Comparison of 3 mm versus 4 mm rigid endoscope in diagnostic nasal endoscopy.

Objective: Compare nasal endoscopy with 3 mm versus conventional 4 mm rigid 30° endoscopes for visualization, patient comfort, and examiner ease.

Methods: Ten adults with no previous sinus surgery underwent bilateral nasal endoscopy with both 4 mm and 3 mm endoscopes (resulting in 20 paired nasal endoscopies). Visualization, patient discomfort and examiner's difficulty were assessed with every endoscopy.

Giant fibrolipoma of the esophagus.

Benign tumors of the esophagus are uncommon, representing <0.5% of esophageal tumors. Fibrolipomas are a subset of benign fibrovascular tumors, which present with dysphagia, odynophagia, and substernal fullness.

Effects of antithrombogenic agents on microvenous anastomoses in a rat model.

Objective: To compare venous thrombosis rates among animals treated with aspirin, clopidogrel bisulfate, and ketorolac tromethamine using an anastomotic "tuck" model.

Design: Single-blind randomized animal study.

Setting: An animal laboratory at a tertiary care academic referral center.

Repair of esophageal perforation due to anterior cervical spine instrumentation.

The complication of esophageal perforation after anterior cervical spine fusion for cervical spine disease is rare but potentially fatal. We describe two cases of esophageal perforation found by esophagoscopic visualization. In one patient, primary closure could not be achieved, and a submental island flap was used to repair the defect.

Diagnostic procedures for detection of lymph node metastases in cancer of the larynx.

Squamous cell carcinoma is the most common malignant neoplasm of the larynx. One of the most important influences on prognosis is the presence of metastases to the cervical lymph nodes. Accurate determination of lymph node involvement is therefore a prerequisite for individualized therapy in patients with squamous cell carcinoma of the larynx.

Combined radiochemotherapy with docetaxel in patients with unresectable locally advanced head and neck tumors.

Background: As the treatment with docetaxel in metastatic head and neck cancer resulted in an encouraging response rate, the following phase-I study examined the effects of a combined radiochemotherapy with weekly docetaxel in patients with inoperable advanced head and neck tumors.

Patients And Methods: Six patients with Stage IV head and neck cancer were included into the study. Within the treatment regimen the primary tumor and the involved lymph nodes were irradiated up to a total dose of 70 Gy, the non involved cervical and supraclavicular lymph nodes received 50 Gy in conventional fractionation.

Lymph node detection of head and neck squamous cell carcinomas by positron emission tomography with fluorodeoxyglucose F 18 in a routine clinical setting.

Background: Accurate determination of lymph node involvement is a prerequisite for individualized therapy in patients with squamous cell carcinoma of the head and neck region. In a previous study, we showed that positron emission tomography (PET) with fluorodeoxyglucose F 18 with and without attenuation correction is superior to magnetic resonance imaging for this purpose in a scientific setting.

Objective: To evaluate the diagnostic accuracy of a shortened PET protocol (acquisition time, 20 minutes) in a routine clinical setting.

[Clinical significance of allergic reactions in glucocorticoid therapy].

Background: Glucocorticoids are widely used in medicine. Within the last few years, however, patients have become very suspicious of corticoids. The attending physicians frequently has to use a great deal of persuasion prior to applying this very effective and often indispensable group of medication.

Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts.

Background: Extramedullary plasmacytoma (EMP) is a rare entity belonging to the category of non-Hodgkin lymphoma. EMPs make up 4% of all plasma cell tumors and occur mainly in the upper aerodigestive tract (UAD). Seven patients with EMP included in this evaluation were under the authors' care and have been clinically followed since 1990.

[Clinical aspects of the osteolytic (inflammatory) phase of cochlear otosclerosis].

During the last years it has been demonstrated that the active stage of otosclerosis (French: otospongieuse) is caused by an osteolytic inflammation associated with a measles-virus infection. Under influences that are not yet well understood (e.g.

Allergic reactions after systemic administration of glucocorticosteroid therapy.

Objective: To describe patients who developed allergic reactions (ie, erythema on their face and body, itching, flushing, drop in blood pressure, respiratory distress, and cold sweats) immediately after intravenous injection of prednisolone hemisuccinate (SoluDecortin H, E Merck, Darmstadt, Germany).

Setting: Academic medical center.

Results: Three of 4 patients had a positive reaction to an intracutaneous test with prednisolone hemisuccinate (SoluDecortin H) but no reaction to the additive sodium succinate.

Changes in tumor oxygenation during combined treatment with split-course radiotherapy and chemotherapy in patients with head and neck cancer.

Purpose: To evaluate the changes in tumor oxygenation during definitive split-course radiochemotherapy in locally advanced head and neck cancer (lymph nodes and primaries).

Materials And Methods: Twenty-four patients with locally advanced head and neck cancer were investigated pretherapeutically and during a defined course of radiochemotherapy (RCTh) with a total dose of 70 Gy given in 35 fractions over 9 weeks (2-week break after 30 Gy). In weeks 1 and 6, the patients received chemotherapy (5 FU and mitomycin C) concomitant with irradiation.

Clinical phase II evaluation of paclitaxel in combination with cisplatin in metastatic or recurrent squamous cell carcinoma of the head and neck.

Background: Paclitaxel as single agent has shown marked activity in several malignancies. The aim of the present phase II trial was to determine the activity of paclitaxel/cisplatin in patients with metastatic or recurrent squamous cell carcinoma of the head and neck.

