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Biomedical subjects

H Stammberger

Publications and source records attributed to H Stammberger.

At least 55 records · Page 3Linked to original sources
PubMed1997

Simultaneous occurrence of metastatic tonsillar squamous cell carcinoma and angioimmunoblastic T-cell lymphoma in a cervical lymph node.

Non-Hodgkin's lymphoma (NHL) is a frequent head and neck malignancy. Squamous cell carcinoma of the tonsil is the second most common head and neck carcinoma. We report a case of a tonsillar carcinoma metastasis in an angioimmunoblastic-transformedlymph node. To our knowledge this is the first description and histopathological documentation of such a case in the literature.

Carcinoma, Squamous Cell↗
PubMed1997

[Anatomic terminology and nomenclature for paranasal sinus surgery].

A consensus on the preferred modern usage of potentially confusing or ambiguous terms in sinus anatomy and nomenclature is described. These terms are intended to provide clear communication among otorhinolaryngologists worldwide and serve as a basis for discussion among anatomists. Terminology is based on Latin nomenclature. An attempt has been made to reconcile or eliminate duplication, redundancy, and overlap in terminology that have arisen over the past century. A key concept is that the ethmoid complex is divided into anterior and posterior sections by the basal lamella of the middle turbinate.

Ethmoid Sinus↗
PubMed1997

[Endoscopic detection of cerebrospinal fluid fistulas with a fluorescence technique. Report of experiences with over 925 cases].

BACKGROUND: For more than 35 years intrathecal fluorescein has been used for identification of cerebrospinal fluid leaks. Whereas some authors apply this technique routinely and with excellent results, significant complications have also been reported, sparking considerable controversy. At the Graz University ENT Department intrathecal sodium fluorescein has been routinely used for more than 25 years and is considered a significant help. MATERIAL AND METHODS: In a retrospective study data of 925 patients who underwent a diagnostic fluorescein test during the period from 1970-1995 at our department were evaluated. The techniques of preparation and intrathecal application of sodium fluorescein are described, as are the techniques of endoscopic diagnostic and intraoperative identification of fluorescein stained CSF. RESULTS: There were three complications during 925 fluorescein tests that resulted in grand mal seizures after suboccipital application. Since 1990, we have discontinued the use of suboccipital punctures, and in more than 250 consecutive cases since then we have not seen any complications. Side effects and complications reported in literature are attributable to three main factors; application of too large quantities of fluorescein, of unsuitable fluorescein preparations, and of excessively high concentrations of fluorescein. False positive results are not possible with this technique; false negative findings can be present in 1-7 percent of cases, however. CONCLUSION: Our results demonstrate that the use of intrathecal fluorescein can be an extremely helpful diagnostic technique involving minimal risk.

Adolescent↗
PubMed1997

[Surgical occlusion of cerebrospinal fistulas of the anterior skull base using intrathecal sodium fluorescein].

BACKGROUND: For more than 25 years, intrathecal 5% sodium fluorescein has been routinely used at the University ENT Hospital at Graz during surgical closures of CSF leaks of the anterior skull base. Especially with endoscopic approaches, this technique has been of significant help in identifying and localizing dural defects. No fluorescein-related complications occurred in the series reported. MATERIAL AND METHODS: In a retrospective study, indications, techniques, and results of surgical closures of CSF leaks of the anterior skull base are reviewed. During 5 1/2 years from 1990-1995, 72 patients with CSF-rhinorrhea were operated on at our department, 69 of whom had sodium fluorescein applied intrathecally. In 41 patients strictly endoscopic techniques were applied, in 22 patients an external approach was chosen and in 9 cases combined approaches were used. Defects in the roof of the ethmoid, the lamina cribrosa, and in the sphenoid sinus almost exclusively were approached endoscopically. Defects in the posterior table of the frontal sinus, especially when located laterally, were approached from externally or via combined endonasal and external routes. The causes of the CSF leaks, their localization, and the surgical approaches chosen are analysed and the surgical techniques described in detail. RESULTS: The direct coronal CT of the paranasal sinuses/anterior skull base proved to be significantly better in detecting lesions compared to axial CT images (82% vs. 53%). In all cases intrathecal fluorescein allowed for a precise localization of the defect(s). There were no fluorescein related complications in this series. In one patient with massive frontobasal chip fractures and substantial dural defect, a rhinosurgical closure was not successful. Two patients developed recurrent fistulae after several months and years respectively. One of these patients had to be operated 3 times until permanent closure was achieved. Two patients had to be revised because of mucoceles of the frontal sinuses, in both cases the initial closure of the dural defect proved to be tight. CONCLUSION: Our results demonstrate that with exception of defects of the posterior lateral table of the frontal sinus, CSF leaks of the rhinobasis can be closed safely endoscopically. After a follow-up from 19-65 months, the overall success rate for 72 CSF leaks was at 94.5%. When applied correctly, the fluorescein technique proves to be an extremely helpful technique for diagnosis and surgery of CSF leaks.

