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Biomedical subjects

P Federspil

Publications and source records attributed to P Federspil.

At least 19 recordsLinked to original sources
PubMed2001

[Squamous epithelial carcinomas of the external ear].

BACKGROUND AND OBJECTIVE: Squamous cell carcinoma of the pinna seems to be associated with a worse prognosis as compared to other locations. PATIENTS/METHODS: We studied 88 patients treated between 1975 and 1990 for a squamous cell carcinoma of the pinna. RESULTS: Lymph node metastases were present in eight cases (9%) prior to treatment. Treatment was intended to be curative in 83 patients (94%). Tumor therapy was operative in all cases. Radiotherapy was instituted postoperatively in three patients; five patients (5.7%) died due to the tumor. Of 83 curatively treated patients, only 2 died of tumor progression. The survival rate was 98% after 2 years and 95% after 5 years. The recurrence rate was 7% after 1 year, 13% after 2 years, and 18% after 5 years. The outcome with regard to local tumor control and survival was significantly poorer when neck metastases were present. CONCLUSIONS: We recommend tumor excision with wide margins (5-10 mm) as first-line treatment. Neck dissection with parotidectomy is indicated when suspicious lymph nodes are detected by ultrasound sonography, the tumor diameter is > 4 cm, cartilaginous invasion is present, and vertical tumor thickness is > 5 mm.

Adult↗
PubMed2000

[Functional and esthetically oriented reconstruction of lip defects].

Reconstruction of lip defects presents a challenge to the surgeon. Apart from attaining a good aesthetic result, preserving the function of the oral sphincter is an essential objective. A variety of techniques and modifications of procedures for reconstructing lip defects have been reported in the literature. It is up to the surgeon to select the reconstruction procedure ensuring optimum functional and cosmetic results, depending on the location, size, and depth of the defect. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures. The upper lip is divided into three aesthetic subunits: two lateral subunits and a median subunit, the philtrum. The lower lip constitutes a single subunit. In this study, established reconstruction techniques are discussed and a concept serving to facilitate the appropriate choice of technique is introduced. This concept differentiates between vermilion defects on the one hand, and partial-thickness and full-thickness lip defects on the other hand. For the lower lip, the full-thickness defects are classified as defects involving one-third, one-third to two-thirds of the lower lip width, and between two-thirds and complete loss of lip tissue. For the upper lip, a distinction is made between isolated defects of the central and lateral subunits and combined defects of the central and lateral subunits. Important principles of surgery and the advantages or disadvantages of different reconstruction techniques are discussed.

Basal Cell Carcinoma↗
PubMed1998

[Percutaneous therapeutic embolization in therapy refractory, non-traumatic epistaxis].

UNLABELLED: The records of 24 patients with severe intractable non-traumatic epistaxis were reviewed to evaluate the efficacy of embolism therapy. MATERIAL AND METHOD: The histories of 17 patients with idiopathic epistaxis, 6 patients with Osler-Rendu-Weber disease and 1 patient with a high-flow angioma were analyzed. All patients were treated by means of percutaneous embolization of the maxillary artery and its branches. RESULTS: In 5/17 patients with idiopathic epistaxis repeat embolization was necessary in 5 cases, while permanent hemostasis was achieved in 16/17 patients with embolism alone. Five of the 6 patients with Osler-Rendu-Weber disease labelled stage III before treatment were managed successfully with repeated embolizations, while all cases were reduced to stage I disease. The high-flow angioma was successfully ablated after embolization combined with direct injection of thrombosing material and laser resection.

Adult↗
PubMed1997

Cystadenoma of the parotid gland with unusual prominent lymphoid stroma.

A rare variant of the cystadenoma of salivary gland origin is presented, which occurred in the parotid of a 36-year-old, otherwise healthy female patient. The tumour showed a dense follicle-containing lymphoid stroma, resembling papillary cystadenoma lymphomatosum (Warthin's tumour). In contrast to that, the epithelial lining gave a more irregular impression and oncocytic metaplasia were completely absent. Light microscopic and immunohistochemical features of the tumour are described and compared with those of classical cystadenoma and papillary cystadenoma lymphomatosum (Warthin's tumour). Other relevant multicystic epithelial parotid lesions, which are commonly associated with a prominent lymphoid component are discussed.

