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The aim of this study was to evaluate Bcl-2 expression in the germinal centers of adenoid in children on the assumption that it can be treated as a marker of adenoidal tissue function. The study involved 95 children. The patients were divided into three age groups: aged up to 5, 5-10 and above 10 years. The analysed material were adenoids removed on the grounds of hypertrophy. Immunohistochemical analyses were carried out using monoclonal antibodies (DAKO/Bcl-2, No. M0887) directed against human Bcl-2 protein. The presence of Bcl-2 positive lymphocytes within the lymphoid follicles and Bcl-2 immunostaining were scored. The immunohistochemical staining showed Bcl-2 positive lymphocytes in the examined sections of adenoidal tissue and their characteristic location, mainly within the mantle zone. Bcl-2 reactivity was widespread in hyperplastic lymphoid tissue, including germinal centers surroundings, scattered cells within the germinal centers and the T-cell areas in general. We have not found statistically significant correlation between Bcl-2 expression and clinical status and change in Bcl-2 expression level according to age. The apoptosis presence within the germinal centers and its lack in mantle zone, the manifestation of which is Bcl-2 expression, is a sign of a proper lymphocytes maturation within lymphoid follicles. It seems that these processes are not influenced by age, so the adenoid involution is probably associated with the changes in the number of lymphoid follicles rather than change or inhibition of the processes that take place in them.

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Adenoid hypertrophy is a common problem of childhood. The peak occurrence of adenoid hypertrophy correlates with the onset of serous otitis media. The aim of the study was to evaluate the lymphocyte subpopulations in the adenoids of children with serous otitis media. The adenoids obtained from 65 children at the age of 1 to 17 years were examined. Two groups were studied: 1) children with persistent effusion in the middle ear, 2) children with adenoid hypertrophy without a history of otitis media. The percentage of the lymphocytes B in the adenoids was similar in both groups. However, the percentage of lymphocytes T (p < 0.04), and CD4+ (p < 0.005) was significantly lower in adenoids of children with serous otitis media. The percentage of lymphocytes T HLA-DR+ was slightly higher in this group, but the percentage of lymphocytes T CD25+ was the same in both groups. The quantitative differences in the lymphocyte subpopulations of adenoids may be the predisposing factor in serous otitis media.

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The purpose of this study was to evaluate the clinical usefulness of squamous cell carcinoma antigen (SCC Ag) in patients with squamous cell carcinoma of the larynx. Plasma specimens were obtained from 70 patients with cancer of the larynx before and after treatment and during follow-up. Disease status and the marker levels were determined blind to each other. Microparticle enzyme immunoassay (IMx SCC) was used to measure the SCC Ag level. Applying standard normal limits the sensitivity of the marker at diagnosis was 25.7%. SCC Ag levels were generally lower after therapy than before. Relapse occurred more often in patients with an abnormal pretreatment SCC Ag level, which was more frequent in those with nodal invasion. The marker level increased in 70% of the patients with relapse before the clinical detection of recurrence. SCC Ag is of limited usefulness in the primary diagnosis of cancer of the larynx, but is useful in detecting recurrence of cancer.

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Second primary neoplasms are the cause of failure in treatment of head and neck carcinoma in 1-34% of cases. The majority of SPM are located within mouth, pharynx, lung or oesophagus. This study was designed to evaluate to effectiveness of exfoliative cytology in postoperative follow-up of patients with carcinoma of the larynx treated with surgery. The group consisted of 81 patients who had cytological evaluation between 1994 and 1996. Cytological smears were taken from six different places in mouth, pharynx and tracheostoma. If cytomorphotic changes, parakeratosis or inflammation was found, the examination was repeated every 6 months. In the first study among 548 smears cytomorphotic changes were found in 16 (2.91%) taken from 8 patients (9.87%). 9 smears presented small or medium degree of dysplasia, 4-severe degree of dysplasia, and 3 smears demonstrated neoplastic cells. Upon completing second and third cytologic examination full remission was found in cases of small and medium dysplasia as in parakeratosis and inflammation. Stagnation was detected in cases of severe dysplasia. In the patient whose smear revealed neoplastic cells SPN of the oesophagus was diagnosed. It seems that exfoliative cytology might be a useful method for follow-up and early diagnosis of SPN in patient after laryngectomy.

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In the period of 1990-1992, 238 patients underwent surgical treatment for laryngeal carcinoma in ORL Department of Medical Academy in Bialystok. Until now 27 cases of second primary malignances (SPM) have been found in this group (11.3% of the screened population). Upper aerodigestive tract was the most frequent location, i.e. it was observed in 18 cases (66.6%). There was 100% mortality among patients with SPM of stomach, oesophagus and lung estabishing 13% deaths in the whole group. There was no correlation between the stage and the location of primary laryngeal cancer and SPM. Carcinogenic influence of smoking and alcohol on primary malignancies and SPM within upper aerodigestive tract development has been confirmed.

