A standardized marking procedure for ENT operations to prevent wrong-site surgery: development, establishment and subsequent evaluation among patients and medical personnel.

Purpose: Wrong-site surgeries are rare but potentially serious clinical errors. Marking the surgical site is crucial to preventing errors, but is hindered in the ENT field by the presence of many internal organs. In addition, there is no standardized marking procedure.

Tobacco use in patients with ENT tumours: Deficits in the provision of education and smoking cessation support.

Purpose: Smoking is not only one of the main risk factors for the development of most malignant and numerous benign ENT tumours but also has an important influence on therapy and prognosis. Even quitting smoking at the time of diagnosis significantly reduces mortality. Patients have a particularly strong desire to stop smoking when they are diagnosed.

Randomized phase-III-trial of concurrent chemoradiation for locally advanced head and neck cancer comparing dose reduced radiotherapy with paclitaxel/cisplatin to standard radiotherapy with fluorouracil/cisplatin: The PacCis-trial.

Background And Purpose: This multicenter, phase 3 trial investigates whether the incorporation of concurrent paclitaxel and cisplatin together with a reduced total dose of radiotherapy is superior to standard fluorouracil-cisplatin based CRT.

Materials And Methods: Patients with SCCHN, stage III-IVB, were randomized to receive paclitaxel/cisplatin (PacCis)-CRT (arm A; paclitaxel 20 mg/m on days 2, 5, 8, 11 and 25, 30, 33, 36; cisplatin 20 mg/m, days 1-4 and 29-32; RT to a total dose of 63.6 Gy) or fluorouracil/cisplatin (CisFU)-CRT (arm B; fluorouracil 600 mg/m; cisplatin 20 mg/m, days 1-5 and 29-33; RT: 70.

[Gastroesophageal reflux disease and chronic sinusitis].

Background: It is increasingly suggested that there may be a connection between gastrooesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) and chronic sinusitis. We therefore wished to establish whether the literature contains sufficient evidence to support this assumption.

Material And Methods: We performed a search in Medline (PubMed) and EMBASE with the key words "GERD, GER, reflux, sinusitis, chronic sinusitis".

[Complications of lumbar administration of 5% sodium fluorescein solution for detection of cerebrospinal fluid fistula].

Background: The detection of cerebrospinal fluid fistulas in the region of the anterior or lateral skull base can be difficult. The fluorescein test with lumbar administration of 5% sodium fluorescein solution can be used to detect cerebrospinal fluid leakage, identify weak points in the dura, achieve precise localisation of cerebrospinal fluid fistulas and to check intraoperatively that watertight dural closure has been achieved. However, use of the test is problematic as the fluorescein solution used is not licensed for this indication in Germany and severe neurological complications are described in the literature.

Use of sodium fluorescein solution for detection of cerebrospinal fluid fistulas: an analysis of 420 administrations and reported complications in Europe and the United States.

Background: Localization of dural fistulas in the region of the anterior or lateral skull base may be difficult. For many years, a sodium fluorescein solution of 0.5 to 5% (2.

[Dacryocystorhinostomy - state of the art, indications, results].

Background: In the ophthalmological literature external dacryocystorhinostomy (DCR) is considered the gold standard for the treatment of lacrimal duct stenoses. Rhinologists, on the other hand, favour the endonasal approach.

Materials And Methods: On the basis of an extensive review of the literature and our own longstanding experience we present an overview of the causes, the necessary diagnostic procedures and the surgical management of lacrimal duct stenosis.

[Chronic bilateral necrotizing and destructive granulomatous inflammatory process in the region of the paranasal sinuses and the orbita as manifestation of localized Wegener's granulomatosis].

Case Report: Granulomatous infectious processes have a wide differential diagnosis. This report describes the case of a 73-year-old woman who had gone through an 8-year ordeal involving several paranasal sinus operations, development of chronic facial pain, orbital exenteration of the left eye, and now threatening loss of the remaining right eye on account of progression of the chronic inflammation. Despite repeated histologic examination of ENT material by various pathologic institutes, neither the histology nor laboratory parameters were able to point us in the right direction.

[First experiences in endonasal duraplasty without antibiotics].

Background: Available evidence does not support the use of prophylactic antibiotics in patients with CSF fistulae. The question arises whether an antibiotic prophylaxis or therapy is mandatory planning an operative closure of frontobasal dural lesions.

Patients: In a retrospective survey a consecutive sample of 7 patients who had undergone endonasal ENT-department of two universities and an university teaching hospital was taken.

Magnetic resonance imaging following fat obliteration of the frontal sinus.

The paper describes the evaluation of magnetic resonance imaging (MRI) following osteoplastic flap procedure with fat obliteration. MRI scans performed in patients after surgery between 1st January 1986 and 31st December 1997 were evaluated. Outcome parameters were time-dependent changes in the distribution of adipose or connective tissue, development of necroses or oil cysts, recurrences, inflammatory complications, or mucocoeles.

