[Postoperative results of stapes revision].

Background: In this retrospective study indications, intraoperative findings, reconstruction techniques and postoperative hearing results in revision stapes surgery were evaluated.

Patients: Between March 1988 and January 1996, 150 patients underwent stapes revision. Indications for surgery were the presence of conductive hearing loss (132), dizziness (12), sensorineural hearing loss (3), deafness (2), and tinnitus (1).

[New developments in endoscopy].

Beside the developments of new imaging modalities in endoscopy, efforts have been made to improve therapeutical possibilities of endoscopic interventions. In addition to the improvement or even development of new instruments for flexible and rigid endoscopy, the potentials of the new technique of argon-plasma-coagulation in ENT are only hardly discovered. This innovative method is based on high-frequency (HF) electric current for non contact tissue coagulation via ionized argon gas.

[Extramedullary plasmacytoma--manifestation in petrous bone].

Background: Extramedullary plasmocytoma of the temporal bone is a rare neoplastic disorder. Only a very few cases are described in the world literature.

Case: We report on a patient who presented with the clinical signs of a glomus jugular tumor.

[Oropharyngeal fat hernia in Madelung's neck as a rare cause of acute dysphagia].

Background: Multiple symmetric lipomatosis (MSL) is a rare disorder clinically characterized by the presence of nonencapsulated lipomatous tissue around the neck, shoulders, and upper part of the thorax. The entity is frequently associated with peripheral neuropathy, chronic hepatopathy, and alcoholism. Despite of the cosmetically aspect of the patient with a reduced range of motion of the head and neck, MSL is asymptomatic in most cases.

[Early and long-term results of rehabilitation of cochlear implant patients]].

Background: Cochlear implantation is nowadays a reliable and well-accepted method of auditory rehabilitation in selected adults and children.

Methods: We present rehabilitation data on 21 adult patients provided with the Nucleus CI22 M cochlear implant using the SPEAK strategy.

Results: Results of first tune-up show an open set speech understanding in approximately 50% of patients.

[Speech disorders in ENT practice].

The most frequent speech and language disorders which ENT doctors are confronted with are generally known to be and presented as: delayed speech and language development, dystalia, dysglossia, rhinolalia, dysarthria, and verbal fluency disorders (stuttering, cluttering). The diagnostic portion in comparison to the therapeutic part is always greater and quite different. The close cooperation with representatives of phoniatrics and pedaudiology, as well as logopedics and other specialities such as neurology, and internal medicine is highly necessary.

[Effect of inner ear hearing loss on delayed otoacoustic emissions (TEOAE) and distortion products (DPOAE)].

Background: The assessment of inner ear hearing loss by means of evoked otoacoustic emissions (EOAE) is already established in practice. Nevertheless, empirical data on the relations between emission and audiologic parameters are required.

Patients And Methods: EOAEs werde measured and analysed in 240 ears with sensorineural hearing loss (excluding cases with conductive and retrocochlear disorders) of 120 patients using ILO88/92 equipment with standard test conditions.

[Malignant transformation of a peripheral nerve sheath tumor in the area of the paranasal sinuses].

Background: Distinguishing schwannoma from neurofibroma of the paranasal sinuses can be difficult.

Patients: We present the rare case of malignant peripheral nerve sheath tumor of the frontoethmoid complex that occurred in a patient who had suffered from schwannoma at the same site 7 years before. The tumor was examined clinically, histologically, and immunohistochemically.

[Amplitude changes in distortion products of otoacoustic emissions after acute noise exposure].

Background: The inner ear responds to acute impact of high-intensity noise with a temporary threshold shift (TTS), which represents a reaction of the outer hair cells. That is why TTS should be detectable as changes of distortion-product otoacoustic emissions (DPOAE).

Methods: DPOAE were measured in 102 ears in 59 test subjects with normal hearing before and after definitive noise exposure (20 min of "white noise" at 90 dB HL).

[Cultivation of human cartilage tissue in a 3-dimensional perfusion culture chamber: characterization of collagen synthesis].

In reconstructive head and neck surgery, there is a great need for cartilage transplants. Sufficient autologous graft is often not available. Heterologous cartilage is used frequently, although there is danger of transmitting viral infections and resorption rates are high.

[Reliability of brain stem audiometry in specific learning disorders (disorders of sensory integration)].

Diagnostic audiological tests performed in ten children from 1985 to 1991 showed remarkable differences between the results of behavioral audiometry (free field or pure tone audiometry) and those of auditory evoked response audiometry. Auditory brainstem response (ABR) was absent in seven children with sensory neural hearing loss. Neuropsychological evaluation was performed on four children, neuropsychological observation was performed on two children, pediatric examination was performed on three children and one child showed signs of neuropediatric disorder.

[The monochord, its path from Pythagorean musicology to testing the upper auditory tone limit. Pictures from the history of otorhinolaryngology, represented by instruments of the Ingolstadt German Medical History Museum].

