Ein neues Visualisierungssystem für die HNO-Chirurgie

Background

This work examines the application possibilities of the panoramic visualization system (HD-PVS) in ENT surgery. The HD-PVS is a new optical system that is neither an endoscope nor a microscope. It has a focal length of 200 mm and a wide field of view.

Patient and Methods

The analysis of the visualization quality took place under laboratory conditions at 4 close-to-surgery scenarios with a total of 40 result values. Furthermore, the system was used for 45 operative procedures on patients (tympanoplasty, parotidectomy, neck dissection, septumplasty, transfacial approaches). The results were analyzed following the ICCAS workflow-scheme and with standardized questionnaires.

Results

The analysis of the visualization quality of the PVS exhibited the best total evaluation in 2 out of 4 scenarios, in 1 scenario HD-PVS attained the maximum score possible, as did the microscope and the endoscope was better than HD-PVS in 1 scenario. The microscope was never evaluated as being better than HD-PVS. Apart from its use in middle ear surgery, the HD-PVS can be considered operational in 4 out of 5 clinical applications with only slight modifications.

Consequences

The advantages of HD-PVS over gold standards such as the surgical microscope are lower initial costs for the optical system with frequently already existing HD-video system, smaller space requirements, equal or sometimes better visualization quality, possibility of videoendoscopic representation of surgery and better ergonomic conditions.     

Die Durchmesser des Stenon- und Wharton-Ganges Bedeutung für Diagnostik und Therapie

In assessing new minimally invasive diagnostic techniques (duct endoscopy) and therapy (lithotripsy) of salivary gland disease, it is of importance to know the true dimensions of the secretory ducts. Twenty-five ducts of the parotid gland and 20 ducts of the sub-mandibular gland were examined histologically at different points of their anatomic course and their in vivo diameters were evaluated using a previously determined formalin-induced shrinking factor. The mean diameter of Stensen's duct at four different points along its length ranged between 0.5 mm and 1.4 mm, depending on the site. A narrowing at the middle of the duct was striking. In all preparations examined, the minimum width of the secretory duct was located at the ostium. In Wharton's duct the narrowest duct diameter was also identified at the ostium. The mean values for the duct diameters ranged between 0.5 mm and 1.5 mm. For diagnostic and therapeutic purposes, endoscopes, balloon catheters and stone-extraction baskets should conform as much as possible to physiological duct widths. A diameter of 1.2 mm should be considered the upper limit for duct instruments. Our findings also suggest that in the case of salivary stone lithotripsy the best results will be achieved when the maximum size of a stone fragment does not exceed 1.2 mm.     

Ein neues Eintheilungsprincip für die verschiedenen Formen der Taubstummheit

Ohne ZusammenfassungVortrag, gehalten in der Sitzung der österr. otolog. Gesellschaft vom 26. Mai 1902.     

Die Bedeutung des Rinne'schen Versuches für die Diagnose der Labyrinthaffectionen

Ohne Zusammenfassung(Von der Redaction übernommen am 10. October 1888.)     

Die Bedeutung der Lumbalpunction für die Diagnose intracranieller Complicationen der Otitis

Ohne Zusammenfassung     

Der Ductus nasofrontalis bei Stirnhöhlenerkrankungen und das Becksche Punktionsverfahren in seiner Bedeutung für Diagnostik und Therapie

Ohne ZusammenfassungMit 6 Textabbildungen.Zum 60. Geburtstag ProfessorK. Becks.     

Ein Galvanokauter für das Trommelfell

Ohne Zusammenfassung     

Über Sequestration im Bereich des Felsenbeins und die Bedeutung der Röntgendarstellung für deren Diagnose

Ohne ZusammenfassungMit 8 Textabbildungen     

Demenz—Aktueller Wissensstand und Bedeutung für HNO-Ärzte

Because of the growing number of elderly people, the incidence of dementia is increasing. This disease is a heavy burden for patients and their relatives, and has growing social and financial implications. The essential feature of dementia is an impairment in both short and long-term memory which is associated with an impairment in abstract thinking, impaired judgment, other disturbances of higher cortical functions, and/or personality change. Mild cognitive impairment represents a transitional state between the cognitive changes of normal aging and very early dementia, and is becoming increasingly recognized as a risk factor for Alzheimer's disorders. ENT specialists require knowledge on the basic problems in patients with (early) dementia and the most common diagnostic/therapeutic assessments. New therapeutic concepts such as cholinesterase inhibitors have been shown to interfere with the progression of Alzheimer's disease. In this report, the strategies in diagnostics and therapy which should be known by ENT specialists are presented.     

Die Bedeutung des Lagenystagmus für die otologische und neurologische Diagnostik

Zusammenfassung Durch den L.N. ist die vestibuläre Diagnostik verbessert und erweitert worden. Es hat sich herausgestellt, daß bei peripheren Ohrerkrankungen, bei retrolabyrinthären und cerebralen Prozessen Gesetzmäßigkeiten vorhanden sind, welche einen für diese Lokalisation charakteristischen L.N. ergeben haben. Regelloser und richtungwechselnder L.N. ist typisch für Hirnerkrankungen; richtungbestimmter L.N. kommt hauptsächlich bei retrolabyrinthären (extracerebralen) Prozessen vor; auch bei peripheren Ohrerkrankungen im allerersten Beginn kann L.N. auftreten. Die für die peripheren Erkrankungen charakteristische Form des L.N. ist scheinbar die rotatorische Schlagrichtung. Ausnahmen von dieser Regel kommen nicht selten zur Beobachtung, da Erkrankungen, welche die Zentren für die Schlagrichtung treffen, wahrscheinlich richtungsbestimmten L.N. erzeugen und viele Erkrankungen sich auf zwei der drei abgegrenzten Teilgebiete des Vestibularissystems erstrecken. Bezüglich des Grades der Vestibularisstörung ist der L.N. wahrscheinlich eine Vorstufe des Spontannystagmus.Auf die Fehlerquellen und Grenzen der Methodik wird ausdrücklich hingewiesen.Mit I Textabbildung.     

Ein neuer Zerstäuber für den Nasenrachenraum und vielleicht auch für andere Höhlen

Ohne Zusammenfassung     

Ein verbessertes Tiermodell für chronische Trommelfellperforationen

BACKGROUND: An inexpensive and valid animal model of chronic tympanic membrane perforation is needed. METHOD: Twelve male rats were selected for different surgical procedures (subtotal tympanic membrane perforation with local microflaps, re-perforation without flaps, partial excision of the handle of malleus). The inhibition of spontaneous healing was accomplished by the application of prednisolon or mitomycin directly onto the tympanic membrane. RESULTS: Only by additional partial excision of the handle of malleus followed by local application of mitomycin were we able to achieve a persistent tympanic membrane perforation. CONCLUSION: Chronic tympanic membrane perforation using this procedure may be useful in further investigations of the medical impact of tympanic membrane healing.