Victor Helmstaedter

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.

Carbon Dioxide Laser Endoscopic Diverticulotomy for Zenker’s Diverticulum: Results and Complications in a Consecutive Series of 40 Patients

Background: Numerous studies regarding CO2 laser endoscopic diverticulotomy for the treatment of Zenker’s diverticulum exist. They show differences in complications, hospitalization time and postoperative treatment. Objectives: We report our experiences and work out recommendations for postoperative care. Methods: All charts of patients who were treated for Zenker’s diverticulum at the University Department of Otolaryngology, Cologne, Germany, between 1983 and 2003, were reviewed retrospectively. Results: The median age was 58 years. Postoperatively, patients were fed nonorally and received postoperative antibiotic treatment. One patient developed mediastinitis and 3 patients a rise in body temperature. A control radiography disclosed pharyngeal leakages in 3 patients. Overall morbidity averaged 10%. Conclusion: To avoid severe complications we recommend postoperative antibiotic treatment and parenteral feeding. In comparison to the stapler-assisted technique the use of the CO2 laser allows a good view at the diverticular wall throughout the procedure. The transcervical technique should be reserved for cases of anatomic abnormalities or for complicated revision surgeries.

Impact of partial mastoid obliteration on caloric vestibular function in canal wall down mastoidectomy.

Objective: To evaluate the influence of our technique of partial mastoid obliteration with autologous bone pâté covered by cartilage plates on vestibular stimulation. Methods: Twenty-six patients who were treated for recurrent chronic otitis media by revision canal wall down tympanomastoidectomy and subsequent partial obliteration were invited for follow-up; 18 patients agreed to a complete follow-up including vestibular testing. Patients received questionnaires for evaluating preoperative and postoperative symptoms associated with vertigo. Examination comprised otomicroscopy, pure-tone audiometry, and caloric testing. Results: Mean follow-up was 6 years. Before surgery, 54% of the patients reported vertigo on caloric stimuli such as wind, water, or suction cleaning of the tympanomastoid cavity. In all patients, these symptoms were suspended after partial mastoid obliteration. The postoperative obliterated cavity volume averaged 3.1 ml. All cavities after surgery appeared completely epithelialized and dry. The postoperative caloric vestibular tests revealed an average nystagmus count of 46 beats per minute compared with 72 beats before surgery. Thus, the partial mastoid cavity obliteration led to a mean nystagmus reduction of 36% in our study group. Conclusion: Our technique of partially obliterating tympanomastoid cavities with autologous bone pâté being covered by cartilage plates results in small cavities with complete epithelialization of all surfaces. Furthermore, obliteration of mastoid cavities confers protection to the labyrinthine organ, thereby reducing postoperative vertigo on caloric stimulation.

Safety and Efficacy of Botulinum Toxin Therapy in Otorhinolaryngology: Experience From 1,000 Treatments

Objectives: The objective of this study was to analyze the safety and efficacy of botulinum toxin (BTX) therapy in a series of 1,000 treatments on 261 consecutive patients at the University Department of Otorhinolaryngology–Head and Neck Surgery, Cologne, Germany.

Raumforderung des Nasenseptums

ten Tag entfernt wurden. Bei Entlassung am vierten Tag zeigte sich endoskopisch ein schlankes Nasenseptum und beidseits freie Nasenhaupth ö hlen ( ● ▶ Abb. 3 ). Weiterhin erfolgte die Gabe eines Breitspektrumantibiotikums f ü r insgesamt sieben Tage. Mikrobiologisch wurden m ä ß ig viele Leukozyten nachgewiesen, jedoch keine Bakterien. Die histologische Begutachtung der entnommenen Schleimhautprobe schloss Malignit ä t und eine fl oride Entz ü ndung aus. Somit konnte die Diagnose einer septalen Zyste gestellt werden. Ambulante Wiedervorstellungen des Patienten zeigten einen reizlosen und bis auf die Septumperforation regelrechten endonasalen Befund. Der Patient ist bis heute beschwerdefrei. Im Falle eines Wiederauftretens der Zyste ist die komplette Exstirpation indiziert.