Silastic replacement of the trapezium.

A retrospective study has been made of the long-term results of silastic replacement of the trapezium, including functional, clinical and radiological assessment of 43 hands, one to 13 years postoperatively. The results showed good function and relief of pain in 88% of hands. Radiolucent bone lesions, presumably due to silastic particle reaction, occurred in 53% of hands, but their presence did not correlate well with symptoms. Four patients (9%) developed significant synovitis which was improved by removal of the prosthesis. In this series, clinical silastic synovitis occurred in the first four years, and its incidence did not increase with further follow-up to 13 years.

DMSO in otology.

The most controversial therapeutic agent in the past decade has been dimethylsulphoxide (DMSO), an industrial solvent to which great healing powers have been attributed. After initial laboratory testing, DMSO was rapidly introduced into veterinarian medicine and clinical medicine as an experimental agent with the ability to relieve pain, reduce swelling and edema in trauma, to show anesthetic, antibacterial and anti-inflammatory properties when applied topically to the skin. Ninety percent DMSO was used alone and in conjunction with alkaloids and antibiotics to test the clinical properties attributed to this drug. Although DMSO was found not to be ototoxic, laboratory and clinical testing which included double blind studies on patients with otological infections demonstrated that DMSO had no antibacterial, anesthetic or anti-inflammatory properties when applied within the external auditory canal. There was no indication that 90% DMSO, when combined with these various preparations, potentiated or acted synergistically to enhance their penetration through the dermal barrier.