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Objective: Evaluation the outcome after extensive surgery of salivary glands tumors with simultaneous reconstruction of soft tissue and skin defect., Material: In the period 2007-2011, surgery treatments performed in 295 of major salivary glands. 31 patients underwent surgery due to malignant parotid gland tumors: 19 women (61%) and 12 men (39%). In 8 (26%) presented skin infiltration. 10 (32%) patients had facial palsy between II-IV degree (House Brackmann scale). The radiographic findings in some patients showed infiltration of the deep lobe of parotid gland, external auditory canal, infiltration of mastoid process, skull base and the subtemporal fossa., Methods: Of the 31 patients in 13 (42%) reconstruction techniques with muscle cutaneous trapezius flap were applied in 4 (31%) patients. In group of 7 (54%) patients using a muscle flap based on the sterno-cleido-gland, in 2 (15%) patients defects were covered using the free anterior lateral thigh flap., Results: In all patients, healing proceeded normally. In the operated patients, one patient did not receive radical surgery due to the infiltration of the skull base. Length of hospitalization ranged between 7-21 days. In no case was lost flap, also there was no local complications at the donor., Conclusions: The choice of treatment for malignant parotid gland tumors which are usually radioresistant is surgical resection. In patients with extensive tumors with infiltration of neighbouring organs reconstruction with use of distant flaps are recommended. It provides a good oncological and aesthetic result., (Copyright © 2012. Published by Elsevier Urban & Partner Sp. z.o.o.)

Aim of the Work: The authors present unusually rare case primary multiple synchronicus benign tumor of the ipsilateral parotid gland: oncocytoma and Warthin's tumor, which is rare among occasionally occurred multiple tumors with different histology in the salivary glands., Material and Method: A 71-year-old man presented with the tumor in the right parotid gland. We performed excision of the superficial lobe of the parotid gland. The preoperative ultrasonography and macroscopic analysis of the removed parotid gland tissue revealed only one tumor recognised histopathologically as adenolimphoma, but upon histopathological examination Warthin's tumor proved to coexist with oncocytoma., Results and Conclusions: In the ultrasonography examination some salivary glands tumors may not be recognised. The histopathological examination is the ultimate method in recognising tumors, which are not detected in the preoperative diagnosis. The superficial parotidectomy protects from the recrudescence of the superficial lobe of the parotid gland tumors. The coexistence of the oncocytoma and Warthin's in one parotid gland is extremely rare. Only a few cases were described in the English literature and in the available Polish literature there is none of such reports.

Introduction: A case of pleomorphic adenoma of the parotid gland was reported. Pleomorphic adenoma is the most common benign tumor of the major salivary glands. A review of the literature confirms that this kind of tumor is less common in the minor salivary glands. We described statistic population, types of the diagnostic, treatment and clinical course of pleomorphic adenoma of the parotid gland., Material and Method: We encountered such a tumor in a 55-year-old woman who was admitted to our Hospital. The only symptom was significant face deformation, growing for 30 years., Results: The tumor was located under the right side of the face and was removed surgically. No complications were observed in the postoperative course but paresis of the facial nerve occurred. The patient was discharged from the hospital with the recommendation of facial muscles rehabilitation. After the two months from the surgery, paresis was diminished. Afterwards contact with the patient got lost., Conclusion: Pleomorphic adenoma is the most common benign tumor of the major salivary glands. Surgery is the main method of the treatment. The most common complication is paresis of the facial nerve.

Introduction: Sarcoidosis is a granulomatous multisystemic disease of unknown origin that can occur in any organ of the body and commonly affects young adults. Pulmonary sarcoidosis is by far the most common manifestation of the disease but occasionally it presents with involvement of the lymph nodes, skin, eyes, liver, spleen, heart, bones, joints, nervous system and the oral organs. The diagnosis of sarcoidosis is complex and includes the presence of noncaseating granuloma in involved tissues, changes in chest x-ray and many other tests., Aim: The aim of the study was to present the rare case of parotid sarcoidosis which was the origin of discussion of diagnostics and treatment of sarcoidosis in ENT field., Material and Methods: The authors present a review of updated opinions on pathogenesis, diagnostics and treatment of sarcoidosis, completed with own experience concerning a case of extrapulmonary sarcoidosis that manifested with isolated parotid gland enlargement., Conclusions: 1. The incidence of head and neck sarcoidosis is rare, although this etiology should be taken into account in ENT diagnostics. 2. The lesions can occur in many organs, most common manifestation is: lungs, peripherial lymph nodes, skin, eyes, articulations, liver and spleen. 3. Course of sarcoidosis is not characteristic, chest x-ray, biopsy and the analysis of clinical signs are required to settle the diagnosis. 4. In cases of isolated salivary gland sarcoidosis the preoperative diagnosis is difficult, fine-needle biopsy and Doppler ultrasonography can be helpful. 5. The possibility of exacerbations and recidivations makes the long follow-up necessary.

