Sylva Bartelfriedrich - Academia.edu (original) (raw)
Papers by Sylva Bartelfriedrich
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...
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GMS current topics in otorhinolaryngology, head and neck surgery, 2007
In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ... more In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ear are predominantly unilateral (ca. 70-90%) and mostly involve the right ear. Inner ear malformations can be unilateral or bilateral. The incidence of ear malformations is approximately 1 in 3800 newborns. Ear malformations may be genetic (associated with syndromes or not, with family history, spontaneous mutations) or acquired in nature. Malformations can affect the outer ear (pinna and external auditory canal, EAC), middle ear and inner ear, not infrequently in combination. Formal classification is advisable in order to be able to predict the prognosis and compare treatment schedules. Various classifications have been proposed: pinna and EAC malformations according to Weerda [1], middle ear malformations according to Kösling [2], and inner ear malformations according to Jackler [3], [4], to Marangos [5] and to Sennaroglu [6]. Additionally, we describe Altmann's classification of ...
Laryngo Rhino Otologie, Apr 1, 2007
... nach Kösling [2], für Innenohrfehlbildungen nach Jack− ler [3,4], Marangos [5] und Sennaroglu... more ... nach Kösling [2], für Innenohrfehlbildungen nach Jack− ler [3,4], Marangos [5] und Sennaroglu [6]. We− gen der klinischen Verbreitung und Praktikabili− tät werden ergänzend für die Atresia auris conge− nita die Altmann ... [35], Lambert [36], Weerda [1], Maran− gos [5] und ...
In Vivo, Mar 1, 2010
The term 'central auditory processing disorder' (CAPD; in German-speaking countries: 'auditive Ve... more The term 'central auditory processing disorder' (CAPD; in German-speaking countries: 'auditive Verarbeitungs-und Wahrnehmungsstörung', AVWS) embraces various complex disorders of central auditory function. The purpose of this preliminary study was to develop a functional magnetic resonance imaging (fMRI) test set in order to extend the diagnostic work-up to include imaging, and thus to improve both diagnostic performance and the monitoring of treatment outcome. fMRI was performed in 11 healthy children ranging in age from 7 to 10 years and in 11 healthy adults (age range: 23 to 31 years). Three tests, used for diagnosis of CAPD, served as the basis for fMRI paradigms: the Hannover phoneme discrimination test (HPDT); the auditory memory span test (MST) and the dichotic listening test (DLT). In the HPDT, activations in the dorsal part of the superior temporal gyrus (STG) were found on both sides, in the Broca area and in the left middle temporal gyrus, typical for phonemic tasks. The MST showed bilateral activations of the STG, typical for processing of pseudo-words. In addition, bilateral activation of the hippocampus was found. However, there was no clear activity in the left supramarginal gyrus, where the phonological store is thought to be located. The DLT showed activations of the bilateral STG and of the left inferior frontal gyrus. Predominantly, the paradigms showed typical activation patterns of the examined central auditory functions. These results can serve as a reference for future examinations in children with AVWS/CAPD.
