[Preliminary results of a preoperative polychemotherapy protocol in carcinomas of the pharyngo-larynx. Oncovin, methotrexate and bleomycin (author's transl)]

213 squamous carcinomas of the pharyngo-larynx (piriform fossa, pharyngo-laryngeal junction and larynx) received preoperative chemotherapy in the form of oncovin, methotrexate and bleomycin (OMB). All the patients then underwent total or partial laryngectomy, associated with lymph node excision of some sort, followed by radiotherapy. A symptomatic improvement after OMB was seen in 21.2% of cases. Overall tumour response regardless of the site was 32%. Tumour response was all the better when lymph nodes were histologically free of disease (38.7% tumour response in N- as against 26.7% in N+). There was no significant difference in 1 year survival rates between those patients in whom there was a tumour response and those in whom tumour size remained the same.

[Epitheliomas of the anterior margin of the larynx. A study of 102 cases (author's transl)]

In this second part, we study 102 cases of epithelioma of the anterior margin of the larynx. The authors insist on the need for bilateral treatment of lymphatic areas on account of their frequent bilateral involvement, jumping from 9% for N0 to 80% for a fixed unilateral enlarged lymph node. Whatever the T stage, the best therapeutic results are provided by total or partial surgery of the lesion combined with surgical treatment of lymphatic areas completed by irradiation.

[Epitheliomas of the lateral margin (author's transl)]

The third part ends the study on epitheliomas of the laryngeal margin and concerns 8 cases of epithelioma of the lateral margin (aryteno-epiglottic fold and intersection of the three folds). The authors emphasize the considerable lymphatic tropism of these tumors. In 58% of these, enlarged lymph nodes were found, 65% of which showed histological involvement. Best results (survival and local sterilisation) are provided by surgery, partial or complete, depending on the T stage, the tumoral site, and combined with lymphadenectomy, completed by irradiation.

[Epitheliomas of the margin of the larynx. Definition, classification and extension (author's transl)]

Studying 213 cases of epithelioma of the laryngeal margin, the authors report on a 3-part study. The first part defines, classifies and specifies the extension of marginal epitheliomas, the second part studies anterior margin epitheliomas and the third, epitheliomas of the lateral margin. This first part shows that the laryngeal margin forms a precise anatomo-clinical entity which must be subdivided into anterior lateral posterior and total margins. The anterior margin consists of the free edge, the supra-hyoid laryngeal side of the epiglottis and, for the authors, the laryngeal side of the epiglottis that belongs, for the UICC, to the oropharynx. The lateral margin consists of the aryteno-epiglottic fold and, for the authors, of the intersection of the three fold that are not mentioned in the UICC or the AJC classifications. The arytenoid cartilage forms the posterior margin. Together, tumors of the anterior margin and the lateral margin make up for 94% of marginal tumors. This first part specifies the macroscopic aspects of marginal epitheliomas with their local and lymphatic extension.

[The value of fibroscopy in laryngotracheal stenosis (author's transl)]

The authors report the results of 297 fibroscopies in 69 patients suffering from laryngotracheal stenosis. These examinations were carried out either before treatment or for follow-up purposes. The majority of patients had undergone respiratory intensive therapy. The underlying reason for this intensive therapy was analysed, as well as the techniques used : intubation 26 %, tracheotomy 33,5 %, intubation followed by tracheotomy 40 %. Results of fibroscopy before treatment (111) are described, emphasizing the fact that this fibroscopy was adequate in the great majority of cases (96 %) to reach a decision as to wether surgery was necessary or not, and this even though certain patients had suffered severe respiratory failure. Follow-up fibroscopies (185) were useful in all cases for aspiration of the patient and observation of the suture. In 17 cases, the opportunity was taken to remove a polyp and in 10 cases removal of a suture. Finally, the authors emphasize the safety of this method of investigation (4 % of untoward incidents) which they feel to be necessary and adequate in the evaluation of laryngotracheal stenosis.,

[The contribution of standard views of the mastoids in the treatment of cholesteatoma (author's transl)]

The authors consider than standard films of the mastoid (bilateral Schüller, mastoid tips displaced) are essential in all cases of chronic cholesteatomous otitis since they frequently provide the surgeon with useful information concerning appropriate management. Their opinion is illustrated by very convincing cases. Furthermore, they form part of personal hypotheses concerning the course and the interpretation of certain aspects.

