[Vestibular neurectomy in the treatment of Meniere's disease]. / Neurectomia nervus vestibularis i behandling af morbus Ménière.

INTRODUCTION: A brief history of vestibular neurectomy is given. This treatment was introduced in Denmark by us, based upon our large experience with translabyrinthine removal of vestibular schwannomas. MATERIAL: Includes all patients (43 operations in 42 patients) who had section of the vestibular nerve performed in the period from 1980 to 1996. Mean age was 51 years and the postoperative observation period varied from 2 to 15 years, mean 6.4 years. RESULTS: The vertigo was under control in 88% of the patients. Fourteen patients developed some imbalance after surgery caused by the abolished vestibular function in the ear involved. Thirty-nine patients indicated satisfaction with the operation, 92% retained their preoperative hearing. Only few and slight complications were seen, including two re-operations for CSF leaks and a slight transient facial nerve paresis. DISCUSSION AND CONCLUSIONS: The results are in accordance with those obtained by other authors, and retrosigmoid section of the vestibular nerves is an effective treatment of vertigo refractory to other treatment modalities. In order to reduce the patients' worries about undergoing an intracranial intervention it is important to inform the patients and patients' associations about the good results obtained by this treatment and in particular to inform about the very few complications. Due to the limited number of patients needing this treatment, and the need for surgical experience in order to maintain the favorable results, centralization of the treatment is mandatory.

[Laryngeal carcinomas and precancerous lesions. Incidence and course in a local area]. / Larynxkarcinomer og praekankroser. Forekomst og forløb i et lokalområde.

Out of 464 laryngoscopies, 23 patients with premalignant and 55 with malignant laryngeal biopsies were followed-up ten years later. Thirteen of the precancerous became malignant, ten within three months, and three after years. All with severe dysplasia later developed a carcinoma. Most male patients (66%) had glottic carcinomas while most female patients (88%) had supraglottic carcinomas. The incidence of larynx carcinomas was significantly higher and the disease specific survival lower in our area than in the rest of Denmark. Crude survival for glottic and supraglottic carcinomas was nearly equal after ten years (36%), but patients with glottic carcinomas had a higher death rate due to other causes. Social factors are suggested to be responsible for this. In 1994-1996 a smaller proportion of patients with glottic carcinomas were diagnosed in stage I, but the overall incidence was a little lower.