[Surgical treatment of traumatic ear drum perforations (author's transl)].
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A primary mesenteric branch of the superior mesenteric artery was embolized with Amicar-mixed clots in seven dogs and with gelatin sponges in five dogs. All of the dogs embolized with Amicar-mixed clots survived the experimental period and no mesenteric damage was found with postmortem studies. Three of the five dogs embolized with gelatin sponges showed a local stricture within the embolized segment of intestine. Collateral blood supply to the strictured segment of bowel in these three dogs developed via arterial arcades, mural branches of the vasa recta and omental arteries.
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Labyrinthine fistula of the round window should be considered in the differential diagnosis of vertigo and sudden hearing loss occurring in patients, who are not only divers, during physical stress or exertion. Surgical exploration and closure of the fistulae are the only means of diagnosis and treatment of this condition. Since these fistulae may heal spontaneously in most instances early surgery is recommended after a short interval of conservative therapy. Five patients, of whom 4 underwent surgery and one was seen for an expert opinion are presented.
Thirty patients had excisional arthroplasty of the elbow, with interpositional Gelfoam and early mobilization. Most of the patients had residual disability from trauma. Most of the patients' results were evaluated four years or more after the operation: 80 per cent were pain-free and 90 per cent were able to return to their previous occupations. One patient had to be reoperated on and therefore was considered to have a poor result.
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In a case of tetralogy of Fallot with numerous bronchial collateral arteries (BCA), the collateral arteries were successfully occluded by transcatheter embolization of Gelfoam and use of the Gianturco spring as a preliminary to intracardiac repair. Pulmonary embolism would not result from this procedure in the absence of large direct communications between collateral and pulmonary arteries. The femoral artery and vein were prepared for cannulation before the procedure, so that it would be possible to start assisted perfusion immediately if arterial PO2 fell after transcatheter embolization. The procedure is performed under fluoroscopic control.
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