Development and calibration of a high dynamic range and autonomous ocean-light instrument to measure sub-surface profiles in ice-covered waters.

The optical chain and logger (OptiCAL) is an autonomous ice-tethered observatory equipped with multiple light sensors for mapping the variation of light with depth. We describe the instrument and present an ensemble calibration for downwelling irradiance E P A R in [µm o l m -2 s -1]. Results from a long-term deployment in the Arctic Ocean demonstrate that the OptiCAL can cover the high dynamic range of under-ice light levels from July to November and produce realistic values in terms of magnitude when compared to modeled surface irradiance. Transient features of raised light levels at specific depths associated with nearby leads in the ice underline the importance of depth-resolved light measurements.

All-sky camera system providing high temporal resolution annual time series of irradiance in the Arctic.

The ArcLight observatory provides hourly continuous time series of light regime data (intensity, spectral composition, and photoperiod) from the Arctic, Svalbard at 79° N. Until now, no complete annual time series of biologically relevant light has been provided from the high Arctic due to insufficient sensitivity of commercial light sensors during the Polar Night. We describe a camera system providing all-sky images and the corresponding integrated spectral irradiance (EPAR) in energy or quanta units, throughout a complete annual cycle. We present hourly-diel-annual dynamics from 2017 to 2020 of irradiance and its relation to weather conditions, sun and moon trajectories.

Treatment of Parotid Malignancies­10 Years of Experience.

PURPOSE: Operative treatment is the main treatment option for parotid gland tumors. The purpose of this study was to present the authors' experience in the operative treatment of parotid gland malignant tumors, especially regarding feasibility and techniques in the most advanced cases. MATERIALS AND METHODS: This is a retrospective cohort study of parotid malignancies. The study included patients treated at the authors' university clinic from 2000 through 2010. The primary predictor variable was stage of disease. The primary outcome variables were 3- and 5-year overall and disease-free survival rates. The secondary predictor variables were nodal status, distant metastases, status of the facial nerve (FN), tumor diameter, extraparotid tumor extension, histology, and surgical procedure. The outcome variable was survival rate. Data were analyzed by χ(2) tests. RESULTS: Of 867 parotid tumors, 103 patients with malignancies (47 female, 56 male; 12 to 88 yr old) underwent 24 partial lateral, 34 lateral, 39 total, and 6 extended parotidectomies. The 3- and 5-year overall survival and 3- and 5-year disease-free survival rates for stages T1 and T2 were 100, 99, 91, and 85%, respectively, and those for stages T3 and T4 were 100, 70, 48, and 34%, respectively. Overall and disease-free survival rates were influenced by FN paralysis and histologic type. CONCLUSIONS: Final oncologic outcomes, recurrence, and survival rates in parotid malignancies are considerably affected by local tumor stage, malignancy, and FN paralysis before treatment. Infiltration of adjacent structures is not connected with a poorer prognosis as long as an extended parotidectomy is performed.

Sonoelastography--a useful adjunct for parotid gland ultrasound assessment in patients suffering from chronic inflammation.

BACKGROUND: Shear wave elastography (SWE) is widely used in breast, liver, prostate and thyroid evaluations. Elastography provides additional information if used to assess parotid gland pathology. We assessed parotid glands by means of SWE to compare the parenchyma properties in different types of inflammation. MATERIAL/METHODS: Prospective analysis included 78 consecutive patients with parotid gland pathology: sialolithiasis (33), Stensen's duct stenosis (15), chronic inflammation (10), and primary Sjögren syndrome (pSS) (20) treated at the Department of Otolaryngology, Head and Neck Surgery of PUMS. The primary predictor variable was type of parotid pathology, and secondary predictor variables were patient age and the duration and intensity of complaints. Ultrasound pictures were compared with elastography values of parotid parenchyma. RESULTS: Mean elasticity values for pSS (111 Kilopascals (kPa), Stensen's duct stenosis (63 kPa), sialolithiasis (82 kPa), and chronic inflammation (77 kPa) were significantly higher than the mean value for healthy patients (24 kPa). Elasticity increased proportionally to the intensity of complaints: mild (51 kPa), moderate (78 kPa), and strong (90 kPa). Increased elasticity did not correspond with ultrasonographic pictures. In pSS the parenchyma was almost twice as stiff as in chronic inflammation (p=0.02), although subjective complaints were mostly mild or moderate, and the ultrasonographic picture did not present features of fibrosis. CONCLUSIONS: Sonoelastography, by improving routine ultrasonographic assessment, might be a useful tool for parotid evaluations during the course of chronic inflammation. An extraordinarily high degree of stiffness was revealed in pSS despite lack of fibrosis by ultrasonography and moderate subjective complaints, suggesting that sonoelastography could be a valuable diagnostic tool.

