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Biomedical subjects

F Schmäl

Publications and source records attributed to F Schmäl.

10 recordsLinked to original sources
PubMed1999

[Infection frequency and type of bacteria after tympanostomy tube drainage in childhood: gilded-silver tubes versus silicone tubes].

Otorrhea is the most common complication after tympanostomy tube insertions. In Germany there are currently two commonly used types of tympanostomy tubes: silicon tubes (ST) and gilded silver tubes (GT). Previously published in vitro studies by Tajima uncovered a positive correlation between the silicon concentration in culture fluid and the rate of growth of Staphylococcus aureus. Our study retrospectively evaluates the types of bacteria and rates of otorrhea after ST and GT insertions. The present study was undertaken to determine which of these tubes had a higher incidence of otorrhea and then whether silicon tubes stimulated the growth of certain types of bacteria, such as Staphylococcus aureus. In all, 186 ST and 59 GT were placed in 245 ears of 144 children. Both ST and GT were separated into three groups: first insertion of a tympanostomy tube, second implantation and insertion of a tympanostomy tube in an infected ear in the course of a mastoidectomy. No differences between ST and GT in causing otorrhea were found in the three groups. Nevertheless, ST in comparison to GT was associated with a higher incidence of infections with Pseudomonas aeruginosa. In contrast, a higher incidence of Staphylococcus aureus related to ST could not be proved. Twenty percent of the ears with mastoiditis were found to have Pseudomonas aeruginosa, but none of these ears implanted with a GT developed postoperative otorrhea. Our findings show that GT should be used when a ventilation tube is used during a mastoidectomy. Further, it is tenable to implant only GT because postoperative otorrhea in many cases is caused by insufficient water protection and water is frequently polluted with Pseudomonas aeruginosa.

Bacteria↗
PubMed1998

[Epidural hematoma with secondary middle ear involvement. A rare differential diagnosis of otogenic brain abscess].

Processes in the middle ear can occasionally lead to clinical disorders extending beyond the anatomic boundaries of the area of the mastoid process. In contrast to this, pathological processes of the areas adjoining the middle ear might also lead to secondary involvement of the tympanic area. The report describes an initially asymptomatic epidural hematoma, which secondarily led to involvement of the middle ear. In general, such cases affecting the middle ear will produce symptoms usually interpreted as primary middle ear pathology. This association shows which disorders must be considered, the differential diagnosis and methods of therapy.

Adult↗
PubMed1997

[Value of smooth pursuit evaluation within the scope of clinical computerized nystagmography].

Testing gaze movements is very important for the detection of central vestibular diseases. The intent of this study was to clarify the pathological importance of partially disturbed and completely disturbed smooth pursuit movements. One hundred patients were analyzed and curves of smooth pursuit movements were classified into three groups of different deformations: i.e, regular, partially disturbed and completely disturbed movements. The correlation index of each curve was then calculated. In 16 patients qualitative analysis showed a completely disturbed result in the smooth pursuit test. Nine of the patients (56.3%) showed morphological signs of a central disease. Twenty-nine patients yielded a partially disturbed test result and in 2 of them (6.9%) a central pathological illness was uncovered. Patients with completely disturbed smooth pursuits showed the highest average binocular correlation index (1.44). Others with partially disturbed results gave an index of 1.24, while persons with regular smooth pursuits yielded a value of 1.17. Because of the scattering seen, it was not definitely possible to attach a correlation index to central disease. On the other hand, an index higher than 1.3 should arouse suspicion for a central illness. Only completely disturbed smooth pursuit movements frequently appear in connection with central diseases. As a rule, a partially disturbed result does not indicate diseases of the central nervous system.

Adult↗
PubMed1997

[Maculo-ocular reflex and visual perception during vertical acceleration].

BACKGROUND: We investigated the effect of vertical acceleration upon the otolithic-ocular reflex of 22 healthy people. The study was performed to obtain standard values for subsequent investigations at patients. METHODS: People sitting on a chair were accelerated in the vertical axis with an amplitude of 4 cm and the frequencies of 0.5 Hz, 1 Hz, 1.5 Hz, 2 Hz, 2.5 Hz and 2.7 Hz. The movements of the ocular globe were initially recorded during vertical acceleration with the eyes closed. Then visual acuity was tested during linear acceleration with the eyes open. As parameters of evaluation we used coherence and alteration of the visual acuity. RESULTS: When the frequency was increased while the eyes were closed, coherence increased and the number of people with vertical eye movements increased. Amplitude was observed to increase and a phase shift occurred. A significant value of coherence (> 0.8) was observed at a frequency above 2.5 Hz. During the test of visual acuity, coherence also increased but did not reach quantity we observed initially. A significant loss of visual acuity occurred at a frequency above 2.5 Hz. A phase shift was also observed. The reason for the loss of visual acuity was the increment of amplitude and the phase shift, which had a negative influence on fixation. CONCLUSIONS: In summary, reactions with closed eyes are best tested at frequencies of 2.5 and 2.7 Hz. We recommended frequencies of 1.5 and 2 Hz for testing visual acuity.

Acceleration↗
PubMed1997

[What is the role of contact lenses within the scope of electronystagmography?].

