Jarosław Markowski

Publications of Jarosław Markowski

• [16 years of experience in laryngeal microsurgery with use laser CO₂: cooperation between laryngologist and anesthesiologist - in material of ENT Department of Silesian Medical University].

  Authors: Jarosław Markowski, Zdzisława Sachajdak-Michalewska, Tatiana Gierek, Danuta Zbrowska-Bielska, Małgorzata Witkowska, Jarosław Paluch

  Otolaryngologia polska. The Polish otolaryngology. 11/2011; 65(6):417-22.

  Laryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laserLaryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laser technology. The laryngeal microsurgery is used mainly laser CO₂. Endoscopic laryngeal microsurgery using the laser poses a unique challenge to the anesthesiologist, ensuring safe conditions of anesthesia, the patient and simultaneously appropriate operating conditions for the surgeon for precisely perform the procedure. MATERIAL AND METHODS: Between 1995 and 2010 carried out in the Department of Otolaryngology SUM 832 microsurgical operations of the larynx using a CO₂ laser. CONCLUSION:The perioperative management and close cooperation with the surgeon and anesthesiologist are essential for safe and efficient conduct of the operation the larynx using a microsurgical CO₂ laser.

• Assessment of vestibulocochlear organ function in patients meeting radiologic criteria of vascular compression syndrome of vestibulocochlear nerve--diagnosis of disabling positional vertigo.

  Authors: Jarosław Markowski, Tatiana Gierek, Ewa Kluczewska, Małgorzata Witkowska

  Medical science monitor : international medical journal of experimental and clinical research. 02/2011; 17(3):CR169-73.

  This study sought to assess the vestibulo-cochlear organ in patients meeting radiologic criteria of vascular compression syndrome (VCS) of the eighth cranial nerve. The authors performed aThis study sought to assess the vestibulo-cochlear organ in patients meeting radiologic criteria of vascular compression syndrome (VCS) of the eighth cranial nerve. The authors performed a retrospective analysis of 34 patients (18 women, 16 men; mean age, 49 years) treated in between 2000 and 2007, with VCS of the eighth cranial nerve by MRI. Contrasted magnetic resonance imaging identified an anterior inferior cerebellar artery vascular loop adhering to the vestibule-cochlear nerve in all 34 cases. All patients were given pure tone audiometry, distortion product otoacoustic emissions, auditory brainstem response, and electroneurographic examinations. Most-common symptoms were unilateral hearing loss (82%), unilateral tinnitus (80%), and dizziness (74%). Most-frequent abnormalities in performed examinations were specific auditory brainstem response changes (interpreted according to Möller's criteria) in 86% of cases and sensorineural hearing loss in pure tone audiometry (82%). Abnormal changes in electronystagmography were found in the absence (12%) or weakness (35%) of a caloric response. No patients were surgically treated. Significantly, there is no more weakness or absence of the caloric response of a vestibular organ in a patient with vascular compression of the vestibulo-cochlear nerve. Despite an absence of electrophysiologic testing of vestibular organ dysfunction, most examined patients (meeting the radiologic criteria of VCS of the eighth cranial nerve) had subjective symptoms like vertigo and dizziness. Disabling positional vertigo should be considered in the differential diagnosis of vertigo when accompanied by tinnitus or deafness.

• The assessment of hearing organ of school children in Upper Silesia region.

  Authors: Tatiana Gierek, Małgorzata Gwóźdź-Jezierska, Jarosław Markowski, Małgorzata Witkowska

  International journal of pediatric otorhinolaryngology. 10/2009;

  Because at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a researchBecause at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a research programme. An important advantage of this study is the assessment of hearing in children from Upper Silesian region, a top ranking region in Europe in industrialisation and environmental pollution. In the selected population of primary school children in the province of Silesia, hearing loss occurred in 6% of the examined pupils; in schools located in urban areas it was higher than in schools from rural areas. In the group of children aged 6-10 years conductive hearing loss occurred significantly more frequently, than main cause of that hearing loss was Eustachian tube dysfunction. The obtained results testify about the society being hardly aware of the problems related to hearing loss, which stresses the necessity of conducting screening examinations of hearing organ in children at school age, as well as improving the health care and prevention in that respect.

