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Biomedical subjects

A Laubert

Publications and source records attributed to A Laubert.

At least 37 records · Page 2Linked to original sources
PubMed1994

Acute bilateral blindness in childhood caused by rhabdomyosarcoma and malignant lymphoma.

Sudden unilateral visual loss in children is usually caused by a complication of acute purulent sinusitis. Differential diagnosis must include malignant tumours of the orbit or the paranasal sinuses involving the optic nerve. Rapid and adequate diagnostic measures are required in this emergency situation. In comparison, acute or progressive bilateral blindness is a very rare disorder. We report two cases of bilateral visual loss caused by malignant tumours and diagnostic and therapeutic strategies are described. Our reports show that these life-threatening disorders and their severe complications can be managed successfully if well-coordinated interdisciplinary cooperation is conducted from the beginning. If surgery is performed in this vulnerable region, it may be facilitated by computer-aided modelling techniques. During the last decade the prognosis for rhabdomyosarcoma and malignant lymphoma, the most frequent mesenchymal tumours of childhood, has improved dramatically. Thus, any loss of time causing a delay in correct diagnosis and the onset of adequate therapy must be avoided. Intensive cooperation with paediatric oncologists has to be enlisted from the beginning to avoid unnecessary, repetitive, invasive, or imaging diagnostics and to accelerate the onset of specific therapy.

Acute Disease↗
PubMed1992

[Cervical interventions on the airway and esophagus in infiltrating thyroid cancer].

In 1989 und 1990 a resection within the region of the cervical airways and/or oesophagus was performed for an infiltrating tumor in 9 out of 95 patients (9.5%) suffering from thyroid carcinoma and in one patient with lymph node metastases from a carcinoma of the uterine cervix. There was no operative mortality. One patient died six weeks after resecting the anterior wall of the trachea of an intratracheal arterial bleeding due to radiation therapy. In one case the reconstruction of the trachea was performed with autologous material, in three patients alloplastic material was used. The oesophagus was reconstructed preferably by means of free microvascular jejunum autografts (n = 4), using a colon interposition in another two patients. In locally advanced differentiated and medullary thyroid carcinoma curative operations of the cervical hollow organs using microsurgical techniques can be performed with an acceptable operative risk and good functional results. They may markedly improve the otherwise limited prognosis of the disease.

Combined Modality Therapy↗
PubMed1991

[Non-Hodgkin's lymphoma: a differential diagnosis of otogenic facial paralysis].

Of all the neoplastic conditions of the lymphatic system, Non-Hodgkin's lymphoma (NHL) represents a heterogenous group. As well as lymph nodes NHL can involve extranodal sites, including regions in head and neck. The mouth and oropharynx are typical extranodal sites, and the ENT surgeon should be aware of this possibility of the swift diagnosis of NHL is to be made. We report two patients with rare invasion of the middle ear, facial nerve paresis, and asymptomatic cerebral involvement by Non-Hodgkin's lymphoma.

Diagnosis, Differential↗
PubMed1990

Toxicological aspects of synthetic tissue adhesives.

Generally, in order to be able to conduct clinical trials or to obtain a product licence for adhesives, toxicological studies have to be conducted in such a way as to provide sufficient data to be able to assess the toxicity, i.e. the risk. This paper discusses the types of studies which may be needed to fulfill these requirements.

Animals↗
PubMed1990

[Audiologic diagnosis of tumor-induced neural hearing disorders based on discrete finding constellations].

Modern electrophysiological and audiometric tests allow the cause of retrocochlear hearing loss to be diagnosed in almost all cases. Assessment of the stapedius reflex, discrimination using the Fowler test, the ERA findings with respect to inter-peak latency, interaural latency difference of the fifth wave, DORAS (difference between the objective response threshold and the subjective tone threshold), and finally the vestibular findings are all important.

Adult↗
PubMed1990

[Neuro-otologic criteria in the diagnosis of tumor-induced hearing disorders. Studies of 300 patients with acoustic neuroma].

Recently, costly technical procedures have been used for the diagnosis of a retrocochlear hearing loss. Electrophysiological methods such as ERA, electrocochleography and promontory tests, and imaging procedures such as CT and MRI have been widely used. Here we demonstrate the diagnostic value of conventional audiometry in retrocochlear lesions. As the clinical audiometric picture shows, a retrocochlear lesion is based on electrophysiological conduction phenomena. The threshold tone decay, absence of stapedius reflex, reduced speech discrimination and ERA findings with electric response decay and synchronization disorders within the brain stem are particularly significant.

