Endoscopic negative pressure therapy (ENPT) of a post-laryngectomy pharyngocutaneous fistula: first report of a new treatment method.

In the current first report, it is shown how a post-laryngectomy pharyngocutaneous fistula was successfully closed by endoscopic negative pressure therapy (ENPT; also termed endoscopic vacuum therapy, EVT). The duration of negative pressure treatment was 14 days. Up until now, ENPT has been used for treatment of transmural defects in the rectum and esophagus.

[Endoscopic negative pressure therapy of a post-laryngectomy pharyngocutaneous fistula-first report of a new therapeutic method. German version].

In the current first report, it is shown how a post-laryngectomy pharyngocutaneous fistula was successfully closed by endoscopic negative pressure therapy (ENPT; also termed endoscopic vacuum therapy, EVT). The duration of negative pressure treatment was 14 days. Up until now, ENPT has been used for treatment of transmural defects in the rectum and esophagus.

Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis.

Objective: This randomised, double-blind, parallel group phase II/III study with adaptive two-stage design and interim analysis compared the efficacy and tolerability of spray (containing a Salvia officinalis fluid extract) against placebo in the treatment of patients with acute viral pharyngitis. -

Study Participants: in two study parts, a total of 286 patients with subjective and objective evidence of pharyngitis were randomized. In the first study part 122 patients were enrolled.

[Is the observation of patients with sleep-apnea-syndrome after surgery of the upper airway in an intensive care unit generally necessary?].

Background: Although it is known that after surgery of the nose and/or the paranasal sinuses serious complications can arise for patients suffering from Sleep-Apnea-Syndrome (SAS), there exists no general recommendation for postoperative care of these patients. This retrospective analysis is dealing with the question whether it is generally necessary to observe SAS-patients after nasal surgery including intubation in an Intensive Care Unit (ICU).

Patients And Methods: 24 Patients of the ORL-Dept.

[Life-threatening complications after plastic tracheostomy closure. Which length of hospital stay according to clinical and forensic viewpoints is necessary?].

Background: Plastic tracheostomy closure represents a safe surgical method with rare but potentially life-threatening complications such as dyspnea. Because of the general tendency to reduce hospital stay, the medically necessary time of hospitalization should be evaluated.

Methods: Ninety-eight patients operated in succession were examined retrospectively for extent, time, and therapeutic procedures in cases of life-threatening dyspnea.

[Sodium selenite reduces acute radiogenic damage of the rat parotid glands during fractionated irradiation].

Background: In vitro studies show that sodium selenite is a potential radioprotector in normal cell cultures, but not tumor cells. The aim of this study was to evaluate the cytoprotective potency of sodium selenite during conventional fractionated irradiation of rat salivary glands, but also on tumor response and metastasis frequency of rhabdomyosarcomas R1H.

Method: The head-neck area of male WAG/RijH rats and the tumor in the flank were irradiated with (60)Co-gamma-rays (60 Gy/30 fractions/6 weeks).

[Retrospective analysis of the prognostic significance of depth of invasion of advanced oral and oropharyngeal squamous cell carcinomas with lymph node metastases].

Background: The often documented prognostic influence of the depth of invasion of oral and and oropharyngeal squamous cell carcinomas should be examined using more advanced lymphogenic metastasized tumours. This should be compared with the established prognostic factors T stage and capsular rupture of the lymph node metastases.

Methods: Five-year postoperative follow-ups of 66 patients treated consecutively were studied retrospectively.

[Course and therapy of an invasive aspergilloma of the skull base in a non-immunocompromised patient].

Fulminant-invasive sinus aspergillosis affects immunocompromised patients and is usually lethal because of intracranial complications. Chronic-invasive and non-invasive types occur in non-immunocompromised patients. In these cases, intracranial extension is possible and life-threatening.

Course and therapy of intoxication with imidazoline derivate naphazoline.

Objective: Imidazoline derivatives like naphazoline have a firm place in diagnostics and therapy of otorhinolaryngology because of their vasoconstrictive and decongestive properties. Their alpha-adrenergic potential could induce not only local but also systemic side effects like hypertension and tachycardia which can increase a life-threatening intoxication. Signs of imidazoline intoxication are excessive systolic and diastolic hypertension and hypotension, bradycardia with arrhythmia, respiratory depression, excitation or severe CNS depression.