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2009
Journal of Neurology Neurosurgery and Psychiatry, Jul 1, 1998
Anticancer Research, 2000
The extent of radiogenic salivary tissue damage (direct cell damage, reactive cell infiltration, ... more The extent of radiogenic salivary tissue damage (direct cell damage, reactive cell infiltration, increasing fibrosis) depends on the radiation dose (RD), the fractionation (FN) and the localisation of the salivary gland (SG) in the radiation field (RF). Because the histological damage is characterized by cellular and structural alterations and because extracellular matrix proteins, for example laminin (LA), are among the main components of the basement membrane (BM), which is considered to possess cell- and tissue structure-regulating functions, we set out to describe radiogenic BM changes. In 124 rat mandibular SG we investigated HE-stained sections and the LA staining profile (LASP) dependent on age [1 year (y) vs. 1 1/2 y], on FN [2 Gy/day up to a total dosage of 20/40/60 Gy (X-rays)], on RF [(left head and neck area); inside (left-sided SG) vs. outside (right-sided SG) RF] and on the latency of irradiation (1/2 y vs. 1 y) using immunohistochemical methods and multivariate analysis. The immunoreactivity of the polyclonal antibody in the rat did not differ from the LASP in humans. LA was detected at variable levels in the glandular tissue, in vascular walls (without staining in the adventitia) and in nerve tissue (NT). No reaction was found in the capsule and the trabecula. In irradiated SG most tissue structures, including the vascular wall and NT, showed significantly stronger staining (both increased intensity and more extended expression). With increasing RD from 20 Gy to 60 Gy we found an increasing staining reaction. In addition, conglomerated LA depots were noted, especially in ares of disturbed or former acini of glands exposed to 60 Gy. The LASP up to 20 Gy was non-uniform and did not differ significantly from that in controls. A remarkable finding was the similar dose-dependent increase in staining reaction on both sides in several tissues of irradiated animals. Predominantly, however, we found considerably greater increases in staining in directly exposed glands than in out-of-field glands. Age and time since irradiation had no significant effect on staining. The BM constituent LA showed dose-dependent increases in expression--analogous to positively dose-dependent increasing SG tissue damage--which could contribute to disturbed cell-matrix interaction and SG radiation damage. Several parenchymal structures may be more sensitive to possible scattered radiation.
Laryngo Rhino Otologie, 2001
Trauma Und Berufskrankheit, 2000
Ziel dieser Untersuchung war, den Stellenwert der B-Bild-Sonographie im Vergleich zur Röntgend... more Ziel dieser Untersuchung war, den Stellenwert der B-Bild-Sonographie im Vergleich zur Röntgendiagnostik für die Diagnostik der Gelenkfortsatzfrakturen des Unterkiefers zu bestimmen. Es wurden 32 Patienten mit ¶39 Frakturen des Gelenkfortsatzes des Unterkiefers B-Bild-sonographisch und konventionell radiologisch untersucht. Die Sonographie hatte mit einer Rate von 67% richtig-positiven Frakturdiagnosen eine nur mäßige diagnostische Treffsicherheit. Insbesondere sind Diastasen, Achsabknickungen und interponierende Weichgewebe
Anticancer Research, 2000
The extent of radiogenic damage in salivary gland (SG) tissue depends on the radiation dose (RD),... more The extent of radiogenic damage in salivary gland (SG) tissue depends on the radiation dose (RD), the fractionation (FN) and the localization of SG in the radiation field (RF). While the functional restriction and the radiogenic SG tissue damage are well documented using histomorphological, electron-microscopic and enzyme-histochemical methods, immunohistochemical analysis (IH) of cytokeratins (CK), epithelial differentiation markers, and vimentin, a marker of mesenchymal cells, are rare. Previous studies have shown stronger immunoreactivities of CK in irradiated glands exposed to 60 Gy total dosage. This study was performed to examine dose dependence and alterations related to age, RF, and latency of irradiation. In 124 rat mandibular SG we investigated the vimentin and CK staining profile dependent on age [1 year (y) vs. 1 1/2 y], on FN [2 Gy/day up to a total dosage of 20/40/60 Gy (x-rays)], on RF (inside vs. outside RF) and on the time since irradiation (1/2 y vs. 1 y) using IH. The mouse monoclonal anti-CK antibodies [(AB) D5/16B4, Ks 13.1, E 3, K8.12, Ks 18.04, against CK 5-6, CK 13, CK 17, CK 13-15-16, CK 18) and the polyclonal anti-vimentin AB GP53 identified different epithelia and mesenchymal structures in rat SG tissue, including excretory duct cells (ECD), striated duct cells (SD), granular convoluted tubules (GTC), intercalated duct cells (ICD) and myoepithelial cells (MC). MC and mesenchymal cells were positive for vimentin AB. The different CK were detected in cell type-specific patterns and at variable levels in non-irradiated SG. In irradiated SG most cell types showed significantly stronger staining for various CKs. With increasing RD from 20 Gy to 60 Gy we found an increasing staining reaction. The CK staining profile up to 20 Gy was non-uniform and did not differ significantly from controls. Age and time since irradiation played a minor role or had no significant effect on staining. The CK and vimentin immunoreactivity showed dose-dependent increasing expressions, which could contribute to radiogenic cell and tissue damage. In some tissue structures a possible scattered irradiation effect should be mentioned. Age and time since irradiation (chosen in the study) had a minor or insignificant effect on staining profiles.