Audiometry, Evoked Response↗
PubMed1989

[Endoscopic cricopharyngeal myotomy, an alternative in surgical treatment of Zenker's diverticula].

A total of 84 operations (64 endoscopic myotomies and 20 external procedures) were undertaken in 72 patients with hypopharyngeal diverticulum. Endoscopic myotomy was preferred for patients with a narrow diverticular bar, or a large sack, and for older patients. Postoperative complications were not observed after this procedure, nor after 10 endoscopic reoperations. Transection of the bar relieves the symptoms and can be repeated at any time, even after an external procedure. Following endoscopic myotomy, carried out under local anaesthesia, the patient is immediately mobile again, which is an advantage for postoperative convalescence, particularly in older patients.

Adult↗
PubMed1989

[Prognosis of peripheral facial paralysis in Lyme borreliosis (Garin-Bujadoux, Bannwarth meningopolyradiculitis)].

Meningopolyradiculitis (Garin-Bujadoux syndrome, Bannwarth syndrome) is the second stage of Lyme disease, a tick-borne Borrelia infection. Almost 60% of these patients develop an acute peripheral facial paresis. The disease can be differentiated from Bell's palsy only by finding the specific Borrelia antibodies in serum and CSF. Other cranial nerve lesions can be found besides facial paresis. The follow-up of seven Borrelia-infected patients is described: one showed bilateral, the others unilateral, facial paresis. High dosage of penicillin or tetracycline for 10-14 days is the appropriate therapy. The prognosis of facial paresis in tick-borne Borrelia infection is considered to be good. All our patients showed complete recovery of motor nerve function.

Adolescent↗
PubMed1989

[Angioedema in ENT practice].

Angioedema is characterized by subcutaneous or submucosal swelling, which often affects the lips, tongue and oral or pharyngeal sites. Laryngeal oedema can be potentially life-threatening. The pathogenesis of angioedema is thought to involve the release of histamine and other mediators with subsequent extravasation of fluid. Over 90% of cases of chronic angioedema are clinically idiopathic. The known causes are allergic and more commonly pseudo-allergic (IgE-independent) reactions, especially drug or food hypersensitivity. Pseudo-allergic angioedemas are mainly evoked by a direct release of mediators or activation of the complement system. At the Department of Otolaryngology (Medizinische Hochschule Hannover) we performed a retrospective evaluation of the clinical histories of inpatients with angioedemas. The most common was swelling of the tongue, with laryngeal edema noted in five cases. Only one patient, whose case is reported, required a tracheostomy. In seven patients the causes of angioedema were determined as drug or food intolerance. The treatment of acute attacks is outlined.

Aged↗
PubMed1989

[Dysontogenetic cysts of the mouth floor].

Congenital cysts of the floor of the mouth are rarely seen. We investigated in the years 1987 and 1988 four patients with swellings in the floor in the mouth. The histological examination results dermoid and epidermoid cysts. A teratoma was not seen. Sonographic investigation and computertomography were both helpful by getting the correct diagnosis of these cysts and their location. The treatment was the exstirpation from the outside of the throat because all cysts were located under the geniohyoid muscle.

Adult↗
PubMed1989

[Differential diagnosis of parotid tumors: toxoplasmosis lymphadenitis of the parotid gland].

The most common clinical symptom of toxoplasmosis in adults is a cervicofacial lymphadenopathy. The cat is very important in the epidemiology of toxoplasmosis, but contact with cat excreta is most uncommon. The cause of oral transmission in adults is more likely to be eating undercooked contaminated meat containing tissue cysts, particularly raw pork. Toxoplasmosis as a cause of lymphadenopathy is an unusual, and normally postoperative, finding after parotidectomy for a "tumour". In the last 8 years we have seen ten patients with an acute toxoplasmosis infection. We report two patients showing clinical signs of a parotid gland tumour in whom we demonstrated an intraglandular toxoplasmosis lymphadenopathy before operation. We treated these patients successfully using pyrimethamine and sulphonamide, so that surgery was unnecessary.

Adult↗
PubMed1988

[Acute bilateral recurrent laryngeal nerve paralysis, a symptom of Shy-Drager syndrome].