Nasopharyngeal endoscopy adds to reliability of clinical diagnosis of infectious mononucleosis.

Frequently, the clinical picture in the oropharynx alone does not lend itself to a reliable differentiation between acute pharyngotonsillitis in infectious mononucleosis and a streptococcal inflammation. Such a differentiation, however, is essential for the indication of antibiotic therapy. Therefore, it was the aim of the present study to investigate whether or not endoscopic verification of larger-than-normal lymphatic tissue with fibrinous membranes in the nasopharynx would enhance the reliability of diagnosis.

Packing in endonasal surgery.

Nasal packing is used to control bleeding in epistaxis and after endonasal surgery, for internal stabilization, and to prevent synechiae or restenosis, particularly after surgery. Generally accepted standards regarding the materials that should be used for packing, how long the packing should be left in place, or the indications for nasal packing are lacking. In view of the present lack of standardization and the many different packing materials used, we review the currently available materials and outline their respective properties, indications, and risks.

[Endonasal endoscopic surgery of maxillary sinus mucoceles after Caldwell-Luc operation].

Background: Mucoceles of the maxillary sinus after Caldwell-Luc procedure develop by entrapment of mucosa. Specially mucoceles far laterally were being revised by a second transoral approach. This procedure carries the risk of damaging the infraorbital nerve.

[Transoral correction osteotomy in transdental fracture dislocation that healed in the wrong position].

Undislocated odontoid fractures may lead on the basis of conventional x-rays only to a wrong conclusion with regard to biomechanical aspect of stability. In this aspect the classification based on Anderson and D'Alonzo takes a high risk to misunderstand the fracture stability and can results in a secondary fracture dislocation. Therefore it is important to make the decision about operative versus nonoperative treatment on the base of the trauma mechanism.

Osteoplastic frontal sinus surgery with fat obliteration: technique and long-term results using magnetic resonance imaging in 82 operations.

Objective: To evaluate the intraoperative and late complications of osteoplastic sinus surgery with fat obliteration with long-term magnetic resonance imaging (MRI) follow-up.

Methods: The operative records of all patients who underwent osteoplastic frontal sinus surgery with fat obliteration between January 1, 1986 and December 31, 1997 were reviewed and the postoperative clinical course and magnetic resonance imaging (MRI) scans were analyzed if available. MRI analyses revealed that changes in the distribution of fatty and fibrous tissue, the development of necrosis or oil cysts, recurrences, inflammatory complications, and mucoceles were time-dependent occurrences.

[Value of multimedia educational software in training of the paranasal sinus surgeon].

Background: When starting sinus surgery, every surgeon has to pass through an individual learning curve. To avoid complications, costly, time-consuming surveillance is necessary. We wanted to analyse the impact of multimedial teaching software on the learning curve.

[Nuclear magnetic resonance tomography after fatty tissue obliteration of the frontal sinus].

Background: The osteoplastic flap procedure with fat obliteration has been hailed as the gold standard of definitive frontal sinus procedures for chronic inflammatory disease. The value of magnetic resonance imaging (MRI) in postoperative follow-up has not yet been sufficiently examined.

Methods: All postoperative MRI scans performed in patients undergoing surgery between January 1, 1986, and December 31, 1996 were evaluated.

Videoendoscopic analysis of nasal steroid distribution.

Topical corticosteroids are one of the main pillars in the treatment of nasal polyps. The exact topography of their intranasal deposition has not yet been adequately visualised. The intranasal distribution of a 1% sodium fluorescein solution applied with original Pulmicort Topinasal (budesonide) metered pump bottles was analysed by videoendoscopy.

Surgical experience and complications during endonasal sinus surgery.

Objective/hypothesis: The introduction of optical aids for endonasal sinus surgery has not produced the expected drop in the rate of serious intraoperative complications.

Study Design/methods: 1. Retrospectively, consecutive procedures of different surgeons were analyzed in regard to major complications (periorbital injury, orbital lesion, dural injury, endocranial lesion, damage to the internal carotid artery).

[Complications with permanent damage in endonasal paranasal sinus operations--more frequent in experienced surgeons?].

Background: The rate of serious complications in endonasal sinus surgery has not gone down although optical aids are widely used nowadays. Are serious complications caused more often by unexperienced or experienced surgeons using a microscope and/or endoscope?

Methods: We defined serious complications as follows: death, persistent neurological deficits or permanent loss of vision, and injury to the internal carotid artery. Two different studies were made: the first consecutive 300 interventions of 6 sinus surgeons were evaluated.

[Tolerance, subjective complaints and mucociliary clearance in rhinitis sicca before and after nasal irrigation with Rhinomer Force 1].

Background: Rhinitis sicca is a widespread disease, caused by a variety of factors. There are many different treatments, but none is more reliable than the other.

Methods: In a prospective study we examined 12 patients before and after a ten-day course of nasal irrigation with Rhinomer Force 1 regarding their symptoms, the mucociliary clearance measured with the saccharin test according to Andersen and tolerance of therapy.