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INTRODUCTION Tumors of the salivary glands account for approximately 3 to 4% of all head and neck neoplasms. It is estimated that 10-15% of them are malignant. The most common benign tumor is pleomorphic adenoma, while the most common malignant tumors are adenoid cystic carcinoma and mucoepidermoid carcinoma. Neoplasms of the salivary glands are extremely histologically diverse, which results from the complex embryogenesis of the salivary glands. The identified risk factors for tumors of the salivary glands are: ultraviolet radiation, ionizing radiation, viral infections, nicotine and alcohol. MATERIAL AND METHOD The aim of the study was an epidemiological analysis of patients with salivary gland neoplasms, the distribution and histopathological characteristics of individual neoplasms treated at the Department of Otorhinolaryngology of the Medical University of Warsaw in 2010-2020. The diagnoses were analyzed according to the latest WHO 2017 histological classification of salivary gland tumors. In addition, the material was supplemented with data on the 5-year survival rates of patients with malignant neoplasms obtained from the Registry of Marital Status. RESULTS AND DISCUSSION The material contained 407 neoplasms of the salivary glands over a 11-year period, of which malignant neoplasms accounted for 17.4%. The malignant tumors were dominated by: adenoid cystic carcinoma (28,2%), mucoepidermoid carcinoma (12,7%), and acinic cell carcinoma (9,9%). Lymphomas (15,5%) were also a large group. The benign neoplasms were dominated by pleomorphic adenoma (54.1%) and Warthin's tumor (36%). Tumors of the salivary gland the most often affected the parotid gland (92%). CONCLUSIONS The obtained data are consistent with the general epidemiological data described in the current literature.

Introduction The association between obstructive sleep apnea and atherosclerosis is confirmed for long time, but the pathomechanism is still not known. The aim of this study was to investigate the prevalence of OSA in patients scheduled for endarterectomy and the influence of this procedure on the sleep study parameters and sleepiness. Materials and methods 46 patients scheduled for open carotid endarterectomy were enrolled in the study. Sleep study and Epworth Sleepiness Scale (ESS) was performed preoperatively. In 11 out of 46 patients, sleep study was performed both before and after the surgery. Results The mean age of the group was 69,9 years (± 8,6), 21 patients (45,7%) were female. For 46 patients mean pAHI, ODI, pRDI and %snoring were 16,2 (± SD=15,2), 10,4 (± SD=12,2) and 18,9 (± SD=14,9), respectively. Normal pAHI was noticed in 14 patients (30%), while mild (pAHI 5-15), moderate (pAHI 15-30) and severe (pAHI>30) OSA was observed in 13 (38%), 11 (24%) and 8 (18%) subjects, respectively. The mean ESS score for 27 out of 46 patients was 6,3 (± SD=5,6). The postoperative results of sleep study in 11 patients showed no significant change. Conclusions This study revealed the prevalence of moderate to severe OSA in 42% of patients scheduled for endarterectomy, while no excessive daytime sleepiness was observed in this group. The results of the study show that patients with carotid atherosclerosis should undergo sleep diagnosis in order to rule out obstructive sleep apnea.

Introduction: In the general population, nasal obstruction is a common complaint. However, an objective evaluation of nasal obstruction is difficult. Nose examination, computed tomography (CT), acoustic rhinometry, and anterior rhinomanometry do not accurately reflect the discomfort reported by patients with nasal obstruction. In patients with nasal obstruction, this study evaluated nasal breathing with a unique device for continuous nasal-oral spirometry - a nasal-oral flow analyzer (NOFA); moreover, quality of life was compared between patients with normal nasal breathing on NOFA and of those with impaired nasal breathing on NOFA., Methods: Of 181 adult patients admitted to an ENT department due to nasal obstruction that were enrolled in the study, 97 (53.6%) completed all per-protocol assessments, including the SF-36 questionnaire and 3-hour, continuous nasal-oral spirometry with NOFA. Based on the presence of normal nasal breathing defined as ≥95% of nasal flow, the 97 patients were divided into those with normal nasal breathing (n=31) and impaired nasal breathing (n=66)., Results: Patients with normal nasal breathing differed from those with impaired nasal breathing with respect to all SF-36 subscales (physical functioning, p=0.004; role-physical, p=0.009; bodily pain, p<0.001; general health, p=0.007; vitality, p=0.002; social functioning, p=0.008; mental health, p=0.009; physical component summary, p<0.001; mental component summary, p=0.02), except for the role-emotional subscale (p=0.1)., Conclusions: Among patients with symptoms of nasal obstruction, compared to patients with normal nasal breathing, those with impaired nasal breathing had significantly lower quality of life in the physical and mental domains. Further research needs to determine whether NOFA can be used to diagnose nasal obstruction.

