Laryngo- rhino- otologie
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Laryngo- rhino- otologie · Apr 2000
Comparative Study[Results of pretherapeutic lymph node diagnosis in head and neck tumors. Clinical value of 18-FDG positron emission tomography (PET)].
Histological studies demonstrate that there is a high percentage of occult nodal metastasis in head and neck malignomas. Patients with positive lymph nodes have a comparatively worse prognosis. A neck dissection is required in these cases. By demonstrating morphological abnormalities, imaging procedures like ultrasound, computer tomography (CT), and magnetic resonance imaging (MRI) can provide important initial informations about possible malignant alteration of the lymph nodes. Positron emission tomography (PET) allows functional metabolic imaging of a suspected tumor site. The aim of this study was a comparative evaluation of different diagnostic procedures with special emphasis on the value of PET in the pretherapeutic diagnosis of nodal spread in head and neck cancer. ⋯ In the primary diagnosis of nodal alterations in the head and neck region, a PET scan has the same diagnostic value as ultrasound or CT. By imaging the metabolism of a suspected nodal metastasis, PET can help to improve the assessment of regions with uncertain anatomic features. To avoid false positive results, acute and chronic inflammatory alterations have to be ruled out before the PET imaging.
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Laryngo- rhino- otologie · Mar 2000
Case Reports[Infection of deep soft tissues of the neck in intravenous drug abuse].
Despite the availability of antibiotics deep neck space infections with anaerobic germs (Ludwig's angina) still carry the potential for significant morbidity and mortality with delayed treatment. Usually, odontogenic infections with involvement of the submandibular space are the source of deep neck space infections in adults, whereas in the pediatric population the most common cause is acute tonsillitis with involvement of the peritonsillar space. During the second half of this century intravenous drug abusers appeared as a new group of patients at risk for deep neck space infections. When peripheral veins sclerosis the addicts feel it necessary to either inject subcutaneously or use the major vessels of the neck and groin. Intravenous drug abusers injecting the major vessels of the neck risk delayed diagnosis because of dissimulation of their injection practices. Dangerous complications of deep neck space infections may be the result. ⋯ Intravenous drug abuse is a rare cause for deep neck space infections but should be considered when swelling of the neck soft tissue of uncertain cause is presented. The search for the diagnose should not keep from taking quick therapeutic steps.
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Laryngo- rhino- otologie · Feb 2000
Case Reports[Necrotizing lymphadenitis (Kikuchi-Fujimoto disease) as a rare cause of cervical lymphadenopathies. Diagnosis and differential diagnosis].
The ENT specialist is often confronted with the inquiry as to the cause of lymph node enlargements. Common causes include inflammations, neoplastic, or autoimmune diseases. We report on three cases of Kikuchi-Fujimoto disease as a benign self-limiting lymphadenopathy of unknown etiology, which is usually found in young women between 20 and 30 years of age. Main symptoms are indolent or light tender, enlarged lymph nodes in the neck area. The correct diagnosis requires the histologic examination of the lymph node. Even for the experienced pathologist the differential diagnosis of malignant systemic disorders can be difficult. ⋯ Kikuchi-Fujimoto disease is a benign, self-limiting lymphadenopathy which is usually diagnosed in young women. Distinguishing Kikuchi-Fujimoto disease from malignant systemic disorders may even be difficult for pathologists using histological examination techniques and requires close cooperation between the ENT specialist and the pathologist. In order to minimize the risk of misdiagnosis and incorrect treatment, the ENT specialist should inform the pathologist about the differential diagnosis of Kikuchi-Fujimoto disease in such cases.
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Laryngo- rhino- otologie · Feb 2000
[Bilateral malfunction of peripheral vestibular organs. Observations of 20 cases of Dandy syndrome].
Dandy's Syndrome initially provokes dizziness and vertigo. Later on patients suffer from motion unsteadiness especially in dark surroundings and from oscillopsies. Gentamicin is ototoxic mostly for the vestibular part of the inner ear, and it is nephrotoxic. It may cause transitory renal dysfunction. Chronic or acute renal insufficiencies inhibit gentamicin clearance. ⋯ The different reactions of the cochlear and the vestibular end organs support the theoretical basis for transtympanic gentamicin treatment of Menière's disease.--Other reasons for Dandy's Syndrome were bilateral Menière's disease, skull fractures, and bilateral vestibular disorders.