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SummaryPurpose. The aim of the study was to evaluate serum concentrations of total sialic acids (TSA) in patients with squamous cell carcinoma of the larynx preoperatively and 4 years postoperatively and to compare the results with the serum concentration of sialic acids in patients with non-neoplastic laryngeal lesions., Methods: The study comprised 52 patients with squamous cell carcinoma of the larynx and 25 patients with non-neoplastic laryngeal lesions. Serum TSA concentrations were assessed in all patients preoperatively. Four years after surgery, serum TSA concentrations were assessed again in 21 patients from the study group in whom recurrence was not detected., Results: Significantly higher serum concentrations of TSA were found in patients with laryngeal cancer compared to the control group (p< 0.0000001). Changes in TSA concentrations in the study group depended only on cancer grade (G). Significantly higher TSA concentrations were found in G3 patients. Such a relationship was not found for other parameters assessed. Alcohol consumption was the only important factor that affected TSA concentration in the control group. Significantly higher TSA concentrations were found in patients who admitted alcohol abuse. Significantly lower TSA concentrations were observed in patients with laryngeal cancer who were assessed 4 years postoperatively (p < 0.000106)., Conclusion: Serum concentration of TSA was increased significantly in laryngeal cancer and decreased significantly after several years of successful treatment. Further studies are warranted to assess the possibility of using sialic acids as a marker or target for immunotherapy., Key Words: sialic acids, squamous cell carcinoma of the larynx, markers in laryngeal cancer, N-acetyl-5-neuraminic acid.

Introduction: Adaptation of laser surgery in laryngeal cancer treatment in 1970s led to great successes and common acceptation of this treatment method in cancer treatment. The results of cancer treatment with CO(2) laser are the same as after radiotherapy or external access method., Material and Methods: The study included 63 patients treated for glottis cancer T1. 33 persons were treated by cordectomy type III with transmuscular cordectomy using CO(2) laser. The remaining 30 persons are patients treated using radiotherapy with so called "small spots". The tested material consisted of 100% squamosus carcinoma. The patients qualified for the examination received a card of voice self-examination. The perceptive examination of the voice was performed according to the GRBAS scale where each of parameters is defined in a four degree scale of the particular disturbance degree. The mobility and vibrations of the vocal folds were accessed using videolaryngoscopy while the acoustic analysis was performed on the basis of the acoustic analysis module., Results: On the basis of the patients' voice quality self-assessment and the perceptive assessment of the voice quality based on the GRBAS scale, no significant differences between the groups were found. Furthermore no statistically significant differences were found for the phonation closure and maximal phonation time in both groups., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Unlabelled: The nasal polyps associated with Samter's triad are often very extensive, difficult to treat, with great tendency to recurrence. In this paper the current opinion on nasal polyps management in aspirin triad patients was presented., Pathogenesis: Opinions on pathogenesis of these disease was remembered as well as its epidemiology., Diagnostic Methods: The available diagnostic methods were presented. Treatment options: The available preservative treatment options was analyzed including aspirin desensitization. The role of surgical treatment, functional endoscopic sinus surgery was analyzed., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Several fungal species are known to cause severe respiratory and cutaneous diseases. The aim of this work was to analyze the fungal flora in maxillary sinuses in patients suffering from chronic sinusitis with polyps. Twenty five patients (11 woman, 14 man) who underwent endoscopic surgical procedures were included into the study. During the operation, the smear from the maxillary sinus were obtained for the incubation. In 6 persons fungal floras was present., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: Bilateral vocal cord paralysis is caused by the damage of both recurrent laryngeal nerves. Such a pathology is not commonplace in the ordinary medical practice. It most often occurs as a complication after the thyroid gland surgery or thyroid re-surgery. In the case of bilateral vocal cord paralysis the treatment of the patient includes performing immediate tracheotomy or one of the surgeries aiming at widening the glottis because of dyspnea caused by the upper respiratory tract obstruction on the glottis level., Aim: The comparison of efficacy and usefulness of two surgical techniques performed to widen the glottis – laser arytenoidectomy with posterior cordectomy and laterofixation., Material and Methods: The research was carried out on the group of 57 patients suffering from bilateral vocal cord paralysis who, in the period of 1997–2009, underwent treatment in ENT Department in Zabrze Medical University of Silesia in Katowice. The first group included 36 patients who underwent laser arytenoidectomy with posterior chordectomy. The second group included 21 patients who underwent laterofixation. All of the patients treated with the laser arytenoidectomy with posterior cordectomy and laterofixation were subjected to respiratory system ventilation examinations before the procedure of widening the glottis and after the healing, at least 4 months after the surgery. Making self-evaluation, each of the patients answered a question concerning the improvement of their breathing comfort after the surgery. The patients from both groups underwent the vocal apparatus examination which included: subjective perceptive voice analysis according to GRBAS scale, videolaryngostroboscopy, evaluation of the maximum phonation time, self-evaluation survey of the post-surgical voice quality., Results: Among 57 patients suffering from bilateral vocal cord paralysis and operated by arytenoidectomy with posterior cordectomy (group I) and laterofixation (group II), a subjective improvement of the comfort of living was achieved which resulted in the possibility of making more physical activities. From the first group, 35 out of 36 patients were decannulated. In the second group, both patients who had previously undergone tracheotomy were successfully decannulated. There were no statistically significant differences in the increase of selected ventilation markers between the patients who underwent laser arytenoidectomy and those who underwent laterofixation. There were no substantial discrepancies in the perceptive voice analysis in GRBAS scale between the patients after laser arytenoidectomy and those treated with the technique of laterofixation. When asked about their post-surgical voice quality, the patients of the first and the second group rated their voice as worse than before the surgery., Conclusion: Both surgical techniques, laser arytenoidectomy with posterior cordectomy and laterofixation, are efficient and useful in widening the glottis in the case of bilateral vocal cord paralysis. The improvement of the ventilation markers allows the growth in the comfort of living, restoration of the physiological respiratory tract and decannulation of the patients who had undergone tracheotomy. The deterioration of the voice quality is characteristic of both surgical techniques.

