Laryngologie, Rhinologie, Otologie最新文献

{"title":"[Plasma concentrations of lidocaine and prilocaine following infiltration anesthesia in otorhinolaryngologic surgery].","authors":"B Bachmann,&nbsp;J Biscoping,&nbsp;H A Adams,&nbsp;A Sokolovski,&nbsp;K Ratthey,&nbsp;G Hempelmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>Infiltration anaesthesia is still relevant for the surgical treatment of patients in otorhinolaryngology. The injection of local anaesthetics in well vascularised areas constantly causes the danger of high plasma concentrations of local anaesthetics combined with undesirable side effects. In our study we tried to determine the development of plasma concentrations of local anaesthetics in patients scheduled for routine tonsillectomies and tympanoplasty.</p><p><strong>Materials and methods: </strong>In 45 patients the development of plasma concentrations was measured immediately after the injection at short intervals; the samples were obtained between 1 minute and 60 minutes after the first injection. Group 1: Lidocaine 0.5% with epinephrine (1:200,000) 15-20 ml for tonsillectomy (n = 18). Group 2: Lidocaine 0.5% with epinephrine (1:200,000) 8-15 ml for tympanoplasty (n = 15). Group 3: Prilocaine 1% with epinephrine (1:200,000) 8-15 ml for tympanoplasty (n = 15). For tactical reasons infiltration anaesthesia for the patients of group 2 was - in addition to general anaesthesia - applied by the otorhinolaryngologist, whereas the patients of groups 1 and 3 were operated exclusively under local anaesthesia.</p><p><strong>Results: </strong>Within the first minute after the initial injection plasma concentrations of the local anesthetic increased close to toxic threshold levels that are associated with undesirable systemic side effects. In the patients of group 1, who underwent tonsillectomy, plasma concentrations of 4-7 micrograms/ml were found during the first minute. The highest average values always appeared within the first five minutes: group 1 2.07 micrograms/ml, group 2: 0.45 micrograms/ml, and group 3: 1.15 micrograms/ml.</p><p><strong>Discussion: </strong>With infiltration anaesthesia in well vascularised areas it may happen that there are--mainly in the early stage--high plasma concentrations of the applied substances, although the total dose was below the known maximum. Despite careful technique (repeated aspiration test in two levels) at least partial intravascular injections are apparently not always avoidable according to the pharmacokinetic data. Our results demonstrate that in addition to a safe peripheral venous line and prophylactic oxygen therapy, intraoperative monitoring of blood pressure, heart rate, electrocardiogram and verbal patient monitoring is of advantage in this group of patients. In our opinion the \"standby function\" of an anaesthesiologist can avoid severe complications.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"335-9"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14340275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Changes of the voice in the Lombard reflex].","authors":"A Lamprecht","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a noisy background the vocal intensity increases (Lombard reflex). The same effect is produced by binaural masking. We demonstrate the regulation of the vocal intensity in the beginning of phonation in eight normal subjects by Hilbert transformation via an FFT analyser. The signals were recorded under normal conditions and with binaural masking. The results are discussed.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"350-4"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14340279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Magnetic resonance tomography in tumors of the salivary glands--a diagnostic advantage?].","authors":"K Mees,&nbsp;T Vogl,&nbsp;O Kellermann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>40 patients with clinically palpable salivary gland masses were included in a prospective study to compare magnetic resonance imaging to computed tomography. MRI has proved superior to CT not only in imaging primary lesions but also in diagnosing local and regional recurrences. In evaluating border structures, signal intensity, T1- and T2-values of space occupying lesions, we can determine the tumour status. Besides, we can define to some extent the internal architecture of the salivary gland or intra-resp. periglandular lymph node masses. Better contrast resolution and more specificity can be obtained by the use of contrast medium gadolinium-DTPA. Even small intraglandular and periglandular masses can be clearly distinguished from the sourrounding structures. At present, magnetic resonance imaging offers the diagnostic potency of both sonography and computed tomography. The advantages of MRI and our present indications in imaging salivary gland masses are discussed.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"355-61"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14340280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Occlusion therapy in chronic recurrent parotitis? A report of clinical experiences with the use of a fibrin glue-gentamycin mixture].","authors":"R Laskawi,&nbsp;J Shröder,&nbsp;J Brauneis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment of chronic recurrent parotitis was attempted in 12 patients by occlusion of Stensen's duct with a mixture of fibrin glue and gentamycin. This therapy failed to induce long-term improvement. It is recommended to undertake surgical intervention as soon as possible in all cases of progressive chronic recurrent parotitis.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"367-8"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13610915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Klinisches Bild und mögliche Ursachen der Funktionsstörungen der Glandula parotis bei der Radiojodtherapie des differenzierten Schilddrüsenkarzinoms*","authors":"M. Deeg1, H. Maier2, H. Bihl3, D. Adler1","doi":"10.1055/s-2007-998518","DOIUrl":"https://doi.org/10.1055/s-2007-998518","url":null,"abstract":"Bei 31 Patienten, die sich wegen eines differenzierten Schilddrüsenkarzinoms nach Thyreoidektomie einer Radiojodtherapie unterziehen müssen, wird die Funktion der Glandula parotis untersucht. Die Untersuchurig erfolgt jeweils unmittelbar vor Therapiebeginn und eine Woche danach. Neben einer akuten Steigerung der Natrium-, Proteinund a-Amylasenkonzentration im Sekret nach jeder Einzeltherapie zeigte sich eine zunehmende Einschrankung der FluI.rate und der Aktivität der a-Amylase in Abhängigkeit von der kumulativen Gesamtdosis. Die Bedeutung des glandularen Kallikreins und der Phosphohexoseisomerase (PHI) werden im Hinblick auf eine mögliche Drusenschadigung diskutiert. Hierbei werden Vergleiche zur chronisch-rezidivierenden Parotitis angesteilt und therapeutische Aspekte angesprochen. Insgesamt zeigen die Befunde, da die Radiojodtherapie, ähnlich wie die externe Strahlentherapie, eine chronische Funktionsstorung der Drüse bewirkt, die im ailgemeinen