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<br><b>Introduction:</b> Malignant minor salivary gland tumors are rare, accounting for fewer than 1% of all laryngeal cancers.</br> <br><b>Aim:</b> This study aims to share our experiences regarding clinical, radiological, pathological profiles and their management.</br> <br><b>Materials and methods:</b> The current study reviews 11 cases of malignant minor salivary gland tumors of the larynx treated surgically at our Institute between 2005 and 2019.</br> <br><b>Results:</b> The mean age of the patients was 54 years (range 38-75 years) with six females and five males in the series (1.2:1). Subglottis and trachea were the sites of origin in 54% of the cases, and hoarseness with dyspnea were the most common presenting symptoms. There were nine Adenoid cystic and two Mucoepidermoid carcinoma patients. Surgery was the primary mode of treatment.</br> <br><b>Conclusions:</b> Most of the larynx's malignant minor salivary gland tumors are submucosal in origin. The outcome and prognosis vary considerably based on the tumor's histology, grade, and stage.</br&gt.

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.

<b>Introduction:</b> Treatment of glottis cancer, despite oncological safety, should consider postoperative voice quality. CO<sub>2</sub> laser endoscopic cordectomy allows radical removal of the tumor while maintaining respiratory, defensive and phonatory functions. <br><b>The aim:</b> The aim of the study is perceptual and acoustic evaluation of voice in patients after endoscopic CO2 III-Va laser cordectomy due to glottis cancer. <br><b>Material and method:</b> The study included 30 men after CO<sub>2</sub> cordectomy. 13 (43%) patients underwent type III cordectomy, 6 (20%) - type IV; 11 (37%) - type Va. Voice quality has been assessed 6 months after the surgery. Control group included 30 healthy men of the same age. GRBAS scale has been used in perceptual evaluation of voice. Acoustic analysis has been performed using DiagnoScope Specjalista software. Narrowband spectrography and Maximum Phonation Time (MPT) measure has been performed. <br><b>Results:</b> In study group, voice has been classified as G<sub>1</sub>R<sub>1</sub>B<sub>0</sub>A<sub>0</sub>S<sub>0</sub> after type III cordectomy; as G<sub>1</sub>R<sub>1</sub>B<sub>1</sub>A<sub>1</sub>S<sub>2</sub> in type IV and as G<sub>2</sub>R<sub>1</sub>B<sub>1</sub>A<sub>0</sub>S<sub>3</sub> in type Va. Acoustic evaluation revealed the highest values of F0, Jitter, Shimmer and NHR after Va cordectomy as well as non-harmonic components in narrowband spectrography and reduction of MPT. <br><b>Conclusions:</b> Postoperative voice quality depends on the type of cordectomy. Perceptual assessment indicates that type IV and Va cordectomy cause intensification of voice disorders. Parameters of acoustic evaluation increase with the extent of the procedure. The presence of non-harmonic components in narrowband spectrography increases with the extent of cordectomy, such as the reduction of MPT. Preservation of anterior commissure influences good voice quality in perceptual and acoustic assessment.

Introduction: CO2 laser endoscopic cordectomy is the method of laryngeal cancer treatment. The type of cordectomy (I-VI) depends on the extent of the tumor. Endoscopic laser surgery provides more satisfactory phonation conditions in comparison to open surgical procedures., The Aim: The aim of the study was to classify phonatory compensation mechanisms after CO2 laser cordectomy using the HSDI. M aterial and methods: The study included 30 men treated and diagnosed at the Department of Otolaryngology and Department of Clinical Phonoaudiology and Logopedics, Medical University of Bialystok. The control included 30 men with no pathological changes in the larynx. Type III, IV and Va CO2 laser cordectomy have been for glottis cancer treatment. Postoperative evaluation has been conducted 6 months after the surgery. HSDI has been used in larynx visualization. R esults: Type I compensation occurs most frequently in patients after type III cordectomy. Advanced glottis cancer, as an indication for type IV and V cordectomy, leads to epiglottic hyperfunction and phonation involving vestibular folds - type II and III compensation. Type IV compensation is most frequent in type IV cordectomy. C onclusions: The type compensation is connected with the extent of glottis resection. In cordectomy including anterior commissure and the part of opposite fold (type Va), supraglottic hyperfunction with the participation of vestibular folds (type II and III compensation) has been recorded. Transmuscular cordectomy (type III) most often resulted in type I compensation. Type III-Va cordectomy caused reduction or absence of MW, decrease in amplitude and aperiodicity of vibrations in HSDI.

Introduction: Treatment planning in T2, T3 laryngeal carcinoma is based on clinical assessment and radiological imaging. However, to delineate precise mucosal margins for transoral laser microsurgery (TLM), a high class, sophisticated endoscopy is indispensable. Narrowband imaging (NBI) which is an optical filter technology, seems to be a useful adjunctive tool in marking superficial margins., Materials and Methods: A total of 98 patients diagnosed with HNSCC underwent cordectomies and were enrolled in the evaluation. T2 and T3 stage cancer were diagnosed in 90 and 8 patients, respectively. Intraoperatively, prior to the first laser shot, all anatomical sites were endoscopically evaluated by WL and NBI., Results: In 10/98 patients (10.2%), 10 samples were taken based only on NBI findings to guarantee better delineation of superficial margins. The result of histology revealed moderate dysplasia in 4 cases (40%), severe dysplasia in 2 (20%), carcinoma in situ in 3 (30%) and hyperkeratosis in 1 (10%). Based on presented results, combined NBI/WL endoscopy reached the sensitivity of 100%, specificity 98.88%, positive predictive value 90%, negative predictive value 100% and accuracy 98.98%. All patients had clear margins according to definitive histology results., Discussion: In this paper, we aimed to assess the usefulness of NBI in intraoperative imaging of laryngeal mucosa and delineation of superficial margins in patients with selected T2 and T3 laryngeal cancer treated with TLM. We proved in our study that with the support of NBI endoscopy, it is possible to increase the accuracy of superficial resection margins in patients with moderately advanced laryngeal cancer (T2, T3).

Purpose of the Study: The aim of the study was to present the treatment outcomes after vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction following the resection of neoplasm-infiltrated vocal fold. The procedure was used in a patient with glottic cancer. Oncological outcomes, morphology of neo-vocal fold and the act of swallowing were evaluated., Material and Methods: 45 patients with T1-T2 glottic cancer were subjected to vertical partial laryngectomy with 26 patients undergoing a procedure with pedunculated sternothyroid muscle flap reconstruction and the remaining 19 patients undergoing a procedure without such a reconstruction. Two female and 43 male patients aged 35-82 years (mean age of 62.5 years) were enrolled in the study. Local tumor spread and the condition of reconstructed vocal fold were assessed in sequential videofiberoscopy examination conducted each month after surgery whereas the regional spread was assessed in ultrasound scans. Postoperative aspiration was graded according to the Pearson's scale., Results: Six patients experienced local recurrence while 2 patients experienced regional recurrence of the tumor. The pedunculated sternothyroid muscle flap neo-fold was structurally resemblant of the non-affected vocal fold. Episodic, daily dysphagia was observed in 1 patient while normal act of swallowing with no Pearson's scale symptoms was observed in the remaining 44 patients. No necrosis of pedunculated flap was observed., Conclusions: Vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction is a good method for the treatment of low- or intermediate-stage glottic cancer, especially when endoscopic access to the tumor is limited and when CO2 laser cannot be used. No significant functional disorders were observed in operated larynges.

