Phase III results with a totally implantable piezoelectric middle ear implant: speech audiometry, spatial hearing and psychosocial adjustment.

Objective: To evaluate the treatment efficacy of an electromechanical middle ear amplifier implant (AI) in patients with chronic moderate-to-severe sensorineural hearing loss (SNHL). The AI is a piezoelectric system with a sound processor and a rechargeable battery within a hermetically sealed titanium canister. Its titanium-sealed microphone is placed in the bony region of the ear canal.

[Interdisciplinary surgery-the throat].

The special anatomic situation and the multitude of combinations of oncological therapeutic and reconstructive modalities in tumors of the cervical region require intensive interdisciplinary planning and discussion during tumor staging, surgical resection, and (neo)adjuvant treatment. We discuss here the various treatment modalities for tumors of the pharynx and cervical esophagus.

A time-frequency feature extraction scheme for the automated detection of binaural interaction in auditory brainstem responses.

The binaural interaction component (BIC), the difference between the summed monaurally evoked potentials of each ear and the binaurally evoked brainstem potentials, has been shown to be related to directional hearing. However, the detection of the beta-peak as the most consistent part of the BIC is often difficult. Furthermore, there is no clearly defined signal feature characterizing the difference between the monaurally and the binaurally evoked brainstem responses.

Experimental robotic milling in skull-base surgery.

Objective: In the field of otorhinolaryngology, a variety of skull implants have been developed to assist hearing-impaired or even deaf patients. The first step in the implantation procedure, and also in lateral skull-base surgery, is to drill the calvarian or mastoid bone. We intended to investigate the hitherto unknown parameters for performing this procedure and to establish the first set-up for robotic milling of the lateral skull base.

[Chromosomal alterations in juvenile angiofibromas].

Introduction: Despite their benign histological appearance, juvenile angiofibromas, which occur mainly in adolescent males, have a locally aggressive growth pattern. beta-catenin-mutations represent their only known genetic abnormality.

Material And Methods: Angiofibroma tissue from seven patients was available for comparative genomic hybridization (CGH).

The binaural interaction component (BIC) in children with central auditory processing disorders (CAPD).

The detection of binaural interaction is of diagnostic interest in patients with central auditory processing disorders (CAPDs), as binaural hearing tasks are frequently affected in these patients. Owing to the comorbidity associated with disorders such as an attention-deficit hyperactivity disorder, pathological results in subjective tests often show extra-auditory factors such as reduced attention rather than impaired central auditory function. Therefore, objective measures for auditory processing disorders are essential.

Hearing preservation after inner ear gene therapy: the effect of vector and surgical approach.

Over seventy studies have examined the potential of gene therapy in the inner ear. For the most part, they have focused on adenoviral vectors and delivery into the cochlea. Most studies have emphasized looking at the expression of marker genes driven by a CMV promoter and have used first-generation adenoviral constructs.

Patient selection for incus body coupling of a totally implantable middle ear implant.

Objective: To evaluate audiologic selection criteria for incus body coupling (IBC) of a totally implantable middle ear implant (TI-MEI) for the treatment of sensorineural hearing loss (SNHL).

Material And Methods: The protocol is specified in the Investigational Device Exemption of a Food and Drug Administration-approved multicenter clinical trial. The prospective study compared pre- and postoperative hearing levels using each patient as their own control.

[Malignant transformation of a tubular adenoma in the paranasal sinuses?].

Background: Whereas a tubular adenoma is a unique finding within the paranasal sinuses, intestinal adenocarcinomas are especially in patients with long-term exposure to wood dust, common tumours in this location.

Case: In a 65 year old joiner endonasal sinus surgery performed to treat suspected chronic pansinusitis brought up by chance the histological finding of a tubular adenoma. As the patient at first refused surgical revision, but magnetic resonance imaging during follow-up revealed evidence for a space occupying lesion affecting the ethmoid and sphenoid sinuses revision surgery took place one year later.

Numerical sex chromosome aberrations in juvenile angiofibromas: genetic evidence for an androgen-dependent tumor?

Juvenile angiofibromas (JAs) are rare benign tumors arising almost exclusively in the posterior nasal cavity of adolescent males. While male sex predominance and tumor manifestation during adolescence are well known clinical features, their genetic causes are still unknown. Observation of an increased androgen binding rate to the cytosol of JAs and immunohistological finding of strong AR expression have suggested involvement of the androgen receptor (AR) in JA biology.