An intracellular metabolic disturbance associated with mitochondriopathy, due to an age dependent metabolic defect, is suggested to cause metaplasia of salivary gland cells into oncocytes. The WHO classification of salivary gland diseases considers 3 oncocytic lesions: oncocytosis, oncocytoma and oncocytic carcinoma. In case of diffuse hyperplastic oncocytosis of the parotid gland, extensive metaplasia of acinic and ductal cells leads to transformation of nearly all cells of the gland into oncocytes, which is clinically characterised by swelling of the parotid gland, and is an extremely rare condition. A 82-year-old man (the eldest of all reported) presented with a 2-month history of increasing diffuse swelling of the left parotid gland, 6 cm in diameter. The mass was soft, painless to palpation and grew in the superficial lobe of the parotid gland. The patient underwent surgical removal of the lesion with wide margins of healthy tissue. Histopathological examination of the operative specimen disclosed oncocytosis of the salivary gland. The patient has been followed-up for 6 months. He is doing well without recurrence. Surgical removal of the diffuse hyperplastic oncocytosis of the parotid gland, with indications and extent of the resection like in benign tumors, was effective in the presented patient.

Introduction: A mucoepidermoid carcinoma is a rare disease of the salivary glands. It usually occurs as a small tumor (a few centimeters diameter). The most important diagnostic procedure for the treatment is a histological examination., Material and Methods: We present the case of 71 years old woman with giant in size tumor of the left parotid gland. The tumor had developed in the three years' time and no paresis of the facial nerve had occurred during that time. Preoperative fine needle aspiration biopsy of the parotid gland masses showed pleomorphic adenoma cells., Results: The surgery treatment was introduced. The function of the facial nerve was preserved. The histological examination result was mucoepidermoid carcinoma. We observed local recurrence of the tumor five months after the operation. But there was still no facial nerve paralysis. The patient was submitted to the radiotherapy treatment., Conclusion: The big size of the tumor may be an obstacle in full resection during an operation. The false negative results during a fine needle aspiration and preserved normal function of the facial nerve can cause correct treatment as an extremely difficult goal.

Introduction: Surgery of the parotid gland tumors can be difficult because of the presence of the facial nerve branches in the parotid tissue. The aim of the surgical treatment is complete removal of the tumor without damaging the facial nerve. There are several surgical techniques to expose the main trunk and the branches of the facial nerve. On the other hand during the surgery the nerve function is continuously observed by using facial nerve monitor., Material and Methods: In the years of 2002-2004 208 patients with the parotid gland tumors were treated. There were 177 benign and 31 malignant tumors. 159 tumors were located in the superficial lobe of the parotid gland, 35 in the superficial and the deep lobe, and 14 only in the deep lobe. All patients were treated surgically., Results: In cases concerning the operations of the tumors located in the deep lobe, the facial nerve branches had to be exposed with help of the microscopic operating techniques. All tumors were removed totally. A paralysis of the facial nerve was observed in two cases of the pleomorhic adenoma with a diameter over 6 cm, and in 9 cases of malignant tumors of the superficial and the deep lobe, where the main trunk or the branches of the facial nerve were integrated with the tumor mass., Conclusion: Surgical treatment of the parotid gland tumors presented in our study demonstrates good results. The risk of facial nerve paresis is higher in malignant tumors and big pleomorphic adenomas.

A foreign body in the parotid gland is extremely uncommon. It can penetrate to the parotid gland through the skin or from the oral cavity via the Stenonís duct. A case of 23-years-old man with the several pieces of glass within the superficial lobe of the right parotid gland was described. The surgical removal was performed and the diagnosis of the foreign body was quite easy.

