Surgery and subsequent irradiation are still considered as the basic treatment of advanced head and neck tumours. Improvements may be achieved by initial combined chemotherapy. However, this regimen has not yet been statistically substantiated. In order to reduce the therapeutic morbidity, Cis-platinum was given as a cytotoxic and radiosensitizing agent simultaneously with percutaneous irradiation. In case of partial tumour regression after a target volume dose of 40 Gy, radiotherapy was continued up to 60 or 70 Gy respectively. In case of minor tumour response, surgery was interposed after a dose of 40 Gy, followed by completing radiotherapy. After a maximum follow-up period of 14 months, 18 out of 22 patients show no evidence of tumour. In two cases a partial regression is seen. One patient died from intercurrent disease, another from uncontrolled primary. This tumour control rate is comparable to the data achieved with initial combined chemotherapy regimens, at a lower level of morbidity. Our preliminary results seem to corroborate the experimentally proven enhancement effect of Cis-platinum.

Cisplatin↗

PubMed1976

[Medical treatment in Menière's disease (author's transl)].

They are different methods of medical treatment in Menière's disease. 1. The dehydration of the hydrops by diet, diuretics, hypertonic solutions and glycerol. 2. Improvement of the blood supply by carbon dioxide, by myotropic and neurotropic vasodilators or by decreasing the blood viscosity and by medical or surgical paralysis of the sympathetic nerve. The optimistic results seen by acupuncture or neural therapy are not confirmed. - Experimental and double blind studies with betahistin (vasomotal) showed a significant effect in improving the blood circulation of the inner ear and the symptoms of Menière's disease. 3. Sedatives especially neuroleptics and tranquilizers were successful only by suppressing the symptoms, but are not a causal treatment. The same mechanism is supposed for procain and lidocain. 4. Partial destruction of the inner ear has been produced by local application of anesthetics or ototoxic antibiotics. These methods succeed in relieving vertigo and save the hearing in most cases.

Anesthetics, Local↗

PubMed1976

[Treatment of Menière's disease with betahistine (author's transl)].

Betahistine was gien to 86 patients with Meniere's disease in a thric daily dose of 8 mg. All patients except for three had earlier been treated medically without success. Symptomatic improvement occurred overall in 82,5%, including in 66% ear pressure symptoms, in 59.5% headache in 57% tinnitus, and in 35% hearing, although this latter statistically was not confirmed. The duration of administration of betahistine is therapeutically important and benefit from 4 months' continued use was demonstrated. After stopping treatment, the therapeutic effects were maintained and more than 6 months later improvement in hearing and ear pressure symptoms was still recorded. There was though a deterioration in symptoms of vertigo, tinnitus and headache in 18% over the same period. The shorter the duration of the symptoms the better the therapeutic effect gained. Improvement estimations of 81% in patients affected for up to 1 month, of 65% in patients affected from 1 to 12 months, and of 50% in patients affected more than one year were obtained. These results compare averagedly with the widely varible results of others. The management of Meniere's disease with betahistine can be regarded as an improvement in the conservative therapy of this disorder.

Audiometry↗

PubMed1974