Efficacy of petrosectomy in malignant invasion of the temporal bone.

We present the outcomes of lateral, subtotal, and total petrosectomies in patients with invasion of the temporal bone by specific primary cancers, with particular emphasis on survival in the advanced stages of disease. We made a retrospective study of 20 consecutive patients (squamous cell carcinoma of the temporal bone, n=11, and primary cancer of the parotid gland with infiltration of the lateral skull base, n=9) treated by total, subtotal, or lateral petrosectomy at the University Department of Otolaryngology, a tertiary referral centre, between June 2006 and December 2010. Fourteen of the 20 patients were alive at the time of analysis, and follow-up ranged from 36-60 months. Six of seven patients whose disease relapsed (4 local and 3 distant metastases) died. The three-year, disease-free survival was 65% and the overall survival 68%. Survival between those with temporal bone and parotid tumours did not differ significantly. The combined group survival was affected by involvement of invaded resection margins (n=6, p=0.03). Involved margins were significant in the development of recurrence (p=0.03). Tumour stage, nodal involvement, type of operation, sex, age, skin involvement, facial palsy, and previous history of disease had no impact on prognosis. There was a significant difference in the survival curves of patients with carcinoma of the temporal bone with and without facial paresis (n=6 compared with n=5; p=0.046). Two of 11 free flaps required revision of the anastomoses, but none was lost.

[Treatment results of patients with adenoid cystic carcinoma in the Otolaryngology Department at the University School of Medical Sciences in Poznan between 1958-1999]. / Wyniki lecznia chorych na raka gruczolowato--torbielowatego w Klinice Otolaryngologii AM w Poznaniu w latach 1958-1999.

In the years 1958-1999 the ENT Department at the University School of Medical Sciences in Poznan treated 125 patients suffering from adenoid cystic carcinoma located in the head and neck area. The aim of this study was to assess treatment results over a span of 41 years. The cases treated included 68 women and 57 men. The highest incidence of the disease was observed in men in their 70's--16 cases and women in their 50's--19 cases. In a majority of cases, the cancer started in major salivary glands, specifically parotid--51, submandibular--11, sublingual--4. Other places included minor salivary glands located in the palate--15, cheek--8, oral cavity--5 and tongue--4. Other glands affected by the tumor were those in the ethmoidomaxillary area--23. The treatment of choice was surgery with subsequent radiation. All patients were subjected to surgical treatment, 89 of them being subsequently radiated. Local recidivation was observed in 12 patients (i.e. 10%), metastases to neighbouring lymph nodes in 9 patients (i.e. 7%). Distant metastases affected the lungs--4 cases, liver--1 and bone--1.

[Cochlear implantation through the middle fossa approach]. / Implantacja wszczepu slimakowego z dojscia przez srodkowy dól czaszki.

The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

[Epidemiology of acoustic neuromas in Poland]. / Epidemiologia nerwiaków nerwu VIII w Polsce.

In 1996 the Polish Skull Base Surgery Society was founded and assembled mainly otolaryngologists and neurosurgeons from several dozen clinics and hospital wards. Its main aim was to encourage co-operation between those two specialties. For this reason among others a common project entitled: "Epidemiology of acoustic neuromas in Poland" was launched in 1997. Information was collected from questionnaires in seven neurosurgery and in three laryngology centres in the years from 1997-1998. So far, no epidemiology of acoustic neuromas was established for the population of Poland. In this span of time 72 patients were operated. The agreement upon similar criteria, terminology and ways of evaluating the treatment results was quite a problem. Most cases were found in patients in their fifties (19 cases) and sixties (15 cases), mostly women. The average duration of the symptoms was 43 months. Large tumours predominated in the study group--T4 in the Samii (67%), and > 26 mm in the Tos (74%) classification. Most commonly, the patients were subjected to computer tomography in the preoperative period. All patients were treated surgically, with the retrosinusoid approach predominating. Only in one case, the translabyrinthal approach was used. Authors of this work are all participants of the project. Despite the fact that the number of performed operations is not too high, the fact of co-operative studies on the results by representatives of those two specialties can be considered a success. Hopefully, in the next years it will gradually be possible to widen the scope of the project and obtain more precise information.

