[Central sleep apnea in multiple sclerosis].

Fatigue is a common problem in patients suffering from multiple sclerosis (MS). The presented case demonstrated concomitant severe central sleep apnea. Selection of the optimal ventilation modus was complex but proved successful.

[Jugular vein thrombosis caused by a neuroendocrine non-small cell lung cancer].

A 65-year-old patient presented with extensive swelling of the lateral neck. B-mode ultrasound showed an oval, well defined, hypoechoic formation consisting of multiple circular layers extending from the base of the skull to the subclavian vein. On subsequent computed tomography the size of the lesion was confirmed and the cause, a mediastinal mass compressing the superior caval vein, was identified.

Application of the Vibrant Soundbridge in bilateral congenital atresia in toddlers.

Conclusion: The Vibrant Soundbridge offers an excellent audiologic rehabilitation for toddlers with microtia and atresia. It provides direct stimulation of the cochlea and straightforward adaption to the given anatomical structures. The 'posterior atresia incision' preserves the physical integrity of the tissue layers around the ear remnant, which is essential for an aesthetic auricular reconstruction.

Tumour-derived prostaglandin E and transforming growth factor-beta synergize to inhibit plasmacytoid dendritic cell-derived interferon-alpha.

In previous studies we reported that plasmacytoid dendritic cells (PDC) infiltrating head and neck cancer tissue are functionally impaired, but the molecular basis for the functional deficiency remained unclear. Here we demonstrate that tumour-derived prostaglandin E2 (PGE(2)) and transforming growth factor-beta (TGF-beta) increase interleukin-8 (IL-8) but synergistically inhibit interferon-alpha (IFN-alpha) and tumour necrosis factor (TNF) production of Toll-like receptor 7 (TLR7)- and Toll-like receptor 9 (TLR9)-stimulated PDC. The inhibitory effect of PGE(2) could be mimicked by the induction of cyclic AMP (cAMP) and by inhibitors of cyclooxygenase.

Sleep apnoea in patients after treatment of head neck cancer.

Conclusions: The prevalence of sleep apnoea among patients following treatment of head and neck carcinomas seems to be slightly higher than in the normal population. The possible importance of tumour treatment features, especially transient tracheostoma, needs further assessment.

Objectives: The epidemiology of sleep apnoea in patients following the treatment of head and neck cancer remains unclear.

A prospective evaluation of psychosocial outcomes following ear reconstruction with rib cartilage in microtia.

Little is known about the psychosocial improvement of microtic patients following reconstruction with rib cartilage. Furthermore, no data exist on detailed follow-ups of patients who refused ear repair. To the best of our knowledge, this is the first report of a prospective evaluation of psychosocial outcomes with a validated instrument in ear reconstruction with rib cartilage.

[Tracheal stents for esophagotracheal fistula in laryngectomy patients. Safe fixation to the tracheostoma].

Background: Postradiotherapy or malignant esophagotracheal fistulas still represent a dilemma. In the absence of surgical options attempts are made to close the fistula endoscopically by means of esophageal and/or tracheal stents. Tracheal stent placement in laryngectomy patients with terminal stomas is particularly problematic due to the risk of stent dislocation during cannula replacement

Patients And Methods: Six laryngectomy patients with high esophagotracheal fistulas were each fitted with a coated Ultraflex stent (Boston Scientific, Watertown/MA, US).

A case of central sleep apnea strictly dependent upon REM-sleep.

Central sleep apnea (CSA) is characterized by the inability to generate regular breathing patterns as a result of the loss of metabolic drive and failure of respiratory muscle control. We present the case of a 54-year-old woman with a severe CSA strictly dependent upon REM-sleep. Extensive diagnostic workup excluded typical underlying causes and serological analysis revealed acute borreliosis infection.

Decreased levels of circulating regulatory NK cells in patients with head and neck cancer throughout all tumor stages.

Background: Natural killer (NK) cells play a crucial role in innate immunity as effectors against tumor cells and pathogen-infected cells. Human NK cells can be subdivided into two functional subsets, the immunoregulatory CD56(bright) NK cells and the cytotoxic CD56(dim) NK cells. NK-mediated host defence against tumor cells is strongly impaired in patients with head and neck squamous cell carcinoma (HNSCC).

Effect of head and neck cancer supernatant and CpG-oligonucleotides on migration and IFN-alpha production of plasmacytoid dendritic cells.

Background: Plasmacytoid dendritic cells (PDCs) infiltrating solid tumor tissues and draining lymph nodes of head and neck squamous cell carcinoma (HNSCC) show an impaired immune response. Immunosuppressive cytokines secreted by HNSCC have been recognized to account for reduced interferon-alpha (IFN-alpha) production, whereas the influence on PDC migration has not yet been investigated.

Materials And Methods: PDCs were isolated from human peripheral blood by magnetic bead separation.

Glandular tissue from human pancreas and salivary gland yields similar stem cell populations.

