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Biomedical subjects

U Eysholdt

Publications and source records attributed to U Eysholdt.

At least 19 recordsLinked to original sources
PubMed1996

[Early indications for surgical vocal cord medial relocation in unilateral recurrent nerve paralysis in advanced age].

BACKGROUND: Unilateral vocal cord paralysis is usually treated conservatively. Phonosurgery is not indicated before 1 year after the onset of the palsy as during this period spontaneous recovery can be expected. In the elderly patient conservative voice rehabilitation is often limited by a restricted general condition. In these cases a severe communication disorder may result unless vocal cord function recovers spontaneously. PATIENTS AND METHODS: In 4 patients aged 68 to 79 years who had suffered from latrogenic unilateral vocal cord paralysis for 6 to 9 months, surgical medialisation of the paralysed vocal cord was carried out in local anaesthesia as an Isshiki-Type-I-operation after unsuccessful conservative treatment prior to surgery. RESULTS: In all cases a definite amelioration of voice function could be reached. There were no local or general complications. No spontaneous recovery of nerve function could be detected by electromyography between 6 to 9 months after the operation. Voice function remained stable during this period. CONCLUSIONS: We conclude that in elderly patients with unilateral vocal cord paralysis with no signs of spontaneous recovery and unsuccessful conservative treatment, surgical voice rehabilitation may be indicated before 1 year after the onset of the palsy.

Aged↗
PubMed1996

[Speech-specific cortical potentials--methodologic aspects and initial clinical results].

BACKGROUND: The purpose of this study was to find out whether specific cortical potentials can be evoked and identified after word stimulation. The clinical relevance was to be investigated in patients with aphasic syndromes. MATERIALS AND METHODS: In 20 young adults with no signs of hearing impairment and in patients with manifest aphasic syndromes, word-evoked cortical potentials were compared with those after an equivalent noise stimulus. The test words were selected from the Freiburger Speech Comprehension Test. The duration of the words was between 450 and 640 ms. The stimulus was presented monaurally. The peak level was 70 dB HL. The noise stimulus was produced by modifying a low-band noise. Potentials were measured between the ipsilateral mastoid and the contralateral forehead. Data were analysed offline. RESULTS: In healthy persons, the potentials after word and noise stimulation did not differ until 100 ms after the stimulus onset. After noise stimulation a negative maximum could be seen 100 ms after the stimulus onset, and a positive maximum 200 ms after the stimulus onset. After word stimulation, a positive maximum of higher amplitude than after noise stimulation was measured 150 ms after the stimulus onset, and a negative maximum was measured 270 ms after the stimulus onset. In all test persons the difference curve of word-and noise-evoked potentials revealed a speech-specific component 170 ms (N 170) after the stimulus onset. The single-word analysis showed that the potentials depend on the phonemes of the test word. The potentials do not alter when the stimulus side is changed. In patients with aphasia the potentials depend on the grade of the disturbance of speech perception: global and Wernicke's aphasia show no significant difference of speech-and noise-evoked potentials, whereas in Broca's aphasia a speech specific maximum is apparent. CONCLUSION: The speech-specific component may be regarded as a paradigm of cortical speech detection processes. Electrophysiological speech audiometry by means of word-evoked cortical potentials seems possible and may be used for clinical purposes.

Adult↗
PubMed1996

Direct evaluation of high-speed recordings of vocal fold vibrations.

A digital high-speed camera system for the endoscopic examination of the larynx allows recording speeds of up to 5,600 frames/s. Recordings of up to 1 s duration can be stored and used for further evaluation. Combined with an image processing program the system is able to render x-t diagrams of vocal cord movement. Data acquired from different locations of each vocal cord can be plotted separately. All of the known objective parameters of the voice can be derived from highspeed glottograms.

Endoscopy↗
PubMed1995

[Familial bilateral atresia of the auditory canal with hypertelorism].

The incidence of malformations of the ear is 1:5000, the incidence of stenosis and atresia is 1:12,000. 30% of the malformations are bilateral. In only 0.3% it is the only malformation. Inherited bilateral atresia of the external auditory canal associated with hypertelorism as the only additional malformation has not yet been described. Basing on a case report the way of interdisciplinary rehabilitation of children affected by bilateral hearing impairment is discussed. Special emphasis is on the discussion of the necessity of radiological examinations for the exclusion of cholesteatoma in an atretic ear which could be found in a 5-year old boy of the described family.

Child, Preschool↗
PubMed1995

[Specificity and sensitivity of transient click-evoked otoacoustic emissions (TEOAE)].

