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Biomedical subjects

S Dazert

Publications and source records attributed to S Dazert.

At least 19 recordsLinked to original sources
PubMed2007

[The Bochum aftercare questionnaire for cancer in otorhinolaryngology: first results of clinical application].

BACKGROUND: The damage caused by cancer disease is multidimensional, affecting a patient physically, emotionally, and intellectually. A post-cancer documentation system is necessary that takes into account a patient's psychosocial well-being. With this objective in mind, the aftercare journal was developed for tumor diseases in otorhinolaryngology in the Department of Otorhinolaryngology of the Ruhr University Bochum. METHODOLOGY AND PATIENTS: From April 2002 to May 2003, 112 patients received a standardized questionnaire to evaluate the aftercare journal newly introduced in Germany for ENT tumor diseases. Six items were presented: outer appearance, format/size of the journal, clarity in the design, recording areas relevant to the disease, improvement in the tumor aftercare, and personal feeling of safety. An evaluation scale of zero to four points served as the basis for assessment. A high point value represented the higher degree of patient satisfaction for each respective item. RESULTS: In all six items, the assessment of the journal predominantly showed agreement of the patients. Assessing the improvement in tumor aftercare and providing a personal feeling of safety, patients with shorter disease remission had a tendency to allocate low point values. CONCLUSION: The aftercare journal for ENT sets the trend for documentation systems in cancer aftercare. The study proved the need to consider concerns of the disease related to medical and psychosomatic factors in patients as a standard for modern psychosocial oncology.

Adult↗
PubMed2006

Posterior canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for radical cavities.

OBJECTIVES: To investigate posterior external ear canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for open mastoids. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral centre. METHODS: As a preliminary study, 15 selected patients underwent reconstruction of a posterior ear canal wall defect with titanium mesh. Large defects of the posterior external auditory canal wall, resulting from canal wall down tympanoplasty or present in revision surgery, were eliminated by reconstruction using a titanium mesh. The mesh was covered with conchal cartilage and attached to the cortical mastoid bone using 3-mm titanium screws. RESULTS: All patients maintained a normal contour of the external ear canal, without depression, extrusion or infection. There were no failures, based on short-term post-operative controls. However, two procedures had to be revised due to incomplete coverage of the titanium mesh. CONCLUSIONS: This study shows that reconstruction of the posterior ear canal wall with a composite cartilage titanium mesh is a valuable method for preserving the morphology of the external auditory canal in selected cases. Problems occurring in canal wall down tympanomastoidectomy and radical cavities may therefore be avoided. However, long-term results have yet to be evaluated.

Adult↗
PubMed2004

[Infection transfer between the maxillary sinus and endocranium].

BACKGROUND: Rhinogenous brain abscesses usually originate from a frontal sinusitis, rarely from the ethmoidal system or the maxillary sinus. However, there are different pathways that can lead to the transfer of a maxillary infection to the endocranial compartment. PATIENT: A patient with frontal brain abscesses originating from a maxillary sinus infection is presented and diagnostic steps, therapy as well as pathophysiology are discussed. PATHOPHYSIOLOGY: The venous plexus of the maxillary sinus drains through the posterior wall of the antrum of Highmore into the deep facial vein that leads into the pterygoid plexus and then through the rete foraminis ovalis into the cavernous sinus. In addition, numerous small veins perforate the osseous roof of the maxillary sinus and enter the orbit joining the superior or inferior ophthalmic vein. They are also connected to the cavernous sinus or the pterygoid plexus. A number of veins perforate the anterior wall of the maxillary sinus communicating with the angular vein that drains into the superior ophthalmic vein and into the cavernous sinus. From the cavernous sinus, the blood arrives at the deep middle cerebral vein that usually communicates through the white substance towards the brain's superficial venous system. CONCLUSION: The presence of these maxillo-cerebral venous anastomoses explains the spread of infection from the maxillary sinus to the white substance of the brain without any direct association with the base of the skull.

Adult↗
PubMed2004

[Complications after endonasal surgery of the paranasal sinuses for inflammatory diseases].