Objective: The aim of the study was to estimate usability of the piezoelectric knife in larynx surgery. Prove that the piezoelectric staff can be used to do any different shape incision within the larynx cartilages., Material and Methods: 35 patients hospitalized in our Department in 2014-2016 were enrolled in our study. 24 patients went vertical partial laryngectomy and 1 patient went horizontal partial laryngectomy because of larynx cancer. 5 patients went partial laryngectomy because of low stage of piriformis recess cancer. Piezoelectric staff was used to do thyroidectomy and resection of thyroid cartilage suspected of carcinomatosis infiltration. The rest 4 patients had done widening of larynx lumen due to larynx stenosis or slenderness. The piezoelectric tool was used to do different incision or resection within the larynx cartilages in case of widening lumen of the larynx., Results: The larynx cartilages, especially thyroid cartilage could be cut in different shapes using piezoelectric tools. The usage of this equipment causes the minimal loss and small destruction of local healthy tissues., Conclusions: The Piezoelectric instrument is useful instrument suit to operate within larynx cartilages. Exchangeable tip available in different shapes enables different resections of cartilages. Using the piezoelectric staff we can remove pathological tissue with minimal local destruction. Our observation shows that larynx operation with a usage of the piezoelectric knife is safe and effective. Current English literature does not describe usage piezoelectric tools in larynx surgery. It is essential to do more observation about that type of operations.

The aim of the study was to analyze the efficacy of treatment of closure of cutaneopharyngeal fistulas, following total laryngectomy, using a fasciocutaneous flap. In the group of 6 patients treated in years 2013-2014, in 4 (67%) patients the healing process was successful, in one patient complete flap necrosis was noted on the 6th day, in another patient a small cutaneopharyngeal fistula was recognized, which closed secondarily with no intervention. Flaps of this type, having a small risk of local complications at donor site and satisfactory functional and aesthetic results, may be an alternative form of flap to others used in the reconstruction of superficial deficits in the head and neck areas.

Objective: The non-epithelial neoplasms of larynx and hypopharynx are of rare incidence but may originate from various histological tissues. These effect in the difficulty of final diagnosis and often delay the proper treatment., Material and Methods: There was performed retrospective analysis of patients with histopathologicaly confirmed non-epithelial neoplasms of larynx or hypopharynx between 2001 and 2013, that included the evaluation of epidemiology, diagnostic methods and treatment., Results: Non-epithelial neoplasms of larynx and hypopharynx were established in 18 patients (9 women, 9 men), mean age - 60,3 years. The malignant neoplasms were diagnosed in 10 patients and benign - in 8. The soft tissue neoplasms were the most common - 8 patients. There were also 4 lymphomas, 4 chondrosarcomas, 1 paraganglioma and 1 malignant melanoma. Tumors manifested clinically as covered by unchanged mucosa. Characteristic features were observed on computed tomography for certain cases of these neoplasms. The results of the tumor biopsy were in most of the cases not diagnostic. Intralaryngeal microsurgery was applied in benign neoplasms, chemiotherapy - for lymphomas and total laryngectomy for chondrosarcomas and malignant melanoma.

Introduction: The aim of this work was to evaluate the therapy results of patients with glottic carcinoma in the T1NoMo advanced clinical stage on internal or external chordectomy via the thyroid cartilage with the use of CO2 laser., Material and Methods: The study was conducted in 110 patients, including 7 women aged 52-68 and 103 men aged 52-73, who were treated in the Department of Otolaryngology and Laryngological Oncology, Military Medical Academy Teaching Hospital in Lodz, during the years 2010-2012, due to laryngeal carcinoma (T1N0M0)., Results: The studied material was subjected to external chordectomy via laryngofissure in 51 men (46.4%), and internal chordectomy with the use of CO2 laser in 52 men (47.2%) and 7 women (6.4%). In the patients operated via laryngofissure, the following types of external chordectomy were performed: IV - in 25 cases (49.0%), Vc - in 12 cases (23.6%), and Vb and Vd - in 7 cases each (13.7% each). Internal chordectomy was conducted with the use of the following types: III - in 31 cases (52.5%), IV - in 15 cases (25.4%) and Vd - in 13 cases (22.1%). During the post-operative follow-up of 1-3 years, no recurrence of carcinoma was observed., Conclusions: The place and size of carcinoma are often dependent on the type of internal and external chordectomy, which is preceded by tracheotomy and is usually dependent on a patient's consent. Too short post-operative follow-up does not allow for the comparison of effective therapies of the two surgical methods., (Copyright © 2014 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Aim: of study was to present material of open partial horizontal laryngectomies (OPHL) in T1b, T2 and T3 larynx cancer treatment in single tertiary referral institution., Material and Methods: Retrospective analysis of operating protocols in patients treated in Poznań ENT University Department between 2000-2012 with glottis (T1b - 185, T2 - 185, T3 - 231) and supraglottis tumors (T1 - 80, T2 - 104, T3 - 206), potentially available for organ preservation treatment. Transoral laser microsurgery, OPHL, radiotherapy and total laryngectomy were treatment options in 210, 191, 271 and 326 patients respectively. OPHL was applied in glottic tumors: 21 - T1b, 103 - T2, 27 - T3 and in supraglottic tumors: 4 - T1, 29 - T2. All procedures were re-evaluated acc. to European Laryngogical Society working committee on nomenclature new classification presented in 2014., Results: There was no discrepancies in supraglottic laryngectomies (4 cases), classified as OPHL Typ I. All the rest: 84 transglottic, 96 supracricoid with CHEP and 7 supracricoid with CHP laryngectomies were re-classified into Typ II (172) and Type III (15) OPHL. Thus, revision of inferior incision changed classification of procedure into supratracheal laryngectomy in 15 cases. Transglottic laryngectomies, in which upper part of thyroid cartilage was preserved and crito-thyreo-pexy was performed (84 pts), have not been distinguished any more. In 7 cases superior incision included epiglottis; thus 165 patients were distinguished as Typ II a and 7 patients as Typ IIb OPHL. The most pronounced difference was stated in description of structures additionally included into surgical specimen: arytenoid (+ARY) in 24, crico-arytenoid-unit (+CAU) in 5 and piriform sinus (+PIR) in 17 cases; none had the base of tongue (+BOT) resected., Conclusions: In 36/191 additional structures and in 15/191 the cricoid ring resection was re-evaluated and pointed out. All these data were available retrospectively in the operating protocols but not pronounced in surgery headlines. Thanks to the univocal, simple new classification all operation details can be included into operation title., (Copyright © 2014 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: In recent years there has been an increasing number of cases of cancer, including cancer of the larynx. The choice of treatment should be primarily dictated by the complete elimination of cancer, but from the point of view of the patient, an important factor to keep in mind, is the quality of the voice that will be created at the end of the therapeutic process., Aim: The aim of this study was to evaluate the voice quality of patients after partial surgery of the larynx with vocal fold reconstruction pedunculated sterno-thyroid muscle flap., Materials and Methods: The study included 30 men aged 53-72 years who were treated at the Clinic of Otorhinolaryngology Department of Medical-Dental Medical University of Warsaw on account of cancer of the larynx, qualified according to the TNM classification T1 or T2. The radical removal of cancer was associated with resection of one vocal fold, laryngeal pouches and ventricular fold. In 15 patients, included to the group I at the end of phase oncology surgery, a reconstruction of "vocal fold" pedunculated sterno-thyroid muscle flap were performed simultaneously. The group II consisted of 15 patients who underwent surgery that removed only the cancerous lesions. Impact assessments arising after surgery of voice disorders on quality of life were made using the self-test failure of the voice (Voice Handicap Index in the Pruszewicz modification). The nature of the created voice was studied using GRBAS scale. All patients performed the laryngostroboscope examination. With "IRIS" program, prepared by a team at Wrocław University of Technology, the voice was recorded, and then was subjected to acoustic analysis. In addition, noise level and the maximum phonation time was measured., Results: The results indicate that the patients of group I gained a better voice confirming the values of objective acoustic analysis. The assessment made by the scale GRBAS patients who supplemented the resulting loss after tumour removal, with much less hoarseness of voice, did not have the hyperkinesis and there was no puff character. They had the better flow of voice and phonation time of vowels "a" was much longer. The assessment of quality of life of patients in group I made in a test of the VHI was higher than in group II. The laryngostroboscope examination confirmed a good phonatory occlusion and a nearly regular, healthy vocal fold vibration in patients who had received flap of muscle., Conclusions: Evaluation of the quality of voice after removing the tumor multiplicity in the glottis with simultaneous reconstruction "vocal fold" has confirmed that this is a very good surgical technique, which allows radically curing cancer for the simultaneous preservation of a good voice. The operation has limited indications for radiotherapy because of the desire to preserve the phonatory function of the larynx, and thus avoids the negative effects of radiation., (Copyright © 2014 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

