[Olfactory ability following rhinosurgery for cerebrospinal-fluid fistulas within the ethmoid bone].
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Biomedical subjects
Publications and source records attributed to M Weidenbecher.
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17 out of 22 patients with a squamous cell cancer of the Hypopharynx (T2-T4,N1-N3) are treated by resection of the pharynx and larynx, combined with radical neck-dissection on both sides, total strumectomy and full course of radio-therapy, reaching from the base of the skull down to the madiastinum. For the immediate reconstruction of a nutritional pathway the preservation of a vertical tumor free strip of the pharyngeal wall at least 15 mm broad is recommended. The remaining mucosa resected at least 20 mm from the margin of the tumor, and the edges controlled by frozen sections can be sutured over a nasal gastric tube of 18 or 16 charr. The reconstruction has several advantages. Though the observation time of 15 months is short, the recurrence rate seems not to be higher than after total resection of the pharynx and larynx.
43 patients with polyps affecting the nose and the sinuses were examined for immunological deficiencies on the basis of clinical, histomorphological and immunological findings. Constant histological findings were a chronic non-specific inflammation of varying intensity; immune-histologically a varyingly dense collection of Ig-producing cells with intracellular and extracellular immunoglobulins was observed. A determination of the immunoglobulins in the serum allowed no conclusion to be drawn as to the local condition of the mucosa. Hypertensitivity reactions played no role as a causal pathogenetic factor in the development of polyposis. In a third of the cases, however, polypi led to a secondary bronchial asthma. After the surgical removal of the polypi from the nose and paranasal sinuses, not only an improvement in nasal breathing and in the aeration of the sinuses was regularly achieved, but obstructive disorders of ventilation also disappeared.
The use of Mersilene mesh in reconstruction of the stable walls anterior to the air-containing sinus cavities is emphasized. The basic advantage of the technique employed is the need for tissue covering on only one side of the mesh. Subsequent penetration of the mesh by connective tissue with secondary epithelialization from adjacent mucosa develops a stable wall, even in the presence of local infection. The possibility for good fixation to surrounding bone, immediate availability as well as good cosmetic and functional results recommend its application to selected patients.
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A 73-year-old farmer developed both blindness of his left eye and a 20 kg loss of weight within 3 months. A protrusion of his left eyebulb was observed, which suggested the retrobulbar growth of a tumor. Histologic examinations of several biopsies from the paranasal sinuses evidenced polypoid tissue with signs of chronic inflammation, ulceration, and fungus infection. The patient died in cerebral coma. The autopsy revealed a destruction of the cranial base by a chronic mycocenic osteomyelitis, a frontal lobe abscess, and a fungus invasion of the internal carotid artery with circumscribed thrombosis of this vessel and adjacent encephalomalazie. The fungus was identified morphologically as aspergillus, a rare differential diagnosis to paranasal malignancies.
Neurothekeomas are benign tumours mostly arising in the face and upper limbs predominantly in young women. Histologically they can be classified as cellular or myxoid, and complete surgical resection is the treatment of choice. In this case of a neurothekeoma located in the anterior tongue of a child, cryotherapy was used as the treatment modality, in order to avoid a greater loss of tongue function.
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