Chemical labyrinthectomy with NaCl. Menière's disease treatment with deposition of NaCl in the vestibule

Thirteen individuals with unilateral Menière's disease were chosen for experimental chemical labyrinthectomy. All subjects suffered from frequent attacks of disabling vertigo and had mean pure-tone thresholds greater than 50 dB in the affected ear. The surgical procedure was similar to stapedectomy; after removal of the stapes, several crystals of NaCl were placed in the vestibule which was then covered with a vein graft. Postoperative recovery was rapid, allowing patients to be discharged 4-6 days after surgery. Of the 13 subjects, all reported complete relief from vertigo. Tinnitus was cured in 7 subjects, greatly improved in 4 and unchanged in 2. Most patients complaining of aural fullness preoperatively reported relief from this symptom following surgery. To date (up to 4 years post-surgery) none of the subjects has shown any significant alteration in audiologic or vestibular function in the contralateral ear. The ease and safety of this procedure make it an attractive method when cochleovestibular deafferentation is indicated.     

Thrombosis at venous insertion sites after inferior vena caval filter placement

Color Doppler flow imaging or compression ultrasound (US) was used to prospectively determine frequency of thrombosis at 54 venous insertion sites (47 in common femoral veins, seven in right internal jugular veins) after percutaneous placement of Greenfield filters for interruption of the inferior vena cava. Fifty-one filters were successfully placed in 51 patients with a dilator set or a balloon angioplasty catheter. Nine focal thrombi were detected in the common femoral vein (19%) and one in the right internal jugular vein (14%). Use of dilators induced eight thrombi (24%), compared with two (10%) from balloon catheters. The left common femoral vein had a high frequency of thrombosis, regardless of dilation technique (five of nine). Of nine patients with acute common femoral vein thrombosis, four became symptomatic within 10 days after the procedure. Patients may remain asymptomatic or have delayed symptoms; thus, US is valuable for determining patients at risk of thrombosis of the common femoral vein.     

Giant central ossifying fibroma of the mandible: report of case.

A case is presented of a patient with a giant ossifying fibroma of the mandible that had been diagnosed earlier as fibrous dysplasia. Surgical resection of the tumor and involved bone was chosen as the mode of treatment because of the extent of the lesion and continued infection. Surgeons should be aware that ossifying fibroma is a very distinct possibility in large growing lesions in age groups older than is deemed compatible with fibrous dysplasia.