Knowledge About Head and Neck Cancer in the Population of Vojvodina: A Comparative Study.

In 2009, the Institute of Oncology of Vojvodina reported the total of 553 newly registered patients with head and neck cancer (HNC) in the Province of Vojvodina, with a lethal outcome in 332 HNC patients. These facts impose the need of investigating the health education of the general population and proposing possible prevention measures. The present prospective study included 200 subjects classified into two groups. Group 1 (100 subjects) consisted of randomly selected adults from urban and rural regions of Vojvodina. Group II (100 subjects) included the adults from the same regions affected by HNC. All subjects answered the anonymous questionnaire which complied with the standards of a similar European Union research project "About Face". The results showed that 96% of the subjects from the Group II and only 77% of the subjects from the Group I were familiar with the term "head and neck cancer" what represented a significant difference. The results from Vojvodina were significantly better than those from the European study (23%). Most subjects were informed about HNC through television programs (60%), hospital leaflets (41%) or internet (37%). Both the patients and the citizens of Vojvodina were better informed about the most common localizations of HNC-pharynx and larynx, but less informed about other HNC localizations than the citizens of seven European countries. The citizens and the HNC patients from Vojvodina were equally well informed about some risk factors (e.g., smoking, alcoholism, aging and sun exposure) as the citizens in Europe. Both the patients and the general population of Vojvodina are mostly worried about the consequences/side effects of the applied surgical treatment. The obtained results may be a good starting point in the prevention and early detection of HNC in Vojvodina.

Serum levels of sex hormones in males with Reinke's edema.

Smoking, laryngopharyngeal reflux and voice misuse/overuse are known possible etiological factors for the development of Reinke's edema (RE) on vocal folds. RE is found more frequently in women. The disparity between the incidence of RE in women and men suggests that endogenous sex hormones such as estrogens, progesterone and/or testosterone may have a significant influence on vocal folds. The aim of the study was to investigate the level of sex hormones such as estradiol (E), progesterone (P), and testosterone (T) in men with RE in comparison with men without laryngeal pathology. Fifty-six men with RE and 48 men without laryngeal pathology participated in the study. All participants received a questionnaire for assessing possible risk factors for the development of RE. The serum levels of T, E and P were determined and the ratios between hormones (T/E, T/P, P/E) were calculated. T and P serum levels were significantly higher in patients with RE (p = 0.002, p = 0.017). No differences were found in the hormone ratio values. Smoking was the only known risk factor for RE (p < 0.001). In conclusion, the difference in the level of sex hormones implies that hormones may affect both, the development and the maintenance of the edema in the lamina propria of vocal folds. The authors suppose that the possible mode of action of sex hormones is through enzymatic activity of nitric oxide synthase in the endothelial cell wall.

The role of allergy in the etiology of Reinke's edema on vocal folds.

AIM: To identify the role of allergy in the occurrence of Reinke's edema on vocal folds. METHODS: This was a prospective study in patients with Reinke's edema on vocal folds (n = 80) and a control group of patients without Reinke's edema (n = 80). All the patients were examined by the same ENT specialist at an ENT outpatient center in the period 2001-2003. The control group comprised 80 successive patients from the same clinic who were willing to cooperate in the study and were not already being treated for allergic disease by any specialist other than an ENT specialist. Patients from both groups were examined by rigid laryngoscope, skin prick allergic testing (type I allergy) and laboratory determination of serum thyroid-stimulating hormone level. RESULTS: The prevalence of allergy was not significantly different between the two groups: 20.0% in the patients with Reinke's edema and 23.8% in the control group (P = 0.576). No significant difference was detected in the prevalence of allergy when comparing patients with recurrent Reinke's edema after previous surgical treatment (n = 10) with patients with a first occurrence (n = 70) (P = 1.000). However, we found significantly more type I allergy in the patients with Reinke's edema and chronic hyperplastic rhinitis than in the patients with Reinke's edema without chronic hyperplastic rhinitis. All other risk factors (reflux of gastric content to the larynx, vocal abuse or misuse, unfavorable microclimate conditions at work, thyroid diseases) appeared significantly more often in the group with Reinke's edema on vocal folds than in the control group. CONCLUSIONS: Type I allergy is not a crucial factor in the pathogenesis of Reinke's edema on vocal folds or in recurrence of the disease after surgical treatment.