[The use of exfoliative cytology in the detection of dysplastic changes in the laryngeal mucosa of postop cancer patients].

Second primary neoplasms are the cause of failure in treatment of head and neck carcinoma in 1-34% of cases. The majority of SPM are located within mouth, pharynx, lung or oesophagus. This study was designed to evaluate to effectiveness of exfoliative cytology in postoperative follow-up of patients with carcinoma of the larynx treated with surgery. The group consisted of 81 patients who had cytological evaluation between 1994 and 1996. Cytological smears were taken from six different places in mouth, pharynx and tracheostoma. If cytomorphotic changes, parakeratosis or inflammation was found, the examination was repeated every 6 months. In the first study among 548 smears cytomorphotic changes were found in 16 (2.91%) taken from 8 patients (9.87%). 9 smears presented small or medium degree of dysplasia, 4-severe degree of dysplasia, and 3 smears demonstrated neoplastic cells. Upon completing second and third cytologic examination full remission was found in cases of small and medium dysplasia as in parakeratosis and inflammation. Stagnation was detected in cases of severe dysplasia. In the patient whose smear revealed neoplastic cells SPN of the oesophagus was diagnosed. It seems that exfoliative cytology might be a useful method for follow-up and early diagnosis of SPN in patient after laryngectomy.