Chondrosarcoma of the larynx is a rare condition of still unknown pathogenesis. This tumor occurs usually between the sixth and seventh decade of life. Forty five years old patient was admitted to the ENT Department in Zabrze for a diagnosis of a slow growing tumor from about 3 years. The great unmovable tumor 2.5 cm/3 cm/3 cm was arising from the cricoid cartilage. The hist-pat result of the biopsy was cartilage. The patient did not agree on the proposed surgical treatment. After one year, in the MRI examination, the tumor sized 46 mm/37 mm/39 mm was found. The patient was again qualified for the operation and agreed for the proposed treatment. In general anesthesia, the tumor together with the part of trachea, cricoids and thyroid cartilages was resected. After excision the reconstruction was performed. During 10 months of the follow-up the patient remains free of the disease.

The abscess of parapharyngeal space is very dangerous health condition graving numerous complications such as: jugular vein thrombosis, mediastinitis, arterial bleeding. This state originates most frequent during the acute pharyngitis, and especially acute tonsillitis. The aim of our study was to review the clinical sings, computed tomography scans and outcome of parapharyngeal space infection. 3 patients treatment in our Department were underwent surgical drainage and aggressive antibiotic therapy. One patient was treated solely with intravenous antibiotic therapy. The average time of hospitalization was 16 days. No one complication was observed.

The frequency of fungal etiology of sinusitis contains between 9 and 49 % according to different authors. Fungal rhinosinusitis has been divided into noninvasive and invasive forms. Noninvasive infections include fungus ball (mycetoma) and allergic fungal rhinosinusitis. Invasive infections include acute (or fulminates) fungal rhinosinusitis and invasive chronic rhinosinusitis. The case of chronic invasive rhinosinusitis was presented. Patient performed surgery--Functional Endoscopic Sinus Surgery and paranasal sinuses operation from subcranial approach. Surgery procedures were followed by antifungal pharmacotherapy (Orungal and Worykonazol). The presented case of fungal invasive chronic rhinosinusitis was treated according to recommended procedures with surgery followed by adequate antifungal farmacotherapy. In this case we have reached a successful outcome.

