Extracorporeal shock wave lithotripsy of submandibular stones: evaluation after 10 years.

The use of extracorporeal shock waves in the treatment of submandibular stones is a minimally invasive approach for the treatment of this disease. Its clinical significance has been determined in a long-term retrospective study, performed as follow-up to the short-term results. From 1989 to 1994, 197 patients (88 female, 109 male; age range, 8 to 83 years) with symptomatic, sonographically detectable concretions of the submandibular gland were treated with extracorporeal shock wave lithotripsy.

[Complications with inflammatory diseases of the nasal sinuses].

The close localization of the paranasal sinuses both to the brain and the orbit can even today lead to severe and potentially lethal complications in patients with sinusitis. These incidents are rare, however, they should be duly diagnosed and treated since fatal outcome is described in 5-10% of cases. Current diagnosis and therapy for acute inflammatory complications and mucoceles of paranasal sinuses are presented in this article.

Differential distribution and expression of leptin and the functional leptin receptor in major salivary glands of humans.

Leptin plays a central role in the regulation of food intake and energy expenditure in rodents. However, it has become clear that this hormone has more than only a satiety-inducing function, and that there are other sources of leptin, such as the central nervous system, placenta and the gastrointestinal tract in addition to adipose tIssue. Knowing about the important role of the salivary glands in food intake and digestion, it was the objective of the present study to investigate how leptin and its receptor are expressed and distributed in the major salivary glands of humans.

Contrast-enhanced color Doppler sonography of parotid gland tumors.

The objective of the present study is to assess the potential of color Doppler sonography in imaging tumors of the parotid gland enhanced by application of ultrasound contrast agents. To this end 26 patients with tumors of the parotid gland were investigated. The color Doppler signal areas before and after administration of Doppler signal-enhancing agent (Levovist, Schering, Germany) were determined by means of computer-assisted analysis, and the relevant parameters were evaluated.

Combined surgical lipectomy and liposuction in the treatment of benign symmetrical lipomatosis of the head and neck.

Benign symmetrical lipomatosis (Madelung syndrome) is a rare disease of unknown aetiology, which is characterised by diffuse growth of non-encapsulated lipomas. Between 1995 and 2000 we treated 11 patients with benign symmetrical lipomatosis in the head and neck. The group comprised 10 men and one woman aged 34 to 62 years (mean 47).

[Surgical therapy of Madelung's disease in the head and neck area].

Patients And Methods: Between 1995 and 2001 we treated 12 patients with benign symmetric lipomatosis in the head and neck. The group comprised 11 men and 1 woman aged 34-62 (M=47). The most frequent complaints were diminished range of motion of the head and obstruction when eating or speaking.

Localized lymphadenopathy due to leishmanial infection.

A 25-year-old female patient presented with an isolated cervical lymph node enlargement several months after having returned from Spain and Latin America. She had no other signs or symptoms of disease. Leishmania infantum/chagasi was identified as the causative agent.

A new device for frontal sinus endoscopy: first clinical report.

Objective: Endoscopically or microscopically controlled paranasal sinus surgery currently represents the state of the art. For anatomic reasons the ostium of the frontal sinus and the frontal sinus itself are difficult to observe. Flexible endoscopes are often difficult to implement and do not provide enough light intensity to visualize all parts of the frontal sinus.

Identification of leptin in human saliva.

Leptin is produced predominantly in adipose tissue but has recently also been found in gastric mucosa. It has been shown that the oral application of leptin induces neuronal activity in the brain stem of rodents. The objective of the present study was to identify this hormone in human saliva and to examine the production and stability of salivary leptin.

Therapy of invasive mucoceles of the frontal sinus.

Mucoceles of the frontal sinus that extend into the orbits and the anterior cranial fossa can, in certain cases, be difficult to manage therapeutically and may lead to lethal complications. The surgeon will have to make a decision between an endonasal and an extranasal, transfacial procedure to provide an adequate access. Between 1995 and 1998 we treated 12 patients suffering from invasive mucoceles of the frontal sinus.

Transoral removal of submandibular stones.

Objective: To assess transoral treatment of submandibular lithiasis.

Design: Study of a series of patients with submandibular stones undergoing transoral removal of the sialoliths. Duration of follow-up: 6 months to 7 years.

[Results of an in vitro study and initial clinical application of a combined Ho:YAG-/Nd:YAG laser].

Background And Objective: A combined Ho:YAG/Nd:YAG laser produces light with properties similar to the beams of the mainly coagulating Nd:YAG laser and the cutting CO2 laser alone.

Patients/methods: The combined laser was tested in vitro on pig tissue. Additionally, we used this new combined tool for enoral operations.

[Diagnosis and therapy of pseudotumors of the orbits].

Orbital pseudotumor is a nonspecific inflammatory process of unknown etiology that can be divided histopathologically into three basic types: granulomatous, lymphoid, and sclerosing. Between 1995 and 1998, 12 patients with pseudotumor orbitae were treated in the ENT Department of the University of Saarland. Histopathological examination showed granulomatous type of pseudotumor in six, lymphoid in three, and sclerosing in three patients.

The influence of noise on blood flow in the basilar artery (BA) - measurements with transcranial color-coded duplex sonography (TCCD).

Acoustic stimuli are being reported as a cause of changes in resistance in the basilar artery (BA). It was the aim of this study to investigate this effect under standardized conditions dependent upon the intensity of the evoking stimulus. Twenty healthy subjects with normal hearing (male/female 14/6; mean age 26.

