Biomedical subjects
H Luckhaupt
Publications and source records attributed to H Luckhaupt.
[Anaerobic infections in the head and neck area. Current status of knowledge].
The classification of anaerobic infections and the most common organisms affecting the head and neck, pathogenesis diagnosis and current therapy are reported. Certain types of infections are particularly important for anaerobic bacteria and include actinomycosis, infectious complications of chronic otitis media or sinusitis, phlegmon of the floor of the mouth, peritonsillar abscess, retro-(para-)pharyngeal abscess, neck space infections, mediastinitis, wound infections following head and neck surgery and septic complications.
[Taste disorders--an overview].
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[History of esophagoscopy].
Since the middle of the 19th century very many experts have endeavoured to develop the oesophagoscopy following two different principles of oesophagus examination. Some tried to transfer the technique of indirect laryngoscopy on the oesophagus by using a larynx speculum. In order to achieve an insight into the oesophagus they separated its closed upper end by means of special retracting instruments. Various instruments were developed for this purpose (by Voltolini, Semeleder, Stoerk, Bevan, Waldenburg, Mackenzie) which however not proved to be effective. Mostly angled or jointed tubes came into use which were stretched after insertion. More successful were those applying simple straight tubes. Except for Stoerk it was Kussmaul who had a sword-swallower swallow a tube instead of a sword. Today flexible fiberglass endoscopes are used as well as rigid tubes.
[Drug and non-drug tumor pain therapy in ENT medicine].
The basic of analgesic therapy in patients with advanced cancer of the head and neck is the regular application of analgesics and adjuvant analgesics. Radiotherapy is the treatment of choice in patients suffering from severe pain by bone metastases. Analgesic-resistant pain of dura in patients with tumour infiltration of the skull base is an indication for intraventricularly application of opioids by neurosurgeon.
[Current antibiotic treatment of ENT infections in the child].
Most acute infections of the upper respiratory tract are primary viral infections. Bacterial infections and superinfections in the head and neck in children require appropriate antibiotic therapy to prevent complications. No essential change of the bacterial spectrum of ENT infections of children has been seen in recent years. Penicillins and macrolides are important antimicrobial agents in current therapy. Beta-lactams are an important therapeutic advance.
[The expanded transconjunctival approach with lateral canthotomy to the orbital margin, floor and infraorbital nerve].
The range of indications for and the surgical technique of the extended transconjunctival approach to the inferior and lateral orbital margin, the floor of the orbit, the upper part of the facial wall of the maxillary sinus and the medial part of the zygomatic bone are described. We present 64 patients with mid-face fractures: 9 with fractures of the orbital margin, 48 with isolated blow-out fractures, and 7 with zygomaticomaxillary fractures. All have been operated on in the last 5 years. The transconjunctival approach extended by a lateral canthotomy is better than infraorbital or subciliary access. Exposure and cosmesis are excellent. None of the complications that follow other methods were seen after our surgical treatment.
[Drug pain therapy in patients with advanced head-neck tumors].
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[History of surgical interventions in the paranasal sinuses].
Hippocratices was the first to describe lesions that obstruct the nasal passages. Andreas Vesalius described the maxillary, frontal, and sphenoid sinuses. Mikulicz, Lothrop and Claoué are considered to have been the first to perform inferior meatal antrostomy of the maxillary sinus. Siebenmann was apparently the first to recommend suprameatal antrostomy in the middle meatus, which is now fashionable again. Grünwald, Hajek, Killian, Halle and Uffenorde developed endonasal ethmoid surgery to an established procedure.
[How I do it. Perioperative preventive use of antibiotics in tumor surgery of the head and neck].
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[What can the additional diagnosis contribute in sudden deafness?].
100 patients suffering from sudden hearing loss were examined with regard to cardiovascular risk factors and compared with a control group without ear diseases. Hypercholesterinaemia and hypertriglyceridaemia were significantly more often seen in patients with sudden hearing loss. No accumulation of pathological findings in neurological, orthopaedic or ophthalmological examinations was observed in patients with sudden hearing loss.
Fetor from ulcerated head and neck tumors: causation and therapy.
Almost all extensive tumors of the head or neck generate a fetor very unpleasant for the patient, his family, and the nursing staff. Thirty-one patients suspected of having a microbial superinfection of the tumor masses caused by anaerobes or an aerobe-anaerobe mixed infection were examined, and tumor samples from the oral cavity, throat, and larynx were obtained. Anaerobes could be demonstrated in every case, especially Bacteroides melaninogenicus. In the antibiotic treatment, clindamycin (Cleocin) proved to be superior to metronidazole (Clont). Within 12 to 24 hours after initiation of treatment, at the most 36 hours, the fetor almost always disappeared. The odor was stopped as long as antibiotic therapy continued.
