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Review of charts of 158 patients with carcinoma of the oral tongue revealed 108 (68 percent) were clinically free of cervical metastasis upon presentation. Patients who were found to have microscopic metastases after elective neck dissection and patients who developed cervical metastases but never a local recurrence were said to have occult regional metastases. The incidence of occult metastases was 23 percent with no difference between T1, T2, and T3 lesions. Determinant survival rates of the T1N0M0 groups were 83 percent and 57 percent at two and five years respectively. Survival rates of the T1N0M0 patients who had occult metastases were comparable (82 percent and 50 percent respectively). Survival rates of patients with T2N0M0 and T3N0M0 lesions with occult metastases were lower than for all patients in each of the two groups. The incidence of local recurrence in these same 108 patients was 27 percent with the incidence highest in the T2N0M0 group (31 percent). Survival rates of these patients, especially of those who developed regional metastases, were lower in all three groups of patients. The combined use of pre‐operative irradiation with cobalt 60 followed by en bloc resection of the primary tumor with the regional lymphatics has been very effective to date. The following conclusions are based on retrospective study of carcinoma of the oral tongue. The incidence of occult regional metastasis is the same for T1 and T2 primary cancers of the oral tongue. To date, combined therapy is resulting in higher survival rates in patients with larger oral tongue carcinomas. To increase the probability of cure, elective treatment of regional lymphatics either by radical neck dissection or irradiation should be considered in the treatment of T1N0M0 epidermoid carcinoma of the oral tongue.

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Summary--The basic anatomy of the guinea pig ear is outlined as background for a description of two surgical approaches to the guinea pig temporal bone. These approaches provide acess to the external, middle and inner ear without significant blood loss or mortality. The superior approach, made by incision at the superior anterior attachment of the auricle and removing the lateral wall of the epitympanic space, exposes the round window, epitympanum, lateral canal, and external auditory canal, leaving the tympanic membrane intact. The inferior approach through the neck exposes the cochlea, Eustachian canal, horizontal and posterior semicircular canals, tympanic membrane, and ossicles.

Corti, in 18 51, 1 described the cells of the stria vascularis and sug gested that they might be the structure for secreting endolymph. Also in 1851 Reissner 2 described the membrane which now bears his name and divides the scala vestibuli from the scala media, showing anatomically that the membranous labyrinth is a closed system. Fol lowing this observation there has been much speculation concerning the characteristics of the endolymphatic and perilymphatic fluids. In 1927 Stacy Guild 3 performed an experiment which he felt fur nished sufficient evidence to indicate the nature of fluid flow within the scala media.Through a small pipette Guild injected a solution of potassium ferrocyanide and iron ammonium citrate into the scala media of sev eral living guinea pigs. After the lapse of various time intervals, the animals were sacrificed and the acid in the fixation fluid precipitated prussian blue granules in sites along the scala media. The temporal bones of these animals were then sectioned and mounted serially so that the location of the granules could be studied with the micro scope. In 16 of 20 animals the blue granules were found in the walls of the endolymphatic sac. From this he concluded that the flow of endolymph was from the stria vascularis down the scala media through the canalis reuniens to the saccule ending finally in the endolymphatic