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The subject of our presentation is the case of a fourteen year old girl with rare histological type of histiocytoma malignum and with rare localisation of the primary neoplasm of the parapharyngeal space. Anatomopathology of histiocytoma fibrosum malignum and its clinical symptoms are described.

Aerosolotherapy is a particularly useful method of treatment for otolaryngolgists because it is a procedure of local treatment within the affected region. Advantages of aerosolotherapy as well as indications and contraindications for aerosolotherapy in patients with otolaryngological diseases are described. Among the indications are: precancerous states located on vocal cords; pooperative states in the region of nose, throat and larynx; states after radiotherapy; mycosis of oral cavity, throat and larynx; The importance of additional techniques of aerosolotherapy such as: vibratory aerosols, additional hypertension and electroaerosols is emphasized.

On the base of retrospective analysis of 927 cases of malignant neoplasms of the nose and paranasal sinuses, diagnosed and treated in 10 clinical centers in Poland from 1992-2001, the assessment of basic epidemiological data, including the localization of tumor, and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 10 years the trends to change the mentioned above parameters has been examined. The index of morbidity in this period was constant and compareable with figures published earlier. In the analyzed material there is a predominance of males and the sex ratio was 1.45. The majority of cases were between 50-69 years (55%). The most common histopathological diagnosis was carcinoma (58%). The majority of cases of malignant tumors of the nose and paranasal sinuses was diagnosed in the advanced stage T3-T4 (72.3%) with the highest percentage in the middle region. 90% of all cases were treated surgically, but in about 30% it was the only treatment (also in cases of stage T2-T4). In 56% of all patients the surgical procedure was completed by radiotherapy. This data suggest that indications for additional irradiation should be extended.

All cases of malignant tumours of the pharynx (excluding tumours of the tongue) were analyzed based on the retrospective data from the 5 clinical centers in Poland from the years 1992-2001. A considerable--over 50% increase in morbidity was found out regarding particularly tumours of the oropharynx. In the analyzed material there is a predominance of males (3:1) and the peak of morbidity significantly falls. The subjects with advanced tumours of the pharynx made 26% of the studied group. The most common histopathological diagnosis was squamous cell carcinoma and the most common site--the oropharynx, in particularly the tonsil. The data the center in Katowice, where tumours of the hypopharynx have been predominant in the last few years, may point a similar tendency in the other centers in the future.

A case of adenoid cystic carcinoma in 41-year old man, localised on nasal septum was described. The course of disease was very unsatisfactory--many local recurrences, lymph node metastases and in the last period generalisation of the neoplasms. The period between diagnosis and the time of death was only 8 months in spite of repeated operations of the tumours local recurrences and lymph nodes metastases as well as radio- and chemotherapy.

30 patients suffering from angiofibroma juvenile were treated in the Department of Otolaryngology in Poznań in the years 1977-2000. The patients aged from 9-36 years. All the patients were treated surgically and the method of choice was Denker's surgery. 3 patients were reoperated because of local recurrence. On the base of own material good results of full recovery of patients with angiofibroma treated surgically are presented.

The introduction of surgical lasers into microsurgery of the larynx has made the resection of the posterior vocal cord with or without the arytenoid cartilage possible. This method of surgical treatment allows one to carry out a fast, non-open larynx procedure and practically bloodless operation with minimal postoperative trauma and edema of the surrounding tissues. Since November 1990 at the Clinic of Otolaryngology of the University School of Medical Sciences 48 arytenoidectomies (40 on the right side, 8 on the left side), 19 partial chordectomies and 25 Kashima operations. All surgical treatment were performed by means of CO2 laser in patients with bilateral paralysis of the vocal cords. In all patients postoperative recovery was correct and breathing difficulties were not observed after extubation. Laryngoscopic control examinations were performed a day after operation and a wide lumen of air through the operative field was observed. At the control examination, narrowing of the lumen of the larynx was not observed, the healing process of the operation area was without granulation. Laser arytenoidectomy allows good results of the breathing and phonation function. No changes of granulation proliferation were observed at the side of the CO2 laser treatment. Lack of reaction to laser beam there was possibility to use endoscopic procedures in patients who did not undergo a tracheotomy.

