Localisation and direction of spread in oral and oropharyngeal cancer in the material of Head and Neck Oncological Surgery Department, University of Medical Sciences in Poznań

The directions of tumor spread are determined by the anatomy of the affected organ. The vessel, nerve anatomy and presence of structures, that may potentially constitute a barrier for spread out of the tumor are of crucial importance. The aim of this paper was to presentation of the spreading directions of oral cavity and oropharyngeal squamous cell cancer based on the own experience. Material include 163 patients surgically treated between 2003-2003 in Department of ENT, Head and Neck Oncological Surgery Department in Poznań. The examination was conducted on the base of retrospective analysis of ambulatory charts and the hospital files. Results: 163 (90%) patients were operated for primary oral and oropharyngeal cancer. The primary localization included in the palatine tonsil (82 patients), trunk of the tongue (48 patients) and floor of the mouth (20 patients) were predominated. The spread directions included: floor of the mouth (36) soft palate (35), base of tongue (33), hypopharynx (20) and trunk of tongue (16). The 31 crossed the midline, 27 infiltrated the tonsillopalatine angle, 9 retromolar area and 3 the mucosa of the cheek. Knowledge of anatomy facility in clinical evaluation of spreading malignancy. It helps in proper qualification to surgery or radiotherapy.     

Methods of larynx phoniatory function measurement in the Poznań University Department of Ear, Throat, Nose and Larynx Diseases between 1922 and 1939

INTRODUCTION: Indirect laryngoscopy development and progress initiated in 1854 by the autolaryngoscopy of the famous singing voice teacher Manuel Garcia in ENT speciality is connected with the names of L. Tuerck and J.N. Czermak, the last one being called the father of laryngoscopy. In 1878 M. Oertel used for the first time stroboscopic light in indirect laryngoscopy. The perception of stroboscopic picture is based on the Talbot principle. OBJECT OF THE PAPER: Two apparatuses used for the evaluation of larynx function in the Poznań ENT Department before the II World War are presented:--Polylaryngoscop enabling evaluation the indirect laryngoscopy simultaneously by several individuals.--Mechanical stroboscop of Oertel type with perforated disc moved by electrical engine. CONCLUSION: For 130 years laryngostroboscopy belongs to the basic examination methods of larynx phonatory function.     

Epidemiological features of cancers of the oral cavity,oropharynx, hypopharynx and larynx cancer in Réunion Island

IntroductionThis study had two objectives: firstly, to identify and compare characteristics of cancer of the oral cavity, oropharynx, hypopharynx and larynx in Réunion Island, a tropical French overseas territory in the southern hemisphere; and secondly, to discuss how incidence of these cancers is presented in the international literature.Material and methodA retrospective study included 599 patients diagnosed with cancer of the oral cavity, oropharynx, hypopharynx or larynx between 2009 and 2013 in Réunion Island. Demographic characteristics and data on alcohol consumption, smoking habits and HPV infection were analyzed. Standardized incidences were calculated for the worldwide population for both genders.ResultsSex ratio was 7.7 and mean age was 60 years. Cancer consisted of squamous cell carcinoma in 99.1% of patients. Three hundred and forty over 375 patients (81.25%) showed alcohol abuse; 309/359 (86.1%) were smokers; 31/184 (16%) had HPV infection. On the International Agency for Research on Cancer (IARC) anatomic classification, the incidence of “other pharynx” locations was 9.3/100,000 for men and 0.7/100,000 for women, and incidence of “larynx” locations was 6.4/100,000 for men and 0.4/100,000 for women.ConclusionRéunion Island features some particularities in terms of incidence: women are less than half as likely as in Metropolitan France to develop any type of cancer, whereas incidence in males is among highest in France. The presentation of results in cancer registries could be improved in line with everyday practice in head and neck surgery.     

Foreign bodies in the lower respiratory tract: experience based on materials gathered in the ENT department of the Poznań Higher School of Medical Sciences between 1945 and 1997

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.     

