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Background/Aim. Human papilloma virus (HPV) infection is the main etiological factor for the development of cervical precancerous dysplastic squamous intraepithelial lesions (SIL). The virus oncoproteins affect several proteins included in cell proliferation. The aim of this study was to evaluate application of immunohistochemical markers related to proteins of the cell cycle and, also, application of nuclear morphometric analysis for assessment of cervical dysplasia. Methods. Retrospective study included 78 women with detection of presence of high-risk HPV by polymerase chain reaction (PCR), with histopathology diagnosis low-grade SIL (LSIL) or high-grade SIL (HSIL). Immunohistochemical staining for p16, p63, cyclin D1 and morphometric analysis of the nuclear surface area were performed. The control group consisted of ten women without SIL and without HPV infection. This study was conducted in accordance with the Helsinki Declaration. Results. Comparing immunohistochemical expression of p16 and p63, highly statistically significant differences (p < 0.001) were established among the control, LSIL and HSIL groups, while cyclin D1 showed significant statistical difference (p < 0.05). Great variations were observed in nuclear morphology and nuclear surface area that had highly statistically significant differences (p < 0.001) among the control, LSIL and HSIL groups. Conclusion. This study demonstrated that immunohistochemical analysis of p16, p63 and cyclin D1 are important for diagnosis of dysplastic changes in cervical epithelium. Also, morphometric analysis of the nuclear surface area demonstrated a high significance for diagnosis of cervical dysplasia.

Background: Surgical site infection (SSI) in laryngeal cancer (LC) patients significantly increases morbidity and may postpone adjuvant therapy. Additionally, SSI can prolong hospitalization, thus representing a burden for the healthcare system. Most of the published studies refer to SSI after salvage laryngectomy. Methods: The present prospective cohort study aimed to clarify the incidence and factors associated with SSI in patients after primary open surgery for LC. Through regular hospital surveillance of patients who underwent primary partial or total laryngectomy, we gathered 24 putative factors and identified SSI from 2013 to 2022. Patients with SSI were compared with patients without SSI. Results: SSI was observed in 21 (6.6%) of 319 patients. ULRA showed that the occurrence of SSI was significantly associated with the American Society of Anesthesiologists (ASA) score, other postoperative healthcare-associated (HAI) infection, T classification, N classification, advanced clinical stage (III–IV), length of stay (LOS), duration of drainage, and the National Healthcare Safety Network (NHSN) risk index. Multivariate logistic regression analysis identified two independent factors associated with SSI occurring in these patients: duration of drainage (RR (relative risk) 1.593; 95% CI 1.159–2.189; p = 0.004) and LOS (RR: 1.074; 95% CI: 1.037–1.112; p < 0.001). Conclusions: Our study provided insight into the burden of SSI in LC patients, highlighting several priority areas and targets for quality improvement. [ABSTRACT FROM AUTHOR]

Background/Aim. The previous researches suggest that matrix metalloproteinases (MMPs) have the ability to degrade extracellu-lar matrix components and play an important role in malignant tumour progression and metastasis. The aim of this study was to investigate MMP-2 and MMP-9 expression in the tissue of laryn-geal squamous cell carcinoma (LSCC) and to evaluate their clini-cal significance. Methods. In this prospective study the samples of tumour tissue of seventy patients with LSCC (45 glottic and 25 supraglottic), and samples of laryngeal mucosa of 70 patients with chronic laryngitis were immunohistochemically stained for MMP-2 and MMP-9. We studied the relationships between MMPs tissue expression and clinical and histological characteris-tics of the patients with LSCC in comparison to the patients with chronic laryngitis. Results. MMP-2 and MMP-9 expression was significantly higher in the tissue of both glottic and supraglottic LSCC than in chronically inflamed laryngeal mucosa (p < 0.001 and p < 0.001, respectively). There were positive correlations be-tween epithelial MMP-2 expression and the presence of perineu-ral invasion (r = 0.515, p < 0.008), lymphovascular invasion (r = 0.559, p < 0.004) and disease recurrence (r = 0.415, p < 0.039) in supraglottic LSCC, as well as between MMP-2 expression and the presence of the exophytic type of tumour growth (r = 0.347, p < 0.020) in glottic LSCC. Epithelial MMP-9 expression was as-sociated with lymphovascular invasion (r = 0.331, p < 0.026) and the presence of the exophytic tumour growth (r = 0.474, p < 0.001) in glottic LSCC. Conclusion. MMP-2 and MMP-9 can be used as potential biomarkers for the assessment of LSCC progression.

