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Biomedical subjects

P Plinkert

Publications and source records attributed to P Plinkert.

14 recordsLinked to original sources
PubMed2007

[Music therapy for tinnitus patients: an interdisciplinary pilot study of the Heidelberg Model].

BACKGROUND: Chronic tinnitus, one of the most common disorders in ENT medicine, requires comprehensive and interdisciplinary treatment. OBJECTIVE: An innovative music therapy approach, developed at the German Center for Music Therapy Research in cooperation with the ENT clinic of the University of Heidelberg ("Heidelberg Model"), strives to integrate the tinnitus sound into a musically controllable acoustic process. The aim of the present study is to evaluate the effectiveness of this current treatment. METHODS: We carried out a prospective, two-armed (music therapy group vs control group) study with 20 patients (10 males, 10 females; mean age 51+/-7 years), suffering from decompensated chronic tinnitus (mean score in the Tinnitus Questionnaire TQ=46.8+/-9.6). The target variables involved TQ values, pre- and post-measurements, and follow-up after 3 and 6 months. RESULTS: Group comparison yields a highly statistically and clinically significant decrease in mean TQ-scores pre- and post in the music therapy group by 25 points or 52% on average as compared to 2 points (4%) in the control group [univariate ANOVA: (F(1,31)=14.19, P=0.001), effect size d=1.73]. Logarithmic regression analysis reveals a fast onset and long lasting effect of music therapy (B=-8.9; F(1,125)=32.11, P=0.000). DISCUSSION: The effectiveness of this highly economic approach was proven as the innovative music therapy concept yields statistically and clinically significant results which remain stable throughout follow-up. Further investigations with larger sample sizes and using brain imaging should strengthen these findings.

Adult↗
PubMed2004

[Interdisciplinary surgery-the throat].

The special anatomic situation and the multitude of combinations of oncological therapeutic and reconstructive modalities in tumors of the cervical region require intensive interdisciplinary planning and discussion during tumor staging, surgical resection, and (neo)adjuvant treatment. We discuss here the various treatment modalities for tumors of the pharynx and cervical esophagus.

Chemotherapy, Adjuvant↗
PubMed2000

[Hybrid 3D visualization and virtual endoscopy in cochlear implants].

PURPOSE: The aim of this study was to demonstrate on a complex anatomical structure the possibilities and the advantages of a superimposition of a color-coded surface and volume rendering (hybrid rendering) method with the possibility of the performance of a virtual endoscopy. MATERIAL AND METHOD: In 6 patients with cochlear implants a high-resolution spiral computed tomography of the petrous bone was performed. The cochlear implants, the middle and inner ear structures were visualized using a color-coded surface rendering method, either shaded or as a grid. The petrous bone was visualized using a transparent volume rendering method. RESULTS: The hybrid 3D visualization uses the advantages of both the color-coded 3D surface and volume rendering method. In comparison to the axial source images, the hybrid 3D visualization thus facilitates a clearer representation and better assessment of the complex topographical relationship without loss of diagnostic information. The virtual endoscopy facilitates an intraluminal visualization and inspection of all color-coded 3D surface- and volume rendered structures. CONCLUSIONS: The hybrid rendering and virtual endoscopy make the morphological assessment of cochlear implants easier by the simultaneous visualization of the surrounding structures and thereby support the diagnostic imaging methods. This image processing method can be used pre-operatively for the individual planning, simulation, training and further development of surgical procedures and interventions and post-operatively for the control of the position and further developments of implants.

Adolescent↗
PubMed1999

[Hearing loss caused by leisure noise].

Although noise in general can induce hearing loss, environmental noise represents an important risk for children, teenagers and young adults. Epidemiological investigations now support the occurrence of an increasing number of irreversible hearing losses in these groups. Major causes of hearing loss are toys (guns), explosives and electroacoustically amplified music delivered by head sets or heard in discotheques and open air concerts. Clinical indications are discussed.

Adolescent↗
PubMed1999

Comparative study of visual, auditory, and olfactory function in Usher syndrome.

