SARCOMATA of the naso-pharvnx are of exceedingly rare occurrence. To distin guish between a benign and malignant growth of this region is sometimes diffi cult. The round-cell variety is that usu ally found in the naso-pharyngeal cav ity. Age has no particular significance, as the disease has been observed in both young and old alike.
Treatment.—Evulsion with forceps is resorted to by soroe operators, a curved uterine ecraseur by others. The galvano cautery-snare and puncture have their advocates.
I employ a powerful post-nasal snare designed by myself especially for this sort of surgical work. The aim should always be to take away as large a mass as is prac ticable with as little hmmorrhage as pos sible. The post-nasal snare fulfills this mission in several respects. To obviate great loss of blood, tamponing the upper pharynx and posterior nares is resorted to. To the tampons are attached oral and nasal ends of tape for purposes of fixation just before the wire is expected to sever the tumor from its base, after which pro cedure the snare is withdrawn. In the course of twelve or twenty-four hours the tampons can be removed without any loss of blood whatsoever.
Electrolysis \vhen judiciously and properly applied holds a valuable and prominent position in the treatment of new growths of the naso-pharynx.
When the tumor is unduly vascular and cannot be manipulated without loss of blood, prior treatment with the electro lytic needle accomplishes considerable toward the limitation of hmmorrhage.
After the use of the post-nasal snare, the remaining base should also be treated by means of electrolysis; resolution is thus favored and the liability to recur rence becomes less marked. The so called. radical operation, for example, the excision of the superior maxillary bone with a vieW of obtaining access to the naso-pharynx, seems unnecessary in any case. The radical method does not seem to accomplish any more than the opera tive measures above stated, and, at the same time immediately jeopards the life of the patient and certainly produces per manent disfigurement.
The accompanying catarrhal states will improve under the use of warm alkaline lotions. The douche or syringe does not recommend itself on account of the danger of forcing fluid into the mid dle ear, from which accident a more or less serious tympanic trouble may arise.