Introduction: The radical treatment of tracheal stenosis comprises segmental resection and its reconstruction. The most successful type of reconstruction is the "end to end" technique. In cases with large tracheal defects (over 6 cm) this kind of reconstruction is impossible. From many years the adequate biomaterial is searched for the tracheal reconstruction. Most of the implanted biomaterials undergo biodegradation process., Aim: The aim of the study was to analyze the biodegradation process in carbon fibers of prosthesis implanted in tracheal defects in animal experiment., Material and Methods: We studied the prosthesis implanted in tracheal defects in sheep. The prosthesis were built with composite biomaterial composed of carbon fibers and polisulfone. The observation period was 1, 2, 3, 4, 6, 8, 24 and 38 weeks. In the morphometric evaluations the breadth, curve width, fullness factor and mean grey level of carbon fibers were assessed., Results: The results showed that carbon fibers undergo progressively degradation in animal environment. The width gradually decreased. The mean grey level in the first three weeks decreased, but in the next period it increased. Conclusion. The carbon fibers of segmental tracheal prosthesis undergo gradually degradation process in biological environment expressed by decreasing of their dimensions connected with the lost of irregularities and changes of structure density.

Introduction: The amplitude of click evoked otoacoustic emissions can be suppressed (reduced) with contralateral acoustic stimulation (CAS). This is thought to be due to the inhibitory control that the medial efferent auditory nerve exerts on outer hair cell function. One commonly used test of medial olivocochlear (MOC) function in humans involves measuring the degree of suppression of ipsilateral otoacoustic emissions (OAEs) by CAS. This effect is called contralateral suppression, efferent effect or olivocochlear reflex. Aim of the study. The objective of this study was to measure cut-off level of contralateral suppression, sensitivity and specificity of the efferent test., Material and Methods: To evaluate the function of MOC system click evoked otoacoustic emissions (CEOAEs) with and without continuous contralateral broadband noise (BBN) stimulation were recorded in 14 patients with multiple sclerosis, 16 patients with unilateral cerebello-pontine angle tumor and control group matched for age and gender. BBN was presented at 50 dB SL and otoacoustic emissions were recorded in response to nonlinear clicks at 70 +/- 3 dB SPL., Results: The cut-off level was established at -1.4 dB. For 1.4 dB cut-off level of contralateral suppression the sensitivity of the efferent test was 90% and specificity was 70%., Conclusions: To conclude, assessment of efferent suppression may be a useful addition to the battery test employed in the investigation of multiple sclerosis and cerebello-pontine angle tumors. The MOC suppression test may provide a tool for an early diagnosis of the brainstem pathology.

Introduction: Chronic sinusitis presents important problem in children. General approach in chronic sinusitis in children consists of: findings the proper diagnosis, optimal pharmacotherapy (oral or intravenous antibiotics), treatment coexisting allergic or systemic diseases and considering employing surgical treatment. The main surgical procedures in the treatment of chronic sinusitis in children are adenoidectomy and functional endoscopic sinus surgery (FESS)., Material and Methods: 32 children with chronic sinusitis treated in ENT Department Silesian Medical University in Zabrze in the years 2000-2005 were presented in this study. 26 patients were treated surgically and 6 children by pharmacotherapy. In the surgically treated patients we performed 10 Functional Endoscopic Sinus Surgery, 4 unilateral and 8 bilateral sinusoscopy of maxillary sinus, and in 4 cases we removed choanal polyps., Results: In the group of 26 surgically treated children we did not observed the recurrence of symptoms in the 24 months follow-up period.

