TREATMENT OF INTRAORAL CARCINOMA—Combined Resection of the Jaw and Radical Dissection of the Neck

Intraoral carcinomas first occur as primary growths. From these sites they spread by the lymphatics to the regional nodes. In the past, treatment of these lesions has consisted of radiation therapy for the primary lesion, followed by radical neck dissection. The results of this treatment have not been satisfactory. On the other hand, for carcinoma elsewhere in the body the results of surgical extirpation of the primary lesion, of the intervening lymphatics and of the regional nodes at the same operation has given much better results.In the past few years an attempt has been made to improve the results of treatment of intraoral carcinoma by removal in continuity of the primary lesion, intervening lymphatics and regional nodes. The improvement in anesthesiology, electrolytes and fluid balance, blood replacement, and the development of the antibiotics, in conjunction with the realization that the cosmetic deformity is not as great as might be expected, has led to this development. In those centers where it has been possible to apply this principle of treatment to intraoral carcinoma the results have been very encouraging.     

DIAGNOSIS AND TREATMENT OF GLAUCOMA—A Review of Recent Developments

Tonography is helpful in the diagnosis of doubtful cases of chronic simple glaucoma. If also gives a good indication of the status of the disease in a given eye.The most useful miotic in the treatment of glaucoma is still pilocarpine. Carbachol is more potent but must be used in an anhydrous base ointment or in a solution of a wetting agent. DFP (diisopropyl fluorophosphate) produces undesirable side effects because of the hyperreactivity of the ciliary body and iris sphincter which it causes. These can be partly overcome by using pilocarpine first. Diamox is a carbonic anhydrase inhibitor that is effective when given orally. In many cases it produces at least a temporary lowering of tension in glaucomatous eyes, apparently by reducing the secretion of intraocular fluid. Its ultimate value in glaucoma remains to be seen.The cyclodiathermy operation which has been modified somewhat by Weekers has had a recent increase in use but the long-term results have been somewhat disappointing.The importance of early operation in narrow angle glaucoma is becoming more and more apparent. Following iridectomy the wound should be tightly sutured to insure the prompt reformation of the anterior chamber.