ORIGINAL ARTICLE: Squamous cell carcinoma of the oral tongue in patients younger than 30 years: clinicopathologic features and outcome

Clin. Otolaryngol. 2010, 35 , 307–312 Objective: To assess the possible effect of young age on clinical behaviour and survival outcome of squamous cell carcinoma of the oral tongue. Design: Retrospective, case control study. Setting: A major tertiary referral centre. Participants: Eighty-five patients with oral tongue squamous cell carcinoma with at least 2 years of follow-up. Main outcome measurements: Clinical and histopathological staging, disease-free survival, disease-specific survival and overall survival. Results: Eleven patients (13%) were younger than 30 years. Compared to the older patients, they had a significantly worse N stage (P = 0.041), more perineural invasion (P = 0.012), and higher rates, though not significant, of treatment failure (46%, including 60% with distant metastases, versus 35%, nearly all locoregional) and mortality (100% of treatment failures versus 73%). There were no significant between-group differences in 5-year disease-free, disease-specific, and overall survival. Conclusion: In this study, patients younger than 30 years of age presented with advanced tumour stages and with a different failure pattern compared to the older age group. This may be attributable to age-related biologic behaviour or delayed cancer diagnosis. Differences in disease free survival and overall survival could not be established.     

Does Epstein-Barr virus infection have an influence on the development of laryngeal carcinoma? Detection of EBV by Real-Time Polymerase Chain Reaction in tumour tissues of patients with laryngeal carcinoma

Epstein-Barr virus (EBV) is a well-known carcinogenic virus, and the association of EBV with some tumours suggests that there may also be an association between laryngeal carcinoma and EBV.ObjectiveThe aim of this study is to determine the role of EBV in the aetiology of laryngeal carcinoma.MethodProspective investigation the EBV with real time polymerase chain reaction in tumour tissues of 25 patients with laryngeal carcinoma and 17 patients with benign laryngeal lesions, and investigation of the relationship between the presence of viral DNA and patients’ smoking habits, alcohol consumption, localization and differentiation of the tumour.ResultsThere was no significant difference between the control group and patient group in terms of EBV polymerase chain reaction positivity (p > 0.05). Also we couldn't find a statistically significant relationship between EBV positivity and differentiation of the tumour, localization of the tumour, smoking and alcohol consumption habits (p > 0.05).ConclusionOur results suggest that, although EBV is present in some of the squamous cell laryngeal carcinomas, its presence has no effect on the pathogenesis of laryngeal carcinomas.     

Hearing loss induced by occupational and impulse noise: Results on threshold shifts by frequencies,age and gender from the Nord-Trøndelag Hearing Loss Study

The aim of the study was to compare the frequency-specific effects of noise on hearing acuity across the range 250–8000 Hz and the extent to which the patterns of frequency-specific threshold shifts differ between occupational noise and impulse noise. Pure-tone audiometry was administered to an adult general population sample with 51?975 subjects who also provided questionnaire information about noise exposure and other risk factors. Threshold shifts induced by life-long occupational noise and impulse noise (mostly shooting) were estimated separately in six age and sex groups for eight frequencies. Reported noise exposure, as well as observed threshold shifts, were moderate among women. Threshold shifts averaged over both ears among subjects in the higher 2% of exposure to occupational noise, reached 13 dB (3000 Hz, age 65 years?+?) among men and were generally largest at 3000–4000 Hz. The shifts induced by impulse noise reached approximately 8 dB among men 45–64 years and men 65 years+. The effects of impulse noise were strongest at 3000–8000 Hz and varied little within this frequency range.     

Hearing loss induced by occupational and impulse noise: results on threshold shifts by frequencies, age and gender from the Nord-Trøndelag Hearing Loss Study

The aim of the study was to compare the frequency-specific effects of noise on hearing acuity across the range 250-8000 Hz and the extent to which the patterns of frequency-specific threshold shifts differ between occupational noise and impulse noise. Pure-tone audiometry was administered to an adult general population sample with 51 975 subjects who also provided questionnaire information about noise exposure and other risk factors. Threshold shifts induced by life-long occupational noise and impulse noise (mostly shooting) were estimated separately in six age and sex groups for eight frequencies. Reported noise exposure, as well as observed threshold shifts, were moderate among women. Threshold shifts averaged over both ears among subjects in the higher 2% of exposure to occupational noise, reached 13 dB (3000 Hz, age 65 years + ) among men and were generally largest at 3000-4000 Hz. The shifts induced by impulse noise reached approximately 8 dB among men 45-64 years and men 65 years+. The effects of impulse noise were strongest at 3000-8000 Hz and varied little within this frequency range.     