Tumours of the neck are very important problem of the contemporary otolaryngology. In the study the use of sonography in evaluation of expansions of the neck was studied in 200 patients with histologically proven diagnosis. To carry out a detailed evaluation of the individual character of particular types of tumours, all basic features were analysed using the following criteria: echogenicity, echostructure, separation and contour. In this group developed 159 (78.5%) benign tumours and 41 (21.5%) malignant tumours. Malignant tumours were mainly: cystic or solid-cystic, with irregular contour, thickened separation and high echogenicity. Benign tumours were regular, smooth, with low echogenicity and clear separation.

A case of 74-year old woman with six separate cancers is presented. Four of them were nonmelanoma skin cancers (2 basal-cell carcinomas and 2 squamous-cell carcinomas), the remaining two were noncutaneous malignancies (invasive lobular carcinoma of the breast and squamous cell carcinoma of the parotid gland). Three lesions were present simultaneously on the head and neck region; basal-cell carcinoma on the cheek, squamous-cell carcinomas on the forehead, and in the parotid gland. All neoplasms were surgically removed, the region of affected parotid gland was additionally radiated. Extreme rarity of the multifocal primary malignancies is emphasized and the non-completely clear etiology, biology and pathology of these tumors is discussed.

Ultrasonography (US) is a well-known and valuable method of detecting lymph nodes in the neck. It is widely used in the preoperative neck assessment and in follow-up patients treated for head and neck cancer. The aim of the study was to compare the larynx cancer patients in two decades: the 80-ies and the 90-ies and the influence of a single diagnostic tool, i.e. ultrasonography, on therapeutic decisions and final results. Two groups of patients were selected: 737 patients treated between 1981-1985 (before the introduction of US) and 840 patients treated between 1991-1995 (routinely examined with the help of US) in ENT Dept. of Karol Marcinkowski University of Medical Sciences in Poznań. We aimed at analysing the percentages of neck metastases at the moment of diagnosis, the frequency of particular types of primary neck treatment, the percentages of neck recurrences, their advancement at the diagnosis and the methods of secondary treatment. Particular attention to feasibility of salvage was paid. Mean survival time in the group of patients with recurrence and the overall 5-year-long survival rates were analysed. No marked differences were stated between both groups as to epidemiological data, primary tumor advancement and types of the performed larynx surgery. Neck metastases occurred in both groups, 34% and 42%, respectively. Relapse rates were 12.9% and 12.6%, respectively. It was found that the number of elective neck dissections over the period given above became smaller, the number of radical neck dissections was stable, while the number of patients referred to wait and see policy increased. The number of successful neck salvage surgeries markedly increased while the number of patients not qualified for salvage decreased. For the both studied data, the curves on diagrams cross around the year 1992. The turning point situated in this time shows that ultrasound, introduced in 1991, gradually changed the types of primary treatment and possibilities of salvage neck treatment. The statistically significant differences in both groups were shown as to: types of the initial i.e. first neck treatment, relapse rate and the possibility of performing surgical salvage, while the only change was the introduction of a new diagnostic tool, i.e. neck ultrasonography. Survival rate was markedly better in the second group of patients. The methods of qualifying patients for the primary neck treatment and follow-up schedule have been changed since ultrasonography diagnostics was introduced in 1991 for routine assessment of the neck lymphatics in the larynx cancer patients. Strict follow-up schedule allow for early detection and successful treatment in high percentage of relapses.

A twenty-year scientific cooperation has been discussed (1979-1998) between four clinics for laryngology at Medical Universities in Cracow, Poznań, Warsaw and Lublin. The results of research concerning the epidemiology, diagnostics and treatment of the carcinoma of the larynx are presented.

Unlabelled: Diagnostics and treatments of precancerous states of cancer of larynx will demand in select chances the multistages treatment, Aim: In work one priced radicality and efficiencies of treatment of precancerous stages of larynx with method of carbone dioxide laser cordectomy. The retrospective examination was executed of years 1991-2000 imicrosurgical interventions of larynx--in talked over period one executed 308 of surgical interventions with use of laser CO2, in number this 41 of interventions were partial laser cordectomies in stages with precancerous changes on the vocal cords. In chances of extensive precancerous changes of vocal cords in sorted chances not one should limit oneself to receiving of specimens from several localization, but change to remove in wholes. Permits this on obtainment radicality of intervention with possibility of obtainment the large material to histopathological investigations.