Noise in magnetic resonance imaging: no risk for sensorineural function but increased amplitude variability of otoacoustic emissions.

Objectives: Objectives were to perform exact measurements of the noise exposure in a magnetic resonance imager and to investigate the effects of magnetic resonance imaging (MRI) noise on hearing sensitivity, which are still controversial, in a large number of patients.

Study Design: Prospective trial.

Methods: Acoustic noise during seven different MRI sequences was measured using a custom-made microphone containing no ferromagnetic parts.

[The use of disposable instruments of a high performance polymer for tonsillectomy and adenoidectomy].

Cases of the new variant Creutzfeldt-Jakob disease (vCJD) in human beings have to be anticipated in Germany. In subclinical vCJD, the accumulation of prions in lymphoid tissue has been identified prior to their manifestation in cerebral tissue. The remarkable resistance of prions to standard methods of sterilisation questions the safety of reusing metallic surgical instruments.

[Expression of members of the cadherin-/catenin-protein family in juvenile angiofibromas].

Background: Angiofibromas are benign, but locally aggressive tumors occurring nearly exclusively in adolescent males. Pathogenesis of this fibrovascular neoplasm is still unknown. Detection of beta-catenin gene mutations and immunohistochemical localization of beta-catenin only in the nuclei of stromal cells has been proposed as evidence for the stromal cells to be the neoplastic cells in angiofibromas (Abraham et al.

Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial.

Background: Vocal cord sequelae and postoperative hoarseness during general anesthesia are a significant source of morbidity for patients and a source of liability for anesthesiologists. Several risk factors leading to laryngeal injury have been identified in the past. However, whether the quality of tracheal intubation affects their incidence or severity is still unclear.

Ear damage caused by leisure noise.

Noise is a health risk. Recent findings suggest that leisure noise is a substantial danger especially to children, teenagers and young adults. Epidemiological studies of teenagers with no occupational noise exposure show an increasing number with a substantial and measurable irreversible inner ear damage.

Dural cell culture. A new approach to study duraplasty.

Fistulas of the cerebrospinal fluid are often repaired by insertion of grafts of various kinds. However, current knowledge of wound healing after graft insertion is limited, and only a few animal studies are available. The objective of this study is to test whether an in vitro model is suited to analyze cellular healing aspects after duraplasty and to assess dura substitutes in such conditions in regard to their surface attractiveness for cellular migration from the dura margins.

Expression of VASP and zyxin in cochlear pillar cells: indication for actin-based dynamics?

Vasodilator-stimulated phosphoprotein (VASP) is a member of the ENA/VASP-protein family. VASP is considered to be a crucial factor in the regulation of actin dynamics, which involves processes such as motility and cell adhesion, e.g.

[Haemostatic disorders in ENT patients. Part 2: Pathophysiology, diagnostics, clinical feature and therapy].

In the first part of the medical education article on haemostatic disorders in ENT patients the basic physiology of haemostasis and main diagnostic tools were presented and discussed. The second part presents disorders of the coagulation system,thrombocyte function and blood vessels with special emphasis on clinical practice in ENT surgery. In this context, haemophilia A and B, von Willebrand disease and different forms of thrombocytopenia are of main clinical importance.

Development of the first force-controlled robot for otoneurosurgery.

Objective: In some surgical specialties (eg, orthopedics), robots are already used in the operating room for bony milling work. Otological surgery and otoneurosurgery may also greatly benefit from the enhanced precision of robotics.

Study Design: Experimental study on robotic milling of oak wood and human temporal bone specimen.

[Haemostatic disorders in ENT patients.Part 2: Pathophysiology, diagnostics, clinical feature and therapy].

In the first part of the medical education article on haemostatic disorders in ENT patients the basic physiology of haemostasis and main diagnostic tools were presented and discussed.The second part presents disorders of the coagulation system,thrombocyte function and blood vessels with special emphasis on clinical practice in ENT surgery. In this context, haemophilia A and B, von Willebrand disease and different forms of thrombocytopenia are of main clinical importance.

[Multimodal treatment strategy for Langerhans cell histiocytosis at head and neck manifestations].

Langerhans cell histiocytosis (LCH) is a rare disorder with different clinical features. An established standardized treatment does not exist.We present a case report of a patient with localized LCH of the temporal bone and discuss the interdisciplinary treatment strategies.