Incidence of cleft lip, alveolus and palate forms.

The different cleft forms of 1,450 cleft lip, alveolus and/or palate patients have been analyzed. Randomized groups of 50 plus the next 50 patients and so forth have been examined. The resulting 29 groups reveal a maximum of 139 different clinical cleft forms. The prediction of a possible maximum was made with the exponential formula y = a. (1-eb.x). The tendency of the prognosis levels at a maximum of 169 different cleft forms in and above 4900 patients.

Data-objective diagnosis of infant cleft lip, alveolus, and palate. Morphologic data guiding understanding and treatment concepts.

Maxillary plaster models of untreated infants with various cleft lip and palate forms have been studied under the Reflex Microscope. From the three- dimensional data processed by a PC, the specific dimensions of various cleft forms can be determined. Unexpected findings are that skeletal maxillary changes are present in infant velar clefts. The mid-sagittal maxillary length in particular becomes shorter with more severe clefting of the bony palate. From the morphologic point of view, Robin's sequence does not represent a specific entity, but usually a severe cleft of the hard palate. Unilateral clefts of lip, alveolus, and palate with a partial cleft lip reveal worse malformations than complete unilateral clefts. The morphologic changes recorded can be explained by a varying degree of lingual malposition. This reveals that displacements and malformations of infant cleft lip and palate are in fact secondary in nature. In correcting these secondary surface manifestations as soon as indicated by physiologic criteria one could hope for early normalization of sensation, perception, and function. Three-dimensional high-precision measurements are crucial for data-objective diagnoses, timing of therapy, choice of treatment, and in later evaluation of the results.

Carcinoma of the oral cavity: on the prognostic significance of the primary tumour site (by organs) in the oral cavity.

The prognostic significance of so-called organ sites was investigated in 585 cases with carcinoma of the oral cavity and lips. For the subsamples studied the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: 1. There is no demonstrable difference in prognosis between identical T catagories in the organs of the oral cavity. 2. In some cases there is a significant difference between identical N categories in organs of the oral cavity. In the No category this is, however, attributable to the substantial differences in the numerical distribution of T categories. By contrast, a logical explanation for the computationally demonstrable significant differences in the Nx category is not available. The problem is currently being investigated. 3. An assessment of identical TN combinations in the "organs" of the oral cavity proved to be impossible on account of the inadequate number of cases available. The so-called "organ localization" of primary tumours in the oral cavity need not - at least for the time being - be accorded any prognostic relevance. The findings should, however, be re-examined on the basis of greater numbers.

[A retrospective study of carcinomas of the oral cavity: a preliminary report (author's transl)]. / Karzinome der Mundhöhle. Vorläufiger Bericht über eine retrospektive Studie.

UNLABELLED: The German-Austrian-Swiss Research Team on Maxillofacial Tumours is investigating a series of 585 carcinomas of the oral cavity, lips and oropharynx by biostatistical methods. The aim of the study is the determination of relevant prognostic symptoms of oral cavity carcinomas, classification of the series on the basis of these symptoms, the determination of therapeutic efficacy and the assessment of collective and individual prognosis. PRELIMINARY RESULTS: 1. Factors of prognostic relevance are probably only tumour size and intensity of regional metastases. 2. The classification of the series becomes problematic due to the lack of relevant prognostic factors.

Carcinoma of the oral cavity: on the prognostic significance of the primary tumour site (by levels and areas).

The prognostic significance of primary tumour site in carcinomas of the oral cavity was investigated in a series of 585 cases. For the subsamples (levels and areas of oral cavity) studied, the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: Given an identical extension and analogous metastazising rate, there is no computationally demonstrable difference in prognosis between primary tumours sited at different levels and areas of the oral cavity. The exception are the T1Nx categories, for which a difference exists between precanine and retromolar sites. These results should be re-examined on the basis of a larger series.

TNM-classification of carcinomas of the oral cavity-efficacy of clinically available data (TN).

Using adequate number of cases, the influence of the spread of primary tumour and the degree of regional metastasis on prognosis were investigated. Assuming a practicable classification as a prerequisite for clinico-therapeutic cancer research, experience has shown that the assessment of the spread of primary tumour alone does not suffice for the establishment of comparable homogenous data. The investigation on the importance of the degree of regional metastasis has shown, above all, that the percentage of N3-metastasis within the T-groups contributes essentially to the fact that these show a marked difference in their prognosis. It would therefore appear necessary also to examine the importance of other clinically accessible data in the assessment of prognosis. Only then could we be in a position to judge whether, and to what extent a clinically practicable classification and integration into special groups is possible on the basis of clinically available data. The inclusion of more clinics in the joint investigation is encouraged.

[TNM-classification of oral cavity neoplasms the value of clinically measurable factors (TN)]. / TNM-Klassifizierung der Mundhöhlenkarzinome--Wertigkeit klinisch fassbarer Sachverhalte (TN).?19H

Problems associated with the classification of cavum oris and labial carcinomata were discussed with particular reference to patients admitted to and treated in seven different clinical hospitals where identical methods of diagnosis and case history evaluation had been used. Using electronic data processing and biostatistical methods it was possible to study the effects of two clinically detectable factors (growth of primary tumor and degree of regional metastasizing) on both the prognosis and classification according to UICC rules. It was possible to show that a determination of the size of primary tumor (T) alone was not sufficient for three homogeneous, prognostically different collectives of tumors to be satisfactorily classified by the new UICC rules. It has been shown that a classification of three collectives of tumors (new classification according to UICC rules), especially as regards the proportion of N3 metastases within the collectives of tumors, was made possible. Therefore, it will be necessary to study the prognostic influences of additional clinically determinable factors with a view to arriving at a useful and practicable classification of oral cavity carcinomata.

[Sialadenitis in a boy with anorexia nervosa]. / Sialadenose bei einem Jungen mit Anorexia nervosa

Isolated sialadenosis of both sumandibular glands and anorexia nervosa are clinical pictures found extremely seldom in boys. This paper describes a case with symptomless enlarged submandibular glands, the bioptic findings which were suggesting the diagnosis of sialadenosis, the verification of the underlying disorder by child psychiatry, and the recuperation of the boy during puberty.

[Sialadenosis as secondary organ manifestation of anorexia nervosa (author's transl)]. / Zur Frage der Sialadenose als sekundärer Organmanifestation der Anorexia nervosa--Beobachtungen an einem 13jährigen Knaben

In a 13-year-old boy the occurence of a sialadenosis of the submaxillary glands was observed in association with anorexia nervosa (a.n.). The non-inflammatory salivary gland enlargement became apparent after the boy had suffered a progressive weight loss of 5 kilograms during a period of three years prior to admission. The psychogenic origin of the disorder could be confirmed by 1. the history of the patient being almost identical compared to the few observations of a.n. in males, 2. the absence of any other organ involvement, and 3. follow up over a period of two years during which time the boy regained normal weight, and the salivary gland enlargement disappeared spontaneously. The diagnosis of sialadenosis was based on histological examination.