John Conley

Malignancies of the ear.

Cancer of the ear is an uncommon occurrence and rarely diagnosed early in its development. Routine biopsy of all granulomatous and neoplastic diseases of the ear is essential to early diagnosis. Polytomography is an aid in documenting the extent of the disease in bone. The surgical anatomy of the region of the ear imposes special disadvantages upon any type of surgical technique employed and supervoltage irradiation given. Temporal bone resection and its modifications, combined with irradiation, enhance the cure rate in the advanced cases and add significantly to the local control of this disease. A review of 273 cases is presented.

Radical neck dissection

Radical neck dissection has evolved into a standard surgical technique over the past century. It has been the most effective method of attempting to control suspected or gross metastasis to the cervical region. The technique embraces the en masse removal of all tissue elements in the space between the subdermis and the fascia colli. The perimeters of the dissection extend from the midline anteriorly to the anterior border of the trapezius muscle posteriorly, and from the clavicle to the mandible. The essential portion of this large mass of tissue is the cervical lymph system with its lymph nodes and afferent and efferent connecting vessels. Controllability of the cancer process is in direct proportion to the number of nodes involved, their size and their position in the neck. Complications in the routine radical neck dissection are minimal. Cure rates are influenced by the type, size and site of the primary cancer, the possibilities for adjunctive treatment such as radiotherapy and chemotherapy, and the, as yet, little understood immunological factors. The radical neck dissection has proven itself to be an essential tool in the management of cancer in the head and neck.

Regional skin flaps in partial laryngectomy

The use of regional neck flaps for rehabilitation has permitted an extension of operations on the glottis. The resection may include both vocal cords, both ventricular bands, one arytenoid and slight subglottic extension in a one- or two-stage technique. The resultant voice is low pitched, soft and has limited range. The cure rate was 85 percent.

Long‐standing facial paralysis rehabilitation

A group of 32 patients with severe facial paralysis from 2 to 30 years and of different etiologies were studied. Various degrees of nerve and muscle atrophy were noted in this group. A new concept relative to the status of the paralyzed face, its nerve and muscle system and their capacity for rehabilitation was acquired.

Symposium: adjuvant cancer therapy of head and neck tumors.

The most effective methods of treatment of patients with head and neck cancer are surgery and radiotherapy. A combination of these in which radiotherapy preceeds surgery in a planned treatment protocol is attractive as it has the potential of combining the best features of each of these proven modalities.