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Dive into the research topics where Susanne Fleischer is active.

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Featured researches published by Susanne Fleischer.


Annals of Otology, Rhinology, and Laryngology | 2005

Office-Based Laryngoscopic Observations of Recurrent Laryngeal Nerve Paresis and Paralysis

Susanne Fleischer; Götz Schade; Markus Hess

Objectives: To evaluate the endoscopic criteria of recurrent laryngeal nerve disorders, we performed a retrospective evaluation of videolaryngoscopic recordings from 50 patients with recurrent laryngeal nerve disorders. Methods: The videolaryngoscopic examination was performed with rigid and flexible endoscopes. The range of motion of three laryngeal structures was assessed: the vocal ligament, the vocal process, and the arytenoid “hump” (mainly the corniculate region). Results: Comparison of movement of these three structures revealed discrepancies. In 16 of 45 patients (36%) rigid endoscopy showed movements of the arytenoid hump associated with absence of any mobility of the vocal process and vocal ligament. In 5 patients the extent of movement of the vocal process and vocal ligament was less than that of the arytenoid hump. Only in 24 of 45 cases were the ratings for the vocal process, vocal ligament, and arytenoid hump identical. The findings of fiberscopy were comparable. Conclusions: In assessing recurrent laryngeal nerve disorders via laryngoscopy, sole judgment of the arytenoid hump movement can mislead. Our interpretation suggests that visible movement of the mucosa covering the arytenoid and accessory cartilages is not always paralleled by movement of the arytenoid cartilage itself. It was shown that the best criterion to rely on in endoscopy is movement of the vocal process or the vocal ligament.


Laryngoscope | 2003

Forced inspiration: a laryngoscopy-based maneuver to assess the size of Reinke's edema.

C. Kothe; Goetz Schade; Susanne Fleischer; Markus Hess

INTRODUCTION Reinke’s edema was first described by the laryngologist Hajek in 1891 as edema of the larynx. Friedrich Berthold Reinke reported about injection of fluids into the vocal fold in an excised human larynx study, creating an artificial edema similar to the clinically well-known vocal fold edema. Today, Reinke’s edema is one of the most often diagnosed benign organic lesions causing a voice disorder. Rigid laryngoscopy with telescopes is used to visualize organic structure, morphological appearance, and extension of laryngeal diseases. Furthermore, videostroboscopy can provide information about the dynamic properties of benign mass lesions of the vocal folds. However, clinical experience reveals that clinical endoscopy with or without stroboscopy may not always reliably predict the actual size of Reinke’s edema, compared with estimations of actual size of edema given when surgery of the Reinke’s edema is performed using general anesthesia. A clinical maneuver that helped the authors to improve preoperative assessment of the size of Reinke’s edema during rigid laryngoscopy is reported.


Current Opinion in Otolaryngology & Head and Neck Surgery | 2016

Laryngeal framework surgery: current strategies.

Markus Hess; Susanne Fleischer

Purpose of reviewLaryngeal framework surgery (LFS) is an indispensable surgical approach for the treatment of voice problems. The purpose of this review is to single out some relevant articles published on the topic of LFS from 2015 to mid-2016. Articles referring to injection laryngoplasty (augmentation) are entirely left aside. Recent findingsIn the vast majority of recent publications, LFS mostly addresses surgery intended to improve vocal function in cases of glottic insufficiency. Here, medialization laryngoplasties remain the most important surgery. Arytenoid adduction remains an important technique within this field. Some clinical studies concerning indications and outcome of LFS are covered in the recent articles, trying to improve decision making for the indication of medialization laryngoplasty to enhance the rate of favorable long-term results. As in the past years, only a few articles report on laboratory research and other aspects of LFS. SummaryArticles published from 2015 to mid-2016 show that further improvements in LFS have been made, both surgically–technically and in respect of patient selection. There is still a debate about the combination of medialization laryngoplasty and arytenoid adduction in patients with unilateral vocal fold paralysis or paresis (UVFP). Although augmentation laryngoplasties are significantly increasing in number, it seems that LFS remains an important procedure within phonosurgery.