Background/Aim. Glassworkers, especially glassblowers are in close contact with a variety of chemical and physical harmful agents at their workplace. Upper aerodigestive pathway is predominantly vulnerable to these agents. Breathing of warm volatile substances and dust, and mouth touch with glassblower's pipe are the main ways for chronic respiratory mucosa inflammation. The aim of this study was to estimate effect of workplace environment in a glass manufacturer plant, as a causative factor, on the prevalence of chronic rhinitis in glassblowers. Methods. Studied groups, one hundred glassblowers and 100 nonglassblowers in a same factory, were examined for diagnosis of chronic rhinitis. Results. This investigation confirmed that chronic rhinitis prevalence among glassblowers was significantly higher than that in non-glassblowers. The duration of exposure to harmful factors was not a significant factor for chronic rhinitis development. Conclusion. On their workplace, glassblowers are exposed to greater influence of noxious factors, and they have statistically greater risk for getting chronic rhinitis than nonglassblowers who work in the same work environment. Glass production by glassblowing is highly significant risk factor for getting chronic rhinitis, but the exposure period is not.

Introduction/Objective Epidemiological studies have established cigarette smoking as one of the most significant risk factors in pathogenesis of laryngeal squamous cell carcinoma (LSCC). One of the possible underlying mechanism is chronic inflammation, but published data regarding the effect of tobacco on systemic immune response is inconsistent. The goal of this study was to evaluate concentrations of serum proinflammatory cytokines [interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α] in patients with LSCC and in healthy subjects according to cigarette smoking. Methods Fifty-nine LSCC patients and 44 healthy controls were enrolled in the study. Samples of peripheral blood and details of tobacco use were gathered from the examinees. Flow cytometry was performed to analyze serum concentrations of IL-6, IL-1β, and TNF-α. The results were compared according to active smoking status. Results Statistical analysis revealed no significant difference between smoking LSCC patients and smoking healthy subjects. Additionally, investigated cytokines were not significantly different in healthy subjects according to smoking status. In non-smoking participants with LSCC, concentrations of serum IL-1β and TNF-α were higher (p < 0.05) in comparison with smoking LSCC patients. Conclusion Findings of our study may indicate that smoking leads to the suppression of proinflammatory response in LSCC patients, whilst proinflammatory response is unaffected by cigarettes in healthy subjects.