Unlabelled: Six subjects before and after surgery because of the laryngeal stenosis were presented. In 3 cases laryngeal web was recognised which arises after endoscopical removal of infant papilloma. The scar after laser chordectomy due to carcinoma of the larynx occurred in remaining 3 patients. All presented patients simultaneously were undergoing removal of the lesion endoscopically and insertion of silastic separator., Aim: Respiratory and phonatory function assessment in patients who were operated because of the laryngeal stenosis was the aim of this study., Methods: Treatment effectiveness was estimate on the basis of pre- and postoperative spirometry with flow--volume loop and postoperative phoniatric examination. Ventilatory function was analysis on the basis of the following parameters: PIF, FEV1, FIV1, PEF, FVC. Phoniatric examination was performed after 2 months of outpatient observation and rehabilitation. It consisted of subjective voice assessment using GRBAS scale, videolaryngostroboscopy and assessment of the phonation time., Results: Some of the analysed parameters especially in patients with posterior stenosis were significantly better after surgery. Phoniatric rehabilitation after surgery caused improvement of voice quality and phonatory function of the larynx., Conclusion: Thanks to insertion of silastic separator good phoniatric function and ventilation efficiency are possible.

Introduction: The sinonasal tumors belong to rare diseases. They state 0.2-0.8% of all the malignant neoplasms and about 3% of head and neck tumors. These tumors are two times frequent observed in men than in women, mainly between 50 and 70 years old. In the sinonasal complex besides the primary are seen also the metastatic tumors. They state about 1% of all tumors (kidney, testum, breast, pulmonary)., Aim: The aim of our study was to retrospective analysis of the sinonasal tumors, treated in the ENT Department Silesian Medical University in Zabrze. The special attention was carried on the preoperative diagnostics and proper qualification to the surgical treatment., Material and Methods: 26 patients treated in the ENT Department Silesian Medical University in Zabrze between 2000 and 2006 suffered from the sinonasal tumors were retrospectively analyzed., Results: In the histological examination in 4 patients the benign neoplasm and in 22 patients malignant tumors were diagnosed. 24 patients were surgically treated (2 patients were not qualify to surgery because of the general diseases). On the basis of the CT and MRI examination as well as the description of the surgical procedure we stated that in 13 cases the primary localization of neoplasm was the maxillary sinus, in 5 cases ethmoidal cells, in 3 nasal cavity. In one patient the estimation of primary tumor localization was not possible, because of the very large extension of the neoplasm. The choice of the surgical procedure was depend on the tumor extension and localization. In 19 cases lateral rhinotomy with different modifications was performed. In one case the cranial incision was done. In 8 patients with the infiltration of lateral nasal wall the medial maxillectomy were performed. In 8 other patients upper maxillary resection were done. In two cases the total maxillectomy were performed, in the next two lower maxillary resection. All the patients were postoperatively treated by radiotherapy.

Introduction: Chronic sinusitis with nasal polyps is very often associated with allergy. The results of surgical treatment (Functional Endoscopic Sinus Surgery--FESS) in this group of patients are different and rather poor, especially in long term observations., The Aim: of our study was to evaluate the results of surgical treatment (FESS) in patients suffering from chronic sinusitis with nasal polyps associated with allergy., Material and Methods: We study the group of 33 patients with allergy-related polypoid lesions in the nasal cavity and paranasal sinuses. The patients with allergy-related disorder were previously under the control of allergologists and pulmonologists. All the patients underwent functional endoscopic sinus surgery. The patients were evaluated in postoperative period 4-6 years after the surgical treatment. The effectiveness of FESS was assessed on the basis of the nasal cavity endoscopic state and amelioration of symptoms., Results: The most frequent symptoms were postnasal drip and breathing disturbance through the nose. In 37.5% of patients the recurrence of symptoms was observed in the 4-6 years follow-up period. When we assessed aspirin intolerance syndrome patients this ratio increased to 64.7%., Conclusion: In the allergy-related patients high rate of recurrence after the FESS treatment is stated in the long term observations.

Introduction: The objective of this study was to measure gender-related changes of otoacoustic emissions level in subjects with normal hearing in tonal audiometry., Material and Methods: Click evoked otoacoustic emissions (CEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were recorded in 146 (n = 292 ears) subjects. Otoacoustic emissions were recorded in response to nonlinear clicks and two different primary tones (L1 = 65, L2 = 55 dB SPL; f2/f1 = 1.22) from 1 to 5 kHz. Subjects were divided into two groups: female (29.4 +/- 12.2 years) and male (27.5 +/- 10.1 years). All subjects had normal hearing and middle-ear function based upon standard audiometric criteria., Results: The principal findings were that CEOAEs and DPOAEs levels were smaller in the male group compared to the female group, especially at the higher frequencies of DPOAEs., Conclusion: The influence of gender on the level of otoacoustic emissions was found.

