Laryngo- rhino- otologie
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Laryngo- rhino- otologie · Oct 1996
Case Reports[Hypoglossal nerve paralysis after endonasal paranasal sinus operation in intubation narcosis].
In the literature the possibility of a pressure trauma to the hypoglossal nerve between the root of the tongue and the ligamentum stylohyoideum is discussed. A recent in vivo study examined the effects of forced reclination of the head on the nerve. ⋯ We believe that the short pressure of the Mcintosh spatula produced the hypoglossal nerve palsy described.
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Laryngo- rhino- otologie · Aug 1996
[Reconstructive surgery in the head-neck area with regional and free tissue transfer].
Operative treatment of head and neck cancer requires radical resection of the tumor with not only severe impairment of important functions like swallowing speech, and respiration but also aesthetic mutilation because of the exposed character of the head and neck region. Therefore the rehabilitation from a functional and cosmetic standpoint is an essential goal of treatment in addition to control of the malignant disease. Fortunately regional plastic surgery offers a variety of options for reconstruction of the defects to receive a solution tailored to each individual patient. ⋯ The potential of modern regional reconstructive surgery enables the surgeon to achieve anatomically and functionally rehabilitation in a one-step procedure in most cases, even after extended resection for head and neck cancer. One should be aware of the fact that these techniques do not offer a significant improvement of prognosis. As such, the aggressiveness of surgical therapy should remain in reasonable relation to the prognosis of the malignant disease.
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Laryngo- rhino- otologie · Aug 1996
[Photodynamic diagnosis of neoplasms of the mouth cavity after local administration of 5-aminolevulinic acid].
The aim of photodynamic diagnosis (PDD) is the complete visualization of all neoplastic lesions in a tumorous organ after topical or systemic application of a tumor selective photosensitizer. In this investigation we performed semiquantitative fluorescence measurements following topical application of 5-aminolevulinic acid (5-ALA) in 11 patients with neoplastic lesions of the oral cavity. ⋯ Labeling of mucosal lesions of the oral cavity with PpIX fluorescence induced by the local application of 5-ALA seems to be a promising diagnostic procedure for neoplastic lesions. Further investigations are required to assess the value of this new diagnostic procedure as a non-invasive and sensitive method for patients with head and neck cancer not only in pre- and postoperative diagnostic studies but also for a fluorescence-guided resection of tumors.
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Laryngo- rhino- otologie · Jul 1996
Review Comparative Study[Local anesthesia in operations of the head-neck area].
Many operations in the head and neck area can be performed under local anesthesia. However, the use of local anesthesia does not automatically reduce the risk for the patient undergoing surgery. ⋯ For several reasons, local anesthesia has become popular for a variety of surgical procedures in the head and neck in recent years. Even though the use of local anesthetics and vasoconstrictors in head and neck procedures has its advantages for both the patient and the surgeon, the limitations for the use of these drugs must always be taken into consideration.
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Laryngo- rhino- otologie · May 1996
[Interdisciplinary therapeutic concept in severe bacterial infections of the central respiratory tract in childhood].
Apart from all advances made in the management of central airway infections, Acute Epiglottitis (AE) and Bacterial Tracheitis (BT) continue to be causes of life-threatening airway obstruction in children. The aim of this retrospective study was to evaluate deficiencies in the diagnostical protocol, to clarify the role of airway endoscopy in acute childhood stridor, and to identify current reasons for fatalities in these diseases. ⋯ In the analysis of the clinical course we found three decisive turning points in managing the disorder; First, the confirmation of the correct admission diagnosis; second, the decision, as to whether an artificial airway should be established; and third, the proper time of extubation. The most decisive factor in decreasing mortality seems to be timely, appropriate presentation at referral centers if AE or BT is suspected. Clinically, progressive management of childhood stridor requires close cooperation between the Pediatric, Anesthesiologic, and ENT Departments. Fiberoptic endoscopy as a guide to current airway management is a major step forward and should be a part of every established protocol.