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S Graumüller

Publications and source records attributed to S Graumüller.

10 recordsLinked to original sources
PubMed2006

Suprastomal tracheal stenosis after dilational and surgical tracheostomy in critically ill patients.

We have previously reported cases of severe suprastomal stenosis after tracheostomy. In this observational study we investigated the occurrence of suprastomal stenosis as a late complication. Patients with persistent tracheostomy after intensive care underwent an endoscopic examination of tracheostoma, larynx and trachea. A percutaneous dilational tracheostomy was employed in 105 (71.9%) and surgical tracheostomy in 41 (28.1%) of the cases (n = 146). The incidence of severe suprastomal stenosis (grade II > 50% of the lumen) was 23.8% (25 of 105) after dilational tracheostomy and 7.3% (3 of 41) after surgical tracheostomy (p = 0.033). Age, gender, underlying disease, ventilation time, and swallowing ability were not significantly associated with the tracheal pathology. This study suggests that dilational tracheostomy is associated with an increased risk of severe suprastomal tracheal stenosis compared to the surgical technique.

Adult↗
PubMed2005

[Arterial aneurysms as cause of gushing post-tonsillectomy hemorrhage].

Aneurysms of the external carotid artery can be causally for threatening late hemorrhage secondary to tonsillectomy. On the bases of typical, extended and finally dramatic bleeding course in a child the "clinical look" and the sensitivity should be raised for this bleeding cause. Characteristic after apparently inconspicuous post-operative first phase is late signal bleeding with little loss of blood which are replaced after following intervals free of bleeding from bleeding as flood with massive loss of blood. Then vessel-imaging (Angio-MRI or CT) is urgently indicated. By confirmation of the suspicion diagnosis the interventional angiography is the therapy of the choice, although after successful embolisation a fine-meshed postcontrol is necessary, because therapy failures are possible how the described case points. The highest security offers the surgical exploration with aimed vessel stopping.

Aneurysm↗
PubMed2004

[Stapes fixation in children].

BACKGROUND AND OBJECTIVE: The audiometric results after stapes surgery in children with isolated stapes footplate fixation were reason enough to analyze intraoperative findings and surgical procedures. PATIENTS/METHODS: A total of 438 stapes surgeries were performed in the years 1985-2000, and a retrospective analysis was made of the anamnestic data, intraoperative findings and audiometric data from 12 children with isolated fixation of the stapes footplate. The average age of the children when operated was 10.2 years (the youngest was 7 and the eldest 13). A loss of hearing had set in 5 years earlier. RESULTS: Taking the anamnestic data and the intraoperative into account, otosclerosis was found in 5 children. One child had a narrow oval window niche, in a further six children a congenital fixation of the stapes footplate was evident. Only 58% (n=7) of the 12 children operated showed acceptable postoperative hearing results. The best hearing results were found in children with juvenile otosclerosis. In three of six children with congenital stapes fixation, a worsening of both bone and air conduction was evident. The average conductive hearing loss was 30 dB at 1, 2 and 4 kHz. CONCLUSIONS: When explorative tympanotomy is indicated, a thin-layer CT scan of the temporal bone should be made to assess the risk of a liquor pressure labyrinth developing.

Adolescent↗
PubMed2003

[An intraosseous hemangioma in the perpendicular lamina of the ethmoid bone].

The incidence of intraosseous hemangiomas is very low. Most of them occur in adult females. The mandible,the zygoma,the maxilla, and the frontal and nasal bones are the areas of most frequent localization in the facial region. The intraosseous hemangioma is a benign, slowly growing,bony hard tumor causing facial deformity. It is diagnosed histologically. We report a case of an 18-year-old male with an intraosseous cavernous hemangioma located in the perpendicular lamina of the ethmoid bone. Intraosseous hemangioma often has characteristic signs on a CT scan, with either coarsened trabeculae lying adjacent to the vascular channels or multifocal lytic areas creating a honeycomb pattern. Because of the age of the patient we considered a midline granuloma and a chondrosarcoma. The therapy of choice is surgical excision; radiation is done in exceptional cases only.

Adolescent↗
PubMed2003

[Influence of rhinologic usual and unusual drugs on fibroblasts from nasal polyps in cell culture].

BACKGROUND: Nasal polyposis is treated by surgery and/or by medication but in parts without permanent remission. Fibroblasts and their proliferation are involved in the complex mechanism of polyp genesis. Therefore we have analysed the influence of 12 medications on fibroblasts from nasal polyps growing in vitro. METHOD: Nasal polyps, obtained during usual surgical procedure, are enzymatically digested and cultured in serum containing media. The growing cells are identified as fibroblasts using flow cytometry with a AS02-FITC antibody (Dianova). The analysis is achieved with 5 - 6 different fibroblast cultures in each medicament tested, mostly using concentrations of the active substance from 0.006 to 1.333 mg/ml. The fibroblasts are cultured 4 days in the presence of active substances or as controls. Finally the cells are trypsinated and counted. RESULTS: Mometason, Beclomethason, Fluticason, Verapamil and Timolol are the group with the strongest reduction of fibroblasts. Mometason shows a reduction to 6 % of controls at a concentration of 30 micro g/ml whereas the reduction at this concentration amounts to 30 - 60 % in the other members of this group. Mesazalin, Methylprednisolone and Pentoxifylline demonstrate the smallest influence; Prednisolon-21-hydrogen-succinate, Pilocarpin, Piroxicam and Diclofenac show an effect on a middle level. CONCLUSIONS: A strong reduction of fibroblasts from nasal polyps in vitro is possible with usual rhinological medicaments but also with unusual substances in this field.