Benzydamine HCL--Tantum Verde is a non-steroid drug of anti-inflammatory, pain-killing and antibacterial activity. The preparation is very easy to use in the form of mouth and throat wash, nebuliser or 3 mg lozenges. It is non-toxic and does not have side-effects. It allows the patients to improve their ability to eat foods and reduces throat discomfort and pain. On the basis of literature and own observation it is to be stated that Tantum Verde has substantial usefulness in the treatment of various, inflammatory conditions, radiotherapy induced mucositis in anti-neoplastic induced stomatitis, in angina, in neoplasms with necrosis, after surgical operation of the mouth and pharynx, after intubation and endoscopic surgery in the larynx.

624 patients with malignant neoplasms of the mouth and the oropharynx treated in the ENT Department K. Marcinkowski University of Medical Sciences in Poznań between 1980 and 1999 were analysed. Since the middle of the 90-ies a rapid increase of neoplasms incidence of this location has been observed. The most numerous group were tumours of the palatine tonsil (34.8%), tongue (32.5%), floor of the mouth (5.9%), soft palate (5.3%). Advanced neoplasms which encompassed the tongue, oropharynx, mouth floor base was observed in 134 patients (21.5%). The precise definition of their site of origin primary location was not possible to establish. In the analysed group males were dominating. Heavy smoker and alcohol-abuse constitute the majority of risk-factor patients. Poor dental status and mouth hygiene in this population was observed. In the histological examination squamous cell carcinoma was a dominating. Prognosis in patients with malignant neoplasms of the palatine tonsil were better in comparison with tongue cancer.

The results concerning examination of DNA adducts in oral (23 patients), pharyngeal (23 patients) and larynx cancer (10 patients) subjects are presented. DNA adduct levels were compared in respect to anatomical structure (primary tumour location), number of cigarettes smoked, TNM stage, and age of patients. DNA was isolated from removed tissue (tumour and non-tumour surrounding tissue) using detergent/phenol extraction. 32P-postlabelling assay including nuclease P1-enhancement modification was applied. Aromatic DNA adducts were found in all studied tissues. Total DNA adduct levels (tumour and non-tumour tissues) was lowest in larynx cancer, higher in oral cancer and highest in pharyngeal cancer. There were no influence of age into formation of DNA adducts. The higher level of DNA adducts was found in tumour tissue of oral cancer in the group of smokers with metastasis into lymph nodes.

One case of rare laryngeal tumor--adenoid cystic carcinoma in 58 year old woman was reported in this paper. Authors wanted to drew attention to few complaints and only slight dysphagia in comparison to local extensiveness of the neoplasm. Diagnostic difficulties were underline. Epidemiology, clinical course and therapy were demonstrated in laryngeal adenoid cystic carcinoma.

A case of latent otogenic cerebellar abscess is presented during chronic otitis media with cholesteatoma, in 42-year-old woman. Good results of the treatment were obtained by draining and substituting the content of abscess into antibiotic solution.

In the years 1958-1999 the ENT Department at the University School of Medical Sciences in Poznań treated 125 patients suffering from adenoid cystic carcinoma located in the head and neck area. The aim of this study was to assess treatment results over a span of 41 years. The cases treated included 68 women and 57 men. The highest incidence of the disease was observed in men in their 70's--16 cases and women in their 50's--19 cases. In a majority of cases, the cancer started in major salivary glands, specifically parotid--51, submandibular--11, sublingual--4. Other places included minor salivary glands located in the palate--15, cheek--8, oral cavity--5 and tongue--4. Other glands affected by the tumor were those in the ethmoidomaxillary area--23. The treatment of choice was surgery with subsequent radiation. All patients were subjected to surgical treatment, 89 of them being subsequently radiated. Local recidivation was observed in 12 patients (i.e. 10%), metastases to neighbouring lymph nodes in 9 patients (i.e. 7%). Distant metastases affected the lungs--4 cases, liver--1 and bone--1.

In the period of 35 years 25 patients with intracranial complications of paranasal sinusitis were treated in the Department of Otolaryngology of the Karol Marcinkowski University School of Medical Sciences in Poznań. In the past 15 years the number of complications decreased annually by half. Intracranial sinusal complications were more frequently present in young men. In 25 patients abscesses of the frontal lobe and epidural abscesses were most often diagnosed. Surgical treatment was carried out in each case when the inflammation process spread into the bony parts or into intracranial space. The method of choice in treatment of frontal lobe abscess and subdural abscesses is elimination of sinuses inflammatory foci with a simultaneous evacuation of the abscess by puncturing of the abscess and gradual exchange of its content into antibiotic solution. Intensive antibiotic therapy was carried out for the period of 4 weeks. Mortality rate in our material concerned patients with the brain frontal lobe abscesses and amounted to 12%. In the last 15 years we succeeded to treat all 17 patients.