Background/Aim. Permanent proliferation and periodical infection are the main clinical characteristics of acquired middle ear cholesteatoma. The aim of this study was to research immunohistochemical characteristics of the skin along with the cholesteatoma process in the nearby tissue. This research should influence further studying of etiology and development of acquired middle ear cholesteatoma. Methods. We investigated clinical, histological and immunohistochemical characteristics of cholesteatoma in 50 samples from operated patients with acquired middle ear cholesteatomas. We classified all samples according to their clinical characteristics of cholesteatoma such as bone destruction, presence of infection or cholesteatoma extension and histological characteristics of cholesteatoma such as keratinisation, inflammatory process and extracellular matrix proliferation. We used mouse monoclonal antibodies for proliferating cell nuclear antigen (MAbs for PCNA), Ki-67, COX-2, CD 4 and CD 8 lymphocytes to investigate the expression of those characteristics in the cholesteatoma and in the control skin tissue. Statistical analyses were performed using SPSS for Windows version 16.0 (SPSS, Chicago, IL, USA). We used the independent group t-test, Spearman’s correlation analysis and Mann-Whitney U test to analyze statistical analysis. Results. Expression of PCNA, Ki-67, COX-2 and CD 8 lymphocytes in more serious clinical picture of cholesteatoma was almost equal as in less serious clinical picture of cholesteatoma. There was statistically significantly higher concentration of inflammation marker CD 4 lymphocytes, both in the acquired cholesteatoma and in the skin of bony portion of the external auditory canal near fibrocartilaginous annulus in more serious clinical picture of cholesteatoma than in less serious clinical picture of cholesteatoma (p < 0.01). There was statistically significant difference of expression of PCNA, Ki- 67, COX-2, CD 4 and CD 8 lymphocytes between all cholesteatoma samples and the skin of bony portion of the external auditory canal (p < 0.05) and statistically significant difference of expression of those markers between the skin of bony portion of the external auditory canal and retroauricular skin (p < 0.05). Conclusion. Inflammation of the skin of bony portion of the external auditory canal is a milestone in pathogenesis of acquired middle ear cholesteatoma. Expression of CD 4 lymphocytes can be the prognostic factor for acquired cholesteatoma clinical picture development. We found so much diversity in biological behavior through very different levels of cholesteatoma development. Expression of Ki-67 in acquired middle ear cholesteatoma is a reliable and stable marker of proliferation for acquired middle ear cholesteatoma.

Background/Aim. Impulse oscillometry (IOS) is a method for estimating lung function which is used for early detection of bronchial hyperresponsiveness (BHR) and asthma. The aim of the study was to determine the prevalence of BHR, the correlation between spirometry and IOS and sensitivity and specificity of IOS in proving BHR in patients with persistent allergic rhinitis. Methods. The study included 81 patients with allergic rhinitis. From all of them, medical history was taken, allergy testing was done, as well as measurements of parameters of lung function by the IOS and spirometry before and after nonspecific bronchial provocation test with histamin via Aerosol provocative system. Changes of the IOS parameters to fall in FEV1 of 20% were measured and compared with changes in the spirometry parameters. After bronchial challenge test subjects were divided into two groups: the group with BHR (group 1) and that without BHR (group 2). Results. The mean age of participants was 25.7 ± 5.7 years, and 50.5% were men. Out of the total number of subjects with allergy rhinitis, 56 (58.9%) had a positive BPT. After bronchoprovocation an average increase in the group 1 was 88.15% for Rrs5, 111.98% for Fres, and for AX 819.69%. The high degree of correlation between the IOS and spirometry was proven in the group 2, while the whole group 1 had a weak correlation between parameters of these two methods. High sensitivity and low specificity for Rrs5 and Fres compared to FEV1 in diagnosing BHR was proven. Conclusion. The study demonstrated a high prevalence of BHR in the study group of patients with persistent allergic rhinitis, poor correlation in relation to the spirometric measurements in the group with BHR and a high sensitivity and low specificity of IOS for the detection of early changes in the airways.

Background/Aim. A short-term high-intensity noise from a gunshot impulse that occurs when using infantry weapon, can result in onset of auditory symptoms such as tinnitus, impaired hearing or feeling of pressure in one or both ears. The aim of this study was to examine the effect of live ammunition shooting from an automatic rifle on the hearing sense in professional military personnel. The examination was done in correlation with the conditions of the common shooting practice procedure. Methods. The research has been conducted on 22 professional soldiers serving in the Serbian Military, during their regular peacetime training shooting from the automatic rifle AP 7.62 mm M70. The training was conducted on the formational shooting field “Bubanj Potok”. The written consent from all subjects was acquired. All subjects were submitted to medical examination prior and after the shooting session. The medical examination consisted of anamnesis, clinical otorhinolaryngological examination, audiometry and impedancemetry. All subjects filled out the following questionnaire forms: “The Questionnaire prior to shooting” and “The questionnaire after shooting.” Subjects who were incapable to undergo shooting practice, whether from psychological or physical reasons were excluded from this study. Results. After the assessment of received data from 22 subjects, the results were as followed: in 2 (9%) subjects hearing impairment was diagnosed. Tinnitus was registered in 5 (22.7%) patients. One (4.5%) patient reported the feeling of pressure in one ear. One of two cases of one ear hearing impairment was on the rifle holding side and second case was on opposite lateral side. In both cases, hearing loss was of sensorineural type of milder degree, with a scotoma at 4,000 Hz in one case up to 50 dB and the second up to 55 dB. Conclusion. Auditory effects of impulse noise that occurs when shooting from automatic rifles cause hearing impairment, tinnitus and a feeling of pressure in the ears. The practical significance of this study lies in prevention which includes the mandatory use of personal protective equipment and functional arrangement of the practice shooting field.

