BACKGROUND:Osteomas of the paranasal sinuses occur rarely in the pediatric population, we find only a few reference of symptomatic osteomas in the literature. Opinions on the indication for surgical treatment are controversial.CASE:The authors present a case of symptomatic osteoma of the right ethoimoidal sinus in a 12-year-old boy, who was treated surgically, with endoscopic endonasal approach. The symptomatology, diagnosis and therapy of these tumors in the pediatric patient are discussed.CONCLUSION:Osteomas of the paranasal sinuses are slow-growing benign lesions. Symptomatic osteomas can grow expansively and cause serious complications. The treatment of osteoma is surgical and the endoscopic approach offers the possibility of removal with cosmetic benefits.

AIM:To evaluate microbial colonization of upper aerodigestive tract in children and to investigate the influence of adenoid hypertrophy, allergy and exposition to cigarette smoke on presence of pathogens.METHODS:In 43 children with adenoid hypertrophy and 17 healthy children bacterial culture was performed by a swab from middle nasal meatus, nasopharynx and tonsils. The effect of adenotomy, presence of allergy and exposure to passive smoking on bacterial colonization were investigated.RESULTS:Identification of potentially pathogenic bacteria in upper aerodigestive tract was significantly higher in children with adenoid hypertrophy compare to control group. Adenotomy was associated with significantly decreased colonization by potential pathogens. Allergy was diagnosed in 33 % children with adenoid hypertrophy. Presence of allergy and exposure to tobacco smoke were associated with significantly more often colonization by potentially pathogenic bacteria in the upper aerodigestive tract.CONCLUSION:Increased colonization of upper aerodigestive tract by potential pathogens and their significant decrease after adenotomy indicate the role of pathogenic bacteria in the etiopathogenesis of adenoid hypertrophy. Allergy and tobacco smoke exposure are related to increased colonization by potentially pathogenic bacteria in the upper aerodigestive tract.

AIM:The incidence of thyroid cancer has been increasing. The aim of this work was to determine risk factors, diagnostic methods and extent of surgical treatment of malignant goiter.MATERIAL AND METHODS:The authors retrospectively analyzed patients who were surgically treated for thyroid disease at the Department of Otorhinolaryngology, Head and Neck Surgery, Comenius University, Jessenius Faculty of Medicine, Teaching Hospital in Martin, Slovakia, from the January 1st, 2006 to December 31st, 2013, for thyroid disease. The incidence, risk factors of malignant thyroid tumors, indication for surgery and its complications were evaluated.RESULTS:A total of 1,620 adult patients were surgically treated for thyroid disease at the Department of ENT, Head and Neck Surgery, CU JMF, UH in Martin, Slovakia, between 2006- 2013. Malignant tumors were identified in 238 patients (15%). Microcarcinoma (incidentally detected malignant tumor 1 cm) occurred in 78 cases (5%). Malignant thyroid tumor was more common in younger patients (p = 0.002). Newly created and larger nodules positively correlated with the occurrence of malignancy (p = 0.003, p = 0.041, resp.). Gender, family history of thyroid disorder, previous radiation therapy, and previous malignancy did not affect the incidence of malignant tumor of thyroid gland. High sensitivity and specificity in the dia-gnosis of malignant thyroid nodule was observed using aspiration cytology (75%, 97%, resp.) and intraoperative histopathological examination (88%, 100%, resp.).CONCLUSION:Malignant tumor of thyroid gland is more common in younger patients with newly developed nodule. The risk factors of malignancy increase with the size of the thyroid nodule. Aspiration cytology and peroperative histopathology have high sensitivity and specificity in the dia-gnosis of malignant thyroid tumor; therefore, they should be a standard method in the dia-gnosis of nodular goiter. The method of choice in the treatment of thyroid malignancy is total thyroidectomy.

Authors address the issue of a frequent benign tumour of the nasal cavity and paranasal sinuses -  inverted papilloma. They analyse the available diagnostic methods and treatment options. On the background of selected case reports of a rare malignant transformation they emphasize the need for longterm dispensarization as a part of management plan for patients with this oncological disease.

Súhrn Úvod: Incidencia zhubných nádorov štítnej žľazy má stúpajúcu tendenciu. Cieľom práce bolo stanoviť rizikové faktory vzniku malígneho nádoru štítnej žľazy, dia gnostické metódy a rozsah chirurgickej liečby malígnej strumy. Materiál a metódy: V práci autori retrospektívne analyzovali pa cientov, ktorí boli chirurgicky liečení na Klinike otorinolaryngológie a chirurgie hlavy a krku JLF UK a UN v Martine v rokoch 2006– 2013 pre ochorenie štítnej žľazy. Sledovali incidenciu, rizikové faktory vzniku malígneho nádoru štítnej žľazy, indikácie na chirurgickú liečbu a jej komplikácie. Výsledky: Na Klinike otorinolaryngológie a chirurgie hlavy a krku JLF UK a UN v Martine bolo v rokoch 2006– 2013 operovaných 1 620 pa cientov v dospelom veku pre ochorenie štítnej žľazy. Malígny nádor dia gnostikovali u 238 pa cientov (15 %). Incidentálny mikrokarcinóm (náhodne detegovaný zhubný nádor veľkosti ≤ 1 cm) sa vyskytoval u 78 pa cientov (5 %). Zhubný nádor bol častejší u mladších (p = 0,002). Novovzniknutý uzol a veľkosť uzla korelovali s výskytom malignity (p = 0,003, resp. p = 0,041). Pohlavie, rodinná anamnéza, rádioterapia, predchádzajúci výskyt malignity nemali vplyv na výskyt malígneho nádoru štítnej žľazy. V diagnostike malígneho uzla sme zaznamenali vysokú senzitivitu a špecifi tu aspiračnej cytológie (75 %, resp. 97 %) a peroperačného histopatologického vyšetrenia (88 %, resp. 100 %). Všetci pa cienti boli liečení chirurgicky v zmysle totálnej tyreoidektómie, ktorá bola doplnená o terapeutickú lymfadenektómiu u 12 %. Z pooperačných komplikácií sme zaznamenali tranzitórnu hypokalciémiu u 10 %, tranzitórnu jednostrannú parézu návratného nervu u 3 % a trvalú léziu návratného nervu u 1 % pa cientov. Trvalá hypoparatyreóza, obojstranná lézia návratného nervu (tranzitórna/ permanentná) sa nevyskytovala. Záver: Malígny nádor štítnej žľazy je častejší u mladších pa cientov s novovzniknutým uzlom štítnej žľazy. Riziko stúpa s veľkosťou uzla. Aspiračná cytológia a peroperačné histopatologické vyšetrenie majú vysokú senzitivitu a špecifi tu v dia gnostike malígneho nádoru štítnej žľazy, preto by mali tvoriť štandardnú súčasť diferenciálnej dia gnostiky uzlovej strumy. Metódou voľby v liečbe zhubného nádoru štítnej žľazy je totálna tyreoidektómia.