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S Tauber

Publications and source records attributed to S Tauber.

At least 19 recordsLinked to original sources
PubMed2003

Transmeatal cochlear laser (TCL) treatment of cochlear dysfunction: a feasibility study for chronic tinnitus.

Low-level-laser-therapy (LLLT) targeting the inner ear has been discussed as a therapeutic procedure for cochlear dysfunction such as chronic cochlear tinnitus or sensorineural hearing loss. Former studies demonstrate dose-dependent biological and physiological effects of LLLT such as enhanced recovery of peripheral nerve injuries, which could be of therapeutic interest in cochlear dysfunction. To date, in patients with chronic tinnitus mastoidal and transmeatal irradiation has been performed without systematic dosimetric assessment. However, light-dosimetric studies on human temporal bones demonstrated that controlled application of laserlight to the human cochlea depends on defined radiator position within the external auditory meatus. This feasibility study first presents a laser application system enabling dose-controlled transmeatal cochlear laser-irradiation (TCL), as well as preliminary clinical results in patients with chronic cochlear tinnitus. The novel laser TCL-system, consisting of four diode lasers (lambda=635 nm-830 nm) and a new specific head-set applicator, was developed on the basis of dosimetric data from a former light-dosimetric study. In a preliminary clinical study, the TCL-system was applied to 35 patients with chronic tinnitus and sensorineural hearing loss. The chronic symptoms persisted after standard therapeutic procedures for at least six months, while retrocochlear or middle-ear pathologies have been ruled out. The patients were randomised and received five single diode laser treatments (lambda=635 nm, 7.8 mW cw, n=17 and lambda=830 nm, 20 mW cw, n=18) with a space irradiation of 4 J/cm2 site of maximal cochlear injury. For evaluation of laser-induced effects complete otolaryngologic examinations with audiometry, tinnitus masking and matching, and a tinnitus-self-assessment were performed before, during and after the laser-irradiation. The first clinical use of the TCL-system has been well tolerated without side-effects and produced no observable damage to the external, middle or inner ear. Changes of tinnitus loudness and tinnitus matching have been described. After a follow-up period of six months tinnitus loudness was attenuated in 13 of 35 irradiated patients, while two of 35 patients reported their tinnitus as totally absent. Hearing threshold levels and middle ear function remained unchanged. Further investigations by large double-blind placebo-controlled studies are mandatory for clinical evaluation of the presented TCL-system and its therapeutic effectiveness in acute and chronic cochlear dysfunction.

Chronic Disease↗
PubMed2003

[Impact of 24-hour intraesophageal pH monitoring with 2 channels in the diagnosis of reflux-induced otolaryngologic disorders].

BACKGROUND: Patients with gastroesophageal reflux disease (GERD) may suffer from a large variety of symptoms in the upper aerodigestive tract such as globus sensation, chronic cough, hoarseness and many others. Diagnosis and causal therapy may sometimes be difficult with gastroenterologic evaluation sometimes revealing no pathologic result. The objective of this study was to determine the impact of 24-hour intraesophageal pH monitoring with 2 channels (gastric and laryngeal) in the diagnosis of reflux-induced otolaryngologic disorders. METHODS: This study included 22 patients presenting to the Department of Otolaryngology with symptoms like chronic cough (n = 3), globus sensation and dysphagia (n = 11), heartburn (n = 2), hoarseness and dysphonia (n = 2) or burning sensation of the tongue (n = 1). Three patients had a pathologic formation in the glottic area (leukoplakia, granuloma, polyp). All patients underwent a otolaryngological examination, a gastroenterological investigation and a 24-hour intraesophageal pH monitoring with 2 channels. RESULTS: All 22 patients showed laryngeal mucosal lesions (posterior laryngitis). The gastroenterological evaluation with esophagogastroduodenoscopy was normal in 4 cases. 13 patients showed a hiatal hernia, 4 patients were suffering from a reflux-esophagitis grade I and 2 patients from grade II. One patient had an erythema and 5 patients showed erosions of the gastric mucosa. Seven patients had more than one of the above mentioned diagnoses. Intraesophageal pH-monitoring with 2 channels over 24 hours revealed a gastroesophageal reflux of all 22 patients and a high reflux to the laryngeal level of 21 patients, probably causing laryngopharyngeal symptoms. Therapy of the patients consisted of medical antireflux treatment with proton pump inhibitor esomeprazol (Nexium, 40 mg, 1-0-0). Within 4 weeks 15 of 22 patients had no more laryngopharyngeal symptoms or at least a significant reduction. CONCLUSION: Patients with laryngopharyngeal symptoms such as hoarseness, globus sensation or dysphagia can suffer from GERD, even if typical symptoms such as heartburn or retrosternal pain do not exist and gastroesophageal intervention reveals a normal result. The best diagnostic instrument for the diagnosis of reflux-induced otolaryngologic disorders is a 24-hour intraesophageal pH-monitoring with 2 channels (measure-points at the distal esophagus and laryngeal level). Medical antireflux treatment should consist of proton pump inhibitors (e. g. Nexium) in a dose of 40 mg per day over at least 4 weeks.