Unlabelled: Aim of the study was to establish clinical utility of intraoral ultrasonography in diagnosis of tonsillar tumours in respect to its magnitude, location, histological structure, presence of satellite lesions and furthermore compare results obtained by endoral to transcutaneous ultrasonography. 64 patients with tonsillar tumour entered the study. Endoral ultrasonography was performed by probe UST-937 Convex 5 MHz., Conclusion: Endoral ultrasonography is very efficient in exact tumour localisation and correlation between endoral ultrasonography and intraoperative assessment of T tumor is statistically significant. Ultrasonography is sensitive in recognition of satellite lesions. In the case of planoepithelial cancer, malignant lymphoma and inflammatory process very characteristic features of tumor can be described. Endoral ultrasonography is better then transcutaneous in tonsillar tumours diagnosis.

An exposure to tobacco smoke carcinogens is followed by an interaction of chemical carcinogens with DNA molecule resulted by the formation of carcinogen: DNA adducts. The study subjects were 40 oral and pharyngeal cancer patients with primary tumours diagnosed as squamous cell carcinoma. The biological samples purchased for analysis included tumour biopsy, the surrounding tissue (histopathologically recognised as non-malignant) and peripheral blood leucocytes. For DNA adducts analysis first DNA was isolated using phenol detergent extraction followed by 32P-postlabelling assay including P1 nuclease enhancement. Aromatic DNA adducts were found in all studied tissues. The average levels of DNA adducts in tumour and non-tumour tissues were found higher than in leucocytes. Biopsies from pharynx contained higher levels of DNA adducts than from oral cavities. Confounding effect of tobacco smoking and alcohol consumption on DNA adducts level was observed but it has not reached statistical significance. Formation of DNA adducts was not depended on such factors as patients age, sex, pulmonary tuberculosis, cancer progression (TNM), environmental pollution and mechanical irritation.

Lymph node metastases are one of the main reasons of treatment failure in head and neck cancer. Thus, knowledge of lymphatic system anatomy and routs of spreading the metastases in particular primary tumor localisation is of great practical importance. Typical sites of neck metastases in larynx and tonsil cancer were presented. The neck lymphatic system classification according to American Academy of Otolaryngology--Head and Neck Surgery from 1991 was used. The most often site of metastases in larynx cancer was the II and III level, in tongue and floor of mouth cancer--level I and II and in nasopharynx malignancies--level II and V respectively. Knowledge of the neck regions with elevated risk of harbouring metastases was important not only during the surgery but as well before planning of the selective or elective radiotherapy.

Subtotal laryngectomies with larynx reconstruction are an acceptable alternative to the total laryngectomy in T2, T3 larynx cancer treatment. One procedure resection and reconstruction allow for radical oncological treatment with simultaneous preservation of air passage continuity and the function of the neolarynx. In the years 1988-1997 in ENT Dept. of Karol Marcinkowski University of Medical Sciences 38 subtotal laryngectomies with larynx reconstruction were performed. They were: 34 supracricoid laryngectomies with cricohyoidopexy, 2 with epiglotohyoidopexy and 3 supraglotic laryngectomies with reconstruction. The basic criterion of the evaluation of such procedures effectiveness was their oncological radicality. The follow-up period ranged from 2 to 9 years. Local relapse was observed in none of the cases, nodal relapse was started in 2 patients. Another aspect taken into consideration was the function of the neolarynx. In 3 cases two or three laser procedures were performed because of neolarynx lumen structure which were followed by T-dren plasty. In 10 patients temporary swallowing difficulties, especially liquids, were observed in the first three month. Gastrostomy was performed in one case. The authors discuss indications to this type of surgery, operation technique, oncological and functional results. Spirometry results and voice analyses after larynx resection and reconstruction in these patients are presented.

