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G Schade

Publications and source records attributed to G Schade.

At least 19 recordsLinked to original sources
PubMed2005

[Clinical application of the endolaryngeal laser measurement technique].

INTRODUCTION: Laser projection techniques have made morphometric measurement of laryngeal structures possible. The clinical application of a new laser measurement technique that uses a double reflecting mirror for laser beam duplication is discussed. MATERIAL AND METHODS: Endolaryngeal measurement with a new two-point laser light projection method was carried out on 25 patients with ten different organic lesions of the vocal folds. The laser measurement tool can be clipped onto the shaft of a rigid endoscope. A special software program enables quick and precise measurements of distances and areas that are in the same horizontal plane as the laser spots. FINDINGS: Using this new system, a clinical examination of the size of organic lesions of the vocal folds is possible, with a precise measurement of endolaryngeal structures being possible in all cases. The findings are easily documented, and the examinations can take place during routine laryngoscopic investigations. CONCLUSION: Systems for endolaryngeal measurements enable morphometric measurements within the larynx. Quantitative examinations have become possible in laryngology.

Endoscopy↗
PubMed2005

[Experiences with intraoperative application of prednisolone during Isshiki type I thyroplasty].

Laryngeal edema is considered a postoperative problem in phonosurgery. In a prospective study we examined if a single intraoperative application of prednisolone can decrease the incidence of postoperative laryngeal edema after Isshiki type I thyroplasty. We examined ten patients undergoing unilateral type I thyroplasty [seven men and three women, age range: 19-60 years (average: 48 years)]. In six patients we administered 250 mg prednisolone i.v. during surgery. In four patients no steroids were given at all. On the 1st and 2nd postoperative day, the larynx was examined in a clinical setting. Five of six patients who received intraoperative steroid medication had no postoperative laryngeal edema. Only in one of those patients we examined a small edema of the arytenoid region. In all four patients without steroid medication a postoperative edema of the ipsilateral arytenoid hump was seen. Thus, intraoperative intravenous steroid administration seems to prevent, or at least reduce, postoperative laryngeal edema. Only in one of those patients we examined a small edema of the arytenoid region.

Adult↗
PubMed2005

[High speed glottographic diagnostics in laryngology].

INTRODUCTION: High speed imaging (HSI) allows thousands of pictures to be taken of the vibrating vocal folds per second. Although already developed in 1939 in the USA, this method only became clinically useful a few years ago as the amount of data exceeded the capacity of physical memory. MATERIALS AND METHODS: Rigid endoscopes are normally used for high speed glottography. After clinical investigation of the patient, kymographic analysis can be carried out off-line. Up to 8,000 grayscale images of 256 x 256 pixels can be stored by the Wolf HS Endocam 5560 that we used in our study. A maximum of 4,000 images/s can be taken by the high speed camera. RESULTS: In high speed glottography, analysis and documentation of single vocal fold movements within the vibratory cycle is possible. In contrast to stroboscopic investigations, aperiodic movements of the vocal folds can be visualized. The duration of a recording differs from 2 to 4 s depending on the capture speed. The data transfer to the computer for archiving and analysing the images takes a few minutes. CONCLUSION: HSI has advantages and disadvantages compared to videoendoscopy and videostroboscopy. The main advantage is the visualisation of aperiodic movements, the disadvantages are the transfer time for the data and the poorer image quality compared to conventional videoendoscopy. Nevertheless HSI is a very promising technique in laryngological investigation.

Endoscopy↗
PubMed2005

[Endolaryngeal distance measurement by laser light projection--from the idea to clinical application].

