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It has been suggested that H. pylori infection upregulates iNOS expresion and synthesis of nitric oxide (NO). In order to extend the scope, exhaled NO in H. pylori-infected patients with chronic gastritis was investigated. Exhaled oral NO level was measured with Niox Mino® analyzer, twice before and six-seven months after successful H. pylori eradication therapy in 26 patients with gastritis and in 16 healthy non-atopic subjects. Exhaled NO was significantly increased in H. pylori-infected patients with chronic gastritis as compared with the healthy subjects. Following eradication the levels were significantly reduced compared to the basal level before the therapy and did not differ significantly from those of the healthy subjects. It seems that H. pylori-associated gastritis is accompanied by an increased level of exhaled NO, resulting probably from the locally increased NO production. [ABSTRACT FROM AUTHOR]

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.

Background: Markers of tumorigenesis are essential factors which may play a major role in the early detection of head and neck carcinoma., Aims/objectives: To assess concentration of HIF-1, GLUT1 and VEGF in tissue samples and blood serum and its correlation to the tumour size, nodal disease, pathologic differentiation and patients' data., Material and Methods: Fifty-two patients diagnosed with laryngeal carcinoma stage I-IV in which concentration of HIF-1, GLUT1 and VEGF was assessed in tissue samples and blood serum using immunoassay method., Results: HIF-1α, GLUT1, VEGF concentration was significantly higher in cancer tissue samples than in normal tissue ( p  < .001) and benign laryngeal lesions. Serum levels of the factors were significantly lower in the control group. Statistically significant difference regarding tumour size was found between T2 and T4 stages in HIF-1α concentration in cancer samples and serum., Conclusions: The results show that high concentration of HIF-1α, GLUT1 and VEGF might be suggestive of carcinogenic process when diagnosing patients with laryngeal lesions and could promote early detection of malignancy., Significance: The results of this study show importance of biochemical assessment in malignant tumours which may affect clinical decisions.

Objectives: The aim of this study was to evaluate serum levels of adiponectin, leptin, visfatin and IL-6 in patients with pleomorphic adenoma, Warthin's tumor and acinic cell carcinoma of the parotid gland., Materials and Methods: Venous blood samples were collected from 30 patients with pleomorphic adenoma, 21 patients with Warthin's tumor and 8 patients with acinic cell carcinoma. Serum adiponectin, leptin, visfatin, IL-6 and CRP concentrations were determined., Results: Our results revealed significantly lower adiponectin serum levels in patients with malignant tumors compared to benign tumor individuals. Moreover, in benign cases the level was significantly higher compared to controls. Furthermore, serum leptin concentrations of benign tumor patients were higher compared to controls. Those differences, however, were observed only in males. The serum visfatin level was elevated in all tumor subjects compared to healthy individuals, whereas the serum IL-6 concentration was similar., Conclusions: We anticipate that adiponectin may play a potential protective role in salivary gland tumors. Also leptin and visfatin seem to play an important role in salivary gland tumor pathology, although in males and females leptin may act or be regulated in a different manner. The influence of visfatin on salivary gland tumors is probably independent of IL-6 production., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Introduction: A pathomechanism of allergic rhinitis is complex. A neurogenic mechanism seems to play a significant role in this phenomenon., Aim: The evaluation of influence of specific immunotherapy of mugwort pollen allergic patients on the bradykinin concentration in the nasal lavage fluid., Material and Methods: The study included 22 seasonal allergic rhinitis patients. Thirty persons with monovalent allergy to mugwort pollen, confirmed with skin prick tests and allergen-specific immunoglobulin E, underwent a 3-year-long allergen immunotherapy with the mugwort extract (Allergovit, Allergopharma, Germany). The control group was composed of 9 persons with polyvalent sensitivity to pollen, who were treated with pharmacotherapy. Before the allergen-specific immunotherapy (AIT) and in subsequent years before the pollen seasons, a provocation allergen test with the mugwort extract was performed, together with collection of nasal fluids, where bradykinin concentration was determined according to Proud method., Results: There were similar levels of bradykinin in both groups at baseline prior to therapy (AIT group: 584.0 ±87.2 vs. controls 606.3 ±106.5 pg/ml) and changes after allergen challenge 1112.4 ±334.8 vs. 1013.3 ±305.9 pg/ml as well. The bradykinin concentration in nasal lavage fluid after mugwort challenge in 1 year was lower in the AIT group (824.1 ±184.2 pg/ml vs. 1000.4 ±411.5 pg/l; p < 005) with a further significant decrease after the 2(nd) and 3(rd) year of specific immunotherapy. Significant reduction of symptoms and medications use was observed in hyposensitized patients., Conclusions: A decreased level of bradykinin as a result of AIT suggests that some of the symptomatic benefits of AIT may be related to the reduced release of bradykinin into nasal secretions. These values correlate with clinical improvement within the course of treatment.