Oxygenation of tumor recurrences following fractionated radiotherapy of primary tumors. Studies on the rhabdomyosarcoma R1H of the rat.

Background And Purpose: Tumor oxygenation is well recognized as a major factor of tumor response to radiotherapy. In this respect, a number of studies have examined the response of primary tumors, whereas little is known about the oxygenation of tumor recurrences after radiotherapy. It was the aim of this study to investigate the oxygenation of tumor recurrences after preceding irradiation of the primary tumor.

Pentoxifylline enhances tumor oxygenation and radiosensitivity in rat rhabdomyosarcomas during continuous hyperfractionated irradiation.

Purpose: To examine the influence of the hemorrheologic agent pentoxifylline (PTX) on tumor oxygenation and radiosensitivity.

Material And Methods: Tumor oxygenation in rat rhabdomyosarcomas R1H after PTX administration (50 mg/kg body weight) was measured using interstitial pO(2) probes (Licox CMP system and Eppendorf pO(2)-Histograph). Tumors were irradiated with (60)Co gamma-irradiation using single doses (15 and 30 Gy), conventional fractionation (60 Gy/30 fractions/6 weeks), and continuous hyperfractionation (54 Gy/36 fractions/18 days) in combination with PTX or an equivalent volume of physiological saline.

Therapy for acute nonpurulent rhinosinusitis with cineole: results of a double-blind, randomized, placebo-controlled trial.

Objectives/hypothesis: Nonpurulent rhinosinusitis can be treated successfully with cineole.

Study Design: Prospective, randomized, double-blinded, placebo-controlled study.

Methods: We compared efficacy and safety of cineole capsules with placebo capsules in 152 patients with acute rhinosinusitis (76 patients in each treatment group).

[Reconstruction of the frontal sinus with a calvarium split galea periosteum transplant after inflammatory complications].

After reconstruction of the frontal sinus with alloplastic material, with or without obliteration of the lumen, inflammatory complications may occur. The authors present a plastic-surgical functional reconstruction technique for revision surgery in cases of inflammatory complications following frontal sinus implantation of alloplastic material, by means of a modified autologous calvarian split graft. The inflammatory complications after primary reconstruction or obliteration of the frontal sinus occurred after a period of 1-10 years.

[Capsular rupture of lymph node metastases as most significant prognostic factor in head and neck squamous cell carcinomas--Hamburg experiences].

Background: TNM classification of squamous cell carcinomas of the head and neck contains only size and number of the lymph node metastases. The histological criterion of capsular rupture and its prognostic significance was assessed by an exact histological scheme of capsular rupture and extracapsular spread of the metastasis and was compared with N0 or lymph node metastases without capsular rupture respectively.

Methods: Incidences of distant metastases, tumor recurrences, and survival of 194 consecutive patients with squamous cell carcinomas of the head and neck were investigated.

The prognostic impact of metastatic pattern of lymph nodes in patients with oral and oropharyngeal squamous cell carcinomas.

In patients with squamous cell carcinomas of the oral cavity and the oropharynx the presence or absence of nodal metastases still is the most important predictive factor. The discriminative significance of extracapsular spread and the influence of features of the primary tumor-such as size and depth of invasion-on metastatic pattern, treatment failure and survival were evaluated. Five-year postoperative follow-ups of 115 consecutively treated patients were studied retrospectively concerning the incidence of distant metastases, local and regional recurrences and the 5-year survival rate.

[The valence of dilatational tracheotomy].

After standardizing surgical procedures around 1900 Shelden, Toye, Weinstein and Ciaglia developed the percutaneous dilational tracheotomy (PDT). At present it is recognized that about 50 % of the anesthesiological Intensive care Units (ICU) in Germany are using the PDT while favoring the Ciaglia-technique in the majority of cases. Further techniques are known as Griggs-, Fantoni-, Percu-Twist- and Blue-Rhino-method.

[Universal newborn hearing screening in Marien Hospital Hamburg from September 1999 till April 2002].