BACKGROUND: Usher syndrome is a genotypically and phenotypically heterogeneous group of autosomal recessive diseases featuring retinitis pigmentosa (RP) and sensorineural hearing loss. A general ciliary dysfunction has been suspected following reports of a mutated cytoskeletal protein (myosin VIIA) in type IB, and preliminary data has suggested an olfactory deficit. The purpose of this study was to quantitatively assess olfactory function in Usher syndrome patients and to search for a correlation between the degree of impairment of the three sensory systems as indication of an underlying ciliary defect. METHODS: 39 patients with Usher syndrome (8 type I, 31 type II) were examined. The ophthalmologic protocol included patient history, visual acuity, eye morphology, Goldmann perimetry, and electroretinography. The ENT protocol included a thorough examination, speech-recognition test, pure-tone audiometry and an olfactory function test. RESULTS: In both groups, visual acuity was typically 20/40, the remaining visual field area was small, and the ERG responses were low to non-detectable. Average hearing loss was 100% in type I and 40% in type II. Olfactory thresholds were normal [median 9.7 (I) and 8.5 (II) vs. 8.5 in the control group]. There were multiple significant correlations between parameters of the same organ, but no relationship between parameters of different sensory systems. CONCLUSION: Almost all Usher syndrome patients in this study had an advanced form of RP. In contrast, auditory function differed considerably between type I and type II. An impairment of the olfactory system could not be detected, and there was no correlation between parameters representing visual function, hearing ability, and olfactory sense.

Adult↗
PubMed1999

Inverted papilloma of the nasal cavity and the paranasal sinuses: using CT for primary diagnosis and follow-up.

OBJECTIVE: Morphologic criteria for the diagnosis of primary and recurrent inverted papilloma as revealed on CT were evaluated in a large series. MATERIALS AND METHODS: Findings of 121 CT examinations that had been performed in 32 patients with histologically proven inverted papilloma were retrospectively analyzed using the following morphologic criteria: localization, size, surface configuration, and bony changes. RESULTS: Unilateral tumor localization involving the lateral nasal wall and the middle meatus was the feature that best correlated with the finding of primary inverted papilloma. A lobulated surface pattern was another typical sign, which was revealed on 19 of the 29 CT scans of patients with primary inverted papilloma. Although tumor localization and the finding of a newly grown soft-tissue mass were less reliable criteria to differentiate between recurrent inverted papilloma and postoperative complications or concomitant inflammatory disease, a lobulated surface pattern was seen on 26 of the 28 CT scans of patients with tumor recurrence but on only three of the 64 follow-up CT scans of patients without recurrent inverted papilloma. CONCLUSION: A unilateral mass within the nasal cavity or paranasal sinuses with a surface configuration that appears lobulated on CT is, to our knowledge, a new sign that strongly suggests inverted papilloma as a primary diagnosis and also suggests inverted papilloma in patients with tumor recurrence.

Adult↗
PubMed1997

Sodium current expression during postnatal development of rat outer hair cells.

Outer hair cells of the cultured organ of Corti from newborn rats (0-11 days after birth) were studied in the whole-cell patch-clamp configuration. A voltage-activated sodium current was detected in 97% (n = 109) of the cells at 0-9 days after birth. The properties of this current were: (1) its activation and inactivation kinetics were fast and voltage-dependent, (2) the voltage at half-maximum activation was -45.0 mV, (3) its steady-state inactivation was temperature-sensitive (the half-inactivating voltage was -92.6 mV at 23 degrees C and -84.8 mV at 37 degrees C), (4) the reversal potential (80 mV) was close to the sodium equilibrium potential and currents could be abolished by the removal of extracellular sodium, and (5) tetrodotoxin blocked the current with a Kd of 474 nmol/l. Current amplitudes were up to 1.7 nA at room temperature. Mean current amplitudes showed a developmental time course with a maximum at postnatal days 3 and 7 for outer hair cells from the basal and apical part of the cochlea, respectively. In current-clamp mode cells had membrane potentials of -59.7 +/- 11.7 mV (n = 9). When cells were hyperpolarized by constant current injection, depolarizing currents were able to trigger action potentials. At 18 days after birth, sodium currents were greatly reduced and barely detectable. The results show that, unlike adult outer hair cells, immature outer hair cells regularly express voltage-gated sodium channels. However, due to mismatching of the sodium current inactivation range and membrane potential in vitro, a physiological function appears questionable.

Aging↗
PubMed1997

Trends and perspectives in minimally invasive surgery in otorhinolaryngology-head and neck surgery.

The roots of minimally invasive surgery (MIS) in otolaryngology-head and neck surgery (ORL-HNS) can be traced to the 1950s. Today, endonasal sinus surgery and endolaryngeal surgery already fulfill the principles of MIS. To widen its spectrum of indications, however, MIS must be able to offer three advantages that conventional macrosurgery and microsurgery already have: free maneuverability for the instrument, sensory feedback, and three-dimensional imaging. Every anatomical region (e.g., paranasal sinuses, upper aerodigestive tract, cerebellopontine angle) requires specific surgical instrumentation. Here, the authors present recently developed steerable instruments that allow two additional degrees of freedom not attainable with conventional instruments. These instruments may permit access to problem zones (e.g., laterally extending frontal and ethmoidal sinus recesses) in the near future. For better control of the instrument and the operative procedure, tactile feedback can be achieved with appropriate microsensor systems. Three-dimensional vision can be realized by three-dimensional video-endoscopes and sequential image processing.

