PubMed Health⌕ Search

Biomedical subjects

S Kösling

Publications and source records attributed to S Kösling.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Computerized tomography in children and adolescents with suspected petrous bone abnormality].

PURPOSE: To demonstrate HRCT findings and their therapeutic relevance in suspected congenital hearing disorders. MATERIAL AND METHODS: It was checked in 96 young patients if HRCT findings of the temporal bone could explain functional findings. Furthermore, the therapeutic consequences were noted. RESULTS: Normal CT and normal functional findings were obtained in 49 temporal bones (TB). In conductive hearing loss (41 TB), dysplasias of the conducting apparatus (37 TB) and inflammatory changes (3 TB) were found. Combined hearing loss (18 TB) was clarified completely or partially in half the cases. There were 22 dysplasias of the inner ear, 3 dysplasias of the middle ear, 1 abandoned examination (2 TB), and 55 normal CT findings in senorineural hearing disorders (82 TB). 1 retardate had a malformation of the inner ear and, contralaterally, inflammatory middle ear. In cases of vestibular disorders (24 TB), 14 malformations of the inner ear were detected. An indication for an operation was given in 23 TB. In 22 TB, it was contraindicated. The CT was one preliminary examination to a cochlea implant in 19 patients. The therapy was carried on with hearing devices in the other patients. CONCLUSION: HRCT is an important method in diagnosis and therapeutic planning of suspected malformations of the temporal bone.

Adolescent↗
PubMed1997

Diagnostic value of 3D CT surface reconstruction in spinal fractures.

Our purpose was to evaluate the diagnostic value of three-dimensional (3 D) CT surface reconstruction in spinal fractures in comparison with axial and reformatted images. A total of 50 patients with different CT-proven spinal fractures were analysed retrospectively. Based on axial scans and reformatted images, the spinal fractures were classified according to several classifications as Magerl for the thoraco-lumbar and lower cervical spine by one radiologist. Another radiologist performed 3 D CT surface reconstructions with the aim of characterizing the different types of spinal fractures. A third radiologist classified the 3 D CT surface reconstruction according to the Magerl classification. The results of the blinded reading process were compared. It was checked to see in which type and subgroup 3 D surface reconstructions were helpful. Readers one and two obtained the same results in the classification. The 3 D surface reconstruction did not yield any additional diagnostic information concerning type A and B injuries. Indeed, the full extent of the fracture could be easier recognized with axial and reformatted images in all cases. In 10 cases of C injuries, the dislocation of parts of vertebrae could be better recognized with the help of 3 D reconstructions. A 3 D CT surface reconstruction is only useful in rotational and shear vertebral injuries (Magerl type C injury).

Humans↗
PubMed1997

[Detection of orbital foreign bodies by CT: are plain radiographs of foreign bodies still useful?].

PURPOSE: To prove the visualisation of orbital foreign bodies by CT. MATERIALS AND METHODS: In vitro we examined defined small objects of various materials (metal, wood, glass, stone) which are common as orbital foreign bodies, Density and minimum detectable size were studied. The findings of 27 patients with suspected orbital foreign bodies were compared with the results of plain radiographs, Comberg radiographs, sonography, and surgery. RESULTS: For iron, the minimum detectable size was 0.02 mm3. A differentiation of various materials by CT was not always possible, especially in small objects. There were wide differences in density of wood (-600 HU to +130 HU) according to hardness and water content. The CT scans correctly showed number and location of foreign bodies. Other methods were inferior in detection of foreign bodies. CONCLUSION: In diagnosis of foreign body injuries of the orbit, CT is the imaging method of choice.

Adolescent↗
PubMed1997

[Spiral computerized tomography diagnosis of abdominal seat belt injuries in children].

Seat belt injury (s.b.i.) arises from not properly applied seat belt in case of car accidents. The importance of spiral CT for the diagnosis of s.b.i., especially of hidden traumatic lesions, will be demonstrated. Our experience includes 9 children in the age of 4 to 13 years suffering from life-threatening s.b.i. After life-saving treatment we took a spiral CT (Somatom plus S): first spiral CT, 10 mm slice thickness, without contrast medium (c.m.) and second spiral CT, 5 mm slice thickness, start delay 35-45 s after a large volume of c.m. Of these, 8 of 9 children survived. Besides bruising signs head injuries, and knee joint lesions in 4 of 9 cases, a combination of ruptured duodenum, ruptured liver or spleen, and chance fractures of the spine was found which is typical for s.b.i. In the remaining 5 cases, two of the lesions were combined. Rupture of the small bowel was manifested mainly as the discrete finding of free air or inhomogeneous ascites with a high density (bowel contents mixed with blood). Not only the emergency doctor but also the radiologist should take into account the complexity of seat belt injuries. Spiral CT is the imaging method of choice in the case of polytraumatic children.

Abdominal Injuries↗
PubMed1996

[Middle ear abnormalities in Klippel-Feil syndrome].

Klippel-Feil syndrome is characterized by a short-neck and a low occipital hairline due to such deformaties of the cervical spine as aplasia, dysplasia and fusions of the cervical and thoracic vertebrae. Approximately 1/3 of cases have sensorineural deafness, although occasional unilateral or bilateral conductive hearing loss due to middle ear malformations have been described. We have now treated two cases with unilateral middle ear malformations in patients with known Klippel-Feil syndrome. In the first case a completely malformed stapes was found as well as an atypical course of the facial nerve, which was found to be exactly over an absent oval window. In the second case aplasia of the stapes was seen and the oval and round windows were absent. No epitympanum was identifiable and a compact mastoid was found. In addition to audiometry, high-resolution CT was indispensable in diagnosis. However, surgical procedures in cases with unilateral middle ear deformations should be performed only on explicit request of the patient and not before the age of 16.

