Treatment of vertebral fractures with percutaneous PMMA vertebroplasty appears to be safe and results in substantial immediate pain reduction and improved functional status. A randomized controlled trial appears warranted to assess the efficacy and safety of vertebroplasty.
Intrathecal morphine delivered by implanted pumps has been used in the treatment of pain caused by terminal cancer. Some authors supports its use in benign pain as well. The authors present three cases in which chronic infiltration of intraspinal narcotic medication was complicated by the formation of a granulomatous mass that became large enough to exert mass effect and induce neurological dysfunction.
The radiologic studies of 107 patients with pulsatile tinnitus or a vascular retrotympanic mass were retrospectively reviewed. Of the 100 patients with pulsatile tinnitus, 25 had objective tinnitus. A vascular tympanic membrane was present in 37 cases (35%). Normal vascular variants were present in 23 patients (21%). Twenty-seven patients (25%) had acquired vascular lesions. Temporal bone tumors were found in 33 patients (31%). No abnormality was identified in 21 cases (20%). To ensure optimal radiologic examination, it is imperative to know the nature of the tinnitus (objective vs subjective) and the appearance of the tympanic membrane. All patients with subjective pulsatile tinnitus or a vascular retrotympanic mass should undergo high-resolution computed tomography of the temporal bone as the initial imaging study. Angiography is recommended for patients with objective tinnitus and a normal tympanic membrane. The role of MR imaging, even with the addition of gradient-echo techniques, remains limited and secondary.
Cine MRI of the airway has the potential to provide novel data regarding laryngeal and tracheal patency and function. This evolving modality may serve as a valuable adjunct to static MR and CT imaging, as well as endoscopy, in the assessment of the airway.
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