The Shy-Drager syndrome causes symptoms of multiple nervous atrophy and orthostatic hypotension. This rare disease was diagnosed in a 40-year-old man after he developed an acute bilateral vocal fold paresis. The respiratory failure required an immediate tracheotomy. The Shy-Drager syndrome can include cranial nerve lesions. It should be taken into account in differential diagnosis in ENT diagnoses.

Autonomic Nervous System Diseases↗
PubMed1988

[Laryngotracheoplasty in early childhood].

Because of increased risk of surgery in infancy and because surgery at this age may affect laryngotracheal growth it is preferable to postpone open surgical correction of congenital or acquired laryngotracheal stenoses until pre-school or even school age. However, early intervention by one of the surgical methods available today appears to be justified if a child with a tracheostomy has unsatisfactory home surroundings, if the tracheostomy impedes a rehabilitation programme or if the laryngeal stenosis does not allow voice production. Of 42 children with congenital (14) or acquired (28) laryngotracheal stenosis, 13 were operated between the ages of 3 months and 6 years. The following surgical methods were used, depending on the type and degree of stenosis: (1) submucosal scar resection (5 cases); (2) "stepped incision" as described by Evans and Todd (2 cases); (3) widening of the anterior wall by an autogenous cartilage graft as described by Cotton (2 cases); (4) laminotomy with interposition of an autogenous cartilage graft as described by Rethi (3 cases); (5) multiple-staged laryngotracheal reconstruction with regional skin flaps and repeated cartilage grafting (1 case). The soft silicon Montgomery T tube was preferred in all cases for stenting the reconstructed laryngotracheal lumen, because it seems to be the most convenient and safest method. The importance of painstaking postoperative intensive care is emphasized. Up to now 11 patients have been extubated, but 4 of them show a mild restenosis. The history of one child who has not yet been decannulated is reported in detail to demonstrate the limits of laryngotracheoplasty in early childhood.

Child, Preschool↗
PubMed1988

[Acute circulatory disorders of the tongue].

Circulatory disturbances of the tongue are extremely rare because of its rich blood supply. Based on five case reports and a review of the literature we show that lingual circulatory disturbances may be due to impairment of venous drainage resulting in a large acute swelling of the tongue, or to ischemia carrying a painful tongue swelling, and possibly ulceration or partial tongue necrosis. The impairment of venous drainage appears to develop only as a consequence of an extensive posttraumatic or inflammatory edema of the floor of the mouth and tongue base. Ischemic lingual necrosis is most often due to giant cell arteritis and mostly occurs in elderly women. The correct diagnosis should be established as soon as possible because high-dose cortisone therapy both relieves the patient's complaints and prevents life-threatening complications such as myocardial infarction and apoplexy.

Aged↗
PubMed1987

[Digital subtraction angiography and iodine 123 amphetamine scintigraphy (IMP-SPECT) in the diagnosis of acute and chronic inner-ear hearing loss].

Vascular lesions may play a role in the genesis of acute and chronic hearing loss. After exclusion of other causes the vascular status of 33 patients was examined using digital subtraction angiography (DSA) for the supra-aortic vessels, and the N-isopropyl-(I-123)p-iodoamphetamine (IMP-SPECT) technique to investigate cerebral blood flow. Not a single case of stenosis affecting the hemodynamics, of a vascular anomaly or of a cerebrovascular perfusion disorder was found.

Adult↗
PubMed1986

[Prognosis of facial paralysis caused by fracture of the petrous bone].

The final outcome of 33 facial palsies (4 bilateral, 25 unilateral) after temporal bone fracture is reviewed. 11 immediate and 22 delayed paralysis were found. Out of the 22 delayed palsies 20 did heal spontaneously. The remaining two patients underwent tympanotomy because of CSF otorrhea. Simultaneously decompression of the facial nerve was performed. 17 of 22 delayed palsies showed complete and 5 incomplete recovery with slight functional defects only. 7 of 11 facial palsies with immediate onsets after injury were treated surgically (6 cases by transmastoid approach, 1 case by transmastoid as well as trans-middle-cranial-fossa approach); in 2 of these patients neural function did not recover. The remaining 4 immediate facial palsies healed spontaneously but showed incomplete recovery. Because it has not been proven yet that the prognosis of traumatic facial palsy can be improved by immediate surgical treatment early surgical intervention should be indicated restrictively. If necessary, reconstruction of the nerve can be done even 6 months after trauma with unchanged prognosis.

Adolescent↗