• [Distant metastases to the parotid gland--review of the literature and report of own two cases]

  Authors: Jarosław Markowski, Tatiana Gierek, Ewa Zielińska-Pajak, Małgorzata Witkowska, Anatol Wodołazski, Jacek Pajak, Jarosław Paluch

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(4):547-52.

  Metastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland. The parotid gland and its lymph nodes are possible sites of metastases from head andMetastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland. The parotid gland and its lymph nodes are possible sites of metastases from head and neck cancers. However, metastasis from distant primary neoplasm below clavicle is possible, too. The authors presented the two cases of distant metastases to the parotid gland. The women with breast cancer and metastases to the parotid gland 11 years after surgery, radio- and chemotherapy of breast cancer. She died 7 months after parotid surgery of systemically advanced disease. The man with metastasis of malignant melanoma of unknown primary site. He underwent total parotid surgery with the tumor and lymph nodes. He died 7 months after surgery. In spite of intensive exam the primary location of the melanoma was unknown. The authors described pathophysiology of distant metastases to the parotid gland with special attention to possibilities of treatment and survival.

• [The use of the vocal prosthesis Provox 2 for speech rehabilitation after total laryngectomy]

  Authors: Jarosław Markowski, Tatiana Gierek, Jarosław Paluch, Piotr Wardas

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(3):373-7.

  The authors have presented the application and usage the alloplastic vocal prosthesis Provox 2 to serve for rehabilitation speech after total laryngectomy. Surgical technique of implantation of vocalThe authors have presented the application and usage the alloplastic vocal prosthesis Provox 2 to serve for rehabilitation speech after total laryngectomy. Surgical technique of implantation of vocal prosthesis was discussed. The authors estimated in 6 patients following parameters of speech; fundamental frequency, maximum phonation time of vowel "a", maximum intensity and degree of dysphonia. In all 6 cases post-operative course was uncomplicated. Above mentioned parameters of voice were measured in order to comparison quality of oesophageal speech to tracheo - oesophageal speech. The authors assessed speech at 6 patients with voice prosthesis and 6 with good oesophageal speakers as a control group. The results of our investigations showed, that quality of tracheo - esophageal speech obtained with usage vocal prosthesis Provox 2 is more like normal speech than oesophageal speech. Social efficiency and quality of tracheo - oesophageal voice is better than oesophageal voice.

• [Disabling positional vertigo (DPV): syndrome of vestibulo-cochlear organ impairment during vascular compression of the vestibulo-cochlear nerve (VCS)]

  Authors: Tatiana Gierek, Jarosław Markowski, Krystyna Majzel, Piotr Wardas

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(3):403-7.

  In 1984 Jannetta et al. introduced a new term-disabling positional vertigo (DPV). DPV is a term used to describe syndrome of cochleo-vestibular organ impairment during vascular compression syndromeIn 1984 Jannetta et al. introduced a new term-disabling positional vertigo (DPV). DPV is a term used to describe syndrome of cochleo-vestibular organ impairment during vascular compression syndrome of eight cranial nerve. They introduced this term to distinct this syndrome from other established vertigo syndromes on the basis of recognized in angio - MRI exam compression of VIII nerve by vessel and clinical and electrophysiological criteria. Existence of DPV syndrome is still not universally accepted, because it is difficult to diagnose vertigo as vascular compression syndrome of the eight cranial nerve when there are no specific finding to detect this syndrome. Only Moller proposed specific ABR abnormalities as a criterion in DPV diagnosis (prolongation of I - III interval). The authors performed retrospective analysis of 28 patients (16 female, 12 men, average age 43) with recognized on basis angio - MRI vascular compression syndrome of eight cranial nerve. Contrasted magnetic resonance imaging identified a vascular loop near to cochleo - vestibular nerve in all 28 cases. All patients were performed pure tone audiometry, DPOAE, ABR and ENG exam. The most common symptoms were unilateral tinnitus (89% cases), unilateral hearing loss (86%) and dizziness (61%). The most frequent abnormalities in above mentioned exams were sensorineural hearing loss in pure tone audiometry (92%). ABR data were interpreted with respect to Mollerís criteria and asymmetry of the I - III, III - V and I - V interval and prolongation of V waves in the auditory brainstem response was found in 36% cases. Abnormal changes in electronystagmography were found: absence (10%) or weakness (36%) of caloric response. The differential diagnosis of DPV syndrome are discussed. We could not find any specific clinical findings valuable for DPV diagnosis. There is no significantly more weakness or absence of caloric response of vestibular organ in patients with DPV. Disabling positional vertigo is the syndrome which should be considered in differential diagnosis in every case of vertigo.

