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  • 1
    Electronic Resource
    Electronic Resource
    The transethmoidal approach to pituitary adenomas a technical note (1982)
    Springer
    Acta neurochirurgica 61 (1982), S. 161-166 
    Details
    ISSN: 0942-0940
    Keywords: Transethmoidal approach ; pituitary adenomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The disadvantages, the technical procedure, and the advantages of the transethmoidal approach to the pituitary gland are described. In our opinion this route has been unjustly neglected by the neurosurgeons.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01740080
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  • 2
    Electronic Resource
    Electronic Resource
    CT of the temporal bone in the CHARGE association (1998)
    Springer
    Neuroradiology 40 (1998), S. 462-465 
    Details
    ISSN: 1432-1920
    Keywords: Key words Temporal bone ; abnormalities ; CHARGE association ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the CT examinations of the temporal bone, performed with 1-mm-thick contiguous sections, of seven patients with the CHARGE association. We found abnormalities of the incus and stapes, with ossicular chain fixation, absence of the stapedius muscle and oval window, hypoplasia or dysplasia of the vestibule and absence of the semicircular canals in all ears. The pyramidal eminence and tympanic sinus were absent and there were anomalies of the cochlea in 13 of 14 ears. Absence of the semicircular canals is the most specific change in patients with the CHARGE association.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050625
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  • 3
    Electronic Resource
    Electronic Resource
    Accuracy of single-sequence MRI for investigation of the fluid-filled spaces in the inner ear and cerebellopontine angle (1999)
    Springer
    Neuroradiology 41 (1999), S. 292-299 
    Details
    ISSN: 1432-1920
    Keywords: Key words Temporal bone ; abnormalities ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively studied 163 patients referred for MRI of the temporal bone. A presumed diagnosis was made using only one of three sequences: a single thick (12 mm) slice fast T2-sequence, 3D fourier transform constructive interference in steady state (3DFT-CISS) sequence and a gadolinium-enhanced T1-weighted sequence. The visibility of the cochlea, vestibule and superior, lateral and posterior semicircular canals of normal temporal bones was assessed on the T2-weighted images: they were almost always visible (98–100 %), with exception of the superior semicircular canal, seen in only 35 % of cases. The images were interpreted as abnormal in 34 patients (21 %). Using only the fast T2-weighted, 3DFT-CISS and gadolinium-enhanced T1-weighted sequences a presumed false positive diagnosis was made in 5, 1 and 0 cases and a false negative diagnosis in 2, 2 and 4 cases respectively. The overall reliability of the thick-section fast T2-weighted images is limited. This study suggests that a combination of gadolinium-enhanced T1-weighted and 3DFT-CISS images can be considered the gold standard for temporal bone MRI and neither sequence performed separately is as accurate as both together.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050751
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  • 4
    Electronic Resource
    Electronic Resource
    Middle-latency responses to assess objective thresholds in patients with noise-induced hearing losses and Ménière's disease (1996)
    Springer
    European archives of oto-rhino-laryngology and head & neck 253 (1996), S. 222-226 
    Details
    ISSN: 1434-4726
    Keywords: Middle-latency response threshold ; Low and middle frequency middle-latency response thresholds ; Noise-induced hearing loss ; Ménière's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study 23 patients with noise-induced hearing loss (NIHL) referred for medico-legal evaluation and a group of 18 cases with Ménière's disease were evaluated audiologically using the middle-latency response (MLR). Cross-correlation functions were used to assess precisely MLR thresholds in low and middle frequencies. Cross-correlation data obtained from suprathreshold levels to below threshold levels were compared with the normal limits of parameters found at threshold levels, allowing us to determine the true MLR threshold. Our results revealed that this MLR threshold and visual detection thresholds were different in 18% of both the NIHL and Ménìere's disease groups. In this population the true MLR threshold was greater by 5 dB. These findings demonstrated that cross-correlation functions can enhance the sensitivity of the definition of the MLR threshold. True MLR thresholds were compared with subjective pure-tone audiometric (PTA) thresholds at the same frequencies (0.5, 1 and 2 kHz). The true MLR threshold and PTA threshold were in agreement within 10 dB in 91% of the NIHL group and all of the Ménière's disease group. The PTA threshold was greater by 15 dB or more in the remaining NIHL group. If a criterion of 15 dB discrepancy indicates non-organic hearing loss, it can be inferred that 9% of an NIHL population referred for medico-legal evaluation is exaggerating subjective audiometric thresholds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00171131
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  • 5
    Electronic Resource
    Electronic Resource
    Panendoscopy as a screening procedure for simultaneous primary tumors in head and neck cancer (1996)
    Springer
    European archives of oto-rhino-laryngology and head & neck 253 (1996), S. 319-324 
