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Biomedical subjects

R Rödel

Publications and source records attributed to R Rödel.

At least 19 recordsLinked to original sources
PubMed2004

[PET/CT imaging in head and neck tumors].

AIM: To evaluate the usefulness of combined PET/CT examinations for detection of malignant tumors and their metastases in head and neck oncology. METHODS: 51 patients received whole body scans on a dual modality PET/CT system. CT was performed without i.v. contrast. The results were compared concerning the diagnostic impact of native CT scan on FDG-PET images and the additional value of fused imaging. RESULTS: From 153 lesions were 97 classified as malignant on CT and 136 on FDG/PET images, as suspicious for malignancy in 33 on CT and 7 on FDG-PET and as benign in 23 on CT and 10 on FDG-PET. With combined PET/CT all primary and recurrent tumors could be found, the detection rate in patients with unknown primary tumors was 45%. Compared to PET or CT alone the sensitivity, specifity and accuracy could be significantly improved by means of combined PET/CT. CONCLUSION: Fused PET/CT imaging with [F18]-FDG and native CT-scanning enables accurate diagnosis in 93% of lesions and 90% of patients with head and neck oncology.

Adult↗
PubMed2004

Long term changes in serum T4, T3, and TSH in benign thyroid disease: proof of a narrow individual variation.

AIM: The diagnosis of abnormalities of thyroid function is generally based on the measurement of thyroid hormones and TSH in blood. The recommended reference ranges for serum T4 and T3 as well as TSH are quite wide as the result of large differences in thyroid function tests in healthy persons. It has been proven that the individual variation within an individual is small, compared with the variation between individuals. We investigated long term variations of these parameters in patients with and without benign thyroid diseases. METHODS: We performed long term follow-up serum determinations of T3, T4, and TSH in a total of 150 patients for a time period of 3 to 13 years. The majority of patients had been put on L-thyroxine. Values of total T3, total T4, free T4 were measured with an almost unmodified test (RIA) over the years. RESULTS: The lowest relative coefficient of variation (<10%) was observed in the group of patients who had been treated with L-thyroxine only. Even for TSH, relatively low cofficients of variation were observed in this group. In the group of patients who had not received any medication, T3 and T4 showed also a variation of 10%. FT4 and TSH revealed a wider range of variation. Even after radioiodine therapy, T3 and T4 showed only a quite small variation, while TSH demonstrated a wide range with a variation of >30%. CONCLUSION: Our data demonstrate that there are only narrow variations of serum T4 and T3 within individuals with and without thyroid disorders.

Female↗
PubMed2003

[Proof of natural spontaneous activity of pelvic and anal musculature by combined positron emission therapy and computed tomography. Importance for diagnosis and therapy].

Since 1991 we have known that the entire abdominal musculature has a distinct resting tone. All other muscles lose their tension almost completely during the resting phase. Only the craniopharyngeal and anorectal sphincter systems retain natural spontaneous activity, which ceases only when a hollow organ is opened. This permanent natural spontaneous activity is extremely sensitive. For example, it increases during coughing and speech. With combined positron emission and computed tomography, it is possible to observe and measure this natural spontaneous activity in the adjacent musculature very clearly. This fact is important for understanding and therapy of the function and failure of sphincter systems.

Adult↗
PubMed2003

[Effectiveness of syringe shieldings using radionuclides in radiation synovectomy].

AIM: The radiation exposure in radiation synovectomy was investigated for technician and therapist using Erbium-169, Rhenium-186 and Yttrium-90 with and without syringe shieldings. METHODS: Dose rates were measured in relation to the distance of the syringe containing the radionuclide. Measurements were repeated using syringe shieldings which consist of plastic surrounded by a lead layer. RESULTS: The most relevant radiation exposure arises from Yttrium-90. Using syringe shieldings radiation exposure can be reduced by a factor of thousand. CONCLUSION: This kind of radiological protection is completely sufficient for the therapist. Concerning the technician preparing the radiopharmaceutics, the limit of the official German dosimetry service (500 mSv) might be exceeded if no special radiological protection is established. Thus, special dosimetry is recommended.

