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The lymphatic flow in the head and neck was investigated, by avoiding with every possible means the artificial disturbance of the flow, for diagnosis and treatment of metastasis of malignant tumors of the head and neck. After injection with tracer dosis of radiogold in the various parts of the head and neck in human, with or without tumor, dogs and rabbits, scintiscan- ning of the neck and measurement of radioactivity of the extirpated lymph nodes were performed. From the results of the experiments the following conclusions could be drawn : 1) 20_30% of the injected radiogold was up- taken by the regional lymph nodes of the injected area. The factors which influence these up-takes were density of the lymphatic nets, specific weight and number of the regional lymph nodes and mo- bility of the injected area. The distribution of the gold in the nodes can be informed in quantity and located by the method of scanning. 2) According to the pattern of the pick up, the cervical lymph nodes were divided as follows submental, submandibular; upper-, lateral- and fro- ntal neck; upper-, mid- and lower jugular and supraclavicular nodes. The upper neck nodes, ref- eied by the author, included the preauricular, retropharyngeal and uppermost groups of the jugular nodes. The upper jugular nodes were both the so- called principal node of the tongue and its surrou- nding nodes. The mid-jugular nodes were suprao- mohyoid node and its surrounding nodes. 3) The lymphatic drainages of the head and neck always pass through the upper jugular nodes or the nodes below these. Therefore the amount of the lymphatic flow along the internal jugular nodes was most prominent comparing with the flow of the other routes. The farther the cervical nodes situated from the jugular vein, the lesser the lymph flowed to the nodes. 4) The majority of the flow to the upper neck nodes came from the external meatus, parotid gland, nose, palate and tonsil. The flow to the lateral neck nodes mostly did from the external meatus and parotid gland; to the frontal neck nodes from the larynx and trachea; to the submandibular nodes from the major salivary glands, cheek, nose, palate, lip, gingiva, tongue and floor of the mouth. The contralateral neck flow was observed in the tongue (except its margin), floor of the mouth, floor of the nose, the septum, palate, pharynx, larynx and trachea. 5) The larynx of dogs was divided in five compartments according to its lymph flow: two supraglottic plus marginal; two glottis; one subg- lottic area. The lymph from each compartment flows chiefly to the l omolateral nodes but also u little extralaryngeally (supraglottic, glottic and su- bglottic compartments) and intralaryngeally (subg- lottic compartment) to the contralateral nodes. 6) Intrinsic factors which change the normal lymphatic flow were the primary tumors and the number, location and size of the metastatic tumors, located at the passways of the flow. Extrinsic factors were radiation, mechanical procedures (ope- ration or massage of the neck) and so on. Unilat- eral radical neck dissection caused an increase of the flow to the contralateral nodes.

A STUDY OF THE LYMPHATIC FLOW IN THE FIELD OF OTORHINOLARYNGOLOGY WITH THE USE OF COLLOIDAL RADIOGOLD 198AU