Is the relation of social class to change in hearing threshold levels from childhood to middle age explained by noise,smoking, and drinking behaviour?

Recent work shows that variation in adult hearing function is related both to social class of origin and current social class. This study examines how much of this relationship after adjustment for childhood hearing impairment is explicable by occupational noise, current smoking, and alcohol consumption. A cohort of 9023 persons born in the UK during one week in 1958 was followed periodically, and hearing threshold levels (HTLs) were measured at 1 kHz and 4 kHz at age 45 years. Most (71% and 68%, at 1 kHz and 4 kHz respectively) of the relation to social class of origin of adult HTLs remains after adjustment for these other factors. For the relation to current social class, corresponding values are 64% and 44% (though varying by gender). The magnitude of social class effect is comparable to that of occupational noise. Susceptibility to hearing impairment is likely to be appreciably determined in early childhood.     

Is the relation of social class to change in hearing threshold levels from childhood to middle age explained by noise, smoking, and drinking behaviour?

Recent work shows that variation in adult hearing function is related both to social class of origin and current social class. This study examines how much of this relationship after adjustment for childhood hearing impairment is explicable by occupational noise, current smoking, and alcohol consumption. A cohort of 9023 persons born in the UK during one week in 1958 was followed periodically, and hearing threshold levels (HTLs) were measured at 1 kHz and 4 kHz at age 45 years. Most (71% and 68%, at 1 kHz and 4 kHz respectively) of the relation to social class of origin of adult HTLs remains after adjustment for these other factors. For the relation to current social class, corresponding values are 64% and 44% (though varying by gender). The magnitude of social class effect is comparable to that of occupational noise. Susceptibility to hearing impairment is likely to be appreciably determined in early childhood.     

Micrometastases in cervical lymph nodes from patients with squamous carcinoma of the head and neck: should they be actively sought? Maybe

Techniques are now being developed, which allow ever smaller metastatic deposits in regional lymph nodes to be detected; the question is, should they be sought, or does their presence convey no additional information for treatment of head and neck carcinoma patients at this time? Preliminary findings have suggested that the presence of micrometastases may carry with it some prognostic information, and as a consequence, the search for micrometastases would, for the foreseeable future, appear to be a fertile ground for investigation. To bring some uniformity to this project, it is suggested that these definitions be adopted: a micrometastasis measures greater than 0.2 mm but less than 2.0 mm in diameter, and smaller deposits should be designated as isolated tumor cells, which, in turn, are subdivided into those isolated tumor cells detected by light microscopy, immunohistochemistry, or molecular methods. At this juncture, the import of such micrometastases remains in the realm of the clinical investigator--it remains an open question whether the identification of micrometastases (however they may ultimately come to be defined) will prove to have an impact on the care of head and neck cancer patients.     

100 years of the Otto Körner ENT Clinic, Rostock. The merits of Christian Lemcke and Otto Körner in the development of ENT specialty

BACKGROUND: The first special ENT hospital in Germany and northern Europe, the Department of Otorhinolaryngology, Head- and Neck-Surgery "Otto K?rner" in Rostock is celebrating its 100th anniversary on October 25, 1999. METHODS: There is a presentation on the efforts in the ENT-specialty from the beginning considering the special situation at the university of Rostock. RESULTS: The efforts of Christian Lemcke (1850-1894), who associated the three sections Otology, Laryngology and Rhinology are appreciated, Otto K?rner (1859-1935) continued this development. He achieved the building of a special ENT-hospital by his excellent knowledge and surgical skills. The opening date was October 25, 1899, K?rner became the first full professor in Otology and Laryngology in Germany in 1901. His "Textbook Of Otology And It's Bordering Specialties" was published in 1906. As one of the first, he supported the independence of ENT-medicine as a separate field in the course of medicine. CONCLUSION: Today, Otto K?rner's claims are more relevant than ever before, because the today's students in their practical course of medicine and even young doctors at the hospitals obviously show a lack of knowledge in the ENT-field. The current "multiple choice" type of examinations could be one of the main reasons.