John C. Gaisford

Management of recurrent salivary gland tumors

The management of 129 patients with recurrent tumors of the salivary glands is analyzed, Principles of approaching recurrent tumors and guidelines for their management are outlined in detail. Age distribution, symptoms, time to recurrence, cases that showed possible malignant degeneration, and complications are reviewed. The surgical procedures, recurrence rate, and survival rates are recorded.

Pilonidal sinus carcinoma

Abstract 1. 1. The previously reported seven cases of malignant change in an area of pilonidal disease are reviewed and an additional case presented. 2. 2. Wide excision of the primary lesion with primary operative defect coverage with a thin split-skin graft and groin dissection for palpable lymphadenopathy are presented as the current management of squamous cell carcinoma arising in an area of pilonidal disease.

A suggested technic for resection of the temporal bone

Abstract 1. 1. The management of tumors involving the temporal bone is briefly presented. 2. 2. Twelve cases of partial resection of the temporal bone performed from 1954 to 1966 by the authors are discussed. 3. 3. Conservative bone resection under direct vision is described and immediate flap reconstruction emphasized. Operative and postoperative complications are believed to be greatly reduced by this technic. 4. 4. A 42 per cent five year survival rate is reported and suggestions for failure to obtain higher survival rates are given.

First branchial cleft cysts and sinuses.

A brief review of the embryology and anatomy of first branchial cleft cysts and sinuses, with a resume of our experience, is presented. An illustrative case of each general type of this anomaly is given. The surgical treatment of these lesions, with special reference to technique and the precautions to be applied to minimize complications and recurrence, is discussed.

Intra-arterial nitrogen mustard for control of pain in head and neck cancer

I NTR,~-ARTERI,~L instihation of nitrogen mustard has been used on our service reguIarIy during the past tweIve years. It has been found to be a usefu1 adjunct in the treatment of a patient with uncontroIIabIe pain as a resuIt of incurabIe malignancy. No patient has been given this drug with the hope of curing a cancer, but to paIIiate the patient when ordinary sedation and narcosis no Ionger afforded comfort. We have managed approximateIy one hundred patients undergoing intra-arteria1 chemicals for pain control and have drawn certain definite concIusions. The compIication rate was high and severa of these diffrcuIties wiI1 be described in some detai1.