Altered glycosylation is a universal characteristic of cancer cells, and various types of glycan structures are well‑known markers of tumor progression and invasion. The present article discusses this aspect of the role of sialic acid, biosynthesis of sialylglycoconjugates and the genetic basis of its disorder, as well as the effects and the correlation between altered sialylation and clinical prognosis in head and neck squamous cell carcinoma (HNSCC). Only a few studies concerning the level of sialic acid in head and neck tumors have been conducted so far. The conclusions of the published reports dedicated to that problem confirm the presence of elevated levels of total sialic acid in these tumors. The authors do not always agree with the level of free or associated form of sialic acid correlated with tumor size, severity of the condition, and lymph nodes. Comparing the progress that has been made in the diagnosis and treatment of other cancers thanks to extensive work on the role of sialic acids, we come to the conclusion that only further detailed studies of this subject in relation to HNSCC are able to answer the question whether the extent of glycoforms of sialic acid may act as a tumor marker or target of immunotherapy.

Introduction: The complicated etiology of chronic sinusitis with polyps and frequent allergy to mould is established., Aim: We aimed to investigate the frequency of the IgE-dependent hypersensitivity in this group of patients and prove the need of surgery in allergic chronic rhinosinusitis patients., Material and Methods: Forty-two patients (19 females, 23 males) aged 34-73 years (55 ±12.6 years), with chronic sinusitis with polyps were included into the study. Functional endoscopic sinus surgery, laryngological examination, sinus computed tomography scans, and smear from maxillary sinus for microbiological examination were done in all patients. Skin prick tests with common perennial and seasonal inhalant allergens, tIgE and sIgE against moulds were required., Results: Thirty-two of 42 patients (71.4%) were allergic to at least one inhalant allergen. A mean concentration of total IgE was 241.2 ±186.3 kU/l (35.0-708.0 kU/l) and was lower in patients with fungal culture found in sinus mucin than in patients without fungal presence 75.1 ±54.6 kU/l vs. 284.3 ±204.1 kU/l. We found no difference in the number of positive skin prick tests in a group with and without fungal culture. None of patients with fungal culture found in sinuses presented a detectable level of mold sIgE. All patients with fungal vegetation in sinuses required at least two polypectomy procedures., Conclusions: The total IgE concentration was significantly lower in patients with fungal presence in sinuses. Nasal polyps occurred more frequently in patients with fungal presence in sinuses.

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.

Nitric oxide (NO) may contribute to the mutagenic processes and has been extensively studied as a noninvasive marker of neoplastic processes occurring in the airways. It has been suggested that an increased expression of inducible NO synthase might appear as an important molecular event involved in the early stage of laryngeal carcinogenesis. The aim of this study was to determine NO levels in the exhaled air of patients with early stage glottic carcinoma. Exhaled bronchial NO was measured using a Niox Mino analyzer in 28 patients with squamous cell glottic carcinoma (T1-T2N0M0) and in 30 healthy controls. There were no significant differences in exhaled NO level between the healthy controls and T1-T2N0M0 patients with glottic cancer or between the subgroups (T1 vs. T2). It seems that early glottic cancer is not associated with significant changes in the exhaled NO level. Early diagnosis of cancer is desirable, however this study does not prove that exhaled NO may be a useful biomarker in patients with early stage squamous cell glottic carcinoma.

Background: Intermittent clamping (IC) of the portal triad is an effective method of protecting the liver from ischemia-reperfusion injury (IR). In clinical practice, this method is employed during a resection, but its mechanism is still not clear., Objectives: To evaluate the effect of IC on rat liver and determine its mechanisms., Materials and Methods: Wistar rats were submitted to 60-min IC (cycles of 12-min clamping followed by 4-min reperfusion), and the samples were collected after 1, 6, and 72 hrs of reperfusion. We determined the serum activity of alanine aminotransferase (ALT), and measured the concentration of TNF-α, malondialdehyde (MDA) and myeloperoxidase (MPO) in liver homogenates. The apoptosis of hepatocytes was evaluated immunohistochemically., Results: When compared to the IR rats, the activity of ALT decreased in the IC group in all periods of observation (the highest decrease of ~48% after 1 hr of reperfusion). When compared to the IR group, a statistically significant decrease (p < 0.05) in the TNF-α concentration (~33%) in the IC rats occurred only after 1 hr of reperfusion, and it was accompanied by a decrease in the MPO concentration after 1 and 6 hrs of reperfusion. IC reduces the effects of reactive oxygen species (ROS) activity, which has been confirmed by a statistically significant decrease in MDA concentration by 25%-35% in all studied periods. The limitation of hepatocytes apoptosis due to IC occurs in the early (~26%; p < 0.05) and late (~45%; p < 0.01) phases of reperfusion., Conclusions: The use of IC in early phase of reperfusion brings about a decrease in TNF-α release, which can be related to liver injury due to neutrophil infiltration and apoptotic cell reduction. It seems that the reduction of lipid peroxidation may also limit the liver injury.