The Aim: of the study was to evaluate the oncological results of laryngeal cancer treatment performed in the Laryngology University Ward in Zabrze in the years 1990-2000, depending on the type of partial surgery applied., Materials and Methods: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. In all 209 patients the squamous cell carcinoma of various degree of malignancy (G1-G3) was found. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), next, vertical partial laryngectomies - 38 (18%), horizontal glottis surgeries - 28 (13%). In 79 patients (38%) partial laryngectomy was complemented with a nodal operation. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to overall survival, disease-free survival, cause specific survival and local control. All the above-mentioned parameters were analyzed with the updated percentages method. The level of statistical significance was assumed to be p≤0.05., Results: The best oncological results were observed after vertical operations. In the vertical operations group the most favourable oncological results were noted after chordectomy. 83% overall survivals, 82% disease-free survivals, 93% cause specific survivals and 96% local controls in the 5-year observation. On the other hand, the least favourable treatment results were observed after ¾ subtotal partial operation, after horizontal supraglottic operation and after reconstruction operation with CHP. Statistically significant differences in treatment results between the groups of patients after various types of partial operations were found in relation to local controls and disease-free survivals., (Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Lingual thyroid is the most common presentation of ectopic thyroid tissue. In contrast, to that laryngeal location is extremely rare. We report a case of 59 years old woman with a history of progressive dyspnea and nodular thyroid goiter. Endoscopic examination revealed subglottic smooth tumor of the right side of the larynx. CT scans revealed mass localized in infraglottic part of the larynx, causing infraglottic stenosis. The biopsy of the tumor revealed: Struma nodosa. Reviewing the literature we found only seven cases described. We present development of the thyroid gland and origins causing ectopy., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Aim of the Work: Assessment of directions and ways of cancer spreading in the anterior commissure of the larynx, depending on the tumor location, age, sex of patients in a clinical trial and in microscopic serial section study., Materials and Methods: The study included 50 larynx preparations obtained from open partial and total laryngectomies (F-7; M-43). For the assessment of larynx anterior commissure microscopic status 28 larynx preparations with macroscopic free anterior commissure were used. For study of the directions and ways of tumor spreading in the anterior commissure served 22 larynx with macroscopic infiltration of anterior commissure. Anterior Commissure (AC) and TNM classifications was used to determine the location and tumor stage. Larynx anterior commissure was extracted and divided into 3 subregions: supraglottic, glottic and subglottic., Results: The direction and the way of cancer propagation in larynx anterior commissure structures is dependent on morphological changes that occur with aging. Cancer spreads in the anterior commissure along the fibers anchoring voice muscle within the Broyles ligament and is seen in tumor cells microembolism., Conclusions: In patients with cancer of the larynx without macroscopically visible neoplastic lesions in the anterior commissure, cannot be excluded its microinfilration. Changed with age anterior commissure' Broyles ligament by the process of neovascularization and ossification is not an effective protection against the spread of cancer. Directions and the ways of cancer spread in the anterior commissure is similar in men and women. AC classification can be important in qualifying patients for organ preservation surgery and should be supplemented by an additional AC4 degree, taking into account subglottic changes in the anterior commissure of the larynx., (Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: The aim of the study was to evaluate the results of radical surgery in group of 355 patients with advanced laryngeal cancer., Material and Method: The paper presents results of treatment in group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998-2007. The advancement stage was defined as III in 147 patients (42%), as IV in 208 patients (58%). Group of 250 patients (70%) underwent total laryngectomy and group of 105 patients (30%) underwent pharyngolaryngectomy. In the group of 327 patients (92%) operation was performed microscopically radically. 298 patients (84%) underwent postoperative radiotherapy. Median follow-up period was 5 years. Local recurrence, nodal recurrence and distant metastasis were rated as treatment failure. Treatment effectiveness was evaluated in relation to overall survival, disease-free survival, local control, locoregional control and observation free from metastases. All of these parameters were analyzed with the method of updated percentages., Results: During observation period 177 patients (50%) died. Local recurrence occurred in 47 patients (13%), nodal recurrence occurred in 19 patients (5%). Distant metastases occurred in 26 patients (7%). 5-year overall survival rate (OS) was 50%. 5-year disease-free survival rate (DFS) was 47%. 5-year local control rate (LC) was 81%. 5-year locoregional control rate (LRC) was 75%. The updated 5-year observation free from metastases rate (FFM) was 89% respectively., Conclusion: Radical surgery is the chance of 5-year survival of 50% of patients with advanced cancer of the larynx and of 5-year locoregional control of 75% patients., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: Surgical treatment of patients with laryngeal or/and hypopharyngeal cancer is combined with potential risk of complications either local and general. The aim of the study was to evaluate the occurrence of them in the large cohort of patients with mentioned localization of cancer., Material and Methods: The group of 447 patients, treated between 2000-2005 in Department of Otolaryngology and Laryngological Oncology, Medical University of Lublin were analyzed retrospectively. There were 412 men and 35 women. 426 patients underwent surgical removal of the tumour without any reconstruction procedure. In 21 (4.7%) patients we performed reconstructions of the pharyngeal defect implementing pectoralis major muscle flap. Complications were classified into general and local. Furthermore, according to the time we classified sequel of the treatment into recent (those during the first 7 days after surgery) and late. Statistical analysis of variables was performed using χ² test., Results: Uncomplicated treatment were accomplished in 78.6% of patients. Local complications occur in 65 (14.5%) and general in 31 (6.9%) individuals. Pharyngo-cutaneous fistula was the most often occurring local sequel which constituted 50.8% of all local complications. Fistula developed in 33 (7.4%) cases. Cardiovascular and pulmonary diseases were the most often among general complications. They occur at the same rate of 25.8% of all general complications cases. Five patients (1.1%) died due to complications developed during the postoperative period., Conclusions: We noticed 10.6% local complications in our group of patients whereas only 2.5% of treated persons developed general sequel. The pharyngo-cutaneous fistula was the most often occurring local complication. It has been treated surgically in 15 (45.5%) patients. Whereas cardiovascular and pulmonary diseases were the most often general complications and they occur in above half of all cases with general complications., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

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.)

