PubMed Health⌕ Search

Biomedical subjects

H Sudhoff

Publications and source records attributed to H Sudhoff.

At least 19 recordsLinked to original sources
PubMed2007

[Silicone as a foreign body in the middle ear: a rare complication after taking an impression of the auditory canal].

For the individual design of ear moulds, silicone is generally used for taking the impression of the external meatus and the cavum conchae. Complications are rare with only a few accounts in the literature. We report on three cases of accidental displacement of silicone into the middle ear cavity during impression taking. Clinical symptoms and detection of silicone as a rare middle ear foreign body are presented and discussed.

Aged↗
PubMed2007

[Management of iatrogenic esophageal perforations].

BACKGROUND: Iatrogenic esophageal perforations are still a life-threatening clinical entity. PATIENTS AND RESULTS: We present the case reports of six patients to demonstrate different treatment options and we focus on new therapeutic strategies which have evolved in the interdisciplinary management of iatrogenic esophageal perforations. Two patients with perforations in the cervical esophagus were operated and in another patient the perforation was closed with fibrin glue. Three patients with perforations in the thoracic esophagus were treated with self-expandable plastic stents. CONCLUSION: The surgical therapy of esophageal perforations still is regarded to be the gold standard and nonadherence should only be considered based on interdisciplinary decisions in individual cases. However, positive results are increasingly being reported for conservative endoscopic treatment, particularly for thoracic perforations.

Adult↗
PubMed2007

Comparative cytokeratin distribution patterns in cholesteatoma epithelium.

Cytokeratins (CKs) are known as the intermediate filament proteins of epithelial origin. Their distribution in human epithelia is different according to the type of epithelium, state of growth and differentiation. We used monoclonal mouse antibodies against cytokeratins to study CK expression in the following human tissues: cholesteatoma, middle ear mucosa, glandular epithelium, and meatal ear canal epithelium. Immunohistochemical processing was performed using the labeled steptavidin peroxidase method to demonstrate the presence of CKs in cells of human epidermis. Positive reaction was obtained for CK4, CK34betaE12, CK10, CK14 in skin and cholesteatoma epithelium. However, a more extensive positive reaction with those CKs was observed in cholesteatoma epithelium. Positive immunoreactivity was seen with anti- CK19 in the glandular epithelium. Middle ear mucosa specimens revealed positive immunoreactivity with the antibodies against CK4. The expression of CK4 was definitely positive within the basal layers of the epidermis. The glandular epithelium showed no positive reaction with anti- CK4, anti- CK34betaE12, anti- CK14 and anti-CK10. Immunohistochemistry for CK18 showed no reaction in all examined tissues. Cholesteatoma is known as a proliferative disease in the middle ear which pathogenesis is not completely understood. Keratinocytes express hyperproliferation- associated CKs and after reaching the suprabasal layers they finally undergo apoptosis creating keratinous debris. Cytokeratin expression observed in the epithelium explains proliferative behavior of cholesteatoma which is associated with increased keratinocyte migration. Cytokeratins can be used as potential proliferative markers. It can also allow for searching the usefulness of inhibiting regulators in the treatment of hyperproliferative diseases.

Animals↗
PubMed2006

[Bilateral auditory canal squamous cell carcinoma].

Only a small number of cases of bilateral carcinomas of the external ear canal have been described in the literature. We present the first case of a 72 year old male patient with a bilateral squamous cell carcinoma of the external ear canal at a very early stage. A computed tomography of the temporal bone revealed a well-pneumatized mastoid on both sides. Both external ear canals were filled with soft tissue without radiological signs of destruction of the adjacent bone. The carcinomas of the external ear canal were surgically removed using a canal-wall down technique and a selective neck dissection of regions II-IV. Histology confirmed a well differentiated squamous cell carcinoma of the external ear canal without lymph node metastasis on both sides (TNM classification: pT1 G2 N0 M0 R0). Bilateral radiation therapy with 59.4 Gy resulted in stenosis of both ear canals. Hearing rehabilitation was achieved with bone conductive hearing glasses. Diagnosis und therapy of bilateral external ear carcinomas are presented and discussed.

Aged↗
PubMed2006

Posterior canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for radical cavities.

