Orlando Guntinas-lichius | University Hospital Jena (original) (raw)

Papers by Orlando Guntinas-lichius

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn, May 1, 2021

PLOS ONE, Feb 10, 2020

Objective To analyze the effect of adjuvant oral application of honey for treating postoperative ... more Objective To analyze the effect of adjuvant oral application of honey for treating postoperative pain after tonsillectomy. Design Single centre prospective cohort study. Setting Two cohorts of patients after tonsillectomy. Participants 56 patients treated with honey 8 times per day (honey group), 18 patients treated without honey (control group); baseline analgesia were non-steroidal anti-inflammatory drugs (NSAID) or coxibs; opioids were used as pro re nata (PRN) medication; mean age 34.4 ± 13.4 years; 36% women. Main outcome measures On first to fifth postoperative day, patients rated their pain using the validated questionnaire of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale (NRS, 0-10) for determination of patient's pain. QUIPS allows standardized assessment of patients' characteristics andpain-associated patientreported outcomes (PROs). The influence of preoperative and postoperative parameters on patients' postoperative pain were estimated by univariate and multivariate statistical analysis.

Brain Structure & Function, Mar 30, 2013

Deafferentation of motoneurons after facial nerve injury is a well-documented phenomenon but whet... more Deafferentation of motoneurons after facial nerve injury is a well-documented phenomenon but whether synaptic inputs to facial motoneurons are completely restored after reinnervation is unknown. Here, we tested the hypothesis that deficits in motor performance after transection/suture of the facial nerve (facial-facial anastomosis, FFA) in adult rats are associated with incomplete recovery of synaptic inputs. At 2 months after FFA, we found, in congruence with previous results, that the amplitude of whisking had recovered to only 31 % of control (sham operation). In the same FFA-treated rats, estimates of number of chemically defined synaptic terminals in the facial nucleus by immunohistochemistry and stereology showed a significant loss, compared with sham controls, of glutamatergic terminals (-26 %) and cholinergic perisomatic boutons (-31 %), but not inhibitory (GABA/glycinergic) terminals (-14 %). Synaptic deficits were accompanied by persistent microgliosis in the facial nucleus but soma area, dendritic arbor volume, and total number of motoneurons were normal. Correlation analyses revealed significant co-variations of whisking amplitude with number of glutamatergic and cholinergic synapses. Compared with 2 months, analyses of animals at 4 months after FFA showed no attenuation of the functional deficit and structural aberrations with one exception, increase of inhibitory terminal numbers beyond control level (?11 %) leading to further reduction of the excitatory/inhibitory terminal ratio. We suggest that deficits in motoneuron innervation in the regenerated facial nucleus-reduced glutamatergic and cholinergic input and reduced excitatory/inhibitory terminal ratio-could attenuate the motor output and, thus, negatively impact the functional performance after facial nerve regeneration. Keywords Cholinergic synapses Á Stereology Á Synaptic terminals Á Vesicular GABA transporter Á Vesicular glutamate transporter 2 Á Whisking Abdulrahman Raslan and Philipp Ernst contributed equally to this work.

Laryngo-rhino-otologie, Dec 21, 2010

ABSTRACT Tonsillectomy leads to strong postoperative pain. Pain management often is not optimal a... more ABSTRACT Tonsillectomy leads to strong postoperative pain. Pain management often is not optimal after tonsillectomy. To date, there exists no clear guideline for pain management after tonsillectomy. In a prospective study 65 tonsillectomy patients were examined at the first postoperative day within the QUIPS project. This allowed a standardised assessment of patients' characteristics, pain parameters, outcome and process parameters. The influence of these parameters on the patients' postoperative pain was estimated with univariate and multivariate statistic analysis. All patients report of constant slight pain during the first postoperative day after tonsillectomy. Although maximal pain intensity was moderate, overall, patients were satisfied with the pain management. Pain management did not result in relevant side effects. Younger patients suffered significantly more from maximal pain than older patients. The same was obvious for patients who needed pain killers already prior to surgery. Perioperative antibiotic treatment and specific counselling about the possibilities of postoperative pain management reduced pain intensity highly significant in univariate and multivariate analysis. Patients receiving opioids on the ward postoperatively had significantly less pain. QUIPS is a very good tool to evaluate the quality of postoperative pain management in one's own hospital. Next step, a detailed comparison to the best practise of other hospitals participating at QUIPS will follow in order to improve and standardize pain management for adult tonsillectomy patients.