Reactivity of various four-coordinate aluminum alkyls towards dioxygen: evidence for spatial requirements in the insertion of an oxygen molecule into the AI-C bond

The interaction of dioxygen with various tetrahedral aluminum alkyls, (tBu)3Al.OEt2 (1), tBu2Al(mu-OtBu)2AltBu2 (6), (tBu)2Al(mesal) (2) [mesal=methyl salicylate anion], R2Al(mu-pz)2AlR2 [pz=deprotonated pyrazole, R= Me (3a), Et (3b), and tBu (3c)], R2Al(mu-3,5-Me2pz)2AIR2[3,5-Me2pz = deprotonated 3,5-dimethylpyrazole, R= Me (4a), and Et (4b)], and Et2B(mu-pz)2AlEt2 (5), has been investigated. We were particularly interested in the effect of steric hindrances both caused by the metal-bonded substituents and those that result from the nature of the bifunctional ligand used in the oxygenation reaction. In the reaction of 1 with O2, only the formation of the monoalkoxide compound6 was observed. The latter di-tert-butyl compound as well as all planar aluminapyrazoles, that is, the tert-butyl derivative 3c and lower alkylaluminum derivatives with the more demanding 3,5-dimethylpyrazoyl ligands 4a and 4b, are stable under an atmosphere of dry oxygen and ambient conditions. Inspection of the space-filling representation of these compounds has undoubtedly shown that the bulky tert-butyl groups or pyrazolyles ligands, respectively, provide steric protection for the metal center from the dioxygen attack. In contrast, the dialkylaluminum derivatives of pyrazole, 3a and 3b, and the diethylaluminum bis(1-pyrazolyl)borate complex 5, all with the metal center eclipsed with respect to the plane defined by the four nitrogen atoms, react smoothly with O2 to form the alkyl(alkoxy)aluminum complexes. In the reaction of 5 with O2 for example, the Et-B bonds remained intact, and the dimeric five-coordinate compound [Et2B(mu-pz)2 Al(mu-OEt)Et]2 (9) was isolated in good yield. The interaction of mononuclear di-tert-butyl chelate complex 2 with O2 at -15 degrees C gives (tBuOO)(tBuO)Al(mu-OtBu)2Al(mesal)2 (7) in high yield, and the presence of the alkylperoxo moiety is a particularly significant point in the resulting product. All the compounds have been characterized spectroscopically, and the structures of 3c, 4a, 6, 7, and 9 have been confirmed by X-ray crystallography. Structural features of 1-6 are discussed and are considered in relation to the possible approach pathways of the O2 molecule to the four-coordinate metal center. This analysis and the observed apparent dissimilarity in the reactions of model four-coordinate aluminum alkyls with O2 clearly show that the stereoelectronic prerequisites are responsible for the fundamentally different reactivity.

[Adenoid cystic carcinomas of the head and neck (cylindromas)]. / Raki gruczolowato-torbielowate glowy i szyi (oblaki).

In the years 1958-1997 111 patients with adenoid cystic carcinoma in the head and neck of different localization were treated at the Department of Otolaryngology--Head and Neck Surgery. Majority of the tumors originated of the major salivary glands, mainly in the parotid gland (47 cases). The most common location among the tumor of the minor salivary glands was the palate (14 persons). The tumors arising from other mucous glands, most frequently has located in the maxillo-ethmoideal complex (20 cases). The authors stress diagnostic difficulties, the necessity of a proper selection of the surgical method and postoperative radiotherapy, describing the treatment results in the patients. Radial surgical procedure of the adenoid cyctic carcinoma yelds optimal local control and survival rates.

[Pleomorphic adenomas in the materials of the Department of Otolaryngology of the Academy of Medical Sciences in Poznan]. / Gruczolaki wielopostaciowe w materiale Kliniki Otolaryngologii AM w Poznaniu.

In the years 1958-1997 were surgically treated in the Department of Otolaryngology Karol Marcinkowski University of Medical Sciences in Poznan 365 patients with pleomorphic adenomas. Majority of the tumors originated of the major salivary glands was parotid gland (273 cases). The given materials confirms the viewpoint that enucleation in the pleomorphic adenomas of the parotid salivary gland--based on total removal of the tumor together with the capsule and pouch constitute a completely sure surgical procedure.

[Diagnostic difficulties in cases of laryngeal cancer]. / Trudnosci diagnostyczne w przypadkach raka krtani.