Sialoendoscopy and combined approach for the management of salivary gland stones.

UNLABELLED: The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal due to sialolithiasis. The aim of this study is to assess the effectiveness of sialoendoscopy, rate of salivary fistula or natural ostium stenosis in parotid sialolithiasis treatment. The endpoint was to analyse the efficiency of a combined transcutaneous and endoscopic approach in the removal of refractory and impacted stones in most difficult cases. STUDY DESIGN: prospective study, tertiary university centre, between XII 2008 and XI 2011, 185 sialendoscopies (SE) were performed in 162 patients. Within the group of 29 patients with parotid sialolithiasis endoscopy was the definite treatment in 15 cases (53 %), in 9 cases lithotripsy (ESWL) was necessary and in 5 patients who failed SE and lithotripsy, a combined approach was performed. This approach comprised both SE and open surgery. We observed no salivary fistula formation after the incision of the duct. Stenosis of the natural ostium thanks to the insertion of stent was observed only in one case. Sialoendoscopy is the method of choice with a high rate of success and gland preservation in small and medium stones. The combined transcutaneous and endoscopic approach is indicated for large stones, for complications after and contraindications in using minimally invasive procedures. Short and medium term follow up shows that surgery can be performed with a high rate of success.

Algorithm changes in treatment of submandibular gland sialolithiasis.

Our research was conducted to determine the algorithm changes during the treatment of submandibular sialolithiasis. Two time periods were compared between 2004-2008 and 2009-2012. The turning point was December 2008, when sialendoscopy procedure was introduced. In the first period, 48 patients were treated: 31 outpatient duct incisions with stone evacuation and 17 surgical excision of submandibular gland. In the second period, 207 sialendoscopy procedures were performed on 197 patients. Out of this particular group, 158 patients were diagnosed with pathological obstruction of salivary glands and 64 of them were confirmed to have sialolithiasis of submandibular gland. Deposits of calcifications in 40 individuals (62.5 %) affected by sialolithiasis were removed endoscopically; however, in 21 patients, due to the increased circumference of the stone, the intimate association of deposits within the wall of the duct along with its presence inside the deep portions of the gland, double approach (incision of the floor of the mouth in hilar area and sialendoscopy) was performed. Three individuals had their salivary glands totally removed due to the presence of calcified deposits within the glandular parenchyma. Our results allow us to affirm that sialendoscopy is the current treatment of choice for submandibular glands affected by sialoliths. Indication for a complete removal of the gland is becoming uncommon as a first line treatment although still indispensable in chosen cases.

Is sonoelastography a helpful method for evaluation of parotid tumors?

Sonoelastography is a novel technique, useful in a noninvasive assessment of lesions in multiple organs. The aim of the study was to examine whether the combination of conventional ultrasonography (US) with sonoelastography might improve the reliability of parotid tumor evaluation. Fourty-three consecutive patients with parotid tumors were surgically treated at a single tertiary center at the Department of Otolaryngology, Head and Neck Surgery. The sample included 27 women and 16 men, aged 15-80 (the mean age = 54 years). The reference group constituted of 54 healthy volunteers. High resolution grayscale ultrasonography (US) was performed preoperatively using a 15 MHz linear array transducer. Elastograms (ES) were scored by the conventional Ueno 5-point scale from ES1 (blue-soft) to ES5 (the entire lesion and surrounding area shaded red-stiff). In addition, detailed stiffness values in kPa were collected. The group consisted of 33 patients with benign and 10 patients with malignant tumors. The mean stiffness value was 146.6 kPa in 10 malignant tumors (mostly ES4) and 88.7 kPa in 33 benign tumors (mostly ES2 and ES3). The differences in tissue stiffness between normal parotid parenchyma in the reference group and the mean value for all tumors in the examined group were statistically significant (p < 0.001), and so was the case with the differences between the benign and malignant tumors (p < 0.001). Low stiffness scores (ES1,2) were found in 2 malignant and 15 benign tumors while high scores (ES3,4) were found in 8 malignancies and 18 benign tumors. Sonoelastography overlapping elasticity to the grayscale images supports additional informations. Preferential selection of the lesions characterized by high stiffness (ES4) improves the differential diagnosis of parotid tumors but the large degree of uncertainty of this method should also be pointed out.