Background/Aim. Sudden sensorineural hearing loss is manifested by the loss of hearing for more than 30 dB at three consecutive frequencies in the timeframe of 72 h. It is of unclear etiology and pathogenesis, which leads to the use of different therapeutic methods. Treatment protocols are not compliant, making it difficult to objectively quantify their impact. The aim of this study was to show the effect of hyperbaric oxygen therapy as the only method for the treatment of sudden sensorineural hearing loss. Methods. This retrospective study included 20 patients treated for sudden sensorineural hearing loss with hyperbaric oxygenation (HBO) in the period from 2004 to 2014. The study was conducted in the specialized medical clinic for hyperbaric and underwater medicine, HBO Medical Center in Belgrade. The patients were treated according to the following protocol: a session of 60 min at the pressure of 2 bars (2ATA) two times a day, a total of 30 sessions. Assessment of the therapy effects was performed by observing the change in the hearing threshold at the frequencies of 500, 1,000, 2,000 and 4,000 Hz at the end of the treatment. Results. After the completion of treatment according to the protocol, a full hearing recovery (total improvement of hearing damage or achieving final hearing threshold above 25 dB) was found in 11 (55%) of the patients. A partial recovery (hearing improvement of up to 15 dB, and a final hearing threshold below 45 dB) occurred in 4 (20%) of the patients. In 5 (25%) of the patients, improvement was not verified (there was no recovery or it was less than 5 dB). The average absolute hearing recovery was 24.94 dB. The mean relative hearing recovery was 65.45%. Conclusion. Because of the unclear multifactorial etiopathogenesis of this disease, there are many therapeutic protocols. Based on the results of our study HBO therapy could be recommended primarily as the treatment for sudden sensorineural hearing loss.

Background/Aim. Attic cholesteatoma is an epithelial cystic pseudotumor which arises in the top compartment of the middle ear. Surgery is the only therapeutic treatment for attic cholesteatoma. The aim of this study was to analyze the surgical and audiological results in tympanoplasties that use a logical application of several techniques for the management of attic cholesteatoma. Our hypothesis was that the tympanoplasty technique with cartilage/bone reconstruction of the achieve better outcome than the tympanoplasty technique with only temporal fascia reconstruction of the lateral attic wall. Methods. This retrospective clinical study included 80 patients, aged 16–65 years, with attic cholesteatoma undergoing canal “wall up” tympanoplasty with lateral attic wall reconstruction, under general anesthesia in the Eear, Nose and Throat Clinic, Military Medical Academy in Belgrade between 2006 and 2010. The patients were divided into two groups according to the type of lateral attic wall reconstruction: the group I of 60 patients with cartilage/bone plus temporalis fascia lateral attic wall reconstruction and the group II of 20 patients with only temporal fascia lateral attic wall reconstruction. Postoperative follow-up examinations were done at least 5 years after the surgery. The χ2 test was used to compare postoperative sequelae for two groups of operated patients with lateral attic wall reconstruction. The independent and paired samples t-test of air conduction and air-bone gap were used to compare the results of preoperative and postoperative hearing tests. Results. The differences between hearing measurements of the two groups according to preoperative and postoperative auditory thresholds of the air conduction and the air-bone gap were considered no statistically significant. The difference between the two groups recarding to recurrent attic retraction pocket appearance and recurrence of cholesteatoma was considered statistically significant and the results were much better in the group I of the operated patients with cartilage/ bone lateral attic wall reconstruction. Conclusion. “Wall up” tympanoplasty for attic cholesteatoma with lateral attic wall reconstruction leads to good anatomical and audiological results. A significant hearing improvement was obtained in both the types of lateral attic wall reconstructions in this study. Reconstruction with cartilage or mastoid cortex bone showed favorably long-term functional and anatomical results compared to primary tympanoplasty using only temporal fascia for lateral attic wall reconstruction in cases of attic cholesteatoma.