Haemangiopericytoma is a rare vascular tumor originated from perivascular cells. A sinonasal-type of haemangiopericytoma is called glomangiopericytoma. This type of hemangiopericytoma is usually of low malignant potential. The most common symptoms are nasal breathing disturbances and epistaxis. The clinical diagnosis may be difficult. The radiological imaging techniques (CT) can provide adequate information with regard to extension of the tumor, although final histological confirmation is essential. Surgery is the treatment of choice. We present a case of 45-year-old male patient complaining of epistaxis and left side nasal obstruction. Radiological examination (CT) showed the tumor localized in the left nasal cavity extending to the left maxillary sinus and ethmoidal cells. The tumor was removed via lateral rhinotomy with complete amelioration of symptoms. The tumor was diagnosed as glomangiopericytoma by histologic and immunohistochemical findings. During the 16-months follow-up no recurrence or epistaxis was observed.

Introduction: The objective of this study was to measure age-related changes of otoacoustic emissions level in subjects with normal hearing in tonal audiometry., Material and Methods: Click evoked otoacoustic emissions (CEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were recorded in 146 (n = 292 ears) subjects. Otoacoustic emissions were recorded in response to nonlinear clicks and two different primary tones (L1 = 65, L2 = 55 dB SPL; f2/f1 = 1.22) from 1 to 5 kHz. Subjects were divided into three age groups: young (19.8 +/- 4.6 years), middle-age (31.2 +/- 4.3 years) and old (48.2 +/- 5.9 years). All subjects had normal hearing and middle-ear function based upon standard audiometric criteria., Results: The principal findings were that CEOAEs and DPOAEs levels were smaller in the old group compared to the young and middle-aged groups, especially at the higher frequencies., Conclusion: The influence of age on the level of otoacoustic emissions was found.

Introduction: The septal nasal perforation is an important problem for the laryngologists and plastic surgeons. The reasons of septal nasal perforations are injuries, neoplasm, self-mutilation, chronic rhinitis, allergy, Wegener granuloma, sarcoidosis, tuberculosis, toxic metals (arsenic, chrome), some drugs (steroids), narcotizing agents (cocaine) and complications after endoscopic and septal nasal operations. The surgical treatment, especially in the cases of large septal perforation, is often difficult because of the atrophy of nasal mucosa and lack of suitable material for reconstruction. In the surgical treatment many of methods and reconstructive materials have been used. The following autogenous tissues were used in the reconstruction of septal perforation: alloderm, temporal fascia, septal and auricle cartilage, cranial periosteum, perichondrium, ethmoidal and hip bone. The defect of such materials is progressive resorption. For many years the suitable synthetic material for septal nasal reconstruction has been searched for. Among the biomaterials the following have been used without success: Dacron, porous polyethylene, dolomite, bioglass. The rejection of synthetic material was the reason of failure. The aim of our study was to evaluate two different biomaterials with proper mechanical and biological features for nasal cartilage replacement., Material and Methods: We studied two types of biomaterials: biostable terpolymer PTFE/PVDF/PP and resorbable copolymer of glycolide and L-lactide (PGLA). The pilot studies were performed on two experimental animals (rabbits). The animals were operated in the general anesthesia. The biomaterials were implanted in the rabbit auricular cartilage because of its similarity to the septum and easy surgical access. Subperichondrically 1 x 1 cm fragment of the cartilage was removed. This fragment was then replaced with the biomaterial. The rabbits were painlessly sacrificed after 4 months of observation., Results: A very good integration of PGLA implant with auricular cartilage was observed. In the histological examination the lack of excessive inflammatory reaction as well as no cartilage necrosis were observed., Conclusions: 4 months after implantation of PGLA in the rabbit auricular cartilage very good macroscopic and histological results were achieved.

