Clinical Impact of Rare and Compound Mutations of Epidermal Growth Factor Receptor in Patients With Non-Small-Cell Lung Cancer.

Background: Standard therapy of advanced non-small-cell lung cancer harboring an activating mutation in the epidermal growth factor receptor (EGFR) gene is treatment with tyrosine kinase inhibitors (TKI). However, for rare and compound mutations of the EGFR gene, the clinical evidence of TKI therapy is still unclear.

Patients And Methods: A total of 2906 lung cancer samples were analyzed for EGFR mutations during routine analysis between 2010 and 2017.

Three-dimensional force analysis of surgical manipulations at the long process of the incus.

Purpose: Surgical manipulation with application of inappropriate force may damage middle ear structures leading to hearing loss. This work analyzes the forces applied in simulated otosurgical exercises in a laboratory set-up by measuring the spatial components of applied forces with objective assessment criteria. With these criteria, the individual force characteristics applied by the surgeon can be quantified and an objective feedback can be given about their surgical maneuvers.

Effect of Tissue Heterogeneity on the Transmembrane Potential of Type-1 Spiral Ganglion Neurons: A Simulation Study.

Electric stimulation of the auditory nerve by cochlear implants has been a successful clinical intervention to treat the sensory neural deafness. In this pathological condition of the cochlea, type-1 spiral ganglion neurons in Rosenthal's canal play a vital role in the action potential initiation. Various morphological studies of the human temporal bones suggest that the spiral ganglion neurons are surrounded by heterogeneous structures formed by a variety of cells and tissues.

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results.

Objective: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant.

Methods: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warble-tone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up.

On the origin of ear clicks during deglutition or pressure equalization.

To explore the origin of clicking sounds in the ear during deglutition or other pharyngeal movements, which are interpreted differently in the literature. Experimental study at a tertiary referral centre. Acoustic phenomena during a forced opening test of the Eustachian tube (ET) were studied in a temporal bone model.

The measurement of Eustachian tube function in a hyperbaric chamber using an ear canal microphone.

Objective: The purpose of this study was to further the understanding of the opening of the Eustachian tube in relation to changes in barometric pressure.

Design: An ear canal microphone was used to measure the specific sounds related to tube opening and possible eardrum movements. Five subjects with normal tube function were examined in a hyperbaric chamber (up to 304 kPa).

Positioning Accuracy in Otosurgery Measured with Optical Tracking.

Objectives: To assess positioning accuracy in otosurgery and to test the impact of the two-handed instrument holding technique and the instrument support technique on surgical precision. To test an otologic training model with optical tracking.

Study Design: In total, 14 ENT surgeons in the same department with different levels of surgical experience performed static and dynamic tasks with otologic microinstruments under simulated otosurgical conditions.

"Physiological" Ear Clicking: Its Origin and Potential Usability as a Test Tool for the Eustachian Tube Function.

Objective: To explore the origin of "physiological" ear clicks during deglutition or other pharyngeal movements, which, in contrast to disturbing frequent clicks under pathologic conditions, mostly remain unnoticed by the patient.

Study Design: Clinical experimental study at a tertiary referral center.

Methods: Ear clicks were recorded by a microphone sealing the external ear canal parallel to endoscopic or manometric evaluations of the Eustachian tube function.

Regional Pattern of Dementia and Prevalence of Hearing Impairment in Germany.

Objectives: To determine the association between hearing impairment and dementia.

Design: Cross-sectional study.

Setting: Claims data of the Allgemeine Ortskrankenkasse, the largest public health insurance company in Germany.

Can nasal decongestants improve eustachian tube function?

Objective: To evaluate the effect of nasal decongestants on eustachian tube (ET) opening.

Study Design: A prospective nonrandomized study.

Setting: A tertiary referral center.

Conservative management of post-intubation tracheal tears-report of three cases.

Iatrogenic tracheal rupture is a rare complication after intubation. We present three patients with tracheal tears. In all of these patients, a common finding was a lesion of the posterior tracheal wall with postoperative subcutaneous and emphysema as the first clinical sign of the rupture.

Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial.

Background: Tracheal intubation without muscle relaxants is usually performed with remifentanil and propofol or sevoflurane. Remifentanil 1.0 to 4.

Polydimethylsiloxane for injection laryngoplasty: two cases necessitating tracheotomy.

The surgical treatment of glottic insufficiency due to lesions of the recurrent laryngeal nerve has become a routine procedure in the last few decades. In particular, injection laryngoplasty with polydimethylsiloxane (PDMS) has proved to be an easy, effective and safe method for vocal fold medialization. It is a biologically inert substance having almost ideal properties as a filler; complications related to its intralaryngeal use such as migration, or granuloma formation are extremely rare and allergic reactions have not been reported as yet.