BACKGROUND: During electronystagmography it is necessary to correct detective vision for calibration, smooth pursuit, and saccadic eye movements. Therefore more and more people use contact lenses instead of normal glasses. Given the lack of detailed information about this phenomenon, in the current literature we decided to investigate the influence of soft contact lenses on electronystagmography. The aim of this study was to find out differences in the results of electronystagmography between using glasses or contact lenses. METHODS: Our investigation involved 20 vestibular healthy human subjects with myopia. In the first part of the examination they used their contact lenses and in the second part they were wearing normal glasses. After measuring the calibration potential we wanted to see if contact lenses would increase the rate of artifacts in the electronystagmogram. Then we attempted to determine whether contact lenses would an influence on the registration of the optokinetic nystagmus. Induced saccadic eye movements were recorded and analysed. RESULTS: Contact lenses had a negative influence neither on the calibration potential nor on the rate of artifacts. The latency of the saccadic eye movements also showed no differences between both parts of this investigation. Only the velocity of the saccades and the gain value during the optokinetic test were reduced when glasses were used. CONCLUSIONS: Contact lenses may stimulate the secretory function of the lacrimal gland and thus decrease friction forces. It is also possible that the reduced image size produced or the reduction-effect of minus by glasses in near sighted persons negatively influences eyeball velocity. In summary, our study demonstrates that contact lenses do not have a negative influence on electronystagmography. Therefore electronystagmographic studies of patients with contact lenses are permissible for purposes of documenting a medical opinion.

Adult↗
PubMed1996

[Effect of various electrode configurations and voluntary, reproducible artifacts in computer-assisted analysis of nystagmus].

BACKGROUND: There is no detailed information in the current literature about the best position for the electrodes with regard to electronystagmography. The computer nystagmograph registers potential changes resulting from electrodes on the forearm as nystagmus (pseudonystagmus). This phenomenon led us to investigate more closely the effect of various electrode arrangements and artifacts on the result of computer nystagmography. METHODS: The following four electrode arrangements were investigated on 20 human subjects: distance between the horizontal electrode and the lateral canthus (1 cm versus 2 cm), diagonal arrangement of the lateral electrodes, and changes to the lower vertical electrode. Recorded parameters included calibration potential, rotary nystagmus, post-rotary nystagmus, and optokinetic nystagmus. After determining the basic activity with closed eyes, the influence of five human artifacts on the computer nystagmography was investigated, namely blinking, contractions of the masticatory muscles, swallowing, facial expression, and squinting. RESULTS: The arrangement in which the horizontal electrodes were placed 1 cm away from the lateral canthus showed the greatest calibration potential and the smallest degree of human influence with regard to frequency and amplitude of the pseudonystagmus since a larger potential does not have to be amplified as much as a smaller one to achieve the same needle deflection. For this reason, the artifacts experience a smaller degree of amplification. CONCLUSIONS: We think the following arrangement of the electrodes guarantees the best signal reproduction: a distance between horizontal electrodes and the lateral canthus of 1 cm. The medial electrode is centered between the eyes on the bridge of the nose. The upper vertical electrode is placed above the left eyebrow in the line with the middle of the pupil. The lower vertical electrode is also in line with the middle of the pupil, 1 cm below the lower eyelid. The result is a clear recording of a physiological nystagmus, e.g. on rotation. In the absence of nystagmus, the analysis program is too unreliable and produces a multiplicity of pseudonystagmi. To avoid this we have to improve the recognition of nystagmus in the analysis program.

Adult↗
PubMed1995

[Clinical and experimental studies of Stenger's experiment with speech].

A speech Stenger test by the numeral words of the German "Freiburger" test material (DIN 45621) has been conducted in 46 cases of suspected pseudohypacusis. Positive Stenger was produced by 30 patients (65%). 20 patients were sent from an otorhinolaryngologist with the diagnosis of inexplicable hearing loss and 16 of them (80%) showed a positive Stenger test. 10 (30%) of the 30 Stenger-positive patients get previously a CT and/or a MRT to exclude an acoustic neuroma. The pseudohypacusis was pretended in 56.7% to the right ear. The interaural difference of the speech level for full lateralisation is 10 dB. The sound level if the percentage of repeated words decreased, was higher in only 56.7% compared with the sound level on the ear with better hearing. 73% of the positive speech Stenger test showed that the percentage of the repeated numeral words did not drop immediately from 100 to 0%; we noticed intermediate values. To understand these better we initiated lateralisation tests in normal hearing people. In a second experience they were asked to simulate unilateral deafness. The interaural difference of the speech level in the Stenger test with simulated unilateral deafness was about 4 dB less than with normal hearing. Concentration to one ear might have some influence on the interaural difference of the speech level that leads to full lateralisation. All persons attained intermediate values and it was shown that all repeated words were heard in the direction of the normal hearing ear.

Adolescent↗
PubMed1995

[Rare tumor of the nose and paranasal sinuses. Leiomyosarcoma].

Leiomyosarcoma is a rare malignant tumor of the nose and paranasal sinuses. Including our patient, 32 cases have been reported in the literature. Radical surgery is currently the best therapy. In comparison with results of conventional irradiation, postoperative neutron treatment appears to be more effective.

Adult↗
PubMed1993

[Evaluation of nasal patency].

The subjective estimation of nasal breathing, the flow in anterior rhinomanometry, nasal peak flow and the results of acoustic rhinometry have been investigated in 30 patients before and after decongestion of the nasal mucosa. The aim of this study was to compare the different methods in view of their results. The effect of decongestion can be seen in all methods. A regression analysis showed no significant correlation between these methods. We found the best correlation between subjective estimation and the flow in anterior rhinomanometry at 75 Pa on the side of the better flow. The decisive drawback of the acoustic rhinometry is the fitting between nosepiece and nostril. Because of the influence of extranasal factors on the results of the peak flow measurement, anterior rhinomanometry seems to be the most reliable method to assess nasal air flow.

Acoustics↗