Introduction: Oesophageal speech were described for the first time by Gutzmann in 1909. The diagnostic method based upon checking the pressure causing opening of oesophagus mouth was developed by Seeman and Van Den Bergh. In the initial stage, the method was meant to determine the level, to which the patient can master oesophageal speech. In the course of further investigations, an additional element of diagnostics was noted, which enabled early detection of recurrence of the neoplastic process in the oesopagus mouth area., Material and Methods: The material includes 96 patients treated in 2008-2010 at the Department of Otolaryngology, Medical University in Katowice. All patients were classified on the basis of CT of the larynx and the result of histopathological examination to the total laryngectomy. All the patients were subjected to examination by device to visualize the process of opening pressure of the sphincter of the esophagus paragraph., Results: During two years of observation in 28 cases (29%), oesophageal pressure was open his mouth more than 80 mmHg. When performed CT of the neck and histopathology examination recurrence of laryngeal cancer was confirmed in 23 cases (82%)., Conclusion: This device is used to determine the best method of voice and speech rehabilitation in patients after total laryngectomy and early diagnosis of laryngeal and/or hypopharynx cancer recurrence., (2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o.)

Aim: The aim of the study was to evaluate the results of partial laryngectomies in patients with laryngeal cancer treated in the 2(nd) Clinical Department of Laryngology SUM in Zabrze in the years 1990-2000., Materials and Methods: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. The group consisted of 20 (10%) women and 189 (90%) men. The mean age was - 51.2 years. The stage of the neoplasm progression was defined as T1 in 91 patients (44%), T2 in 109 patients (52%). In other 9 patients (4%) the progression stage was T3 and T4. Clinical examination in 191 patients (91%) did not show enlarged lymph nodes in the area of head and neck (N0). In the group of remaining 18 patients (9%) the node progression was found to be N1-N3. In all 209 patients the squamous cell carcinoma of various stage of malignancy (G1-G3) was found in preoperative histopathological tests, out of which five cases were of papillary squamous cell carcinoma. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), followed by 38 (18%) vertical partial laryngectomies, 28 (13%) horizontal glottis surgeries, 19 (9%) frontal-lateral and frontal-anterior operations, and supracricoid operations with a reconstruction of CHEP and CHP type, a total of 20 operations (9%). Other types of partial operations were performed less commonly. In 79 patients (38%) partial laryngectomy was complemented with a nodal operation, while cervical lymph nodes were not removed in 130 patients (62%). In 19 cases (9%) the metastases of squamous cell carcinoma to regional lymph nodes were confirmed in postoperative material. 82 patients of the study group (39%) underwent radiotherapy. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to local control, overall survival, disease-free survival and cause specific survival. All the aforementioned parameters were analyzed with the method of updated percentages. The level of statistical significance was assumed to be p ≤ 0.05., Results: The updated 5-year and 10-year percentage of overall survivals was respectively 75% and 63%. The updated 5-year and 10-year percentage of cancer specific survivals was 85% and 79%, respectively. The updated 5-year and 10-year percentage of disease-free survivals was 72% and 56%, respectively. The percentage of 5-year and 10 year local controls was 86% and 79%, respectively., (Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

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.

Unlabelled: Pharyngocutaneous fistula is an important therapeutic problem. It occurs in approximately 20% of cases as a complication after total laryngectomy, performed due to the larynx and/or hypopharynx cancer. The process of fistulas' conservative treatment is very long and sometimes reconstructive surgery of the pharynx and esophagus is necessary. Clinically, it is desirable to isolate a group of patients with risk factors of this complication. Numerous pathologies implicated in fistula formation are mentioned in the literature: wound infection, radiotherapy prior to surgery, hypoalbuminaemia, concomitant general diseases, postoperative anemia, location of the cancer in larynx and many others., Objective: This paper analyzes the incidence and etiology of cutaneous fistulas after total laryngectomies as well as overall characterization of risk factors on the basis of the material collected by the Department of Otolaryngology Medical University of Warsaw between the years 2006-2011. Furthermore, an analysis of the literature on cutaneous fistula after total laryngectomy of the last 10 years was performed., Material and Methods: A retrospective analysis of medical records of patients with laryngeal and hypopharyngeal cancer, treated with total laryngectomy was performed. 12 patients developed cutaneous fistula in the early postoperative period., Results: The mean time of appearance of fistula after total laryngectomy was 19.3 days. In most cases, conservative management was used to obtain fistulas' closure - after an average of 32.5 days. For two patients operative closure was needed. Microbiological study confirmed the infection in the region of the fistula in 10 patients. There were identified different pathogens, both aerobic and anaerobic bacteria and fungi. 3 patients with a fistula were preoperatively irradiated. The most common location of the cancer in this group was supraglottic area and piriform recessus (8/12 patients)., Conclusions: The pathogenesis of cutaneous fistula as a complication after total laryngectomy seems to be complex. The most significant risk factors for fistula formation are: radiotherapy, supraglottic location of the tumor, extension of the surgery to the pharynx and malnutrition of the patient. Postoperative wound infection favors the formation of fistulas and extends their healing time. It seems reasonable to plan the surgery with the reconstruction of the pharynx for patients with several risk factors of fistulas' onset., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Introduction: CO(2) laser endoscopic surgery, introduction in the treatment of early glottic malignancies in the early seventies is the method has been well studied in such cases, and its utility for these lesions is well-established. Transoral resection with the CO(2) laser, open partial laryngectomy and radiotherapy are the main options for treatment of early laryngeal cancer. As all the therapies are all equally effective in controlling an early glottic cancer the choice of treatment must consider such factors as possible complications, functional outcome and patient compliance. For properly selected patients the laser therapy provides equivalent oncologic outcomes when compared to traditional surgical therapies while improving the functional aspects of postoperative speech, voice and swallowing. Its advantages over open surgery include quicker recovery, less morbidity, fewer side effects and greater cost-effectiveness too. The disadvantages of radiotherapy are: duration of treatment, loss of time for work and social activities, higher rate of other possible complications, and partial preclusion of further conservative salvage surgery. Some authors report radiotherapy offers the better quality of voice but further investigations are needed to compare the voice following endoscopic resections with that obtained after radiotherapy., Aims: The aim of the study was to analyze the character of the peri- and postoperative complications after CO(2) laser endoscopic surgery for the early glottis cancer., Material and Methods: [corrected] This was a retrospective study of a files of 55 patients (7 female and 48 male) in age range 38-85 with early glottic carcinoma (Tis - T2) treated by cordectomy. Diagnosis was based on histopathological examination of the biopsy specimen of the lesion and ultrasonographical examination of the lymphonodules of the neck. Videolaryngostroboscopy and acustic analize of the voice was complicated. All of them underwent one of the types of cordectomy using a CO(2) laser, between 2007 and 2010. Cordectomies were categorized according to the classification of the European Laryngological Society (2000 and rev. 2007). In our series most cordectomies were type III 24 patients. Type IV - 2 patients, type Va - 18, type Vb - 4, type Vc - 6 and type VI - 1 patient. We observed peri-and postoperative complication and functional result of the treatment such as quality of voice and swallowing difficulties., Conclusions: Among 55 patient postoperative bleeding was the most commonly seen complication. It appeared in 34 of them (62%). All the cases of bleeding were easy to control. In 23 cases pain and mild laryngeal oedema were observed. It resolved in 3-4 day after medical treatment. None of our patient required tracheotomy. Eight patients needed revision procedures: four due to granulation tissue formation, two due to adhesion and another two due to laryngocele. This entire patient was manageable locally with repeated surgery. Our functional data, including stroboscopic findings and perceptual and objective voice evaluations, demonstrate that patients who underwent cordectomy and foniatric rehabilitation presents social efficient voice but with pathological components. All the patients have good long-term swallowing function., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Introduction: Hypopharynx is the anatomical region created by strictly functionally connected regions: two pyriform sinuses, retrocricoid region and the posterior pharyngeal wall on its level. Hypopharyngeal Cancer is in 95% planoepithelial carcinoma, it constitute about 5-10% of all malignant tumors of the upper part of digestive tract and the respiratory system. Occult early symptoms make it advanced stages detectible. It easily spreads in to surrounding anatomical structures such as: larynx, oral cavity, oropharynx, esophagus, prevertebral space. It gives relatively quick and common metastases to lymph nodes (opposed or both sites)., Aim: The aim of our study is to analyze the complications of the advanced hypopharyngeal tumor surgery., Material and Methods: Material was 53 patients treated for advanced hypopharyngeal cancer (or hypopharyngeal cancer with larynx and cervical part of esophagus involved), in Otolaryngology Clinic, Medical University of Warsaw, between 1999 and 2010. We performed the circular removal of hypopharynx, cervical part of esophagus and larynx with concomitant digestive tract reconstruction by autotransplantation of the jejunum (41 cases) or the ileocecal segment (12 cases). In most cases surgery was extended to lymph nodes removal., Conclusion: In our group of patients we had complications such as: Intraoperative complications of surgery - the intestine transplant ischemia. Early post operative complications - transplant ischemia, salivary fistula, hematoma of postoperative cavity (without necrosis of the transplant), massive arterial anastomosis bleeding, and wound infection. Late postoperative complications - late salivary fistula, tracheostomy stenosis, local tumor recurrence, spread of the cancer and swallowing disorder. The different complications were very uncommon., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Introduction: Effective communication is an important element of social life. For a long time depravation of the capacity of such communication has been perceived as one of the most aggravating disabilities. It happens when the necessity to remove the larynx in patients with cancer appears. Contemporary methods of speech rehabilitation in patients after total laryngectomy create the possibility to communicate by three methods. One of them is generated speech with the use of voice prosthesis., Material and Methods: The examination included group of 76 patients (7 women, 69 men) after total laryngectomy with implanted voice prosthesis Provox 2. All the patients were operated on at the Department of Otolaryngology CM UMK. The early and late complication after implantation of voice prosthesis was analyzed., Results: In our material we observed more frequentyly late complications. In 97.4% a leakage through or around the prosthesis was observed. In 35 cases we observed leakage through the wide tracheooesophagal fistula with good outcome due to spontaneusly contract of it after removal of the prosthesis. In four cases we used stitches above the fistula and in three patients we did tracheostomal plastic. The granulation tissue from the region of the fistula was removed in 11 patients. Spontaneous falling out of the prosthesis appeared in 6 cases. The late complications as tracheal immflamation, stricture of the oesophagus or occlusion of the fistula were less common., Conclusions: The late complications after implantation of Provox 2 prosthesis are more common in this type of patients' rehabilitation. The leakage through or around the prosthesis required its exchange and generated additional medical costs, which should be reserved in medical insurance policies.