OBJECTIVES: To investigate posterior external ear canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for open mastoids. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral centre. METHODS: As a preliminary study, 15 selected patients underwent reconstruction of a posterior ear canal wall defect with titanium mesh. Large defects of the posterior external auditory canal wall, resulting from canal wall down tympanoplasty or present in revision surgery, were eliminated by reconstruction using a titanium mesh. The mesh was covered with conchal cartilage and attached to the cortical mastoid bone using 3-mm titanium screws. RESULTS: All patients maintained a normal contour of the external ear canal, without depression, extrusion or infection. There were no failures, based on short-term post-operative controls. However, two procedures had to be revised due to incomplete coverage of the titanium mesh. CONCLUSIONS: This study shows that reconstruction of the posterior ear canal wall with a composite cartilage titanium mesh is a valuable method for preserving the morphology of the external auditory canal in selected cases. Problems occurring in canal wall down tympanomastoidectomy and radical cavities may therefore be avoided. However, long-term results have yet to be evaluated.

Adult↗
PubMed2005

Photodynamic effect of argon and diode laser on cholesteatoma cell cultures after intravital staining with absorption enhancers.

Chronic epitympanic otitis media, or chronic suppurative osteitis, is a destructive form of chronic middle-ear inflammation. The therapy of choice is complete surgical removal of the squamous epithelium from the middle ear. It is often impossible to inspect all areas of the middle ear with the posterior canal wall intact. Not all recesses can be reliably monitored with the microscope, particularly in the area of the antrum and hypotympanum. Residual squamous epithelium here causes frequent recurrences following cholesteatoma surgery. This study examines the effect of argon and diode lasers on cholesteatoma tissue. The aim is to develop a laser treatment selectively directed against cholesteatoma cells that can be performed after cholesteatoma surgery to eliminate any residual squamous epithelium. Intraoperatively harvested monolayer-cultured cholesteatoma cells stained in vivo with various absorption enhancers served as the in vitro examination model. Argon (499 nm) and diode lasers (810 nm) were applied since their irradiation has an appropriate tissue penetration depth and is absorbed by various chromophores such as neutral red (475-500 nm), fluorescein (488 nm), and indocyanine green (790-810). Intracellular staining of cultured cells increased the optical density at the wavelength corresponding to the dye. Neutral red damaged 50-60% of cultured cells merely by intracellular accumulation at high concentrations. An additive cell destruction of about 30% was achieved by also applying argon laser irradiation. Fluorescein diacetate caused no appreciable stain-induced damage to cultured cholesteatoma cells. Argon laser irradiation destroyed up to 60% of the cultures. Indocyanine green resulted in only minor damage to cultured cells. The diode laser destroyed up to 60% of the irradiated cells. Selective staining of cholesteatoma cells was not achieved with any of the dyes examined. Thus, other stained tissue could be damaged. Staining and subsequent laser irradiation destroys up to 60% of cultured cholesteatoma cells. Unstained irradiated cells are not affected. Indocyanine green and fluorescein are nontoxic and may thus be used as absorption enhancers. The diode and argon lasers appear to be basically suitable. Cell staining is not selective, i.e., other tissues would also be stained and damaged. To avoid such unwanted damage, it would be desirable to couple the chromophore to a specific antibody that binds only to cholesteatoma cells.

Argon↗
PubMed2005

[Congenital hearing loss. Molecular genetic diagnosis of connexin genes and genetic counselling].

BACKGROUND: About 50% of congenital non-syndromic hearing impairment is caused by genetic factors. Research on the genetics of deafness has revealed a vast number of relevant genes. Mutations in the GJB2 gene have been shown to be the most common in several populations. METHODS: Mutation analysis of the genes for connexin 26, 30 and 31 (GJB2, GJB6 and GJB3) was performed in 67 patients with profound hearing loss. RESULTS: Of the participants, 9% had two pathogenic mutations in the GJB2 gene. Pedigree information indicates that in these families further offspring have a 25% to a 100% chance of having hearing impairment. CONCLUSIONS: Patients with non-syndromic hearing impairment should be offered molecular diagnostics of the GJB2 gene. Genetic counseling is mandatory for mutation carriers in order to advise them on the individual consequences of the gene test results.

Connexin 26↗
PubMed2005

[Infections of the deep neck spaces with accompanying mediastinitis].