Carcinoma of unknown primary (CUP-syndrome) is taken into consideration when the patient has histologically confirmed metastases but the primary focus remains unknown or it's diagnosis is delayed. Metastases of unknown origin constitute from 5% to 31% of all neck metastases. Squamous cell carcinoma and anaplastic carcinoma metastases in the neck lymphatics suggest that location of primary focus can be found in head and neck region. Diagnostic procedures applied in detection of primary foci have been described. The knowledge of lymphatic metastases spreading routes is helpful in the primary focus detection. In the material of 1348 patients treated oncologically in the years 1991-1997 in ENT Department of Karol Marcinkowski University of Medical Sciences in Poznań, 22 were diagnosed for CUP syndrome. Primary foci were not found in 7 cases. In the remaining 15 patients the primary was located in nasopharynx, palatinal tonsil, tongue, hypopharynx, testes or breast. The treatment included the radical neck dissection with consecutive irradiation and/or chemotherapy, and in the case of diagnosing the primary one applied it's radical removal or radiotherapy.

Primary malignant melanoma of the larynx is very rare. The case of larynx malignant melanoma in 71-years old men is presented. Hoarseness was the main complaint that encouraged the patient to visit a doctor. The patient was heavy smoker, he had been smoking 40 cigarettes for the last 50 years. He used to drink about 200 ml of pure alcohol per day. In the direct laryngoscopy gluish had cyanotic tumor, extending to the true vocal cord, ventricle, ventricle fold and subglottic space was seen. Enlarged cervical lymph nodes, laterally to the main vessels were found both in palpation and in US examination. Total laryngectomy and neck dissection was performed. The histological examination of surgical specimen revealed; Malignant melanoma. Metastases in the lymph nodes. Neoplastic infiltration of the nodal capsule. The patient was admitted to the complementary radiotherapy. At the moment the follow up in outpatient. The article contains the review of literature concerning the diagnosis, treatment and prognosis in cases of laryngeal malignant melanoma.

Diagnostic possibilities in lethal midline granuloma (Wegener's granulomatosis, angiocentric lymphoma) based on the literature were presented. Results of diagnostic examinations in a case of 34 years old man admitted to the Dept. of Otolaryngology in Poznań were described.

Unlabelled: The new diagnostic method, intraoperative ultrasound is presented. There are very few publications in the literature, but they mainly concern the application of transcutaneous ultrasound in localizing the abscesses, their puncture and drainage. Intraoperative imaging of tongue, tonsil, larynx tumors, submandibular and parotid glands and neck masses have been provided by means of a linear 7.5 MHz probe in Poznań ENT Dept. K. Marcinkowski University of Medical Sciences. The application of this method is pioneer and new. The aim of the study was to compare the sensitivity and the specificity of preoperative, transcutaneous ultrasound with the intraoperative one, to assess how the new method influences the extensiveness of the performed procedures and sonographic-surgical correlation of safety margins., Material: 5 patients with parotid tumors, 4 with tongue, 6 with tonsil and 6 with larynx cancers have been examined. In 13 of them, apart from primary site diagnostics, the neck masses have been assessed. The imaging documentation is presented and the preliminary conclusions concerning the usefulness of this method have been drown.

Neuromas are being mesenchymal tumors which are very rare in the mouth. The authors presented the case of the tumour of this localisation of 46-year old female, treated in the Department of Otolaryngology University School of Medical Sciences in Poznan, with suspicion of sublingual cyst.

The span of time between the appearance of the first symptoms of larynx cancer and the moment it is diagnosed in Poland amounts to approximately 6 months. It is the result primarily of the fact that patients tend to consult a doctor late after the symptoms show as they underestimate them due to their lack of knowledge concerning their nature. In some cases the diagnosis may be difficult to give even for a specialist. The paper presents the cases of three patients with an unusual course of larynx cancer.

One of the most common reasons of failure in head and neck cancer treatment are metastases in regional lymph nodes. Preoperative assessment of the neck lymphatic system is an important task, but even more crucial goal is to monitor the patients after initial operation or combined treatment. The frequency of nodal recurrences ranged from 9% to 23%. It constitute nearly 50% of all treatment failures in larynx, tongue and tonsil malignancies. There are different methods of therapy in nodal recurrence treatment, but the most recommended, easily accessible and widely used is surgery. The group of 2134 patients (1580--larynx cancer, 286--tongue and floor of mouth cancer, 268--tonsil cancer) treated between 1987-1997 were operated in ENT Dept. of K. Marcinkowski University of Medical Sciences in Poznań. In 269 patients were detected the nodal recurrence. In 149 cases the recurrence was homolateral, in 48 heterolateral, in 71 patients the neck was not previously treated. 152 patients were irradiated on the neck fields just after primary surgery. The rate of recurrences was 12.6%. Authors analysed and compared the percentage of recurrences for different primary lesions: larynx, tongue and tonsil neoplasms. The period of time from the last control examination to the moment of recurrence detection, its frequency on particular nodal levels, number of recurrences and trends between years 1992-1997 were assessed. 208 patients who developed nodal recurrence had surgical salvage, 59 patients were not qualified to surgery because of the lesion extension. Neck re-operations were divided into 3 main types: selective, modified radical and radical neck dissection. The frequency of particular neck dissection types, curative rates and difficulties of performing the salvage surgery were discussed.