Introduction: The operation of total laryngectomy deprives patients of the ability of voiced communication, causes isolation and loneliness. The loss of voice and speech leads to a predominant cripplehood, disturbs verbal communication in the social and family circle. The best ways of voiced communication of the patients after laryngectomy are an esophageal speech and the speech using voice prosthesis., Aim: The aim of the study is to estimate the voice and speech rehabilitation of the patients after total laryngectomy., Material and Methods: The study comprised 30 patients who in the years 2007-2009 underwent an operation of laryngectomy at the Department of the Surgery of the Head and Neck and the Laryngological Oncology in the Greater Poland Cancer Center in Poznań. In this group 9 patients used voiced speech after grafting the voice prosthesis, 15 patients (12 men and 3 women) underwent a classical rehabilitation of the esophageal speech, 6 patients (4 men and 2 women) used an electronic voice prothesis. The most important factors which influenced on mastering an esophageal speech were: pressure inside the esophagus, appearing a reverberation, time of training at home, length of time of logopedic rehabilitation, age and education., Results: Necessary time to master a speech in the group of 9 patients with voice prothesis was 4-5 days. Length of time of the classical speech rehabilitation lasted from 3 to 8 months. 3 persons (20%) mastered a very good degree of esophageal speech, 7 patients a good degree (46.67%) and 2 patients (13.33%) - a sufficient degree of esophageal speech despite of low pressure inside the esophagus and appearing a reverberation quickly. 3 patients (20%) used an oral and guttural pseudo-whisper, a voiced reverberation was not obtained during the whole time of logopedic rehabilitation., Conclusions: The surgical voice rehabilitation, in spite of the possibility of complications, enjoys a great popularity among patients. The classical rehabilitation of the esophageal speech was more difficult for the tasted group of patients but mastering a speech to a very good and good degree lets communicate naturally.

Unlabelled: Pharyngeal anterior diverticulum, also known as pseudoepiglottis is one of the most common disorders after total laryngectomy., The Aim of This Study: was to evaluate frequency of diverticulum after different types of total laryngectomy and severity of dysphagia in patient with developed pseudoepiglottis., Material and Methods: The material consisted of 80 patients after following surgeries: total laryngectomy with hyoid bone resection, total laryngectomy without hyoid bone resection, total laryngectomy with hyoid bone and base of tongue resection, total laryngectomy and partial pharyngectomy with hyoid bone resection and total laryngectomy and partial pharyngectomy with hyoid bone and base of tongue resection. To evaluate morphologic and functional disorders clinical examination, videopharyngoscopy and cineradiography of swallow act were performed., Results: Pseudoepiglottis was present in 34 (43%) of patients, mainly after surgeries without hyoid bone resection. There was no correlation between diverticulum formation and pharyngeal closure (muscular or non-muscular), shape of closure (vertical or "T"), pharyngocutaneous fistula, radiotherapy., Conclusions: This study indicates that leaving hyoid bone is a major risk factor for developing pseudoepiglottis.

Aim: The aim of study was test efficacy of accelerated postoperative radiotherapy--concomitant boost in patients with advanced larynx cancer., Methods and Materials: The prospective study included 112 patients with advanced larynx cancer after radical surgical treatment. Patients had postoperative radiation therapy, conventional (C) or accelerated (CB)., Results: The 3-year overall survival in CB was 59%, in C--58% (p = 0.2), 3-year locoregional control in CB--83%, in C--75% (p = 0.01), the 3-year disease free survival was in CB--72%, C--66% (p = 0.1)., Conclusion: Concomitant boost postoperative radiation therapy did not improve overall survival, loco-regional control, disease free survival. Patients with close surgical margins, longer interval between surgery and radiation, high level of hemoglobin, T4 had benefit from accelerated radiotherapy.

Introduction: Recurrent respiratory papillomatosis (RRP) is a rare disease in children and adults. It is characterized by proliferation of benign squamous cell papillomas within the respiratory-digestive tract, predominantly the larynx. Standard treatment consists of surgical excision of papillomata to maintain airway patency and voice quality. For last several years cidofovir is the most contemporary adjuvant anti-viral treatment for recurrent respiratory papillomatosis and its topical use is widely described., Material and Methods: Intralesional cidofovir therapy was given to 20 patients treated for laryngeal papillomas in the Department of Otolaryngology in Poznan between I-XII.2009. The character of the lesion differed: from one anatomical site and moderate growth to four or five localizations with heavy extension. The number of cidofovir injections per patient varied from one to six times and the volume of solution ranges from 1-12 ml. The cidofovir injections were combined with laser or mechanical excision of the lesions. In disperse papillomata the injections administered in particular anatomical sites in 4-6 weeks period. In massive lesions injections were repeated in the same anatomical site., Results: Complete remission was observed in 3 out of 20 patients. 12 patients show remission in a place of cidofovir injection. In 4 patients during the 4 week observation new foci of papillomatosis occurred. In two patients hepatic toxic side effect were observed., Conclusions: Intralesional cidofovir injection has been shown to be an effective an safe therapy for laryngeal papilloma and should be considered in those patients who experienced disease relapse.

