Tuberculosis of temporomandibular joint.

Tuberculosis of the temporomandibular joint is a very rare disease. Its close relation to the parotid can cause diagnostic confusion. This case is being reported keeping this point in view.

Reproductive endocrine effects of intranasal administration of norethisterone (NET) to women.

Four consecutive menstrual cycles were studied in six healthy parous women. A solvent mixture comprising propylene glycol:ethanol:water (3:3:4) was sprayed intranasally daily using a glass atomizer between days 5 and 24 of the first (control) menstrual cycle. NET was dissolved in the solvent and similarly administered at a daily dose of 100 mcg during the second and third menstrual cycles. Nasal sprays were not administered during the fourth post-treatment cycle. Blood samples were taken during four consecutive cycles between days 8 and 15 and again between days 20 and 24 of the cycle to estimate levels of estradiol (E2), FSH, LH and progesterone (P). These studies revealed that nasal sprays of NET were well accepted and that no adverse clinical effects or menstrual disturbances occurred. NET inhibited ovulation in one cycle. The E2-induced mid-cycle rise in FSH and LH was either suppressed or inhibited in nine out of the 12 treated cycles. P levels in three treated cycles were indicative of luteal inadequacy. These endocrine effects of NET persisted into the post-treatment cycle in two cases.

Ossicular reconstruction--a new prosthesis.

We have used human teeth for ossicular reconstruction in 20 tympanoplasties, the longest follow-up being over 2 years. The take of the graft and the hearing improvement have been very satisfactory and long-lasting. This preliminary report discusses the merits of the tooth as a prosthetic material for ossicular reconstruction. Our experience to-date indicates that the material satisfies all the criteria of an ideal prosthesis.

Transnasal preganglionic vidian nerve section.

Vidian neurectomy is a useful procedure in relieving the symptoms of vasomotor rhinitis. However, the nerve is difficult to approach because of its deep location in the pterygopalatine fossa. A direct transnasal approach to the pterygopalatine fossa, passing through the sphenopalatine foramen in the lateral wall of the nose, is described and its merits are discussed. We have operated upon 247 cases by this approach over the past four years without any significant complications.

Optic nerve decompression in head injuries.

Diminution of vision arising from head injuries involving the optic foramen can be treated by transethmoidal decompression of the optic nerve. Early surgery is associated with good recovery of function. In this paper, the surgical procedure is discussed, with the results in 10 cases.

Otoneurological problems in head injuries and their management.

In facial nerve injury, the guidelines for treatment are time of onset, electrical responses, other concomitant damage such as CSF otorrhea or ossicular disruption, and associated infective conditions such as cholesteatoma. Four patients with CSF otorrhea responded well to conservative treatment, one patient needed postauricular mastoidectomy as there was an associated cholesteatoma and one required surgery when conservative treatment failed to stop the otorrhea. Two cases of deafness due to ossicular disruption were seen in the postoperative convalescent phase. Five other cases were discovered during routine examinations for conductive deafness. All seven patiens underwent surgery for incudostapedial joint separation.