Actins↗
PubMed1997

[Percutaneous embolization therapy in severe cervicofacial hemorrhages].

PURPOSE: To analyse the use of transcatheter embolisation. MATERIAL AND METHODS: We report on 43 patients treated by transcatheter embolisation for head and neck haemorrhage from 1987 to 1995. There were 13 patients with idiopathic intractable epistaxis, 6 with iatrogenic and three with traumatic bleeding, 7 patients with bleeding from vascular malformations, 12 patients with haemorrhage from tumours, one ruptured aneurysm of the inferior thyroid artery and one patient bleeding from a retrolingual dystrophic goitre. RESULTS: In 11/13 patients with idiopathic epistaxis, this could be stopped. In 8/9 of the traumatic and iatrogenic bleedings the haemorrhage was treated by embolisation alone. In two cases additional elective surgical interventions were necessary. In 6/7 patients with vascular malformations embolisation resulted in long-lasting periods free from bleeding. Palliative embolisation in bleeding tumours resulted in haemostasis in 10/12 patients. Bleeding was definitely stopped in a patient with aneurysm of the inferior thyroidal artery as well as in a patient with bleeding from a dystrophic goitre. We observed a total of three complications, two transitory neurological disturbances and one permanent amaurosis. CONCLUSION: Transcatheter embolisation is an effective tool in the treatment of life-threatening head and neck bleedings.

Acute Disease↗
PubMed1997

[Effects of standardized Myrtol in therapy of acute sinusitis--results of a double-blind, randomized multicenter study compared with placebo].

BACKGROUND: In the management of non-purulent acute sinusitis, alpha adrenergic substances are administered topically and secretolytics systemically. Antibiotic therapy should be restricted to purulent forms. This study was designed to demonstrate the importance of the maintenance of permanent ventilation and drainage of the sinuses as a therapeutic concept. PATIENTS/METHODS: In a multicentric trial the efficacy and safety of myrtol standardized and another essential oil were investigated in 331 patients with acute sinusitis in comparison to placebo. Three hundred thirty patients were evaluated in an intent-to-treat-analysis and 291 patients remained for statistical analysis. The study was conducted in 16 centers in a double-blind, double-dummy, randomized design versus placebo. During an observation-period of 14 days the patients were treated for 6 +/- 2 days with the respective study medication. RESULTS: With respect to efficacy, both myrtol standardized and the other essential oil proved to be significantly superior to placebo. As to the tolerance, a slight advantage of myrtol standardized was demonstrated in comparison to the other verum substance. CONCLUSION: These results which do support the value of essential oils like myrtol as an effective treatment in acute, uncomplicated sinusitis instead of antibiotics as first choice, are confirmed by the existing literature.

Acute Disease↗
PubMed1996

[Long-term outcome of tympanoplasty in chronic suppurative middle ear infection in childhood].

Controversy continues regarding tympanoplasty for central perforations due to chronic otitis media in children. Between 1972 and 1988, 144 children (160 cases) were operated on for central perforations after chronic otitis media and were managed at the ENT Hospital of the University of the Saarland, Homburg/Saar. Eighty-seven of these children were evaluable for this study. Post-operative follow-up was more than 5 years in 94% of the cases. The tympanic membrane was closed in 90% of the cases at follow-up examination. The age of the patient did not influence the success rate. Social hearing was improved from 49% before operation to 86% after operation and at follow-up. At follow-up, air-bone gaps were closed to within 10 dB in 67% of the cases, within 20 dB for 88% and within 30 dB for 96%. These very good and stable results show that an early operation can be recommended for children with chronic otitis media to prevent further damage to the middle ear.

Adolescent↗
PubMed1994

[Pleomorphic parotid adenomas and their recurrence].

