B. Danz

Zum Stellenwert der Bildgebung vor Tubendilation mit dem Bielefelder Tubenkatheter

Balloon dilation is a novel method in the management of chronic Eustachian tube dysfunction. Routine preoperative CT has been recommended in order to rule out possible bone dehiscence in the region of the carotid canal or aneurysms of the internal carotid artery which can lead to vascular injuries and life-threatening bleeding or brain damage during the dilation procedure.We evaluated head CT scans of 1000 patients to assess the occurrence of carotid canal dehiscence, aneurysms or other vascular malformations and to measure the osseous part of the carotid canal.No dehiscence was noted in a total of 2000 boney carotid canals. The mean thickness of the carotid canal wall was 1.02 ± 0.29 mm. No aneurysms or vascular malformations were detected.The necessity of routine CT scans before balloon dilation should be critically discussed with a view to protecting patients from unnecessary radiation exposure and saving costs in the health care system.

Penetrierende Gesichts- und Halsverletzungen

Penetrating head and neck injuries often present with vascular lesions and airway compromise and may be life-threatening. Thus controlling bleeding and airway stabilisation take priority in emergency treatment. High-velocity projectiles, fragmentations from improvised explosive devices (IEDs) and shrapnel can cause severe tissue injury, representing a challenge for the head and neck surgeon. Since several organ structures, such as the eyes, midface, pharynx, larynx, trachea, esophagus, nerves, vessels and vertebral spine can be injured at the same time, patients should be referred to a specialized trauma center for interdisciplinary treatment following emergency treatment. High-speed ballistic injuries were once confined to the battle field and have been uncommon in Europe since World War II. For this reason, experience among civilian head and neck surgeons is at present limited. With the increased incidence of terrorism and the use of IEDs as the preferred weapon in terrorism it has become important for civilian head and neck surgeons to understand the role of ballistic injuries in mass casualty events. The present paper discusses current viewpoints in the diagnosis and treatment of penetrating head and neck injuries.

Penetrating injuries in the face and neck region. Diagnosis and treatment

Penetrating head and neck injuries often present with vascular lesions and airway compromise and may be life-threatening. Thus controlling bleeding and airway stabilisation take priority in emergency treatment. High-velocity projectiles, fragmentations from improvised explosive devices (IEDs) and shrapnel can cause severe tissue injury, representing a challenge for the head and neck surgeon. Since several organ structures, such as the eyes, midface, pharynx, larynx, trachea, esophagus, nerves, vessels and vertebral spine can be injured at the same time, patients should be referred to a specialized trauma center for interdisciplinary treatment following emergency treatment. High-speed ballistic injuries were once confined to the battle field and have been uncommon in Europe since World War II. For this reason, experience among civilian head and neck surgeons is at present limited. With the increased incidence of terrorism and the use of IEDs as the preferred weapon in terrorism it has become important for civilian head and neck surgeons to understand the role of ballistic injuries in mass casualty events. The present paper discusses current viewpoints in the diagnosis and treatment of penetrating head and neck injuries.

Role of imaging before Eustachian tube dilation using the Bielefeld balloon catheter

Balloon dilation is a novel method in the management of chronic Eustachian tube dysfunction. Routine preoperative CT has been recommended in order to rule out possible bone dehiscence in the region of the carotid canal or aneurysms of the internal carotid artery which can lead to vascular injuries and life-threatening bleeding or brain damage during the dilation procedure.We evaluated head CT scans of 1000 patients to assess the occurrence of carotid canal dehiscence, aneurysms or other vascular malformations and to measure the osseous part of the carotid canal.No dehiscence was noted in a total of 2000 boney carotid canals. The mean thickness of the carotid canal wall was 1.02 ± 0.29 mm. No aneurysms or vascular malformations were detected.The necessity of routine CT scans before balloon dilation should be critically discussed with a view to protecting patients from unnecessary radiation exposure and saving costs in the health care system.

Leiomyosarcoma of the larynx

Leiomyosarcoma is usually found in the female genital tract, retroperitoneum, the wall of the gastrointestinal tract and subcutaneous tissues. An appearance of this malignant tumor in the larynx is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report on a 64-year old male with a supraglottic leiomyosarcoma who was treated with supraglottic laryngectomy and postoperative radiotherapy. After 19 months the patient was well and free of disease. The most commonly used diagnostic and therapeutic procedures are analysed in a review of the 46 published cases of laryngeal leiomyosarcoma.

Leiomyosarkom des Kehlkopfs

Leiomyosarcoma is usually found in the female genital tract, retroperitoneum, the wall of the gastrointestinal tract and subcutaneous tissues. An appearance of this malignant tumor in the larynx is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report on a 64-year old male with a supraglottic leiomyosarcoma who was treated with supraglottic laryngectomy and postoperative radiotherapy. After 19 months the patient was well and free of disease. The most commonly used diagnostic and therapeutic procedures are analysed in a review of the 46 published cases of laryngeal leiomyosarcoma.

Zum Stellenwert der Bildgebung vor Tubendilation mit dem Bielefelder Tubenkatheter@@@Role of imaging before Eustachian tube dilation using the Bielefeld balloon catheter

Balloon dilation is a novel method in the management of chronic Eustachian tube dysfunction. Routine preoperative CT has been recommended in order to rule out possible bone dehiscence in the region of the carotid canal or aneurysms of the internal carotid artery which can lead to vascular injuries and life-threatening bleeding or brain damage during the dilation procedure.We evaluated head CT scans of 1000 patients to assess the occurrence of carotid canal dehiscence, aneurysms or other vascular malformations and to measure the osseous part of the carotid canal.No dehiscence was noted in a total of 2000 boney carotid canals. The mean thickness of the carotid canal wall was 1.02 ± 0.29 mm. No aneurysms or vascular malformations were detected.The necessity of routine CT scans before balloon dilation should be critically discussed with a view to protecting patients from unnecessary radiation exposure and saving costs in the health care system.

Penetrierende Gesichts- und Halsverletzungen@@@Penetrating injuries in the face and neck region: Diagnostik und Therapie@@@Diagnosis and treatment

Penetrating head and neck injuries often present with vascular lesions and airway compromise and may be life-threatening. Thus controlling bleeding and airway stabilisation take priority in emergency treatment. High-velocity projectiles, fragmentations from improvised explosive devices (IEDs) and shrapnel can cause severe tissue injury, representing a challenge for the head and neck surgeon. Since several organ structures, such as the eyes, midface, pharynx, larynx, trachea, esophagus, nerves, vessels and vertebral spine can be injured at the same time, patients should be referred to a specialized trauma center for interdisciplinary treatment following emergency treatment. High-speed ballistic injuries were once confined to the battle field and have been uncommon in Europe since World War II. For this reason, experience among civilian head and neck surgeons is at present limited. With the increased incidence of terrorism and the use of IEDs as the preferred weapon in terrorism it has become important for civilian head and neck surgeons to understand the role of ballistic injuries in mass casualty events. The present paper discusses current viewpoints in the diagnosis and treatment of penetrating head and neck injuries.

Leiomyosarkom des Kehlkopfs@@@Leiomyosarcoma of the larynx

Leiomyosarcoma is usually found in the female genital tract, retroperitoneum, the wall of the gastrointestinal tract and subcutaneous tissues. An appearance of this malignant tumor in the larynx is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report on a 64-year old male with a supraglottic leiomyosarcoma who was treated with supraglottic laryngectomy and postoperative radiotherapy. After 19 months the patient was well and free of disease. The most commonly used diagnostic and therapeutic procedures are analysed in a review of the 46 published cases of laryngeal leiomyosarcoma.