Humans↗
PubMed2002

[Long-term results after surgical tracheotomy and percutaneous dilatation tracheostomy. A comparative retrospective analysis].

Besides surgical tracheostoma for treatment of long-term intubation, percutaneous dilatational tracheostomy (PDT) has become available during the last few years. Long-term results of the PDT are rare in the medical literature. This paper reports a retrospective analysis comparing the results after PDT with those after surgical tracheostomy. The methods include subjective evaluation of both techniques by the patients using a standardized questionnaire. It also includes the objective cosmetic result of the outside scar, as well as endoscopic inspection of the larynx and trachea. The patients own evaluation showed a higher content in the PDT group mainly due to the cosmetic result. The objective data confirmed those results. Patients with surgical tracheostomy had an average scar length of 5 cm (2 inches), compared to 1,2 cm (5 inch) in the PDT group. The endoscopic examination showed minor stenosis of the trachea in both groups that were not functionally relevant. The average stenosis of 14% for the PDT was similar to that observed after surgical tracheostomy which was 19%. The choice of the best technique should be made in close cooperation between head- and neck surgeons and anesthesiologists.

Adult↗
PubMed2001

[Blocking secretion of exocrine glands in the head-neck area by administration of botulinum toxin A. Therapy of a rare disease picture].

BACKGROUND: Hypersecretion disorders of the exocrine glands of the head and neck area are a therapeutic problem in the field of otorhinolaryngology. In the present study, we demonstrate the effectiveness of local injections of botulinum toxin A to block secretions of exocrine glands of the head and neck area. PATIENTS AND METHODS: Four patients suffering from hypersecretion disorders received local injections of botulinum toxin A. Two patients suffered from disorders of the salivary glands: one presented an idiopathic hypersialorrhea and another a salivary fistula after parotidectomy. A third patient suffered from epiphora and a further patient presented severe hyperhidrosis on the pilose head region. In a retrospective clinical study, the outcome of therapy was evaluated by clinical examination and chemical parameters. RESULTS: Clear blocking of secretion in the treated glands could be demonstrated in all four cases. Possible side effects of the treatment could not be observed. CONCLUSIONS: The present study was able to demonstrate a clear blocking of secretion of the exocrine glands of the head and neck region through botulinum toxin A, offering an improvement in therapy especially for the innovative indication of blocking the salivary glands of the head.

Adult↗
PubMed2000

[Inner surface imaging of laryngeal and tracheal stenosis by spiral-CT: role of a new diagnostic procedure].

BACKGROUND: Inner-surface-reconstruction calculated from helical-CT data sets offers a new diagnostic option for upper airway assessment. Using a special software, it is possible to create a continuous overview on the inner surface of hollow viscera on a monitor, similar to an endoscopic view. However, reports on the clinical value of this examination procedure with regard to laryngeal or tracheal stenosis are rare. METHOD: We compared the results of this "virtual endoscopy" with real endoscopic or intraoperative findings in 11 patients suffering from laryngeal or tracheal stenosis of various etiologies. RESULTS: Data on extension and localization of airway stenosis obtained by virtual endoscopy corresponded well with our endoscopic or intraoperative findings in all patients. The grade of airway stenosis as assessed by inner-surface-reconstruction could be confirmed by endoscopy in 8 of 11 cases investigated. Detection of 2 additional airway stenoses distal to an endoscopically non-passable tracheal stenosis was possible by virtual endoscopy in one case. CONCLUSION: As a supportive diagnostic procedure, virtual endoscopy offers a valuable overview on extension and localization of laryngeal or tracheal stenoses with regard to a possible therapeutic management.

Adult↗
PubMed1999

Gustatory sweating: clinical implications and etiologic aspects.

