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Experience with 79 adult patients treated for thyroid cancer. The authors study different parameters of these cancers, particularly sex and age, circumstances of discovery and histological distribution. The state precisely their operative procedure and arguments on account of total thyroidectomy.

About 21 cases, the authors recall general characteristics of undifferentiated cancers of thyroid gland. They underline the difference between undifferentiated trabecular cancers and anaplastic cancers of which evolution is highly malign and explosive. A few observations confirm interest of Adriblastin associated with a wide surgery.

The anti-oedematous effect of tetracosactide (Synacthene Immediate) was studied on a rat brain transient global ischaemia model. Brain oedema was evaluated by proton nuclear magnetic resonance, with measurement of T1 and T2 relaxation times in the cortex and white matter. The effective kinetic dose of tetracosactide was 0.4 mg/kg, and a comparison of the results obtained with those observed after treatment with dexamethasone 13 mg/kg confirmed that both drugs may be regarded as potent anti-oedematous agents, but there was nothing in this study to suggest that the mechanism of action of tetracosactide was different from that of corticosteroids.

This study of reinnervation of the larynx results from the research for a functional method of treatment for laryngeal paralysis of peripheral origin. The physiological reality of reinnervation of a denervated muscle by a nerve other than that anatomically destined for it, or "neurotisation", is now an established fact. This experimental study in 12 dogs consisted of neurotisation of a posterior crico-thyroid muscle, denervated by section of the recurrent laryngeal nerve, by implantation of a graft of sub-hyoid muscle with a nerve pedicle. Only one positive result at six months was seen. 8 failures could be explained by the absence of ventilatory difficulty necessary for the sub-hyoid muscles to be brought into action, and the other 3 failures two months after the operation by muscular fibrosis of the graft before neurotisation could occur. Physiology and the experience of other teams justify the continuation of this study.

The authors first report the histopathological distribution of 111 parotidectomies carried out between 1965 and 1975. They then describe a case of a malignant tumour of the parotid which was shown by histological examination to be a metastasis of a carcinoma of the kidney, this being the first manifestation of the primary tumour. Finally, the authors review the literature concerning metastases of carcinoma of the kidney to the ENT area. They feel that the great rarity of parotid localisations is due to the fact that they may be confused with an acinous carcinoma of the parotid if histochemical stains are not used.

The authors explain a new case of discordance between scintigraphy with Technetium 99 and Iodin 131. Medullary carninoma with appearance of hot nodule with Technetium and cold with Iodin.

Concerning 2 Observations of giant cholesteatomas with twins, the authors recall the existing danger, at a long period of time, of extensive cholesteatomas, even. They are primitive or secondary.

The authors report the case of a 78 year old man with an unusual localization (soft palate and tonsil) of an angio-immunoblastic lymphadenopathy. Clinically, the syndrome combines fever, a marked change in general condition, multiple lymphadenopathy and skin rash. From a laboratory standpoint, the picture is dominated by polyclonal hypergammaglobulinemia, often associated with a hemolytic anemia. Histologically, only lymphnode biopsy allows the diagnosis to be made, with the following findings: disruption of the normal architecture of the node, marked vascular neogenesis, presence of acidophilic interstitial substance, lympho-plasmo-immunoblastic proliferation. The course is in general rapidly fatal despite corticosteroids and multiple chemotherapy.

13 children suffering from velo-pharyngeal insufficiency were operated. A transposition of the posterior pillar was carried out. After exposing the principle of the method, the anatomical bases of the operation and the operation technique used are described. The pharyngeal sphincter thus reconstituted has nearly always resulted in an improvement in the phonation in these subjects.

About a homogeneous statististic of 158 parotidectomies, authors study repartition parameters of parotid gland tumors. They insist on particular surgical and evolutive problems in relation to histology sometimes very difficult.

A case of ethmoidal fibroma in an 18-month-old infant is reported, and nosological, histological, and pathogenic features of this rare affection discussed. Though similar in some respects to Jaffe Lichtensteins fibrous dysplasia in its localized form, it differs, in that it sometimes runs a rapid course and has a tendency to relapse.

Of 185 cases of substernal goitre operated upon between 1976 and 1985, four were patients with autonomous mediastinal goitre. Diagnosis was established from results of clinical examination, a scan of mediastinum and radiologie imaging with a cervical and mediastinal CT scan as the investigation of choice. Treatment is exclusively surgical because of the risk of mediastinal compression. Most cases in this series were operated upon through a purely cervical approach, but 22 patients required partial upper sternotomy combined with cervicotomy, this minimal approach route allowing very good exposure of upper mediastinum.

The authors have observed the complete regression of a facial palsy in a tuberculous otitis by precocious decompression of the nerve and anti-tuberculous medical treatment.

Following a brief review of anatomical features, the risk of injury to the recurrent nerve is discussed as a function of the type of operation performed: subtotal thyroidectomy, ablation of a retrosternal goitre, lobectomy, and total thyroidectomy. Particular attention has to be paid to the risk of anomaly in the nerve pathway: early division or a nerve branching directly from the Xth nerve without a recurrent pathway. Paralysis may be due to simple stretching of the nerve, when regression occurs in approximately three months. Paralysis of the recurrent nerve occurred in 1.69% of cases (7 definite, including 2 of necessity), in a series of 1 184 recurrent nerve exposures.