[Clinical and diagnostic findings of sialolithiasis].

Introduction: Sialolithiasis is one of the most common diseases of the salivary glands. Within the scope of a retrospective analysis we report on our clinical and diagnostic findings in the largest patient group suffering from sialolithiasis reported in literature.

Material And Methods: Between 1987 and 1997, data from 635 patient histories and follow-up examinations were systematically collected and analysed to look for typical symptoms of sialolithiasis, locations of stones and possible risk factors.

In vitro tissue effects of a combined Ho:YAG/Nd:YAG laser: sprinkling of tissue fragments by Ho:YAG laser light may be problematic for oncological interventions.

Background And Objective: Surgery of soft tissue, for example, of the tongue or the liver, requires a cutting and coagulating device. Therefore, a combined Ho:YAG/Nd:YAG laser providing the laser beam of both systems together in one bare fiber seems to be useful.

Study Design/materials And Methods: We studied the effect of such a laser system in vitro on tongues of pigs.

[Hiccup].

Hiccup is defined as involuntary contractions of the diaphragm and the auxiliary respiratory muscles, mostly in irregular series, followed by glottic closure, thereby producing a typical "hiccupping" inspiration. This is a physiologic phenomenon, which already exists in utero. Hiccup is believed to be a gastrointestinal reflex; however, function and the reflex arch are hypothetical.

[The diameter of the Stenon and Wharton ducts. Significance for diagnosis and therapy].

In assessing new minimally invasive diagnostic techniques (duct endoscopy) and therapy (lithotripsy) of salivary gland disease, it is of importance to know the true dimensions of the secretory ducts. Twenty-five ducts of the parotid gland and 20 ducts of the sub-mandibular gland were examined histologically at different points of their anatomic course and their in vivo diameters were evaluated using a previously determined formalin-induced shrinking factor. The mean diameter of Stensen's duct at four different points along its length ranged between 0.

[Treatment of deep neck infections].

Background: The incidence of deep neck space infections has been significantly reduced by modern antibiotic therapy. These infections are relatively rare and yet the life-threatening complications merit special consideration by head and neck surgeons.

Patients: Seven cases of deep neck space infections as a consequence of purulent pharyngitis (3), peritonsillar abscess (2), retropharyngeal (1), and odontogenic (1) abscess are presented.

Cytotoxic and anti-proliferative effects of high-energy pulsed ultrasound (HEPUS) on human squamous cell carcinoma cells as compared to connective tissue fibroblasts.

The cytotoxic and anti-proliferative effects of high-energy pulsed ultrasound (HEPUS) on human squamous cell carcinoma cells cloned from the hypopharynx (FaDu) and benign connective tissue cells (fibroblasts) were investigated in vitro. Sonication was carried out using an experimental piezoelectric, self-focusing burst-signal transducer. To increase the induction of cavitation, the transducer used was specifically designed to produce multiple oscillations with a high negative pressure amplitude.

Extracorporeal shock wave lithotripsy of parotid stones. Results of a prospective clinical trial.

The extracorporeal shock wave treatment of parotid stones is a rather new therapy. Its usefulness was determined in a prospective study. Seventy-six patients (36 female, 40 male, 2 to 80 years of age) with symptomatic, sonographically detectable solitary sialoliths of the parotid gland were treated with an extracorporeal piezoelectric shock wave therapy after unsuccessful conservative therapy (sialagogues, gland massage, bougienage of the secretory duct).

[Long-term results of extracorporeal peizoelectric shock wave lithotripsy of parotid stones].

Objective: To evaluate prospectively the recently developed method of extracorporeal shock-wave treatment of stones of the parotid gland.

Patients And Methods: 76 patients with symptomatic, sonographically proven, solitary stones of the parotid gland (36 females, 40 males; aged 2-80 years) were treated with extracorporeal piezoelectric shock-wave lithotripsy (ESWL) after failed conservative management (sialagogues, gland massage, duct bougie dilation).

Results: Parotid stones were no longer demonstrable after a mean follow-up time of 48 (6-71) months in 38 of the 76 patients; they were symptom-free and no new stones had formed.

[Long-term experience with percutaneous endoscopic controlled gastrostomy (PEG) in ENT tumor patients].

Percutaneous endoscopically controlled gastrostomy (PEG) enables patients suffering from a tumor of the upper aerodigestive tract to receive direct gastric feedings. The procedure also avoids the social stigma of a nasal feeding tube. The results of 630 PEG procedures used in 555 patients suffering from various head and neck cancers are reported.

Diameters of the main excretory ducts of the adult human submandibular and parotid gland: a histologic study.

In assessing new minimally invasive diagnostic techniques (duct endoscopy) and therapy (lithotripsy), it is of importance to know the true dimensions of the excretory ducts. Twenty-five ducts of the parotid gland and 20 ducts of the submandibular gland were examined histologically at different points of their anatomic course, and their in vivo diameters were evaluated with the use of a previously determined formalin-induced shrinking-factor. The mean diameter of Stensen's duct at four different points along its length ranged between 1.

[Color Doppler ultrasound studies of benign and malignant lymph nodes].

Color-coded duplex sonography is being increasingly used in the head and neck as another method for diagnosis of such disorders as stenosis of arteries or veins or hemangiomas. A possible additional advantage of testing is the ability to differentiate benign from malignant tumors. Since the underlying cause of a suspicious lesion is most important for treatment strategies, we investigated histologically-proven benign and malignant cervical lymph nodes for determining the value of color-coded duplex sonography.