Comparative Study between the Surgeon's Intraoperative Evaluation and Histopathology for Diagnosis of Laryngeal Lesions.

Objective. To compare the surgeon's evaluation and histopathology for diagnosis of laryngeal lesions. Material.

Laryngeal injuries following endotracheal intubation in ENT surgery: predictive value of anatomical scores.

Endotracheal intubation has been associated with a threefold higher incidence of laryngopharyngeal complaints following anesthesia in comparison to laryngeal mask airway. Such complaints, including hoarseness and sore throat, have been reported in up to 90% of patients within 24 h of extubation. The purpose of this study was to determine which preoperatively documented clinical and anatomic parameters are predictive of laryngo-pharyngeal trauma resulting from elective endotracheal intubation.

Would an endosteal CI-electrode make sense? Comparison of the auditory nerve excitability from different stimulation sites using ESRT measurements and mathematical models.

Unlabelled: Regarding potential endosteal cochlear implant electrodes, the primary goal of this paper is to compare different intra- and extra-cochlear stimulation sites in terms of current strengths needed for stimulating the auditory nerve. Our study was performed during routine cochlear implantation using needle electrodes for electric stimulation and by visually recording electrically elicited stapedius reflexes (ESRT) as a measure for the stimulus transfer. Of course this rather simple setup only allows rough estimations, which, however, may provide further arguments whether or not to proceed with the concept of an endosteal electrode.

Anesthesia with Propofol versus Sevoflurane: Does the Longer Neuromuscular Block under Sevoflurane Anesthesia Reduce Laryngeal Injuries?

Anesthesia can be maintained with propofol or sevoflurane. Volatile anesthetics increase neuromuscular block of muscle relaxants. We tested the hypothesis, that sevoflurane would cause less vocal cord injuries than an intravenous anesthesia with propofol.

Fibroblast colonization of modified silicone films.

Hypothesis: Development of silicone films with hydrophilic surface properties and with associated fibroblast colonization for tympanic membrane reconstruction.

Background: Silicone films are used in ear surgery for splinting fresh eardrum perforations. The cure rate is high if the perforation is small and fresh.

Cochlear Implants.

Cochlear implants have evolved to become the treatment of choice for severely hearing-impaired patients. Speech signals are picked up by a microphone, processed and then delivered to the stimulating electrodes (the current maximum number being 22) that are placed on an electrode array implanted into the scala tympani of the cochlea. The target cells of electrical stimulation, the spiral ganglion cells (SGCs), are located some distance away in the central axis of the cochlea.

Cochlear implants.

Cochlear implants have evolved to become the treatment of choice for severely hearing-impaired patients. Speech signals are picked up by a microphone, processed and then delivered to the stimulating electrodes (the current maximum number being 22) that are placed on an electrode array implanted into the scala tympani of the cochlea. The target cells of electrical stimulation, the spiral ganglion cells (SGCs), are located some distance away in the central axis of the cochlea.

Distribution of circulating natural killer cells and T lymphocytes in head and neck squamous cell carcinoma.

Objective: Natural killer (NK) cells are capable of eliminating malignantly transformed cells without prior sensitization. In contrast to NK-cells, T lymphocytes possess antitumourous activity that is restricted to major histocompatibility complex (MHC) recognition. The aim of this study was to determine the causes of the different distributions of these cell types in the peripheral blood of patients with head and neck squamous cell carcinomas (HNSCC).

Development of a specially tailored local drug delivery system for the prevention of fibrosis after insertion of cochlear implants into the inner ear.

A cochlear implant (CI)-associated local drug delivery system based on dexamethasone (DMS) was developed with the purpose to inhibit the growth of fibrotic tissue which influences the signal transmission from the CI to the neurons of the inner ear. For the realization of a targeted DMS delivery the following concepts were combined: modification of the silicone-based electrode carrier by incorporation of DMS and a DMS-containing polymeric coating chemically attached on the surface of the electrode carrier. It was demonstrated that the coated CI showed a high coating stability in a simulated implantation procedure.

Taste function after stapes surgery.

Objective: A manipulation of chorda tympani nerve (CTN) is frequently necessary during the surgical therapy of stapedial ankylosis. The aim of this study was to re-assess the taste function before and after stapes surgery in patients with unilateral stapes ankylosis.

Methods: Eighteen patients (14 female and 4 male) with unilateral stapedial ankylosis were included.

Effects of high hydrostatic pressure on bacterial growth on human ossicles explanted from cholesteatoma patients.

Background: High hydrostatic pressure (HHP) treatment can eliminate cholesteatoma cells from explanted human ossicles prior to re-insertion. We analyzed the effects of HHP treatment on the microbial flora on ossicles and on the planktonic and biofilm states of selected isolates.

Methodology: Twenty-six ossicles were explanted from cholesteatoma patients.