Heat exchange in the cryosurgery of Menière's disease: experimental and clinical studies.
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Biomedical subjects
Publications and source records attributed to O Elbrond.
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A case of abnormal course of the facial nerve is described. It was observed in a patient without malformations of the auricle or the external auditory meatus and with a normal otoscopic picture; but multiple malformations, especially of the upper limbs and the genitalia, were present. The chromosome conditions were normal.
An analysis of a series of 127 patients with malignant tumours of the oropharynx is presented. All cases of epidermoid carcinoma were retrospectively classified according to the TNM system. Primary treatment consisted in irradiation in all cases of malignant lymphoma and epidermoid carcinoma. The corrected 5-year survival rate for patients with malignant lymphoma was 53 per cent, and for those with epidermoid carcinoma 40 per cent. In epidermoid carcinoma, 60Co treatment seemed to result in a better prognosis than 250 kV radiation therapy. Both in malignant lymphoma and epidermoid carcinoma, the prognosis was definitely related to the spread to regional lymph nodes.
A case of infrasellar craniopharyngioma in a 14-year-old girl who was subjected to radical operation by a transpalatal approach is reported.
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Esthesioneuroblastomas are malignant tumours, usually of slow, invasive growth and low metastatic rate. Skeletal destruction must be assumed to be common, but is often demonstrable only by tomographic sections. Clinically these tumours do not differ from others of the same site, so that the diagnosis has to be based upon the histological appearances. In the light microscope the presence of neurofibrils is considered a specific differential diagnostic factor against other small-cell malignant tumours in this region. There seems to be no basis for a morphological classification into previously described sub-groups, neither according to histogenetic, light, nor ultra-microscopic findings. The general degree of differentiation and the number of mitoses appear to be the main factors of prognostic significance. Combined irradiation and surgical excision is considered the best treatment.
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Twenty-one cases of glomus jugulare tumours were analysed in retrospect. Six had been treated surgically, ten by irradiation, and five by a combination of incomplete surgical excision followed by irradiation. Recurrences appeared in four cases, but no patient has died of the tumour during the follow-up period which is from a few months to eleven years. Metastases were not found in any case. The optimal time of irradiation in combined treatment is discussed.
The value of various radiographic methods (except laryngography) in laryngeal carcinoma was assessed in a material of 71 patients. Radiography proved of no value in T1 and T2 tumours if a satisfactory clinical examination could be performed but gave valuable information in recurrences as well as in T3 and T4 cases.
A series of 115 patients with malignant tumours of the nasopharynx were primarily irradiated. All the cases of carcinoma were TNM classified in retrospect. 60Co irradiation appeared to afford a somewhat better prognosis than conventional irradiation previously used. The 5-year crude survival rate for the patients with lymphoma and with carcinoma was 40.0 per cent and 23.8 per cent respectively. A distinctly better prognosis was found for women than for men and the prognosis was independent of whether or not lymph node metastases were present. There seems to be no indication for maintaining lympho-epithelial carcinoma as a special group of tumour. Surgical procedures are rarely indicated in the treatment of malignant nasopharyngeal tumours.
A retrospective microscopic evaluation of primary biopsies was carried out in a material of 438 patients with carcinoma of the lip. A multifactorial grading system consisting of 8 parameters, each sub-divided into 4 grades, was used. The degree of malignancy showed a statistically significant correlation to the frequency of metastases, frequency of recurrence or residual tumour, mortality and T classification. This grading system may allow a separation of risk groups in which special treatment and follow-up should be applied.
In a series of 49 patients with epidermoic carcinoma of the tongue microscopy of the primary biopsy was performed, using a multifactorial grading system consisting of 8 parameters, each of 4 grades. The score value (degree of malignancy) revealed a statistically significant correlation with the frequency of regional metastases. As this was particularly marked in the T1 and T2 groups, it seems to be an important supplement to the clinical evaluation of risk groups.
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