[MEDCARE for People in Eritrea : A report on 9 years' help through self-help].

The current article is an experience report on the establishment of an ENT clinic in Asmara/Eritrea and the organization of regular work stays for the further education of local colleagues. Objectives of the project are content and structural support for self-help and thus achievement of sustainable development aid, which benefits both the medical development of the country and the care of the local patients.

Modifications of the midline mandibulotomy for access to the parapharyngeal space.

When considering a mandibular osteotomy for access to resect a parapharyngeal neoplasm, the following goals should be considered: preservation of the facial nerve, complete removal of the neoplasm without tumor rupture, maintenance of the preoperative teeth occlusion, acceptable temporomandibular joint function, functional preservation of the inferior alveolar nerve sensation, and satisfying aesthetic results. We propose a modified median osteotomy technique, which combines the advantages of sufficient exposition of the tumor with very good functional and aesthetic results. A case series of nine patients suffering from extended pleomorphic adenomas of the inner lobe of the parotid gland is presented.

Prognostic index for patients with parotid carcinoma: international external validation in a Belgian-German database.

Background: Prognostic indices for recurrence-free interval in patients with parotid carcinoma were developed and validated in a nationwide database. International validation would increase generalizability.

Methods: In a Belgian-German database that contained 237 consecutive patients with parotid carcinoma, a pretreatment prognostic index (PS1) and a post-treatment prognostic index (PS2) were validated by calculating both indices for each patient, comparing coefficients, constructing survival curves, calculating the concordance measure C, and performing Wald tests for scale and weight optimization of included variables and for the possible inclusion of new variables.

In vitro culturing of porcine tracheal mucosa as an ideal model for investigating the influence of drugs on human respiratory mucosa.

It has been previously shown that fresh mucosa from different mammals could serve as raw material for in vitro culturing with the differentiation of cilia, which are the most important morphological structures for the function of the mucociliary system. Increasing legal restrictions on the removal of human tissue and changing surgical techniques have led to a lack of fresh human mucosa for culturing. Most of the animals that have been used as donors up to now are genetically not very close to human beings and must all be sacrificed for such studies.

[The influence of different alpha-sympathomimetic drugs and benzalkoniumchlorid on the ciliary beat frequency of in vitro cultured human nasal mucosa cells].

Background: An appropriate in-vitro model of the human nasal mucosa was developed, which allowed to measure the influence of different pharmaceutical substances on the ciliary beat frequency (CBF) under standardized conditions.

Method: The present study describes the effect of the alpha-sympathomimetic drugs naphazolin, xylometazolin and oxymetazolin as pure substances and the preservative Benzalkonium chloride in rising concentrations on the CBF. For these investigations human cells of the human nasal mucosa were cultured, which exhibited a high constancy during the equilibration measurements over at least 200 minutes.

Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients.

Background: Surgery for recurrent parotid pleomorphic adenoma is a challenging problem.

Methods: One hundred eight patients who underwent 134 reoperations for recurrent parotid pleomorphic adenoma (follow-up, 22 years) were evaluated for histopathologic features and risk factors for recurrence.

Results: The number of reoperations for tumor recurrence ranged from 1 to 10.

Parotidectomy for benign parotid disease at a university teaching hospital: outcome of 963 operations.

Objective/hypothesis: The objective of this study was to analyze the perioperative and long-term complications after standardized lateral and total parotidectomy for benign parotid tumors and chronic parotitis with special regard on the training skill of the surgeons at a university teaching center. All teaching operations were performed under strict microscopic control and supervision of experienced surgeons.

Study Design: The authors conducted a retrospective unicentric study in a tertiary university center.

Postoperative functional evaluation of different reanimation techniques for facial nerve repair.

Background: The facial nerve function after facial-facial nerve anastomosis, grafting, hypoglossal-facial nerve anastomosis, hypoglossal-facial interpositional jump nerve anastomosis, or a combined approach was analyzed.

Methods: Facial function was assessed after operation using a 7-point visual analog scale (VAS) and by electromyography (EMG) in 53 patients. The final result was judged by May's facial nerve grading system.

18F-FDG PET for detecting recurrent head and neck cancer, local lymph node involvement and distant metastases. Comparison of qualitative visual and semiquantitative analysis.

Aim: Assessment of the clinical value of (18)F-FDG-PET for detection of recurrent head and neck cancer, local lymph node involvement and distant metastases comparing a qualitative visual with a semiquantitative analysis (SUV values).

Patients, Methods: Retrospective evaluation of 73 (18)F-FDG PET studies in 55 patients by use of a four-step qualitative visual grading system and calculation of standard uptake values in pathological lesions. Calculation of SUV values in normal regions for generating a map of physiological (18)F-FDG distribution.

Primary parotid malignoma surgery in patients with normal preoperative facial nerve function: outcome and long-term postoperative facial nerve function.

