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Between 1987 and 1999--1289 patients were treated by surgery in the Department of Otolaryngology and Laryngologic Oncology PAM in Szczecin due to the cancer of the larynx. In this group total, eventual subtotal excision of the larynx was carried out in 801 cases. In 154 cases the phonation way was restored. In this study the remaining group of 502 patients was analysed, which underwent partial aiming at restoration of all basic functions of the larynx. In the mentioned group partial vertical laryngectomy was done in 176 cases, and partial horizontal laryngectomy in 326 cases. Larynx reconstruction with the use of tissue materials was carried out in 59 cases after vertical and in 88 cases after horizontal laryngectomy. Shortcomings and advantages of the method of various tissue application were discussed (cartilage of epiglottis, vasculary based pedicle flap of thyroid gland, submaxillary salivary gland, strap muscles among others were used).

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The results of the surgical treatment of the larynx cancer (glottic-supraglottic) by supracricoid laryngectomy with CHP and CHEP type of reconstruction were presented. Material consists of 160 cases (88 after CHP and 72 after CHEP). 5 years survival rate was obtained in over 71% of cases in all material. Decannulation was possible in 126 (79%) patients. Feeding tube removal before 4 weeks after operation was done in 139 (87%) cases. In subjective assessment all patients had social efficient speech. Favourable results of the treatment encourage wider application of supracricoid laryngectomy.

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Principles of the operative technique and indication for permanent laryngotracheal separation in chronic aspiration after oncological operations are being presented. The operation is done while the tracheostomy is present. It consists of horizontal section of the trachea on the level of the tracheostomy and formation the new one by using the lower of the trachea with the skin. Upper sublaryngeal section of the trachea is being closed by stitches. This operation was performed in our clinic in one patient after partial laryngectomy due to the cancer and in two patients after extended resection of the palatal tonsil, base of the tongue and lateral wall of the hypopharynx. In all the cases the follow up was without major complications.

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In ENT Clinic of Medical Academy in Szczecin 962 patients with advanced cancer of the larynx was surgically treated between 1976 to 1995 year. In this group local statement of T3 was observed in 510 cases (53%) and T4 in 452(47%). In the analysis group total laryngectomy was performed in 506 (62.3%) cases, subtotal laryngectomy with phonatory way reconstruction was performed in 234 (24.4%) cases, partial laryngectomy with airway reconstruction in 223 cases (in this number horizontal partial laryngectomy in 207 cases and vertical partial laryngectomy in 15 cases. Efficacy of surgical treatment in 5-years of survival was estimate. In whole material it was 505/962 (52.4%) of cases. Cause of failure, possibility and efficacy its treatment is described.

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The purpose of this paper was the retrospective evaluation of the results after horizontal partial larynx resection of different dimension. The material comprised 468 patients treated according to the described techniques in ENT Clinic Pom. Med. Acad. between 1970-1991. The series of patients subjected to analysis consisted of 35% of all cases treated by surgery and 70% of all conservative operations performed for cancer of the larynx in the above-mentioned period of time. Particulars were obtained from: a) case history, b) control examination, c) correspondence, d) data from USC. The results of the treatment in particular groups were submitted for detailed analysis. The assessment of applied technique from oncologic point of view was done on the basis of local recurrences and percentage of 3 and 5 years survival rate. Functional results were evaluated according to protective, respiratory and phonatory functions of the residual larynx. Results of the investigations were submitted for statistic valuation. In all types of operations satisfactory oncologic results were achieved. They were represented by high percentage of survival rate and low percentage of local recurrences. The longest survival 3- and 5-years respectively (73.90%) and 63.45%) and the lowest index of local failure (4.2%) were seen after classic, supraglottic resection. After horizontal glottic larynx resection 8/10 of patients operated on survived 3 years, 4/6 survived 5 years. Local recurrence was observed in 1/12 patients (Tab. 2). The lowest rate of survival (54.76% and 42.86%) and the highest number of local failures (11.3%) were revented after supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP)--in this group carcinomas staged T3 were predominant. After enlarged supraglottic laryngectomy and supracricoid resection with cricohyoidopexy (CHP) oncologic results were very close (Fig. 1). No substantial statistical difference was recorded in survival percentage after enlarged supraglottic larynx resection (70.51% and 61.66%) and supracricoid one with CHP (68.54% and 58.43%), nor in percentage of local recurrences (4.4% and 5.7%). The efficiency of the residual larynx was dependent on the extent of the resection. From the discussed types of operations the best functional results were achieved after classic supraglottic and glottic larynx resections. This was distinct in the best quality of speech, efficient respiratory tract protection and high percentage of decannulated cases (93%). In the glottic resection the respiratory tract protection was satisfactory in 9/11 patients and in 7/8 satisfactory speech quality was noticed. Following the extended laryngeal structures resection (extended supraglotic and supracricoid laryngectomies) worse protection of respiratory tract, higher percentage of not decannulated cases and worse quality of speech were observed than in operation previously discussed. It was proved that the one-stage reconstruction of the laryngeal structures (arytenoid cartilage and/or vocal cord) or base of the tongue improves the result considerably, in particular the deglutition and phonation. The oncologic and functional results after the discussed types of operation should stimulate their more frequent application in larynx cancer treatment.