Background: Respiratory papillomatosis is caused by HPV. The most common location in head and neck is larynx, palatine tonsils and arches of palate, uvula and mucosa oral and nasal cavity. The disease is benign but recurrent. The aim of this study was to estimate new methods of treatment respiratory papillomatosis based on intralesional injection of cidofovir into sites where papillomas had just been excised., Methods: The purpose of the study were 59 patients treating in Otolaryngology Clinic Stomatology Department Medical University of Warsaw. The treatment was based on surgical excision of papilloma and after it intralesional injection of cidofovir in after 4-5 weeks., Results: We observed the patients during 28 months. 41 patients had 4 times intralesional injection of cidofovir. 18 patients had increased number of injection of ciodofovir because of recurrent papilloma. Rest of this group of the patients clinical studies showed remission disease., Conclusion: Surgery with intralesional cidofovir injection in the place after removal of papilloma is very effective methods. We observed that this treatment caused long lasting remission of papilloma recurrence.

Unlabelled: High pressure of pharyngo-esophageal segment is the most important factor of impaired development of alaryngeal speech (esophageal speech, tracheoesophageal speech) after total laryngectomy. To prevent pharyngo-esophageal spasm in Department of Otolaryngology in Szczecin are used: pharyngoesophageal plastic surgery with interposition of vascular thyroid flap, two-layer (only mucosa) non-muscular pharyngeal closure and tree-layer closure (mucosa and muscle layer leaving inferior pharyngeal constrictor unsutured)., Aim of Study: The aim of this study was to compare the pharyngo-esophageal pressure between patients after pharyngo-esophageal plastic surgery and following the non-muscular pharyngeal closure., Material and Methods: One hundred eighty two subjects after total laryngectomy were enrolled in this study, and included 108 patients subjected to the pharyngo-esophageal plastic surgery, 44 patients who underwent the two-layer pharyngeal closure, and 30 patients with the tree-layer closure. To evaluate the pharyngo-esophageal pressures manometric tests were performed, and to asses the pharynx morphology videopharyngoscopy was used., Results: The average pharyngo-esophageal pressure in the group after the pharyngo-esophageal plastic surgery was 32 (min.-5, max. 50) mmHg. After the two-layer non-muscular pharyngeal closure mean pressure was 35 (min.-17, max.-40) mmHg, and after the tree-layer non-muscular pharyngeal closure the average pressure was 22,42 (min. 5, max. 40) mmHg. The average pharyngo-esophageal pressure was significantly lower (p < 0.01) among patients after the tree-layer non-muscular closure., Conclusion: The study suggests that the tree-layer non-muscular pharyngeal closure with inferior pharyngeal constrictor unsutured is the preferable method to prevent pharyngo-esophageal spasm after total laryngectomy. However, the efficacy and safety of this surgical procedure should be explored in further multicenter studies.

Introduction: Stenosis of the trachea and main bronchia can occur in patients with lung, larynx, thyroid gland, esophagus, in metastatic tumors, can be also caused by trauma and foreign bodies. Treatment in this condition can be difficult. Tracheal stenosis in patients after total removal of the larynx is relatively rare. It can be caused by recidiv tumor and inflammation processes., Aim of the Study: Was to evaluate usefulness of stents in patient with stenosis of the trachea after total laryngectomy due to squamous cell carcinoma., Material and Methods: Authors described two cases of patient after total laryngectomy. Nitinol, expandable, tracheal stents were used in both cases. Placement of the stent into the trachea was relatively simple. Patients have undergone this procedure in short general anesthesia., Results: After stenting patients exhibited dramatic improvement in their respiratory symptoms and quality of life., Conclusions: Stents are useful in cases of tracheal stenosis and the effect is related to the reason of stenosis.

Unlabelled: For optimalisation glottis morphology and its phonatory function after frontolateral laryngectomy (FLL) the reconstruction of larynx is made; in Clinic of Otolaryngology the most common is using epiglottis wit or without its vertical incision., Aim of the Study: the influence of widening laryngeal resection and epiglottis incision on shape of reconstructed glottis, level and degree of phonatory closure and perceptive--acoustic characteristic of voice and speech., Material: 39 patients (38 M and 1 F) after FLL widened of false vocal cord (n = 11), false vocal cord and part of cricoid cartilage (n = 22), whole cricoid cartilage (n = 6). Vertical incision of epiglottis was made in 31 cases. Mean age was 52 (min.-39, max.-70) years. METHODICS: videolaryngoscopic examination, subjective voice estimation using GRBAS scale, objective phonetic--acoustic voice analysis., Results: In videolaryngoscopic examination the most common shape of glottis was irregular triangle (n = 24), rhombus (n = 7), half--moon (n = 2), irregular (n = 6). 2 patients were using whisper. In spectrographic recordings (n = 39) only noise character of stimulation source was in 2 patients, noise--periodic with noise component present in whole acoustic spectrum in 37. F0 for single word and sentence vocalized in affirmative and interrogative form had the value of male voices and its changes during speaking were well noted. In subjective and objective estimation, the worse voice quality was after FLL widened of false vocal cord, part or whole cricoid cartilage., Conclusion: 1) FLL with subsequent epiglottoplasty in 94% of patients makes satisfactory morphologic and biophysical conditions for production of voice and sociological efficient speech. 2) Widening resection of false vocal cord, part or whole cricoid cartilage has unbeneficial influence on perceptive--acoustic characteristic of voice and speech.

Purpose: The aim of the present study was to investigate the recurrence prevalence in patients with laryngeal squamous cell carcinoma (LSCC) underwent surgery as primary treatment., Material: The assessed group consisted of 148 patients with operable LSCC underwent surgery as primary treatment between 1999-2002. Surgery was performed in all cases. Total laryngectomy was performed in 107 (72.3%) patients and laser endoscopic tumor resection was performed in 41 (27.7%) patients., Results: Local recurrence occurred in 18 (12.2%) patients, nodal recurrence in 12 (8.1%) and both and/or remote metastases in 6 (4%) patients. Altogether, recurrence was present in 36 (24.3%) patients and 111 (75.7%) patients had no symptoms of recurrence. Recurrence prevalence in 3-year follow-up--prevalence of recurrence significantly increased with tumor's T feature (p=0.04), N feature (p=0.03), progression of clinical stage (p=0.008) and histological malignancy G stage (p=0.01). Recurrence prevalence in 5-year follow-up--prevalence of recurrence significantly increased with tumor's T feature (p=0.02), N feature (p=0.01), progression of clinical stage (p=0.003) and histological malignancy G stage (p=0.002). Tumors localized in glottic area had less recurrences than those localized in supraglottic area (p=0.05). There were no significant dependence between recurrence type (local or nodal) and tumor's clinicopathological features. Multiple factor analysis with logistic regression model did not revealed simultaneous influence of many variables on recurrence's presence and type. Using multiple factor analysis with Cox's regression model it was proved that recurrence presence (p<0.00001) is a significant independent prognostic factor in the analyzed group of patients with laryngeal carcinoma in 3-year follow-up., Conclusions: Recurrence prevalence depends on localization, systemic progression stage, clinical progression stage, cervical lymph nodes state and histological malignancy stage of tumor. Patients with local recurrence have statistically significantly worse prognosis than patients with no recurrence. Recurrence presence is significant independent prognostic factor in 3-year follow-up.