A case of Wegener's disease is described. In eight years of remission a patient, treated with cyclophosphamid and steroids demonstrated sterosis of the trachea and upper way obstruction. We have performed carbon dioxide laser photoresection of granulotion mucosis and scars with an excellent results.

On the basis of cases of their own and the literature the authors review the etiology, pathophysiology and management of rhinophyma.

The bleomycin test is a recognised method of evaluation of hidden genetical instability. The concept of the test consists in inducing chromosome aberrations in lymphocytes exposed in vitro to bleomycin and subsequent quantitative analysis of chromosome breaks. The study material was whole venous blood from 61 laryngeal cancer patients and from 30 healthy persons taken as a control. For each patient two parallel cultures where carried out in the standard procedure. Bleomycin was added to one of the cultures to induce chromosome breaks. Then, in microscopic metaphasal plates stained by Giemsa dye, the chromosome instability index estimated as a number of chromosome breaks per cell (b/c) and the percentage of cells with chromosome breaks were calculated. Higher indices of chromosome instability were demonstrated in laryngeal cancer patients in comparison to the controls. The persons with chromosome instability (b/c > 0.8) or with chromosome oversensitivity to mutagens (b/c > 1) were identified only among larynx cancer subjects. Furthermore, it was established that an increased chromosome instability is associated with high aggressiveness recognised by histological grading. The latter finding requires confirmation on an enlarged group of subjects.

The paper presents three cases of localised amyloidosis of the larynx. The study was focused on case histories, findings of larynx examination and method of treatment was discussed. Amyloidosis is a disease characterised by gathering of amyloid deposits in extracellular space. The amyloid fibres consist of different kinds of proteins which have the ability of forming laminae. This disease may be secondary to numerous general processes in which amyloid proteins forms. Etiopathogenesis of this disease has not been explained yet. In the following paper the latest theories and classification of amyloidosis are presented.

1496 patients with foreign bodies of esophagus, reported between 1945-1997 to ENT Department of K. Marcinkowski University of Medical Sciences, were analysed. The age ranged from 0.5 to 95 years, but the most numerous group was under 5 years of age. Men outnumber women. Very detailed anamnesis, oropharynx and hypopharynx examination, neck palpation, chest X-ray were crucial for diagnosis. More than 50% of patients reported within first 10 hours after foreign body wedged. The most often met foreign bodies were: bones, coins, denture, fish bones, fruit-stones, buttons. The most dangerous were supposed to be: needles, pieces of glass, springing anchores, safety razors. Foreign bodies were removed by means of rigid esophagoscopes. In 75.3% foreign bodies occupied the first isthmus. Serious complications met in the analysed material, included: esophageal wall perforation [27], mediastinitis [21], aortal hemorrhage [3], esophagus-tracheal fistula [1]. Intramural abscesses, posteriol pharyngeal wall abscesses were found more often. 98% of esophageal foreign bodies were removed by the same route they had been introduced.

The late results of the larynx reconstruction by means of the mucoseptal nasal graft after an enlarged fronto-lateral laryngectomy were described. The analysis of 460 patients showed a satisfying larynx lumen in almost all cases. In 21 cases due to the neoplasm recurrence a total laryngectomy were performed. The voice after surgery was socially good, and the wide larynx lumen was obtained.

In the years 1958-1997 111 patients with adenoid cystic carcinoma in the head and neck of different localization were treated at the Department of Otolaryngology--Head and Neck Surgery. Majority of the tumors originated of the major salivary glands, mainly in the parotid gland (47 cases). The most common location among the tumor of the minor salivary glands was the palate (14 persons). The tumors arising from other mucous glands, most frequently has located in the maxillo-ethmoideal complex (20 cases). The authors stress diagnostic difficulties, the necessity of a proper selection of the surgical method and postoperative radiotherapy, describing the treatment results in the patients. Radial surgical procedure of the adenoid cyctic carcinoma yelds optimal local control and survival rates.

