The purpose of this presentation is to detail steps of a method of treatment of cancer of the maxillary antrum by a combination of surgery and radium. The principles underlying the combined approach were outlined by Quick in 1930 (4). Extensive surveys of antral cancer in all its aspects have been published by Öhngren (3) and Windeyer (8). Surgical treatment alone has produced survivals of five years and more. The failures of surgery have been due to the site and nature of the disease. Complete extirpation of the involved maxilla is technically difficult. By the time the patient presents himself for treatment, the disease has usually infiltrated beyond the confines of the maxilla and a block resection is impossible. Irradiation alone has also produced survivals of five years or more. The failures of radiotherapy have been due to the difficulty of identifying the extent of involvement by physical examination and roentgenograms. Unless the disease can be accurately localized, unsuspected marginal extensions to the pterygoid fossa, the ethmoid air cells, or the floor of the orbit will receive less than a cancerocidal dose. Surgical exploration permits a more accurate determination of the extent of the disease. The surgical pathologist should be present in the operating room so that sites of local extension can be identified by frozen sections. The radiotherapist should be present so that he may gain exact knowledge of the condition he will be called upon to treat. With these points in mind, the steps in our procedure are now outlined. Surgery Preparation for operation includes a general survey of the patient with particular reference to distant metastases and evaluation of respiratory, cardiac, and kidney function. Examination of the chest by x-rays, an electrocardiogram, blood urea nitrogen and blood sugar determinations, a complete blood count, and urinalysis are secured. Corrective and protective medicines are ordered as indicated. Locally, much reliance is placed on the benefits of mouth and nasal irrigations and power sprays. Intramuscular administration of penicillin is started twenty-four hours before operation. The anesthesia is intravenous pentothal, supplemented by nitrous oxide and oxygen by way of an endotracheal tube passed through the opposite nostril. Passage through the mouth would interfere with the surgical manipulations. The pharynx is packed with a continuous strip of moist 3-inch gauze. When local anatomy prevents the use of the nasal passage, a preliminary tracheotomy under local anesthesia is carried out and the gas is introduced after the method of Schweizer (6). A tracheotomy is done in the very old and the very frail, preferably at the completion of surgery, to ensure an adequate airway during recovery from anesthesia and the ensuing few days. The external carotid artery is ligated in continuity on the side of surgery only when as near total resection of the maxilla as practicable is planned.