BACKGROUND: Infections of the deep neck spaces with accompanying mediastinitis are still a therapeutic problem with a high mortality. PATIENTS: We report on three patients with deep neck space infections and accompanying mediastinitis who have been treated in the Departments of Otorhinolaryngology at the Universities of Bochum and Essen in the past 2 years. In two patients the infection originated from a peritonsillar abscess and in one patient from an odontogenic infection. THERAPY: One patient was successfully treated by a tonsillectomy and drainage of the parapharyngeal abscess in conjunction with a thoracotomy because of a mediastinal abscess and bilateral pneumothorax. The second patient was cured by a tonsillectomy, wide cervical drainage und cervical mediastinotomy. The third patient with pre-existent alcohol abuse died because of multiorgan failure despite wide cervical und mediastinal drainage. CONCLUSION: In every deep neck infection a mediastinal involvement has to be taken into account. Fast diagnosis and treatment are essential for the prognosis of this life-threatening disease.

Drainage↗
PubMed2005

[Muramidase and lactoferrin in adenoidal hypertrophies, hypertrophic and chronic infected tonsil tissue--a quantitative analysis].

BACKGROUND: Muramidase and lactoferrin are important components of the antimicrobial defense system. Muramidase has the ability of opsonization and immunopotentiation and therefore a close relation to the lymphatic tissue. Till now there are only immunohistochemical and microbiological studies on the presence of muramidase and lactoferrin in adenoid and tonsil tissue available. METHOD: We investigated the concentrations of muramidase and lactoferrin in palatine tonsils and adenoidal hypertrophies quantitatively using ELISA. MATERIAL: We investigated tissue of 18 palatine tonsils and 16 pharyngeal tonsils. RESULTS: We found a significant difference in the concentration of muramidase but no difference in the concentration of lactoferrin between adenoids and tonsils. There was no significant difference in the concentration of lactoferrin and muramidase between the hypertrophic and chronic infected tonsils. There was no correlation between the age of the patients and the concentration of muramidase and lactoferrin. A connection between the microbial biofilm, the concentration of the proteins and the recurrent tonsillitis is discussed. CONCLUSIONS: Due to the production of muramidase and lactoferrin adenoids and tonsils play an important role in the local antimicrobial defense in any age or inflammation.

Adenoids↗
PubMed2004

[Infection transfer between the maxillary sinus and endocranium].

BACKGROUND: Rhinogenous brain abscesses usually originate from a frontal sinusitis, rarely from the ethmoidal system or the maxillary sinus. However, there are different pathways that can lead to the transfer of a maxillary infection to the endocranial compartment. PATIENT: A patient with frontal brain abscesses originating from a maxillary sinus infection is presented and diagnostic steps, therapy as well as pathophysiology are discussed. PATHOPHYSIOLOGY: The venous plexus of the maxillary sinus drains through the posterior wall of the antrum of Highmore into the deep facial vein that leads into the pterygoid plexus and then through the rete foraminis ovalis into the cavernous sinus. In addition, numerous small veins perforate the osseous roof of the maxillary sinus and enter the orbit joining the superior or inferior ophthalmic vein. They are also connected to the cavernous sinus or the pterygoid plexus. A number of veins perforate the anterior wall of the maxillary sinus communicating with the angular vein that drains into the superior ophthalmic vein and into the cavernous sinus. From the cavernous sinus, the blood arrives at the deep middle cerebral vein that usually communicates through the white substance towards the brain's superficial venous system. CONCLUSION: The presence of these maxillo-cerebral venous anastomoses explains the spread of infection from the maxillary sinus to the white substance of the brain without any direct association with the base of the skull.

Adult↗
PubMed2004

[Complications after endonasal surgery of the paranasal sinuses for inflammatory diseases].