Introduction: Sleep-disordered breathing is an important risk factor for neurobehavioral impairment in children. This study was conducted to estimate the prevalence of sleep-disordered breathing in a population of first graders and to determine the association between behavior problems, body mass index (BMI) and snoring., Material and Methods: A population-based, cross-sectional study was conducted using a parent-reported questionnaire. The study evaluated 2,474 first-graders. Data including age, weight, height, BMI, snoring intensity, and problems with child behavior were analyzed., Results: Of 3,480 eligible children, 2,474 (71.1%) returned completed questionnaires. Of these, 72% were reported to be non-snorers, 28% snorers, and 6.4% habitual snorers. There was a positive linear association between behavior impairment and snoring severity measured on a 5-point scale, with highly significant differences between each of five snoring intensity groups (p<0.00001). Compared to non-snorers, snorers in the normal-weight and overweight subgroups had significantly more aggressive behavior (p<0.0001; p=0.002, respectively) and more concentration problems (p<0.0001; p=0.03, respectively). There was no significant difference in aggressive behavior and concentration problems intensity in the screened groups of obese and normal subjects (p=0.70; p=0.79, respectively)., Discussion: Behavior problems were positively associated with increasing snoring frequency. However, there were no differences in the prevalence of behavioral or concentration problems between obese and non-obese first-graders studied.

Introduction: Nasal obstruction is often reported by patients. It is a consequence of a subjective feeling of impaired airflow through the nasal cavity. Currently, objective measures of nasal patency rates are very limited. Functional tests only analyze nasal breathing; they do not simultaneously assess airflow through the mouth., Objective: The aim of this study is to present a new functional test that assesses a single-stage nasal and oral breathing route., Methods: The NOFA (Nasal-Oral Flow Analyzer) is a three-channel flow meter used to perform continuous and simultaneous measurements of nasal and oral respiratory parameters. We present the application of the device and the proposed study protocol., Results: The respiratory tracks of four selected patients are presented. Different breathing patterns are visible: exclusive nasal, exclusive oral, and mixed nasal-oral ventilation pattern., Conclusions: The preliminary results suggest the potential use of the NOFA in ENT practice. Further studies are necessary to evaluate the usefulness of this device in the diagnosis of patients with upper respiratory tract disorders., (Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Objective: The thorough knowledge about anatomy and morphology of the stapedial artery is of such importance to the laryngologist. In rat this artery persists throughout life. The following study was performed to analyze the morphology and course of stapedial artery in rat., Methods: 30 Wistar rats weighing 300-400 g were used to analyze the stapedial artery. After the anesthetic induction with ether, the lethal doses of thiopental were administered. The stapedial arteries were dissected after latex injection and an immersion and preservation in 9% formalin solution., Results: The stapedial artery branches off internal carotid artery and course through the stapes. After that it gives middle meningeal artery and continues in a bony canal laterally to the tegmen tympani. In the orbit stapedial artery gives off ophtalmic artery to supply mainly the orbit structures (muscles, lacrimal gland and eyeball) and the infraorbital artery with palatine artery. Additionally, the ophtalmic artery gives off the central retinal artery., Conclusion: Our study reveals that the stapedial artery and its distal branches are the only vessels supplying all tissues of the orbit, including the eyeball in rats.

