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Modifying and extending Bernard's method Fries (1971) developed a universal technique for reconstructive surgery of the lip after tumour resection. So far this technique has been employed in 80 cases, 50 of which were available for follow-up studies. Cosmetic results were invariably found to be optimal. Functional deficits were predominantly associated with whistling and pouting, while eating, speaking and laughing were unimpaired.

Using adequate number of cases, the influence of the spread of primary tumour and the degree of regional metastasis on prognosis were investigated. Assuming a practicable classification as a prerequisite for clinico-therapeutic cancer research, experience has shown that the assessment of the spread of primary tumour alone does not suffice for the establishment of comparable homogenous data. The investigation on the importance of the degree of regional metastasis has shown, above all, that the percentage of N3-metastasis within the T-groups contributes essentially to the fact that these show a marked difference in their prognosis. It would therefore appear necessary also to examine the importance of other clinically accessible data in the assessment of prognosis. Only then could we be in a position to judge whether, and to what extent a clinically practicable classification and integration into special groups is possible on the basis of clinically available data. The inclusion of more clinics in the joint investigation is encouraged.

The prognostic significance of primary tumour site in carcinomas of the oral cavity was investigated in a series of 585 cases. For the subsamples (levels and areas of oral cavity) studied, the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: Given an identical extension and analogous metastazising rate, there is no computationally demonstrable difference in prognosis between primary tumours sited at different levels and areas of the oral cavity. The exception are the T1Nx categories, for which a difference exists between precanine and retromolar sites. These results should be re-examined on the basis of a larger series.

The prognostic significance of so-called organ sites was investigated in 585 cases with carcinoma of the oral cavity and lips. For the subsamples studied the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: 1. There is no demonstrable difference in prognosis between identical T catagories in the organs of the oral cavity. 2. In some cases there is a significant difference between identical N categories in organs of the oral cavity. In the No category this is, however, attributable to the substantial differences in the numerical distribution of T categories. By contrast, a logical explanation for the computationally demonstrable significant differences in the Nx category is not available. The problem is currently being investigated. 3. An assessment of identical TN combinations in the "organs" of the oral cavity proved to be impossible on account of the inadequate number of cases available. The so-called "organ localization" of primary tumours in the oral cavity need not - at least for the time being - be accorded any prognostic relevance. The findings should, however, be re-examined on the basis of greater numbers.

An attempt is made to analyse mid-face deformities objectively in operated cleft lip and palate patients with the help of cephalometric techniques. Mid-face growth of cleft patients after the age of 10 years is compared with growth parameters of non-cleft subjects. This comparison indicates that some of the angles in the nasal area (Subnasale angle, Alaria angle) do not undergo any change in size with increasing age. Others which are subject to change (Rhinion angle, Pronasale angle) show no difference in the extent of growth between cleft patients and normal subjects inspite of different conditions at the age of 10 years. The lateral growth of the nasal soft parts (bialar distance) is largely independent of the lateral growth of the bony structures.