INTRODUCTION: In clinical and scientific examinations with rigid and flexible endoscopes quantitative morphometric measurements of intralaryngeal structures have been difficult whereas qualitative laryngoscopic examinations are routine procedures. MATERIAL AND METHODS: The development of a two-point light projection method for endolaryngeal morphometry in its different phases is described. The way from a first prototype for endolaryngeal morphometry that works with a prism technique to the latest, most modern prototype, which works with a double reflecting mirror is shown. RESULTS: In combination with a newly developed PC software the latest prototype for two-point laser-light projection enables an accuracy of 95 % to 99 % in the measurement of intralaryngeal distances. The contrast of the laser beams to the mucous membrane of the larynx could be optimized by the use of green--instead of red--laser light. CONCLUSION: Morphological measurements within the larynx are now possible for clinical and scientific questions. Former limitations in quantitative morphometric examinations will be reduced.

Equipment Design↗
PubMed2004

[Vocal cord dysfunction. An important differential diagnosis to bronchial asthma].

Vocal cord dysfunction (VCD) is described as a functional disorder of the vocal folds which leads to an intermittent, inspiratory 'paradoxical' glottal closure. We report on three women with frequent repetitive shortness of breath attacks caused by VCD. This was diagnosed by transnasal videofiberendoscopy, with glottal closure being seen during inspiration. Because of the different etiologies, one of the patients was treated with breathing and speech therapy, another received Omeprazol for laryngopharyngeal reflux, and the third was treated by intralaryngeal botulinum toxin injections. All three patients showed a reduction in attacks. Clinically, VCD seems to mimic asthma. However, with a thorough patient history and diagnostics, especially with transnasal laryngoscopy during a (triggered) attack, a precise diagnosis seems possible.

Adult↗
PubMed2004

[Influence of the head position in laryngoscopy].

INTRODUCTION: The aim of this study was to determine the optimal position of the head during larygoscopy. MATERIAL AND METHODS: During fiberoptic evaluation of the larynx, the head position of eight subjects (5 male, 3 female) was changed systematically. The influence of reclining and anteversion, tilting and rotation of the head on the quality of the endoscopic images was determined. RESULTS: The vocal tract became wider and the view onto the glottis could be improved by reclining the head and anteversion of the chin. On rotation of the head, the hypopharynx of the same side became narrower. This is well known and is used worldwide in the therapy of dysphagia. DISCUSSION: Positioning of the patient is important in laryngoscopy. Reclining the head and forward inclination of the trunk (horizontal axis of the mouth) seems to be the best position for obtaining an optimal view onto the glottis.

Adult↗
PubMed2004

[Voice-improving laser-surgical therapy in amyloidosis of the larynx].

Laryngeal amyloidosis is relatively uncommon, accounting for only 0.2-1.5% of all laryngeal tumours. Hoarseness, dysphagia and stridor are potential clinical symptoms. A systemic amyloidosis should be excluded even though symptoms are only apparent in the head and neck region. For the localised form, surgical excision of the excess tissue is performed. We discuss the development of the disease, together with its diagnostics and therapy, based on the case report of a 42 year old female patient.

Adult↗
PubMed2004

[Is there a consensus in the division of the vocal folds in thirds?].

INTRODUCTION: In clinical routine we have noticed a disagreement of ENT-specialists and phoniatricians in the division of the vocal folds in thirds. To show if there is consensus in this field by the german phoniatricians this study was done. MATERIAL AND METHODS: In two parts of a study, a pilot study and a follow up study, we sent twelve different images of the larynx to all german phoniatricians. In six of these images the physicians should set the marks of the ventral and dorsal limitation of the second third of the vocal folds. In six different images a mark should be related to the particular third of the vocal folds. The phoniatricians were asked to assess how certain they were in their valuation. They were asked either, how long they have been working as a physician and how long they have been specialized as a phoniatrician and as an ENT-surgeon. In the follow up study the phoniatricians were requested to first divide up the thirds in a way that the dorsal third corresponds to the cartilaginous part of the vocal folds (scheme 1) and second divide up the thirds in a way that all three thirds correspond to the ligamental part of the vocal folds. DISCUSSION AND FINDINGS: In the pilot study, when no instructions for the division of the thirds were given, the data differed much more than in the follow up study, when the physicians were told to use scheme 1 and scheme 2. That was because some phoniatricians divided up just the ligamental part and others the ligamental plus the cartilaginous part of the vocal folds in thirds. The more the physicians could overlook the membraneous part of the vocal folds the more certain they were in their assessment. CONCLUSION: The assessment of the division of the vocal folds in thirds is more homogeneous when the phoniatricians were requested to divide up the thirds in a way that the dorsal third corresponds to the cartilaginous part of the vocal folds (scheme 1). Therefore we suggest that this way of division should be used further on.