Data reported until today suggested a pivotal role of nuclear DNA mutations in the process of carcinogenesis. Recently more and more authors claim that disruption of mitochondrial DNA should not be excluded from this analysis. mtDNA have been reported in many cancers of head and neck region. Mitochondrial D-loop has been proven to be mutation hot - spot with majority of mutations in the positions 303 to 315 of poly-C tract. Data show that 37% of patients with premalignant lesions and 62% with carcinoma in situ are positive for mtDNA mutations. Moreover mutations in genes encoding ND2, ND5, COIII, CYTB, and ATP6 were observed in 17% of patients. Mutations in mitochondrial rRNA genes occured in similar number of cases. Neoplastic cells undifferentiation and disease progression is accompanied by multiplication of mtDNA number and increased mtDNA content. mtDNA content corellates with the stage of the disease. mtDNA mutations faciliate cell proliferation and inhibit apoptosis by increasing the production of ractive oxygen species (ROS). Cells harbouring mutated mtDNA have increased proliferation rate, as increased ROS concentration may act as an endogenous growth factor.

Introduction: Submucosal arytenoidectomy is one of many surgical techniques used in the treatment of the median bilateral vocal fold paralysis. The technique evolved from the large extralaryngeal operation to the endoscopic, intralaryngeal procedure. Gradually it excluded tracheostomy from the methods of treatment of dyspnoea caused by bilateral vocal fold paralysis., Materials and Methods: We present two patients with bilateral vocal fold paralysis with dyspnoea, caused by the neoplastic mass primarily localised in the left lung. In both cases the nonmicrocellular carcinoma was diagnosed. Both patients had the left recurrent laryngeal nerve palsy for more than 18 months and the right nerve palsy for 10-14 days before admission, with concomitant dyspnoea., Results: Both patients were successfully extubated, 24 hours after the operation. The breathing improved significantly. None of the patients had to be reintubated or tracheotomized., Conclusions: The Authors conclude, that the arytenoidectomy with laterofixation should be the method of choice in the treatment of the bilateral vocal fold paralysis caused by the lung cancer. The method does not exclude the upper airway from the respiratory tract which is of special importance for the patients with the lung problems.

Introduction: Esthesioneuroblastoma is a malignant tumour arising from the olfactory epithelium located in the upper part of the nasal cavities. Recent clinical and preclinical studies shed more light on etiopathogenesis, diagnosis, and treatment of this rare malignancy., Material and Methods: A systematic review of PubMed/Medline and available Polish literature., Results: Molecular studies indicate basal progenitor cells of the olfactory epithelium as the origin of esthesioneuroblastoma. Tumour symptoms are related to its location and typically include: epistaxis, nasal obstruction, olfactory and ophtalmic disturbances as well as craniofacial pain. Esthesioneuroblastoma should be differentiated from embryonic rhabdomyosarcoma, Ewing's sarcoma, melanoma, lymphoma, and pericytoma. A combination of surgery and radiotherapy seems to be the optimum approach to treatment. More aggressive treatment regimens are promising but require further studies., Conclusions: Esthesioneuroblastoma is a rare malignant tumour arising from the olfactory epithelium. Early diagnosis and interdisciplinary approach to treatment is vital in the management of the tumour.

Carcinoma planoepitheliale of larynx is the most common cancer present in the upper part of the respiratory system. The molecular mechanism of this cancer generation is unknown and there is no a specific marker for its early diagnosis. The properties, physiological function, as well as the results of studies on genetic polymorphism indicate that glutathione-S-transferase (GST) may play an important role in etiology of this cancer. In the present work the studies on expession of GST isoenzymes pi, alfa, mu4, and mu5 in larynx cancer (carcinoma planoepitheliale laryngis) were performed. Specimens of larynx cancer and their corresponding normal adjacent tissues were obtained from patients by surgery. Expression was studied on the level of mRNA using RT-PCR method. The results indicated raised expression of GST pi (the major isoform in larynx) and lowered expression of GSTs mu4 and alfa in cancer as compared with the control tissue. No expression of GST mu5 was observed in tumor and normal larynx tissues. Obtained results indicate various mechanism in regulation of GSTs expression in cancerous and normal larynx tissues. They also indicate a special role of GST pi in larynx carcinogenesis.