Adult↗
PubMed2003

[Diagnosis and management of squamous cell carcinoma of the head and neck region with unknown primary. A survey of 167 patients].

BACKGROUND: Carcinoma of unknown primary is defined as histological diagnosis of metastasis without diagnosis of a primary tumor. The incidence of CUP is stated in the literature between 3 % and 15 % of all patients with an malignant disease. Histological examination of CUP-metastasis of the neck most frequently shows a squamous cell carcinoma. A retrospective study of patient data was undertaken. PATIENTS AND METHODS: The study included 167 patients admitted and treated for cervical CUP at the department of Oto-Rhino-Laryngology, Klinikum Grosshadern from 1979 to 1998. Cervical swelling was the first noted symptom in all cases. Other symptoms were pain and dysphagia. Of the 167 patients 134 were men and 33 were women. The average age at admission was 55 years. In the studied collective squamous cell carcinoma had the highest incidence (n = 123). During the 10 year follow-up a primary tumor was found in 36 of the 167 initially diagnosed CUP-patients. In over 90 % of these cases the tumor was localized in the head and neck region. The origin of the tumor was most frequently the tonsilla palatina (n = 7). Of the 167 patients included in the study 118 patients (70,7 %) underwent surgery and additional postoperative radiotherapy. Primary radiotherapy was the treatment of choice in 28 patients, 8 patients received combined radio-chemotherapy as primary treatment and 7 patients were treated with chemotherapy alone. No treatment was performed in 6 patients. RESULTS: By comparing the treatment methods there was a significant difference of patient survival in regard to the treatment. Patients treated according to treatment-plan II, which includes an additional "diagnostic" tonsillectomy, is significantly higher than that of patients simply undergoing neck dissection and postoperative radiotherapy or primary radiotherapy alone. Treatment of choice in patients with cervical CUP should be a surgical procedure including radical neck dissection and diagnostic bilateral tonsillectomy followed by postoperative radiation of the cervical lymph drainage. DISCUSSION: Bilateral tonsillectomy is especially important and is correlated with a significant improvement of the survival rate in CUP patients. Additional postoperative radiation of the pharynx from the base of the skull to the upper oesophagus should also be considered, in order to treat a possible--small--primary tumor in this region.

Adult↗
PubMed2002

[Respiratory manifestations of reflux disease. Gastric acidity--poison for larynx, teeth and respiratory tract].

Gastroesophageal reflux is now a generally accepted risk factor for the development of adenocarcinoma of the esophagus. Less well known is the relationship of reflux disease (GERD) and respiratory disorders. Among the extra-esophageal manifestations of reflux disease is reflux laryngitis, which affects up to 78 patients with chronic hoarseness, Reinke's edema, laryngeal stricture, postnasal drip, asthma and non-cardiac chest pain. Despite popular opinion, changes in lifestyle (for example, cessation of smoking and drinking, avoidance of fatty foods) do not result in an improvement in symptoms. The treatment of choice for GERD is the use of proton pump inhibitors (PPI) in the form of stepdown therapy; in individual cases as symptom-orientated on-demand therapy.

Esophageal Neoplasms↗
PubMed2002

[Follow-up assessment of intratympanic gentamicin therapy and Saccotomia in Menière's Disease].

BACKGROUND: The intratympanic application of ototoxic antibiotics and saccotomia have been well documented in severe cases of one-sided Menière's disease for 30 years now. Both treatment methods are still subject to controversial discussion. PATIENTS AND MATERIAL: This study includes 8 patients suffering from persistent one-sided Menière's disease after treatment with gentamicin application and additional saccotomia (n=2). We performed follow-up visits including the assessment of hearing ability, vestibular function and cranial MRI, 2-10 years after onset of treatment. RESULTS: After therapeutic interventions 7 patients reported to be healed of their symptom vertigo. In 4 patients the gentamicin-treated vestibular organ did not respond to thermic stimulus at the time of follow-up examination. Auditory threshold shift was observed in 3 patients (1 permanent, 2 temporary), whereas hearing threshold improved in 2 patients. Tinnitus was attenuated in 3 patients, while 1 patient suffered from posttherapeutic onset of tinnitus. Morphological and structural changes due to Menière's disease and treatment procedures were ruled out by cranial MRI. CONCLUSION: The intratympanic application of ototoxic medication is a safe and effective treatment method in severe cases of Menière's disease. Saccotomia should be considered as therapeutic regimen for persistent symptoms after repeated application of gentamicin.