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The measurement of distortion product otoacoustic emissions (DPOE), one of the types of otoacoustic emissions (OES) gives the possibility of frequency--specific, objective assessment of cochlear function. Data were collected from 67 ears with sensorineural hearing loss and 30 normally hearing ears as a control group. Percentage of DPOE response detected above the noise floor level was evaluated in relation to the pure-tone audiometric thresholds. Analysis of correlation coefficient between amplitude of DPOE and degree of hearing loss for respective frequencies was performed. DPOE were detected in significantly lower percentage in the group of ears with sensorineural hearing loss exceeding 60 dB HL. The amplitude of DPOE decreased with the degree of hearing loss detected in pure-tone audiometry. There was statistically significant correlation (r -0.65(-)-0.85) in all examined frequencies between DPOE and hearing loss (1-6 kHz).

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The aim of this study was to evaluate the influence of the middle ear status on detection and amplitude of otoacoustic emissions-DPOAE. DPOAE were detected in all healthy ears and their amplitude was between 11.4 and 22.4 dB SPL. Responses at frequencies of 0.5 and 0.75 kHz were not detected in the group of children with Eustachian tube dysfunction in 60% and 27% of ears respectively. The absence of DPOAE responses in the group of children with B type tympanometry was found in 3/4 of the investigated ears at frequencies of 0.5 and 0.75 kHz and in over 50% of ears at frequencies of 1.0 and 8.0 kHz. No influence of cochlear reserve on detection and amplitude of DPOAE was found in the studied group. Conductive hearing loss associated with a presence of negative pressure and effusion in the middle ear inhibits DPOAE detection and causes decrease of otoacoustic emission amplitude.

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Between 1989 and 1994 17 patients with carcinoma of the soft palate were treated in Department of Otolaryngology, Bialystok. Majority of patients (15) had small tumors T1-T2. 1/3 of the patients developed regional metastases during the course of disease. 23.5% of the patients had second primary tumor in the upper aerodigestive tract, two previously, one synchronously and one metachronously. 10 patients were treated with surgery and 5 with radiotherapy as single treatment modalities. In one case surgical treatment was followed by radiotherapy. After surgical treatment no local recurrences were observed up to now. Of the five patients who died because of carcinoma of the palate four had advanced regional metastases in the time of diagnosis. In conclusion, localized soft palate lesions are amenable to surgical excision without causing significant functional disability.

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This study deals with an inconsistency concerning the existence of branchiogenic carcinoma. The data from the literature dealing with lateral cervical (branchial) cyst and branchiogenic carcinoma are presented. There are growing evidence that branchiogenic carcinoma in in fact cystic metastases from oropharyngeal carcinoma, most commonly tonsillar primary. The case of the patient with tonsillar carcinoma and cystic metastases to the neck, supporting this thesis is presented.

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19 patients with adenoid cystic carcinoma of the minor and major salivary glands were analysed clinicopathologically. Majority (8) of the tumours originated in the parotid gland. The palate was the most common location among the tumour of the minor salivary glands. The tumours were classified by their histology patterns into three groups: I tubular and cribriform pattern, II cribriform with less than 30% of solid pattern, III solid forms. A positive correlation between increasing grade and aggressive behavior was not observed in our study. All patients were treated with surgery. Eight of them received postsurgical radiation therapy. Recurrence of disease at the primary site occurred in 5 of 19 patients. Distant metastases developed in 3 patients. An adequate surgical excision of the tumour yields optimal local control and survival rates.

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The semi-quantitative grading system for squamous cell carcinoma based on estimation of multiple histologic variables according to Jakobsson is presented. Selected histologic parameters have been also evaluated regarding their importance in predicting patient outcome. Features such as differentiation of the tumor cells, their nuclear polymorphism, number of mitoses and vascular invasion significantly correlated with clinical outcome. The structure of the tumor and cellular host response had no influence on survival. There was statistically significant relationship between the patient outcome and histologic grade of malignancy expressed by total point value. The incidence of cervical node and distant metastases was three times more frequent in the group of poorly differentiated tumors than in others. There was no correlation found between the localization of the tumor and the degree of cancer differentiation, but the supraglottic tumors poorly and moderately differentiated infiltrated towards the glottis more often then highly differentiated.

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This study is a review of 57 patients with tumours in the parotid glands who underwent surgery at the ORL Clinic in Bialystok. Malignant tumours constituted 17.5% of all parotid tumours and adenoid cystic carcinoma was the dominant type in this group. Pleomorphic adenomas were the most common benign tumour. The role of fine needle aspiration biopsy in diagnosis of parotid tumours is discussed. Superficial parotidectomy was the predominant form of treatment (47 cases). Total parotidectomy was done in 7 cases. The results of treatment are presented.

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