Trauma und Berufskrankheit, 2000
... Das Ausmaß der Disloka-tion des kurzen Fragments war sono-graphisch nur sehr eingeschränkt zu... more ... Das Ausmaß der Disloka-tion des kurzen Fragments war sono-graphisch nur sehr eingeschränkt zu be-urteilen und erforderte zur korrekten Einschätzung die ... Ultraschall Med 15:213216 4. Graif M, Stahl-Kent V, Ben-Ami T, Strauss S, Amit Y, Itzchak Y (1988) Sonographic ...
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, 2008
Large endolymphatic duct and sac (LEDS) syndrome is the most common radiologically detectable for... more Large endolymphatic duct and sac (LEDS) syndrome is the most common radiologically detectable form of inner ear malformation (IEM) associated with sensorineural hearing loss (SNHL). Nevertheless, it is relatively unknown in the German-speaking countries. Among all patients referred from ear, nose, and throat specialists to the radiology department with clinically suspected IEM between 1994 and 2003, we identified the cases of LEDS. The retrospective study included clinical records, high-resolution computed tomography, and magnetic resonance imaging. Of 169 patients, 17 (median age 12 years; 12 females) showed LEDS. A total of 28 ears were affected. Ten patients (6%; 15 ears) had isolated LEDS, while seven patients showed additional IEM (4%; 13 ears). The most frequent of these was dysplastic vestibule (13/13 ears), followed by Mondini deformity (10/13 ears) and dilated semicircular canals (7/13 ears). Three of 13 ears revealed severe IEM of the cochlea, vestibule, and semicircular canals. No correlation could be demonstrated between the severity of morphological changes and the degree of SNHL. LEDS may be an underestimated cause of SNHL. Imaging is necessary for a confident diagnosis.
HNO, 2008
The aim of this study was to clarify the clinical course of large endolymphatic duct and sac synd... more The aim of this study was to clarify the clinical course of large endolymphatic duct and sac syndrome (LEDS). Although LEDS is the most common form of radiologically detectable inner ear malformation associated with sensorineural hearing loss (SNHL), it is relatively unknown in the German-speaking countries. We hoped to derive useful pointers for clinical care. We evaluated the clinical audiometric records and imaging findings of 169 patients with clinically suspected inner ear malformation seen between 1994 and 2003. Following identification of all LEDS cases, we serially investigated the anamnestic and functional data with regard to severity and course. Among 169 patients, 17 (median age 12 years; 12 females) showed LEDS. A total of 28 ears were affected. Clinically, most cases were of prelingual or perilingual onset and displayed steady or fluctuatingly progressive severe SNHL with emphasis on the high frequencies or deafness. Episodes of sudden hearing loss were relatively frequent. No correlation could be demonstrated between the severity of morphological changes and the degree of SNHL. Progression of SNHL and episodes of sudden hearing loss were seen mainly in late childhood or adolescence. This should be taken into account when informing and advising patients and planning therapy.
