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Papers by Stephan Knipping
Laryngo-Rhino-Otologie, 2001
HNO, 2002
Zusammenfassung Das primre ziliare Dyskinesiesyndrom (PZD) stellt ein seltenes autosomal-rezess... more Zusammenfassung Das primre ziliare Dyskinesiesyndrom (PZD) stellt ein seltenes autosomal-rezessiv vererbtes Krankheitsbild dar. Ein Subtyp des PZD mit einer Kombination von Bronchieektasien, Situs inversus und einer chronischen Sinusitis wird als Kartagener-Syndrom bezeichnet. Die Patienten leiden besonders unter rekurrenten Infekten der oberen und unteren Luftwege. Ein 25-jhriger mnnlicher Patient stellte sich mit schweren rezidivierenden Brochopneumonien und nachgewiesener Aspergillusinfektion der Lunge im
Klin Monatsbl Augenheilk, 2008
Hno, Mar 1, 2009
Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. ... more Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. We wanted to answer the following question: Are postoperative antibiotics mandatory after abscess tonsillectomy? In an epidemiological observational study, 283 patients (98 females and 185 males, age range 2-72 years) were treated with abscess tonsillectomy for PTA. For a prospective randomized multicenter study, 105 patients were divided into two groups; one group was treated postoperatively with benzylpenicillin, and antibiotics were omitted in the control group. We evaluated postoperative pain scores, swallowing disorders, and well-being. Additionally, laboratory parameters such as C-reactive protein, leukocytes, and antistreptolysin titer were measured, and blood cultures were collected. Male patients in the 2nd-4th decades of life were predominantly affected, mostly in the summer. For the patients in the two groups, we assessed no significant differences in either the subjective or the laboratory parameters. The blood cultures showed no evidence of bacteremia. We conclude that immediately performed abscess tonsillectomy is an effective and safe treatment for PTA. No higher complication rate was found when additional antibiotic treatment was not used. Because of the small number of cases, the results can be regarded only as a tendency, not as a general recommendation.
Laryngo-Rhino-Otologie, 2003
Background: Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced ... more Background: Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced by external as well as internal stimuli. In addition to classic and peptidergic neurotransmitters, Nitric oxide (NO) was increasingly found to be important in the control ...
Laryngo-Rhino-Otologie, 2001
Laryngo-Rhino-Otologie, 2002
Laryngo-Rhino-Otologie, 2002
Hintergrund: In zunehmendem Ausmaß leiden Patienten unter den Symptomen der allergischen Rhinitis... more Hintergrund: In zunehmendem Ausmaß leiden Patienten unter den Symptomen der allergischen Rhinitis. Basierend auf einer Immunglobulin-vermittelten Hyperreaktivität kommt es zu morphologischen Veränderungen der Nasenschleimhaut. Neben Cytokin-Interaktionen scheinen auch ...
Laryngo-Rhino-Otologie, 2007
... Vergleich zu Gold deutliche Vorteile [93], zusätzlich stehen mittlerweile flexible Ketten zur... more ... Vergleich zu Gold deutliche Vorteile [93], zusätzlich stehen mittlerweile flexible Ketten zur Verfügung, nachdem sich gezeigt hat, dass starre Implantate den ... Plast Reconstr Surg 1992; 90: 1121-1122 45 Keen M, Burgoyne J, Kay S. Surgical management of the paralyzed eyelid. ...
HNO, 2009
Acute trauma with laryngeal fracture is a rare injury affecting all functions of the larynx. Resu... more Acute trauma with laryngeal fracture is a rare injury affecting all functions of the larynx. Resuscitation follows the ABC principles for acute trauma life support. The priority has always been the establishment of an adequate and secure airway. To achieve optimal therapeutic long-term results, permanent stabilisation of the airway and good functional restoration of phonation and swallowing are necessary. We describe the therapy and long-term follow-up of two patients who suffered laryngeal fracture. The first case concerns a 31-year-old woman who suffered polytrauma with laryngotracheal separation in a car accident. The fracture was reduced and fixed utilizing miniplates. After decannulation the patient had a patent airway. She regained normal voice and was able to swallow without difficulty. The other case concerns a 16-year-old boy who suffered a laryngeal fracture in a bicycle accident. He also underwent subsequent operative therapy using adaptation plates. This patient also reg...