BACKGROUND: There are sufficient reports on the incidence of complications after endonasal surgery of the paranasal sinuses. It is the aim of this study to calculate the incidence of typical complications after primary and revision surgery, after "functional" and "extended" operations, together with the influence of expertise and of different optical devices on the complications rate. Preoperative computer tomography of the paranasal sinuses are the golden standard. There exists a historical interest to compare the complication rate in patients operated without and those with a CT, especially in those countries where the availability of CTs is low or not existent. METHODS: 266 consecutive patients who underwent an endonasal surgery of the paranasal sinuses from January 1989 to December 1990 were revised to study the incidence and relative risk rate of typical complications after primary and revision surgery, after "functional" or "extended" surgery, the rate for more experienced or less experienced surgeons, as well as the differences between endoscopic or microscopic surgery. The study also compares the complication rate of patients operated on with and without a preoperative computed tomography. RESULTS: 207 out of 263 patients (78.7 %) had no complication. 58 minor and three severe complication were registered for 56 patients. 6 patients had two or more minor complications. No surgeon showed a higher complication rate compared to others (p = 0.33), and there was no statistically significant difference (p = 0.279) in the complication rate between experienced and less experienced surgeons. Endoscopic or microscopic surgery showed no statistically significant differences (p = 0.117) and extended sinus surgery displayed more complications compared to minor surgery (p = 0.041), as well as primary surgery compared to revision surgery (p = 0.003). No statistically significant differences could be found for surgeries performed with or without computed tomography (p = 0.097). CONCLUSIONS: A higher complication rate is to be expected for primary surgery and after extended sinus surgery, especially when an infundibulotomy was performed. In our series no learning curve was observed, especially as the variable "experience" showed no statistically significant difference. Endonasal surgery without CAT scan is not recommended, however, no higher complication rate was found in surgery without CAT scan.

Adolescent↗
PubMed2004

[Management of nasal fistulas with intracranial extension].

BACKGROUND: Medial nasal fistulas are rare congenital malformations that mostly become obvious by recurrent infections such as secretion from the fistula opening or swelling of the nasal tissues. In rare cases, these fistulas may extend intracranially with meningeal irritations. PATIENT PRESENTATION: Three patients with medial nasal fistulas were operated during the last two years in our department. In two children, the fistulas ended at the glabella. In one older boy, the fistula revealed an intracranial extension. In the last case, a combined rhino- and neurosurgical approach was applied to perform a complete resection of the fistula. DISCUSSION: During the second embryonic month of facial development, the medial nasal processes approach each other with a fusion of their epithelial covering that completely disappears during later stages. If parts of this epithelial fusion zone persist, epithelial remnants may develop into nasal fistulas or dermoids. The adequate therapy of these nasal malformations consists of a complete surgical removal.

Child↗
PubMed2004

[Malignomas of the nasal cavity and the paranasal sinuses: clinical characteristics, therapy and prognosis of different tumor types].

BACKGROUND: Malignomas of the nasal cavity and the paranasal sinuses count for less than 3 % of the ENT-malignancies. PATIENTS AND METHODS: This retrospective chart review reports about 46 patients that were first diagnosed and treated with a nasal cavity or paranasal sinus malignancy between 1998 and 2002 in the ENT department of the Ruhr-Universität Bochum. RESULTS: 18 of 46 malignomas were squamous cell carcinomas. At initial diagnose, already 52 % of malignomas were staged T4. Accordingly the origin in 17 % of malignomas could not be determined anymore. Additional 43 % of malignomas originated from the nasal cavity, another 20 % from the maxillary sinus. 11 of 46 patients (24 %) showed histological proven nodal involvement at initial diagnose. 92 % of patients underwent surgical therapy. 25 patients were radiated postoperatively. Over-all 1-year-survival-rate was 75 %, over-all 2-year-survival-rate was 47 %. Beside patients age, tumor free margins at initial surgery and absence of nodal involvement correlated to improved survival. 16 (76 %) of the 21 patients who died had local recurrence. Maxillary sinus malignomas recurred more often than malignomas of the ethmoid and the nasal cavity. CONCLUSIONS: Malignancies of the nasal cavity and paranasal sinuses are very often diagnosed in advanced T-stages because of unspecific symptoms. The limited prognosis mainly depends on free surgical margins at the first resection and nodal involvement at the first diagnose. For improvement in outcome of nasal and paranasal sinuses malignancies, prospective multi-center trials are necessary.

Adenocarcinoma↗
PubMed2004

[Collision tumor of a hypopharyngeal adenoidcystic carcinoma and a laryngeal squamous cell carcinoma].

