The sinonasal mucosa has an essential role in defense mechanisms of the upper respiratory tract. The innate immune system presents the primary defense against noxious microorganisms followed by induction of the adaptive immune mechanisms as a consequence of the presence of pathogens. This well-known activation of adaptive immune system in response to presence of the antigen on mucosal surfaces is now broadly applicated in vaccinology research. Prevention of infectious diseases belongs to substantial challenges in maintaining the population health. Non-invasive, easily applicable mucosal vaccination purposes various research opportunities that could be usable in daily practice. However, the existence of multiple limitations such as rapid clearance of vaccine from nasal mucosa by means of mucociliary transport represents a great challenge in development of safe and efficient vaccines. Here we give an updated view on nasal functions with focus on nasal mucosal immunity and its potential application in vaccination in nearly future.

In head and neck cancers the occurrence of nodal metastases is the most important prognostic factor. Their early diagnosis is crucial for proper treatment. Detection of early metastases is still very difficult. Predictive diagnostic methods such as the sentinel lymph node detection is limited by the occurrence of skip metastases. At our Clinic we prefer a selective neck dissection based on a surgical treatment of predilected lymphatic spread area for each type of head and neck tumor with a preservation of non-lymphatic structures of the neck. The main objective of this article is to analyze the distribution of neck metastases and to study the frequency of skip metastases in head and neck cancer.

Madelung’s disease also called benign symmetric lipomatosis is a rare disorder of unknown etiology. The disease affects almost exclusively middle-aged men with a history of multi-year alcohol abuse. The major symptom is presence of non-encapsulated benign fat masses, especially in the area of the head and neck. Limited head and neck movement, dysphagia, and dyspnea may appear as well. The diagnosis is clinical and is supported by imaging methods, often elevated hepatic enzymes in blood serum, and histological examination with finding of mature adipose tissue without signs of proliferation. Therapeutic methods involve liposuction or excision which is a method of choice nowadays. In this article the authors review current knowledge, research state, and present five cases of the Madelung’s disease occurring within the last 10 years at the Clinic of Otorhinolaryngology and Head and Neck Surgery in Martin, Slovakia.