BACKGROUND: There are sufficient reports on the incidence of complications after endonasal surgery of the paranasal sinuses. It is the aim of this study to calculate the incidence of typical complications after primary and revision surgery, after "functional" and "extended" operations, together with the influence of expertise and of different optical devices on the complications rate. Preoperative computer tomography of the paranasal sinuses are the golden standard. There exists a historical interest to compare the complication rate in patients operated without and those with a CT, especially in those countries where the availability of CTs is low or not existent. METHODS: 266 consecutive patients who underwent an endonasal surgery of the paranasal sinuses from January 1989 to December 1990 were revised to study the incidence and relative risk rate of typical complications after primary and revision surgery, after "functional" or "extended" surgery, the rate for more experienced or less experienced surgeons, as well as the differences between endoscopic or microscopic surgery. The study also compares the complication rate of patients operated on with and without a preoperative computed tomography. RESULTS: 207 out of 263 patients (78.7 %) had no complication. 58 minor and three severe complication were registered for 56 patients. 6 patients had two or more minor complications. No surgeon showed a higher complication rate compared to others (p = 0.33), and there was no statistically significant difference (p = 0.279) in the complication rate between experienced and less experienced surgeons. Endoscopic or microscopic surgery showed no statistically significant differences (p = 0.117) and extended sinus surgery displayed more complications compared to minor surgery (p = 0.041), as well as primary surgery compared to revision surgery (p = 0.003). No statistically significant differences could be found for surgeries performed with or without computed tomography (p = 0.097). CONCLUSIONS: A higher complication rate is to be expected for primary surgery and after extended sinus surgery, especially when an infundibulotomy was performed. In our series no learning curve was observed, especially as the variable "experience" showed no statistically significant difference. Endonasal surgery without CAT scan is not recommended, however, no higher complication rate was found in surgery without CAT scan.

Adolescent↗
PubMed2004

[Management of nasal fistulas with intracranial extension].

BACKGROUND: Medial nasal fistulas are rare congenital malformations that mostly become obvious by recurrent infections such as secretion from the fistula opening or swelling of the nasal tissues. In rare cases, these fistulas may extend intracranially with meningeal irritations. PATIENT PRESENTATION: Three patients with medial nasal fistulas were operated during the last two years in our department. In two children, the fistulas ended at the glabella. In one older boy, the fistula revealed an intracranial extension. In the last case, a combined rhino- and neurosurgical approach was applied to perform a complete resection of the fistula. DISCUSSION: During the second embryonic month of facial development, the medial nasal processes approach each other with a fusion of their epithelial covering that completely disappears during later stages. If parts of this epithelial fusion zone persist, epithelial remnants may develop into nasal fistulas or dermoids. The adequate therapy of these nasal malformations consists of a complete surgical removal.

Child↗
PubMed2004

[Malignomas of the nasal cavity and the paranasal sinuses: clinical characteristics, therapy and prognosis of different tumor types].

BACKGROUND: Malignomas of the nasal cavity and the paranasal sinuses count for less than 3 % of the ENT-malignancies. PATIENTS AND METHODS: This retrospective chart review reports about 46 patients that were first diagnosed and treated with a nasal cavity or paranasal sinus malignancy between 1998 and 2002 in the ENT department of the Ruhr-Universität Bochum. RESULTS: 18 of 46 malignomas were squamous cell carcinomas. At initial diagnose, already 52 % of malignomas were staged T4. Accordingly the origin in 17 % of malignomas could not be determined anymore. Additional 43 % of malignomas originated from the nasal cavity, another 20 % from the maxillary sinus. 11 of 46 patients (24 %) showed histological proven nodal involvement at initial diagnose. 92 % of patients underwent surgical therapy. 25 patients were radiated postoperatively. Over-all 1-year-survival-rate was 75 %, over-all 2-year-survival-rate was 47 %. Beside patients age, tumor free margins at initial surgery and absence of nodal involvement correlated to improved survival. 16 (76 %) of the 21 patients who died had local recurrence. Maxillary sinus malignomas recurred more often than malignomas of the ethmoid and the nasal cavity. CONCLUSIONS: Malignancies of the nasal cavity and paranasal sinuses are very often diagnosed in advanced T-stages because of unspecific symptoms. The limited prognosis mainly depends on free surgical margins at the first resection and nodal involvement at the first diagnose. For improvement in outcome of nasal and paranasal sinuses malignancies, prospective multi-center trials are necessary.

Adenocarcinoma↗
PubMed2004

[Collision tumor of a hypopharyngeal adenoidcystic carcinoma and a laryngeal squamous cell carcinoma].

INTRODUCTION: Malignancies in head and neck cancer are mainly squamous cell carcinomas. Adenoid cystic carcinomas are rare lesions of this site. Laryngeal adenoid cystic carcinoma is estimated to occur in 0.1 - 0.7 % of all laryngeal carcinomas. Adenoid cystic carcinomas are rarely located in the hypopharynx. To our knowledge there is no case report of adenoid cystic carcinoma of the hypopharynx as part of a collision tumor of the larynx. CASE REPORT: A 47-year-old male patient was diagnosed with an adenoid cystic carcinoma of the hypopharynx and a squamous cell carcinoma of the larynx. Because of local extension of both tumors laryngectomy and partial pharyngotomy with bilateral neck dissection was performed followed by radiation therapy. Clinical aspects as well as histomorphological and immunohistochemical criteria of both tumor entities are discussed. DISCUSSION AND CONCLUSIONS: Immunohistochemical characteristics showed two different carcinoma entities in the larynx and hypopharynx. Only by complete histological investigation of a carcinoma those rare cases of a collision tumor can be detected. Both tumor entities need to be considered for therapy strategy and oncological follow-up planning.

