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Mucosal melanoma comparison to cutaneous melanoma of the head and neck are rare and do poorly. Approximately 0.5-2% of all melanomas occur from the mucous membranes of aerodigestive tract. Most common site of the tumor are the nasal cavity and paranasal sinuses but melanoma of the oral cavity are described too. Therapy usually consists of surgical resection with or without postoperative radiotherapy and immunochemotherapy eventually. The definite role of a kind of therapy in the treatment of mucosal melanoma is not remains to be defined as the small number of cases make prospective study challenging. This article reviews 19 patients with mucosal melanoma of the head and neck treated at the Department of ENT and Head and Neck Surgery Charles University of Prague since 1980 to 1999. Clinical data were obtained from the patient's charts. Analysis of the metastatic disease, type of therapy and follow-up was retrospectively reviewed. The site of the tumor was the lateral wall of the nasal cavity (five cases), nasal septum (four cases), maxilar cavity (two cases), and ethmoidal cavity, orbitoethmoidal complex, nasopharynx, saccus lacrimalis to ethmoidal sinuses diffused, tonsilla (one case each) and hypopharynx (two cases). Primary treatment was surgical resection in ten cases, in one case with radiation therapy, and in seven cases chemotherapy. In three cases were diagnostic surgery only and one patient was without therapy. Three patients received radical neck dissection more. Four patients were treated radiation therapy and three chemotherapy after surgery. In two cases were surgery after primary radiotherapy. For nine cases of recurrence of the disease were surgery (in five cases) and chemotherapy (in four cases). Overal and disease free interval was from 2 to 22 month, approximately 9.3 month and 3-year survival was 41.18%.

The most important problem of the useful life of vocal prostheses is bacterial and especially mycotic colonization of their surface which impaired tightness of the closing valve of the prosthesis and caused subsequent leakage of fluids and food into the airways. The objective of the present study was to prevent colonization of the silicone surface and to prolong the service life of the prosthesis. The implanted prostheses were examined under microscope after varying intervals in vivo. The silicone of the implanted prosthesis was colonized by numerous microorganisms, in particular moulds. Seventeen bacterial and mycotic strains were identified. They behave to Candida, Acinetobacter, Micrococcus, Pseudomonas, Bacillus and Chryseomonas. The results confirmed the deep degradation of silicone rubber located in islets. Plant of bacterial tissue were inoculated on two types of silicone disks. Two types of silicone were tested (Silastic Q7-4550-50ShA and Q7-4765-65) after 4, 8 and 12-week exposure. Neither of these materials was attacked by mycotic agents in vitro. Only frame print was appreciable in five hundred times magnification. The second object of the study was to recognize the main degradation factor that means a kind of microorganism. The ability of microorganisms to assimilate oligo- and polyorganosiloxans was studied. Candida albicans does not seem like a typical microorganism assimilating silicon rubber. The results of our study proved Microccus as a typical vector which assimilates silicone.

Total laryngectomy has a profound impact on the life of a patient. The loss of the larynx creates a major communication problem that can result in disruption of the patients normal pattern of social interaction. It is for this reason that adaptation to the loss of normal speech has been the focus of research on the rehabilitation of laryngectomized patients. Tracheoesophageal puncture and induction of the voice prosthesis have very well results in rehabilitation of the voice. The long terms clinical results obtained by experience with any of the complication are described. We use 4 types of voice prosthesis (Provox, Blom-Singer, Bivona Colorado and Czech prosthesis). We have very good experiences with system Provox. Our collection of the patients with Provox prostheses are 53 patients after total laryngectomy. All tracheoesophageal punctures were done in second time. Over 85% patients were able to produce satisfying voice. Speech quality was evaluated by Robe scale. 38.9% of them can speak fluently, which corresponds with a category F. Local inflammatory reaction occurred in 28.1% that resulted in extrusion or removal of voice prostheses in 14.2% patients. Use of voice prostheses in rehabilitation of laryngectomized patients occupies a significant place.

Loss of the voice after laryngectomy eliminates to a great extent patient's social life. Apart from other frequently used methods in laryngectomized patients, a number of tracheoesophageal vents called voice prostheses, has been developed in past decade. A survey of their most important features is given. A basic way of induction of these vents with technique of tracheoesophageal functions is described.

Inverted papilloma is a relatively rare benign tumour of nasal mucosa and paranasal sinuses which approx. in 15% is connected with malignancy. The morphology, occurrence, etiology and biological behaviour of this tumour are dealt with. A group of 8 patients is presented. The significance of nasal polyps routine histologic investigation for early detection of these tumours is stressed. Various treatment possibilities are discussed and a therapeutic procedure based on radical surgery is suggested.

The paper provides information concerning basic types of lasers used in medicine. Their most frequent indications are summarized and advantages of single types of apparatus are described.

CO2 laser surgery is becoming a part of larynx surgery. The authors inform about their experience in benign larynx tumours treatment. They present analysis of concrete therapeutic procedures in individual larynx affections. They conclude that laser surgery is an advantegous method for benign larynx tumours treatment.