Chondrosarcoma is a very rare neoplasm in the head and neck region. This region is associated with favourable prognosis. Only 340 cases of chondrosarcoma of the larynx and nearly 300 of sinus maxillaris have been reported in this localization. The most reasonable treatment is radical surgery. Radiotherapy and chemotherapy are of little value. Without metastasis the long term prognosis is excellent. Clinical, pathologic and radiologic characterities of these tumors are described and review of the literature is presented. The authors present two cases chondrosarcoma of the larynx and one case chondrosarcoma of sinus maxillaries.

Ill applying with extensive infiltration of new-growth within of larynx will demand radical therapeutic procedure, which is operation completely removals of organ. Aim of work was estimation of voice and speeches ill with vocal fistula in comparison with oesophageal voice and speech and with physiological. With research one embraced 81 men in age 42-75 of years. Group I--32 ill with cancer of larynx, to which executed total laryngectomy and placed the voice prosthesis Provox 2. Group II--30 ill after operation total removals of larynx, whiches used oesophageal speech. The control group III--19 persons with physiological voice. Research one began from subjective estimation of replacement voices. Then one executed measurements maximum phonation time of vowel "a". To objective estimation of voice one used polish programme "IRIS". One compared: maximum intensities of voices for colloquial speech, F0, Jitter, Shimmer and NHR. In subjective estimation voice of the patients with voice prostheses was greater freedom of production and voice of the patients with voice prostheses appeared to be more loud in relation to oesophageal voice. Greatest statistical essential differences one obtained between maximum phonation times of vowels "a" where clearly is visible, that values obtained for voices of the patients with voice prostheses are to nearer values for physiological voices. Obtained averages values of acoustic analysis: F0, Jitter, Shimmer and NHR did not show statistical of essential differences between voices supplementary, though parameters of voice of the patients with voice prostheses one was to nearer parameters of physiological voice. Characterization perceptive and acoustic speech of the patients with voice prostheses in comparison with oesophageal speech is to nearer characterization of physiological speech. Lack of satisfactory effects of rehabilitation of oesophageal speech, should be effective secondary implantation vocal prosthesis.

Plasmocytoma solitare is a rare disease of lymphoprolipherative origin. It is usually diagnosed occasionally on ORL departaments because of its close relation to head and neck localisation. Surgical treatment and/or radiotherapy is a treatment of choice. It becomes disseminated after years usually. Carcinoma of larynx is a squamos cell carcinoma of well known ethiology strongly corralated with alcohol and nicotin abuse. There is described a case of patient in this paper, who in a short time of few months developed two neoplasms of different histological origin, but localised in the same region of head and neck: Plasmocytoma solitary of uvulae and carcinoma of larynx. Due to early diagnoses the radical treatment (combined surgery and radiotherapy) was performed. However the extremly short time of follow up do not allow to make the observation of the DFS and OS of the patient.

Purpose: Results of treatment of locally advanced larynx cancer T3-4No-4 are unsatisfied. The aim of study is analysis of risk factors., Methods and Materials: 112 patiens with larynx cancer after radical surgical treatment had postoperative radiotherapy (conventional or accelarated)., Results: The 3-year overall survival (OS) was 58%. Margin status and numer of risk factors had impast on OS. The 3-year locoregional control (LRC) was 80%. Number of risk factors, level of hemoglobin, overall tratment time and dose were significantly associated with LRC. Incidence of distant metastases was asssociated with G3 suamous cell carcinoma and index of nalignancy H. Glanz.

Introduction: Early glottic cancer (stage T1, T2) is connected with very good prognosis as well as organ and function preservation. The aim of the study was the assessment of early glottic treatment results., Material and Methods: Between 1999-2005 1007 patients with larynx cancer were treated in Dept. of Otolaryngology Head Neck Oncological Surgery Poznań University of Medical Sciences. The majority constitute the patients with II and III stage of clinical advancement of the disease. Early glottic cancer was diagnosed in 43 patients (4.3%). The diagnose of the larynx cancer was set upon indirect and direct laryngoscopy, histological examination of larynx samples and neck ultrasonography. In all 43 patients CO2 laser surgery in Klein1 sasser microlaryngoscopy set was performed., Results: In all cases, confirmed in histological examination the resection was radical. Follow-up was conducted every month in the first year of observation, then every 2-3 months. The time of follow-up ranged from 40 to 64 month, mean 51 month. In 4 patients (9.3%) treated for early glottic cancer with CO2 laser surgery the local relapse occurred after 10, 15, 19 and 28 month respectively. In two patients total laryngectomy, in one reconstructive partial laryngectomy and in one radiotherapy was performed. The mean time of observation after salvage treatment is 29 months. All patients are alive and free of disease., Conclusion: The laser surgery is an effective and non-invasive treatment of early glottic cancer but the strict follow-up regimen is demanded.

The authors present a rare case of the primary multiple planoepithelial laryngeal cancer and clarocellular renal cancer in a patient operated in the Clinic. The patient, called EJ., was admitted to the Clinic of Otolaryngology and Laryngological Oncology due to hoarse voice he had been suffering for 6 months. On the interview with the patient, otolaryngological and videolaryngostroboscopic examinations we diagnosed hypertrophic changes in the whole length of the right vocal fold with the fold mobility preserved. The hypertrophic changes in the right vocal fold were removed by Kleinsasser direct microlaryngoscopy. However, the histopathological examination showed carcinoma planoepitheliale keratodes infiltrans mucosae laryngis G-2. In the further treatment the patient was qualified to the dexter chordectomy by the CO2 laser. The histopathological examination confirmed the total removal of the changes within the healthy cells. After about one year from the completed laryngological treatment the patient visited the urological outpatient clinic due to pain ailments in the right lumbar part. The urographic examination and CT of the abdominal cavity showed a tumour (8 x 9 cm), in the right kidney. The patient was admitted to the 1st Clinic of Urology the Chair of Urology and qualified to the dexter nephrectomy. Following the operation the histopathological examination indicated carcinoma clarocellulare partim cysticum renis dextri. Class, Fuhrman 20, pT2 Nx Mx. The hyperplasia limited to the renal parenchyma. Cut-off lines of the ureter and vessels without neoplastic infiltration. The patient remains under constant catamnesis at the urological and laryngological outpatient clinic, no symptoms of the neoplasm relapse.

Introduction: Leiomyosarcoma is a malign neoplasm coming from the non-epithelial tissue. It rarely developes in the larynx. 0,5-1% of all of the neoplasm of the larynx is leiomyosarcoma. It usually developes in the age of 40-70 and mostly effects men., Aims: Improvement of the therapy of patients with leiomyosarcoma of the larynx., Material and Methods: The analysis of the medical documentation of the 5 patients with the diagonosis of leiomyosarcoma laryngis treated in Otorhinolaryngologic Clinic UJ in 1996-2006 was performed. The procedures and effects of the therapy were analized., Results: In this particular period of time 11 patients was operated because of the sarcoma of the larynx. In this group there were 5 cases of leiomyosarcoma, 4 cases of chodrosarcoma and 1 case of agniomyxofibrosarcoma and 1 case of sarcomy synoviale., Conclusions: On the basis of the material of the Clinic the frequency of these tumors was estimated and the therapeutic procedure including widening of the surgical indications for the partial laryngectomy and narrowing the indications for nodular surgery of the neck was proposed.