Sarcoidosis and its aetiopathogenesis, epidemiology and diagnostic procedures (including the Kveim reaction) are presented in this paper. The clinical manifestations of this disease, especially in otolaryngological organs, including the larynx, salivary glands, nose and paranasal sinuses, are described. Treatment procedures, including surgical interventions and prognosis, are also discussed.

Liver ischaemia and reperfusion (IR) injury is a significant clinical problem. The aim of our study was to investigate the protective effect of tumor necrosis factor-alpha (TNF-alpha) on rat liver ischaemia-reperfusion injury. A TNF-alpha dose of 3 microg/kg body weight was injected into rats that had undergone partial (70%) ischaemia and reperfusion. The activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total blood antioxidant level (using the FRAP test), and the concentrations of TNF-alpha, myeloperoxidase (MPO) and malondialdehyde (MDA) in liver homogenates after 1, 6, and 72 hours of reperfusion were measured. It was demonstrated that, rats subjected to IR, the administration of small doses of TNF-alpha significantly reduced ALT and AST activities after 60- minute liver ischaemia and 1 or 6 hour of reperfusion. The strongest reductions in ALT and AST activities were seen after 1 hour of reperfusion (30% and 35%, respectively). Exogenous TNF-alpha reduced the release of this cytokine in all observed periods, with the greatest reduction observed after 1 hour of reperfusion. Decreases in MPO concentration (by 40-45% in all periods of observation), as a marker of hepatic neutrophil infiltration, and in MDA concentration, the end-product of lipid peroxidation (by 55-60% at all time points), accompanied the reduction of TNF-alpha release. The administration of TNF-alpha to the rats after IR did not alter total plasma antioxidant potential, as assayed by the FRAP test, after 1 hour of reperfusion; however, at the later times a marked increase (approximately 40-50%) occurred. We demonstrated that intraperitoneal injections of small doses of TNF-alpha protect rat livers from IR injury. The mechanism of this protection is related to reductions in the release of TNF-alpha during IR after injection of this cytokine, resulting in reductions in oxidative stress and inflammation during the later phase of reperfusion.

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.

Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation and daytime somnolence. Obesity is one of the most important risk factor for the development of OSAS. The exact mechanisms responsible for the relationship between obesity and OSAS are still unclear. The fat deposits in the pharynx region as well as the reduction in the lung volume have been considered as factors that might be responsible for the increase of the upper airway collapsibility. The aim of our study was to evaluate the correlation between the Body Mass Index (BMI) and sleep study parameters in overweight and obese patients suffering from breathing disturbances during sleep. We studied a group of 106 consecutive obese or overweight patients with a primary complaint of snoring or other breathing disturbances during sleep. In all cases, BMI and sleep studies (PolyMESAM) were examined. We evaluated relationship between the BMI and sleep study parameters such as Respiratory Disturbance Index (RDI), Apnea Index (AI), Desaturation Index (DI) and Average of Lowest Saturation (LSAT). The results showed the lack of significant statistical correlations between BMI and all the sleep parameters studied in the overweight patients and the statistical positive correlation between the BMI and RDI in the obese cases. We conclude that BMI determination may be considered as a simple, yet important predictor, of the OSAS in the group of obese patients.

Unlabelled: 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, nose and paranasal sinuses, middle ear, pharynx, tonsils, tongue, parotid glands and central nervous system. The diagnosis of head and neck tuberculosis is based on patient's examination as well as on the bacteriologic and histologic study of the biopsy specimen., Aim: The aim of the study was to show our own, very rare cases of head and neck tuberculosis., Material and Methods: We showed our own experience in the diagnosis and treatment of patients suffer from head and neck tuberculosis. 7 cases of head and neck tuberculosis (4 laryngeal, 2 sinonasal and 1 middle ear) were treated from 1986 to 2004 in the II ENT Department Silesian Medical University in Zabrze. In all the cases the diagnosis was based on the histological examination of the tissue specimen. All of the patients were suspected of the neoplastic disease. We assessed good long-term results after the conservative treatment (sometimes completed by surgery)., Conclusions: Tuberculosis of the head and neck region should be taken into consideration during the differential diagnosis of neoplastic diseases.

In this study the very rare case of a parotid gland sialolithiasis was presented. The authors described opinions concerned with symptomatology, localization, diagnostics and methods of treatment in parotid sialolithiasis. The 12 months follow-up period was free of symptoms.