Adolescent↗
PubMed1996

Choristoma of the middle ear.

Choristoma is a mass of tissue histologically normal for an organ or part of the body other than the site at which it is located. A rare case of ectopic salivary gland choristoma in the middle ear is described in a 4-year-old boy whose only symptom was a 50 dB conductive hearing loss in the presence of a normal tympanic membrane.

Audiometry↗
PubMed1996

Ultrafast computed tomography and three-dimensional image processing of CT sialography in patients with parotid masses poorly defined by magnetic resonance imaging.

The purpose of this study was to determine the efficacy of ultrafast computed tomography (UF CT) in patients with parotid masses poorly defined by magnetic resonance imaging (MRI) and to evaluate the diagnostic potential of three-dimensional (3-D) UF CT sialography when compared with conventional CT sialograms. Thirteen patients with clinical suspicion of a parotid mass, in whom MRI was degraded by motion, underwent UF CT of the parotid region. Two radiologists independently assessed the CT and MR with respect to tumor localization, intraglandular tumor location, tumor margin characteristics, and infiltration of surrounding tissue. In 9 patients, CT sialography was performed using 3-D image processing. Anatomical details and pathologic findings were assessed by three readers using a numerical grad and compared with the findings derived from conventional CT sialography. Histopathologic specimens were obtained in all cases and correlated with the radiographic findings in a consensus manner following the blinded interpretations. UF CT and (suboptimal) MRI provided the same diagnostic information for the evaluation of tumor localization, and intraglandular location. UF CT was superior to MRI in the detection of tumor infiltration, and definition of tumor margins in 2 cases (15%), resulting in a substantial difference in treatment. Three-dimensional CT sialography offered significant improvement in demonstration of anatomic detail (2.5 +/- 0.2 vs 1.5 +/- 0.1, respectively) and pathologic findings (2.6 +/- 0.1 vs 1.3 +/- 0.2, respectively) when compared with conventional CT sialography. UF CT is a viable alternative in uncooperative patients with parotid masses. UF CT 3-D sialography has the potential to allow more precise pre-surgical planning and contributes to the diagnosis and therapy planning of parotid masses.

Adult↗
PubMed1995

The treatment of chronic sinusitis: a controversial issue.

The persistence of sinusitis after upper respiratory tract infection is influenced by a range of aetiological factors such as anatomical variation which may be surgically corrected, mucociliary abnormalities and immune deficiency. The latter is more common than previously realised, encompassing IgG subclass deficiency, reduced opsonization and Fc gamma receptor polymorphism. This has therapeutic implications, with the possibility of IgG replacement therapy and vaccination. CT scanning suggests that the age of the patient and anatomical abnormalities are important aetiological factors in chronic rhinosinusitis. Only when medical therapy fails, is surgery considered. Although a range of surgical procedures are available, an endoscopic approach may be directed at the ostiomeatal complex and is generally very conservative. Scanning is a prerequisite to this surgery, demonstrating both the extent of disease and the anatomy but requires careful interpretation. Furthermore, an endoscopic technique can be employed for a number of other sinus conditions though this should only be undertaken by an experienced surgeon. A long-term prospective study of children undergoing radical sinus surgery for neoplasia strongly suggests that concerns that surgery in the middle meatus might disturb subsequent facial development are unfounded.

Adolescent↗
PubMed1995

Three-dimensional processing of ultrafast CT sialography for parotid masses.