Adult↗
PubMed2003

[Sonography of the larynx--an alternative to laryngoscopy?].

PROBLEM: The aim of this study was to determine whether the pictorial results obtained from B-mode ultrasonography duplicate those of laryngeal endoscopy and whether there are any additional advantages when using ultrasonography. PATIENTS AND METHODS: A total of 22 patients with various diseases of the larynx were examined ultrasonically with the ultrasound plusing a Sonoline Elegra as well as with a '7.5 L40' and a 'VF 13/5' linear array. In order to compare both methods directly, reference data were prepared and contrasted. RESULTS: All of the laryngeal lesions recognised in the endoscopic investigation were also demonstrable by the use of ultrasound, although minor changes were difficult to detect. In one case, ultrasonography suggested the presence of an infiltration of the thyroid cartilage, otherwise no additional information was available using this method. CONCLUSIONS: Using ultrasonography, the image quality of the larynx is worse than that of the soft tissue of the neck, which is determined by the air-mucous membrane boundary as well as the (ossified) cartilaginous skeleton. Thus, ultrasonography is useful in cases of larger laryngeal lesions, while there is no advantage in the detection of small processes.

Adult↗
PubMed2003

[Reinke edema--helpful in unilateral recurrent laryngeal nerve paralysis?].

We report on a 57-year-old teacher who consulted us for her known unilateral recurrent nerve paralysis subsequent to strumectomy. Video laryngoscopic and stroboscopic examinations revealed Reinke's edema in addition to the left-sided immobile vocal fold with maintenance of good vocal function. Because of the left-sided Reinke's edema, complete glottal closure was possible although the left vocal ligament remained slack. Surgical removal of the vocal fold edema in this case would presumably result in considerable impairment of vocal function. This example illustrates that in selected cases Reinke's edema can contribute to maintenance of phonation in unilateral vocal fold paralysis. In these cases, indication for edema surgery should be very restrictive and should always take the vocal function into consideration.

Female↗
PubMed2003

[Preliminary experiences with Photopic ultrasound imaging in the head and neck region].

BACKGROUND: The application of high end ultrasound platforms increases the quality of sonographic images. New software developments like Tissue Harmonic Imaging (THI) have improved the resolution of images and help to better visualize anatomic findings. Photopic-mode uses color-coding to gain contrast. METHODS: This investigation compares the use of the Photopic-software in comparison to conventional B-mode. The ultrasound platform Sonoline Elegra was used. RESULTS: The Photopic-mode revealed in 8 of 40 patients a slight improvement within image quality. However, the use of Photopic-mode did not lead to other diagnostic results. CONCLUSION: Ultrasound investigation with Photopic-mode can be a useful supplement to the conventional B-mode-sonographic examination in selected cases by gain in contrasting. A disadvantage of the Photopic-mode is that it cannot be used simultaneously with color Doppler-mode examination.

Adult↗
PubMed2003

[Non-invasive screening for GJB2 mutations in buccal smears for the diagnosis of inherited hearing impairment].

