[Reconstruction of the cervical oesophagus (author's transl)]. / Zur Rekonstruktion des zervikalen Oesophagusabschnittes.

From the numerous methods of reconstruction of the hypopharynx and cervical oesophagus following laryngopharyngectomy a modification of the classical procedure of Gluck and Soerensen is described. the oesophagus is reconstructed 4-5 weeks after the primary excision by two medially based "swinging door" cervical skin flaps with overall wound cover by a deltopectoral flap. This method has been used successfully on 6 patients in the past 2 years and has proved technically simple and functionally sound.

[Surgical management of heavily irradiated tissues (author's transl)]. / Chirurgische Versorgung bei schweren Strahlenschäden.

Pathological changes caused by high-dosage radiation in tissues and bone are described. Characteristic features include compromised blood supply, fibrosis, as well as damage of lymph nodes and osteocytes. Even minor trauma can cause ulceration, infection, radionecrosis or great vessel rupture. Operative treatment is illustrated in two patients.

[Disturbances of taste from oral disinfectants (author's transl)]. / Geschmackstörungen durch Munddesinfizientien.

Oral disinfectants containing chlorhexidine or hexetidine are able to produce disturbances of taste, as demonstrated by Krarup's electrogustometric method and the gustometric method of Harris and Kalmus. Hypo- and dysgeusia are characterized by dissociated disturbances, the most prominent of which concerns the sweet perception. The bitter taste is least affected, whereas the effects on salty and acidic tastes range between that for sweet and bitter. Taste disturbances which include ageusia for 48 h were observed when the tongue was touched with a 20% solution of chlorhexidine. Not only the disinfectants themselves provoked dysgeusia but also other "taste improving" agents (particularly, the volatile oild). In addition to dysgeusia, the authors found disturbances of the mucous membrane sensitivity caused by the test substances.

[Corrective operation of the upper lip-columella-region after closure of bilateral clefts (author's transl)]. / Spätkorrektur der Oberlippen-Columellaregion bei operierten beidseitigen Lippen-Kiefer-Gaumenspalten unter Verwendung des Submentallappens

For the correction of the retracted upper lip and columella after bilateral cleft-operations we use a submental hairbearing flap which cut as a narrow stripe of skin and subdermal tissue and autonomised is swung to the upper lip. The defect to cover results after circumcision of the scarred middle part of the upper lip used as the lower portion of the shortened columella. This method has been used with good results in 4 cases, 3 men and 1 woman.

[Reconstructive surgery of the lips (author's transl)]. / Rekonstruktive Eingriffe an den Lippen

In reconstructive surgery of the lips after resection of tumours the method of Fries will grow to be a most universal procedure. Clinical examples show the advantage of this method which, especially in case of necessary excision of the regional lymphnodes can successfully be combined with a methodical variation.

[The pathogenesis of the nasopharyngeal bursa (Tornwaldt's disease) (author's transl)]. / Zur Formalgenese der Bursa pharyngea (Tornwaldtsche Krankheit)

The pharyngeal recess, first described in 1842 by Mayer, is a cavity in the middle of the nasopharynx, just between the nasal septum and the ventral tuberculum atlantis. It was assumed to be an excavation of the pharyngeal mucous membrane often persistantly fixed to the embryonic spine (Chorda dorsalis). It might be therefore, looked upon as a malformation. The recess is always stuffed with mucous membrane of the pharyngeal tract and ends next to the adenoids. It might pass into the occipital bone as an epithelialized cleft surrounded by connective tissue. Cystic transformation of the recess was first described by Tornwaldt in 1885, causing discomfort in the epipharyngeal and adjacent areas, and was named Tornwaldt's disease. The clinical data of 12 patients with pharyngeal cysts are presented. The conclusion is made, that we have evident lack of knowledge between the rare clinical manifestation of the pharyngeal recess only in adults on the one hand and the almost constant presence of the pharyngeal recess in human embryos on the other. It is therefore assumed, that frequent inflammatory discharge of the nasopharynx during life initiates the development of the nasopharyngeal cyst and not vice versa.

[Covering of defects in the lateral head and neck regions with shoulder flaps (author's transl)]. / Defektdeckung in der seitlichen Kopf-Hals-Region unter Verwendung des Schulterlappens

In many situations the head and neck surgeon is forced to excise large areas of tumor bearing skin in the lateral head and neck regions. This skin, either containing primary malignancies or tumors arising from underlying structures (such as lymph nodes, the mandible or the parotid gland), often is heavily irradiated. Consequently, free full-thickness skin grafts have limited chance of survival because of the reduced blood supply of the adjacent tissue. In these cases we use the so-called shoulder flap, as first described by Conley, to cover large defects. This flap, bases between the trapezius muscle and the scapula, has a rich blood supply, closes the defects in one stage and avoids restriction of the head. In addition, the donor site can be closed transposition of adjacent skin when possible without functional defect. Nine clinical cases are presented.

[Radiogenic disorder in sense of smell (author's transl)]. / Radiogene Riechstörungen

The influence of radiotherapy on the sense of smell was investigated in 24 patient (age 28-80 years) with Elsberg's method. Out of 19 patients, who were measured 1-15 years after radiotherapy, the thresholds exceeded the normal range in no case, i.e. no permanent disturbance of smell after radiotherapy. In 5 patients, tested before, during and after irradiation, the thresholds rised continuously to the upper margin of the normal limit between 1,000 and 6,000 rads and, after the end of therapy returned to initial levels within 6-8 weeks.