Carcinoma, Adenoid Cystic↗
PubMed2004

[Expression of osteoclast stimulating and differentiating factors in a murine model of localized inflammatory bone resorption].

BACKGROUND: The pathology associated to cholesteatoma is predominantly a consequence of osteoclast-mediated bone resorption within the middle ear. To assess its pathogenesis a murine model for dermal-implant induced osteolysis was evaluated for the expression of osteoclast stimulating and differentiating factors. METHODS: Mouse calvaria were analysed for the expression of osteoprotegerin ligand (OPGL), osteoprotegerin (OPG) and macrophage-colony stimulating factor (M-CSF) using immunohistochemistry. The detection of osteoclast cell lineage was acquired by immunohistochemistry using markers CD 4, CD 11a, CD 11b, CD 14, CD 51, CD 68 and TRAP. RESULTS: An increased expression of the investigated cytokines M-CSF, OPG and OPGL was demonstrated by immunohistochemistry. The presence of osteoclast precursor cells and mature resorbing osteoclasts was confirmed in time-dependent manner triggered by dermal implantation. CONCLUSIONS: This study reveals the basic events in osteoclast biology in localized inflammatory bone resorption and provides new insights into the comprehension of cholesteatoma-induced bone resorption.

Animals↗
PubMed2004

[Clear cell chondrosarcoma (CCCS) of the nasal septum].

INTRODUCTION: Chondrosarcomas belong to the most common malignomas of the skeletal system. The vast majority is located at the epiphysis of the long bones or in the pelvis. Less than 10% of chondrosarcomas are located in the head and neck area, most common in the bony viscerocranium and the larynx. Five histological variants can be differentiated: conventional, mesenchymal, myxoid, dedifferentiated and in less than 5% clear cell chondrosarcomas (CCCS). This case report gives the first description of a CCCS originating from the nasal septum. CASE REPORT: A 79 year old female complaining about a 6 month history of nasal obstruction revealed a huge ballooning of the basal septum in anterior rhinoscopy. Computed tomography exhibited a septal tumor with amorphous calcification. Histology of the tumor resected via lateral rhinotomy confirmed a diagnosis of CCCS. Because of clear surgical margins no radiation therapy was performed. The patient stayed free of recurrence during follow-up of sixteen months. DISCUSSION: The patient presented with typical symptoms of nasoseptal tumors as well as representative CT-scans and histologic findings of CCCS. Because of the complete resection and the CCCS-subtype, the patient is expected to have a positive prognosis.

Aged↗
PubMed2003

[Experimental investigations of CO2 laser application in middle ear ossicles].

BACKGROUND: During the last few years, several laser systems have been applied for procedures in middle ear surgery. In this study, we determined the technical parameters for the dissection of the middle ear ossicles with the CO(2) laser and analyzed the histological findings. METHODS: The malleus necks of 16 human temporal bones were dissected under standardized conditions using a CO(2) laser with a power output between 35 and 55 kW/cm(2). The specimens were fixed and histological probes of 50- micro m thickness were prepared. RESULTS: The laser outputs led to crater diameters from 0.14 to 0.55 mm. As an analogy between laser energy and thermal tissue destruction, three zones of thermal damage were differentiated: a cinder zone, a carbonization zone, and a zone of dehydration. The metrical dimensions of these zones did not show any correlation to the applied laser energy. CONCLUSIONS: The data of this study show that commercially available CO(2) lasers are sufficient for a safe and effective partial resection of middle ear ossicles using a power output of 35 kW/cm(2).

Ear Ossicles↗
PubMed2003

[Foudroyant rhinocerebral zygomycosis].

We present a fatal case of rhino-orbital-cerebral zygomycosis in an 81-year old immunocompromised patient with a 18-year history of multiple myeloma. The patient initially presented with symptoms of an orbital complication, loss of vision after acute sinusitis and agranulocytosis. Endonasal sinus surgery with orbital decompression was performed. Within days a rapid visero-cerebral progression of necrosis developed finally causing the patient's death. Invasive fungal infections are generally characterized by diagnostic difficulties in the early stage and exhibit an extremely high mortality. Definitive diagnosis of rhino-orbital-cerebral zygomycosis caused by Rhizopus microsporus was made by histology, culture and polymerase chain reaction. Early diagnosis and treatment are imperative for the management of patients afflicted with this devastating and life-threatening fungal infection.

Aged↗
PubMed2003

[Surgery of anterior skull base fractures].