Transient click evoked otoacoustic emissions (TEOAE) have been shown to be a good test of hearing impairment especially when used for infant screening. However, occasional cases of false positive results--TEOAEs in spite of severe hearing loss--have been reported. This study encompasses 243 children whose hearing thresholds were known from subjective hearing tests and--in questionable cases--derived from additional auditory evoked potentials. The TEOAEs proved to have a high sensitivity (93%) and a reasonable specificity (67%), if the margin between good and bad hearing was set at 30 dB. However, four ears showed good TEOAEs in spite of poor hearing thresholds. In three cases, the children proved to have a central auditory hearing loss due to a cerebral disorder. One child with bilaterally superb TEOAEs had a unilateral deafness of unclear origin with no obvious retrocochlear or central disorder. Possible explanations under discussion included the presence of a retrocochlear lesion which was too small to show up in the tests used or that the defect was located just between the outer hair cells and the first neuron, for example in the inner hair cells. Additionally, efferent inhibition might cause a functional deafness as described by Rajan (1989) for the guinea pig. The results also show that TEOAEs should always be used in the differential diagnosis of hearing impairment in generally disabled children. The need for hearing aids and especially their adjustment has to be discussed in case of good TEOAEs, i.e., normal peripheral hearing.(ABSTRACT TRUNCATED AT 250 WORDS)

Audiometry, Pure-Tone↗
PubMed1995

[Esophagomediastinal fistula and recurrent laryngeal nerve paralysis after radiotherapy of Hodgkin's disease].

The case of a female patient 21 years old at the time of diagnosis is reported. The patient suffered from stage IV Hodgkin's disease of the nodular sclerotic type with head and neck manifestations in cervical lymph nodes and in the esophagus. After radiotherapy; she suffered from an esophageal/mediastinal fistula and unilateral paralysis of the recurrent laryngeal nerve. Fifteen years later, there are no signs of recurrent tumor growth or a secondary neoplasm. Dysphonia was ameliorated by speech therapy, and surgery was not necessary.

Adult↗
PubMed1994

[Velopharyngeal closure in adolescents after repair of cleft lip, jaw, palate or isolated cleft palate].

We examined two groups of teenagers (between 13 and 21 years of age) who had been surgically treated as small children for congenital cheilognathouranoschisis or cleft palate. A group of 62 teenagers had been treated by the Dept. of Orthodontics at the University of Erlangen-Nuremberg, the other group of 61 by the Dept. of Orthodontics at the University of Rostock. There were differences between the two departments in sequence and time of the surgical closure as well as in the frequence of velopharyngoplasties. The velopharyngeal closure was examined in all patients by means of a flexible fibre endoscope which was pushed forward endonasally up to the choanae. Simultaneously we judged the audibility of the nasal perflation while pronouncing /k/. A residual gap during articulation of /k/ with clearly audible or alternately clearly and discreetly audible nasal perflation was noted in 8 subjects in Erlangen and 14 subjects in Rostock. In subjects whose velum moved only anterior-posteriorly, closure was likely to be less good than in those with a circular closing mechanism of velum and lateral and/or posterior parts of the pharyngeal musculature. In rare cases we found a good velopharyngeal closure in spite of a large gap between the velum and the posterior pharyngeal wall at rest. This was the case when the velum moved more against the upper than the posterior wall of the nasopharynx. Velopharynxplasty did not reduce nasal airflow in case of insufficient function of the velar muscles. Differences in the mode of velopharyngeal closure might be due to statistically significant regional differences in skull structure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Transitory evoked otoacoustic emissions in patients with cerebellopontile angle tumors].

Click-evoked transitory otoacoustic emissions (TEOAE) were recorded in 34 patients suspected of having an acoustic neuroma with consequent hearing loss. Measurements took place one day prior to transtemporal removal of tumor. The evoked otoacoustic emissions were compared to hearing thresholds of the pure-tone audiogram. In 31 of the 34 patients tested, the spectrum of the emissions corresponded to the audiogram, in that an emission was not detectable at frequencies with a hearing loss exceeding 30 dB HL. Three patients showed good emissions in spite of a demonstrable hearing loss. This can be expected when only retrocochlear lesions are present. These results suggest that in most cases the hearing loss accompanying a retrocochlear process is combined with secondary lesions of the cochlea and is rarely due to isolated retrocochlear malfunction.

Adult↗
PubMed1993

[Short-term changes in the larynx and voice after intubation].