INTRODUCTION: Malignancies in head and neck cancer are mainly squamous cell carcinomas. Adenoid cystic carcinomas are rare lesions of this site. Laryngeal adenoid cystic carcinoma is estimated to occur in 0.1 - 0.7 % of all laryngeal carcinomas. Adenoid cystic carcinomas are rarely located in the hypopharynx. To our knowledge there is no case report of adenoid cystic carcinoma of the hypopharynx as part of a collision tumor of the larynx. CASE REPORT: A 47-year-old male patient was diagnosed with an adenoid cystic carcinoma of the hypopharynx and a squamous cell carcinoma of the larynx. Because of local extension of both tumors laryngectomy and partial pharyngotomy with bilateral neck dissection was performed followed by radiation therapy. Clinical aspects as well as histomorphological and immunohistochemical criteria of both tumor entities are discussed. DISCUSSION AND CONCLUSIONS: Immunohistochemical characteristics showed two different carcinoma entities in the larynx and hypopharynx. Only by complete histological investigation of a carcinoma those rare cases of a collision tumor can be detected. Both tumor entities need to be considered for therapy strategy and oncological follow-up planning.

Carcinoma, Adenoid Cystic↗
PubMed2004

[Expression of osteoclast stimulating and differentiating factors in a murine model of localized inflammatory bone resorption].

BACKGROUND: The pathology associated to cholesteatoma is predominantly a consequence of osteoclast-mediated bone resorption within the middle ear. To assess its pathogenesis a murine model for dermal-implant induced osteolysis was evaluated for the expression of osteoclast stimulating and differentiating factors. METHODS: Mouse calvaria were analysed for the expression of osteoprotegerin ligand (OPGL), osteoprotegerin (OPG) and macrophage-colony stimulating factor (M-CSF) using immunohistochemistry. The detection of osteoclast cell lineage was acquired by immunohistochemistry using markers CD 4, CD 11a, CD 11b, CD 14, CD 51, CD 68 and TRAP. RESULTS: An increased expression of the investigated cytokines M-CSF, OPG and OPGL was demonstrated by immunohistochemistry. The presence of osteoclast precursor cells and mature resorbing osteoclasts was confirmed in time-dependent manner triggered by dermal implantation. CONCLUSIONS: This study reveals the basic events in osteoclast biology in localized inflammatory bone resorption and provides new insights into the comprehension of cholesteatoma-induced bone resorption.

Animals↗
PubMed2004

[Clear cell chondrosarcoma (CCCS) of the nasal septum].

INTRODUCTION: Chondrosarcomas belong to the most common malignomas of the skeletal system. The vast majority is located at the epiphysis of the long bones or in the pelvis. Less than 10% of chondrosarcomas are located in the head and neck area, most common in the bony viscerocranium and the larynx. Five histological variants can be differentiated: conventional, mesenchymal, myxoid, dedifferentiated and in less than 5% clear cell chondrosarcomas (CCCS). This case report gives the first description of a CCCS originating from the nasal septum. CASE REPORT: A 79 year old female complaining about a 6 month history of nasal obstruction revealed a huge ballooning of the basal septum in anterior rhinoscopy. Computed tomography exhibited a septal tumor with amorphous calcification. Histology of the tumor resected via lateral rhinotomy confirmed a diagnosis of CCCS. Because of clear surgical margins no radiation therapy was performed. The patient stayed free of recurrence during follow-up of sixteen months. DISCUSSION: The patient presented with typical symptoms of nasoseptal tumors as well as representative CT-scans and histologic findings of CCCS. Because of the complete resection and the CCCS-subtype, the patient is expected to have a positive prognosis.

Aged↗
PubMed2003

[Foudroyant rhinocerebral zygomycosis].

We present a fatal case of rhino-orbital-cerebral zygomycosis in an 81-year old immunocompromised patient with a 18-year history of multiple myeloma. The patient initially presented with symptoms of an orbital complication, loss of vision after acute sinusitis and agranulocytosis. Endonasal sinus surgery with orbital decompression was performed. Within days a rapid visero-cerebral progression of necrosis developed finally causing the patient's death. Invasive fungal infections are generally characterized by diagnostic difficulties in the early stage and exhibit an extremely high mortality. Definitive diagnosis of rhino-orbital-cerebral zygomycosis caused by Rhizopus microsporus was made by histology, culture and polymerase chain reaction. Early diagnosis and treatment are imperative for the management of patients afflicted with this devastating and life-threatening fungal infection.

Aged↗