Background/Aim. Hyperreactivity of the airways caused by inflammation in asthmatics is the most important pathophysiological change. It represents a suitable ground that in the presence of risk factors and the drivers of asthma, asthmatic attack occurs. Atopic constitution is one of the most important risk factors for the development and expression of asthma. The aim of our study was to investigate the relationship between nonspecific airway hyperreactivity and atopic constituton in asthmatics. Methods. This retrospective analysis was conducted considering the results of nonspecific bronchoprovocative test with histamine, skin tests to inhalant allergens and total IgE levels in the serum of asthmatic patients with controlled bronchial asthma. The sample consisted of 162 asthmatics examined during one-year period. Results. The examinees were male asthmatic patients, aged between 18 and 30 years. We found that the examinees with a pronounced non-specific hyperreactivity had more significant skin reaction to inhaled allergens and higher levels of total IgE in serum. Conclusion. The results of our study show that the intensity of airway hyperresponsiveness to histamine in asthmatics is directly related to atopic constitution.

Background/Aim. Secretory otitis media (SOM) is a chronic, nonpurulent inflammation of the middle ear, characterized by a long-term presence of liquids of different density in the middle ear for at least three consecutive months, different degrees of hearing loss and the absence of perforation of the eardrum. The aim of this study was to estimate the early postoperative complications after insertion of tympanostomy tube (TT) in children with secretory otitis media (SOM) in an 18-month period after TT insertion. Methods. This retrospective study included children with SOM (n = 478), aged from 2.5 to 16 years, operated from 2000 to 2009. During these ten years 365 children had TT in both ears, 131 children had TT in one ear and 55 children were operated two or more times. Totally 843 ears were operated on. Date were obtained by regular fallow up in Out-patient clinic concerning symptoms reported by children and parents, otomicroscopy findings and hearing measurements (audiometry and tympanometry). Results. Transient otorrhea was the most common early postoperative complication (16.5%), then obstruction (9.5%), premature extrusion of TT (3.9%), chronic otorrhea (3.1%), granulation tissue (1.1%) and medial displacement (0.5%). According to our experience gold and silicone TT were shown less successful than others. The incidence of premature extrusion of TT was significantly higher with gold TT, comparing to others (6/33, 18%; p < 0.001). We also found significantly more frequent medial displacement with silicone TT than with other ones (2/4, 50%; p < 0.001). Conclusion. There are many early postoperative complications of TT insertion, but they depend on the meticulous surgery techniques, regular postoperative examinations and the type of TT. The type of TT should be determined according to own experience.

Immunomodulatory treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) by macrolide antibiotics represents a challenging alternative to conventional therapy and surgery, still being at the very beginning. Immune and inflammatory processes in nasal and paranasal sinus mucosa, crucial in the etiopathogenesis of nasal polyps (NPs) are reflected in levels of various local mediators, found both in mucosa and nasal fluid. In this prospective study, we assessed the immunomodulatory and clinical effects of longterm low-dose oral macrolide treatment in the management of CRSwNP. Twenty-two (n = 22) nonasthmatic, nonallergic patients with CRSwNP were administered clarithromycin (CAM) 500 mg/day single oral dose for eight weeks. We measured the levels of proinflammatory cytokines TNF-a, TNF-b, and IL-1b, Th1 cytokines IL-2, IL-12, and IFN-g, Th2 cytokines IL-4, IL-5, IL-6, and IL-10, and chemokine IL-8 in the nasal fluid samples, before and after treatment, using a flow cytometric method. We also scored each of the 22 patients before and after therapy according to Tsicopoulos' global nasal symptom score and Malm's endoscopic score. Following treatment, we found significantly reduced levels of IL-8 (p