Journal of Oral and Maxillofacial Surgery, 2000
This study investigated the distribution of collagen III and IV in experimental microvascular ana... more This study investigated the distribution of collagen III and IV in experimental microvascular anastomoses and correlated the findings with the quality of the healing process. A previously excised and reanastomosed section of the left common carotid artery of 21 female Wistar rats were explanted 4 weeks after surgery. Collagens III and IV were identified in perfusion-fixed specimens by immunohistochemistry. The identification and distribution of collagens reflected the quality of each suturing procedure. A myointimal hyperplasia was present, extending into the vascular lumen, and was closely related to the ends of the vessel segments. The extent of myointimal hyperplasia was dependent on the length and the vitality of the vessel segments. The media was the weakest part of the tissue layers with regard to regenerative potential in the axial direction. The marked cuff of the adventitia around the anastomosis was rich in collagen III-positive vasa vasorum. Collagen IV was distributed in net-like patterns in the media. The distribution pattern in the media was not observed in anastomoses with incomplete approximation and necrotic segment ends. The collagen IV-positive subendothelial basal membrane was incomplete in the aneurysms because of partial necrosis. The experimental findings support the need for atraumatic suturing in microvascular surgery. Immunohistochemical detection of collagens can be a valuable tool for studying the basic processes of wound healing and the integration of microvascular flaps into their recipient sites.
Clinical Oral Investigations, 2003
The aim of this study was to evaluate the application and limitation of ultrasound in the diagnos... more The aim of this study was to evaluate the application and limitation of ultrasound in the diagnosis of midfacial fractures. Eighty-one patients with radiologically proved fractures of the facial skeleton were included in this study. Examinations were performed using a 7.5-MHz small-part applicator. Another ten patients without facial fractures served as controls with normal sonoanatomical findings. The most important deficiency of ultrasound in the diagnosis of midfacial fractures is the difficult detection of non-dislocated fractures. According to our own experiences, the application of ultrasound in midfacial fractures is most useful for visualization of the zygomatic arch and the anterior wall of the frontal sinus, with immediate imaging after closed reduction avoiding radiation exposure. Moreover, it is restricted to fractures of the orbital margin and nasal bone. If ultrasound is performed as the first imaging modality in cases of suspected facial fractures by an experienced investigator, the visualization of fracture lines can avoid conventional imaging, so that only an indicated CT scan can be added. In doubtful cases, an individual combination of conventional radiographs would be the next step. By this, an overall reduction of radiation exposure seems possible.
American Journal of Medical Genetics Part A, 2005
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...
GMS current topics in otorhinolaryngology, head and neck surgery, 2007
In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ... more In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ear are predominantly unilateral (ca. 70-90%) and mostly involve the right ear. Inner ear malformations can be unilateral or bilateral. The incidence of ear malformations is approximately 1 in 3800 newborns. Ear malformations may be genetic (associated with syndromes or not, with family history, spontaneous mutations) or acquired in nature. Malformations can affect the outer ear (pinna and external auditory canal, EAC), middle ear and inner ear, not infrequently in combination. Formal classification is advisable in order to be able to predict the prognosis and compare treatment schedules. Various classifications have been proposed: pinna and EAC malformations according to Weerda [1], middle ear malformations according to Kösling [2], and inner ear malformations according to Jackler [3], [4], to Marangos [5] and to Sennaroglu [6]. Additionally, we describe Altmann's classification of ...
Laryngo Rhino Otologie, Apr 1, 2007
... nach Kösling [2], für Innenohrfehlbildungen nach Jack− ler [3,4], Marangos [5] und Sennaroglu... more ... nach Kösling [2], für Innenohrfehlbildungen nach Jack− ler [3,4], Marangos [5] und Sennaroglu [6]. We− gen der klinischen Verbreitung und Praktikabili− tät werden ergänzend für die Atresia auris conge− nita die Altmann ... [35], Lambert [36], Weerda [1], Maran− gos [5] und ...