Biochemical and physiological principles of biological sealing are presented. Various methods of application of biological seal and indications for its use in otorhinolaryngology are discussed.

A case of 18 years old male with tracheoesophageal fistula as a result of esophageal foreign body (chestnut) is described. Foreign body was removed using esophagoscopy. Bronchofiberoscopy performed because of difficulties with swallowing and frequent airway infections revealed tracheoesophageal fistula. Fistula was closed from intratracheal access. Symptoms of dysfagia disappeared after surgery.

In the years 1958-1997 were surgically treated in the Department of Otolaryngology Karol Marcinkowski University of Medical Sciences in Poznań 365 patients with pleomorphic adenomas. Majority of the tumors originated of the major salivary glands was parotid gland (273 cases). The given materials confirms the viewpoint that enucleation in the pleomorphic adenomas of the parotid salivary gland--based on total removal of the tumor together with the capsule and pouch constitute a completely sure surgical procedure.

Pleomorphic adenoma localised in nasal cavity is extremely rare. Authors described a case of mixed salivary gland tumor in the lateral wall of nasal cavity. We are presented, on the base of our experience and literature data, pathogenesis, clinical course and treatment of this tumors situated in atypical places.

Primary neoplasms of parapharyngeal space are rare. In this location the so called non-malignant tumors occur many times more than the malignant ones. In our paper, employing statistics, objective symptoms and complaints connected with these tumors were ordered according to frequency. In recent five years in ENT Department of Karol Marcinkowski University of Medical Sciences in Poznań 9 persons were surgically treated. The differentiated histopathological picture is discussed and described (6 malignant and 3 non-malignant). It can be claimed that MR is more useful in diagnosis than CT. The treatment is usually surgical; both external and oral approaches are used.

Patient aged 48 with the cyst of the cervical part of thoracic duct was described. Cyst appeared as the result of inflammation. Histopathological examination excluded the cystic lymphangioma.

A group of 66 patients with acute inflammatory upper respiratory tract diseases were examined in the ENT Department of Poznań Medical Academy between November 1996 and November 1997. Specimens for bacteriological cultures were collected from the ear, nose and throat. The subjects were treated with ceftibuten. Clinical improvement was reported in all cases. In 44 patients, ceftibuten treatment eliminated pathogenic bacteria (as evidenced by microbiological analysis).

Malignant nonepithelial neoplasms of the larynx are rare, and tumors of mesenchymal origin constitute 4-6% of all malignant neoplasms of the larynx. Sarcoma neurogenes vel malignant schwannoma make up 10% of all soft tissue sarcomas. In this paper a case of the extremely rare malignant schwannoma of the larynx is presented. In world literature we have met four case reports describing tumors of this histological morphology and location.

258 foreign bodies were removed from the lower respiratory tract in ENT Department of Poznań High School of Medical Sciences between 1945 and 1997. The age ranged from 0 to 85 years, but the most numerous group (68%) was found between 0 and 10 years. 86.5% patients were admitted to hospital during first three days after inserting the foreign body. The longest time of foreign body existence inside the bronchus was a period of 18 years. The most often met foreign bodies were: bones, bean seeds, fruit stones, pieces of food, iron nails. Spontaneous evacuation of the foreign body took place in 4% of cases. 98% of foreign bodies were removed by means of rigid bronchoscopy. Bronchofiberoscopy was performed for diagnostic purposes or for taking out foreign bodies located in the peripheral parts of the bronchial tree. 3% of patients were referred to the further toracosurgery treatment.

According to epidemiological data concerning laryngeal cancer there is almost ninefold higher morbidity in male population than in females. The aim of this study was to analyse on molecular level the genotoxic effects arising under the same exposure to tobacco smoke in males and females. In biopsies received from laryngectomy material we determined levels of aromatic and alkylated DNA adducts in tumours and in adjacent non-tumour tissue. It was established that levels of DNA adducts found in male DNA samples exceeded those in female DNA samples 1.5-3.8 times, which was recognised as a molecular evidence for epidemiological differences. Next, testosterone and sex hormones binding globulin (SHBG) were determined in male subjects blood serum. The levels of testosterone and SHBG very weakly correlated with DNA adduct levels even when subjects were separated into age groups. It is concluded that levels of testosterone and SHBG are not the proper markers of individual susceptibility to genotoxicity of tobacco smoke carcinogens.