Background. Angiofibromas are histologically benign vascular tumors, originating from the nasopharynx, near by the area of sphenopalatine foramen. These neoplasms occur typically in male adolescents. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature in English. We present the first case of an elderly woman with tumor arising from the middle turbinate, diagnosed as angiofibroma. Case report. A 63-year-old female presented with left-sided nasal obstruction and epistaxis. Endoscopic evaluation revealed a polypoid mass arising from the anteroinferior portion of the left middle turbinate. Computed tomography (CT) scan showed a soft-tissue opacity that filled the anterior part of the left nasal cavity. After the endoscopic excision of the mass, postoperative pathohistological and immunohistochemical analysis confirmed the diagnosis of an angiofibroma. Two years later, the patient was free of symptoms and without endoscopic evidence of recurrence. Conclusion. Extranasopharyngeal angiofibromas arising from the nasal cavity are extremely rare tumors. Immunohistochemical analysis is very important in all doubtful cases, especially in those with atypical location.

Background. Concha bullosa (CB) is pneumatization of the middle turbinate and one of the most common anatomic variation of the sinonasal region. It is found in about 25% of the population. Middle meatus obstructive syndrome (MMOS) is, usually connected with CB. The main symptoms of this syndrome are headaches, impaired nasal breathing and hyposmia. Headache is the most common symptom and it may occur due to contact between a CB and other structures of the nasal cavity. Case report. We presented a case of 32 year-old-woman with headaches, located in the orbital and the left frontal region. The headaches were intermittent and corresponding to the nasal cycle. After neurologic and alergic examination, endoscopic nasal examination demonstrated a septal deviation to the right side and a large middle turbinate in the left side of the nasal cavity. Coronal computerized tomography (CT) of the paranasal sinuses demonstrated the septal deformation and pneumatization of the left middle turbinate. Diagnosis was confirmed by lidocaine test. In the functional endoscopic surgery (FESS), the lateral lamela of the anterior CB was removed. At the same time, the septoplasty was done. At the control examination, the patient was without symptoms. Conclusion. Although CB is the common anatomic variation of the nasal cavity, MMOS is rare. Headache (rhinogenic origin) is the most important symptom. Surgical treatment is the lateral resection of the CB in the FESS technique and the septoplasty.

Background. Mucocoele is histopathologically benign, cystic change of paranasal sinuses filled with mucoid contents, which with its growth is pressuring and destroying local bone walls. In only 3% of the cases it can be localized in maxillary sinuses. Etiology is unknown. Pyocoele develops by secondary infection. Case report. The male patient was 21 years old. His symptoms were runny nose with thick contents and heavy breathing on the right side of the nose, headaches, as well as the swelling of the right cheek. During clinical examination, the expansive change was found. It was completely closing the right side of the nose cavity. Computerized tomography (CT) of paranasal cavities showed excessive expansion of the right maxillary sinus, with very thinned walls, while the cavity was filled with liquid. After antibiotics therapy, the radical operation of the right maxillary sinus was performed, based on Caldwell Luc method. The frontal wall was found to be extremely convex and thinned, while the medial wall was with dehiscention. The cystic change was extirpated. Mucocoele was proved by pathohistologic findings. Its wall was about 2 mm thick and it showed squamous metaplasia in the large part of the mucocoela epithel. In the submucosa fibrosis and inflammatory infiltrate was present. Postoperative follow-up was under control. Clinically and radiographycaly, six months after therapy, the patient does not have troubles. Conclusion. The rare localization of the mucocoeles in maxillary sinus can be explained with the width of the maxillary ostia. Infected mucocoeles, expanded to the local anatomical structures, should be operated on with classic radical surgical operation. .