The presence of facial nerve weakness on diagnosis of a parotid gland malignant process.

The objectives of this article are to assess the frequency and significance of facial paralysis and undiagnosed nerve infiltration in patients with parotid malignancies. 103 patients with parotid gland malignancies were treated in a single institution, the tertiary center for ENT at the University Department in Poznan between 1996 and 2006. Facial palsy at the initial presentation was found in 32 patients. The stage of the primary tumor in the examined group of 103 patients is as follows: 20-T1, 31-T2, 20-T3, 32-T4. The correlation between facial nerve function before treatment and patients' characteristics, including the treatment methods, were analyzed. Intact facial nerve function at patient presentation was a very strong prognostic factor determining the treatment and final outcome for malignant neoplasms of parotid gland. Similarly, T stage and a high-grade malignant histology had a direct influence on the duration of patients' survival.

[A proposal for the classification of chronic sialadenitis of the major salivary glands with current diagnostic and treatment schedule]. / Nowe spojrzenie na klasyfikacje przewleklego zapalenia duzych gruczolów slinowych i algorytm postepowania.

UNLABELLED: Approximately 5% of patients visit the ENT doctors with major salivary gland complaints. Chronic sialadenitis is one of the major disorders that can cause salivary hypofunction and correct diagnosis and management is essential for its recovery. The classification of this pathological condition have changed in the past eight decades and nowadays was revised and modified, for new diagnostic (high resolution ultrasonography, CT and MR sialography and sonoelastography) and therapeutic methods (sialoendoscopy) were introduced. THE AIM OF THE STUDY: was to revive the past classifications of chronic inflammatory diseases of the major salivary glands and present the current one with implications for diagnostic and treatment schedule. MATERIAL AND METHOD: 20 patients with parotid and 44 with submandibular gland sialadenitis were treated in Otolaryngology, Head and Neck Surgery Department Poznan Medical University in the years 2007-2010. Two periods of time: 2007-8 and 2009-10 were compared, the turn point was December 2008, when sialoendoscopy was introduced. RESULTS: 25 out of 50 patients with parotid and 73 out of 95 with submandibular sialadenitis suffered from lithiasis. Surgical evacuation of the stone was performed in 10 cases in 2007-08, and in 4 between 2009 and 10. In this last period 94 sialoendoskopies was performed, in this number in case 38 submandibular and 7 parotid lithiasis. Stensens duct stenosis was diagnosed in 7 and Wharton duct in 12 patients. To conclude, authors underline that the prompt diagnosis is indispensible for the proper further treatment. The recommended treatment of chronic and obstructive sialadenitis obtains the novel technique, sialoendoscopy.

[Retrospective analysis of the treatment failure of the oral cancer in Department of Otolaryngology and Clinical Oncology University of Medical Sciences in Poznan in the year 2000-2005]. / Retrospektywna analiza przyczyn niepowodzen w leczeniu nowotworów jamy ustnej i gardla w Klinice Otolaryngologii i Onkologii Laryngologicznej Uniwersytetu Medycznego w Poznaniu w latach 2000-2005.

AIM: Retrospective analysis of treatment results in the patients group with oral cancer treated in Department of Otolaryngology and Clinical Oncology K. Marcinkowski University of Medical Sciences in Poznar' between the years 2000-2005. The critical view of the cause of the failure. MATERIAL: The clinical date include: sex, age, stage of the tumor (TNM classification), histological grading, nodes status and 5-years follow up. The parameters were analysed regarding to history of the patients, operative books, outpatients documentation. All parameters were underwent statistical analysis using following tests: Kaplan-Meier, Wilcoxon regarding Gehan and chi2. Date for analysis was classified as ,,end feature" (death or lack of postoperative control) and ,,cut feature" (patient still under control). RESULTS: Between 2000 and 2005 263 patients were operated due to oral cancer. Only 144 undergo analysis. The rest of 108 patients were calculated as a treatment failure. The middle age was 63 years. There was statistical correlation between tumor stages T (p< or =0.00768), pathological N stage (p< or =0.07225) and 5 year survival. No correlation was found between age, extracapsular spread of the nodes and histopathological grading G and prognosis. In our group 5-years survival present 32% of the patients. CONCLUSIONS: The results of 5-years survival in our patients group are still unsatisfactory. The key lies probably on both side. The first the patients visited doctors still to late with significant advancement of the tumor and second we need better education, introduction of new technologies and shorter time for histological diagnosis and waiting list for post operative radiochemioterapy.