Endoscopes↗
PubMed1994

[Computed tomography of the paranasal sinus prior to endonasal surgery].

In a retrospective study 170 computed tomographies recorded in patients with chronic sinus disease were evaluated. The extent of sinus disease and the involvement of the different paranasal sinuses were well seen. Up to now 50 patients have undergone surgical treatment. The coincidence of the preoperative CT with the intraoperative findings was about 90%. Anatomic particularities of the paranasal sinus in an individual patient may predispose to recurrent sinusitis or mean there is an increased risk of intraoperative complications. The main risk factors are a far lateral location of the posterior ethmoid cells (28.8%), a much lower position of the cribriform plate in comparison to the ethmoid roof (11.8%), and extensive lateral aeration of the sphenoidal sinus (1.2%). All patients should undergo CT scanning in coronal and axial planes prior to endonasal sinus surgery. This gives a guide for detection of inflammatory lesions and anatomic variations or anomalies, thus making it possible to prevent intraoperative complications.

Humans↗
PubMed1988

Anatomical studies and a correlative management of facial skeleton and skull base injuries with bone plate fixation.

Miniplate osteosynthesis is an osteoplastic procedure that achieves secure stabilization of the midface, even following extensive fractures of the midface and the floor of the anterior cranial fossa. This procedure can be considered a satisfactory operative treatment in terms of cosmetic and functional results. Correlative osteology is discussed and clinical experiences are reviewed.

Adult↗
PubMed1984

Effects of fentanyl on a bradykinin-induced excitatory cardiac reflex in the anaesthetized rat.

A reflex increase in arterial blood pressure and heart rate was elicited by application of epicardial bradykinin (4 X 10(-8), 2 X 10(-7), 10(-6) g/ml) in pentobarbital-anaesthetized, thoracotomized rats. The influence of the opioid fentanyl and the tranquilizer diazepam on this increase was then investigated. When fentanyl (2.2 micrograms/(kg X min] was infused i.v. during periods of bradykinin application, a highly significant suppression of the excitatory reflex resulted. Epicardial bradykinin (10(-6) g/ml) induced an increase in mean arterial blood pressure of 25.3 +/- 3.5 mm Hg during the control period and of 6.8 +/- 1.4 mm Hg during fentanyl infusion. The corresponding changes in heart rate were +20.8 +/- 4.7 beats/min during the control period and +1.9 +/- 1.3 beats/min during fentanyl infusion. When cardioacceleration was induced by the carotid occlusion reflex, fentanyl antagonized this effect too. The effect of fentanyl was entirely neutralized by injecting naloxone (30 micrograms/kg i.v.) prior to application of the former. Diazepam had no influence on the bradykinin-induced reflex. The results support the view that morphinoceptors may modulate the excitatory cardiac reflex induced by epicardial application of the algesic bradykinin in the rat.

Anesthesia↗
PubMedDate not supplied

A novel microperfusion system for the long-term local supply of drugs to the inner ear: implantation and function in the rat model.

Local therapy is practiced for middle and inner ear diseases but is usually restricted to cases of ear drum perforation or repeated invasive intratympanic drug application. Perfusion of drugs on the round window or through the scalae of animals using a pump system suggests that the chronic local drug treatment might also be feasible in humans. However, drug delivery systems that are currently on the market involve repeated reimplantation if they are to be used for long-term drug supply. A bone-anchored, totally implantable micro-drug delivery system (MDS) for patient-controlled drug supply has been developed [Lehner et al., 1997]. In this study, we show the first successful long-term in vivo test of the MDS micro-pump in rats. The process of implantation and first functional tests will be described. The biomaterial used to manufacture the delivery system did not cause any inflammation reaction in any of the 9 animals successfully implanted. After activation of the micro-pump, the drug reservoir and port was found to be fluid-tight. Bolus applications of tetrodotoxin (TTX) to the round window induced a transient decrease of evoked brainstem responses. In 2 animals which carried the MDS for more than 8 months the proper functioning of the pumping device was examined in a 2-3 week interval over a 3 month period. The MDS can be autoclaved even after long-term implantation and can then be reused for subsequent implantations. Designed for life-long implantation in humans, the demonstration of an effective long-term drug supply to the inner ear using the MDS provides an encouraging first step towards future long-term drug treatment of the inner ear in humans.

Administration, Topical↗