• [Primary extranodal non-Hodgkin's malignant orbital lymphomas treated surgically in ENT Department of Medical Academy of Silesia in Katowice in the years 1996-2001]

  Authors: Tatiana Gierek, Jarosław Markowski, Ewa Zielińska-Pajak, Małgorzata Witkowska, Maciej Kajor, Jacek Pajak, Lukasz Kulesa, Jarosław Paluch

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2005; 58(11-12):598-601.

  The authors presented 7 cases of primary extranodal non-l-odgkin's malignant orbital lymphomas in patients treated surgically in the ENT Department of the Medical University of Silesia in the yearsThe authors presented 7 cases of primary extranodal non-l-odgkin's malignant orbital lymphomas in patients treated surgically in the ENT Department of the Medical University of Silesia in the years 1996-2001. In the course of the diagnostic process we examined the patients carefully to be sure that the cancer had not disseminated. We used some imaging techniques such as: ultrasonography (USG), computer tomography (CT) and magnetic resonance imaging (MRI). We also used the needle aspiration biopsy, as an additional examination. However the material was no significant in the most cases and we were unable to make a definitive diagnosis on the basis of this method alone. After prior examinations we performed the radical operations and removed the tumors. In each case the postoperative material was examined using histopatological and immunohistochemical methods. Afterwards the pathomorphological diagnosis was made by the specialists. Next the patients were observed and treated in the Haematological and Radiotherapy Departments.

• [The evolution of epidemiology and clinical characteristics of laryngeal and hypopharyngeal carcinoma in Poland from 1991 to 2001]

  Authors: Stanisław Bień, Bartłomiej Kamiński, Stanisław Zyłka, Ryszard Mezyk, Zdzisław Piasta, Jarosław Markowski, Jarosław Paluch, Magdalena Kordylewska, Małgorzata Wierzbicka, Kamal Morshed [......] Antoni Bruzgielewicz, Ewa Osuch-Wójcikiewicz, Leszek Szymański, Tomasz Krecicki, Piotr Karasiewicz, Wojciech Mikulewicz, Aldona Pietrysiak, Dariusz Jurkiewicz, Paweł Kubik, Tadeusz Janeczek

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(2):169-81.

  On the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiologicalOn the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiological data, including the localization of tumor and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 11 years the trends to change of the mentioned above parameters has been examined. The significant increase of female patients in this period was observed, with average proportion M:F = 8:1. The glottis localization of carcinoma dominated (47.6%), followed by supraglottis (40.8%) and pyriform fossa (7.8%), with significant increase of pyriform fossa tumors in the analyzed period of 11 years. In the majority of cases the carcinoma of larynx and hypopharynx was diagnosed in the advanced stage (T3 + T4) of local disease, with the highest percentage in localization within the pyriform fossa (81.0%), and the lowest percentage in glottis tumors (45.6%). The regional lymph nodes metastases has been diagnosed in 46.7% of the analyzed group, with the highest percentage in tumors localized in pyriform fossa (82.9%), and the lowest percentage in tumors of glottis localization (33.1%). In the 11 years time the significant drop down of N0 cases and tendency to increase of N2 and N3 in the supraglottis localization of tumor. The distant metastases in the analyzed group at the time of diagnosis has been registered in 2.0%, with the highest percentage in posterior pharyngeal wall (7.6%) and pyriform fossa (7.4%). The authors postulate the renewal of prospective study on epidemiology, clinical characteristics and treatment results of larynx and hypopharynx carcinoma in Poland.

• [Histologic and clinical assessment of primary extranodal non-Hodgkin malignant lymphomas of the head and neck region]

  Authors: Jarosław Markowski, Maciej Kajor, Tatiana Gierek, Małgorzata Witkowska, Lukasz Kulesa, Maciej Ligienza, Jacek Pajak, Joanna Wolańska-Karut

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(3):429-35.