PURPOSE: To evaluate the diagnostic potential of three-dimensional image processing of ultrafast CT sialography in comparison with conventional CT sialography in patients with parotid masses. METHODS: In nine patients, CT sialography was done with three-dimensional image processing. The visibility of anatomic details and pathologic findings, derived from three-dimensional images, were graded numerically by three observers and compared with the findings obtained from conventional CT sialograms. Histopathologic specimens were obtained in all cases. RESULTS: Ultrafast CT images showed no motion artifact. Three-dimensional CT sialography offered significant improvement in demonstration of ductal anatomy (2.5 +/- 0.2 versus 1.5 +/- 0.1, respectively) and ductal pathology (2.6 +/- 0.1 versus 1.1 +/- 0.2, respectively) over conventional CT sialography. In two cases, the therapeutic regimen was altered substantially. CONCLUSION: Ultrafast CT three-dimensional sialography has the potential to allow more precise presurgical planning and contributes to the diagnosis and therapy planning of parotid masses, especially in patients in whom MR image quality is degraded by motion artifact.

Adult↗
PubMed1994

The sphenoid sinus during childhood: establishment of normal developmental standards by MRI.

To obtain baseline standards of normal age-related development of the sphenoid sinus during childhood magnetic resonance images of the sphenoid sinus in 401 patients less than 15 years old were reviewed. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformly low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypo- to hyperintense (bone marrow conversion) started at age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13-15 months. By age 43-48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. The recognition of this phenomenon may serve as a reference for evaluating normal and abnormal development of the sphenoid sinus and may be of great value for diagnostic and therapeutic management of pathologic conditions of the child's sphenoid sinus and its surrounds.

Adolescent↗
PubMed1994

[Synovial sarcoma, a rare tumor of the larynx. Case report and differential diagnostic considerations].

The synovial sarcoma of the larynx is a very rare tumour. Only six cases have been published so far in international literature. We describe a synovial sarcoma of the larynx in a 53-year old patient. Laryngectomy and neck-dissection were performed, followed by adjuvant radiotherapy. 16 months after therapy neither locoregional recurrence nor lung metastases have occurred. Clinically, an attempt can be made to differentiate a synovial sarcoma from a squamous cell carcinoma based on the appearance of the surface epithelium. It is still a problem to safely establish the diagnosis of a synovial sarcoma on the basis of a biopsy. The poor prognosis of this tumour requires radical surgical removal. The effects of radiation are discussed controversially.

Combined Modality Therapy↗
PubMed1994

Magnetic resonance assessment of age-related development of the sphenoid sinus.

Magnetic resonance images of the sphenoid sinus in 401 patients under 15 years old were reviewed to establish normal age-related standards. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformly low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypointense to hyperintense (bone marrow conversion) started at the age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13-15 months. By age 43-48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. Because paediatric sinus disease is a challenging problem in children, these results may be useful as baseline standards of normal age-related development of the sphenoid sinus during childhood.

Adolescent↗
PubMed1992

Danger areas of the posterior rhinobasis. An endoscopic and anatomical-surgical study.

In 52 cadaveric half-heads, an endoscopic sphenoethmoidectomy was performed. Then, an anatomical preparation with registration of specific data like bulging of the optic canal, thickness of the bony wall covering the optic nerve and the internal carotid artery was achieved, followed by histological sections in specially selected cases. Thus the two key areas of major surgical hazard in the posterior rhinobasis could be clearly demonstrated: the immediate topographic relation of the optic canal and the internal carotid artery to the lateral wall of the sphenoid sinus and the cells of the posterior ethmoid respectively. Onodi cells of varying degrees were found in 42% of all cases. The thickness of bony wall over the maximum bulging of the optic canal averaged 0.28 mm. Bony dehiscences could be demonstrated in 12% of the cases. The technique of data acquisition, the anatomical and histological findings as well as their clinical and surgical relevance are discussed.

Endoscopy↗
PubMed1991

[Danger areas of the posterior nasal base: anatomical, histological and endoscopic findings].

In 52 cadaveric half-heads and endoscopic sphenoethmoidectomy was performed. Subsequently an anatomical preparation with registration of specific data like bulging of the optic canal, thickness of the bony wall covering the optic nerve and the internal carotid artery was achieved, followed by histological sections in specially selected cases. Thus the two key areas of major surgical hazard in the posterior rhinobasis could be clearly demonstrated: the immediate topographic relation of the optic canal and the internal carotid artery to the lateral wall of the sphenoid sinus and the cells of the posterior ethmoid, respectively. Onodi cells of varying degrees were found in 42% of all cases. The thickness of bony wall over the maximum bulging of the optic canal averaged 0.28 mm. Bony dehiscences could be demonstrated in 12% of the cases. The technique of data acquisition, the anatomical and histological findings as well as their clinical and surgical relevance are discussed.

Endoscopy↗