PURPOSE: It was the aim of this study to provide detailed general information on the clinical picture of different kinds of gustatory sweating, including reevaluation of a series of patients who underwent parotidectomy, removal of the submandibular gland, or neck dissection. PATIENTS AND METHODS: This study summarizes the statements of 548 patients questioned about the occurrence of gustatory sweating after parotidectomy (n = 296), extirpation of the submandibular gland (n = 79), and neck dissection (n = 173). RESULTS: After parotidectomy, 45% of the patients had noticed gustatory sweating. In most of them (70%), the symptoms began within 6 months after surgery. Gustatory sweating developed in only one patient with submandibular extirpation (1.5%), and not at all after neck dissection. Most patients (52%) reported that the symptoms occurred independent of the kind of food ingested. These results show that the "masticatory component" is an important trigger for Frey's syndrome. Application of Minor's test localized gustatory sweating mainly in the region of previous parotid lobe removal, but also in other areas deriving their sensory supply from the auriculotemporal, greater auricular, and lesser occipital nerves. The size of the area affected by the sweating was similar after lateral and total parotidectomy. When evaluating clinical symptoms, subjective assessment by the patients seemed to play a major role. After submandibular extirpation and neck dissection, some patients reported gustatory sweating that was not verified by Minor's test. CONCLUSION: There is general agreement that the cause of gustatory sweating is sympathetic or parasympathetic innervation of previously denervated sweat glands, initiated by gustatory triggers. The location of the "erroneous innervation" depends on the type of lesion. In cases after parotidectomy, misdirected parasympathetic regeneration is the model integrating all known factors into a rational concept. For didactic and systematic-pragmatic reasons, a clinically oriented classification of gustatory sweating (types I to III) seems to be useful.

Chi-Square Distribution↗
PubMed1999

[Possible one-dimensional determination of cortical representative fields of mimetic lower lip muscles by transcranial magnetic stimulation].

BACKGROUND: Recent reports as well as results from animal studies indicate changes of cortical organization in patients with facial palsy with a decrease in size of the face-associated cortical representation area. With regard to these alterations, there are no detailed reports in the literature about the possibility of a cortical mapping of mimetic muscles by TMS. METHOD: In 21 healthy volunteers we investigated the amplitude and the onset latency of motor evoked potentials (MEPs) from the depressor anguli oris and depressor labii inferioris muscles during cortical transcranial magnetic stimulation by use of a figure-8-shaped coil (double 70 mm coil) as a function of the scalp positions stimulated in order to establish a reproducible representation area along the interaural line. RESULTS: Cortical evoked MEPs characterized by onset latencies of 6-30 ms were elicited by contralateral and ipsilateral stimulation from coil positions between 4 and 13 cm lateral to the vertex. Maximal responses (mean amplitude 1.5 +/- 0.8 mV contralateral, 0.8 +/- 0.5 mV ipsilateral) with shortest mean onset latencies (11.5 +/- 1.5 ms contralateral, 12.2 +/- 2.8 ms ipsilatral) were observed at a coil position of 10 cm latral to the vertex. CONCLUSION: TMS offers a noninvasive method of one dimensional quantification of the cortical representation area of lower lip mimetic muscles.

Brain Mapping↗
PubMed1998

Retrospective analysis of 35 patients with acinic cell carcinoma of the parotid gland.

PURPOSE: This retrospective study evaluated data pertaining to the history, symptoms, treatment, and prognosis of a series of patients treated for acinic cell carcinoma (ACC). PATIENTS AND METHODS: Data were based on the records of 35 patients. Follow-up was done by analyzing their records and contacting the referring doctors. RESULTS: In 71% of the ACC patients, painful swelling of the lateral region of the face was the main symptom. Facial paralysis occurred in 11% of cases before treatment. Tumor recurrence after therapy was noted in 42% of cases. Highly differentiated ACC was the most frequent histologic subtype (74%). The grade of differentiation of the tumor was decisive for the prognosis. Highly differentiated ACC had a better prognosis (2 years overall survival, 100%; 5 years overall survival, 83%; 10 years overall survival, 50%) than lowly differentiated tumors (2 years overall survival, 70%; 5 years overall survival, 50%; 10 years overall survival, 30%). CONCLUSION: ACC is a rare tumor located mainly in the parotid gland that is characterized by some special attributes. Surgery is the therapy of choice. Prognosis depends mainly on the histologic subtype.