Stem cells derived from pancreatic tissue are well characterized and exhibit a broad plasticity as they can differentiate beyond lineage boundaries into many cell types. The aim of this study was the comparative characterization of pancreatic stem cells with one other derivate of the embryonic foregut, namely salivary glands, for the existence of similar stem cell populations. The expression of stem cell markers as well as lineage-specific markers was detected by reverse transcription polymerase chain reaction, flow cytometry and immuncytochemical staining.

Inflammatory pseudotumor of the hypopharynx: clinical diagnosis, immunohistochemical findings and treatment of this rare disease.

Inflammatory pseudotumor (IPT) is a rare benign lesion, often imitating a malignant disease. An IPT was found in the sinus piriformis of a 40-year-old male who suffered from dysphagia, globus feeling and a weight loss of 5 kilograms in six months. Neither common infections previously described in combination with IPT such as human herpes virus (HHV) 8, human immunodeficiency virus (HIV) or acute Epstein Barr virus (EBV), nor evidence of manifestation of a systemic mastocytosis or a malignant disease were found.

[Patient satisfaction in the outpatient department--a pilot study for customer satisfaction in ENT].

Background: Customer satisfaction in German hospitals is becoming more important because of increasing competition in the healthcare market. Because the majority of patients with ear-nose-throat (ENT) problems are treated in an outpatient setting, this competition is not only taking place among hospitals but also among specialists in private practices. To assess patient preferences, reliable and valid questionnaires are necessary, which so far exist only for inpatients.

Application of the Vibrant Soundbridge to unilateral osseous atresia cases.

Objectives/hypothesis: Patients with high-grade atresia-microtia suffer from a combined malformation of the outer and middle ears, typically leading to a severe hearing impairment. Long-term results of middle ear reconstruction with tympanoplasty are often insufficient due to persistent air-bone gaps, and new techniques in hearing rehabilitation are required. The objective of this research is to evaluate the active middle ear implant, the Vibrant Soundbridge (VSB), for hearing rehabilitation of patients with unilateral osseous aural atresia.

Toll-like receptor modulation in head and neck cancer.

Toll-like receptors (TLRs) are the archetypal pattern recognition receptors that have emerged as key mediators of immune functions. Activation of TLRs is a first line of defense of the immune system, leading to the activation and recruitment of different types of immune cells to sites of infection and malignant cell growth. Cells of human cancers, such as head and neck squamous cell carcinoma (HNSCC), are known to develop numerous molecular strategies to escape from efficient antitumor immune responses.

Up-regulation of NK cell function against head and neck cancer in response to ss-isRNA requires TLR7.

Natural killer (NK) cells play a crucial role in innate immunity as effectors against tumor and pathogen-infected cells. NK-mediated host defense against tumor cells is strongly impaired in patients with head and neck squamous cell carcinoma (HNSCC). Tumor secretion of various immune suppressive mediators contributes to massively compromised immune functions.

[Posttraumatic gusher phenomenon following fracture of the petrous bone].

The gusher phenomenon is a very rare complication that may occur during stapedectomy or cochleostomy. A sudden perilymphatic flow of cerebrospinal fluid can be seen following platinotomy. The cause is an abnormal connection between subarachnoid and perilymphatic spaces due to congenital malformation, leading to an abnormally wide cochlear aqueduct or due to an internal auditory canal fistula.

[Application of skin adhesives in head and neck surgery: analysis of cosmetic results, applicability and cost-effectiveness of cyanoacrylate-based adhesives].

Background: In this work cyanoacrylate-based skin adhesives used in Germany for skin closure in head and neck surgery are compared with respect to ease of application, cost-effectiveness and cosmetic results.

Patients And Materials: We compared 25 wounds sealed with a skin adhesive with 25 suture-sealed wounds.

Results: Bonding of surgical wounds with glue had a high level of acceptance in all patients.

[Structured residency training program for otolaryngology: a trendsetting principle].

A concept for an ORL residency training program is necessary because of personnel bottlenecks, quality assurance and benchmarkings. We have created a 2.5 years' program, which is based on 6 pillars: 1.

[Spontaneous retropharyngeal hematoma: a rare differential diagnosis of acute dysphagia].

Spontaneous retropharyngeal hematoma is a rare but potentially fatal disease. It occurs with no underlying medical condition such as trauma, hemorrhagic diathesis, or medically induced anticoagulation.We report a case of a 48-year-old man who presented with progressive dysphagia, signs of inflammation, and a reduced general health status.

[A rare cause of facial asymmetry: nasoalveolar cyst: a clinical report].

Unlabelled: Nasoalveolar cysts are rare nonodontogenic cysts that develop from the soft tissue in the mucobuccal area of the nasal ala. Their origin is a residuum of the nasolacrimal canal.

Clinical Case: A 45-year-old woman had been aware of a painless tumor at the base of the nose and in the region of the left nasal ala for several months.

[Acute hearing loss from scuba-diving holidays: diagnosis and treatment of barotrauma of the inner ear].

A 35-year-old diver noticed hearing loss and tinnitus after his diving holiday. He presented to the Lübeck clinical practice for divers, and we found vascular injections on the eardrum. Audiometry showed a high-degree hearing loss of 40-60 dB.