  The authors presented 27 cases of primary extranodal non-Hodgkin's malignant lymphomas of the head and neck area in patients treated surgically in the ENT Department in the years 1996-2001. WeThe authors presented 27 cases of primary extranodal non-Hodgkin's malignant lymphomas of the head and neck area in patients treated surgically in the ENT Department in the years 1996-2001. We observed tumors in the various areas: palatine tonsil, naso-pharynx, eye socket, paranasal sinuses, parapharyngeal space and lingual base. In the course of the diagnostic process we examined the patients carefully to be sure that the cancer had not disseminated. We used some imaging techniques such as: ultrasonography, CT and MRI. We also used the needle aspiration biopsy, as a additional examination. However the material was not significant in the most cases and we were unable to make a definitive diagnosis on the basis of this method alone. After prior examinations we performed the radical operations and removed the tumours. In each case the postoperative material was examined using immunohistochemical methods. Afterwards the pathomorphological diagnosis was made by the specialists. Next the patients were observed and treated in the Haematological Department and Radiotherapy Department. In all cases pathomorphological diagnosis were performed on the base of usage postoperative histochemical examinations. All treated patients were performed as diagnostic preoperative USG, CT, MRI and fine-needle biopsy aspiration exam. All patients for further treatment were observed at Haematological Department.

• [Spectral and spectrographic voice acoustic analysis in selected patients after various types of partial laryngectomy for malignant neoplasms after radiotherapy]

  Authors: Jarosław Markowski, Tatiana Gierek, Krystyna Majzel, Danuta Zbrowska-Bielska, Jarosław Paluch, Witold Mrukwa, Janusz Kompała

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(3):395-401.

  The aim of this study is the assessment of voice pathology in patients after various types of partial laryngectomy because of malignant neoplasms and after Co--60--therapy. Voice quality in aboveThe aim of this study is the assessment of voice pathology in patients after various types of partial laryngectomy because of malignant neoplasms and after Co--60--therapy. Voice quality in above mentioned diseases and in healthy patients was compared. Voice was analysed by subjective (videostroboscopy) and objective spectrographic methods. This method seems to be very valuable to assess social efficiency of voice.

• [Neuroendocrine carcinoma of the larynx--review of literature and report of 2 own cases]

  Authors: Jarosław Markowski, Tatiana Gierek, Maciej Kajor, Łukasz Kulesa, Małgorzata Witkowska, Monika Ciupińska-Kajor

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(2):291-4.

  A review of the international medical literature was conducted regarding the laryngeal neuroendocrine tumors. This paper discusses the diagnosis, histopathology, treatment, and prognosis in laryngealA review of the international medical literature was conducted regarding the laryngeal neuroendocrine tumors. This paper discusses the diagnosis, histopathology, treatment, and prognosis in laryngeal neuroendocrine tumors. It also discusses the heterogenous classification schema of such tumors. Two cases of a very rare neuroendocrine cancer of larynx are described. Both were localized in the supraglottic area and occurred in the 5th and 6th decades of life, consistent with previously reported cases of such neoplasms.

• The influence of environmental pollution on the amount of glycosoaminoglycans in the tissue of palatine tonsils.

  Authors: Maria Wardas, Tatiana Gierek, Jarosław Paluch, Katarzyna Pawłowska-Góral, Jan Pilch, Jarosław Markowski

  Pathology, research and practice. 02/2002; 198(6):425-7.

  In this study, we investigated persons exposed to high and low air pollution caused by metals. This investigation was done against the background of changes in the connective tissue of palatineIn this study, we investigated persons exposed to high and low air pollution caused by metals. This investigation was done against the background of changes in the connective tissue of palatine tonsils. We evaluated the qualitative and quantitative composition of glycosoaminoglycans (GAG) isolated from palatine tonsils. GAGs were separated by column chromatography. We found that as the total amount of GAGs increased, the amount of heparin and chondroitin sulphate also increased, whereas the amount of hyaluronic acid, dermatane sulphate, heparane sulphate and keratane sulphate decreased. The changes observed in the amount of GAGs in the tissue of palatine tonsils can influence the incidence of infections of the upper airways.

• [Assessment of hearing organ ability in high-frequency auditory in patients suffering from chronic renal failure treated by haemodialysis and human recombinant erythropoietin (rhPEO)]

  Authors: Jarosław Markowski, Tatiana Gierek, Andrzej Wiecek, Dariusz Klimek, Jerzy Chudek

  Otolaryngologia polska. The Polish otolaryngology. 02/2002; 56(5):589-96.