In Vivo, Mar 1, 2010
The term 'central auditory processing disorder' (CAPD; in German-speaking countries: 'auditive Ve... more The term 'central auditory processing disorder' (CAPD; in German-speaking countries: 'auditive Verarbeitungs-und Wahrnehmungsstörung', AVWS) embraces various complex disorders of central auditory function. The purpose of this preliminary study was to develop a functional magnetic resonance imaging (fMRI) test set in order to extend the diagnostic work-up to include imaging, and thus to improve both diagnostic performance and the monitoring of treatment outcome. fMRI was performed in 11 healthy children ranging in age from 7 to 10 years and in 11 healthy adults (age range: 23 to 31 years). Three tests, used for diagnosis of CAPD, served as the basis for fMRI paradigms: the Hannover phoneme discrimination test (HPDT); the auditory memory span test (MST) and the dichotic listening test (DLT). In the HPDT, activations in the dorsal part of the superior temporal gyrus (STG) were found on both sides, in the Broca area and in the left middle temporal gyrus, typical for phonemic tasks. The MST showed bilateral activations of the STG, typical for processing of pseudo-words. In addition, bilateral activation of the hippocampus was found. However, there was no clear activity in the left supramarginal gyrus, where the phonological store is thought to be located. The DLT showed activations of the bilateral STG and of the left inferior frontal gyrus. Predominantly, the paradigms showed typical activation patterns of the examined central auditory functions. These results can serve as a reference for future examinations in children with AVWS/CAPD.
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2009
Journal of Neurology Neurosurgery and Psychiatry, Jul 1, 1998
Anticancer Research, 2000
The extent of radiogenic salivary tissue damage (direct cell damage, reactive cell infiltration, ... more The extent of radiogenic salivary tissue damage (direct cell damage, reactive cell infiltration, increasing fibrosis) depends on the radiation dose (RD), the fractionation (FN) and the localisation of the salivary gland (SG) in the radiation field (RF). Because the histological damage is characterized by cellular and structural alterations and because extracellular matrix proteins, for example laminin (LA), are among the main components of the basement membrane (BM), which is considered to possess cell- and tissue structure-regulating functions, we set out to describe radiogenic BM changes. In 124 rat mandibular SG we investigated HE-stained sections and the LA staining profile (LASP) dependent on age [1 year (y) vs. 1 1/2 y], on FN [2 Gy/day up to a total dosage of 20/40/60 Gy (X-rays)], on RF [(left head and neck area); inside (left-sided SG) vs. outside (right-sided SG) RF] and on the latency of irradiation (1/2 y vs. 1 y) using immunohistochemical methods and multivariate analysis. The immunoreactivity of the polyclonal antibody in the rat did not differ from the LASP in humans. LA was detected at variable levels in the glandular tissue, in vascular walls (without staining in the adventitia) and in nerve tissue (NT). No reaction was found in the capsule and the trabecula. In irradiated SG most tissue structures, including the vascular wall and NT, showed significantly stronger staining (both increased intensity and more extended expression). With increasing RD from 20 Gy to 60 Gy we found an increasing staining reaction. In addition, conglomerated LA depots were noted, especially in ares of disturbed or former acini of glands exposed to 60 Gy. The LASP up to 20 Gy was non-uniform and did not differ significantly from that in controls. A remarkable finding was the similar dose-dependent increase in staining reaction on both sides in several tissues of irradiated animals. Predominantly, however, we found considerably greater increases in staining in directly exposed glands than in out-of-field glands. Age and time since irradiation had no significant effect on staining. The BM constituent LA showed dose-dependent increases in expression--analogous to positively dose-dependent increasing SG tissue damage--which could contribute to disturbed cell-matrix interaction and SG radiation damage. Several parenchymal structures may be more sensitive to possible scattered radiation.