HNO, 2009
Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. ... more Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. We wanted to answer the following question: Are postoperative antibiotics mandatory after abscess tonsillectomy? In an epidemiological observational study, 283 patients (98 females and 185 males, age range 2-72 years) were treated with abscess tonsillectomy for PTA. For a prospective randomized multicenter study, 105 patients were divided into two groups; one group was treated postoperatively with benzylpenicillin, and antibiotics were omitted in the control group. We evaluated postoperative pain scores, swallowing disorders, and well-being. Additionally, laboratory parameters such as C-reactive protein, leukocytes, and antistreptolysin titer were measured, and blood cultures were collected. Male patients in the 2nd-4th decades of life were predominantly affected, mostly in the summer. For the patients in the two groups, we assessed no significant differences in either the subjective or ...
Laryngo- rhino- otologie, 2003
Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced by external ... more Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced by external as well as internal stimuli. In addition to classic and peptidergic neurotransmitters, Nitric oxide (NO) was increasingly found to be important in the control of various physiological functions. NO regulates nasal immunology, influences macrophages activity and has antiviral and bacteriostatic properties. The aim of this study was to detect the localization of nitric oxide synthases (NOS) I and III in the normal human nasal mucosa with immunoelectron microscopical techniques. Specimens of non-inflamed inferior turbinates from 35 patients who required nasal surgery were fixed in phosphate-buffered glutaraldehyde. After dehydration, incubation in unicryl and polymerization ultrathin sections were cut. Primary antibodies against NOS I and III were applied and the immunocomplexes were visualized by an immunocytochemical staining-technique using a gold-labeled antibody. Immunostained structur...
Laryngo- rhino- otologie, 2002
In middle Europe the prevalence of allergic rhinitis is up to 15 % to 25 %. Allergic rhinitis is ... more In middle Europe the prevalence of allergic rhinitis is up to 15 % to 25 %. Allergic rhinitis is characterised by an inflammation of the nasal mucosa induced by different allergens. The patients suffer from symptoms like sneezing, rhinorrhea and nasal airway obstruction caused by morphological changes of the nasal mucosa. This symptomatology is considered to be a result of accumulation and activation of inflammatory cells. Further some neuropeptides like Calcitonin Gene Related Peptide (CGRP) and Substance P (SP) play an additional role in pathophysiology of allergic rhinitis. Tissue samples from 28 human turbinates of patients with perennial rhinitis were taken during nasal surgery and preserved in phosphate-buffered glutaraldehyde or paraformaldehyde. Ultrathin sections were cut. The samples were dehydrated and embedded in Araldit. After polymerization an immunocytochemical staining-technique using a gold-labeled antibody was carried out. Immunostained structures were photodocumen...
HNO, 2002
Primary ciliary dyskinesia syndrome (PCD) is a rare, autosomal receive disorder. Kartagener's... more Primary ciliary dyskinesia syndrome (PCD) is a rare, autosomal receive disorder. Kartagener's syndrome is a subgroup of the PCD with situs inversus, bronchiectasis, and sinusitis. The symptoms results from an abnormal ultrastructural morphology of the cilia such as absence of dynein arms and other changes. As a consequence ciliary motility is disturbed. A 25-year-old man was examined because he suffered from recurrent severe pneumonia and Aspergillus infections of the lungs. On electron micrographs, ciliary abnormalities including deficiency of inner and outer dynein arms, dysmorphic outer dynein arms, and disorientation of the cilia were demonstrated. The diagnosis of PCD requires electron-microscopic investigations of the ciliated mucosa. Special attention should be given to ultrastructural changes of nasal or bronchial mucosa if a young patient suffers from recurrent severe respiratory infections.
Laryngo- rhino- otologie, 2001
Seromucous glands are important components of the human nasal mucosa. The innervation patterns ar... more Seromucous glands are important components of the human nasal mucosa. The innervation patterns are relevant for understanding the control of the different physiological and pathophysiological glandular functions. Beside classic neurotransmitters some neuropeptides seem to influence the glandular secretion. Tissue samples of 35 human inferior turbinates were taken during nasal surgery and preserved. Serial cryosections or paraffin sections were cut and incubated with antibodies either to Tyrosinhydroxilase or to Vasoactive Intestinal Peptide (VIP), Calcitonin Gene-Related Peptide (CGRP) and endothelial or brain Nitric Oxide Synthase (eNOS or bNOS). AChE- and NADPH-diaphorase-histochemistry were performed. Immunoreactive nerve fibers were found in the periglandular tissue around the acini, ducts and in the periglandular connective tissue. The density of positive immunoreactive structures depended on the different antibodies. VIP was found in contact to acinus cells, CGRP in the connec...