    Details
    ISSN: 1434-4726
    Keywords: Panendoscopy ; Synchronous neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Head and neck cancer is often associated with second primary neoplasms. These cancers most commonly involve other regions of the head and neck, esophagus, and lung. The majority of cases are also squamous cell carcinomas. In view of this rather frequent occurrence of multiple primary cancers and how they adversely affect the patient's survival, it becomes imperative to analyze how the clinician can intervene effectively. One such approach is to detect multiple primaries as early as possible. As such, panendoscopy as a part of the tumor-staging procedure has been advocated by many investigators to search for simultaneous second primary malignant neoplasms in patients presenting with head and neck cancer. In a 24-month period, data were gathered from 127 consecutive patients referred to University Hospital, Ghent with previously untreated, squamous cell carcinomas of the head and neck. One hundred-eighteen patients underwent an endoscopic examination under general anesthesia, during which 4 simultaneous second primary tumors were found in 3 patients. This represents an incidence of 3.4% of simultaneous second primary neoplasms. The results for the different parts of the endoscopy are discussed and compared with literature findings. Guidelines are given for the initial evaluation of the head and neck cancer patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00178285
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  • 6
    Electronic Resource
    Electronic Resource
    Selecting the best tone-pip stimulus-envelope time for estimating an objective middle-latency response threshold for low- and middle-tone sensorineural hearing losses (1995)
    Springer
    European archives of oto-rhino-laryngology and head & neck 252 (1995), S. 275-279 
    Details
    ISSN: 1434-4726
    Keywords: Stimulus-envelope time ; Middle-latency evoked response ; Frequency-specific sensorineural hearing losses
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of rise-fall and plateau times for the Pa component of the middle-latency response (MLR) were investigated in normally hearing subjects, and an objective MLR threshold was measured in patients with low- and middle-tone hearing losses, using a selected stimulus-envelope time. Our results showed that the stimulus-envelope time (the rise-fall time and plateau time groups) affected the Pa component of the MLR (quality was determined by the (χ2-test and amplitude by the F-test). The 4-2-4 tone-pips produced good Pa quality by visual inspection. However, our data revealed no statistically significant Na-Pa amplitude differences between the two subgroups studied when comparing the 2- and 4-ms rise-fall times and the 0- and 2-ms plateau times. In contrast, Na-Pa became significantly smaller from the 4-ms to the 6-ms rise-fall time and from the 2-ms to the 4-ms plateau time (paired t-test). This result allowed us to select the 2- or 4-ms rise-fall time and the 0- or 2-ms plateau time without influencing amplitude. Analysis of the stimulus spectral characteristics demonstrated that a rise-fall time of at least 2ms could prevent spectral splatter and indicated that a stimulus with a 5-ms rise-fall time had a greater frequency-specificity than a stimulus of 2-ms rise-fall time. When considering the synchronous discharge and frequency-specificity of MLR, our findings show that a rise-fall time of four periods with a plateau of two periods is an acceptable compromise for estimating the objective MLR threshold. The correspondence between MLR and pure-tone audiometric (PTA) thresholds was high, with a correlation coefficient around 0.92–0.96 in these cases with rising low- and middle-tone sensorineural hearing losses. The MLR and PTA thresholds were within 10 dB for all cases. A comparison of the mean difference (MLRt-PTAt) at 0.5, 1 and 2 kHz revealed no significant differences (F-test). The MLR threshold in the present study approximated the psychoacoustic threshold in the hearing-impaired subjects, while the MLR using 4-2-4 tone-pips was able to measure objective thresholds across low and middle frequencies. This study has again demonstrated the clinical usefulness of the MLR for estimating low- to middle-frequency auditory thresholds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00185389
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  • 7
    Electronic Resource
    Electronic Resource
    Effectiveness of ribosomal fractions ofKlebsiella pneumoniae, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae and the membrane fraction ofKp (Ribomunyl) in the prevention of clinical recurrences of infectious rhinitis (1997)
    Springer
    European archives of oto-rhino-laryngology and head & neck 254 (1997), S. 372-375 
    Details
    ISSN: 1434-4726