BACKGROUND AND METHODS: The medical records of 144 patients that underwent surgery due to fractures of the anterior skull base between 1990 and 1999 were assessed retrospectively. Fracture causes, symptoms, fracture lines, surgical approaches and materials for dura repair were analyzed. RESULTS: The most frequent fracture causes were automobile (46.1%), recreational (24.8%) and occupational accidents (16.3%). While a decrease in automobile accidents was observed from 1996 (71.4%) to 1999 (33.3%), an increase in sports accidents was documented from 1990 (5.3%) to 1999 (16.7%). The most common accompanying injuries were CSF leakage (38.9%), loss of vision (28.5%) and intracranial bleeding (21.5%). The roof of the ethmoid sinus (79.7%) and the frontal sinus (anterior and posterior wall) (73.6%) were fractured most commonly. The lamina cribrosa was involved in 32.6%, the sphenoid sinus in 29.2% of the fractures. Most commonly the bitemporal Unterberger approach (75.7%) was used. To a lesser degree the uni- (13.9%) or bilateral (4.8%) Kilian approach, the reopening of the old wound (4.2%) and the endonasal approach (1.4%) were utilized. Conserved dura was applied for the closure of CSF leaks in 80.7%, periostal flaps in 20.7%, fascia lata in 14.8% and TachoComb in 8.2%. CONCLUSIONS: The results of this study indicate that posttraumatic fractures of the anterior skull base are declining in frequency. The most common causes for these injuries were automobile accidents but increasingly sports accidents. Typical fracture lines or combinations were not observed. In the period observed the bitemporal Unterberger approach and resorbable implant materials such as the coated collagen fleece TachoComb were increasingly used for surgery.

Accidents, Occupational↗
PubMed2003

Regeneration of inner ear cells from stem cell precursors--a future concept of hearing rehabilitation?

The use of stem cells offers new and powerful strategies for future tissue development and engineering. Common features of stem cells are both their capacity for self-renewal and the ability to differentiate into mature effector cells. Since the establishment of embryonic stem cells from early human embryos, research on and clinical application of human ES cells belong to the most controversial topics in our society. Great hopes are based upon the remarkable observation that human ES cells can be greatly expanded in vitro, and that they can differentiate into various clinically important cell types. Recent advances in the cloning of mammals by nuclear transplantation provide new concepts for autologous replacement of damaged and degenerated tissues. In contrast, somatic stem cells of the adult organism were considered to be more restricted in their developmental potential. However, recent investigations suggest that somatic stem cells may have a wider differentiation potential than previously thought. In otology, initial experiments have revealed neural stem cell survival in cochlear cell cultures and under neurotrophin influence, neural stem cells seemed to develop into a neuronal phenotype. Further studies have to be carried out to investigate the full potential of stem cells as well as the molecular mechanisms that are involved in regulating cellular identity and plasticity. Clinically, advances in stem cell biology may provide a permanent source of replacement cells for treating human diseases and could open the development of new concepts for cell and tissue regeneration for a causal treatment of chronic degenerative diseases.

Animals↗
PubMed2002

Herpes zoster-associated trigeminal trophic syndrome: a case report and review.

The case of a 75-year-old Caucasian woman with a trigeminal trophic syndrome (TTS) is presented and discussed. TTS of the ala nasi subsequent to a herpes zoster infection has not been described previously. We provide a review of the literature with insights into the pathogenesis and current therapeutic strategies.

Aged↗
PubMed2002

[Histomorphometric assessment of spiral ganglion neurite outgrowth in vitro].

BACKGROUND: During the last years, various groups of growth factors have been identified to influence spiral ganglion cell survival and neurite extension in the mammalian cochlea. To evaluate and compare the effects of different growth factors, a precise histomorphometrical analysis of neurite outgrowth patterns has to be applied. The here presented technique is compared to already published methods, that only approximately estimate the neurite length. METHOD: A software has been developed to analyse digitalised scans of spiral ganglion cells and to measure the length of the neurites. Therefore, the neurites are being separated in any given number of straight lines. The totals of these lines can then be added like a polygon. This polygon method was compared to a semi-quantitative procedure in which the neurite length was determined by concentric circles that were crossed by the neurites in a certain distance. The accuracy of both methods was analysed. Both methods were performed in 20 specimen of neonatal rat spiral ganglion cells after in vitro stimulation with neurotrophic factors. RESULTS: The semi-quantitative method has shown to involve a systematic error between +/- 10 to 15 %. The polygon method, on the contrary, has a systematic error of around +/- 1 %, which admits much more accurate measurement of spiral ganglion neurite outgrowth. CONCLUSION: With the described polygon method, spiral ganglion neurite growth patterns in cell culture studies can be characterised more precisely and, thus, helps to better differentiate the action domain of neurotrophic factors.

Animals↗