Chondroid tumors of the larynx are extremely rare and their develope and symptoms are difficult to diagnosis. The importance of well radiological diagnosis prior chirurgical treatment of chondroid tumors of the larynx is empasised. Conservative surgical management when possible, is advocated to preserve the larynx. We presented a case of chondroma of cricoid cartilage developing in 49-year old woman with 4 year history of hoarsness, treated by surgical management - laryngofissure. During 36 months follow up no reccurency is observed. In the paper review of literarature is presented.

Introduction: Paratracheal lymph nodes receive the lymph from the larynx, hypopharynx, esophagus, thyroid gland and trachea. It is evaluated, that metastases to these nodes occur in about 10-30% of patients with cancer of the larynx, hypopharynx or cervical esophagus. These metastases can lead to the most tragic complication after total laryngectomy, which is the stomal recurrence, Paratracheal lymph nodes are not accessible to examine by palpation or ultrasonography., Aim: The aim of this study was to estimate the usefulness of CT, MRI and clinical intraoperative investigation in the search for enlarged paratracheal lymph nodes., Material and Methods: The investigation was performed in 15 patients with advanced larynx and/or hypopharynx cancer. In all the patients we carried out palpation and ultrasonography of the neck, in 7 cases CT and in another 8 cases MRI of the neck. In all the patients who were operated (14 cases) the exact search for enlarged paratracheal lymph nodes during operation was performed., Results: Palpation and ultrasonography of the neck did not found any enlarged paratracheal lymph nodes in anybody of the patients. CT showed one enlarged prelaryngeal lymph node in one patient. MRI showed one enlarged pretracheal lymph node in another one patient. During operation we found one enlarged paratracheal lymph node, which was not seen in MRI. All these nodes were pathologically not metastatic., Conclusions: The analysis of the state of paratracheal lymph nodes is very important in prophylaxis of stomal recurrence after total laryngectomy. However preoperative estimation of these nodes is very difficult and limited. It seems to us, that the best way of estimation of the state of paratracheal lymph nodes is intraoperative exploration of the area between trachea and esophagus and excision even loose tissue to pathological examination.

Introduction: For many years, we are operating tumor conditions of the larynx, and periodically we evaluate our work. It is important as it allows us to compare the operational materials and the results of treatments., Material and Method: We have conducted almost 1000 surgeries of larynx cancer and we have decided to subject our results from the past 35 years to proper analysis. The purpose of this work--beyond verification of regular epidemiological parameters--is to evaluate the increase in number of patients and changes in therapeutic procedures--with particular attention paid to surgical cases. The results of treatment was the third problem we have analyzed. Additionally, we own 968 records of the patients, who are systematically controlled in the widely accepted formula. The controls take on the nature of laryngological and oncological counsels. Moreover, we periodically conduct surveys, for instance acceptance of the after-treatment life., Results and Conclusions: From the obtained analysis, we have determined, that the number of the sick for the studied time frame--the 1990's--is constant. The number of women grows at a greater rate than that of men. The most significant changes appeared in the way of treatment, for instance, the new methods of oncological treatments, especially growth of operational preservation procedures of the larynx. I consider it to be the outcome of the awareness of the society, the technological step forward, and the care of surgeons of the quality of life after the treatment.

Postoperative wounds infections due to surgical intervention of laryngeal cancer are serious therapeutic problem. This process led to the necrosis of surrounding tissues and in consequence prolongs the wounds healing and cause longer hospitalisation, delay of vocal rehabilitation and cause chronic inflammation of trachea and bronchi. We investigated a cause of patient after surgical intervention. Postoperative wound as well as upper respiratory tracts of this patient were colonized by methicillin-resistant Staphylococcus aureus (MRSA). The following symptoms of in inflammation were noticed: subfebrile condition, muscles and joints pain, excessive secretion of mucus in respiratory tracts and malaise. Patient was treated many times (repeatedly) with antibiotics and chemotherapeutics ambulatory and during hospitalisation. The susceptibility to antibiotics and chemotherapeutics to isolated MRSA strain was established. The effective therapy occurred using combine of rifampicin and co-trimoxasole. The patient status was radically improved. Patient after therapy was monitored microbiologically for a several month and in clinical material isolated from him did not found MRSA.

The aim of our study was to estimate the probability of the neoplasm recurrence in patients with T1 and T2 glottic carcinoma operated with CO2 laser microsurgery. We analyzed the material of 171 patients treated in the Otolaryngology Department of the Collegium Medicum Nicolaus Copernicus University between 1991 and 2003. The statistical method of logistic regression was used to estimate factors disposing the local recurrence of laryngeal cancer. We studied: age, sex, extent and location of the lesion, time up to recurrence, carbon granuloma, smoking cigarettes before and after the operation. We confirmed statistically significant correlation between the local recurrence and anterior commissure involvement.

Three patients with exogenous lipoid pneumonia are presented. All of them had laryngectomy because of the cancer of larynx. In a period of time ranging from a few months up to a few years after the operation they started to have dyspnoea, cough, sometimes hemoptysis and slightly elevated temperature. The chest X-ray revealed massive opacities in the lower zones of both lungs suggesting lung cancer or metastases of the laryngeal cancer. HRCT showed ground glass lesions. Histological examination of the lungs detected accumulation of multiple macrophages with vacuolated foamy cytoplasms in the alveoli. Neoplastic disease was excluded. Additional data from the patients history revealed that all of them were inhaling or administering mineral oil-containing products through the tracheostomy. Exogenous lipoid pneumonia was diagnosed. Patients were asked to stop inhalations with the mineral oil.

Between 1989-1999, 573 patients (501 male and 72 female) with laryngeal cancer underwent laryngectomy in the Otolaryngological Clinic of the Medical University in Bydgoszcz. The age varied from 32 to 88 years (mean age--56.5 years). The aim of the investigations was the analysis of correlation between age and postoperative complications after laryngectomy. The greatest percentage of fever as a postoperative complication was observed in the youngest group of patients. The least number of pharyngo-cutaneous fistulae occurred in the group of patients older than 65 years. Both relationships were not statistically significant. The numbers of other complications were almost similar in all groups related to age. The results of our investigation suggest, that the advanced age as a sole factor (without additional diseases of circulatory or respiratory organ, or neurological diseases) is not a contraindication for surgical treatment of laryngeal cancer.

Introduction: Malignant fibrohistiocytoma is one of the rare neoplasms of the larynx. It has nonepithelial origin. The most common sites of the neoplasm are: limbs, trunk and retroperitoneal space. Other localizations within head and neck are very rare. There are 5 histologic types. The most common is pleomorphic type. It is built of histiocytes, fibroblasts and multinuclear giant cells. An examination of the neoplasms consists of microscopic and immunohistologic examination with identification specific tissue markers and intermediate filaments of proteins. Treatment methods of the neoplasms are radical surgery, radiotherapy, chemiotherapy and associate methods of therapy. Prognosis is very bad., Material and Methods: [corrected] We present 71 years old man with croak for four mounths. The tumor of the larynx was examined in laryngoscopy. Biopsy of the tumor confirmed malignant fibrohistiocytoma. Laser surgery (chordectomy) was used to treatment this tumor without radiotherapy., Results: One year observation of the patient didn't show recurrence of neoplasm, but he had only croak., Conclusions: Malignant fibrohistiocytoma of the larynx doesn't differ from other malignant neoplasms of the larynx. Malignant fibrohistiocytoma of the larynx is very rare malignant neoplasms of the larynx.