BACKGROUND: Approximately 1 out of 1000 children is affected by severe or profound hearing impairment at birth. In the last years it has been shown that more than 50 % of inherited prelingual, sensorineural hearing impairment may be attributed to genetic defects. Most commonly, the GJB2 gene (chromosome 13q11) that encodes connexin 26 (Cx26) is affected. Cx26 is crucial for the formation of gap junctions which play an important role in the intercellular exchange of electrolytes. A variety of autosomal recessive GJB2 mutations associated with inherited hearing impairment has meanwhile been identified. The most common GJB2 mutation in Caucasian populations, 35delG accounts for the majority of cases and has a carrier frequency of more than 2.5 %. Other distinct mutations account for hearing impairment in other parts of the world. MATERIAL AND METHODS: We examined in 59 Caucasian and Ghanaian individuals whether DNA recovered from buccal smears was appropriate for genetic testing by polymerase-chain reaction (PCR) based DNA-sequencing. RESULTS: Buccal smears could be taken conveniently in all cases, even from small babies. In 53 out of 59 samples the material recovered from buccal smears could be subjected to PCR of the second exon of the GJB2 gene and subsequent DNA-sequencing. GJB2 mutations were identified in 34 patients. 13 Caucasian individuals exhibited the most common mutation 35delG. In addition, four cases of the rare W24X and each one heterozygous case of the V153I- and the L90P mutation were found. In two African individuals the 35insG mutation was detected. All other African patients had mutations exclusively identified in Ghana so far with the exception of R143W. R143W accounts for most cases of profound deafness in Ghana and has been identified in low frequencies in other ethnic groups as well. CONCLUSION: Screening for GJB2 mutations in DNA recovered from buccal smears of individuals with inherited hearing impairment offers an easy, non-invasive method for early diagnosis and a basis of genetic counselling.

Adult↗
PubMed2003

[Oropharyngeal vocal tract space during singing--comparison of tactile-kinesthetic and auditory perception with objective endoscopic findings].

BACKGROUND: In this study we compared the perceived diameter of the vocal tract's oropharyngeal part with the diameter that was determined endoscopically. METHODS: 28 singers (13 male, 15 female) were examined with transnasal fiberscopic pharyngoscopy while singing the vowels /a/, /i/ and /u/ in 4 different timbres (normal, opened, covered, dumpled) and 3 different pitches (chest/modal register, subjective comfortable pitch for singing, head/falsetto register). The tactile-kinesthetic and auditive rating of the singers, the auditive rating of a singing teacher and the visual-endoscopic analysis of three laryngologists were compared. RESULTS: The tactile-kinesthetic and auditory self-perception of the singers was quite different from the auditive perception of a singing teacher and visual endoscopic findings of the laryngologists. The singers had the impression that the different singing timbres (normal, opened, covered, dumpled) influence oropharyngeal vocal tract space during singing. They judged the vowel itself and the pitch as having very little influence. Based on his auditory perception, the singing teacher also rated that the timbre plays an important role for the oropharyngeal vocal tract space but he found vowels to be the parameter with the greatest impact. Via visual endoscopic examination we found that, among the three parameters (vowel, timbre, pitch), the different vowels are most influential on the oropharyngeal vocal tract space. Analysis of video sequences revealed that pitch and timbre are less important. CONCLUSION: Subjective tactile-kinesthetic and auditory perception of the singers differs from auditory perception of the singing teacher as well as from endoscopic findings. The endoscopically determined oropharyngeal vocal tract space during singing the vowels /i/ or /u/ tends to be larger compared to the oropharyngeal vocal tract space while singing the vowel /a/.

Adult↗
PubMed2002

[Possibility for endolaryngeal morphometric measurements with a new laser light method].

Morphometric measurement of horizontal laryngeal structures is difficult and poses many problems in laryngology. It is difficult to determine the size of vocal fold tissue lesions as well as the range of amplitudes during vocal fold vibration in rigid endoscopy. We present a new method by using two parallel light beams which are projected onto the surface of the vocal folds during examination of the larynx with a rigid 90 degrees-endoscope. Because of the fixed distance of the light points, measurement of the laryngeal structures can be accomplished, e.g., using a video print after the examination. With this new technique morphometric measurement of horizontal laryngeal structures during routine endoscopic examination becomes feasible.

Equipment Design↗