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Stapes surgery is performed using both conventional techniques and a variety of laser systems. The Er-Yag laser is a type of pulsation laser deemed by many to be the safest for ear surgery. The aim of this study was to assess the long-term effects of using the Er-Yag laser in stapes surgery and its impact on inner ear function. The study was conducted on 95 ears (48 right and 47 left) that had undergone Er-Yag laser-assisted stapedotomy. The follow-up time was at least 3 years. Pure tone audiometry was performed on all patients. The frequency ranged from 125 to 8,000 Hz. Air conduction and bone conduction were both assessed. Moreover, all patients had their stapedius reflex assessed and were given a Rinne test. The results were evaluated according to the Committee on Hearing and Equilibrium guidelines and then statistically analyzed using the Wilcoxon sequence pair test with a p value of <0.05. A decrease in the hearing threshold of 0.5, 1, and 3 kHz, for both bone and air conduction was observed for all patients (p < 0.0001). The Wilcoxon sequence pair test revealed a statistically significant correlation between the pre- and postoperative treatment mean air-bone gap values (p < 0.0001). No facial nerve paralysis was observed. No Er-Yag laser side effects were observed on inner ear function. The patients also had lower hearing thresholds. These observations demonstrate the usefulness of Er-Yag lasers in stapes surgery.

Laminins are a family of glycoproteins that consist of one heavy alpha chain and two light beta and gamma chains. The laminin molecule is a major component of the basement membrane and plays an important roles in cell differentiation, adhesion, and migration. It has been reported that laminin is strongly expressed at the invasive front of the tumor and plays an important role in forming the metastases. The aim of the study was to assess the importance of laminin expression in a group of patients with laryngeal carcinoma and neck metastases. The study was carried out on 70 patients with squamous cell carcinoma of the larynx treated at the ENT Department University of Medical Sciences in Poznań. The clinical data consisted of sex, age, stage of the tumor, and histological and immunohistochemical studies. The average time of the follow-up was 3 years. The immunohistochemical study was performed using formalin-fixed and paraffin-embedded tissue sections. Monoclonal mouse anti-human laminin (DAKO, code no. MO638) antibodies were used for immunohistochemistry. To evaluate the laminin staining, a four-point grading system were used: score 0, continuous; score 1, loss of staining <10%; score 2, loss of staining <50%; score 3, loss of staining >50%. The correlation between staining intensity of the laminin and the presence of neck metastases (classified as N-positive "N+" and N-negative "N-"neck) was calculated. All parameters underwent statistical analysis. The patients with advanced clinical disease dominated in our material. Most of the tumors were classified as T3 and T4. A total of 36 patients had metastases to the regional lymph nodes. Positive laminin staining was observed in 62 cases. There was no correlation between laminin staining and occurrence of neck metastases in our studied group (30 N+ and 32 N-). The gravity level in Wilcoxon test was at P < 0.000001 and in Spearman rank order correlation was statistically not significant (P > 0.09).

Cyclin D1 is one of the key proteins involved in cell cycle control, and it is believed that its overexpression may be connected with tumorigenesis. A reason for cyclin D1 deregulation may be connected to a common G870A polymorphism at codon 242 in exon 4 of the CCND1 gene. This single nucleotide substitution, localized in the conserved splice donor site between exon 4 and the intron 4 boundary, might modulate the frequency of alternative splicing. It has been postulated that the A allele results in a higher level of mRNA (transcript b) encoding a protein with an altered C-terminal domain. The influence of CCND1 G-->A polymorphism for the risk of cancer and the prognosis of patients with different types of solid tumors has already been suggested. This study was conducted to investigate the association between the cyclin D1 gene polymorphism and laryngeal cancer risk, as well as the clinical outcome. We also examined the relationship between genotype/allele distributions and the cyclin D1 expression profile. The genotyping study was done using the PCR-RFLP method in 63 patients with larynx cancer and 102 healthy controls. The heterozygotic genotype GA as well as a combination of GA and AA genotypes were associated with an increased risk of larynx cancer compared to the GG genotype (OR =3.02; P =0.004 and OR =2.52; P =0.013, respectively). The A allele frequency was higher in cancer cases (0.484) than in controls (0.416) that were connected with a slightly increased risk of cancer development (OR =1.34); however, the difference was not significant. The AA genotype was associated with an early cancer onset compared to the GG genotype (median age: 51.5 and 63.0 years, respectively). We also demonstrated that the AA genotype was associated with the occurrence of lymph node metastases (OR =3.26) and a higher level of cyclin D1 overexpression. These results suggest that the CCND1 A allele may be a genetic factor that modulates the risk of larynx cancer development, and it may also have an effect on tumor biology and disease prognosis.

The prognosis in patients suffering from head and neck squamous cell carcinomas depends on many factors. However, regional lymph node metastases are the most important parameter in determining the cure and survival of patients with head and neck cancers. The evaluation of cancer cell biology enables differentiation of their proliferation and tendency of metastases. Immunohistochemical examinations complement the well-established routine histological examination. The aim of this study was to evaluate the prognostic importance of the level of immunoproliferating proteins such as cyclin D1, nuclear antigen Ki67 and suppressor gene p53 for regional lymph node metastases in laryngeal carcinoma. The research was carried out on 73 patients treated for squamous cancer of the larynx in the Department of Otolaryngology University School of Medical Sciences in Poznan in the years 1994-1999. The group was comprised of 4 female and 69 male patients. Their ages ranged from 37 to 79 years, with a mean of 59 years. Clinical data included sex, age, localization and local and regional extent of the tumor, presence or lack of distant metastases, treatment, histological examination as well as immunohistochemical evaluation of suppressor gene p53, proliferative proteins Ki67 and cyclin D1. No statistically significant correlation was found between staining intensity of suppressor gene p53, cyclin D1 and the degree of local advancement (T). There was no correlation between the level of immunoproliferative markers and regional lymph node metastases. Statistically significant correlation was found between T stage and staining for Ki67 (P=0.017) as well as between cyclin D1 level and Ki67 (P<0.05). In conclusion, (1) no significant correlation was found between Ki67 and cyclin D1, p53 and TNM classification; (2) lack of correlation was confirmed between N+, p53, Ki67, cyclin D1 and Jacobsson classification; (3) the degree of histological grading correlated, however, with Jacobsson classification and cyclin D1 expression.