and transnasal microscopic tumor excision. Medical records of patients were retrospectively reviewed. The main outcome measures were complications and recurrences. Preoperative embolization of feeding vessels was performed in 7 patients. RESULTS: According to Andrews' classification, the group included 2 stage I patients, 6 stage II patients and 2 stage IIIA patients with the extensive occupation of the infratemporal fossa. 9 patients had no recurrence in 6-11 years follow up. One stage IIIA patient had a recurrence posteriorly to the pterygopalatine process and it was completely removed. No complications during or after surgery occurred. CONCLUSION: Transnasal microscopic excision is an effective approach to resect stage I-IIIA JNA.

The influence of the sequence of surgical steps on complications rate in stapedotomy.

OBJECTIVE: To assess whether the incidence of complications of stapes surgery depended on the sequence of surgical steps and CO2 laser use in stapes surgery. STUDY DESIGN AND SETTING: Retrospective and prospective analysis of 420 consecutive stapedotomies was set in tertiary referral University Hospital. PATIENTS: 376 patients with otosclerosis in whom 420 primary stapedotomies were performed. INTERVENTION: Stapedotomy under local anesthesia using manual perforators and CO2 laser. MAIN OUTCOME MEASURE: The incidence of incus subluxation, floating footplate during stapedotomy. RESULTS: Comparison of the incidence of incus luxation in groups with the piston inserted after removal of the stapes arch, and groups with the piston inserted on the intact ossicular chain showed statistical significance. In the group where perforation of the footplate was performed after removal of the stapes arch floating footplate occurred more often than in groups with reversed sequence of steps. CONCLUSION: Perforation of the footplate before removal of stapes arch reduces the risk of floating footplate, and placing the prosthesis on the incus before removal of stapes arch reduces the risk of subluxation of the incus. CO2 laser stapedotomy with reversed sequence of steps was the safest method of stapes surgery.

An immunohistochemical study of cyclin D1 protein expression in laryngeal squamous cell carcinoma.

CONCLUSION: Contrary to most reports, our study shows that the expression of cyclin D1 is not an independent prognostic factor in patients with laryngeal cancer (LC). No correlation between cyclin D1 expression and survival rates in LC was found in a multivariate analysis. OBJECTIVES: The aim of this study was to determine the possible relevance of the expression of cyclin D1 protein in LC as prognostic criteria and to analyse correlation of the expression with clinicopathological features and survival rates. MATERIALS AND METHODS: Immunohistochemistry staining was used to detect the expression of cyclin D1 in 130 samples of laryngeal cancer and in 22 specimens of laryngeal nodules. RESULTS: Cyclin D1 expression was found in 52 (40%) LC samples and in 3 (13.6%) samples of laryngeal nodules. There was no significant correlation between cyclin D1 expression and clinicopathological features of LC. A multivariate analysis of survival confirmed that cyclin D1 expression was not an independent prognostic factor in LC.

[Nasal cavity dermoplasty as a treatment of recurrent bleeding in Rendu-Osler-Weber's disease]. / Dermoplastyka jam nosowych w leczeniu nawrotowych krwawien z nosa w chorobie Rendu-Oslera-Webera.

INTRODUCTION: Rendu-Osler-Weber's (ROW) disease is a systemic disorder of blood vessels classified as a capillary malformation. The most common manifestation of hereditary hemorrhagic teleangiectasia is recurrent epistaxis. The diagnosis of ROW disease is made clinically using the Curacao criteria. Management of epistaxis is usually difficult and many types of treatment have been described. MATERIAL AND METHODS: We report 12 patients, 7 female and 5 male, aged 52 to 78 with ROW disease and recurrent epistaxis with frequency varying from 5 episodes monthly to 3 - 5 episodes daily. In most of them blood transfusion was required. The patients were treated with intranasal dermoplasty described by Saunders. The dermoplasty was performed on the septal, lateral or both walls of the anterior part of the nasal cavities. RESULTS: In all the patients the graft was taken completely. Two patients had scars and narrowing of nasal valve region. Recurrence and increase in the intensity of nasal bleeding were observed in 3 patients. In the course of further therapy the second partial septal dermoplasty was successfully performed in 2 of them. The second surgery revealed new bleeding teleangiectases beyond of the dermal graft. CONCLUSION: Nasal cavity dermoplasty remains an effective way of reducing epistaxis and blood transfusion in patients with ROW disease and subjectively improves their quality of life. The surgical treatment can be repeated, if nasal bleeding recur.

[Extension of nasal and paranasal sinus malignancies on the basis of computed tomography]. / Rozleglosc nowotworów jamy nosowej i zatok przynosowych na podstawie tomografii komputerowej.

INTRODUCTION: Location and extension of tumour are crucial for results of treatment and prognosis in patients with nasal and paranasal sinus malignancies. The aim of the study was to evaluate the site and extension of nasal and paranasal sinus malignancies using computed tomography (CT). MATERIAL AND METHOD: The group included 124 patients aged 5-83 years. Biopsy confirmed malignant neoplasm in all the patients. Surgery was performed in 92 patients, for 32 inoperable patients palliation was applied. RESULTS: CT revealed that the most common (just above 70%) tumour sites were the nasal cavity, maxillary and ethmoid sinuses. The most common (about 50%) extrasinusal involvements were the orbit, subcutaneous cheek tissue and infratemporal fossa. Only 24.2% of patients had tumour limited to the nose and sinuses. CONCLUSIONS: CT well demonstrates extension of nasal and paranasal sinus malignancies. Vast majority of patients (75.8%) present with tumour extended beyond sinuses.