Administration, Topical↗
PubMed2003

[Taste disorders and recovery of the taste function after middle ear surgery].

BACKGROUND: The incidence and the scale of recovery of the taste function after middle ear surgery is usually determined by the use of anamnestic data and electrogustometry. METHODS: Taste tests (regional chemical taste test, electrogustometry and subjective evaluation) were performed preoperatively, 2 to 3 weeks and 6 to 9 months after middle ear surgery. These results were evaluated by taking the scale of chorda tympani nerve (CTN) manipulation into consideration. Three groups were chosen: group 1: no or small CTN manipulation, n = 54; group 2: strong CTN manipulation, n = 14; group 3: severed CTN, n = 50. PATIENTS: In a prospective study 118 patients were examined after middle ear surgery in the ENT-Department of the University of Rostock between 2001 and 2002. 61 females and 57 males, age from 7 - 81 years, were included. RESULTS: Complaints were observed in all three groups, mainly in groups 2 and 3. These included taste disorders, taste phenomenon and numbness of the tongue. Using regional chemical taste tests, the taste loss of group 3 could be proven for those patients with complaints in 64 % and for those patients without complaints in 27 %. The electrogustometry is more sensitive than chemical taste test. All patients had pathological thresholds after chorda cutting (78 % no thresholds; 22 % elevated thresholds). 68 out of 118 patients (58 %) had a second follow-up after 6 to 9 months after middle ear surgery. The complaints are declining in all groups. In groups 2 and 3 a recovery of taste function could be observed. Even if the number of patients with severed chorda, who suffer from taste disorders, diminishes, a recovery of the taste function could only be observed in 30 %. CONCLUSIONS: The scale of chorda manipulation is important for the recovery of the taste function after middle ear surgery. The CTN should be preserved intraoperatively, especially when an operation of the contralateral ear is planned as well.

Adolescent↗
PubMed2001

[Vertigo in suction of open mastoid cavities ("radical surgery cavities")].

BACKGROUND: Vertigo during suction-cleaning of open mastoid cavities is caused by cold stimulation of the vestibular organ. In clinical and model-experimental measurements we tried to estimate the physical background and the dimension of this temperature drop. METHODS: Using different techniques like thermo-probes, thermovision, or additional model experiments temperature changes during suction were measured in 5 volunteers with open mastoid cavities. These registrations were carried out with special regard to the moisture of the cavity-walls. RESULTS: Distinct temperature changes during suction were observed. In moist cavities superficial temperature decrease was much higher than in dry ones. Using additional model experiments, temperature conduction towards e.g. the horizontal semicircular canal could be simulated. DISCUSSION AND CONCLUSIONS: Among other mechanisms like replacement of sucked-off air by colder air, or taking away warm air close to the cavity walls, effects of evaporative cold seem to be very significant. This could be demonstrated by moistening cavity walls in patients as well as in model experiments. The conclusion to keep the cavity walls as dry as possible is already a clinical demand. In this paper, the physical background and the dimensions of thermal effects during suction-cleaning could be elucidated.

Body Temperature Regulation↗
PubMed2001

Late sequelae of percutaneous tracheotomy compared to epithelized tracheostomy.

BACKGROUND: Since Ciaglia described in 1985 the method of percutaneous dilational tracheotomy at first time, it has emerged to be a favored used technique in the treatment of critically ill patients to prevent the complications associated with prolonged translaryngeal intubation. There are currently several commercial kits for sequential dilatational percutaneous tracheotomy available. Essential advantages are the simplicity, rapidity, low risk and independence of the physician. But there are also risks for long time complications with essential disadvantages for neurologic and phoniatric rehabilitation. PATIENTS: From September 1997 to September 1999 we examined 168 patients with tracheostoma of three different rehabilitation centers with special attention to early rehabilitation. The examinations included an endoscopic control of the subglottic area, the stoma and the trachea until the bifurcation. RESULTS: During our examinations we mainly found pathological findings in the subglottic area and the stoma himself with an important difference between the percutaneous tracheotomy and the epithelized tracheostomy. CONCLUSIONS: There is a need for critical indications in performing the percutaneous tracheotomy. We propose its use for short-time only. Critically ill patients with a tracheostoma in requirement of a airway bypass more than 6 weeks should get an epithelized tracheostomy primarily.

Adolescent↗