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O Reichel

Publications and source records attributed to O Reichel.

9 recordsLinked to original sources
PubMed2006

[Sinonasal undifferentiated carcinoma. A rare and aggressive neoplasm of the nasal cavity and paranasal sinuses].

Sinonasal undifferentiated carcinoma (SNUC) is a rare tumor of the nasal cavity and paranasal sinuses first described in 1986. Olfactory neuroblastoma and SNUC may appear quite similar on histological examination. Due to the fact that olfactory neuroblastoma has a much better prognosis, a distinction with SNUC has to be drawn. We report a case of SNUC and describe the role of immunohistochemistry in making an accurate histological diagnosis. In addition, potential factors influencing the development of SNUC described in the literature and current treatment modalities are discussed. Despite aggressive and multimodal treatment regimens, the outcomes of patients suffering from SNUC have remained dismal. A randomized controlled clinical study could be the basis for determining the optimal treatment for SNUC.

Biomarkers, Tumor↗
PubMed2006

[Diagnosis and treatment of laryngopharyngeal reflux].

BACKGROUND: During the last decades an increased prevalence of reflux disease can be observed. Otolaryngologists play an increasing role in the treatment of patients suffering from laryngopharyngeal reflux (LPR). Typical symptoms for LPR are globus sensation, dysphagia, throat clearing, chronic cough and hoarseness. The most frequent laryngoscopic finding in patients suffering from LPR is a posterior commissure hypertrophy. LPR is confirmed by laryngoscopy, LPR-related laryngoscopy scoring, 24-hour dual-probe pH-monitoring, and by empiric trial with proton pump inhibitors (PPI). For therapy PPI-medication in a dosage of 40 mg BID for at least 3 months is successful in many patients. Additional lifestyle modifications can also have a positive effect. When medical management fails, further diagnostic procedures should be initiated. CONCLUSION: In patients suffering from unspecific laryngeal and respiratory symptoms LPR is an important differential diagnosis.

Adult↗
PubMed2004

[Synovial sarcoma of the hypopharynx - two case reports].

BACKGROUND: Synovial sarcoma is a rare soft tissue malignancy that most often occurs in the extremities of young adults. Approximately 3 % of these mesenchymal malignant tumors occur in the head and neck region. Up to now about 100 cases have been published. PATIENTS: We report on two cases of a synovial sarcoma of the hypopharynx. In the first case the patient died 3.5 years after beginning of therapy including all therapeutical efforts (surgery, chemotherapy, radiotherapy). The second patient with a synovial sarcoma of his left hypopharynx and a distant metastasis in his 8th thoracic vertebral body is actually treated by neoadjuvant chemotherapy and included into a clinical study to optimize therapy of advanced soft tissue sarcomas. Further surgical treatment depends on the success of this therapeutic approach. CONCLUSION: Despite multitherapeutic approaches over all 5-year survival rates for advanced synovial sarcomas of the head and neck have moderately improved in the recent decades and an ideal treatment has not yet surfaced. Modification of accepted treatment modalities is discussed and therapy options in controlled clinical studies are described.

Adult↗
PubMed2004

Dual-probe 24-hour ambulatory pH monitoring for diagnosis of laryngopharyngeal reflux.

BACKGROUND: Patients with gastroesophageal reflux disease may suffer from a variety of symptoms from the upper aerodigestive tract. The objective of this study was to determine the impact of dual-probe 24-hr pH monitoring in the diagnosis of reflux-related otolaryngological disorders. METHODS: Twenty-two patients with symptoms such as chronic cough, globus pharyngeus, heartburn, dysphonia and burning sensation of the tongue underwent a complete ear, nose and throat examination, 24-hr dual-probe pH monitoring, and oesophago-gastro-duodenoscopy. RESULTS: pH monitoring revealed gastroesophageal (distal) reflux in all patients and pharyngeal (proximal) reflux in 21 patients. Treatment consisted of a proton pump inhibitor (esomeprazole). Within 4 weeks 68 per cent of patients had no laryngopharyngeal symptoms; within 8 weeks 95 per cent of patients were symptom-free. CONCLUSIONS: Patients with atypical reflux symptoms such as hoarseness, globus sensation or throat-clearing responded well to anti-reflux treatment.

Adult↗
PubMed2003

[Treatment of sudden hearing loss through Fibrinogen/LDL-apheresis. A prospective, randomized multicenter trial].