European Archives of Oto-rhino-laryngology, Apr 13, 2012

Postoperative pain after functional endoscopic sinus surgery (FESS) and its optimal management ha... more Postoperative pain after functional endoscopic sinus surgery (FESS) and its optimal management has not been described in detail. The objective was to evaluate pain, its influencing factors and its management on the first postoperative day following FESS. In a prospective case study, 101 FESS patients were examined after removal of the nasal packing within the Quality Improvement in Postoperative Pain Management (QUIPS) project allowing a standardized assessment of patients' characteristics, pain parameters, outcome and process parameters. The influence of these parameters on the patients' postoperative pain was estimated by univariate and multivariate statistic analysis. Pain during the first postoperative day after FESS was moderate. Younger patients reported significantly more pain than did older patients. Specific counseling about the possibilities of postoperative pain management reduced pain intensity highly significantly in univariate and multivariate analysis. Patients demanding for pain relief in the recovery room and on the ward predominantly received acetaminophen as non-opioid and piritramide as opioid. This pain management was obviously insufficient as these patients still reported significantly more from pain on the first postoperative day than patients not demanding for pain relief. We conclude that QUIPS could help to optimize the quality of postoperative pain management following FESS.

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery, Apr 11, 2016

Das Ziel dieser Arbeit war es die postoperative Schmerzwahrnehmung der Patienten nach Kopf-Hals-T... more Das Ziel dieser Arbeit war es die postoperative Schmerzwahrnehmung der Patienten nach Kopf-Hals-Tumor Eingriffen darzustellen und Prädiktoren für postoperative Schmerzen darzustellen. Hierzu bewerteten insgesamt 145 Patienten die postoperative Schmerzwahrnehmung mit Hilfe des standardisierten QUIPS (Qualitätsverbesserung in der postoperativen Schmerztherapie) Fragebogens 24h nach einem tumorchirurgischen Eingriff. Die Schmerzen wurden mittels numerischen Ratingskalen (NRS) von 0 (kein Schmerz) bis 10 (stärkster Schmerz) erfasst. Insgesamt bestand die Gruppe aus 2/3 der männlichen und 1/3 weiblichen Patienten, welche im Mittel 62a alt waren. Die durchgeführten Verfahren waren: Panendoskopie, kurative Resektion des Primärtumors, Neck Dissection, Tracheotomie und Lappenplastiken. 53% der Patienten hatten einen maximalen Schmerz-Score NRS3. Die mittlere Schmerzstärke bei Bewegung sowie der maximal und minimal Schmerz waren NRS2,55±2,36; NRS3,18±2,86 und NRS1,38±2,86. Es berichteten 92% ...

Clinical Neurophysiology, 2016

Journal of Neuroscience Methods, 2016

h i g h l i g h t s • We developed a new tool for automated detection of untagged rat vibrissae. ... more h i g h l i g h t s • We developed a new tool for automated detection of untagged rat vibrissae. • Automated and manual tracking produced equal results in a nerve regeneration model. • Our automated whisker tracking method allows for increased sample sizes. • Bilaterally coordinated whisking is lost after facial nerve regeneration.

Laryngoscope, Mar 8, 2010

Laryngo-rhino-otologie, May 1, 2022

Elsevier eBooks, 2009

Direct coaptation and interpositional nerve grafting (IPNG) of an injured peripheral nerve is sti... more Direct coaptation and interpositional nerve grafting (IPNG) of an injured peripheral nerve is still associated with poor functional recovery. Main reasons for that are thought to be an extensive collateral axonal branching at the site of transection and the polyinnervation of motor endplates due to terminal axonal and intramuscular sprouting. Moreover, severe changes occurring within the muscle after long-term denervation, like loss of muscle bulk and circulation as well as progressive fibrosis, have a negative effect on the quality of functional recovery after reinnervation. We have recently shown that manual stimulation (MS) of paralyzed vibrissal muscles in rat promotes full recovery after facial nerve coaptation. Furthermore, MS improved functional recovery after hypoglossal nerve repair, hypoglossal-facial IPNG of the facial nerve in rat. In contrary, MS did not improve recovery after injury of the median nerve in rat, which is however a mixed peripheral nerve comparing to the facial nerve. It is speculated that manually stimulated recovery of motor function requires an intact sensory input, which is affected in case of mixed peripheral nerves but not in case of pure motor nerves. In this article, we summarize our results of MS in several peripheral nerve injury models in order to illustrate the application potential of this method and to give insights into further investigations on that field.

