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W Dillo

Publications and source records attributed to W Dillo.

6 recordsLinked to original sources

Pediatric cochlear implantation in cochlear malformations.

OBJECTIVE: This study aimed to present relevant information about pediatric cochlear implantation in malformed cochleas based on the experience gathered with 12 implanted children. STUDY DESIGN: A retrospective analysis was performed. SETTING: All patients were diagnosed and implanted at the Medical University of Hannover. Medical check-ups were performed regularly. The rehabilitation concept was developed by the Cochlear Implant Center of Hannover. PATIENTS: All children were female and were between 2 and 13 years of age at the time of implantation, with the average age being 4 years and 2 months. Only patients who were younger than 14 years of age and implanted between September 1992 and October 1995 were evaluated. INTERVENTION: Diagnostic computed tomographic scans including three-dimensional reconstructions and magnetic resonance imaging images were performed. In all cases, Nucleus devices (Mini 22 or 20 + 2) were implanted. Medical University of Hannover standard surgical technique was used, although in most cases, facial nerve monitoring and electrically evoked auditory brain stem responses were additionally recorded. Total or partial obliteration of the middle ear had occurred in two cases. An anteroposterior approach was used four times. The implantation was followed by the standard rehabilitation procedure for children. RESULTS: No serious complications occurred. All children responded to acoustic stimuli and showed improvement in their speech production. However, one autistic child performed poorly, and for another child suffering from a CHARGE syndrome, results still are pending. CONCLUSIONS: Given suitable preconditions, cochlear implantation is feasible with an acceptable risk of complications. Implantation appears to be beneficial in most cases with cochlear malformations provided that eighth nerve and cochlear lumen are present.

Adolescent↗

Malformations in cochlear implant patients.

OBJECTIVE: To report on cochlear implantation in children with bony inner ear malformations. PATIENTS: 30 children with bony inner ear malformations who have received cochlear implants. INTERVENTIONS: High-resolution spiral computed tomography is used to identify malformations. Magnetic resonance imaging is used to detect the presence of an acoustic nerve and determine the integrity of the auditory pathway and central nervous system structures. Both imaging techniques may be used intraoperatively, as well as facial nerve monitoring and electrical auditory brainstem response monitoring. Three-dimensional reconstructions are helpful in preoperative planning. Large vestibular aqueducts and vestibular malformations can be successfully managed. RESULTS: Postoperative results have been encouraging, although children with malformations tend to occupy the lower third of rehabilitation results of all children with implants.

Child↗

[Possibilities and limitations of CT angiography in comparison to DSA in intracranial aneurysm].

PURPOSE: The purpose of this study was to determine the value of CT angiography in the detection of intracranial aneurysms and to discuss its qualities compared with DSA. METHODS: 26 patients with subarachnoid bleeding confirmed by unenhanced CT or lumbar puncture were examined with CT angiography. In 23 of these patients results of DSA were available. RESULTS: In 21 cases 30 aneurysms were found with DSA, whereas in two cases there were no aneurysms. The size of the aneurysms was between 3 and 36 mm. With CT angiography two small 3 mm aneurysms were not detected. In three patients with vasospasms the diagnosis was primarily confirmed by CT angiography. The sizes measured by CTA and DSA were approximately the same. CONCLUSION: Because of the limited spatial resolution small aneurysms (< 5 mm) could not be diagnosed in CTA. Definitive exclusion of aneurysms is therefore not possible. Aneurysms larger than 5 mm are reliably diagnosed. CTA is indicated if identification of the bleeding aneurysm is sufficient for further patient management.

Adult↗

[Cochlear implant in inner ear abnormalities and footplate malformation].

BACKGROUND: Malformations of the cochlea can cause deafness and otogenic meningitis. Cochlear implantation in children with such malformations, which are sometimes quite complex, require special attention before, during and after surgery. PATIENT: The concept developed for these patients at Hannover Medical School is illustrated in a patient with severe bilateral inner ear malformation and bilateral stapes defect. Implantation of a cochlear implant was performed in this 2-year-old girl. A large endostal sack originating from the inner ear, which had caused meningitis twice, was observed in the right middle ear. Both ears had to be obliterated to prevent recurrent meningitis. RESULTS: The child had no post-operative problems and the initial rehabilitation efforts have been successful. The immediate and differentiated reactions to stimulation are very encouraging. This article briefly summaries all diagnostic and therapeutic procedures established over the last three years at Hannover Medical School in cases of implantation into a malformated cochlea. In particular, we describe perioperative radiology (CT scans, MRI and plain radiographs), facial nerve monitoring and intraoperative screening for "hearing sensations", details of surgical technique, and possible postoperative complications. CONCLUSIONS: Based on experience with 13 of these cases, we discuss the different aspects of implantation into a malformated cochlea. Given certain preconditions implantation into a malformated cochlea may be recommended.

Child, Preschool↗

[Jugular vein thrombosis as incidental ultrasound finding in tumor patients].

At present thrombosis of the internal jugular vein is an uncommon event that is now more frequently associated with diagnostic or therapeutic catheterization. If an apparent spontaneous thrombosis occurs, malignancy should be considered in the differential diagnosis. Two cases of clinically asymptomatic thrombosis of the internal jugular vein are presented. A 69-year-old female patient with metastasizing renal cell carcinoma had bilateral thrombosis and a 73-year-old male with a small laryngeal carcinoma had a unilateral thrombosis. Increased blood coagulability as part of a paraneoplastic syndrome was considered to be the possible etiology. The role of sonography in the diagnosis is emphasized.

Aged↗