Introduction: Tuberculosis, considering entry of infection, most frequent concerns the lungs. Rarely we observed extrapulmonary cases of tuberculosis within the bones, joints, urogenital organs and lymph nodes as well as within the head and neck region--larynx, middle ear, pharynx, tonsils, tongue, parotid glands and central nervous system. Sinonasal tuberculosis, either primary or secondary to pulmonary infection, is very rare, but should be considered in the differential diagnosis of sinonasal granulomas. The diagnosis of the head and neck tuberculosis is based on the medical patientis examination as well as on the bacteriological and histological study of the biopsy specimen., Aim: The aim of the study was to show own, very rare case of primary sinonasal tuberculosis., Material and Methods: We described a case of primary sinonasal tuberculosis in an adult female. She was suspected of the neoplastic disease. The diagnosis was based on the histopathology. The treatment was successful and consisted with antituberculous drug therapy and surgery (Functional Endoscopic Sinus Surgery). The patient was followed up for 12 months and during this time we did not notice any symptoms of recurrence., Conclusions: Tuberculosis of the head and neck region should be take in to consideration during the differential diagnostic of the neoplastic diseases.

The usefulness of helical multidetector computed tomography in diagnosis of some laryngeal and tracheal diseases was presented. Also, the benefits of CT applications in the evaluation of the treatment results were emphasized. Based on the CT images the value of the CT in laryngeal neoplasms, laryngeal and tracheal stenosis and vocal cord paralysis was confirmed. The excellent precision and resolution is helpful in qualification for suitable therapy due to the cancer. In laryngeal and tracheal stenosis helical MDCT helps to choose the treatment strategy as well. In case of vocal cord paralysis this technique is useful in evaluation of the treatment results and prognosis according to the ventilation efficacy.

Proceeding rules in the larynx narrowing scars were presented. The clinical material consisted of patients with bilateral vocal cord paralysis, oedema Reincke and early stages of laryngeal carcinoma who underwent laser microsurgery of the larynx. The attention was paid to prophylaxis relating to the surgical procedure and perioperative care. The possibility of the silastic sheet insertion into the glottis was introduced as a way of treatment in recurrent scars.

Ceruminous adenoma (ceruminoma) of the external auditory meatus is a rare neoplasm with benign clinical behavior. This tumor is mainly composed of the ceruminous gland cells (modified apocrine sweat glands). These glands are localized deep in the skin mostly in the cartilaginous part of the external auditory meatus. The most often symptom of the ceruminous adenoma of external auditory meatus is the unilateral conductive hearing loss. Occasionally symptoms of this tumor (pain, otorrhoea) can result from an otitis externa secondary to meatus obstruction. Ceruminous adenoma should be radical excised with adequate margins of the normal tissues. The prognosis of these tumors is good. The difficulties of nomenclature, histological structure of the auditory external meatus ceruminoma, as well as symptomatology, treatment and clinical behavior are discussed on the basis of the literature. A case of histologically confirmed ceruminoma (ceruminous adenoma) of the external auditory meatus in a surgically treated 53 years old men is presented.

The paranasal sinus cancers comprise about 10% of all head and neck neoplasms. There are 80% of SCC among them. Paranasal sinus cancer is difficult to treat with surgery due to the anatomic integration of sinuses into the cranial base. Suborbital approach allows to simultaneous resection of the tumor from sinuses and anterior cranial fossa. The excision of the nasofrontal bone lamella gives a chance to orbital decompression and optic nerve decompression as well and opening the anterior cranial fossa through posterior wall of the frontal sinus. The goal of the study was to present cases showing advantages and effectiveness of this kind of surgical procedure.

The vocal cord paralysis as a multidisciplinary problem requires commitment of different medical specialities. The diagnostic difficulties and necessity of laryngoscopic evaluation in cases suspected of vocal cord paralysis were pointed out. The analysis of ventilation parameters (flow-volume loop) was presented. The significant usefulness of inspiratory parameters, especially in upper airway obstruction was emphasized. The most useful parameters and coefficients were shown. Based on another authors data the criteria of airway obstruction classification were presented. The flow volume loop was found as a uniquely suited to the examination of upper airway obstruction. According to this examinations the unilateral vocal cord paralysis was defined as a variable extrathoracic obstruction which does not influence ventilation significantly.

