[Surgical voice rehabilitation following laryngectomy].

A survey is given concerning different techniques for the restoration of voice after total laryngectomy. Our experiences with tracheo-esophageal shunts without or with valve prostheses are compared and the advantages of specific surgical methods are reported. The threedimensional postoperative voice recording (fast Fourier-transformation) is demonstrated.

[The reaction of the human middle ear mucosa to the implantation of plastics. A light and electronmicroscopic study].

We studied the middle ear mucosal reaction to implanted plastic materials. The implants were removed from noninfected middle ears from 9 months to 20 years postoperatively. In most cases the mucosa was normal, and invariably the implant was covered by a thick fibrous capsule.

[Thyroid gland diseases in old age. Clinical aspects and therapy. Part 2: Hypothyroidism, bland struma, thyroid gland neoplasms].

Because of the slow lingering course of this disease, the diagnosis of hypothyroidism is generally made by chance particularly because the euthyroidism can change unobserved into manifest hypothyroidism. In old age the course of hypothyroidism may be oligosymptomatic: only adynamia and abnormal susceptibility to cold may be diagnosed. Because of the augmented oxygen requirement of tissues during therapy with thyroid hormones the medical treatment of hypothyroidism has to start - especially in old age - with a fractional part of the final dose.

[Obliteration of the mastoid air cell system with porous tricalcium phosphate ceramic. An animal experiment of the bulla tympanica of the pig (author's transl)].

The paper reports on an animal experiment on the obliteration of mastoid cavities with tricalcium phosphate ceramic. The pneumatic air cell system of the bulla tympanica of pigs of 11-12 weeks of age was totally removed in one group of animals and partially removed in the second group. In this second group, apical part of the bulla was left intact.

Ceramic implants in otologic surgery.

We have examined the suitability of ceramic materials for reconstruction in middle ear surgery. The excellent tolerance of bio-inert aluminum oxide ceramic implanted into the middle ear has been shown by our electron microscopic studies and clinical experience. Our implants developed for ossicular chain reconstruction were covered by a delicate middle ear mucous membrane within a few weeks.

[Thyroid diseases in old age. Clinical aspects and therapy. Part 1: Hyperthyroidism].

The clinical signs of thyroid disease in older people may differ considerably from those in younger patients. The symptoms are often incorrectly interpreted and attributed to old age. The age is also important to the kind of therapy.

[HLA association of insulin-dependent diabetes mellitus type I (author's transl)].

HLA antigens A, B, C, DR and BF were determined in 14 sibling pairs with type I diabetes and in 61 patients without familial risks. Significantly positive associations of the disease with HLA DR3 and DR4 and a negative association with DR2 were found. Positive and negative associations with the various HLA A, B and C antigens (A1, A2, B8, B15, B18, Cw3) are of a secondary nature due to strong genetic coupling with primarily associated DR alleles.

[Practical recommendations concerning the use of aluminum oxide implants in middle ear surgery (author's transl)].

Our experiences with the implantation of bionert aluminum oxide ceramic middle ear prostheses are described. We have found that each implant must be shaped to fit exactly the specific defect encountered in the middle ear. Recommendations for shaping and inserting the implants are detailed.

[Ceramic implants in middle ear surgery (author's transl)].

Several different ceramic materials have recently been used in middle ear surgery: bio-inert aluminum oxide, bio-active glass and bio-active tri- and tetra-calcium phosphate. We have compared these materials with regard to their physical properties as well as various characteristic biological reactions when used in implantation. All of these materials were found to exhibit excellent biocompatibility.

[Permeability barriers of the inner ear. Fine structure and function].

This paper summarizes the own electronmicroscopic studies on the inner ear fine structure (guinea pig) with the peroxidase tracer technique and mainly with the freeze-etch-technique. New findings are presented concerning the blood-perilymph-barrier, perilymph-endolymph-barrier as well as cell membrane differentiations of the stria vacularis cells and the sensory epithelia. The physiological and pathophysiological meaning is discussed in detail.

[Reconstruction of the frontal base with ceramic materials (author's transl)].

Frontal base reconstruction presents significant problems, expecially during initial handling of injuries involving comminuted fractures. The main goal is the immediate application of effective surgical techniques to reestablish a functonally and aesthetically acceptable state with a minimum of additional stress to the patient, who is usually in a polytraumtic, critical condition. The use of ceramic in such situations offers several particularly advantageous features: a) There is no additional surgical stress from obtaining autogenic transplants.

The blood-perilymph barrier.

Freeze fracture replicas of the guinea pig inner ear were studied under the electron microscope to define the blood-perilymph barrier morphologically. This barrier is represented basically by the continuous endothelium of the inner ear capillaries. The endothelial cells contain only a few micropinocytotic vesicles in contrast to those of the stria vascularis vessels.

The fine structure of the cochlear plexus.

Ultrathin sections and freeze-fracture replicas of the guinea pig cochlear plexus were studied under the electron microscope. Generally, the capillaries possess a continuous endothelial cell layer. The endothelial cells are connected by tight junctions.

Freeze-fracture study of taste bud pores in the foliate papillae of the rabbit.

In freeze-fractured specimens of taste buds from the foliate papillae of rabbits, the intercellular spaces are separated from the pore of the taste bud by zonulae occludentes of the "tight-type". Below these tight junctions numerous desmosomes are found at irregular intervals. The epithelial cells adjacent to the pore are also joined by single strands of fusion.

[Carotid body and glomus vagale tumours (author's transl)].

Twentyfour chemodectomas (non-chromaffin paragangliomas) of the neck seen in 20 patients are presented. The investigation including angiography and the surgery in respect to risk factors and preoperative assessment is discussed. The long term results are also presented.

[Hypacusis in acquired hypothyroidism (author's transl)].

We examined 56 patients with latent or clinical hypothyroidism and a control group of 18 patients with acute hypothyroidism. We were especially interested in the localization and extent of hearing abnormalities. 45% of the patients with chronic hypothyroidism showed a hearing loss.

[Hypacusis in acquired hypothyroidism (author's transl)].

We examined 56 patients with latent or clinically manifest hypothyroidism and 18 patients with acute athyreosis as a control group. We were especially interested in the localization and extent of hearing abnormalities. 45% of the patients with chronic hypothyroidism showed a hearing loss.

[The pathogenesis of the acute symptoms of Menière's disease (author's transl)].

The pathogenesis of vertigo attacks and hearing fluctuations in Menière's disease is discussed on the basis of new electronmicroscopic observations on the perilymph endolymph barrier. The zonulae occludentes (z.o.