Journal of Neuroscience Methods, Dec 1, 2009

Recent studies using molecular and genetic techniques just have started to elucidate the complex ... more Recent studies using molecular and genetic techniques just have started to elucidate the complex process that drives successful peripheral nerve regeneration. Introducing proteomics to this field, we unilaterally performed a facial nerve axotomy in 13 adult Wistar rats. Seven days later, a total of 40 20-m coronary cryostat sections of the operated and contralateral unoperated nucleus facialis were microdissected. On the one hand, microdissected areas were pooled for each side, lysed and applied to ProteinChip Arrays. On the other hand, one microdissected area from the right and left facial nucleus each was directly placed on the affinity chromatographic array. Facial motoneurons were lysed in situ and released their proteins to spatially defined points. 215 laser addressable distinct positions across the surface of the spot enabled a high spatial resolution of measured protein profiles for the analysed tissue area. Protein profiles of the single positions were plotted over the used tissue section to visualize their distribution. The comparative analysis of the protein lysates from operated and normal nuclei facialis revealed, for both approaches used, differentially expressed proteins. Although by direct application of one cryostat section only a few hundred motoneurons were analysed, results comparable to these using lysates were obtained. Additionally, the applied technique revealed differences in the intensity distribution of several proteins of unknown function in the lesioned in comparison to the contralateral normal facial nucleus. This proteomic analysis with ultra high sensitivity paired with potential for a spatial resolution is a promising methodology for peripheral nerve regeneration studies.

Clinical Otolaryngology, Apr 22, 2018

All authors contributed substantially to the conception, design and writing of this manuscript. *... more All authors contributed substantially to the conception, design and writing of this manuscript. * Beutner D and Grosheva M share the senior authorship There was no financial support, no funding and no conflict of interest during the preparation of this article. This material has never been published and is not currently under evaluation in any other peerreviewed publication.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn, 2021

Abstract- und Posterband – 91. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Welche Qualität macht den Unterschied, 2020

Neural Plasticity, 2018

Botulinum neurotoxin A (BoNT) and brain-derived neurotrophic factor (BDNF) are known for their ab... more Botulinum neurotoxin A (BoNT) and brain-derived neurotrophic factor (BDNF) are known for their ability to influence synaptic inputs to neurons. Here, we tested if these drugs can modulate the deafferentation of motoneurons following nerve section/suture and, as a consequence, modify the outcome of peripheral nerve regeneration. We applied drug solutions to the proximal stump of the freshly cut femoral nerve of adult rats to achieve drug uptake and transport to the neuronal perikarya. The most marked effect of this application was a significant reduction of the axotomy-induced loss of perisomatic cholinergic terminals by BoNT at one week and two months post injury. The attenuation of the synaptic deficit was associated with enhanced motor recovery of the rats 2–20 weeks after injury. Although BDNF also reduced cholinergic terminal loss at 1 week, it had no effect on this parameter at two months and no effect on functional recovery. These findings strengthen the idea that persistent p...

Laryngo-Rhino-Otologie, 2019

ZusammenfassungHypersalivation bezeichnet einen übermäßigen Speichelfluss, der durch insuffizient... more ZusammenfassungHypersalivation bezeichnet einen übermäßigen Speichelfluss, der durch insuffiziente orofaziale Fähigkeiten, verminderte zentralnervöse Kontrolle und Koordination oder gestörte Schluckabläufe entstehen kann. Die Aktualisierung der S2k-Leitlinie soll den neuen diagnostischen und therapeutischen Kenntnisstand berücksichtigen.Die Diagnostik- und Therapiemaßnahmen sollten multidisziplinär erfolgen. Schwerpunkte sind die Abklärung von Schluckstörungen mit Speichelaspiration. Hier sind klinische Screeninguntersuchungen und die fiberendoskopische Schluckuntersuchung (FEES) hervorzuheben.Bei fast allen Ursachen sind die schlucktherapeutischen Übungsmaßnahmen zur Aktivierung und zum Erlernen von Kompensationsmechanismen unverzichtbar. Insbesondere bei Kindern mit hypotoner orofazialer Muskulatur sind myofunktionelle Therapiekonzepte indiziert, allerdings ist die Kompetenz zur Mitarbeit entscheidend. Zusätzlich können orale Stimulationsplatten durch die Veränderung der Zungenpos...

Journal of Neural Transmission, 2019

Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself an... more Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This update presents recent changes and innovation in the treatment of hypersalivation. Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, saliva aspiration, and oro-motor deficiencies. Clinical screening tools and diagnostics such as fiberoptic endoscopic evaluation of swallowing generate important data on therapy selection and control. Many cases profit from swallowing therapy programmes to activate compensation mechanisms as long compliances are given. In children with hypotonic oral muscles, oral stimulation plates can induce a relevant symptom release because of the improved lip closure. The pharmacologic treatment improved for pediatric cases as glycopyrrolate fluid solution (Sialanar ®) is now indicated for hypersalivation within the EU. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long-lasting saliva reduction. Here, a phase III trial is completed for incobotulinum toxin A and, in the US, is indicated for the treatment of adult patients with chronic hypersalivation. Surgical treatment should be reserved for isolated cases. External radiation is judged as a safe and effective therapy when using modern 3D techniques to minimize tissue damage. Therapy effects and symptom severity have to be followed, especially in cases with underlying neurodegenerative disease.