[Juvenile angiofibroma]. / Juveniles Angiofibrom.

There is no definite attitude towards etiology of angiofibroma. In diagnostics, besides the classic epypharyngoscopy, X-rays and CAT, an endoscopical epypharyngoscopy which gives insight into the diameter of the tumour base, also proved to be useful. Embolisation of art, maxillaris on the tumour's side would also be necessary in order to diminish bleeding upon the surgical manipulation. Surgery proved to be the only effective therapy in the treatment of angiofibroma. The surgical approach to the tumour depends on its localisation and on its being a primary tumour or a recurrence. A radical removal of the tumour with the least possible mutilation of the patient should be accomplished by the surgery. From 1962 to 1984, 28 cases of angiofibroma were treated at the Dept. of Otorhynolaryngology. All the patient were from 10 to 52 years old. The tumour was distributed by stages as it follows: T1 = 7; T2 = 6; T3 = 14; T4 = 1. There were 13 recurrences.

[Relationship between surgery, chemotherapy, irradiation and immunological state in patients of laryngeal cancer (author's transl)]. / Einfluss von Operation, Zytostatika und Bestrahlung auf den immunbiologischen Zustand von patienten mit Larynxkarzinom.

The relationship between surgery, chemotherapy, irradiation and the immunological state in patients of laryngeal cancer with or without metastasis was investigated. The lymphocyte reaction to PHA (Phytohaemagglutinin) stimulation and T-lymphocyte count was examined before and immediately after the therapy in 66 patients divided into three groups. From the results the authors conclude that surgical treatment (partial or total laryngectomy, with or without radical Neckdissection influence the immunological state of the patients at least, chemotherapy more and irradiation at most.

Immunological investigations in laryngeal cancer.

The authors carried out immunological investigations in 96 patients with laryngeal cancer. The following tests were applied: DNCB, PPD, phyto-test and the lymphocyte count. The patients were divided into three groups: 1) cured, one year following treatment; 2) relapses; 3) died during the first year. The separate group of 13 patients tested twice in first year was analysed too. The immunological tests were also performed in 24 patients with no relapses of laryngeal cancer in the period between 3 and 10 years after treatment. This group was used for a comparative analysis with laryngeal relapses. In our opinion each individual test has its relative merit. According to our results patients with normal and elevated test values have the best prognosis of cancer disease.

Contribution to therapy of dysphonia plica ventricularis.

Excision of the hypertrophic ventricular folds was performed in 35 patients by means of laryngomicroscopy. In most of our patients this therapy promptly resulted in a clear voice. Correlating the laryngomicroscopic finding and the histological picture we were able to classify hypertrophy of the ventricular folds into three stages, each of which presents with a characteristical clinical and histological picture and thus requires approapriate therapy. In Stage I the histological changes are reversible and conservative phoniatric therapy leads to success relatively quickly. In the second stage histological changes may also be reversible, and the prolonged and persistent phoniatric therapy leads to success but we prefer microsurgical excision because of the direct effect. In Stage III, however, we found irreversible histological changes in the sense of connective hyperplasia which prompted us to conclude that microsurgical excision alone may lead to regression of the hoarseness.

[Our results with partial vertical laryngectomies]. / Unsere Resultate bei partiellen vertikalen Laryngektomien

The method of covering a broad endolaryngeal defect following extensive partial surgery of the larynx by means of the fascia of the sternohyoid muscle is presented. Of 71 cases of vertical and combined vertical and horizontal partial laryngectomy recurrence was seen in 15 cases, nine of them died. The fascia showed resistance to all postoperative complications and there was not a single case of rejection. In only 4 cases it was not possible to carry out decannulation because of postirradiation complications in the form of oedema, stenosis or fixation of the cricoarythenoid joint.

[Preoperative irradiation of larynx and hypopharynx carcinoma]. / Die präoperative Bestrahlung von Patienten mit Larynx-und Hypopharynxkarzinom

30 patients with carcinoma of the larynx or hypopharynx were irradiated preoperatively with a dosis of 1,500 to 4,500 rads. The results are compared with those of an identical group of patients who were only operated. The operation was mostly partial (20 cases). In laryngeal cancer the cure rate after two years was 69% and 47%, in hypopharyngeal cancer 43% and 28% respectively.

[Malignant case of angiofibroma (author's transl)]. / Bösartiger Verlauf eines Angiofibroms

Various opinions about the etiopathogenesis of angiofibroma are mentioned. The authors, however, have not succeeded in confirming the frequently mentioned theory of hormonal formation of these tumours. It appears that surgical therapy is the only efficient way today of providing a clear view and a rapid radical removal of tumours, thus reducing the usually profuse haemorrhage during surgical treatment. Pre-operative ligation of the external carotid artery has no noticable effect on the reduction of haemorrhage during the operation. X-rays have no effect on the growth of the tumours. There is no great difference between the histological picture of a primary tumour and that of its recurrences. The malignant course of an angiofibroma in an adult is described which recurred several times and led to the involvement of the endocranium with a letal ending. The histological picture remained unchanged all the time. A spreading of the tumour was noticed in areas distant from the primary localisation of the tumour which we consider to be due to implantation and which indicates great potential growth of tumour cells of this angiofibroma.

[About some changes of the vocal cord mucosa and of Reinke's Subepithelial space (author's transl)]. / Uber einige Veränderungen an der Stimmlippenschleimhaut und im Reinkeschen Raum

The mechanical irritation alone or in combination with an inflammatory component and fragility of blood vessels plays the decisive role in the development of some vocal cord morphological changes. The duration of the mechanical irritation modifies the clinical picture. The plase of the strongest physiological mechanical irritation is the place of localization of the vocal cord morphological changes. The histological picture of different pathomorphological vocal cord changes is almost identical, this being the consequence of the specific structure of Reinke's subepithelial space. The treatment of all these morphological entities is surgical by means of microlaryngoscopy, except in cases of recent nodules which respond to conservative phoniatric therapy in the majority of cases.