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Results of surgery treatment from the external access and radiotherapy in early, stage of vocal cords carcinoma were presented. Clinical material consisted of 94 cases with squamous cell carcinoma of vocal cords with stage T1a and T1b treated in Szczecin University Department of Otorhinolaryngology from 1987 to 1996. 51 cases were operated on (26 by chordectomy and 25 by frontolateral laryngectomy). Radiotherapy was applied in 43 patients. The 3 and 5 years' survival rate in the surgery group was 97% and after radiotherapy 88 to 80%. The functional results were also presented. It was concluded that the mode of treatment in early stages of vocal cord carcinoma should be individualized.

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Original application technology of SBD (Slownikowa Baza Danych) from Szczecin in evaluation of treatment results in larynx and hypopharynx carcinoma was presented. The aim of the report is to present advantages of a system which provides multidirectional date and its particular analysis.

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The authors present a retrospective study of 463 partial horizontal laryngectomy of various types (horizontal supraglottic laryngectomy and its modifications, supracricoid laryngectomy with CHP and CHEP, glottic laryngectomy) performed in the years 1970-1991 in the ENT Clinic of Pomeranian Medical Academy in Szczecin. The aspiration pneumonia in 46 (about 10%) patients was observed as a result of insufficient lower airway protection. In cases of extended supraglottic laryngectomy (including the removal of one arytenoid cartilage and/or one vocal cord) aspiration pneumonia appeared more often (16%) than after classic supraglottic laryngectomy (6%). Reconstruction of elevation of arytenoid cartilage and/or vocal cord and base of tongue its extended resection augmented the efficacy lower airway protection.

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The surgical technic of horizontal glottic laryngectomy and the oncological and functional results in 12 cases treated in ENT Clinic of Pomeranien Medical Academy in Szczecin during the years 1985-1991 are presented. In all cases the changes concerned the vocal cords and were of following extend: T1b--5 cases and T2--7 cases. The survival rate was: 5-years--4/6 patients, 3-year--8/10 patients and 1-2-years--2/2 patients. 3 patients died. The causes of death were: intraoperation--1 case, local recurrence--1 case and non neoplastic case--1 case. Among 12 cases decaniulation were possible in 9.

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The authors present a report on 62 cases of partial horizontal supracricoid reconstructive laryngectomy, including 28 cases of cricohyoidopexy (CHP) and 34 cases of cricohyoidoepiglottopexy (CHEP). The surgery was carried out in the years 1971 to 1989 in the ENT Clinic of Pomeranian Medical Academy in Szczecin. The indications, surgical technique and oncological results are presented. 78% patients survived after 3 years and 73% after 5 years without recurrence. The reasons of failure and the way of treatment are discussed.

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The functional results in 61 patients after supracricoid reconstructive laryngectomy with CHP (28 cases) and CHEP (33 cases) performed in the University ENT Department in Szczecin between 1971-1989 are presented. Satisfactory lower airway protection in about 93% and respiration in the natural way in 83% are obtained. It was impossible to decaniulate 11 patients. The voice was socially sufficient in 89%.

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The rare case of the pedicle oesophageal polyp was described. The diagnostic difficulties, treatment and clinical course were also discussed.

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The aim of the thesis was the observation of the gastric mucus secretion on the basis of carbohydrate components and protein secretion into the gastric lumen. 15 healthy volunteers were investigated: 7 males and 8 females aged 20-37 (average rate 27). In this group gastric juice was aspirated after administration of single 6 micrograms/kg BW stimulus of pentagastrin. Concentration and output of hydrochloric acid, pepsin, protein and carbohydrate components of gastric juice fucose, sialic acid, hexosamines and hexoses were measured. Carbohydrate components and proteins included informations concerning gastric mucus secretion into gastric lumen. It was shown that the highest gastric mucus secretion occurred before maximal gastric acid secretion. This is of importance for keeping balance between so called aggressive and protective mechanisms. It is of great importance in pathophysiology of stomach.

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