Aged↗
PubMed2001

Lightdosimetric quantitative analysis of the human petrous bone: experimental study for laser irradiation of the cochlea.

BACKGROUND AND OBJECTIVE: Application of laser irradiation targeting the inner ear has to be investigated for therapeutic effectiveness in cochlear injury and dysfunction. In vitro data demonstrate low-level laser-induced photochemical and photobiologic cell response, depending on cell type and irradiation parameters such as light dose. The aim of the presented study was to determine the light dose received by the cochlear hair cells by using different irradiation modalities for the human petrous bone. STUDY DESIGN/MATERIALS AND METHODS: Lightdosimetric assessment was performed in human cadaver temporal bones (n = 13) after removing the cochlear membranous labyrinth. The external auditory meatus, the tympanic membrane (quadrants), and the mastoid bone were illuminated by a helium-neon laser (lambda = 593 nm) and diode lasers of different wavelengths (lambda = 635, 690, 780, and 830 nm). The spatial distribution of transmitted light in the cochlear windings was measured by means of a retrocochlearly positioned endoscopic CCD camera for image processing and was assigned to acoustic frequencies according to the tonotopic organization of the cochlea. For an estimation of the corresponding space irradiance in an intact cochlea, correction factors have been calculated by a Monte Carlo procedure on the basis of experimentally determined optical properties of skull bone. RESULTS: The transmission of light across the tympanic cavity and the promontory depends strongly on wave-length of the laser and the position of the radiator. Transtympanal irradiation results in spatial intensity variations of a factor 4 to 10 within the cochlear windings. The space irradiance in an intact cochlea is 10 to 20 times the measured irradiance. For an irradiation of the mastoid, the light transmission within the cochlea is 10(3) to 10(5) times smaller compared with an irradiation of the tympanic membrane and is extremely variable for different specimens. CONCLUSION: The strong dependence of the cochlear light distribution on various irradiation parameters demonstrates the impact of preclinical lightdosimetric investigations for effective individual laser irradiation of the human cochlea. Because of the observed spatial intensity variations, the optimal external light dose has to be chosen with regard to the tonotopy of the human cochlea. The obtained results are enabling us to apply defined laser light doses to different cochlear winding areas. Mastoidal irradiation leads to therapeutically insufficient light doses within reasonable treatment times, whereas transmeatal irradiation is recommendable. Further studies are mandatory for development of clinical devices for transmeatal irradiation of the cochlea.

Cadaver↗
PubMed2001

[Fluorescence cytology of the urinary bladder].

5-aminolevulinic acid induced fluorescence cystoscopy is invaluable for diagnosing urinary bladder carcinoma and its precursors. Because neoplastic cells of the urinary bladder possess striking fluorescent properties due to protoporphyrin IX, we initiated a study to evaluate the use of fluorescence microscopy in urinary sediments. In 27 patients suspected of having bladder carcinomas, we instilled 5-aminolevulinic acid into their urinary bladders before transurethral therapy and compared thereafter our studies of standard cytological sediments with those made under fluorescence microscopy. The results of fluorescence cystoscopy and those using urinary sediments for neoplastic cells under fluorescence microscopy correlated extremely well. In this pilot study using fluorescence microscopy, we found that we could diagnose with precision urinary neoplasms of different grades of differentiation. Accordingly, we regard fluorescence microscopy as a valuable complement for standard urinary cytology, especially since with fluorescence microscopy we can readily recognize fluorescing cells of highly differentiated urinary tumors and flat premalignant dysplasias.

Aminolevulinic Acid↗
PubMed2001

[Manifestations of gastroesophageal reflux in the otorhinolaryngology tract].