Chondromesenchymal hamartoma (CMH) is a rare, benign lesion of the nasal cavity, paranasal sinuses, and skull base, composed of islands of hyaline cartilage in a myxoid background. The vast majority of CMH cases are infants and young children. According to the world literature, nasopharyngeal involvement of CMH is extremely rare. In all cases, the lesions were masses protruding from the nasal cavity or paranasal sinuses to the nasopharynx. We hereby report 2 adult male patients with masses completely situated in the nasopharyngeal space. In the first patient, the tumor originated from the posterior edge of the nasal septum and in the second one, from the posterolateral wall of the nasopharynx, adjacent to the pharyngeal orifice of the Eustachian tube. In both patients, the lesion was excised endoscopically, and histopathological analyses were consistent with a diagnosis of CMH. To our knowledge, those are the only cases of CMH completely situated in the nasopharynx. [ABSTRACT FROM AUTHOR]

Objective: In this prospective study, we compared the diagnostic potential of Pentax’s System of Autofluorescent Endoscopy (SAFE 1000) with standard microlaryngoscopy in the diagnosis of laryngeal precancerous and malignant lesions. Methods: We compared the sensitivity and specificity of microlaryngoscopy and SAFE 1000 in a total of 128 patients with various laryngeal pathologies. Fiberoptic endoscopic examinations of the larynx in white light and autofluorescent mode were performed, followed by microlaryngoscopy with obtaining biopsy from suspected areas, performed by another endoscopist. During the microlaryngoscopy, the endoscopist evaluated images provided by SAFE and compared them with the findings of microlaryngoscopy and, if necessary, took biopsies from areas with autofluorescent irregularities. Histopathological examination of biopsy samples was used as a “gold standard” for definitive diagnosis and for comparison of studied methods. Results: Overall sensitivity of SAFE was higher than the sensitivity of microlaryngoscopy (89.06% vs. 83.59%, P = .016). Specificity of detection of defect in autofluorescent signal in cases with laryngeal premalignancies and malignant tumors by SAFE 1000 endoscopy was 81.71%. The results suggest that SAFE has a significantly higher sensitivity than standard MLS in detection and description of precancerous and malignant lesions of the larynx. The specificity of SAFE 1000 was relatively insufficient, suggesting the necessity for histopathological analysis. Conclusion: SAFE 1000 could be a powerful tool in recognizing and describing premalignant and malignant lesions of the larynx in addition to standard microlaryngoscopy. Authors recommend the simultaneous use of SAFE 1000 and microlaryngoscopy in the diagnostics of laryngeal lesions, in order to obtain the most accurate diagnostic results [ABSTRACT FROM AUTHOR]

The article presents the cross-sectional study on the correlation between macrophage inflammatory protein-I (MIP) alpha production and eosinophil infiltration in chronic rhinosinusitis with nasal polyps (NP). The study involved nonatopic and atopic NP patients and healthy subjects as controls and flow cytometry for measuring nasal secretions. The results reportedly revealed that NP patients have more MIP alpha concentrations, suggesting that it is useful for assessing eosinophil inflammation.