Background: With a prevalence of 5 in 1000 newborns with a hearing disorder, the congenital hearing disorders apparently constitute a serious health problem. The aim of this study was the introduction of a universal newborn hearing screening at our clinic. We also investigated if a universal screening only on parents' demand is possible.

[Therapy of iatrogenic pharyngocutaneous fistulas--possibilities of surgical treatment].

Background: During tumor surgery of the upper respiratory and digestive tract, pharyngocutaneuos fistulas may occur postoperatively. Predisposing factors are tissue disorders, as can be seen after radiation therapy or wound infections. The aim of this study was to create a systematic approach to the treatment of such complications.

[Advance in therapy of acute rhinitis--comparison of efficacy and safety of xylometazoline in combination xylometazoline-dexpanthenol in patients with acute rhinitis].

Background: Acute Rhinitis is based on an inflammation of the nasal mucous membrane with nasal discharge and obstruction. Symptomatic treatment includes local application of decongestants as Xylometazoline and epithelia-protective agents as Dexpanthenol. After proving a synergistic effect of Xylometazoline and Dexpanthenol (Nasic) in patients after nasal surgery, this result should be checked in patients with acute non-allergic rhinitis.

[Comparison between transoral microsurgery by CO2 laser and conventional surgical therapy for T2 glottic carcinoma].

Background: Transoral CO2 laser excision of early glottic cancer was first introduced in the 1970s. Since then it has become a serious alternative to surgery with conventional instruments.

Patients And Methods: Between January 1987 and December 1997, 46 patients with T2 N0 M0 glottic carcinoma have been treated by either transoral laser microsurgery or fronto-lateral partial laryngeal resection with curative intention.

[Naphazoline intoxication: course and therapy].

Background: As potent alpha-adrenergic agonists imidazoline derivatives like naphazoline are frequently used drugs because of their vasoconstrictive and decongestant properties. Beside their well-known local side effects also rare systemic ones like hypertension, excitability and nausea are possible. In case of intoxication this can enhance to ischemia of vital organs, bradycardia with arrhythmia, respiratory depression, hypothermia, excitation or marked sedation.

[Cutaneous malignant melanoma of the head and neck with intermediate tumor thickness: the role of elective lymph node dissection for clinical stage I].

Background: At present a tendency towards a more limited surgery in the treatment of clinical stage I and II melanoma exists. The controversy of elective lymph node dissections (ELND) in stage-I-melanoma with intermediate tumor thickness continues to be discussed. The sentinel lymph node biopsy may provide improved staging accuracy.

Studies on the radioprotective potency of amifostine on salivary glands of rats during fractionated irradiation: acute and late effects.

The purpose of this study was to evaluate the radioprotective potential of amifostine on the salivary glands of rats with respect to the acute and late effects. The head and neck area of WAG/RijH rats was irradiated with (60)Co-gamma rays (60 Gy/30f for 6 weeks). Amifostine (250 mg/m(2) body surface) or an equal volume of physiologic saline was applied intravenously 15 min before each irradiation.

A phase III placebo-controlled study in advanced head and neck cancer using intratumoural cisplatin/epinephrine gel.

Patients with recurrent or refractory head and neck squamous cell carcinoma received cisplatin/epinephrine injectable gel or placebo gel injected directly into the clinically dominant tumour. The double-blind phase III trial comprised of up to 6 weekly treatments over 8 weeks, 4 weekly evaluation visits, and then monthly follow-up; open-label dosing began as needed after three blinded treatments. Tumour response was defined as complete (100% regression) or partial (50-99% regression) sustained for > or =28 day, and patient benefit as attainment of palliative or preventive goals prospectively selected by investigators and patients.

[Reducing late toxicity with amifostine in fractionated irradiation of the rat salivary glands].

Clinical studies show that amifostine can reduce xerostomia and mucositis during radiotherapy of head and neck cancers. The aim of this study was to evaluate the radioprotective potency of amifostine with respect to late toxicity of salivary glands of rats. The head-neck-area of 8 male WAG/RijH rats (295 +/- 7 g) were irradiated with 60Co-gamma-rays (60 Gy/30 f/6 weeks).