[Pain therapy in patients with incurable tumors of the head and neck].
The treatment of pain in patients with terminal cancer of the head and neck is discussed. The treatment must be tailored to the individual patient and should use oral agents if possible. The basic medication consists of peripherally acting analgesics; if the results are inadequate, these must be combined with centrally acting agents. Neuroleptics are important adjuvant analgesics, which have proved to be particularly valuable for more severe pain in head and neck cancer. This treatment can be carried out either in hospital or in domiciliary practice.
Chemotherapy of advanced and relapsed squamous cell cancer of the head and neck with split-dose cisplatinum (DDP), 5-fluorouracil (Fura) and leucovorin (CF).
58 patients with locally advanced or relapsed squamous cell head and neck cancer were treated on 5 consecutive days with DDP 20 mg/m2/d IV-push, followed by CF 100 mg/m2/d IV-bolus and Fura 400 mg/m2/d IV-push 60 minutes later. Treatment was recycled on day 22(-29), according to toxicity. CF was added to the widely used DDP/Fura combination, because recent studies showed enhancement of Fura-activity by CF. 45/58 patients had no prior therapy and 13/58 pts were relapsed after chemotherapy and/or radiation therapy. All patients were evaluable for toxicity and response. After 3 courses of induction chemotherapy 23/45 pts in the previously untreated group had a complete response (CR); 20/45 a partial response (PR), 2/45 were restaged as no change (CR + PR: 95%). Induction chemotherapy was followed by radical surgery and postoperative radiation therapy. In the pretreated group 4/13 pts had a complete response; 6/13 a partial response; no change in 3/13 pts. Median duration of remission (MDR) has not been reached in the primarily untreated group, whereas in pretreated patients the MDR was 3.8 months (range 2.3 - 11.7 months). Hematologic and gastrointestinal toxicity was substantial but manageable and therapy was performed on an outpatient basis. The combination of DDP, CF and Fura has high activity in untreated and pretreated head and neck cancer patients. The obtained results are comparable to the widely used DDP/Fura continuous infusion regimen.
[The history of tracheotomy].
Tracheotomy is one of the oldest operations in medicine. The development of tracheotomy from antiquity to our time is reported. After the beginnings of the operation in Greek and Roman medicine, the operation was called laryngotomy or bronchotomy. It was Heister who coined the name "tracheotomy". Tracheotomy is still an important operation even after more than 2000 years. In recent years there has been a change from simple tracheotomy to plastic tracheostomy.
[Antibiotics and blood coagulation--current references for the ENT physician].
A rare but important side effect of antibiotics is their inhibitory effect on haemostasis and blood coagulation. Modern antibiotics with a wide spectrum like cephalosporins of the 2nd and 3rd generation, as well as semisynthetic penicillins, can imitate warfarin in its effect on the blood clotting system. Other antibiotics can enhance the effect of warfarin derivatives when given simultaneously. The mechanism by which penicillin and its derivatives inhibit platelet aggregation is not yet clear. Other antibiotics can induce thrombo-cytopenia. Before antibiotic treatment is started the doctor should consider liver and kidney function, a possible malnutrition, interaction with other drugs (especially inhibitors of platelet aggregation and warfarin derivatives), and other diseases of the patient that also prolong bleeding time.
[History of intubation].
The Arabian doctor Avicenna (980-1037) described the first orotracheal intubation in dyspnoea. The history of peroral endotracheal intubation actually begins in the 18th century. At that time obstetricians and lifesavers used breathing tubes. In 1880 Macewen preoperatively intubated a patient to prevent the aspiration of blood during extirpation of a tumour from the base of the tongue. Regular peroral intubation to keep the respiratory tract clear during narcosis was first applied by Franz Kuhn in 1900; unfortunately, the pioneer himself did not live to see his method become a routine procedure. It was only as late as 1945, that endotracheal intubation became part of hospital practice at our clinic.
[Fibrolipomas of the hypopharynx and esophagus. Contribution to their clinical aspects and therapy].
Five patients with benign fibrolipomas of the hypopharynx or the oesophagus are presented. The diagnosis, clinical features, differential diagnosis and therapy of these rare tumours are discussed with special reference to an uncommon case.