Laryngo-Rhino-Otologie, 2001
HNO, 2002
Zusammenfassung Das primre ziliare Dyskinesiesyndrom (PZD) stellt ein seltenes autosomal-rezess... more Zusammenfassung Das primre ziliare Dyskinesiesyndrom (PZD) stellt ein seltenes autosomal-rezessiv vererbtes Krankheitsbild dar. Ein Subtyp des PZD mit einer Kombination von Bronchieektasien, Situs inversus und einer chronischen Sinusitis wird als Kartagener-Syndrom bezeichnet. Die Patienten leiden besonders unter rekurrenten Infekten der oberen und unteren Luftwege. Ein 25-jhriger mnnlicher Patient stellte sich mit schweren rezidivierenden Brochopneumonien und nachgewiesener Aspergillusinfektion der Lunge im
Klin Monatsbl Augenheilk, 2008
Hno, Mar 1, 2009
Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. ... more Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. We wanted to answer the following question: Are postoperative antibiotics mandatory after abscess tonsillectomy? In an epidemiological observational study, 283 patients (98 females and 185 males, age range 2-72 years) were treated with abscess tonsillectomy for PTA. For a prospective randomized multicenter study, 105 patients were divided into two groups; one group was treated postoperatively with benzylpenicillin, and antibiotics were omitted in the control group. We evaluated postoperative pain scores, swallowing disorders, and well-being. Additionally, laboratory parameters such as C-reactive protein, leukocytes, and antistreptolysin titer were measured, and blood cultures were collected. Male patients in the 2nd-4th decades of life were predominantly affected, mostly in the summer. For the patients in the two groups, we assessed no significant differences in either the subjective or the laboratory parameters. The blood cultures showed no evidence of bacteremia. We conclude that immediately performed abscess tonsillectomy is an effective and safe treatment for PTA. No higher complication rate was found when additional antibiotic treatment was not used. Because of the small number of cases, the results can be regarded only as a tendency, not as a general recommendation.
Laryngo-Rhino-Otologie, 2003
Background: Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced ... more Background: Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced by external as well as internal stimuli. In addition to classic and peptidergic neurotransmitters, Nitric oxide (NO) was increasingly found to be important in the control ...
Laryngo-Rhino-Otologie, 2001
Laryngo-Rhino-Otologie, 2002
Laryngo-Rhino-Otologie, 2002
Hintergrund: In zunehmendem Ausmaß leiden Patienten unter den Symptomen der allergischen Rhinitis... more Hintergrund: In zunehmendem Ausmaß leiden Patienten unter den Symptomen der allergischen Rhinitis. Basierend auf einer Immunglobulin-vermittelten Hyperreaktivität kommt es zu morphologischen Veränderungen der Nasenschleimhaut. Neben Cytokin-Interaktionen scheinen auch ...
Laryngo-Rhino-Otologie, 2007
... Vergleich zu Gold deutliche Vorteile [93], zusätzlich stehen mittlerweile flexible Ketten zur... more ... Vergleich zu Gold deutliche Vorteile [93], zusätzlich stehen mittlerweile flexible Ketten zur Verfügung, nachdem sich gezeigt hat, dass starre Implantate den ... Plast Reconstr Surg 1992; 90: 1121-1122 45 Keen M, Burgoyne J, Kay S. Surgical management of the paralyzed eyelid. ...
HNO, 2009
Acute trauma with laryngeal fracture is a rare injury affecting all functions of the larynx. Resu... more Acute trauma with laryngeal fracture is a rare injury affecting all functions of the larynx. Resuscitation follows the ABC principles for acute trauma life support. The priority has always been the establishment of an adequate and secure airway. To achieve optimal therapeutic long-term results, permanent stabilisation of the airway and good functional restoration of phonation and swallowing are necessary. We describe the therapy and long-term follow-up of two patients who suffered laryngeal fracture. The first case concerns a 31-year-old woman who suffered polytrauma with laryngotracheal separation in a car accident. The fracture was reduced and fixed utilizing miniplates. After decannulation the patient had a patent airway. She regained normal voice and was able to swallow without difficulty. The other case concerns a 16-year-old boy who suffered a laryngeal fracture in a bicycle accident. He also underwent subsequent operative therapy using adaptation plates. This patient also reg...
