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Laryngeal microsurgery has been performed using a CO2 laser since 1978. It is essential to conduct a strict phoniatric pre-operative examination and to ensure correct anesthesia. Results after 735 operations underline the advantages of this technique for the treatment of benign laryngeal lesions (diffuse papillomatosis, sessile polyps, granuloma), in phonosurgery (nodules, bundle edema, corditis) and in the repermeabilization of the laryngeal network (paralysis, stenosis, laryngeal edema).

The authors describe a microsurgical procedure for translaryngeal arytenoidectomy in bilateral vocal cord paralysis and relate their clinical experience. They consider this approach as very valuable in as much as a rather minimal surgical procedure will create a good airway while conserving a satisfactory vocal function.

The authors present one case of systemic lupus erythematosus associated with paralysis of the larynx and spontaneous expulsion of the arytenoid cartilage followed by healing. Two cases of chronic atrophic polychondritis are also presented, and the diagnostic and therapeutic criteria of the disease are discussed.

The aim of this research was to compare isolated ganglionic development in patients treated surgically for cancer of the larynx. This research included the cases of 232 patients operated on for laryngeal cancer and who underwent either total laryngectomy with or without conservation of the cricoid, or supra-glottal laryngectomy, or sub-glottal pharyngectomy. For the treatment of the ganglionic areas, there are six possibilities: --cobalt used in isolation; --uni- or bi-lateral cellulo-adenectomy; --uni- or bi-lateral curettage (a month apart); --curettage on one side, cellulo-adenectomy on the other. The results obtained were particularly significant as far as the N0 and regrouped N1 were concerned. The rate of ganglionic recurrence was 25 p. 100 for the N0 treated with cobalt and 6,5 p. 100 when surgery was carried out (cellulo-adenectomy or curettage). Also, curettage seems in N + cases to give better results : 26 p. 100 recurrence in cases of cellulo-adenectomy for N0-N1 and 4 p. 100 only in cases of curettage. These results appear to justify on the spot histological examination followed by curettage in N + cases.

Facial paralyses in children may be grouped under headings displaying a certain amount of individuality. Chronologically, first to be described are neonatal facial paralyses. These are common and are nearly always cured within a few days. Some of these cases are due to the mastoid being crushed at birth with or without the use of forceps. The intra-osseous pathway of the facial nerve is then affected throughout its length. However, a cure is often spontaneous. When this desirable development does not take place within three months, the nerve should be freed by decompressive surgery. The special anatomy of the facial nerve in the new-born baby makes this a delicate operation. Later, in all stages of acute otitis, acute mastoiditis or chronic otitis, facial paralysis can be seen. Treatment depends on the stage reached by the otitis: paracentesis, mastoidectomy, various scraping procedures, and, of course, antibiotherapy. The other causes of facial paralysis in children are very much less common: a frigore or viral, traumatic, occur ring in the course of acute poliomyelitis, shingles or tumours of the middle ear. To these must be added exceptional causes such as vitamin D intoxication, idiopathic hypercalcaemia and certain haemopathies.