The endoscopic and stroboscopic picture of the larynx as well as the voice were examined pre-operatively and on the first or second post-operative day in 75 patients who had been anaesthesized with intubation. The stroboscopic findings were evaluated according to the criteria suggested by Schürenberg (1990). The quality of the voice was estimated with a voice purity index (Moser 1984) and the dynamic and frequency range of the voice was measured. After intubation, we found alterations of the mucous membrane in 73% of the patients: increased amount of visible blood vessels, bleeding into the vocal cords or the trachea, bruises at the processus vocals or the arytenoid cartilages. The stroboscopic picture showed deterioration: pre-operatively large amplitudes and/or mucosal waves became even larger postoperatively, small amplitudes and mucosal waves decreased even further. The timing and the spatial symmetry of the vocal cord movements also deteriorated. On the average, the dynamic range and the frequency range of the voice did not change. However, in individual cases the changes were considerable. The same was true for the parameters of the voice purity index. There was no statistically significant dependency on sex or age of the patients, the duration of the intubation or the diameter of the intubation tube.

Adolescent↗
PubMed1993

[Ear manifestations in adolescents after closure of lip-jaw-palate- or isolated palatal clefts].

We examined two groups of teenagers who had been surgically treated as small children for cleft palate. Most patients were between 13 and 21 years of age. One group had been looked after by the Dept. of Orthodontics at the University of Erlangen-Nürnberg, the other by the Dept. of Orthodontics at the University of Rostock. There were differences in sequence and time of the surgical closure between the two departments. Additionally, 60% of the people treated in Rostock had a velopharyngoplastic, which was rarely the case in Erlangen. In both groups only a few patients had been seen by an ENT-doctor regularly. Only some patients had been previously treated with tubes. There was one patient in each group with a bilateral, most likely genetically determined, sensorineural hearing loss. In Erlangen we examined 66 teenagers (132 ears). Six ears had been previously treated with one or more tympanoplasties. 10 ears needed further treatment due to a seromucotympanon, adhesions, perforations of the ear drum, suspicion of cholesteatoma or insufficient improvement of hearing after previous tympanoplasty. Another 18 ears showed signs of former inflammations. The control group in Rostock included 63 patients (i.e. 126 ears). 14 of the ears examined had undergone one or more tympanoplasties previously. 13 other ears needed further treatment for seromucotympanon, adhesions, perforations of the ear drum, insufficient improvement of hearing after tympanoplasty or cholesteatoma. Residuals due to prior inflammations were found in another 26 ears. Possible reasons for the different occurrence of middle ear problems in both groups are discussed.

Acoustic Impedance Tests↗
PubMed1993

Evoked otoacoustic emissions in children in relation to middle ear impedance.

The influence of changes in middle ear impedance with and without serotympanon on the measurement of evoked otoacoustic emissions (EOAE) was investigated in 108 children between 3 and 12 years of age. Children with proven serotympanon never showed good EOAE. In those who only had changes in middle ear impedance without a serotympanon, the decrease in EOAE amplitude was more related to the magnitude of conductive hearing loss than to the change in impedance itself. These results are compared with those of a neonatal screening project in which some of the 532 healthy fullterm newborns showed poor emissions in the first days of life. It seems reasonable to assume that this is due to incomplete pneumatization of the middle ears of these children, especially as a control audiogram later in their lives showed normal hearing thresholds.

Acoustic Impedance Tests↗
PubMed1990

[The treatment of tinnitus].

Tinnitus does not present a uniform clinical picture but may represent a symptom of local or systemic disease. If it persists after treatment of the underlying disease or condition, symptomatic treatment should be instituted. Selection criteria for the therapeutic strategy are provided by a classification on the basis of the following points: 1. can be masked by a sound, 2. response to parenteral lidocaine. For clinical purposes, these forms of tinnitus can be considered cochlear or neural, respectively. The cochlear form is best treated by physical means (tinnitus masking), peripheral-neural tinnitus by antiarrhythmic drugs. Successful management requires a particular doctor/patient relationship in which the patient needs above-average time and attention, which the physician cannot delegate to others.

Anti-Arrhythmia Agents↗
PubMed1983

[Malignant tumors of the salivary glands: early diagnosis, follow-up and therapy].