Adolescent↗
PubMed1995

[The value of computed tomography in persistent balance disorders following the use of stapes prostheses].

10 of 150 patients had persistent vertigo after implantation of stapes prostheses. These patients were evaluated by high-resolution CT in the axial and coronal plane. Scans showed in all cases findings which related to the symptoms. The CT findings were proved intraoperatively in 9 cases. A new indirect sign of a perilymphatic fistula is described in form of an air bulla at the end of the prosthesis. Retympanotomy could be planned better with the help of HR-CT.

Evaluation Studies as Topic↗
PubMed1995

[First experiences with electron beam computed tomography of the heart:comparison with heart catheterization and echocardiographic findings].

AIM: To evaluate the diagnostic value of ultrafast CT in comparison to established methods in cardiology. MATERIAL AND METHODS: Cine and flow studies were performed in 30 patients with cardiac diseases on evolution CT. Cardiac structure and function were analysed visually and quantitatively (left ventricular ejection fraction, left ventricular myocardial mass, patency of coronary arteries, perfusion of left ventricular myocardium). The CT findings were compared with echocardiographic and angiographic findings. RESULTS: Cardiac structure, functional parameters and disorders of myocardial contraction were clearly detectable by ultrafast CT, which proved inferior in assessing cardiac valves. The patency of the first and second third of normal main coronary arteries could be estimated correctly. The estimation of the distal third, of obstructed coronary arteries and of the role of collaterals was impossible. Ten of 16 areas of myocardial infarction showed low or no enhancement. CONCLUSIONS: Ultrafast CT excellently reflects cardiac structure and function. It is an alternative to echocardiography. In view of the results of coronary artery patency one can hope that part of cardiac catheterisation would be avoidable in future.

Adult↗
PubMed1995

[Diagnosis in persistent vertigo after stapes surgery].

One hundred sixty-two otosclerotic patients who underwent a stapedotomy between October 1991 and April 1994 were examined after experiencing postoperative vertigo. Twenty-eight complained of dizziness. In sixteen patients, we observed vertigo and nystagmus only within the first six postoperative days; in these cases, special treatment was not necessary. However, in twelve patients in whom vertigo persisted even after their stay in the hospital, the problem seriously affected their quality of life and their return to work. In these cases, an individualized diagnostic and therapeutic procedure was indicated. Case reports demonstrate the usefulness of several diagnostic methods (analysis of the case history, audiogram, investigation of the vestibular system, and elimination of non-vestibular causes of vertigo. But only high-resolution computed tomography scans of the temporal bone showed definite results. Air bubbles at the end of the prosthesis as indirect sign of perilymphatic fistula, bad position of the piston, new centers of otosclerosis, cicatrices, and in one case fracture of the prosthesis. Ten of the twelve patients required revision surgery. In most patients with persisting vertigo following stapedotomy, revision surgery was justified. However, high-resolution computed tomography is recommended.

Adult↗
PubMed1995

Value of computed tomography in patients with persistent vertigo after stapes surgery.

RATIONALE AND OBJECTIVES: The value of computed tomography was evaluated in 14 patients with persistent vertigo after otosclerosis operation. METHODS: High-resolution computed tomography was performed with 1-mm slice thickness and table feed in the axial and coronal planes. RESULTS: Computed tomography scans showed in 13 case findings that related to symptoms. An air bubble at the end of the prosthesis as a new, indirect sign of a perilymphatic fistula was found in 6 cases. An incorrect position of the stapes prostheses was diagnosed in 7 patients. One patient had recurrence of otosclerosis, and two others developed scarring around the prosthesis. In 1 case, an incus necrosis was found. Some patients showed two signs simultaneously. The computed tomography results were confirmed by retympanotomy in 12 cases. CONCLUSIONS: Computed tomography proved to be a valuable method in the diagnosis of persistent vertigo after otosclerosis operation. The indication for a repeat operation was facilitated by the use of computed tomography.

Follow-Up Studies↗
PubMed1994

[Detection of coronary calcification by ultrafast CT compared with coronary angiography].

The angiographical findings of 24 patients with coronary artery disease were compared with qualitative and quantitative detection of coronary calcification by ultrafast CT. Doubts concerning the capabilities of the ultrafast CT for a screening of coronary artery disease arise when the results of one third false positive and false negative findings are considered. Variations in the quantification of coronary calcification were too great to allow a realistic assessment of the degree of stenosis of the coronary arteries.

Adult↗
PubMed1993

[Osseous variations in the coronary CT of the paranasal sinuses].

Bony variations in the anterior ethmoids may, if severe, play an important role in the development of chronic sinusitis and present the surgeon with added risks during operation. We have, therefore, analysed 390 preoperative CT examinations of the sinuses performed in the coronary plane with respect to the frequency of bone variations. Concha bullosa, increased pneumatisation of the agger nasi, large ethmoidal bullae, Haller's cells and increased pneumatization of the sphenoid were found with equal frequency in about 20%. The most common variants occurred in the uncinate process (31.5%), less common were paradoxical curve of the middle turbinates (13.3%) and very rare were Onodi cells (1.3%).

Adolescent↗
PubMed1993

[Congenital aneurysm of the left atrial wall. A case report].

An intrapericardial aneurysm of the left atrial wall in a 28-year-old man is reported. This is a rare congenital anomaly. The patients are usually identified by clinical signs, when complications such as cardiac arrhythmias and systemic embolism occur. Clinical findings including the ECG are non-specific. Cardiomegaly and unusual configuration of the heart are consistantly found, but are not pathognomonic. The diagnosis is usually confirmed by angiocardiography. Echocardiography, computed tomography and/or MRI can contribute to the diagnosis. Operation seems to be indicated if complications are to be avoided.

Adult↗