Adolescent↗
PubMed1998

[Isolated paralysis of the ramus marginalis mandibulae nervi facialis: clinical aspects, etiology, diagnosis and therapy. An overview].

BACKGROUND: Disorders of lower lip in facial expression are mostly caused by functional impairment of the marginal mandibular branch of the facial nerve. In a typical case, active exposure of the incisors of the mandible is not possible and the lip appears distorted towards the healthy side. The most frequent cause of a lesion of the marginal mandibular branch is iatrogenic injury during operations in the mandibular or parotid region. DIFFERENTIAL DIAGNOSIS: Functional disorders of the platysma, congenital hypoplasia or aplasia of the lower lip muscles, and defective healing following facial palsy may lead to a similar disorder which, however, must be differentiated from an isolated paralysis of the marginal mandibular branch. TREATMENT: In addition to inactivation of the nerve branch on the opposite side, several surgical procedures have been described to achieve not only aesthetic, but also functional rehabilitation of lower lip expression. The present review gives an overview on the causes, clinical appearance, diagnosis, differential diagnosis, and therapy of unilateral isolated paresis of the marginal mandibular branch of the facial nerve.

Facial Expression↗
PubMed1998

Peripheral scotoma associated with chronic ethmoidal sinusitis. A case report and review of the literature.

Diseases of the paranasal sinuses may cause visual disturbances, especially diminished visual acuity and visual field defects, by affecting the optic nerve. We report the unusual case of a female patient with unilateral peripheral, quadrantic scotoma and concomitant chronic ethmoidal sinusitis. Visual acuity was not diminished. Despite extensive diagnostic examinations no other cause of the scotoma could be evaluated. As conservative therapy had been unsuccessful, endonasal pansinus operation was performed. Upon surgery, nearly all ethmoidal cells appeared to be filled with polypous mucosa. The sphenoid sinuses, however, contained air. In contrast, pre-operative CT scans had shown only a slight opacity of the ethmoid bone. Already two weeks after surgery a reduction in size of the scotoma could be noted. In addition to this case report, possible causes of visual field defects due to inflammatory diseases of the paranasal sinuses are discussed. In cases of unilateral visual field reduction associated with symptoms of chronic paranasal sinusitis, early operative exploration of the paranasal sinuses should be considered after exclusion of other possible causes, even if radiological findings do not warrant such a procedure.

Adult↗
PubMed1996

[Peripheral branches of the facial nerve in the cheek and chin area. Anatomy and clinical consequences].

The available descriptions of the innervation of the depressor anguli oris muscle and the peripheral distribution of the terminal branches of the marginal mandibular branch and buccal branches of the facial nerve are conflicting. Based upon dissections of 25 head halves we investigated the courses of the terminal branches of the marginal mandibular and buccal nerves. The marginal mandibular and buccal branches were found to form in the area of the mental foramen the mental and buccal plexus innervating the mimetic muscles by terminal nerve branches in the cheek area. The buccal plexus supplied the muscles of upper lip, cheek and nose. Furthermore, the depressor anguli oris muscle was also supplied by the buccal plexus. We also observed connections between marginal mandibular branch and mental nerve and between buccal branches of the facial nerve and buccal nerve of the trigeminal nerve. In case of injury to the marginal mandibular branch the depressor anguli oris muscle is not affected. Injury to the nerve branches of the depressor anguli oris muscle can be caused by operations or lesions in the area of the posterior border of this muscle.

