Wednesday, August 03, 2005

Radiation to the nasopharynx -- Excerpt from 1958 Publication - sent by Dave Heaney

In 'Medical Problems Involved in Underwater Compression and Decompression', published by CIBA, Vol 10. number 4, July-August 1958, Capt. G.J. Duffner, MC, USN opines on the prevention of Aerotitis. He advises that those in those "who dive extensively because of vocation or avocation, the frequency of this condition may be reduced by radiation of the nasopharynx in order to shrink the lymphoid tissue present. This involves the use of 3 to 8 applications of radium, each application separated by two weeks to one month. Fifty mg. of radium, contained in a Monel metal cylinder 2 cm. long and 2.3 mm in diameter, is applied to the pharyngeal orifice of each Eustachian tube for a period of 8 to 10 minutes".

Wow, I almost *%$# when I read that. Please tell me that as late as 1958 this was not normal. ? pleaseee?
The original article has perhaps the best illustrations (by Frank Netter, the absolute BEST medical illustrator ever) of how gas embolism happens, of bubbles forming in tissues, and of the TEED scoring system. After long searching for the publication, the Duke Medical Library (associated with the UHMS now) found it in only days.

My answer:

Hi Dave:
Nasopharyngeal radium irradiation (NRI) was used widely from 1940 through 1970 to treat otitis serosa in children and barotrauma in airmen and submariners. There have been many studies to try and incriminate this outdated treatment modality - with little to indicate that there is any increased cancer morbidity.
"After a mean follow-up of 31 years, there was no strong evidence for an elevated risk of head and neck tumors or hormone-related disorders in adulthood among subjects who had been treated with nasopharyngeal radium irradiation during childhood. "
On another note, Frank Netter, MD was a hero figure to me - mainly because a Histology prof once compared some of my art to his. Of course, this pumped me up terribly - and I was enamored of his really great medical art forever.
Best regards:
Ernie Campbell