nach einer kumulatiyen Gesamtdosis von 470 mCi zu meIbaren Veranderungen führt.","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"29 1","pages":"362 - 366"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-998518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58050191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experimental studies of static stress on the footplate in the reconstruction of the sound conduction system].","authors":"H W Pau,&nbsp;K B Hüttenbrink","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>If a destroyed ossicular chain is substituted by a drum-to-footplate prosthesis (TORP), not only sound pressures but also static pressures are conducted via this new connection. To measure these effects in the area of the oval window, in isolated temporal bones the stapes was removed and substituted by a piece of plastipore, attached to the incus. This piece was connected by a very fine needle to a foil strain gauge, in order to registrate the effects of experimentally changed pressures in the external ear canal towards the inner ear. The incus was then also removed too and a TORP was introduced. Under the same measuring condition we found the conducted pressures ten times higher than in the previous situation. This can only be explained by movements in the incudo-malleal joint, if this is intact. Consequently patients with TORPs should avoid all situations of rapid changes of surrounding pressure, such as diving etc., especially if the tube function is impaired. These situations may be dangerous for the footplate and the inner ear. In fortunately rare cases perforations of the footplate were reported by some ear surgeons.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"331-4"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14340274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical picture and possible causes of functional disorders of the parotid gland in radioiodine therapy of differentiated thyroid cancer].","authors":"M Deeg,&nbsp;H Maier,&nbsp;H Bihl,&nbsp;D Adler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The parotid gland function was examined in 31 patients with thyroid carcinoma treated with radio-iodine. Beside enhanced values of sodium concentration, protein concentration and alpha-amylase activity following each therapy, a continuous reduction of flow rate and alpha-amylase activity is found according to the cumulative total dose. The importance of glandular kallikrein und phosphohexoseisomerase (PHI) are discussed with regard to their possible role in glandular damage. A comparison is made with chronic recurrent parotitis, and therapeutical aspects are considered. On the whole the present investigation shows that radio-iodine therapy causes damage to the parotid gland, which normally leads to measurable effects after cumulative doses of 470 mCi.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"362-6"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14340281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Quantitative evaluation of hearing disorders in expert assessment. A recent recommendation for calculating the percentage of hearing loss].","authors":"H Feldmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A short historical survey is given of grading the severity of hearing disorders and assessing the relevant disability for recompensation purposes according to the tables of Boenninghaus, Röser, and Feldmann. The present situation and the reasons giving rise to dissatisfaction with this procedure are analysed. They are the high threshold of 20% disability for recompensation, the rigidity of the tables, and the technical development of speech audiometry without concomitant adaptation of the tables. The following possible solutions are discussed and rejected: changing the tables, substituting speech audiometry by tone audiometry, speech audiometry with interfering noise, filtered speech audiometry, special bonus for recruitment. The following feasible solution is proposed: Retaining all tables in use up to this time, however, instead of using the sum of discrimination scores which simply adds the scores at 60, 80 and 100 dB SRL, weighting factors are introduced according to the formula [3 x (% at 60 dB) + 2 x (% at 80 dB) + 1 x (% at 100 dB)]: 2 The advantages and the effect of this procedure on calculating hearing loss and disability are discussed.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 7","pages":"319-25"},"PeriodicalIF":0.0,"publicationDate":"1988-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14194567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hearing screening in neonates and infants using brain stem evoked acoustic potentials].","authors":"H von Wedel,&nbsp;U Schauseil-Zipf,&nbsp;W H Döring","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reported failure rates of screening using the conventional brainstem auditory response (BAER), audiometry range from 5% to 60% with about 30% of the babies having normal hearing sensitivity on follow-up. The results of testing by an automated infant screener using advanced evoked response technology are compared with those of a conventional evoked response system operated by skilled personnel. 50 newborn were tested at a gestational age of 40-42 weeks. Normal results were obtained in all 25 newborn (50 ears) of the control group using both testing procedures. Out of 25 newborn (50 ears) at risk for congenital perinatal or postnatal hearing disorder, abnormal results for either screening or conventional BAER recording were seen in 6 ears with both methods.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 6","pages":"307-11"},"PeriodicalIF":0.0,"publicationDate":"1988-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14529481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Morphometry of the larynx in horizontal sections. Normal data for the quantitative evaluation of current imaging technics].","authors":"G Friedrich,&nbsp;J Kainz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laryngeal anomalies as a predisposing factor for pathogenesis of vocal disturbances have been discussed for a long time. Laryngeal structures can be made visible in vivo, and structural details be measured, only since the development of new imaging techniques, mainly of CT. As adequate descriptions have not been published in literature unto now, we measured horizontal sections of laryngeal specimens to collect reference data for a quantitative analysis of CT images. An evaluation technique was therefore developed, which, by clear definition of the planes and points of measurements, yields reproducible results. Direct measurement of the thyroid angles can be abandoned, since these can be easily calculated from the known distances.</p>","PeriodicalId":76098,"journal":{"name":"Laryngologie, Rhinologie, Otologie","volume":"67 6","pages":"269-74"},"PeriodicalIF":0.0,"publicationDate":"1988-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14175439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}