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All clinical classifications for laryngeal cancer are compromises based on clinical and imaging evaluations, with no concern for important elements such as phenotype, host-tumor relationship, and any concomitant nonneoplastic disease. The various staging systems are critically examined along with a report on the outcome of an international survey on the applicability of the TNM system in relation to laryngeal neoplasms, promoted by The Laryngeal Cancer Association.

The operation of lateral rhinotomy does not perhaps receive as much attention as it might, despite the excellent exposure of the nasal passages and surrounding anatomy that can be obtained. A personal account of 100 consecutive operations for varying pathology is described in the hope that more surgeons may be aware of the value of this procedure.

Involvement of the thyroid cartilage attracts a high T rating in all systems of classification for carcinoma of the larynx. Evaluation of 145 patients with laryngeal cancer treated by total laryngectomy emphasizes the difficulties of preoperatively determining cartilage invasion. The operative specimen was serially sectioned and studied to determine the means by which ossified and nonossified thyroid cartilage is invaded by carcinoma. A minimum 5-year follow-up of these cases indicates the prognostic significance of such invasion.

The three-dimensional morphology of the mammalian larynx was studied for 15 years. Using specimens obtained from a wide variety of sources, efforts were made to correlate structure with function and thus explain the variations in size and morphology seen in over 150 families of mammals.

All the classification systems at present adopted for use in carcinoma of the maxillary sinus suffer from both intrinsic inaccuracies and an apparent failure to relate T (extent of primary tumor) categories to clinical experience of the spread of these tumors. Three systems are critically analyzed in relation to personal experience of 86 patients with sinus carcinoma and a fourth system proposed as a compromise solution to this problem.

Fifty-eight patients with osseous or fibro-osseous conditions affecting the craniofacial bones are reviewed in order to determine difficulty of diagnosis, natural history, and management. In many patients separation into individual categories is possible on clinical grounds alone. However, by correlating clinical examination with radiological and histological findings, it is clear that each of the pathological conditions discussed is a separate entity and not merely part of a broad spectrum of bony disorders.

To determine the effect of the normal living gallbladder upon biliary calculi, the gallbladders of 8 normal dogs were opened under surgical anesthesia and asepsis and stones from human bladders, too large to pass through the canine ducts, were inserted. The stones chosen were of the compact variety made up of bile pigments, calcium, iron, and, in some, cholesterol. The experimental animals were confined in laboratory cages and were given a regular mixed diet. After an average duration of 60 days in these 8 dogs, the stones had diminished in size in 3 and had disappeared in 5.