Skull base osteomyelitis: HBO as a therapeutic concept Effects on clinical and radiological results.

Introduction: Skull base osteomyelitis is a rare but potentially life-threatening disease. It usually occurs as a complication of severe otitis externa or infection in the nasopharynx, often in immunocompromised patients. The therapeutic strategy is complex, patient-specific and requires interdisciplinary cooperation.

Delayed facial nerve palsy after vestibular schwannoma resection: risk factors, extent and prognosis.

Introduction: Facial nerve palsies may develop during the postoperative period of microsurgical removal of vestibular schwannomas (VSs), even after normal facial function for days or weeks after surgery. The aim of this study was to identify the pathomechanism and predictive factors of delayed palsy.

Material And Method: The clinical data of 193 patients who underwent vestibular schwannoma surgery between 2012 and 2021 were retrospectively analyzed.

Odynophagia as the first symptom of monkeypox infection.

A 50-year-old patient with confirmed monkeypox infection presented with odynophagia and nocturnal dyspnea. Clinically, there was a lesion on the tongue without any skin lesions and fibrinous plaques on the right tonsil with asymmetry of the palatoglossal arch. Due to a suggested abscess in the CT scan, a tonsillectomy à chaud was performed.

Preference matters: New aspects on how foreign bodies should and could be removed from a child's airway.

Background: Foreign body aspiration in children is a potentially life-threatening event that can be diagnosed and treated by airway endoscopy. We aimed to analyze the influence of the examiner's experience and preference on the choice of the technique and the resulting complication rate.

Methods: In this international study, experts in the field documented their preferred and applied technique as well as the outcome of each case of foreign body removal.

[Odynophagia as the first symptom of monkeypox infection].

A 50-year-old patient with confirmed monkeypox infection presented with odynophagia and nocturnal dyspnea. Clinically, there was a lesion on the tongue without any skin lesions and fibrinous plaques on the right tonsil with asymmetry of the palatoglossal arch. Due to a suggested abscess in the CT scan, a tonsillectomy à chaud was performed.

New software for three-dimensional visualization and calculation of volume of living cells.

We investigated the physical properties of head and neck cancer cells to develop new cell-selective treatment strategies for squamous cell carcinoma. For better characterization and subsequent differentiation of cancerous and healthy cells, we developed MATLAB-based software to analyze image stacks obtained using a confocal laser-scanning microscope. A confocal laser-scanning microscope was used for three-dimensional (3-D) imaging of a cell line from the head and neck area.

Laryngeal sensation and its association with aspiration and cough in children with neurological impairment.

Background: Aspirations are frequent in children with neurological impairment. They significantly increase the risk for acute and chronic respiratory insufficiencies leading to high morbidity and mortality. Laryngeal sensation deficits have been linked to aspirations in adults and are a suspected cause for dysphagia in children.

Retrospective in silico evaluation of optimized preoperative planning for temporal bone surgery.

Purpose: Robot-assisted surgery at the temporal bone utilizing a flexible drilling unit would allow safer access to clinical targets such as the cochlea or the internal auditory canal by navigating along nonlinear trajectories. One key sub-step for clinical realization of such a procedure is automated preoperative surgical planning that incorporates both segmentation of risk structures and optimized trajectory planning.

Methods: We automatically segment risk structures using 3D U-Nets with probabilistic active shape models.

i3PosNet: instrument pose estimation from X-ray in temporal bone surgery.

Purpose: Accurate estimation of the position and orientation (pose) of surgical instruments is crucial for delicate minimally invasive temporal bone surgery. Current techniques lack in accuracy and/or line-of-sight constraints (conventional tracking systems) or expose the patient to prohibitive ionizing radiation (intra-operative CT). A possible solution is to capture the instrument with a c-arm at irregular intervals and recover the pose from the image.

Patient quality of life after vestibular schwannoma removal: possibilities and limits to measuring different domains of patients' wellbeing.

Purpose: Since the 1980s, health-related quality of life (HRQOL) has been recognized in the assessment of medical treatment. To determine the health-related quality of life (HRQOL) of vestibular schwannoma (VS) patients, a specific questionnaire that has been validated in different languages is essential.

Methods: The Short Form-36 Health Survey (SF-36) and PANQOL questionnaires in German were evaluated in patients after removal of a VS via the translabyrinthine approach.

Automatic Registration for Navigation at the Anterior and Lateral Skull Base.

Objective: Navigation systems create a connection between imaging data and intraoperative situs, allowing the surgeon to consistently determine the location of instruments and patient anatomy during the surgical procedure. The best results regarding the target registration error (measurement uncertainty) are normally demonstrated using fiducials. This study aimed at investigating a new registration strategy for an electromagnetic navigation device.

High-precision evaluation of electromagnetic tracking.

Purpose: Navigation in high-precision minimally invasive surgery (HP-MIS) demands high tracking accuracy in the absence of line of sight (LOS). Currently, no tracking technology can satisfy this requirement. Electromagnetic tracking (EMT) is the best tracking paradigm in the absence of LOS despite limited accuracy and robustness.

Toward an automatic preoperative pipeline for image-guided temporal bone surgery.

Purpose: Minimally invasive surgery is often built upon a time-consuming preoperative step consisting of segmentation and trajectory planning. At the temporal bone, a complete automation of these two tasks might lead to faster interventions and more reproducible results, benefiting clinical workflow and patient health.