[Sialendoscopy as a non-invasive treatment method of sialolithiasis and non-inflammatory processes causing salivary gland swelling]. / Sialoendoskopia jako nieinwazyjna metoda leczenia kamicy i niezapalnych zmian obrzekowych gruczolów slinowych.

Inflammatory and non-neoplastic diseases of salivary glands affect approximately 5% of patients in every day laryngology practice. Sialolithiasis is the most common cause of obstructive diseases in salivary glands and is supposed to affect 1,2% of population. Other, non inflammatory reasons of glandular swelling are sialodochitis (acute ductal inflammation), stenosis of the duct, and chronic, obstructive changes in the ductal epithelium found in patients with chronic recurrent (juvenile) parotitis. Sialendoscopy is a minimal invasive technique aiming to visualize the lumen of the salivary ducts and their pathologies. It could be used for diagnostic reasons, in case of sialolithiasis extraction of stones and in case of stenosis dilatation is performed (interventional sialendoscopy). In ENT Department Medical University in Poznan, in the period 2008 XII between 2010 IV, 46 sialendoscopies were performed. Sialolithiasis was observed in 29 patients, stenosis of main duct in 16 patients. In 1 case any changes in ductal system were observed. In group with sialolithiasis, in 19 cases stones were removed endoscopically, in 4 patients papillotomy was performed to extraction of the stone. In 3 patients with big stones and an extreme posterior location, bilateral (external and endoscopical) approach was used. Any postoperative complications were observed.

[Epidemiology of non-malignant salivary gland tumours based on 675 cases]. / Epidemiologia guzów niezlosliwych slinianek podzuchwowych i przyusznych na podstawie 675 przypadków.

Neoplasm of salivary glands constitutes about 3% of all tumours of head and neck. Within the category we can differentiate tumours of a very different histological structure. What lies behind such great differences in the changes within the salivary glands is complex embryogenesis of the glands. About 80% of all tumours of salivary glands is located in parotid gland, from 10 to 20% - in submandibular gland and several percent in sublingual and small salivary gland. This work aims at the assessment of the frequency of occurrence of non-malignant neoplasm in parotid and submandibular gland based on the material collected at the ENT Department of the Medical University in Poznan in the years 1995-2006. In the 12-year period, 778 patients in total suffered from tumours of large salivary glands. The number of non-malignant neoplasm was 675, and the number of malignant neoplasm was 103. With regard to paroid glands, 586 non-malignant tumours and 82 malignant tumours were identified, with regard to submandibular glands the numbers were respectively: 89 and 21. Main aim of this work has been achieved through the execution of partial steps: the analysis of the trends in occurrence of non-malignant neoplasm in the 12-year period, the analysis of the epidemiological differences: sex, age, place of residence - town or country, duration of symptoms, diameter of the tumour at the time the patient reported for treatment, histological structures that were carried on the basis of the comparison of data collected in the two periods of time: period I--the years 1995-2000 and period II--the years 2001-2006. The frequency of operations on non-malignant tumours of salivary glands (as compared to the total number of operations) was 4.11% in the first period and 4.18% in the second. In both periods the most frequent benign tumour was the mixed tumour (54.9% of all tumours) and constituted 60% and 54% of all tumours in the respective periods analyzed. The next most frequently occurring tumour was Warthin's tumour, identified in 31.2% of the patients, in 23% in period I and 35% in period II. Duration of the symptoms, ranged from 1 month to 20 years, 14 months on average, yet in 263 cases the tumour has been developing developed for over a year. The diameter of the non-malignant tumours undergoing operation ranged from 1 cm to 8 cm, with the average being 3 cm. It was 3 cm with regard to the most frequently occurring tumours: adenoma polymorphum, adenoma monomorphum and cystadenolymphoma.

[Incidence of salivary gland malignancies in 12 year time period in ENT Department Medical University in Poznan]. / Guzy zlosliwe slinianek w materiale kliniki otolaryngologii i onkologii laryngologicznej w Poznaniu w okresie 12 lat.

