[The oto-rhino-laryngology clinic at Lund--yesterday, today, and tomorrow].

Oto-rhino-laryngology became a separate unit of the University Hospital in Lund in 1904 and has since then had only four heads: F.V. Törne, G.

Early postoperative basal serum GH level and the GH response to TRH in relation to the long-term outcome of surgical treatment for acromegaly: a report on 39 patients.

During a 10-year period 39 patients with acromegaly, aged 23-73 years, underwent selective adenomectomy via a trans-sphenoidal or transfrontal (one case) approach. Six to 12 months after the operation, the serum level of growth hormone (GH) was reduced to less than 5 micrograms l-1 in 28 patients (74%) in at least two of three random samples and/or suppressed to less than 3 micrograms l-1 during an oral glucose load, thus fulfilling the commonly used criteria for a successful operation. In 10 patients these criteria for adequate GH reduction were not fulfilled, but their median S-GH level was reduced from 38 to 11 micrograms l-1 (P less than 0.

Management of parotid gland neoplasms.

This clinical review presents a survey of the different types of epithelial neoplasms in the parotid gland. The incidence, histopathological classification, grade of malignancy, and staging system are discussed. Diagnostic procedures are reviewed and a scheme for treatment is proposed for the different types of epithelial parotid neoplasms.

Intra-arterial chemotherapy of malignant head and neck tumours with superselective angiographic technique.

A technique is described for repeated superselective angiographic infusion of anticancer drugs into advanced malignant tumours of the head and neck region. The technique allows for a high concentration of the drug in the tumour and, furthermore, it is possible to ensure that the infused anticancer drug adequately reaches the tumour. Mitomycin C was given to 15 patients with advanced malignant tumours of the head and neck region.

Ultrastructure of salivary calculi.

Twenty-one submandibular salivary calculi from 19 patients were examined with the light and electron microscope. Adjacent to the peripheral parts of the calculi metaplastic squamous epithelium or connective tissue was seen in close contact to the mineralized matrix. Disintegrated cellular substances from these tissue components were in some cases found to condense in a peripherally located zone of the salivary calculi.

Angiolithiasis in the parotid gland.

Angiolithiasis in salivary glands is a very rare finding, and the knowledge of the morphology and histogenesis of these stone formations is therefore limited. Six small angioliths from the left parotid gland of a 19-year-old girl were examined histologically, microradiographically and diffractometrically. The angiolithiasis developed from a regressed hemangioma which had been observed since the patient was 3--4 years old.

Selective intra-arterial cytotostatic injections in malignant head and neck tumors.

Regional intra-arterial drug administration has been advocated in order to reduce the risks of systemic complications in conjunction with systemic tumor chemotherapy. We have been using superselective angiographic techniques to administer the antitumor drug mitomycin C directly into the feeding arteries of the tumor in 15 patients with advanced malignant head and neck tumors. No complications were observed.

Antibiotic concentrations in saliva of purulent parotitis.

In patients with unilateral acute purulent parotitis treated with penicillin and doxycycline the antibiotic concentration was determined in plasma and saliva from both the healthy and the affected parotid gland. The results show that the penicillin concentrations in purulent saliva of the diseased gland is considerably higher than in non-purulent saliva of the healthy parotid gland. There was no such marked difference in concentrations of doxycycline.

The relation of lipids to the mineral components in salivary calculi.

Using lipid histochemical and microradiographic methods, the distribution of lipids and the inorganic component in different areas of salivary calculi was investigated. Two main groups of lipids were found, i.e.

Preoperative facial paralysis in malignant parotid tumours.

Preoperative paralysis of the facial nerve was found in 145 of 1,029 patients with malignant parotid tumours (14%) treated at nine university clinics in Scandinavia. The incidence of facial paralysis varied between the different clinics. A parellelism between the incidence of the facial paralysis and the impairment of the prognosis of the different tumour types is shown.

A cytochemical method of grading the malignancy of salivary gland tumours preoperatively.

Aspiration biopsy is an accurate but still a somewhat controversial method of diagnosing salivary gland tumours preoperatively. During the last few years this method has been more and more accepted dependent on its increasing reliability in diagnosing the different types of tumours, but for an adequate treatment it is also important to know the malignancy degree of the individual tumour. Since invasiveness is the most significant morphological criterion in evaluating the prognosis of a salivary gland tumour it has, however, been difficult to grade the malignancy morphologically on a cytological basis.

The antibacterial effect of antibiotics in treatment of maxillary sinusitis.

The antibacterial effect of antibiotic treatment in maxillary sinusitis has been assessed by studying the elimination of bacteria from the maxillary sinus during treatment with penicillin and tetracycline. As adequate antibiotic concentrations are the prerequisite for maximal antibacterial effect, the antibiotic concentrations were controlled. The antibiotic concentrations were determined in maxillary sinus secretions and/or mucosas of 113 patients with maxillary sinusitis, treated with single or repeated doses of penicillin or tetracycline, or the two antibiotics in combination.