Methods: We propose an automatic segmentation and trajectory planning pipeline for image-guided interventions at the temporal bone.

Cochlear Implantation in Patients With Single-sided Deafness After the Translabyrinthine Resection of the Vestibular Schwannoma-Presented at the Annual Meeting of ADANO 2016 in Berlin.

Objective: To evaluate effectiveness of the cochlear implant (CI) to facilitate single-sided deafness (SSD) rehabilitation following translabyrinthine resection of the vestibular schwannoma.

Study Design: Retrospective patient review.

Setting: Single center, University hospital.

Robotic cochlear implantation: feasibility of a multiport approach in an ex vivo model.

Purpose: A recent clinical trial has shown the feasibility of robotic cochlear implantation. The electrode was inserted through the robotically drilled tunnel and an additional access through the external auditory canal was created to provide for means of visualization and manipulation. To obviate the need for this additional access, the utilization of multiple robotically drilled tunnels targeting the round window has been proposed.

Influence of patient-specific anatomy on medical computed tomography and risk evaluation of minimally invasive surgery at the otobasis.

Purpose: With the increasing use of new minimally invasive approaches in temporal bone surgery, the need arises for evaluation of the risk of injury to sensitive anatomical structures. The factors that influence the measurement uncertainty (variation in representation of position and shape of anatomical structures) of imaging are of relevance. We investigate the effect of patients' anatomy on the measurement uncertainty of medical CT.

Willingness of medical students to be examined in a physical examination course.

Background: Physical examination courses are an essential part of the education of medical students. The aim of this study was to ascertain the factors influencing students' motivation and willingness to participate in a physical examination course.

Methods: Students were asked to complete a questionnaire subdivided into five domains: anthropometric data, religiousness, motivation to take part in physical examination courses, willingness to be physically examined at 11 different body regions by peers or a professional tutor and a field for free text.

Quality of Life After Translabyrinthine Vestibular Schwannoma Resection-Reliability of the German PANQOL Questionnaire.

Objective: To quantify the postoperative quality of life (QOL) of patients after translabyrinthine surgery for vestibular schwannoma (VS) using the German version of the Penn acoustic neuroma quality-of-life questionnaire (PANQOL) in a university hospital.

Methods: The PANQOL questionnaire was administered to 72 patients who were treated in our department with translabyrinthine surgery for VS between January 2007 and January 2017. Descriptive evaluations of results were performed in addition to analyses of the reliability and convergent validity of the results and a subgroup analysis.

[Hearing rehabilitation with the cochlea implant following translabyrinthine CPA tumor removal ?].

We present a quality analysis of 10 patients with an individual treatment trial for a simultaneous or consecutive cochlea implantation after translabyrinthine removal of a neurinoma at the cerebellopontine angle. The results show that most of the patients benefit from the cochlea implantation after unilateral deafness. Through a careful surgical preparation technique at the inner ear canal and its surroundings the morphological and functional integrity of the neurovascular structures can be guaranteed.

Multistep translation and cultural adaptation of the Penn acoustic neuroma quality-of-life scale for German-speaking patients.

Background: Monitoring the health-related quality of life (HRQOL) for patients with vestibular schwannoma (VS) has garnered increasing interest. In German-speaking countries, there is no disease-specific questionnaire available similar to the "Penn Acoustic Neuroma Quality-of-life Scale" (PANQOL).

Method: We translated the PANQOL for German-speaking patients based on a multistep protocol that included not only a forward-backward translation but also linguistic and sociocultural adaptations.

Minimally invasive, multi-port approach to the lateral skull base: a first in vitro evaluation.

Purpose: The aim of the study was to validate a minimally invasive, multi-port approach to the internal auditory canal at the lateral skull base on a cadaver specimen.

Methods: Fiducials and a custom baseplate were fixed on a cadaver skull, and a computed tomography image was acquired. Three trajectories from the mastoid surface to the internal auditory canal were computed with a custom planning tool.

[Surgical simulation on the lateral skull base].

Critical neurovascular structures are confined in a small bony space at the lateral skull base. Thus, high quality of surgical training and planning of minimally invasive procedures is crucial. Simulation of lateral skull base procedures can improve motor skills, anatomical orientation, and complication management in a safe environment.

[Physical Properties of Squamous Cell Carcinoma Cells using Atomic Force Microscopy].

Introduction: Malignant and benign cells differ according to their elasticity. An atomic force microscope is a useful tool for measuring these mechanical cell properties. If cells of different dignity show different resonance behavior, due to their different elasticity, a selective ablation of specific tissue types by ultrasound would be possible.

Challenges in Histologic Diagnosis of Nonchordomatous Lesions of the Clivus.

Importance: Nonchordomatous clival lesions are rare and represent a wide range of different benign and malignant pathologies. For an accurate and specific final diagnosis, biopsy procedures and/or resections followed by histologic examination are mandatory.

Objective: To illustrate the challenges in obtaining a final histologic diagnosis in patients with various types of clival lesions.

Granulomatosis with polyangiitis and multiple bilateral cranial nerve palsies: a diagnostic challenge.

Background: Granulomatosis with polyangiitis is characterized by vasculitis of small and medium sized vessels and non-caseating granulomas with head and neck symptoms in 95% of those affected. Cranial nerve palsies are rare; while, chronic rhinosinusitis and ear problems are common.

Case Report: We describe the serious course and the diagnostic challenge of a patient with granulomatosis with polyangiitis of bilateral mastoids and the right temporal lobe.