INTRODUCTION: Sudden sensorineural hearing loss (SSHL) is thought to be of various origins. Disturbances of microcirculation, autoimmune pathology and viral infection are among the most likely causes. Acute reduction of plasma fibrinogen and serum LDL positively influences hemorheology and endothelial function and might thus be an effective therapy for SSHL. OBJECTIVE: To test the hypothesis that fibrinogen/LDL-apheresis is as effective or superior to conventional therapy with plasma expanders and prednisolone in the treatment of SSHL. DESIGN: controlled, prospective, randomized, multicenter trial. SETTING AND PATIENTS: 201 patients were recruited from 01/2000 to 6/2001 at the University Clinics of Munich, Berlin, Hamburg and Bochum. Inclusion criteria was sudden sensorineural hearing loss of unknown origin within 6 days of onset. INTERVENTIONS: Single fibrinogen/ LDL-apheresis infusion of prednisolone (250 mg, tapered by 25 mg daily), hydroxyethyl starch (500 ml, 6%) and pentoxifylin (400 mg/day). MAIN OUTCOMES: Improvement of pure tone thresholds 48 h after onset of therapy. RESULTS: Over all improvement of pure tone thresholds in the fibrinogen/ LDL-apheresis treated patients is slightly but not significantly better than in the standard therapy group. After 48 h, 50% speech perception in the fibrinogen/ LDL-apheresis group (21.6+/-20.1 dB) is significantly (p<0.034) better than in the standard group (29.3+/-29.4 dB). Patients with plasma fibrinogen levels of more than 295 mg/dl have a substantial and significantly (p<0.005) better improvement of speech perception (15.3+/-17.3 dB) than standard treated patients (6.1+/-10.4 dB). CONCLUSIONS: Fibrinogen/LDLapheresis is at least equally effective compared to prednisolone treatment in sudden hearing loss. Selected patients with plasma fibrinogen of more than 295 mg/dl improve significantly better when treated with fibrinogen/LDLapheresis.

Adolescent↗
PubMed2003

[Impact of 24-hour intraesophageal pH monitoring with 2 channels in the diagnosis of reflux-induced otolaryngologic disorders].

BACKGROUND: Patients with gastroesophageal reflux disease (GERD) may suffer from a large variety of symptoms in the upper aerodigestive tract such as globus sensation, chronic cough, hoarseness and many others. Diagnosis and causal therapy may sometimes be difficult with gastroenterologic evaluation sometimes revealing no pathologic result. The objective of this study was to determine the impact of 24-hour intraesophageal pH monitoring with 2 channels (gastric and laryngeal) in the diagnosis of reflux-induced otolaryngologic disorders. METHODS: This study included 22 patients presenting to the Department of Otolaryngology with symptoms like chronic cough (n = 3), globus sensation and dysphagia (n = 11), heartburn (n = 2), hoarseness and dysphonia (n = 2) or burning sensation of the tongue (n = 1). Three patients had a pathologic formation in the glottic area (leukoplakia, granuloma, polyp). All patients underwent a otolaryngological examination, a gastroenterological investigation and a 24-hour intraesophageal pH monitoring with 2 channels. RESULTS: All 22 patients showed laryngeal mucosal lesions (posterior laryngitis). The gastroenterological evaluation with esophagogastroduodenoscopy was normal in 4 cases. 13 patients showed a hiatal hernia, 4 patients were suffering from a reflux-esophagitis grade I and 2 patients from grade II. One patient had an erythema and 5 patients showed erosions of the gastric mucosa. Seven patients had more than one of the above mentioned diagnoses. Intraesophageal pH-monitoring with 2 channels over 24 hours revealed a gastroesophageal reflux of all 22 patients and a high reflux to the laryngeal level of 21 patients, probably causing laryngopharyngeal symptoms. Therapy of the patients consisted of medical antireflux treatment with proton pump inhibitor esomeprazol (Nexium, 40 mg, 1-0-0). Within 4 weeks 15 of 22 patients had no more laryngopharyngeal symptoms or at least a significant reduction. CONCLUSION: Patients with laryngopharyngeal symptoms such as hoarseness, globus sensation or dysphagia can suffer from GERD, even if typical symptoms such as heartburn or retrosternal pain do not exist and gastroesophageal intervention reveals a normal result. The best diagnostic instrument for the diagnosis of reflux-induced otolaryngologic disorders is a 24-hour intraesophageal pH-monitoring with 2 channels (measure-points at the distal esophagus and laryngeal level). Medical antireflux treatment should consist of proton pump inhibitors (e. g. Nexium) in a dose of 40 mg per day over at least 4 weeks.

Adult↗
PubMed2001

[A patient with acoustic neuroma--The reason for the functional disorder of his inner ear?].

BACKGROUND: Acoustic neuroma is one of the classic causes of retrocochlear hearing disorders. Auditory brainstem response (ABR) testing with a sensitivity of about 90 % in the diagnosis of acoustic neuroma plays an important role as a screening method. CASE REPORT: A patient suffering from an acute, unilateral sensorineural hearing loss with tinnitus recovered for a short period of time after being treated with low density lipoprotein (LDL-) apheresis improving hemorheology. Surprisingly, the reason for the sudden hearing loss was a tumor in the cerebellopontine angle with a maximum diameter of 2 cm, which was detected by magnetic resonance imaging (MRI). Auditory brainstem response testing (ABR), audiovestibular tests and other standard tests were negative concerning this diagnosis. There was no previous evidence for an acoustic neuroma in all investigations of cochlear disfunction except MRI. CONCLUSIONS: The acoustic neuroma caused a compression of the labyrinthine artery in the inner auditory canal resulting in an acute unilateral hearing loss with tinnitus. Low Density Lipoprotein-apheresis was able to achieve a short term improvement of blood supply to the inner ear. Thus the compression of the labyrinthine artery caused by an acoustic neuroma could be compensated for the duration of about one week. Within this time the effect of LDL-apheresis decreased more and more. After a sudden unilateral hearing loss an acoustic neuroma must be ruled out even if the retrocochlear testing by ABR primarily shows no prolonged interpeak latency.

Adult↗