Radiosialometry. II. The diagnostic accuracy of different evaluation parameters.

The temporal course of 99TcmO4 accumulation in the parotid gland after fast intravenous injection of the radionuclide was measured quantitatively by radiosialometry in 32 patients suffering from inflammatory or neoplastic diseases of the parotid glands. The diagnostic accuracy of five different evaluation parameters was compared. It was found that without reducing diagnostic accuracy, the method used could be simplified by omitting three of the five evaluation parameters.

Radiosialometry. 1. A method for evaluation of salivary gland disorders.

The temporal course of the total 99Tcm40 acumulation in the parotoid glad after fast intravenous injection of the readionucleotide, is studied by examination with quantitative radiosialometry. The method adopted is based on the use of two collimated, symmetrically located and opposite placed NaI-detectors. The normal ranges of five evaluation parameters are obtained from a control material of 100 parotoid glands in 50 individuals without disorders of the parotoid glands.

Aspiration biopsy of salivary gland tumors. VI. Morphologic studies on smears and histologic sections from mucoepidermoid carcinoma.

The cytologic findings in fine-needle aspiration biopsy of 24 primary mucoepidermoid carcinomas of salivary glands are reviewed. The morphologic details which permit recognition of this tumor in smears of the aspirate are described.

[Clinical aspects of salivary gland tumors].

This paper reports on epithelial tumours arising primarily in the major and minor salivary glands. The purpose of this presentation is to summarize our experience of salivary gland tumours on the basis of a material comprising of approximately 3000 salivary gland tumours as well as a review of the literature to date. The tumours are classified according to the classification recommended by WHO 1972.

Mucosal malignant melanomas of the head and neck with special reference to cases having a prolonged clinical course.

A histological re-examination and re-classification of primary mucosal tumours of the head and neck region, treated at Radiumhemmet and Karolinska Sjukhuset during the period 1927-1970, revealed that 41 tumours were malignant melanomas. All these 41 tumours were located in the nasal cavity, paranasal sinuses and oral cavity and not a single case of primary mucosal malignant melanoma was found in other locations of the head and neck region. In the present study, the long-term prognosis has been analysed.

The relationship between the nuclear DNA content in smears of aspirates and the prognosis of mucoepidermoid carcinoma.

Cytophometric analysis of nuclear DNA content was performed in a series of mucoepidermoid carcinomas with an extreme difference in the clinical course, which was observed during a follow-up period of 6-13 years. The prerequisite for such a study was the development of a method, which made it possible to study the nuclear DNA content in tumour cells obtained at the time of diagnosis, i.e.

Crystalline structure of salivary calculi. A microradiographic and microdiffractometric study.

The crystalline substances localized in different areas of salivary calculi were identified by using microradiographic and X-ray microdiffractometric techniques. All 19 calculi analyzed had a general pattern of apatite which was recognizable both in the center and at varying distances from the core. In addition to apatite patterns, six of the calculi gave a diffraction pattern of whitlockite, which in all but one case was located in the central part of the calculi.

Morphology of salivary calculi. The distribution of the inorganic component.

Different hypotheses concerning the pathogenesis of salivary calculi have been postulated on the basis of their morphology. In the present study, microradiography of plane-polished ground sections of a number of salivary calculi has shown that the morphology of salivary calculi varies considerably. The commonly accepted concept that salivary calculi emanate from an inorganic nucleus, which then successively grows by the apposition of alternating shells of organic and inorganic substances, could not be established by this study, as the microradiographs show that the distribution of mineral elements varied extensively from one calculus to another.

Malignant melanoma of the oral cavity.

Mucosal malignant melanomas of the oral cavity are rare and the present series comprising 23 patients is one of the largest ever published. The poor prognosis of these tumors appears from the fact that only two of the 23 patients could be presumed to have been treated sucessfully. The survival time of the 21 patients who died during the follow-up period was short in all but one patient, surviving 35 years after the first symptom of the tumor despite regional lymph node metastases in an early stage of the disease and repeated local recurrences.

Antibiotic concentrations in maxillary sinus secretions and in the sinus mucosa.

In maxillary sinusitis, the blood circulation is supposed to be impaired in the oedematous sinus mucosa, and in such cases the transport of antibiotics into the maxillary sinus should be reduced. To prove the accuracy of this assumption a comparison has been made between the concentrations of penicillin and doxycycline (Vibramycin, Pfizer) in sinus mucosa and secretions and the serum concentrations in patients under treatment with these antibiotics. Measureable concentrations of penicillin (greater than 0.

Evaluation of the antibiotic effect of treatment of maxillary sinusitis.

As the effect of antibiotic treatment of maxillary sinusitis has been questioned, the elimination of bacteria from sinus secretions was studied during antibiotic treatment. Penicillin V, azidocillin, tetracycline or doxycycline was administered to 54 patients with maxillary sinusitis. Samples of sinus secretion were aspirated both before treatment and 2-3 days after the onset of treatment.