Laryngo Rhino Otologie, 2001
Trauma Und Berufskrankheit, 2000
Ziel dieser Untersuchung war, den Stellenwert der B-Bild-Sonographie im Vergleich zur Röntgend... more Ziel dieser Untersuchung war, den Stellenwert der B-Bild-Sonographie im Vergleich zur Röntgendiagnostik für die Diagnostik der Gelenkfortsatzfrakturen des Unterkiefers zu bestimmen. Es wurden 32 Patienten mit ¶39 Frakturen des Gelenkfortsatzes des Unterkiefers B-Bild-sonographisch und konventionell radiologisch untersucht. Die Sonographie hatte mit einer Rate von 67% richtig-positiven Frakturdiagnosen eine nur mäßige diagnostische Treffsicherheit. Insbesondere sind Diastasen, Achsabknickungen und interponierende Weichgewebe
Anticancer Research, 2000
The extent of radiogenic damage in salivary gland (SG) tissue depends on the radiation dose (RD),... more The extent of radiogenic damage in salivary gland (SG) tissue depends on the radiation dose (RD), the fractionation (FN) and the localization of SG in the radiation field (RF). While the functional restriction and the radiogenic SG tissue damage are well documented using histomorphological, electron-microscopic and enzyme-histochemical methods, immunohistochemical analysis (IH) of cytokeratins (CK), epithelial differentiation markers, and vimentin, a marker of mesenchymal cells, are rare. Previous studies have shown stronger immunoreactivities of CK in irradiated glands exposed to 60 Gy total dosage. This study was performed to examine dose dependence and alterations related to age, RF, and latency of irradiation. In 124 rat mandibular SG we investigated the vimentin and CK staining profile dependent on age [1 year (y) vs. 1 1/2 y], on FN [2 Gy/day up to a total dosage of 20/40/60 Gy (x-rays)], on RF (inside vs. outside RF) and on the time since irradiation (1/2 y vs. 1 y) using IH. The mouse monoclonal anti-CK antibodies [(AB) D5/16B4, Ks 13.1, E 3, K8.12, Ks 18.04, against CK 5-6, CK 13, CK 17, CK 13-15-16, CK 18) and the polyclonal anti-vimentin AB GP53 identified different epithelia and mesenchymal structures in rat SG tissue, including excretory duct cells (ECD), striated duct cells (SD), granular convoluted tubules (GTC), intercalated duct cells (ICD) and myoepithelial cells (MC). MC and mesenchymal cells were positive for vimentin AB. The different CK were detected in cell type-specific patterns and at variable levels in non-irradiated SG. In irradiated SG most cell types showed significantly stronger staining for various CKs. With increasing RD from 20 Gy to 60 Gy we found an increasing staining reaction. The CK staining profile up to 20 Gy was non-uniform and did not differ significantly from controls. Age and time since irradiation played a minor role or had no significant effect on staining. The CK and vimentin immunoreactivity showed dose-dependent increasing expressions, which could contribute to radiogenic cell and tissue damage. In some tissue structures a possible scattered irradiation effect should be mentioned. Age and time since irradiation (chosen in the study) had a minor or insignificant effect on staining profiles.
Trauma und Berufskrankheit, 2000
... Das Ausmaß der Disloka-tion des kurzen Fragments war sono-graphisch nur sehr eingeschränkt zu... more ... Das Ausmaß der Disloka-tion des kurzen Fragments war sono-graphisch nur sehr eingeschränkt zu be-urteilen und erforderte zur korrekten Einschätzung die ... Ultraschall Med 15:213216 4. Graif M, Stahl-Kent V, Ben-Ami T, Strauss S, Amit Y, Itzchak Y (1988) Sonographic ...
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, 2008
Large endolymphatic duct and sac (LEDS) syndrome is the most common radiologically detectable for... more Large endolymphatic duct and sac (LEDS) syndrome is the most common radiologically detectable form of inner ear malformation (IEM) associated with sensorineural hearing loss (SNHL). Nevertheless, it is relatively unknown in the German-speaking countries. Among all patients referred from ear, nose, and throat specialists to the radiology department with clinically suspected IEM between 1994 and 2003, we identified the cases of LEDS. The retrospective study included clinical records, high-resolution computed tomography, and magnetic resonance imaging. Of 169 patients, 17 (median age 12 years; 12 females) showed LEDS. A total of 28 ears were affected. Ten patients (6%; 15 ears) had isolated LEDS, while seven patients showed additional IEM (4%; 13 ears). The most frequent of these was dysplastic vestibule (13/13 ears), followed by Mondini deformity (10/13 ears) and dilated semicircular canals (7/13 ears). Three of 13 ears revealed severe IEM of the cochlea, vestibule, and semicircular canals. No correlation could be demonstrated between the severity of morphological changes and the degree of SNHL. LEDS may be an underestimated cause of SNHL. Imaging is necessary for a confident diagnosis.