Objectives/hypothesis: Most patients with primary parotid cancer present with normal facial nerve function. The common surgical strategy for these patients is to perform a parotidectomy with facial nerve preservation. Nevertheless, the functional outcome for the facial nerve and oncological outcome is unclear.

New aspects in parotid gland surgery.

We present our results of current research on parotid gland surgery at our clinic. a) Histopathological characteristics of pleomorphic adenomas, especially of capsular alterations like thin capsule areas, capsule-free regions, satellite nodules, and pseudopodia in the different subtypes were analyzed in 100 consecutive patients. 51 pleomorphic adenomas were classified as stroma-rich type, 35 as cell-rich-type, and 14 as classical subtype.

Recurrent pleomorphic adenoma of the parotid gland: a prospective histopathological and immunohistochemical study.

Objectives/hypothesis: Histopathological characteristics and proliferation indices of recurrent pleomorphic adenoma were described in a series of 31 patients who were referred to the authors' clinic for revision surgery.

Study Design: Prospective series of 31 patients.

Methods: Serial sections of surgical specimen using the whole-organ sectioning technique were carried out for light microscopic examination after total parotidectomy and periparotid fat resection.

Pleomorphic adenoma of the parotid gland: a 13-year experience of consequent management by lateral or total parotidectomy.

Optimal surgical management of parotid pleomorphic adenoma is important because of a considerable risk of tumour recurrence and complications. Our series of primary surgery cases with standardised parotidectomy technique in a university hospital were evaluated. Medical records of 295 patients treated from 1987 to 1999 were reviewed, and 171 patients answered a questionnaire about long-term sequelae.

High incidence of lymph node metastasis in major salivary gland cancer.

Objective: To analyze the incidence and risk factors for clinically apparent and occult lymph node metastases in patients with major salivary gland cancers.

Design: Cohort of patients with a median follow-up of 46 months (range, 1-174 months).

Setting: University-based referral center.

Local application of extracellular matrix proteins fails to reduce the number of axonal branches after varying reconstructive surgery on rat facial nerve.

PURPOSE: A major reason for the poor functional recovery after peripheral nerve injury is the outgrowth of supernumerary axonal branches at the lesion site. Projecting within several nerve fascicles, the branches of one axon often re-innervate synchronously muscles with antagonis-tic functions and impair any coordinated activity. We hypothetized that accelerated axonal elongation through extracellular matrix proteins fos-tering neurite outgrowth might reduce axonal branching and improve recovery of function.

Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas.

Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region.

Impact of functional endoscopic sinus surgery on symptoms and quality of life in chronic rhinosinusitis.

Objectives: Chronic rhinosinusitis restricts the quality of life of millions of involved patients. The aim of the study was to evaluate how functional endoscopic sinus surgery modifies patients symptom profiles and quality of life.

Study Design: Open prospective clinical trial.

Histopathology of pleomorphic adenoma in the parotid gland: a prospective unselected series of 100 cases.

Objectives/hypothesis: Histopathological characteristics of pleomorphic adenomas, especially of capsular alterations such as thin capsule areas, capsule-free regions, capsule penetration, satellite nodules, and pseudopodia in the different subtypes, are described.

Study Design: Prospective unselected series of 100 consecutive cases from 1997 to 2000.

Methods: Light microscopic examination and semiquantitative analysis of the pleomorphic adenomas.

[Infected epidermoid cyst as cause of peripheral facial palsy. A case report].

Background: Extratemporal processes are rare causes of peripheral facial palsy. Only 17 cases of facial palsy in association with a suppurative or necrotic parotitis are reported in the literature.

Patient And Results: We present a case of a peripheral facial palsy initiated by an infection of a epidermoid cyst, which consecutively involved the whole parotid gland.

Rhino-frontal sinuseptotomy (RFS): a combined intra-extra nasal approach for the surgical treatment of severely diseased frontal sinuses.

Objectives: Frontal sinus surgery is a challenge to those involved in the treatment of recurrent frontal sinusitis. The purpose of this report is to describe the technique and to present the results of a combined endoscopic and external approach to the frontal sinus (rhino-frontal sinuseptotomy [RFS]).

Material: RFS was performed in 45 patients by the author; 41 of these patients had a follow-up over 12 months and were included in this series.

Immunohistochemical detection of vascular endothelial growth factor (VEGF) and VEGF receptors Flt-1 and KDR/Flk-1 in the cochlea of guinea pigs.

Vascular endothelial growth factor (VEGF) is known as an endothelial cell-specific mitogen. There are no reports concerning the presence of VEGF in the inner ear. To gain information, immunohistochemical analysis using specific antibodies to VEGF and to both known VEGF receptors Flt-1 and KDR/Flk-1 was performed on paraffin-sectioned temporal bones from five guinea pigs.

Prognostic value of electromyography in acute peripheral facial nerve palsy.

Objective: To analyze the value of electromyography in predicting recovery from acute idiopathic facial nerve paralysis.

Study Design: Retrospective case-series review.

Setting: University-based hospital department of otorhinolaryngology/head neck surgery.