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Endoscopic laser-assisted dacryocystorhinostomy (DCR) offers several advantages over standard external (SE) DCR. The technique eliminates the cutaneous scar and cosmetic blemish of an external dissection and causes less surgical trauma and bleeding than SE-DCR, with shortened postoperative recovery time and lessened postoperative pain. However, the equipment is expensive. We modified this technique using simple instruments such as the curette, Kerrison punch, Freer elevator, Storz endoscope, Ellman Surgitron unit, and the Javate DCR electrodes instead of the laser. Fifty patients with epiphora and nasolacrimal obstruction underwent surgery with our new technique. Fifty age-matched, paired external DCR were performed, and comparisons were made with the endoscopic procedure described. If preoperative epiphora was resolved and nasolacrimal patency was confirmed by lacrimal irrigation 3 months after tube removal, the operation was considered a success. The study attained a 90% success rate for endoscopic radiofrequency-assisted DCR, as compared to a 94% success rate (p > 0.05, not statistically significant) for the SE-DCR.

Massive gastrointestinal bleeding is a recognized late complication of aortic replacement surgery. In some instances, the bleeding is due to erosion and perforation of the intestinal tract by the prosthesis without an aortico-enteric fistula. Bleeding at this time from the wall of the intestine may be moderate in degree and of long duration. The roentgen findings in this situation are specific and consist of identification of the area of intestinal perforation. The prosthesis may protrude into the lumen of the intestine through the perforation, or contrast medium may extravasate through the perforation to outline the external margins of the graft. The crimped tubular pattern of the commonly used Dacron prostheses, when observed, affords positive identification.

Osteomyelitis of the mandible following irradiation for the treatment of cancer has been recognized since 1922 (3). In spite of newer technics, including megavoltage (4), osteomyelitis is likely to remain a recurrent problem as long as portions of the mandible lie within the field of irradiation. It has been believed that the likelihood of this complication is decreased by the preliminary extraction of any teeth that are diseased or lie within the area to be irradiated. This opinion, however, has not been universal and experienced radiation therapists, such as Quick (2) and Paterson (1), have advocated postponement of extraction. More recently, Wildermuth and Cantril (5) have proposed that extraction of teeth before irradiation actually predisposes to osteomyelitis. We are reporting the results to date of a series of experiments designed to study certain features of this problem. Material Adult mongrel dogs were used throughout these experiments. They were housed in individual cages and were maintained on...