  The problem of hearing loss occurrence in the course of chronic renal failure (CRF) was investigated in numerous research studies, attempting to explain both the etiological factors and treatmentThe problem of hearing loss occurrence in the course of chronic renal failure (CRF) was investigated in numerous research studies, attempting to explain both the etiological factors and treatment possibilities. According to various authors, the percentage of hearing loss occurrence in patients suffering from CRF differs between 20% and 80%. The idea of this paper is based on an observation that if peripheral blood parameters such; haemoglobin, amount of red blood cells improve when influenced by rhEPO, then tissue oxidation improvement connected with it causes also better metabolism of cilliar's cells, what helps to improve hearing. The purpose of this study has been to assess the influence of treatment with human recombinant erythropoietin obtained through genetic recombination and by haemodialysis upon the condition of the hearing organ in patients with CRF (as a result of both a single procedure and long-term treatment). 65 haemodialysed patients with chronic renal failure were enrolled in this study. 31 of them (with haematocrit value below 28%) were treated with rhEPO for 4 months (3 times a week, 4000 units). The remaining 34 patients (with haematocrit values of above 28%) were not treated with rhEPO. Impairment of hearing was found in 87.1% of the CRF patients examined, while the hearing loss in high frequency range (9-18 kHz) was significantly more pronounced than those observed in the conventional range. In 70% of the patients the hearing loss was the cochlear type. Thus, combining haemodialysis with recombinant human erythropoietin in treatment of CRF patients results in significant improvement of hearing, correlated with positive results in fighting anaemia. The improved hearing found is, most surely, related to better oxygen supply of ciliated cells of internal ear, resulting from improved oxygen supply in peripheral blood and tissues of the body, and may also be related to the centric activity of erythropoietin, as the presence of receptors for EPO was found in the central nervous system (CNS) neurocytes, and it was also proven that EPO is produced in CNS, probably in astrocytes.

• [The evolution of threshold values of air conduction in the extended high frequency range (9-18 kHz) in patients suffering from the pulmonary tuberculosis treated with combination of SM, INH, RFM, and PZA]

  Authors: Tatiana Gierek, Jarosław Markowski, Jolanta Kieda-Szurkowska, Jarosław Paluch, Ireneusz Bielecki

  Pneumonologia i alergologia polska : organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruźlicy i Chorób Płuc. 02/2002; 70(5-6):296-304.

  The evolution of threshold values of air conduction in the extended high frequency range (9-18 kHz) at patients suffering from the active pulmonary tuberculosis treated with the combined therapy (SM,The evolution of threshold values of air conduction in the extended high frequency range (9-18 kHz) at patients suffering from the active pulmonary tuberculosis treated with the combined therapy (SM, INH, RFM, PZA). There were audiologically examined 13 patients (the average age 41.2) suffering from the active pulmonary tuberculosis and treated with the combined therapy (SM, INH, RFM, PZA). In 13 tuberculosis patients the full range of audiometric tests and measurements including: the pure tone audiometry, acoustic impedance and the extended high frequency range threshold audiometry (9-18 kHz) have been applied before starting the treatment with SM, INH, RMP and PZA and in the two months later--after its completion. The reference group was composed of 10 audiologically healthy individuals (the average age 40.2). A significant hearing loss with respect to air conduction within the extended range of high frequencies (9-17 kHz) was stated. The said hearing pathology can be diagnosed at earlier stages by the use of the extended high frequency range audiometry than through applying methods of conventional audiometry.

• [Electrophysiological examinations (ABR and DPOAE) of hearing organ in hemodialysed patients suffering from chronic renal failure]

  Authors: Tatiana Gierek, Jarosław Markowski, Franciszek Kokot, Jarosław Paluch, Andrzej Wiecek, Dariusz Klimek

  Otolaryngologia polska. The Polish otolaryngology. 02/2002; 56(2):189-94.