Aged↗
PubMed1996

[Studies of the course of the marginal branch of the facial mandibular nerve].

BACKGROUND: In many operations involving the submandibular and lower cheek region, the mandibular branch of the facial nerve is in danger. METHODS: On the basis of 55 facial dissections, we classified the course of the nerve into one of three types. RESULTS: In about 66% of cases, the nerve runs below the angle and below the inferior border of the mandible. Typically, the mandibular branch consists of up to four major branches. The maximum distance between the lowest point of the mandibular branch and the inferior border of the mandible was 1.4 cm. We also studied the location of the nerve in relation to the facial vessels and the posterior facial vein. CONCLUSIONS: Incisions in the submandibular region should be performed at least 2 cm below the inferior border of the mandible. The nerve can be spared by ligature and by retracting the anterior facial vein.

Aged↗
PubMed1994

[3-dimensional representation of transient evoked otoacoustic emissions].

A new method for the transformation of TEOAE signals into 3-dimensional diagrams is presented. The special transformation algorithm is based on a latency related frequency analysis of the cochlear response. The analysis and presentation are implemented in a C-programme. In a first clinical study 390 TEOAE signals from ears with and without hearing impairment were evaluated. For normal hearing the 3-dimensional diagram of TEOAE-signals is characterised by a typical wave form: with increasing frequency the latency of the cochlear response decrease. In the case of hearing loss there is an overall tendency to increasing wave latencies in comparison to normal hearing. An additional wave in the 3-dimensional diagrams of ears with tinnitus was observed. This characteristic is interpreted as an indicator of cochlea dysfunction. The 3-dimensional diagram promises to give a new aspect in the clinical interpretation of click-evoked otoacoustic emissions.

Adolescent↗
PubMed1994

[Evoked otoacoustic emissions and middle ear function].

Transiently evoked otoacustic emissions (TEOAE) recorded in 98 ears were compared depending on the results of tympanometry. The values of middle ear pressure in patients without detectable TEOAE are significantly smaller compared to those of patients with detectable TEOAE. In cases of detectable TEOAE, the amplitudes and frequency components were compared to the results of tympanometry. When maximal compliances are shifted towards negative values of middle ear pressure, the amplitudes of TEOAE are reduced with a loss of low frequency components. Small compliance values result in reduced amplitudes of TEOAE with the loss of low frequency components. By means of cluster analysis in the scatter plot of middle ear compliance and pressure, a classification is obtained separating two groups representing significantly groups of patients with and without detectable TEOAE. Summing up, it must be stated that there is an effect of middle ear function on TEOAE which must be taken into consideration when TEOAE are used in clinical application.

Acoustic Impedance Tests↗
PubMed1992

[Intraoperative monitoring of early auditory evoked potentials in hearing acoustic neuroma patients complemented by cochlear nerve action potentials].

Hearing preservation was attempted in eight cases of acoustic neurinomas with good preoperative hearing. This was successful in 3 cases. Brain-stem auditory evoked potentials (BAEP0 were monitored in all cases, and compound nerve action potentials (CNAP) were recorded from the cochlear nerve in the last 3 cases. The BAEP was extremely sensitive to intraoperative manipulation. Intraoperative loss of wave V in BAEP was observed not only in all 5 cases with postoperative hearing loss, but also in 2 out of 3 cases with successful hearing preservation. CNAP correlated better with the hearing outcome than BAEP. In the cases where hearing was preserved, intact CNAP responses were demonstrated at the end of the operation. Conversely, deterioration of CNAP was seen in a case of postoperative hearing loss. CNAP was 10-15 times larger in amplitude than BAEP, so that the new responses were obtainable in shorter intervals. This capability of frequent examination seemed to increase the possibility of avoiding irreversible damage to the hearing by changing surgical tactics. The addition of CNAP monitoring is a good supplement to conventional BAEP monitoring in acoustic neurinoma surgery.

Adult↗