Problems of early recognition, postoperative care, and therapy were studied in 207 patients with malignant tumors of the salivary glands, who were treated from 1965 to 1975. Early recognition of these malignant tumors is hampered by the circumstance that only a very short time span is available for diagnosis of the highly malignant types and by the lack of knowledge about specific risk groups among the population. Important for postoperative care is the high rate of local tumor recurrence, especially of salivary-duct, mucoepidermoid, acinic-cell, and adenoid-cystic carcinomas, ranging from 71% to 83%. Late recurrence is frequent. There is also a close connection between local recurrence and lymphogenic or hematogenic formation of metastases. The therapy of choice for malignant tumors of the salivary glands is surgery and, depending on the tumor type, postoperative irradiation. Chemotherapy is at present still of minor importance. Histologic tumor type and tumor stage determine the extent of the surgical procedures, which range from lateral parotidectomy with preservation of the facial nerve to radical parotidectomy with or without reconstruction of the facial nerve. In spite of radical surgery, many malignomas of the salivary glands, particularly the adenoid-cystic carcinomas, tend to recur. In such cases the long-term prognosis is poor and cannot be improved by postoperative irradiation. Supplemented by the experience gained in postoperative care, we have summarized the guidelines along which these 207 salivary-gland malignomas were treated into a modified concept of therapy.

Female↗
PubMed1983

[Malignant salivary gland tumors. Effect of histology and site on prognosis].

From 1965-1975 we treated 207 patients with malignant tumors of the salivary glands. While the localization of these tumors (minor salivary glands, submandibular gland, parotid gland) had no distinct influence on their prognosis, the influence of the histological tumor type is substantial. After histological reclassification of all tumors with grading of differentiation of adenoid cystic carcinomas (tubular, solid, cribriform), mucoepidermoid and acinic cell carcinomas (both well-, respectively poorly differentiated) we could establish 4 different prognostic groups by observing the respective determinate survival rates. The most favorable prognosis is found for tubular adenoid cystic carcinomas, well-differentiated acinic cell and mucoepidermoid carcinomas (5 year survival rate 100%), followed by the solid and cribriform adenoid cystic carcinomas, the poorly differentiated acinic cell carcinomas and the salivary duct carcinomas (5 year survival rate about 65%). With 5 year survival rates of 40%, the adenocarcinomas, poorly differentiated mucoepidermoid carcinomas and squamous cell carcinomas have a poor prognosis, and the prognosis of the carcinomas in pleomorphic adenoma and of undifferentiated carcinomas is even poorer with a 5 year survival rate of 25%.

Humans↗
PubMed1982

Maximum length sequences -- a fast method for measuring brain-stem-evoked responses.

A technique is described which allows faster evaluation of brain-stem-evoked responses (BER) than the conventional method. It is based on a pseudorandom arrangement of the click stimuli in "maximum length sequences' (MLS). In this way, the responses to each click stimulation can overlap with the responses to other clicks. A simple deconvolution of the averaged response to MLS leads to a click response pattern which is in good agreement with the responses obtained by conventional BER audiometry (BERA). Thus, the procedure for the assessment of BER can be accelerated by a factor of about 6. Repetition rates up to 856 Hz were tested. Even for high repetition rates, the main features of the BER are preserved, although the latency of wave V increases by as much as 1.3 ms.

Adult↗
PubMed1981

[The influence of therapy on adenoid cystic carcinomas of the parotid gland (author's transl)].

The occurrence of adenoid cystic carcinomas of the parotid gland is relatively uncommon. From 1964-1974, we performed surgery on 20 patients with such tumors. In these patients, the course of the disease was characterized by local recurrences, the formation of hematogeneous metastases, and long survival times. We have found that patient prognosis is distinctly influenced by the histological type of the neoplasm. Thus, the tubular form has a much better prognosis than the cribriform or the solid types of tumors. On the basis of the "determinate survival rate" of our patients, we were unable to demonstrate a definite positive effect of either radical surgery or radiation therapy on the course of the disease.

Adolescent↗
PubMed1980

Adenoid cystic carcinoma of the head and neck. Controllable and uncontrollable factors in treatment and prognosis.

Histological re-examination of 64 adenoid cystic carcinomata showed that 15 of them were different tumours, mainly adenocarcinomata. The remaining 40 adenoid cystic carcinomata were solid in 6 cases, cribriform in 24 cases and tubular in 14 cases. No precise classification was possible in 5 cases of adenoid cystic carcinoma. Uncontrollable factors important for the prognosis of adenoid cystic carcinomata included the histological type and the site of the tumour: major salivary glands (28 cases), area of paranasal sinuses (11 cases) and minor salivary glands (10 cases). Adenoid cystic carcinomata of tubular type or situated in minor salivary glands had a relatively favourable prognosis related to survival rate, 'state of health' and tendency to recurrence. Controllable factors exerted a favourable influence on the commonly poor prognosis of adenoid cystic carcinomata. They included an early diagnosis and, because of the tendency to recurrence, radical surgery and radiotherapy. The poor long-term prognosis of this tumour was due to a tendency to local recurrence (80% of cases) and mainly haematogenous metastasis (37% of cases). Lymphogenous metastasis was less frequent (6% of cases).

Adult↗