HNO, 2008
The aim of this study was to clarify the clinical course of large endolymphatic duct and sac synd... more The aim of this study was to clarify the clinical course of large endolymphatic duct and sac syndrome (LEDS). Although LEDS is the most common form of radiologically detectable inner ear malformation associated with sensorineural hearing loss (SNHL), it is relatively unknown in the German-speaking countries. We hoped to derive useful pointers for clinical care. We evaluated the clinical audiometric records and imaging findings of 169 patients with clinically suspected inner ear malformation seen between 1994 and 2003. Following identification of all LEDS cases, we serially investigated the anamnestic and functional data with regard to severity and course. Among 169 patients, 17 (median age 12 years; 12 females) showed LEDS. A total of 28 ears were affected. Clinically, most cases were of prelingual or perilingual onset and displayed steady or fluctuatingly progressive severe SNHL with emphasis on the high frequencies or deafness. Episodes of sudden hearing loss were relatively frequent. No correlation could be demonstrated between the severity of morphological changes and the degree of SNHL. Progression of SNHL and episodes of sudden hearing loss were seen mainly in late childhood or adolescence. This should be taken into account when informing and advising patients and planning therapy.
Journal of Oral and Maxillofacial Surgery, 2000
This study investigated the distribution of collagen III and IV in experimental microvascular ana... more This study investigated the distribution of collagen III and IV in experimental microvascular anastomoses and correlated the findings with the quality of the healing process. A previously excised and reanastomosed section of the left common carotid artery of 21 female Wistar rats were explanted 4 weeks after surgery. Collagens III and IV were identified in perfusion-fixed specimens by immunohistochemistry. The identification and distribution of collagens reflected the quality of each suturing procedure. A myointimal hyperplasia was present, extending into the vascular lumen, and was closely related to the ends of the vessel segments. The extent of myointimal hyperplasia was dependent on the length and the vitality of the vessel segments. The media was the weakest part of the tissue layers with regard to regenerative potential in the axial direction. The marked cuff of the adventitia around the anastomosis was rich in collagen III-positive vasa vasorum. Collagen IV was distributed in net-like patterns in the media. The distribution pattern in the media was not observed in anastomoses with incomplete approximation and necrotic segment ends. The collagen IV-positive subendothelial basal membrane was incomplete in the aneurysms because of partial necrosis. The experimental findings support the need for atraumatic suturing in microvascular surgery. Immunohistochemical detection of collagens can be a valuable tool for studying the basic processes of wound healing and the integration of microvascular flaps into their recipient sites.
Clinical Oral Investigations, 2003
The aim of this study was to evaluate the application and limitation of ultrasound in the diagnos... more The aim of this study was to evaluate the application and limitation of ultrasound in the diagnosis of midfacial fractures. Eighty-one patients with radiologically proved fractures of the facial skeleton were included in this study. Examinations were performed using a 7.5-MHz small-part applicator. Another ten patients without facial fractures served as controls with normal sonoanatomical findings. The most important deficiency of ultrasound in the diagnosis of midfacial fractures is the difficult detection of non-dislocated fractures. According to our own experiences, the application of ultrasound in midfacial fractures is most useful for visualization of the zygomatic arch and the anterior wall of the frontal sinus, with immediate imaging after closed reduction avoiding radiation exposure. Moreover, it is restricted to fractures of the orbital margin and nasal bone. If ultrasound is performed as the first imaging modality in cases of suspected facial fractures by an experienced investigator, the visualization of fracture lines can avoid conventional imaging, so that only an indicated CT scan can be added. In doubtful cases, an individual combination of conventional radiographs would be the next step. By this, an overall reduction of radiation exposure seems possible.
American Journal of Medical Genetics Part A, 2005