BACKGROUND: Gastroesophageal reflux disease (GERD) is associated with a wide spectrum of otolaryngologic disorders and extraesophageal complications of the upper aerodigestive tract. Previous studies of patients diagnosed with GERD have reported symptoms such as asthma, chronic cough, pneumonia, laryngitis, but also other oral, rhinopharyngeal and laryngeal disorders, e.g. sore throat, globus sensation, and hoarseness. The objective of this study was to determine the incidence of gastroenterologic diseases in patients complaining of upper aerodigestive, pulmonary, laryngeal, pharyngeal, oral, and cervical disorders that are possibly attributable to GERD. PATIENTS: This study included 40 patients, who presented to the department of Otolaryngology with chronic complaints of at least one of the following symptoms or disorders during a minimum period of 3 months: dysphagia (n = 28), sensation of globus pharyngeus (n = 28), hoarseness (n = 20), odynophagia (n = 22), heartburn (n = 16), postnasal drip (n = 15), sore throat (n = 22), cough (n = 14), throat clearing (n = 11), laryngospasm (n = 6), and voice fatigue (n = 6). A complete examination of the head and neck was performed. Inflammatory disorders of the nose and the paranasal sinuses could not be confirmed by history, nasal endoscopy and Water's view x-ray or CT-scan of the paranasal sinuses in all patients. RESULTS: The main otorhinolaryngologic findings were laryngeal lesions (n = 38), including posterior laryngitis, erythema and edema of the interarytenoideal region, and chronic hyperplastic laryngitis. All patients were referred for gastroenterologic evaluation, where esophagogastroduodenoscopy was performed with histological examination of biopsy specimens. Different gastroenterologic diseases such as GERD, gastritis and hiatal hernia were confirmed in 30 of 40 cases, and appeared solely or in combination with each other. GERD was the most frequent gastroenterologic disease (48%), followed by hiatal hernia (45%) and Helicobacter pylori positive antrum gastritis (23%). Patients with GERD were treated with medical antireflux therapy, e.g. 20 mg to 40 mg of the proton pump inhibitor omeprazole daily. There was a remarkably good therapeutic outcome, since laryngeal disorders and findings as the result of gastroenterologic diseases resolved in 29 out of 30 patients. To date, these therapeutic results were maintained for the mean follow-up period of 8 months. CONCLUSIONS: It is concluded that in many patients, suffering from the above-mentioned otolaryngologic symptoms, occult gastroesophageal diseases are present. However, laryngoscopic findings are subtle and meticulous examination is mandatory. Medical antireflux treatment is effective for relief of symptoms and mucosal healing. Thus, extraesophageal otolaryngologic symptoms and laryngeal manifestations are to be considered as extragastrointestinal manifestations mainly of reflux disease.

Adult↗
PubMed2000

Diode laser treatment of hyperplastic inferior nasal turbinates.

UNLABELLED: Background and Objective Different laser types have been used for the treatment of hyperplastic inferior nasal turbinates. The clinical experiences of its treatment by means of a diode laser are presented. Study Design/Materials and Methods A total of 76 patients suffering from nasal obstruction due to hyperplastic inferior nasal turbinates were treated with a continuous diode laser (wavelength of lambda = 940 nm, laser parameter 10 W/energy/turbinate 5 kJ) in "noncontact" mode and under local anesthesia. All patients were refractory to conservative medical treatment. Fifty patients (26 of 50 [52%] with allergic rhinitis and 24 of 50 [48%] with vasomotor rhinitis) were included into this clinical trial with a follow-up of 1 year. The study was conducted by a questionnaire, photo documentation, allergy test, mucociliary clearance test, rhinomanometry, acoustic rhinometry, conventional radiology of the paranasal sinuses, and histology. RESULTS: The mean operation time took 6 min/turbinate, no nasal packing was necessary and no immediate complications (e.g., major bleeding) were observed. During the first 2-4 weeks, nasal obstruction was correlated to the extent of postoperative edema and nasal crusting. Statistical analysis revealed significant improvement of the nasal airflow (rhinomanometry) and nasal cavity volume (acoustic rhinometry) 6 months and 1 year after laser surgery, respectively. A total of 86% of the patients described a subjective improvement of nasal airflow 6 months and 76% of the patients 1 year after laser treatment. The mucociliary function test showed no significant variation in comparison to the preoperative measurements 1 year after laser treatment. CONCLUSION: Diode laser treatment of hyperplastic inferior nasal turbinates is a useful procedure, which can be performed as an outpatient surgery under local anesthesia, resulting in a controlled coagulation and ablation of the soft tissue. The short operation time and the good results provide an excellent patient acceptance.

Adolescent↗
PubMed1997

[Fibroblast growth factor (b-FGF) in serum and urine of patients with head-neck malignancies].