The methods applied up to now do not allow to define the border between the tumor and healthy tissue especially in advanced cases. Microlaryngoscopy facilitates the evaluation of the infiltration superficially, but does not allow for estimation its deeper penetration. CT and MRI often do not answer the question concerning the tumor spread as well. That is why the monoclonal antibodies marked with isotopes directed against specific antibodies of different neoplasms are applied in diagnostic. In the neoplasm development the great role play endopeptidases. They degrade the intercellular matrix and basement membrane and by this way made possible the neoplasm invasion. The high level of the endopeptidase in patients with neoplasm is a bad prognosis. The disposition of endopeptidase in neoplasm tissue is characteristic and gives opportunity to localise the border of healthy tissue thanks their inhibitors application. The inhibitor of cysteine endopeptidase obtained from hen egg and marked by J 125 was used in our study. The reaction between the cysteine endopeptidase inhibitor and malignant cells received directly from patients with tongue and laryngeal carcinoma and cells cultivated in vitro from the carcinoma.

The orbitozygomatic craniotomy was presented in resection of giant tumour of maxillary-ethmoidal region, orbital cavity and anterior cranial fossa. As a result of this approach the possibility of whole tumour resection was obtained. Also, easy closure of anterior fossa and avoidance of the facial deformation was achieved.

A case of giant osteoma of paranasal sinus passing into anterior cranial fossa was presented. The frontal craniotomy in order to removing this tumor was applied. In any case of such tumor the CT seems to be a necessary examination.

The aim of the research work was to estimate the risk of functional complications arising within thyroid after radiotherapy, when thyroid of patients being ill with carcinoma of head and neck area skin was afflicted with radiation beam as well as to examine whether the circadian rhythmand concentration of hypophysis and thyroid hormones are dependent on combined treatment. The group contained 18 pilot patients treated with combined method, which were examined for concentration and circadian rhythm of TSH, T3, T4, fT3, fT4 three times: before commencement of treatment, one month and six months after completion of treatment. Results of circadian rhythm and concentration of thyroid hormones examinations proved that in case of all hormones the circadian rhythm exist which undergoes a dysrrythmia after one month and six months from completion of combined treatment.

A retrospective analysis of patients with tongue, floor of the mouth and tonsil carcinoma treated in II ENT Department University School of Medicine in Zabrze between 1994 and 1996 was undertaken. 32 male and 10 female underwent operation of the oropharynx. The visor flap, mandibulotomy or peroral approach was used. In 32 cases mandibulotomy, in 2 cases visor flap and in 3 cases peroral approach was performed. The usefulness of bone grafts from iliac ala, skin flaps and part of the tongue applied to replace the defect after extensive operation of the oropharynx was analysed and presented. In 2 patients partial mandibulectomy was performed. In 2 patients defect was replaced with iliac crest. Good graft's vitality, availability and function were emphasized.

A new pneumohydraulic water manometer for measuring pressure generated in the pharynx and oesophagus during swallowing was presented. It consists of measuring and pneumatic parts and a computer.

The purpose of this study was to evaluate the hearing aid fitting of 179 regularly controlled, hearing-disabled children from the Silesian area, first time admitted to Phoniatric Outpatient Clinic in Zabrze in years 1986-1990. The mean age of provision of a hearing aid was high. Children were supplied with hearing aids at mean age of 4,9 years (losses > 60 dB) and of 9,3 years (losses < or = 60 dB). There was a delay from 8,4 up to 12,5 months (losses < or = 60 dB) between the age of fitting and the issue of the hearing aid. It was also stated that the total amount of children wearing their aids binaurally decreased significantly from 118 to 74 during 5 years' period. As for the utilisation of hearing aids, prevalence of full-time users (57.9%) was demonstrated in confrontation to non-users (5.6%).

