The role of HPV in malignant transformation of infected cells remains unclear. It is well known that the carcinogenesis must depend on promoters such as alcohol, tobacco, and metabolites of chronic inflammations. All patients with positive biopsies confirming HPV 16, 18, or 33 must receive special care to prevent the development of a carcinoma.

Together 35 papillomas of the larynx (8 juveniles, 27 adults) were studied for the presence of HPV-DNA by means of nucleic acid hybridization. The hybridization procedure was carried out "in situ" with biotinylated probes of HPV 6/11 and 16/18 under stringent conditions. The results are shown in Table 1. In all juvenile papillomas we detected HPV 6/11, but we did not find positive signals after hybridization with HPV 16/18, 25 (92.6%) of the examinated adult papillomas were HPV 6/11 positive. The detection procedure of HPV 16/18 was positive twice (11.8%). The results of our studies support the hypothesis of HPV 6/11 in development of larynxpapillomas.

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Adenomas of the middle ear are rare benign glandular neoplasms arising from the middle ear mucosa. After previous operations 25 and 15 years before, a 67-year-old female complained about dizziness, tinnitus, and unilateral hearing loss on the left side. A tumor in the tympanum that was revealed by otoscopy could be removed completely. Histological examinations showed an adenoma of the middle ear with cholesteatoma. This was inconsistent with the histological result of the operation in 1983, which had described a hidradenoma. An exact analysis of the preparations confirmed that a middle ear adenoma had already been present in 1983. Hidradenoma is one of the most important differential diagnoses. The characteristic histological sign of middle ear adenomas in contrast to hidradenomas is the lack of myoepithelial cells. In addition, it is very difficult to differentiate middle ear adenoma and adenocarcinoma using histopathological and clinical methods. Therefore, thorough follow-up is mandatory for patients after surgical treatment of middle ear adenomas.

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