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Biomedical subjects

H Decher

Publications and source records attributed to H Decher.

At least 19 recordsLinked to original sources
PubMed1992

[Partial obliteration of radical cavities with ceramic granules].

The canal wall surgery is the safest way to eradicate cholesteatoma. Extensive radical cavities often induced a permanently discharging ear. This article review first of all the common obliteration methods of radical cavities. Since july 1987 to may 1991 we made a partial obliteration of radical cavities with hydroxylapatite granulate in 72 cases. 66 patients were reexaminated. In more than 95% we see a permanent dry cavity, no cholesteatoma recurrence. The ceramic granulate technique is contradicted in fistula of the labyrinth, dissection of the sinus sigmoideus or of the dura. Compared with other relevant techniques (i.e. pedicaled subcutis muscle flaps, free tissue flaps or bone chips) we see no crumpling up of the obliterated areas and no retractions. We have leaved our obliteration technique with homologous cartilage chips because of the possibility of HIV-infection, and longer ear-secretion after cartilage chips.

Ceramics↗
PubMed1985

[Reduction of radical cavities by homologous cartilage chips].

The article reviews, first of all, the common obliteration methods of radical cavities. This is followed by a description of the author's own technique which has been practiced for the last 13 years. This method employs preserved (Cialit solution 1:5000) homologous septal cartilage chips, shaped into small cubes of 3-4 mm. size. The chips are implanted in obscure districts (apical mastoid, sinus dura angle) of radical cavities for primary or secondary (old cavities) partial obliteration, as shown in Figs. 1 and 2. Crushed homologous septal cartilage plates and temporal muscle fascia are placed additionally on the chips. The effect is the construction of a small, easy-care cavity, which can be appreciated at a glance. Statistical results of 314 cases (170 cases of primary obliteration, 144 old cavities) are presented. Chips in cavities are well tolerated. Chips were partially rejected in 13 cases only, whereas in 3 cases they were completely rejected. A permanent dry cavity and dry ear was achieved in 86% of the cases. Cholesteatoma recurred in 5 cases. The homologous cartilage technique is contraindicated in fistulas on the labyrinth or fenestra, as well as in exposed facial nerve or dehiscence of the facial nerve canal, in case of healed fistula of the dura, and in dissection of the sinus sigmoideus. In these cases, autologous cartilage (tragus, cavum conchae) must be implanted. One of the most important advantages of this method is that there is no crumpling up of the obliterated areas and no retractions over a longer period of time, compared with other relevant techniques (i.e., pedicled subcutis muscle grafts or free tissue flaps).

Cartilage↗
PubMed1976

[Morbus Menière and cervical symptoms (author's transl)].

The history of the patient is very important. In cervical syndroms typical pain in neck, shoulder and arm are present, often combined with occipital headache and paraesthesias. The symptoms are more pronounced during the night, while waking-up and after sudden head movements. Radiological changes mainly occur at C 4-C 7, but are not pathegnomonic. Hearing loss is rather frequent, usually one-sided and non fluctuating. The audiogram is not characteristic for its cervical origin. In 80% recruitment is present, tinnitus occurs in 30--60% of the patients, but displacusis and fullness of the ear do not occur. The vestibular symptomatology is the best differential diagnostic tool.

Brachial Plexus Neuritis↗
PubMed1975

[Hearing alterations in vertebro-basilar insufficiency (author's transl)].

The morphological facts are represented, to see hearing alterations as a possible consequence of vertebro-basilar insufficiency. The conception: "vertebro-basilar insufficiency" is defined. Compared to vestibular disturbances cochlear disturbances in vertebro-basilar insufficiency are extremely rare. Always we find sensorineural hearing loss or complete unilateral deafness, most combined with tinnitus. All publications we got reported, only 4 from otologists. The conception "sudden deafness" is defined by differential diagnosis. The vertebro-basilar insufficiency, secured by arteriographical or neurological examinations, is not the same as a syndrome of cervical spine with effects to the vertebro-basilar artery system, except the pathogenesis of this syndrom is evident. But this evidence is not given till now.

Audiometry↗