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We assayed 38 middle ear effusions from 23 children aged 4-13 years (mean 7) undergoing tympanostomy tube placements. All fluid was assayed for tumor necrosis factor (TNF) alpha, interleukin (IL) 1beta, IL-8, and IL-10. Cytokine concentrations were measured by means of an enzyme-linked immunosorbent assay. Detectable levels of IL-1beta, IL-8, and IL-10 were found in all of the effusions. TNF-alpha was detected in 18 of the middle ear effusions (47.4%). The mean concentration of TNF-alpha, IL-1beta , IL-8, and IL-10 was, respectively, 0.423 +/- 1.39, 30.58 +/- 68.7, 7001.9 +/- 6743, and 56 +/- 58.7 pg/ml. There was a strong, statistically significant correlation between the concentrations of TNF-alpha and IL-1beta (r = 0.87, P = 0.001) and between IL-1beta and IL-8 (r = 0.53, P = 0.001). There was no correlation between the concentrations of IL-10 and other cytokines examined or between tympanic membrane pathology and the concentrations of TNF-alpha, IL-1beta , IL-8, or IL-10. The presence of IL-10 in middle ear effusions may be one of the causes of a lack of clinical features of acute inflammation and may lead to a chronic inflammatory state.

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Celluar DNA content has been found to be an important prognostic factor in many head and neck tumours, yet within the larynx few studies have examined its effect on survival. 31 patients with squamous carcinoma of the larynx treated in years 1983-85 by total laryngectomy were studied. The tumours were classified according to the TNM classification 1987 and graded histopathologically according to Jaccobson's classification. Quantitative DNA content was determined with the use of image cytometry performed by an image analyzer (CAS-200). Quantitative DNA analysis correlated with tumor grade and patient outcome within 6 years of follow-up.

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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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This study was carried out to investigate the features of hearing impairment in subjects with Down syndrome. Forty-seven children and 14 adults with Down syndrome were included in the study. In all cases, a complete otorhinolaryngological examination was performed, followed by audiological assessment. Depending on age, intellectual level and middle ear status the following examinations were performed: pure-tone 'play audiometry', tympanometry, acoustic reflex, auditory brain response (ABR) and distortion products otoacoustic emissions (DPOAE). The results were compared with age matched control groups. Among the group of children with Down syndrome, we have frequently found impairment of the conductive function of the middle ear which was expressed by pathological tympanometry. Tympanometry of B and C type was detected in 56% of ears. The amplitude of DPOAE was lower in children with Down syndrome than in the control group. This difference was more expressed in adults with Down syndrome. DPOAE examination results in subjects with Down syndrome without conductive hearing loss indicate early age related inner ear impairment.

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Partial horizontal supracricoid laryngectomy with cricohyoidopexy at the Department of Otolaryngology, Medical University of Bialystok, involves resection of the entire thyroid cartilage with the pre-epiglottic and paraglottic spaces. Experience has shown that this technique will permit adequate phonation, respiration and deglutition in selected advanced cases of supraglottic and glottic carcinoma. The purpose of this study was to verify histologically the indications for this surgery by examining sections of whole-organ laryngeal specimens. Post-laryngectomy specimens from 90 patients with otherwise previously untreated supraglottic (48), transglottic (22) and glottic (20) carcinomas were reviewed retrospectively. The majority (66) of the specimens were staged as pT4. Findings showed that 22 of the specimens analyzed (mostly supraglottic tumors) could have been eradicated by supracricoid laryngectomy alone. The present study confirmed the principles of supracricoid laryngectomy for selected large tumors.

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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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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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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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19 patients have been checked by the ENG control examination who had demonstrated during first examination lack of evoked Ny in one direction. The control examinations have been conducted from a few months to 4 years after the first ENG examination. Obtained results showed out that lack of evoked Ny in one direction can be persist or can be improved by going into symmetrical directional preponderance, after that in some cases coming to restitution and integrum. It can be explained by the degree of brainstem reticular substance lesion. The obtained results from the study allow to conclude, that lack of evoked Ny in one direction and coming after it the symmetrical directional preponderance have a topo-diagnostic value.

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23 years old woman with sudden deafness and ipsilateral lack of rapid phase caloric nystagmus was described. The necessity of multi-discipline examination was stressed.

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