Endovideolaryngostroboscopy is the obliged evaluation tool in our everyday practice. Standardized protocol in management of broad spectrum of vocal pathology is useful in clinical, scientific and educational evaluation of patient from the first interview till the end of the treatment. Using of contemporary computerised multidimensional analysis of stroboscopic image we are approaching to optimum evaluation of any kind of interpersonal communication disorder. There were 66 patients in prospective clinical study of correlation between suspect endovideolaryngostroboscopic findings and histo-pathology verification of glottis carcinoma. Asymmetric and irregular vibrations with absent mucosal wave or absent vibrations of one part or of the whole vocal fold was improved as carcinoma in 85% of patients. The most frequent diagnosis was Ca planocellularae invasivum G2 NG 2, with subsequent open chordectomy. In every case of hoarseness longer more than 14 days, endovideolaryngostroboscopy is the golden standard for evaluating the need for microlaryngoscopy and biopsy.

The authors have analyzed a group of 90 patients (105 operations) that have underwent stapes surgery over three years period. First group of 40 patients (45 operations) have been operated on by a classic stapedotomy from 2006 to 2007 and the second group of 50 patients (60 operations) by inverse stapedotomy in 2007. Manual perforator has been used in all of the patients. In a group of patients operated by inverse technique not a single case of floating basal plate has occurred during surgery. Rate of postoperative complaints regarding nausea and balance disorders was considerably lower when reversal of the steps has been used. Closure of air bone gap better than 20dB in about 80% patients in both series, with slight advantage of the inverse technique, but no statistically significant difference was proven. Inverse stapedotomy is efficient procedure as compared to classic stapedotomy with less intraoperative complications and postoperative complaints. Postoperative audiograms have shown similar improvement of hearing thresholds in both groups.

Objectives: The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical treatment of headache caused by contact points (CPs) between the nasal septum and inferior or middle turbinate. Methods: The research was designed as a prospective clinical case-series study. The patients with CP headaches were offered to choose between 2 treatment options, surgery and medical treatment. Two groups of surgically treated patients (surgery groups 1 and 2, depending on whether there is a contact between nasal septum and inferior turbinate or middle turbinate) were evaluated and compared for headache intensity and frequency. Headache intensity was measured using a visual analog scale value from 0 to 10; the frequency of headache was expressed as the number of days during 1 month with a headache (before surgery, 1 month, and 6 months after surgery). A comparison was also made between surgically and nonsurgically treated patients. Results: We found more intensive and frequent headache in patients who had CP between the nasal septum and the middle turbinate ( P = .038 and P = .003, respectively). A significant reduction in headache intensity and frequency was found in both groups of surgically treated patients 6 months after surgery; however, this reduction was more significant in patients with mucosal contact between nasal septum and middle turbinate. The nonsurgical treatment made a significant reduction of headache intensity and frequency at 1-month follow-up ( P = .012 and P = .031, respectively), but not at 6-month follow-up ( P = .114 and P = .088, respectively). Conclusion: Surgery gave a statistically significant reduction in the intensity and frequency of headache, which was assessed 6 months after surgery. Surgery was found as superior to nonsurgical treatment in the therapy of CP headache.

Aspiration of foreign bodies of the lower respiratory tract is the most common cause of accidental death in children under 6 years of age in the United States. The aim of the study was to actualize the problem of foreign bodies in modern society, to determine the most common types of foreign body, who and why usually aspires foreign body, whether the incidence is changing, and to define principles for optimal prevention. During our five-year study, we had 166 cases of aspiration of foreign bodies of the lower respiratory tract. The incidence is highest in children under three years of age (54.8%). Cough (94.6%) and breathing difficulties (78.9%) were the dominated symptoms. The majority of aspirated objects were grain (peanuts, walnuts, sunflower seeds)--29.5%. Localization of foreign bodies was mainly in the right and left main bronchus, and the most common complications were atelectasis and emphysema. All patients had undergone a rigid upper tracheobronchoscopy and foreign body was found in 80 patients (48%). There was no need to perform neither tracheotomy, nor any further surgical treatment, as for example thoracotomy, in any patient. Good education is the best prevention.

Introduction. Primary sarcomas are uncommonly seen in larynx and comprise around 1% of all laryngeal malignant tumors. We present three cases of patients with different types of laryngeal sarcomas and discuss about diagnostic and treatment difficulties. Case outline. Each patient presented with hoarseness and shortness of breath. Computed tomography scans showed large transglottic tumors of the larynx with no signs of cervical lymphadenopathy and definitive diagnoses of sarcomas were made by pathologists. Each patient underwent total laryngectomy with clear resection margins. Patient with laryngeal leiomyosarcoma developed large locoregional relapse of malignant disease and pulmonary metastasis four months after surgery and patient with laryngeal osteosarcoma was diagnosed with inoperative locoregional relapse of malignant disease three months after surgery. Both patients died within six months after surgery. On the other hand, patient with laryngeal chondrosarcoma was disease-free during three-year follow-up. Conclusion. Primary laryngeal sarcomas have low incidence and they differ from SCC by their biological characteristics and behavior. Radical surgical resection remains the mainstay of treatment with uncertain outcome due to their high potential for recurrence or metastatic spread.

Carcinoma of unknown primary location are heterogeneous group of metastatic tumours where primary location could not be discovered with detail anamnesis, clinical examination and diagnostic procedures. Patients with metastasis carcinoma of unknown primary location in clinical oncology are represent with about 4% of total number of patients with solid tumours. The most frequent location carcinoma of unknown primary location, discovered with autopsy, are lungs, pancreas, colon, kidney, prostate and breast. Metastasis in cervical lymph nodes carcinoma of unknown primary location are represent between 3-9% of total number of patients with head and neck carcinoma. Patients with persistent cervical lymph node should be examined through diagnostical plan "step by step" for identification carcinoma of unknown primary location.

The Nomenclature Committee of the European Laryngological Society taken the personal classification used by various members were analyzed and integrated into a common format. Thus, a new classification (Remacle et al., 2000) end next modification (Remacle et al., 2007) in was proposed and accepted by the members. This nomenclature takes into account both the histological and anatomical extent of surgery, and groups it into several categories. Subepithelial cordectomy--excision of the epithelium and the superficial layer of the lamina propria. Subligamentous cordectomy--excision of the epithelium, Reinke's space, and vocal ligament is undertaken. Transmuscular cordectomy--resection consists of the epithelium, lamina propria, and part of the vocal fold muscle, and may extend from the vocal process to the anterior commissure. Total or complete cordectomy--excision extends from the vocal process to the anterior commissure. Anteriorly, the incision is made at the anterior commissure. Type Va extended cordectomy--includes the anterior commissure and contralateral vocal fold, if necessary. In type Vb extended cordectomy, the excision is extended to remove part or all of the arytenoids. The posterior arytenoids mucosa is preserved. In Type Vc extended cordectomy, the whole of the ventricle and the ventricular fold is removed together with the vocal fold. In Type Vd extended cordectomy, surgery is extended inferiorly to include the subglottic mucosa. Type VI cordectomy--Anterior billateral cordectomy in this operation surgical intervention is focused on anterior commissure, therefore some authors name it commissurectomy.

Pathological form of tympanograms is more often present in purely inflammatory changes of nasal cavities with higher nasal resistance than in mechanical nasal obstruction. All forms of higher nasal resistance are more often accompanied with Eustachian tube dysfunction. There was no significant differences in Eustachian tube passage between the subgroups and the control group.