Neoplasm of salivary gland constitutes about 3% of all tumours of head and neck. Within the category we can differentiate tumours of a very different histological structure. What lies behind such great differences in the changes within the salivary glands is complex embryogenesis of the glands. This work aims at the assessment of the frequency of occurrence of malignant neoplasm in parotid gland and submandibular gland based on the material collected at the ENT Department of the Medical University in Poznan in the years 1995-2006. In the 12-year period, 103 patients suffered from malignant neoplasm. 82 tumours were diagnosed in paroid gland and respectively 21 - in submandibular gland. No neoplasm was identified in sublingual gland. It was concluded, that trends in occurrence of neoplasm of salivary glands, assessed on the basis of the number of patients operated in the years 1995-2006 show that the number of malignant neoplasm cases remains on the same level. The analysis of the epidemiological differences based on the comparison of the groups of patients treated for salivary gland neoplasm in the years 1995-2000 and 2001-2006 has shown that with regard to malignant neoplasm such parameters as sex, age, duration of symptoms, diameter of the tumour and level of advancement have not differed much from each other in the analyzed periods. Epidemiological differences were identified in respective histological structures in the two periods analyzed: adenoid cystic carcinoma was in fact more frequent in the years 1995-2000 than in the years 2001-2006 (58.8% versus 24.1%). On the other hand, metastasis to the salivary glands was less frequent in period I than in period II (11.8% and 27.6% respectively), so was cancer in mixed tumour (2.9% and 17.2%). Facial nerve paralysis was statistically more frequent in highly malignant tumours than in comparison to tumours malignant only to a slight extent.

[Reconstruction of dissected Stensen's duct after facelift surgery]. / Rekonstrukcja uszkodzonego przewodu wyprowadzajacego slinianki przyusznej po zabiegu odmladzajacym twarzy.

Rejuvenation procedures, especially facelift are nowadays common type of cosmetic surgery. According to the statistical data, facelifts were the seventh most popular aesthetic surgery performed after liposuction, breast augmentation, blepharoplasty (eyelid surgery), abdominoplasty (tummy tuck), breast reduction and rhinoplasty. The most common complication after surgery is bleeding. Less common, but potentially serious, complications may include damage to the facial nerves and necrosis of the skin flaps, infection and damage of parotid duct. We present a case of 50 years old woman, who has undergone facelift surgery with damage of parotid duct and consequently formation of sialocele. Localisation of damage and repair of dissected Stensen's duct was performed using external approach. The duct was sutured end to end using intraductal stent. After 3 weeks stent was removed. We observed normal saliva flow from natural orifice of parotid gland.

[Tracheal stenting in patients treated due to carcinoma of the larynx]. / Protezowanie tchawicy za pomoca stentów u chorych leczonych z powodu raka krtani.

INTRODUCTION: Stenosis of the trachea and main bronchia can occur in patients with lung, larynx, thyroid gland, esophagus, in metastatic tumors, can be also caused by trauma and foreign bodies. Treatment in this condition can be difficult. Tracheal stenosis in patients after total removal of the larynx is relatively rare. It can be caused by recidiv tumor and inflammation processes. AIM OF THE STUDY: Was to evaluate usefulness of stents in patient with stenosis of the trachea after total laryngectomy due to squamous cell carcinoma. MATERIAL AND METHODS: Authors described two cases of patient after total laryngectomy. Nitinol, expandable, tracheal stents were used in both cases. Placement of the stent into the trachea was relatively simple. Patients have undergone this procedure in short general anesthesia. RESULTS: After stenting patients exhibited dramatic improvement in their respiratory symptoms and quality of life. CONCLUSIONS: Stents are useful in cases of tracheal stenosis and the effect is related to the reason of stenosis.

[Middle ear cancer hidden by chronic otitis media--a case report]. / Przewlekle zapalenie ucha srodkowego maskujace rozwój nowotworu--opis przypadku.

The authors would like to present a rare case of the middle ear cancer which has been developed in postoperative cave in 67 years old patient operated for cholesteatoma 50 years earlier. The patient was admitted to the ENT Department of Poznan University of Medical Sciences because of the ear suppuration and headache occurring for 3 months. CT and MR images suggested granulation tissue filling the postoperative spaces with bone destruction, infiltration of the dura and temporal lobe abscess formation. Intraoperative findings allowed excluding the preliminary diagnosis of intracranial complication in the course of chronic otitis media, revealing the tissue masses resembling neoplastic infiltration. The histopathology examination confirmed the final diagnosis of squamous cell cancer. The patient was directed to radiotherapy. The authors report a case of middle ear squamous cell carcinoma and discuss its diagnostic aspect.

[Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznan University of Medical Sciences, Poland]. / Znaczenie angiografii i embolizacji w leczeniu malformacji naczyniowych glowy i szyi w materiale Kliniki Otolaryngologii Uniwersytetu Medycznego w Poznaniu.

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznan University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

[Salivary gland damage after 131I therapy in patients with differentiated thyroid cancer. Preliminary report]. / Uszkodzenie slinianek po terapii 131I u pacjentów ze zróznicowanym rakiem tarczycy. Doniesienie wstepne.

INTRODUCTION: The purpose of the study was to evaluate salivary gland dysfunction after a high-dose radioiodine therapy administered to patients with differentiated thyroid carcinoma. MATERIAL AND METHODS: The study group consisted of 60 patients (age range 20-78 years). Detailed history about complaints from the oral cavity were taken, followed by the ultrasonography and dynamic scintigraphy. The procedure was performed on 40 patients before and one year after radioiodine administration, and a single-time on 20 patients treated with multiple doses in the past. RESULTS: Data analysis shows no statistically significant increase of subjective sufferings after first radioiodine dose (60-150 mCi), small decrease of uptake ratio UR (< 10%) and diminished parotid glands transverse diameter (approximately 10%). The patients after multiple therapies (i.e. average dose of 250 mCi) informed more often about problems connected with decreased salivation (approximately 20% patients), in scintigraphy there was a reduction of parotid UR 21-23% and parotid maximal secretion MS 7-13%. Ultrasonography did not show changes in salivary glands echogenicity after 12 months from the first dose of 131I. There was no close relationship between scintigraphically revealed dysfunctions and the occurrence of complaints; no correlation between appearance of acute sialadenitis symptoms after radioiodine therapy and subsequent dysfunctions. CONCLUSIONS: The main conclusion is that a single dose of 131I has no significant influence on salivary gland function; a repeated high-doses therapy is connected with an essential risk of side-effect occurrence. Scintigraphy can evaluate salivary gland function with high sensitivity. Parotid glands are more radiosensitive than submandibular.

[Scared atrophy of the cervical part of trachea as an effect of prolongated intubation]. / Bliznowaty zanik odcinka szyjnego tchawicy w nastepstwie przedluzonej intubacji.

Tracheal intubation is presently one of the basic medical procedures. It is connected with many different complications. One of them is tracheal stenosis, which occurs in 6-21 percent of patients after intubation of the trachea. In contrast to this high frequency of tracheal stenosis we didn't find any publications about complete atrophy of a big part of trachea after prolongated intubation and we describe a first case of such complication. The reasons and the possibilities of treatment in such situation are discussed.

Multicenter experiences in temporal bone cancer surgery based on 89 cases.

OBJECTIVE: To present outcomes of extensive surgery: lateral, subtotal, total petrosectomies in patients with temporal bone invasion resulting from specific primary cancers. STUDY DESIGN: Retrospective case review. SETTING: Four tertiary referral centers. MATERIAL: 89 patients with cancer of the temporal bone treated between January 2006 and December 2010. INTERVENTION: Multidisciplinary team approach including surgical resection, reconstruction, and postoperative radiotherapy. MAIN OUTCOME MEASURE: Disease-specific survival, overall survival. RESULTS: In 27.0% of the patients, relapse was reported, with an average of 6.3 months after surgery; 31 patients (34.8%) died during the follow-up. The average mortality was 22.1 months. Fifty-four patients (58.7%) stayed alive during the time of observation. The average survival time was 42.0 months. The median time of survival with relapse was 12 months (range: 1-51 months). The three-year disease-free rate was 38.0% and the overall survival rate was 58.7%. CONCLUSIONS: Petrosectomy is an effective treatment for malignant temporal bone invasion. The probability of a good outcome was statistically decreased with a high T grade, positive margins, and salvage surgery. Younger age is connected with better prognosis. One of the major tasks remains to improve detection and to shorten the time to diagnosis, keeping in mind that symptoms are insidious and in younger people, the time before diagnosis was longer.