Laryngologie, Rhinologie, Otologie
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Laryngol Rhinol Otol (Stuttg) · May 1987
Comparative Study[Histologically controlled comparison of palpation and sonography in the diagnosis of cervical lymph node metastases].
During a period of 2 1/2 years palpation and high-resolution real-time sonography were carried out in 83 non-selected patients with head and neck carcinomas to diagnose metastatic involvement of cervical lymph nodes. The findings were compared with the results of the microscopic examination of the lymph nodes from the neck dissection specimen. Sonography is characterized by a high sensitivity in the detection of lymph node metastases. ⋯ Therefore, it can be presumed that pathological transformations besides the reactive hyperplasia occurring during metastatic involvement will also influence the echographic representation of lymph nodes. The accuracy data of other methods used for detecting lymph node metastases (computed tomography and lymphoscintigraphy) were compiled from the literature and compared with those of palpation in more than 5000 patients. Basing on our experiences with sonography in this field we tried to assess the chances and limitations of ultrasound in the pretherapeutic diagnosis of cervical lymph node metastases.
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Laryngol Rhinol Otol (Stuttg) · Nov 1986
[Differences in the neuromuscular blockade of the larynx and thenar muscles following relaxation with vecuronium].
To objectivate the clinical impression of different neuromuscular depression in the larynx- and limb-musculature, an attempt was made in 5 patients to quantify laryngeal muscle relaxation by electromyographic recordings of evoked responses from the vocalis muscle during endolaryngeal microsurgery. Mechanographic and evoked electromyographic recordings of the thenar muscles were obtained simultaneously. Nearly total suppression of evoked responses at the peripheral muscle site was observed after a bolus dose of either 60 micrograms/kg or 100 micrograms/kg of the nondepolarising muscle relaxant Vecuronium. ⋯ In no case was the recommended intubating dose (ED 95) of 60 micrograms/kg sufficient for complete relaxation of the vocalis muscle. The present results do not support that the extent and/or time course of intrinsic laryngeal muscle relaxation correlates with peripheral neuromuscular depression in a quantitative manner. The different degree of relaxation achieved by Vecuronium in the hand and larynx is probably due to their different content of acetylcholine receptors.
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Laryngol Rhinol Otol (Stuttg) · Oct 1986
Biography Historical Article[Was Beethoven's deafness caused by Paget's disease? Report of findings and study of skull fragments of Ludwig van Beethoven].
Paget's disease of bone (osteitis deformans) has been repeatedly named as a possible cause for Ludwig van Beethoven's deafness. In 1985 a descendent of Franz Romeo Seligmann (a Viennese medical historian who in 1863 had studied Beethoven's mortal remains on the occasion of their relocation) presented to us three bone fragments allegedly from Beethoven's cranium. ⋯ They did not show signs of Paget's disease of bone. It must therefore be concluded that Beethoven's deafness was not caused by Paget's osteitis deformans.
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Laryngol Rhinol Otol (Stuttg) · Oct 1986
[Edema prevention with aprotinin in elective interventions in the area of the jaw and face (preliminary results)].
The effect of aprotinin on oedema prevention and pain following different maxillo-facial surgical interventions has been recorded in an open, non-comparative pilot study with 87 patients. After high dosage application of the proteinase inhibitor aprotinin only few cases exhibited a fully developed oedema and tension pain in the postoperative period. Postoperative wound-healing appeared also remarkably convenient. Incidence and severity of the postoperative swelling were altogether distinctly reduced in comparison to what would have been expected as the usual postoperative clinical condition of such patients.
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The Arabian doctor Avicenna (980-1037) described the first orotracheal intubation in dyspnoea. The history of peroral endotracheal intubation actually begins in the 18th century. ⋯ Regular peroral intubation to keep the respiratory tract clear during narcosis was first applied by Franz Kuhn in 1900; unfortunately, the pioneer himself did not live to see his method become a routine procedure. It was only as late as 1945, that endotracheal intubation became part of hospital practice at our clinic.