Laryngoscope | 2017

High‐sensitivity FEES with NBI‐illumination

Susanne Fleischer; Christina Pflug; Markus Hess

INTRODUCTION Flexible endoscopic examination of swallowing (FEES) with colored bolus is a routine procedure to assess swallowing function and check for laryngeal penetration and aspiration of colored liquids and solid food. With this method, sometimes it is not easy to decide whether colored bolus can be seen when only small amounts are diffusely spread on the mucosa of the pharynx and larynx or when the colored bolus gets diluted and therefore cannot be seen with enough contrast. Especially coloring of the trachea, which indicates aspiration, might be overlooked because the bolus is too far away to be easily visualized and also because of image resolution and illumination. Narrow band imaging (NBI) is an image enhancement technology that normally is used to improve the visibility of superficial small vessels due to its strong absorption by hemoglobin. As a side effect of NBI illumination, the green color will turn red. This effect can be used in FEES. We describe a technique for enhancing bolus contrast and visualizing even the smallest amounts of penetrated or aspirated bolus. By coloring the bolus with green food colorant and using NBI, the bolus will change its color from green to red; moreover, an enormous contrast enhancement is elicited. Even very thin secretion layers containing food colorant are easily detectable. Thus, with this technique even minor laryngeal penetration and aspiration can be detected, and early treatment can help prevent aspiration pneumonia. MATERIALS AND METHOD Our routine procedure for FEES is bolus coloration using food colorant (light green, E 104 Chinolingelb 1 E 123 Indigotin I, Schreiber-Essenzen GmbH & Co. KG, Barsb€ uttel, Germany). We usually use one part of food colorant for two to three parts of water for liquids. With the new technique, we are able to dilute the bolus color by factor 10. For solid bolus, we add one scoop (15 mL) of instant food thickener to 50 to 100 mL green liquid for thickening of the bolus. While the flexible endoscope is placed transnasally (Flexible Video Endoscope ENT-VH, Olympus Medical Systems Corp., Tokyo, Japan), we ask the patient to swallow 1 teaspoon of liquid and solid bolus, respectively. During FEES, we use white light from preto postdeglutitive endoscopy. During the postdeglutitive respiratory phase, the illumination is switched to NBI mode. All videos are recorded on a Mac (iMac, Apple Inc., Cupertino, CA) for offline image analysis.


HNO Nachrichten | 2016

Diagnostik und Therapie von Stimmstörungen

Susanne Fleischer; Markus Hess

ZusammenfassungStimmstörungen gewinnen in unserer Gesellschaft zunehmend an Bedeutung. Sie sind häufig und ihre Ursachen vielfältig. Eine wichtige Rolle spielt dabei neben der Beeinträchtigung von Stimmklang und Stimm-Image die verminderte Belastbarkeit der Stimme. Bei der Behandlung ist ein interdisziplinärer Ansatz hilfreich, wie man ihn beispielsweise im Ausland in den zahlreichen „Voice Clinics“ findet.


HNO Nachrichten | 2016

Durch Augmentation wieder gut bei Stimme

Susanne Fleischer; Markus Hess

Rund 10.000 mal pro Jahr wird in Deutschland die Diagnose „Recurrensparese“ gestellt. Ein bewährtes Verfahren, um die Folgen der einseitigen Recurrensparese zu therapieren, ist die Stimmlippen-Augmentation. Die Weiterentwicklung der Implantate und Operationstechniken eröffnete neue Möglichkeiten, die der folgende Beitrag erläutert.


Archive | 2018

Laryngoscopic Techniques and Office-Based Phonosurgery in Neurolaryngological Disorders

Markus Hess; Susanne Fleischer

Neurolaryngological diseases and disorders can affect voice function, swallowing, and breathing. With comprehensive office-based laryngoscopy procedures, mostly performed transnasally, the biomechanics needed for voice production, breathing, and effective swallowing can be assessed in almost all cases. With ambulatory phonosurgical interventions under topical anesthesia such as vocal fold augmentation and botulinum toxin injections, patients can be helped by improving vocal loudness, voice quality, durability, and stabilizing vocal function significantly. Concerning aspiration of liquid and solid food due to glottic insufficiency as one of the most severe problems, office-based vocal fold augmentation may effectively improve swallowing function.


HNO Nachrichten | 2018

Chirurgisch zur höheren Stimmlage

Markus Hess; Susanne Fleischer

Die männliche und die weibliche Stimme unterscheiden sich durch viele verschiedene Aspekte. Eine Option, um für eine Stimmveränderung von „Mann zu Frau“ eine höhere Stimmlage zu erreichen, ist die chirurgische Stimmfeminisierung. Dazu stehen verschiedene Operationstechniken zur Verfügung, eine Auswahl der häufigsten Methoden stellen wir im Folgenden vor.


HNO Nachrichten | 2018

Postoperativer Stimmgebrauch: Ist Schweigen wirklich Gold?

Susanne Fleischer; Markus Hess

Die Empfehlung, nach einer phonochirurgischen Operation mehrere Tage zu schweigen und auch keinesfalls zu flüstern, ist weit verbreitet. Es stellt sich jedoch die Frage, ob nicht auch für die Stimmlippen der Einsatz frühzeitiger Stimmübungen im Sinne einer frühen Rehabilitation zu besseren funktionellen Ergebnissen führt — wie es sich in anderen Bereichen der Medizin bereits durchgesetzt hat. Und: Ist Flüstern wirklich schädlich?


HNO Nachrichten | 2018

Leukoplakie an den Stimmlippen — Dysplasie oder Biofilm?

Susanne Fleischer; Markus Hess

Als Leukoplakie (wörtlich „weiße Fläche“) gelten alle weißen, nicht abwischbaren Effloreszenzen der Schleimhaut. Traditionell hat dieser Begriff eine gewisse Alarmwirkung. Eine Leukoplakie wird reflexhaft oft gleichgesetzt mit dem Vorliegen einer Dysplasie, die histologisch abgeklärt oder zumindest engmaschig kontrolliert werden muss. Andererseits zeigen viele Studien, dass sich bei Leukoplakien der Stimmlippen nur in etwa der Hälfte der Fälle Dysplasien nachweisen lassen. Differenzialdiagnostische Überlegungen sind deshalb besonders wichtig.

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C. Kothe

University of Hamburg

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