    Keywords: Recurrent infectious rhinitis ; Treatment ; Immunostimulant ; Ribosomes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A multicenter, double-blind, placebo-controlled study was conducted to investigate the efficacy of an immunostimulant, Ribomunyl, in the prevention of recurrences of infectious rhinitis in adults. This trial involved 327 patients (168 Ribomunyl treated and 159 placebo cases) with an average of 4.3 ± 1.8 rhinitis episodes per patient recorded during the year preceding the study. The main criterion of efficacy was the cumulative number of recurrences of infectious rhinitis during a 6-month follow-up period, as analyzed by standard tests. An additional analysis of relative risk of recurrences used multivariate failure for time data. Ribomunyl was effective throughout the study period, starting from the first month of treatment: a mean of 1.0 ± 1.1 recurrences was recorded in the Ribomunyl group as compared to 1.5 ± 1.4 recurrences in the placebo group; this indicated one-third fewer infections (P = 0.001). The protective effect of Ribomunyl on the relative risk for recurrences was estimated to be 0.58 by multivariate analysis (95% CI: 0.43–0.78,P = 0.0001). Analysis of secondary criteria also favored Ribomunyl: 38.5% less antibiotic courses per patient (0.8 ± 1.3 vs 1.3 ± 1.6;P = 0.002) and the number of days with antibiotics (5.6 ± 9.3 vs 9.1 ± 12.1;P = 0.002).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01642553
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  • 8
    Electronic Resource
    Electronic Resource
    Cytokeratin expression patterns in the human tympanic membrane and external ear canal (1993)
    Springer
    European archives of oto-rhino-laryngology and head & neck 250 (1993), S. 78-81 
    Details
    ISSN: 1434-4726
    Keywords: External ear canal ; Tympanic membrane ; Cholesteatoma ; Cytokeratins ; Immunochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Immunohistochemical investigations were carried out to further reveal the pattern of cytokeratin (CK) expression in middle ear cholesteatoma. Using chain-specific monoclonal antibodies and the indirect immunoperoxidase technique, 10 out of 19 CK polypeptides were screened in cryoslices of fresh postmortem eardrums and external ear canal specimens. Our data, combined with those published before, indicate an intimate relationship between middle ear cholesteatoma lesions and epidermal tissues in the immediate vicinity. Our CK data do not favor the metaplastic origin of cholesteatoma, because the CK complement of cholesteatoma lesions does not include major and typical CK constituents of the middle ear mucosa.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179302
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  • 9
    Electronic Resource
    Electronic Resource
    A comparative study of age and degree of facial nerve recovery in patients with Bell’s palsy (1999)
    Springer
    European archives of oto-rhino-laryngology and head & neck 256 (1999), S. 520-522 
    Details
    ISSN: 1434-4726
    Keywords: Key words Idiopathic facial nerve palsy ; Functional nerve recovery ; Age-related prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to investigate if there is any relationship between the age of a patient and the degree of facial nerve recovery in patients with Bell’s palsy. Between 1987 and 1995 250 patients with peripheral idiopathic facial nerve palsy were examined at the ENT Clinic of the University of Ioannina. In this group 134 were male and 116 were female. The patients’ ages ranged from 4 to 80 years and had an average of 47.7 years. The average age of the male patients was 46.5 years and that of the female patients was 49.1 years. In the overall group of 250 patients 129 presented with a paralysis of the right facial nerve and 121 on the left. There was no case of bilateral palsies. When comparing the age of the patients and the degree of recovery, measuring age was associated with a decrease in complete recovery. While the percentage of complete recovery between age 4 and 50 years varied from 83% to 74%, respectively, the percentage of complete recovery decreased to less than 54% at age 80. Our results show that the age of the patient is a very important factor for facial nerve recovery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004050050203
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  • 10
    Electronic Resource
    Electronic Resource
    A comparison of electroneuronography with facial nerve latency testing for prognostic accuracy in patients with Bell's palsy (1996)
    Springer
    European archives of oto-rhino-laryngology and head & neck 253 (1996), S. 35-38 
    Details
    ISSN: 1434-4726
    Keywords: Facial nerve palsy ; Electrodiagnosis ; Electroneuronography ; Evoked electromyography ; Facial nerve latency test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to evaluate the ability of electroneuronography (ENOG), also called evoked electromyography (EEMG), and facial nerve latency testing (FNLT) to assess the prognosis of facial nerve palsy, using the House-Brackmann facial nerve grading system as criterion. From 1988 to 1994 these tests were employed at the ORL Clinic of the University of Ioannina in 250 patients with idiopathic facial nerve palsy. The ENOG test results indicated that when the amplitude of the compound muscle action potentials ranged from 51% to 95% of the normal value, 97% of the patients achieved complete functional recovery (grade 1) within at least 2 months. When the muscle action potential decreased to a value below 51% of normal values, prognosis for recovery was considerably worse. FNLT test results indicated that as the latency time extended, the recovery grade of the facial nerve worsened. When latency time was within the normal range (group A patients), about 92% of patients had complete functional recovery. In contrast all patients having either a very extended latency time or unable to be monitored (groups C and D) demonstrated incomplete functional recoveries that ranged from grade 11 to grade VI. Comparing each test with the House-Brackmann facial nerve grading system, we ascertained that the percent accuracy for ENOG was 97.6%, and that for FNLT was 94.4%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00176700
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