Gero Quante

Impact of functional endoscopic sinus surgery on symptoms and quality of life in chronic rhinosinusitis.

Objectives Chronic rhinosinusitis restricts the quality of life of millions of involved patients. The aim of the study was to evaluate how functional endoscopic sinus surgery modifies patients symptom profiles and quality of life.

Primary parotid malignoma surgery in patients with normal preoperative facial nerve function: outcome and long-term postoperative facial nerve function.

Objectives/Hypothesis: Most patients with primary parotid cancer present with normal facial nerve function. The common surgical strategy for these patients is to perform a parotidectomy with facial nerve preservation. Nevertheless, the functional outcome for the facial nerve and oncological outcome is unclear.

Proinflammatory Effects of Staphylococcus Aureus Exotoxin B on Nasal Epithelial Cells

OBJECTIVE: The aim of this study was to evaluate the effects of Staphylococcus aureus exotoxin B (SE-B) on proinflammatory cytokine/chemokine releases in primary nasal epithelial cell cultures (NECC) of subjects with and without chronic rhinosinusitis (CRS). STUDY DESIGN AND SETTING: NECC (CRS: n = 14; Controls: n = 11) were stimulated with SE-B. Protein concentrations of interleukin-(IL)-1β, IL-6, and IL-8 levels were measured in NECC supernatants by ELISA before (T0) and after 24 hr stimulation with SE-B (T1). RESULTS: T0: supernatants of the NECC of CRS patients contained significant lower levels of IL-8 (2.1 ng/ml) compared to Controls (IL-8: 6.2 ng/ml; P < 0.01). T1: SE-B induced a significant increase of IL-6 in NECC (P < 0.001). IL-1β was not detectable. CONCLUSIONS: This is the first study evaluating the effects of exotoxins on NECC. SE-B showed proinflammatory effects on NECC. SIGNIFICANCE: Our data suggest that resident NECC are involved in immunological responses to Staphylococcus aureus toxins, supplementing the so-called “superantigen hypothesis” in CRS.

Nasal colonization with Staphylococcus aureus is not associated with the severity of symptoms or the extent of the disease in chronic rhinosinusitis

OBJECTIVES: There is an increasing knowledge that the severity of perennial allergic rhinitis is associated with nasal carriage of Staphylococcus aureus (S. aureus). The aim of this study was to evaluate the rate of bacterial colonization with S. aureus in the nose of subjects with and without chronic rhinosinusitis (CRS) and to correlate these findings with the severity of symptoms and the extent of the disease. STUDY DESIGN AND SETTING: Open, prospective controlled trial. METHODS: 190 subjects with CRS and 42 subjects with septal deviation without sinusitis (control subjects) were included in this study. Swabs were taken endoscopically from the middle meatus and bacteria were cultured and identified. Airway symptoms were assessed by subjects in standardized questionnaires and frequencies of respiratory tract infections were noted. The rhinosinusitis extent was graded by CT scan assessment. Analysis of variance, chi-square test, and Pearsons correlation test were applied for statistical analyses. RESULTS: The S. aureus carriage rate was 25.5% in CRS and 31.4% in control subjects. Further facultative pathogens were cultured in 20.6% of subjects with CRS and in 8.5% of controls. 73.8% of S. aureus were ampicillin-resistant, multiresistant strains were cultured in 5.8%. Most airway symptoms and the frequencies of respiratory tract infections were significantly higher in the CRS group compared with control subjects. In post hoc comparison between the subgroups with and without S. aureus colonization, no significant differences were found between the extent of rhinosinusitis and the severity of airway symptoms. CONCLUSIONS: Facultative pathogens were detected in more than 40% of CRS patients without acute respiratory tract infections. In contrast to the findings in atopic dermatitis and perennial allergic rhinitis, the colonization rate with S. aureus is not increased and S. aureus carriage is not a risk factor for the severity or the extent of rhinosinusitis.