BACKGROUND: The angiogenic peptide basic fibroblast growth factor (b-FGF) has been suggested to significantly promote angiogenesis; a central event for the growth and metastasis of solid tumors. Elevated levels of b-FGF in the serum and urine of patients with various types of cancer have been reported. No information exists about b-FGF levels in patients with primary head and neck cancer. The present study was performed to determine serum and urine levels of b-FGF in these patients. METHODS: b-FGF was quantified in the urine of 50 (62.5%) patients with head and neck cancer as well as 30 (37.5%) patients with diseases unrelated to cancer using an immunoassay with a detection limit of 1.0 pg/ml (FGF basic "Quantikine", DFB00. Biermann GmbH, Bad Nauheim, Germany). Urine was collected from patients before breakfast and centrifuged for 10 min at 1000 g. The supernatants were stored at -80 degrees C until the assay was performed. RESULTS: In the serum and urine of all patients, b-FGF was detectable by immunoassay. Cancer patients revealed significant increased serum b-FGF concentrations, in addition, advanced tumor size (T3/4) showed significant increased b-FGF levels in both serum and urine. There seems to be a correlation between serum b-FGF concentrations with degree of histologic differentiation. CONCLUSION: The results of this study demonstrate that b-FGF levels are elevated in serum and urine of patients with primary head and neck cancer. These findings suggest an involvement of b-FGF in the formation of solid tumors. The value of b-FGF as a non-invasive monitoring of treatment response in cancer therapy, the correlation with angiogenesis in histologic sections as well immunohistochemical detection are the aim of further investigations.

Adult↗
PubMed1990

Ocular effects and detection in tears of aerosolized intranasal cocaine and fluorescein.

Ocular effects of intranasal cocaine were investigated. Twenty-nine outpatients from an otolaryngology clinic received 1 mL of aerosolized cocaine 4% (40mg) in each nostril. Intraocular pressure, corneal sensitivity, pupil size, and tear cocaine concentration were assessed before and after cocaine administration. Pupil size was unchanged; intraocular pressure increased in 75% of patients (not statistically significant). Corneal sensitivity decreased by 11% (P less than .05). Cocaine, however, was not detectable in tears using high-performance liquid chromatography. Since corneal sensitivity decreases after intranasal cocaine administration, it may travel retrograde through the nasolacrimal duct. In addition, three pathways of pharmacologic absorption using fluorescein were explored because of its ease of detection. We measured tear fluorescein concentrations in five patients undergoing intravenous angiograms with fluorescein 25% and in six patients who received aerosolized fluorescein 2% intranasally. Fluorescein concentration was 29 times higher per mg dose in intranasal subjects. This finding suggests that reflux occurs through the nasolacrimal duct.

Administration, Intranasal↗
PubMed1989

Comparison of hand-held, suction, and automated trephines on experimental corneal wound size.

Three trephines were tested to determine their uniformity in creating a circular opening during penetrating keratoplasty. Twenty-one globes (seven per instrument) were trephined with a hand-held, suction or automated trephine. The mean astigmatism was greatest with the hand-held device (mean 0.73 cm) and least with the automated trephine (mean 0.50 cm). The automated and the suction trephines (mean astigmatism 0.51 cm) may result in reduced corneal astigmatism during penetrating keratoplasty.

Astigmatism↗
PubMed1989

Descemetocele formation in a patient with a postoperative corneal dellen.

Dellen formation generally follows localized evaporation and dehydration of the cornea. The condition follows a disruption in the ocular tear film and usually can be managed conservatively with lubricants. We recently treated a patient with a postoperative dellen that progressed to a descemetocele and required a patch graft to prevent perforation. Recognition of this potential complication emphasizes the need to begin treatment immediately after the onset of dellen.

Corneal Dystrophies, Hereditary↗
PubMed1980

An algebraic model for blood concentrations.

The exchange of substances between organs and the blood vessels analyzed and represented in input-output form. The concentration in the blood of the substances is represented by algebraic means and shown to be representable by scators. A holistic representation although not given is anticipated.

Mathematics↗
PubMedDate not supplied

Basic fibroblast growth factor in serum and urine of patients with head and neck cancer.

Between 1996 and 1997 serum and urine levels of basic fibroblast growth factor (b-FGF) in patients with head and neck cancer were measured to answer the following questions: i) Are increased levels of b-FGF in serum and urine detectable in patients with malignant head and neck tumors? ii) Do these parameters correlate with tumor stage and differentiation of tumors? iii) Is there an association between growth behaviour (local or metastatic growth) and b-FGF levels in serum and/or urine? Eighty-nine patients with head and neck cancer as well as 45 patients with diseases unrelated to cancer were investigated. Detectable levels of b-FGF were found in the serum and urine of patients with malignant head and neck tumors. In addition, there was a significant correlation between tumor size and b-FGF levels in either serum or urine. No association of b-FGF concentrations with degree of histologic differentiation and tumor growth behaviour was observed. The results of this study demonstrate that b-FGF levels are elevated in serum and urine of patients with head and neck cancer. These findings suggest an involvement of b-FGF in the formation of solid tumors.

Biomarkers, Tumor↗