Even today, a wide variety of techniques are performed in parotid pleomorphic adenoma surgery, ranging from enucleation to total parotidectomy. This study reports the results of our experiences. Among a total of 587 surgically treated parotid lesions at the Homburg/Saar University ENT Department from 1968 through 1991, 205 were parotid pleomorphic adenomas. Among these, 166 patients received primary surgery at our department. Twenty-one enucleations led to 3 recurrent tumors (14%), while 108 superficial parotidectomies had 3 recurrences (2.8%). Fifteen extended superficial parotidectomies also produced 3 recurrences (20%) and 22 total parotidectomies had one recurrent case (4.5%). The overall recurrence rate was 6%, but increased to 8.3% in 5 years, 9.5% in 10 years and 12.5% in 15 years follow-up. The "true" overall recurrence rate after 10 years was estimated to be between 9.5 and 20% and that for lateral parotidectomies between 4.4 and 13%. Patients younger than 30 years of age at the time of primary surgery developed a tumor recurrence in 17% of all cases. The overall recurrence rate following secondary surgery was 13%. Clinical findings and surgical techniques for resections of pleomorphic adenomas and their recurrences are discussed. Segmental parotidectomy is the preferred treatment, but may have to be changed locally to enucleation in some cases in order to preserve the facial nerve.

Adenoma, Pleomorphic↗
PubMed1993

[Comparative studies of the ototoxicity of cisplatin and carboplatin].

The application of the potent anticancer drug cisplatin is limited by major side effects such as its ototoxicity and its nephrotoxicity. Since carboplatin has been introduced into clinical use, a platinum derivative with less pronounced ototoxicity and nephrotoxicity is available. The aim of this study was to quantify the ototoxicity of carboplatin comparing it to cisplatin using the wellknown guinea-pig model. Using morphological and functional methods it could be shown that the ototoxic damage was by far higher in a group which had received a total dose of 12 kg cisplatin/kg than in a group which had received a dosage of 90 mg carboplat/kg. Our investigations show that the ototoxic potential of cisplatin in the guinea-pig is more than 9 times higher than that of carboplatin.

Animals↗
PubMed1993

[Combined surgical flaps for simultaneous reconstruction of the tongue, mouth floor and pharynx in expanded glossectomy within the scope of multi-modal treatment of squamous epithelial cancers of UICC stage IV].

Multimodal approach and improved surgical techniques enable the head and neck surgeon to operate even far advanced tumours of the head and neck under curative intention. Microanastomosed distant flaps and intestinal grafts expanded the operative spectrum while having the disadvantages of being time-consuming and in most cases the necessity to call for the specialist (e.g. the abdominal, vascular surgeon). In 6 cases of total glossectomy combined with hemipharyngectomy and hemimandibulectomy the possibilities of closing large defects by combined regional and pedicled flaps in the head and neck area are shown. In all of our cases surgical therapy had been placed at the end of therapeutic interventions in a multimodal treatment protocol. Treatment started with induction chemotherapy with a regimen including cisplatin, bleomycin and vindesin sulfate and was followed by a subsequent radiotherapy reaching a total reference dose of 60 to 70 Gy. After radiotherapy 5 patients received adjuvant chemotherapy of 1-4 cycles. Despite the aggressive presurgical treatment, the postoperative complications were minor. In a median survival of 37.5 months there were 3 recurrences, 2 patients died of tumour progression. All of our patients benefited from of the "salvage-operation" especially with regard to tumour pain. Quality of the patients' life could be improved upon by percutaneous endoscopic gatrostomy (PEG) and as well good functional and cosmetic results of the surgical reconstructions. The results justify the discussion about a palliative indication of extended surgical procedures and reconstructive surgery in far advanced head and neck cancer in the course of a multimodal treatment regimen.

Adult↗
PubMed1992

[Bone-anchored epitheses and audioprostheses: 4 years' experience with the Branemark system in Germany].

Osseointegration describes direct contact between titanium and vital bone. The Branemark System uses this principle for bone anchorage of hearing aids and craniofacial prostheses. The experience made in the ENT Department of the University Hospital in Homburg/Germany with this procedure in the last 4 years is described. During this period, 40 patients have been operated and 119 titanium fixtures have been implanted. 30 patients got bone anchored prostheses (ear, nose or orbit) and 25 patients received bone anchored hearing aids. The large group of 15 patients with congenital ear malformation presented both indications. 100 out of 119 implants i.e. 84% caused no major problems. The most frequent complications were granulations (10 implants i.e., 8.4%). More severe problems as non-integration of three pillars or rejection of one pillar were rare. Our experience for 4 years in an important number of patients was very positive in the majority of cases and allows us to consider the bone anchorage of hearing aids and craniofacial prostheses as a major advance in craniofacial rehabilitation and audiology.

Aged↗