An Analysis of Surgical Complications, Morbidity, and Cost Calculation in Patients Undergoing Multimodal Treatment for Operable Oropharyngeal Carcinoma

Objective/Hypothesis: Tumor control and survival are considered the most important measures of treatment efficacy for patients with primary oropharyngeal squamous cell carcinoma. Furthermore, multimodal treatment protocols should be judged by their complication rates, morbidity, and therapy costs.

CERVICAL HEMORRHAGE DUE TO SPONTANEOUS RUPTURE OF THE SUPERIOR THYROID ARTERY: CASE REPORT AND REVIEW OF THE LITERATURE

Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life‐threatening condition.

Easy and safe dental protection in rigid endoscopy

Dental injuries following laryngotracheal intubation for general anesthesia are a well-recognized potential complication. Although rigid endoscopies are routinely used in diagnostic and operative interventions, dental injuries following these procedures are poorly described in the literature. Especially during suspension laryngoscopy (SL), the upper front teeth may suffer from high pressure applied to them. In a prospective study that we conducted recently, an overall dental injury rate of 6.5% in 339 patients undergoing SL was observed. As a result of these observations we have designed a simple and inexpensive dental guard that can easily be custom-made during endoscopy from dental disclosing material in combination with a metal spoon. Frequently, the surgeon preoperatively does not know how difficult it is to obtain a wide enough access to the larynx during SL. In such cases, the advantage of the proposed procedure is that the surgeon can switch to it intraoperatively if he or she anticipates damage to the teeth. We recommend having this option available for dental protection in the operating room.

Raumforderung im Bereich des Zungengrundes

Unter reizloser, intakter Schleimhaut ließ sich im Bereich des Zungengrundes eine ausgedehnte weiche Raumforderung palpieren. Gaumenbögen und Tonsillen waren dadurch beidseits erheblich nach lateral verdrängt; das Pharynxlumen medial und lateral bis auf ein Restlumen von etwa 1×1 cm obstruiert. Die Funktion des Nervus hypoglossus war beidseits symmetrisch intakt. Die Epiglottis war schlank; die supraglottischen Strukturen wurden von der Raumforderung nach kaudal verdrängt. Die Stimmlippen präsentierten sich beidseits als regelrecht beweglich. Die äußerliche Inspektion war bei Normalhaltung des Kopfes unauffällig. Palpatorisch fand sich submental eine indolente Raumforderung, die lateral beidseits bis in die Submandibularregionen zu tasten war. Erst bei Reklination des Kopfes war diese Raumforderung auch inspektorisch diagnostizierbar. Überdies zeigte sich ein ansonsten unauffälliger HNOStatus (. Abb. 1). Sonographie

Gestielte Raumforderung der aryepiglottischen Falte

Nach dem malignen fibrosen Histiozytom stellt das Liposarkom den zweithaufigsten malignen Weichteiltumor im Erwachsenenalter dar. Unter allen Sarkomen betragt der Anteil der Liposarkome etwa 9–18%. Allerdings sind Lokalisationen im Kopf-Hals-Bereich selten, deren Haufigkeit in der Literatur mit etwa 4–9% angegeben wird [1]. Eine laryngeale Liposarkommanifestation ist fur etwa 2% aller Sarkome beschrieben worden. Manner erkranken deutlich haufiger an dieser Tumorentitat als Frauen, der Altersgipfel liegt etwa in der 4.–6. Lebensdekade.

Zervikales Neurofibrom als Ursache von Globusgefühl

A 33-year-old, otherwise healthy female nursing student presented to the ear-, nose-, and throat- (ENT) outpatient clinic with a globus sensation that had been progressing for 6 months. Tomographic imaging revealed a neck mass extending from the 4th vertebrum to the subclavicular region and apex of the left lung. A surgical resection with histopathological examination exposed a neurofibroma. Management and differential diagnoses of globus sensation are herein discussed. This case underlines the importance of tomographic imaging, even in common but persisting symptoms such as globus sensation.