The span of time between the appearance of the first symptoms of larynx cancer and the moment it is diagnosed in Poland amounts to approximately 6 months. It is the result primarily of the fact that patients tend to consult a doctor late after the symptoms show as they underestimate them due to their lack of knowledge concerning their nature. In some cases the diagnosis may be difficult to give even for a specialist. The paper presents the cases of three patients with an unusual course of larynx cancer.

[The evaluation of ceftibuten (Cedax) effectiveness in the prevention of perioperative infections]. / Ocena skutecznosci preparatu Ceftibuten (Cedax) w profilaktyce okolooperacyjnej.

Cedax is the antibiotic drug of the third generation cephalosporin type. In the Department of Otolaryngology of the University Medical School in Poznan tests were carried out on the effectiveness of this drug in the prevention of perioperative infections (tonsillectomy, adenotomy, septoplastics, nasal polypectomy, mucotomy). The experiment comprised 50 patients who were administered Cedax once a day of the period of five consecutive days, beginning on the day of the surgery. Control group compare 50 patients who did not receive the antibiotic cover. For the comparison of both groups the following symptoms were taken into account: general condition of the patient, body temperature in the first few days after the surgery, the healing of the operative wound (the condition of mucosa, healing "per primam" or "per secundam"), the presence and type of nasal discharge. A high degree of efficiency of ceftibuten has observed.

[Acute fibromatosis from the standpoint of otolaryngology]. / Wlókniakowatosc agresywna w obrebie narzadów ORL.

Aggressive fibromatosis in the otolaryngological region is a curious clinical entity, demanding accurate histopathologic interpretation. It is rare connective tissue tumor, which growth infiltratively with a destructive biological behaviour similar to malignant tumours and a high recurrence rate. Morphologically reactive fibromatosis and fibrosarcoma should be considered amongst others in differential diagnosis. CT and MR scans are useful in determining the extent of the tumors and help to distinguish the tumor from nerves, vessels and bone. Surgery is the treatment of choice. Our observations of the course of disease in the maxillary sinus, nasal cavity and nasopharynx confirmed the date in literature.

[Adenoid cystic carcinoma in patients in the ENT Department of the K. Marcinkowski University of Medical Sciences in Poznan in years 1980-1995]. / Raki gruczolowato-torbielowate w materiale Kliniki Otolaryngologii Akademii Medycznej im. Karola Marcinkowskiego w Poznaniu w latach 1980-1995.

In the years 1980-1995 60 patients with adenoid cystic carcinoma in the head and neck of different localization were treated at the Department of Otolaryngology. Majority of the tumors originated of the major salivary glands was parotid gland (24 cases). The most common location among the tumor of the minor salivary glands was the palate (5 cases). The tumors arising from others mucous glands, most frequently has located in the maxillo-etmoideal complex (12 cases). The authors stress diagnostic difficulties, the necessity of a proper selection of the surgical method and postoperative radiotherapy, describing the treatment results in the patients. Radical surgical procedure of the adenoid cystic carcinoma yields optimal local control and survival rates.

[Laser resection of the vocal cord growth of the arytenoid cartilage in the treatment of contact ulcer]. / Resekcja laserowa wyrostka glosowego chrzastki nalewkowatej w leczeniu owrzodzenia kontaktowego.

4 cases of larynx contact ulcer cured with the use of laser resection of vocal process of arytenoid cartilage were presented. Advantages of using laser been in microsurgery of larynx were discussed.

[Measurements of DNA-ploidies in patients with carcinoma of the larynx]. / Badania DNA-ploidii u chorych na raka krtani.

In recent years there has been a lot of research done on using DNA-cytometry in the evaluation of larynx cancer. Everyone unanimously emphasizes that aneuploidal and polyploidal neoplasms require special therapeutical treatment. The definition of proliferating activity of neoplasm is of utmost importance. Other than diploidal amount of DNA is characteristic for cells fast dividing and incorrectly dividing. For the evaluation of own material, 20 cases of larynx cancer were collected and underwent a routine morphological and electron microscope evaluation, also flow-cytometry of DNA on Coulter apparatus was carried out. Generally, it can be said that cytometry of DNA in comparison with morphological examination has a secondary function but is nevertheless and important test. It allows the doctor to be more objective in evaluating the population of dividing cells.