  Deterioration of function of hearing organ is one of the most important clinical problem in uremic patients with chronic renal failure. The present study aimed to assess the function of hearing organDeterioration of function of hearing organ is one of the most important clinical problem in uremic patients with chronic renal failure. The present study aimed to assess the function of hearing organ using the brainstem auditory evoked responses (ABR), impedance audiometry and distortion product otoacoustic emission cochlear function (DPOAE) in 31 haemodialysed patients with chronic renal failure (16 females and 15 males, mean age 43.0 years). The control group consisted of 15 healthy subjects. The latency of the waves I, III, V and I-V interpeak in evoked response audiometry were significantly longer in the patients with CRF (chronic renal failure) compared to the control group. Measurement of DPOAE showed decrease of DPOAE level in patients suffering from CRF. A influence of single hemodialysis and treatment of hemodialysis by 6 months on ABR latencies and DPOAE values were not observed.

• [Gene expression profile in laryngeal cancer in vivo by high-density oligonucleotide microarrays analysis].

  Authors: Jarosław Markowski

  Otolaryngologia polska. The Polish otolaryngology. 64(6):400-2.

• [Head and neck tuberculosis - still current problem in ENT practice].

  Authors: Jarosław Markowski, Małgorzata Witkowska, Tatiana Gierek, Katarzyna Pasternak, Monika Ciupińska-Kajor, Maciej Kajor, Jarosław Paluch, Katarzyna Smółka

  Otolaryngologia polska. The Polish otolaryngology. 65(4):272-5.

  It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009 estimately 9 million new cases were registered worldwide, mortality due tuberculosis reached 1.5 million. In Poland extrapulmonary tuberculosis is rare (7% of overall morbidity) and most commonly affects pleura, lymph nodes, bones, joints and genitourinary system. Head and neck tuberculosis is rare and causes many diagnostics problems. Retrospective analysis of case histories of patients admitted to ENT Department of Silesian Medical University in Katowice. Between 1993 and 2010 four cases of head and neck tuberculosis were diagnosed in our Clinic. Two of patients were admitted to the hospital with symptoms of laryngeal tumor such as difficulty in swallowing. During direct laryngoscopy tissue specimens were taken. Examination of the third patient showed tumor located below left angle of mandibule. During superficial parotidectomy tumor was removed. In the fourth registered case tuberculosis manifested as tumor of nasopharynx. In every case which is mentioned above pathology reports revealed epithelioid cell granulomas with caseous necrosis typical for tuberculosis. Patients underwent tuberculostatic treatment. Rare occurrence and lack of characteristic symptoms of head and neck tuberculosis often lead to misdiagnosis. Histopathological examination is the most important diagnostic procedure. Microbiological examination is difficult in extrapulmonary tuberculosis, because of low concentration of pathogens in specimens. Tuberculostatic therapy is the leading method of treatment in every case of tuberculosis.

• [Küttner's tumor (chronic sclerosing sialadenitis) - a rare cause of submandibular gland enlargement].

  Authors: Jarosław Markowski, Tatiana Gierek, Małgorzata Witkowska, Jarosław Paluch, Monika Swiderek, Ewa Zielińska-Pająk, Jacek Pająk, Lucyna Klimczak-Gołąb, Katarzyna Smółka

  Otolaryngologia polska. The Polish otolaryngology. 65(4):289-92.

  Küttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis ofKüttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis of submandibular gland. This is an underrecognized entity in the surgical pathology and cytology literature. Most patients experience recurrent pain, discharge and swelling that is often associated with eating, but others only have asymptomatic hard swelling of the submandibular gland. Histologic examination of the excised submandibular glands revealed preserved lobular architecture, thickening of interlobular septa by sclerotic tissue, dense lymphoplasmacytic infiltrate, preservation of ducts with periductal fibrosis, and variable loss of acini. The morphologic appearance, in conjunction with the elevated IgG4 expression, distinguishes chronic sclerosing sialadenitis from other inflammatory diseases of the salivary glands. Chronic sclerosing sialadenitis belongs to the spectrum of IgG4-related diseases. We present a case of Küttner's tumor in a 62-year-old female treated by surgery. Although this disease was first described by Küttner in 1896, this clinical entity which masquerades as carcinoma is underdiagnosed by many surgeons. There is not enough evidence to support any diagnostic means that could help in the differential diagnosis of this benign condition. Given the high rate of malignancy in firm, painless lesions of the submandibular gland, surgical excision is often advocated and Küttner's tumor is usually diagnosed by the histopathologist.