The monochord consists of a frame with a string or pianowire stretched across it. The length of the wire can be varied by a movable bridge. The string or wire is plucked, hit, or bowed, producing transverse vibrations.

[Specificity and sensitivity of transient click-evoked otoacoustic emissions (TEOAE)].

Transient click evoked otoacoustic emissions (TEOAE) have been shown to be a good test of hearing impairment especially when used for infant screening. However, occasional cases of false positive results--TEOAEs in spite of severe hearing loss--have been reported. This study encompasses 243 children whose hearing thresholds were known from subjective hearing tests and--in questionable cases--derived from additional auditory evoked potentials.

[Distortion product otoacoustic emissions (DPOAE) in chronic noise-induced hearing loss--recommendations for expert assessment].

The German guidelines for evaluation of chronic noise-induced hearing loss (NHL) require two special auditory tests besides pure tone and speech audiometry tests as proof of damage to the organum spirale. This requirement is the subject of controversy because of the subjective nature of the tests as well as the secondary ascending degeneration of neurons in cases of long-term NIHL. The application of otoacoustic emissions (OAE) could be a new starting point, independent of recruitment.

[Modern aspects of tympanoplasty. An overview].

The cholesteatoma should be removed with a canal wall down-technique in small mastoids. In patients with well or highly pneumatized temporal bones the reconstruction of the posterior canal wall is recommended after complete removal of the matrix. Myringoplasty is mainly performed using perichondrium.

[Effect of growth factors on cell proliferation and matrix synthesis in cultured human chondrocytes].

In reconstructive surgery, autologous cartilage grafting is commonly performed to reconstruct skeletal defects. Because of the limited supply of fresh autologous cartilage, many investigators concentrate on the in vitro production of cartilage tissue. Several growth factors regulate the metabolism and activation of cartilage cells.

[Possible applications for micro-plates in ENT surgery].

Microplates are smaller and more ductile than miniplates. We used microplates for fixation of fractures in children (seven cases), reconstruction of isolated frontal sinus wall fractures (39 cases), fixation of lateral mid-facial fractures (79 cases), fractures of the nasoethmoidal complex (14 cases), for different osteoplastic procedures (40 cases) and for laryngoplasty (three cases). Thirty fractures of the lateral mid-face were treated only with microplates.

[The Galton whistle and discovery of presbycusis. Images from the history of otorhinolaryngology, exemplified by equipment from the collection of the Ingolstadt German Medical History Museum].

One of the many interests of Sir Francis Galton (1822-1911), a singularly versatile English research worker, was anthropometry, i.e. measuring and comparing physical attributes in men.

[Grass seed kernel in the efferent duct as a rare cause of acute parotitis].

A patient with a case of acute parotitis resulting from a foreign body is reported. In the case presented, Stensen's duct was found to be blocked by a grass seed. Removal of this foreign body resulted in quick resolution of the patient's symptoms.

[Treatment of acute and chronic laryngeal and tracheal stenoses in the 19th and beginning of the 20th century by tracheotomy, coniotomy, intubation and dilatation. Pictures from the history of otorhinolaryngology illustrated by instruments from the collection of the Ingolstadt Medical History Museum].

Although tracheotomy had been described in the Middle Ages and especially in the 17th century in writings (Fabricius d'Aquapendente 1620) and illustrations (Scultetus 1645), there was hardly any possibility of actually performing this operation as a life-saving intervention until the middle of the 19th century. It was only after suitable cannulae had been introduced by Trousseau in 1851 (double cannula with removeable insert) that tracheotomy became a routine procedure, and it was immediately carried out in a great many cases of diphtheria, croup, typhus, and lues, which often caused critical dispnea. Within the following 25 years, all technical modifications of cannulae were devised that are in use up to this day: the flap valve for the artificial larynx (1861), inflatable cuff (1871), and extra long flexible cannula.

[Collapse of the nasal alae and instruments for treating this condition, especially with the Feldbausch nasal dilator. Pictures from the history of otorhinolaryngology, presented by instruments from the collection of the German Museum of Medical History in Ingolstadt].

Although the anatomy of the nasal muscles and the active movement of the nasal alae brought about by them, were already known in ancient times (Galenos), it was only at the end of the 19th century that the collapse of the nasal alae was recognized as a passive mechanism obstructing the inspiratory air passages. Since surgical methods for treating this condition were not available at that time, various small gadgets to be introduced into the nasal vestibulum were invented for stabilising the alae. Among these, Feldbausch's nasal dilator was the best known.

[Noninvasive assessment of intracochlear pressure. III. Case reports of patients with intracochlear hyper- and hypotension].

It was the scope of two previous papers to outline the basics and possible neurotological applications of the tympanic membrane displacement technique (TMD). The present paper is aimed at briefly reviewing five distinct cases where a sudden sensorineural hearing loss with/without tinnitus could be monitored by the TMD technique. These features include a sudden hearing loss upon lumbar puncture, the audiological manifestation of an internal hydrocephalus, stapes gusher and the round window rupture.