Background. Mucocoele is histopathologically benign, cystic change of paranasal sinuses filled with mucoid contents, which with its growth is pressuring and destroying local bone walls. In only 3% of the cases it can be localized in maxillary sinuses. Etiology is unknown. Pyocoele develops by secondary infection. Case report. The male patient was 21 years old. His symptoms were runny nose with thick contents and heavy breathing on the right side of the nose, headaches, as well as the swelling of the right cheek. During clinical examination, the expansive change was found. It was completely closing the right side of the nose cavity. Computerized tomography (CT) of paranasal cavities showed excessive expansion of the right maxillary sinus, with very thinned walls, while the cavity was filled with liquid. After antibiotics therapy, the radical operation of the right maxillary sinus was performed, based on Caldwell Luc method. The frontal wall was found to be extremely convex and thinned, while the medial wall was with dehiscention. The cystic change was extirpated. Mucocoele was proved by pathohistologic findings. Its wall was about 2 mm thick and it showed squamous metaplasia in the large part of the mucocoela epithel. In the submucosa fibrosis and inflammatory infiltrate was present. Postoperative follow-up was under control. Clinicaly and radiographycaly, six months after therapy, the patient does not have troubles. Conclusion. The rare localization of the mucocoeles in maxillary sinus can be explained with the width of the maxillary ostia. Infected mucocoeles, expanded to the local anatomical structures, should be operated on with classic radical surgical operation. [ABSTRACT FROM AUTHOR]

Background. Concha bullosa (CB) is pneumatization of the middle turbinate and one of the most common anatomic variation of the sinonasal region. It is found in about 25% of the population. Middle meatus obstructive syndrome (MMOS) is, usually connected with CB. The main symptoms of this syndrome are headaches, impaired nasal breathing and hyposmia. Headache is the most common symptom and it may occur due to contact between a CB and other structures of the nasal cavity. Case report. We presented a case of 32 year-old-woman with headaches, located in the orbital and the left frontal region. The headaches were intermittent and corresponding to the nasal cycle. After neurologic and alergic examination, endoscopic nasal examination demonstrated a septal deviation to the right side and a large middle turbinate in the left side of the nasal cavity. Coronal computerized tomography (CT) of the paranasal sinuses demonstrated the septal deformation and pneumatization of the left middle turbinate. Diagnosis was confirmed by lidocaine test. In the functional endoscopic surgery (FESS), the lateral lamela of the anterior CB was removed. At the same time, the septoplasty was done. At the control examination, the patient was without symptoms. Conclusion. Although CB is the common anatomic variation of the nasal cavity, MMOS is rare. Headache (rhinogenic origin) is the most important symptom. Surgical treatment is the lateral resection of the CB in the FESS technique and the septoplasty. [ABSTRACT FROM AUTHOR]

Background: Respiratory epithelial adenomatoid hamartoma (REAH) is a benign pseudo-glandular proliferation of the nasal cavity with poorly-understood etiopathogenesis. This study aimed to examine the frequency of comorbidities in patients with REAH and to determine whether comorbidity affects the clinical characteristics of REAH. Methods: A retrospective cohort study included patients with REAH treated at 2 university hospitals over 15 years. Clinical parameters included the side of the nasal cavity, localization and size of the lesion, duration of symptoms, follow-up period, and associated chronic inflammation. Results: Twenty previously-unoperated patients with REAH were included. We found an association of REAH with chronic sinonasal disorders in 70% of cases: in 30% with perennial allergic rhinitis (PAR), in 25% with chronic rhinosinusitis with nasal polyps (CRSwNP), and in 15% of cases with aspirin-exacerbated respiratory disease (AERD). In 87.5% of cases of bilateral REAH, the lesion was associated with NPs, in 80% of patients with CRSwNP as a comorbidity, and in 100% of patients where it was AERD. Symptoms were longer in REAH patients with associated sinonasal inflammation ( P < .038). We found a far-greater average volume of REAH in patients with AERD than in cases with PAR, and CRSwNP ( P < .001; P < .001, respectively) and a positive correlation between the duration of symptoms and the lesion volume ( R = .700; P = .001). The follow-up period was longer in patients with comorbidities ( P < .028), and recurrences of REAH were noted only in 2 patients with AERD as a comorbidity. Conclusion: A high degree of association between REAH and chronic sinonasal inflammation was found. Also, the results suggest that inflammation in AERD is the strongest provoking factor for the growth of REAH. A direct correlation was observed between the duration of nasal symptoms and the lesion size., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.