[Exenteration: taboo of cholesteatomatous chronic otitis. Opinion based upon personal experience (author's transl)]

The authors recall that in cholesteatomatous chronic otitis exenteration should be performed only as a last resort. This accepted, to wish to present it as an opprobious operation responsible for all evils is excessive. In 288 cases of cholesteatomatous chronic otitis treated between 1971 and 1978 (out of 433 cases of progressive otitis) 241 were treated surgically by the technique involving destruction of the osseous meatus. Amongst these 241 exenterations, there were 106 (i. e. 40%) in which the indication was absolute since they involved ears which were either cophotic or had already undergone exenteration. Reviewing a recent study of the local appearance in 225 cases of exenteration including 198 for cholesteatoma, they find 84% of ears perfectly dried up and healing in the long term. With regard to the restoration of healing, this problem arose, later, in only 6% of cases.

[Compressive brachio-cephalic arterial trunk and gastro-oesophageal reflux following surgery for oesophageal atresia (author's transl)]

6 cases of cardiorespiratory complications occurring after surgical treatment of oesophageal atresia are reported by virtue of the association of tracheal compression by the brachio-cephalic arterial trunk and of gastro-oesophageal reflux. In all cases, medical (2 cases) or surgical (4 cases) treatment of gastro-oesophageal reflux led to the disappearance of all respiratory symptoms and signs. Emphasis is placed upon the need for a routine and thorough search, radiological and endoscopic, of such associated oesophageal pathology, before proceeding to surgery on the compressive brachio-cephalic arterial trunk.

[Study of a series of 158 parotidectomies and histological problems in mixed tumors of salivary glands (author's transl)]

About a homogeneous statististic of 158 parotidectomies, authors study repartition parameters of parotid gland tumors. They insist on particular surgical and evolutive problems in relation to histology sometimes very difficult.

[Thyroid gland carcinomas. Statistical study of 79 cases (author's transl)]

Experience with 79 adult patients treated for thyroid cancer. The authors study different parameters of these cancers, particularly sex and age, circumstances of discovery and histological distribution. The state precisely their operative procedure and arguments on account of total thyroidectomy.

[Undifferentiated cancers of the thyroid gland. Value of adriblastin]

About 21 cases, the authors recall general characteristics of undifferentiated cancers of thyroid gland. They underline the difference between undifferentiated trabecular cancers and anaplastic cancers of which evolution is highly malign and explosive. A few observations confirm interest of Adriblastin associated with a wide surgery.

[Primary bronchogenic and pharyngo-laryngeal carcinomas (author's transl)]

The study of 112 case histories of lung cancers, both primary and secondary, has allowed the authors to determine as being of 5% the incidence of primary bronchogenic carcinoma associated with treated pharyngo-laryngeal cancer. One out of three such primaries was a solitary lung opacity. Bronchogenic primaries appeared be almost as frequent as lung, pleura and mediastine secondarie. They can be diagnosed at any moment of the treatment or follow-up of pharyngo-laryngeal cancer, and appear to occur later than pulmonary metastases. Their symptoms are more "bronchopulmonary" in nature. They are more frequently associated with endolarynx and chorda carcinomas. They are possibly more frequent in cases of smaller primaries without lymph-node involvement. Solitary lung opacities should be considered as independent primaries and constitute the best candidates for efficient pulmonary treatment. Treated pharyngo-laryngeal patients should undergo regularly spaced lung roentgenograms and frequent tracheal sputum cytology.

[Primary pharyngolaryngeal carcinoma, pulmonary metastases and carcinoma of the bronchus (author's transl)]

On the basis of 112 cases of pulmonary or mediastinal neoplasms observed during the treatment or follow-up of 952 carcinomas of the pharynx and larynx, the authors study in detail 45 cases of metastases. They draw the following conclusions:--metastases present clinically relatively early in the treated course of pharyngolaryngeal carcinomas: 85% before 18 months.--cannonball lesions are the commonest endo-thoracic clinical metastases: 6 out of 10.--carcinomas of the hypopharynx are at the origin of 2/3 of cannonball lesions (alpha less than or equal to 0.02) and 1/4 of mediastinal lymphadenopathies and pleural effusions.--endolaryngeal carcinomas are rarely at the origin of cannonball lesions and are associated almost exclusively with mediastinal lymphadenopathies and pleural effusions (alpha less than 0.001). The influence of the size of the primary tumour, of lymph node involvement, of capsular rupture and of failure to eliminate all malignant cells from the primary lesion are considered and discussed.