Myoepithelioma of the parotid gland occurs relatively rarely. In the literature was described only 33 cases of this tumors. It's growth's slow and distension. Basing upon the case of 48-year old woman, the authors discuss the difficulties of diagnostic, treatment and the course of the disease.

The authors presented a 4 cases of esophageal scar tissue stenosis due to burns. The results of treatment in 3 patients were successful. One patient needs periodical dilatation. Therapeutic problems were discussed.

Malignant oncocytoma of the parotid gland occurs relatively rarely. Basing upon the case of 48-years old man, the authors discuss the difficulties of diagnostic, treatment and the course of the disease.

Sternocleidomastoid myocutaneous flaps have been used for reconstructive procedures in 6 oncologic patients. In two of them, flaps were used after pharyngolaryngectomy. Healing was successful and feeding tube removed 14 days after operation. In the other cases, flaps was used for reconstruction of defects of the floor of mouth tongue and lateral wall of pharynx. The flap healed primarily in three out of four cases. All patients underwent radiotherapy.

In the paper by the authors the case of big size pleomorphic adenoma of the parapharyngeal space was presented. The tumors was taken out without any difficulties by transcervical approach with splitting mandibulae and cutting the muscles of the mouth bottom with wide exposure of the parapharyngeal space. This way of operations is considered and proved us a practicable method concerning the localization of the tumor.

The authors presented own results concerning complications in wound healing after total laryngectomies. 59 total laryngectomies and 4 pharyngo-laryngectomies were performed. In 18 cases local and systemic complications were observed. Pharyngo-cutaneous fistulas developed in 15 patients. Therapeutic management was successful in all cases.

The three cases of simultaneous reconstruction after some partial laryngectomies in patients with laryngeal cancer were presented. The indications to those operations were defined and the surgical technique was introduced. The important advantages from this technique was pointed out. Also a very good functional results and possibility of early extubation were emphasized. The possibility of some postoperative complications after this reconstruction were suggested. Based on our experience and literature the procedure was found as a good and useful surgical method.

A four cases of sigmoid sinus thrombosis due to chronic exacerbated otitis media were presented. In all patients surgical intervention involved a radical mastoidectomy and exposure of the sinus. In two cases sigmoid sinus was incised and the internal jugular vein ligated. In the two others, sinus was only needled. A high dosages of antibiotics were administered parenterally. All patients were discharged in good state of heals.

A case of chondrosarcoma of paranasal sinuses and orbit penetrating to anterior cranial fossa is described. Treatment was surgical. Metastases and local recurrence after 7 month hasn't been reported.

The preliminary results of activity changes of antioxidant enzymes (glutathione peroxidase, catalase and superoxide dismutase) in erythrocyte in 19 patients with laryngeal cancer were presented. Enzymes activity in patients was signified three times: before surgery, before and after radiotherapy. During Co-60-therapy patients received leaven preparation of selenium CE-ROSEL in dose 100 micrograms Se/day. Obtained results showed increase of enzymes activity after CE-ROSEL supplementation. This changes are probably the result of selenium influence on protected mechanism before the free radicals.

In the paper by the case of glomus caroticum malignum of a woman aged 54 was presented. The tumor was taken out operatively without any difficulties by splitting mandibulae and cutting the muscles of the mouth bottom with wide exposure of the parapharyngeal space. This way of operations is considered and proved us a practicable method concerning the localization of the tumor.

The authors present hand support for nasal endoscopy and functional endonasal surgery which prevents fatique of the surgeons hand during operation. The advantages of this device are that it provides precession and shorten time of operation.

The authors described a rare case of 13 years old girl burnt by lightning. The burns of the skin of neck, perforation and destruction of the handle of malleus were stated. No internal ear injury was observed.

The case of skin defect reconstruction after pharyngolaryngectomy with simultaneous removal of cancer recidivism from tracheostomal region was presented. The method of preparation and suturing of the deltopectoral flap in place of skin defect was introduced. The defect after flap removal was covered by epidermis from the high. The simplicity of the procedure and high vitality of the flap, despite of the irradiation was emphasized.