Patients And Methods: 200 mg/m2 paclitaxel was administered over three hours followed by cisplatin (100 mg/m2), repeated every 22 days.

Treatment of an esophagorespiratory fistula by insertion of an esophageal Montgomery and tracheal dynamic stent after failure of conventional endoprosthesis.

Esophagorespiratory fistulae at the adult age can develop through malignant tumor growth, endoscopy, bougienage, laser therapy, or through a radiochemotherapy. We report a female patient with inoperable bronchial cancer, who developed a symptomatic esophagorespiratory fistula during radiochemotherapy with cisplatin. At first, conventional plastic tubes and then novel selfexpanding silicone-coated Gianturco-Song stents were used in an unsuccessful attempt to close the fistula.

[Occlusion of an esophagobronchial fistula by implantation of a Montgomery esophageal and a dynamic tracheal stent after failure of conventional endoprosthesis].

Esophagorespiratory fistulas were frequently caused by malignant tumors, bougienage, laser therapy or radiochemotherapy. We here report the case of a patient with inoperable bronchial cancer, who developed a symptomatic esophagorespiratory fistula during combined radiochemotherapy with Cisplatin. A sufficient occlusion of the fistula could not be achieved with conventional plastic tubes or novel self-expanding silicone-coated Gianturco Song stents.

Experiences with the Montgomery Salivary Bypass Tube (MSBT).

Patients with hypopharyngeal and cervical esophageal strictures and fistulas caused by advanced malignancy, ingestion of caustic material, or following surgery or radiation therapy often suffer from marked dysphagia. In such cases the implantation of a Montgomery Salivary Bypass Tube (MSBT) can be an effective therapeutic option to bridge the fistulous tract or bypass a stenosis. Being able to eat and drink without the need for intravenous supplementation or nasogastric or gastrostomy tube feeding in general greatly improves the patient's quality of life.

Effectiveness of hyperbaric oxygen therapy in patients with acute and chronic cochlear disorders.

Over the course of 18 months 359 patients with defined acute and chronic inner ear disorders who had not responded to treatment with medication were given hyperbaric oxygen (HBO) therapy. The inner ear diseases of the patients were divided, based on the duration of their conditions, into four symptomatic groups. Of the patients who had had hearing loss for less than 3 months, noticeable improvement or complete recovery was seen in 13% (20 dB in at least three test frequencies); 25.

Paclitaxel administered over 3 h followed by cisplatin in patients with advanced head and neck squamous cell carcinoma: a clinical phase I study.

We have performed a clinical phase I trial of a combination treatment with paclitaxel given as 3-hour infusion and cisplatin to determine the maximum tolerated dose and the dose-limiting toxicity in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. Treatment was repeated every 21 days. Doses administered ranged from 135 mg/m2 paclitaxel/75 mg/m2 cisplatin to 250 mg/m2 paclitaxel/100 mg/m2 cisplatin.

Somatostatin receptor scintigraphy and therapy of neuroendocrine (APUD) tumors of the head and neck.

Through the development of somatostatin scintigraphy with the labeled somatostatin analog Indium111-Octreotide, it has recently become possible to accurately diagnose primary tumors of the APUD system as well as their metastases, since these tumors usually have somatostatin receptors. Experience with this method is already available for endocrine and exocrine tumors of the gastrointestinal tract, neuroendocrine and breast tumors, small cell bronchial carcinomas and certain lymphomas. In the present study, this new diagnostic technique was used for the first time in various head and neck tumors (carcinoid of the larynx, Merkel cell tumor, glomus tumor of the carotid and glomus jugulare tumor).

Clinical phase I study of paclitaxel followed by cisplatin in advanced head and neck squamous cell carcinoma.

We performed a clinical phase I trial of the combination of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and cisplatin in patients with recurrent or metastatic squamous cell carcinoma of the head and neck, using a 3-hour infusion of paclitaxel followed by a 1-hour infusion of cisplatin. Treatment with this combination was repeated every 21 days. Patients who had received prior treatment with platinum-containing regimens were excluded.

Comparison of fluorine-18-fluorodeoxyglucose PET, MRI and endoscopy for staging head and neck squamous-cell carcinomas.

Unlabelled: Accurate, preoperative assessment of tumor extent and lymph node involvement is mandatory for individualized therapy in patients with squamous-cell carcinomas (SCCs) of the head and neck region. Metabolic imaging, [18F]fluorodeoxyglucose (FDG) PET and MRI were compared with postoperative, histologic tissue characterization.

Methods: Dynamic and static PET with 370 MBq [18F]FDG up to 60 min postinjection and MRI were compared prospectively in 22 patients with head and neck SCCs.

[Detection of somatostatin receptors in tumors in the area of the head and neck and their clinical importance].

The development of a radiolabelled somatostatin analogue Indium-111-Pentetreotide makes the detection of somatostatin receptor-bearing tumours by scintigraphic techniques possible. The existence of high-affinity binding sites for somatostatin has been described previously for most endocrine active tumours of the gastroenteropancreatic system (GEP), malignant lymphomas, small cell lung carcinomas, a subgroup of breast tumours and several types of neuroendocrine related human tumours. Using this new diagnostic tool we investigated some head and neck tumours of neuroendocrine origin (carcinoid of larynx, Merkel cell carcinoma, paragangliomas) with the newly developed radiolabelled somatostatin analogue Indium-111-Pentetreotide whether in vivo visualisation of somatostatin receptors might be possible.