Introduction: Malignant tumors constituted 25% of all gland tumors, the most frequently in parotid gland., Material and Methods: The study is analysis of 436 patients with parotid gland tumors who underwent surgery in ENT Department. The results of histopatological diagnosis are presented. We analysed surgical treatment, intraoperative tumor stage and accuracy of fine - needle aspiration cytology in diagnosis., Results: Malignant tumors constituted 22% of all gland tumors. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumor. Tumor stage T3-T4 was in 88,5% cases. Accuracy of fine-needle aspiration cytology in diagnosis of parotid tumors is 81,2%.

Introduction: The operation of parotic gland tumors are challenge for the surgeon. The main aim of these operations is tumor removal and facial nerve preservation. Despite of imaging examinations, showing the localization of the tumor, it's important for surgeon to have the opportunity to discriminate between tumor and normal parotic gland tissue during the operation, e.g. in color difference. Methylene blue (MB) has been used in intravital staining of various tissues for a long time., Material and Methods: The aim of the study was an attempt of intravital staining of parotic gland, using MB during the surgery of five benign gland tumors., Results: In all cases parenchyma of the parotic gland was dark-blue stained and in all cases, while the tumor didn't show any staining., Conclusions: Using of MB may be useful in the surgery of parotic gland.

Haemangiopericytoma is a vascular, soft tissue neoplasm with rare occurrence in the head and neck region. On the basis of literature we discuss etiology, symptomatology, histopathology, diagnosis, treatment and prognosis. We present the case of 66-old woman with haemangiopericytoma in the parotid gland treated by surgery.

We describe two cases of venous malformations in the parotid gland that were operated on due to cosmetic reasons. We present the main differences between hemangiomas and vascular malformations and we also emphasize the importance of correct diagnosis in vascular lesions what is crucial for selection of appropriate treatment.

Malignant oncocytoma of the parotid gland occurs relatively rarely. Basing upon the case of 48-years old man, the authors discuss the difficulties of diagnostic, treatment and the course of the disease.

The case of big size pleomorphic adenoma of the partoid gland was presented. Attention was paid on the necessity of the surgical treatment of pleomorphic adenomas by superficial or total parotidectomies. Possibility of the post operative complications avoidance, even in such big cases was emphasized.

The case of 60 years old man with oncocytoma in parotid gland is reported. According to the available literature there is less than 200 cases reported.

The authors present data on 46 cases of tumors of parotid gland treated in the IInd Department of Laryngology of Sl. AM. in the Zabrze city in years 1979 to 1988. The analysis of histopathological examinations of operated tumors and the principles of the parotid gland neoplasia has been presented.

The influence of Encortone treatment in the dose of 1 mg/kg of body mass on the secretory segments of male rat parotid gland was investigated. The changes of section area of cell nuclei, secretory cells, serous acini and changes of the number of cells in the acini were statistically analyzed. The observed changes depended upon the period of Encortone treatment. Seven-day Encortone treatment caused a statistically significant increase of the cell nuclei size and decrease of the cell and acini sizes. Changes of these parameters were result of cell hyperplasia and formation of new acini. Thirty-day Encortone treatment caused hypertrophy of cell nuclei, cells and acini of rat parotid.

In the radiologic assessment of extension tumors of parotid glands CT method was used and for comparative purposes sialography was performed. In comparative analysis there was assessed CT method and its usefulness in the preoperative assessment of tumor extension.

Three mixtures of herbicides have been administered to white rats of Wistar strain by means of stomach tube. After 9 months of studies laboratory examinations were carried out in these animals namely analysis of urine, peripheral blood, bone marrow smears and segments of parotid glands and cheek's mucous membrane were uptaken to histopathological examinations. Morphological changes whose intensification didn't depend on the dose and type of preparation have been found in the glands. These changes were of non-specific character--similar changes were also present in the glands in rats in the course of poisoning by other toxic agents. Vacuolar changes whose intensification was increasing with the exposure time have been observed in the cells of mucous membrane epithelium.

The influence of bilateral gonadectomy on the secretory segments of the partoid gland in male rats was investigated. The changes in the section area of cell nuclei, secretory cells, serous vesicles as well as in the mean number of cells in the vesicles were statistically analyzed. Eleven-day gonadectomy caused a statistically significant increase of the mean section area of cell nuclei, secretory vesicles and cells. Eight-day mesterone treatment in the dose of 2 mg/kg of body mass does not eliminate the changes caused by gonadectomy but results in the further increase of the mean section area of cell nuclei and secretory vesicles, as well as in the increase of cells in the vesicles.