HNO, 2009
Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. ... more Peritonsillar abscess (PTA) is a common and serious complication of acute exudative tonsillitis. We wanted to answer the following question: Are postoperative antibiotics mandatory after abscess tonsillectomy? In an epidemiological observational study, 283 patients (98 females and 185 males, age range 2-72 years) were treated with abscess tonsillectomy for PTA. For a prospective randomized multicenter study, 105 patients were divided into two groups; one group was treated postoperatively with benzylpenicillin, and antibiotics were omitted in the control group. We evaluated postoperative pain scores, swallowing disorders, and well-being. Additionally, laboratory parameters such as C-reactive protein, leukocytes, and antistreptolysin titer were measured, and blood cultures were collected. Male patients in the 2nd-4th decades of life were predominantly affected, mostly in the summer. For the patients in the two groups, we assessed no significant differences in either the subjective or ...
Laryngo- rhino- otologie, 2003
Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced by external ... more Nasal vasculature and seromucous glands are exposed to complex mechanisms influenced by external as well as internal stimuli. In addition to classic and peptidergic neurotransmitters, Nitric oxide (NO) was increasingly found to be important in the control of various physiological functions. NO regulates nasal immunology, influences macrophages activity and has antiviral and bacteriostatic properties. The aim of this study was to detect the localization of nitric oxide synthases (NOS) I and III in the normal human nasal mucosa with immunoelectron microscopical techniques. Specimens of non-inflamed inferior turbinates from 35 patients who required nasal surgery were fixed in phosphate-buffered glutaraldehyde. After dehydration, incubation in unicryl and polymerization ultrathin sections were cut. Primary antibodies against NOS I and III were applied and the immunocomplexes were visualized by an immunocytochemical staining-technique using a gold-labeled antibody. Immunostained structur...
Laryngo- rhino- otologie, 2002
In middle Europe the prevalence of allergic rhinitis is up to 15 % to 25 %. Allergic rhinitis is ... more In middle Europe the prevalence of allergic rhinitis is up to 15 % to 25 %. Allergic rhinitis is characterised by an inflammation of the nasal mucosa induced by different allergens. The patients suffer from symptoms like sneezing, rhinorrhea and nasal airway obstruction caused by morphological changes of the nasal mucosa. This symptomatology is considered to be a result of accumulation and activation of inflammatory cells. Further some neuropeptides like Calcitonin Gene Related Peptide (CGRP) and Substance P (SP) play an additional role in pathophysiology of allergic rhinitis. Tissue samples from 28 human turbinates of patients with perennial rhinitis were taken during nasal surgery and preserved in phosphate-buffered glutaraldehyde or paraformaldehyde. Ultrathin sections were cut. The samples were dehydrated and embedded in Araldit. After polymerization an immunocytochemical staining-technique using a gold-labeled antibody was carried out. Immunostained structures were photodocumen...
HNO, 2002
Primary ciliary dyskinesia syndrome (PCD) is a rare, autosomal receive disorder. Kartagener's... more Primary ciliary dyskinesia syndrome (PCD) is a rare, autosomal receive disorder. Kartagener's syndrome is a subgroup of the PCD with situs inversus, bronchiectasis, and sinusitis. The symptoms results from an abnormal ultrastructural morphology of the cilia such as absence of dynein arms and other changes. As a consequence ciliary motility is disturbed. A 25-year-old man was examined because he suffered from recurrent severe pneumonia and Aspergillus infections of the lungs. On electron micrographs, ciliary abnormalities including deficiency of inner and outer dynein arms, dysmorphic outer dynein arms, and disorientation of the cilia were demonstrated. The diagnosis of PCD requires electron-microscopic investigations of the ciliated mucosa. Special attention should be given to ultrastructural changes of nasal or bronchial mucosa if a young patient suffers from recurrent severe respiratory infections.
Laryngo- rhino- otologie, 2001
Seromucous glands are important components of the human nasal mucosa. The innervation patterns ar... more Seromucous glands are important components of the human nasal mucosa. The innervation patterns are relevant for understanding the control of the different physiological and pathophysiological glandular functions. Beside classic neurotransmitters some neuropeptides seem to influence the glandular secretion. Tissue samples of 35 human inferior turbinates were taken during nasal surgery and preserved. Serial cryosections or paraffin sections were cut and incubated with antibodies either to Tyrosinhydroxilase or to Vasoactive Intestinal Peptide (VIP), Calcitonin Gene-Related Peptide (CGRP) and endothelial or brain Nitric Oxide Synthase (eNOS or bNOS). AChE- and NADPH-diaphorase-histochemistry were performed. Immunoreactive nerve fibers were found in the periglandular tissue around the acini, ducts and in the periglandular connective tissue. The density of positive immunoreactive structures depended on the different antibodies. VIP was found in contact to acinus cells, CGRP in the connec...