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Biomedical subjects

B Schmelzer

Publications and source records attributed to B Schmelzer.

At least 19 recordsLinked to original sources
PubMed2006

Wegener's granulomatosis presenting as otomastoiditis. A case report.

A 55-year-old male presented with left-sided otorrhoea, hearing loss and tinnitus of 3 months duration. On clinical examination polypoid tissue was seen prolapsing in the external ear canal. A CT scan of the mastoid cells and middle ear showed otomastoiditis with osteolysis. Oral antibiotic therapy and eardrops were started. When a facial nerve paresis appeared one month later, a mastoidectomy was performed. The mastoid cells and middle ear were filled with a connective tissue-like substance. Postoperative corticosteroids were administered. Despite the therapy the facial nerve problem aggravated and the patient developed severe parietotemporal headache, meningeal irritation and somnolence. The diagnosis of neurosarcoidosis was hypothesised. Blood analysis, including c-ANCA's, culture of the otorrhoea and biopsies of the connective tissue were inconclusive. A CT scan of the brain showed thickening of the left tentorium. A biopsy of the dura indicated a diagnosis of Wegener's granulomatosis. The patient was treated with immunosuppressive medication with satisfactory results.

Adrenal Cortex Hormones↗
PubMed2003

Congenital laryngeal cyst: a case report.

Congenital laryngeal cysts are a rare cause of stridor in the neonate. Nevertheless, delayed diagnosis and treatment can cause life-threatening airway obstruction. Even though the diagnosis is easily made by careful inspection, treatment results often in recurrence. These facts are illustrated by a case of a baby with a saccular cyst. Immediately after diagnosis and 5 days later the cyst was de-roofed using a CO2 laser via an endolaryngeal approach. Because of a second recurrence an excision of the cyst was performed via a lateral cervical approach.

Airway Obstruction↗
PubMed2002

Velopharyngeal anatomy in snorers and patients with obstructive sleep apnea.

Velopharyngeal structures play an important role in the pathogenesis of snoring and obstructive sleep apnea (OSA). Hence they form a tempting target for surgical interventions in the treatment of these sleep-related breathing disorders. The assessment of the patient with snoring should therefore include a thorough evaluation of the velopharynx. The clinical evaluation of the velopharynx is discussed in normals and patients who snore (with or without OSA), as well as the features obtained using cephalometry and CT and MR imaging.

Cephalometry↗
PubMed2001

Oncocytic laryngeal cysts: a case report and literature review.

Some 150 cases of oncocytic laryngeal cysts have been published. We report another case of laryngeal oncocytic cysts with atypical presentation of acute, progressive stridor and sore throat. Literature was reviewed with special regard to etiology, clinical presentation, imaging, incidence, localization, associated lesions and treatment options. Oncocytic laryngeal cysts are rare, but may be underreported. They represent a separate clinicopathological entity in the group of all laryngeal cysic lesions and occur in persons over 60 years. The symptomatology varies from asymptomatic to hoarseness and dyspnea. Diagnosis is made by histological examination. Treatment is surgical. Although it is a benign lesion, follow up is recommended, as recurrence is possible.

Acute Disease↗
PubMed1999

Tonsillectomy and adenotomy as a one day procedure?

With special reference to the postoperative hemorrhage rate and its subsequent course, we retrospectively evaluated the outcome of 2,363 tonsillectomies and 3,295 adenotomies performed over the last 11 years at our department. The postadenotomy major bleeding frequency was 0.2%. After tonsillectomy the immediate postoperative major bleeding frequency was 2.6% and 3.0%, respectively in children and adults. Secondary bleeding after tonsillectomy occurred in 0.3% of the children and 0.5% of the adults. In contrast to adenotomy, which can be considered as a safe one day procedure, based on our results we propose to perform tonsillectomy as a more prolonged, one night stay procedure.

Adenoids↗
PubMed1998

[Fixation of nasogastric tubes in agitated and uncooperative patients].

To prevent extubation, nasogastric tubes (NGT) were attached to a fine bore polyurethane tube, which loops loosely around the nasal septum. In a prospective study 180 cases were evaluated concerning the efficacy and possible complications related to this techniques. On average, a nasal septal loop (NSL) remained 20.1 +/- 1.3 days and a NGT 14 +/- 0.9 days. Complications were rare. In 45 of the cases NGT had to be replaced after self extubation and in 2.2% extubation presented more than twice. We think NSL is an easy and useful technique to secure NGT in non-cooperative and/or agitated patients for a relatively short term enteral nutrition or gastric decompression.

Adolescent↗
PubMed1997

Premalignant lesions of the vocal cords. A retrospective study of 62 cases treated with CO2 laser.

A series of 62 patients treated by (repeated) CO2 laser excision and/or vaporization for premalignant lesions of the vocal cords was analysed retrospectively. Of the 54 patients available for follow-up (ranging from 1 to 15 years), five patients (9%) developed an invasive glottic carcinoma and needed radiotherapy. Only two patients (4%) needed extensive surgery (total laryngectomy). One patient (2%) died of a recurrent carcinoma despite radiotherapy and laryngectomy, and six patients (11%) died of a metachronic lung carcinoma. The therapeutic results of (repeated) laser therapy were comparable to those in other reports regarding radiotherapy or stripping. The subjective functional results were satisfactory and tended to improve along with refinement of laser surgery techniques. Follow-up of patients who once had a premalignant laryngeal lesion is mandatory ad vitam, regardless of the grade of the lesion. For the screening of lung cancer, there is still no consensus on a standard-of-care. The classical chest X-ray remains the most accessible and comfortable screening procedure.

Carcinoma in Situ↗
PubMed1997

Posterior epistaxis: our experience with transantral ligation and embolisation.

Transantral ligation of the arteria maxillares internae (AMI) (with or without ligation of the arteria ethmoidalis) and percutaneous embolisation of AMI in cases of intractable epistaxis (i.e. epistaxis not responding to classical posterior packing) are compared. Except when ethmoidal bleeding is suspected, we recommend embolisation for epistaxis not responding to classical measures as it leads to fewer complications and recurrences, to shorter hospital stay and to improved postoperative comfort.

Adolescent↗
PubMed1996

Our technique of partial inferior turbinoplasty: long-term results evaluated by rhinomanometry.

Conservative surgical technique (Partial inferior turbinoplasty) for enlarged inferior turbinates, not responding to adequate local and systemic therapy is described. Short and long term results are evaluated. Relief of nasal obstruction is reported in 94.7% of the patients. There is a good correlation between this success-rate and the objective measurements of the nasal resistance by active anterior rhinomanometry. Rhinorrhea or postnasal drip was still present in 34.2%. Atrophic changes in the nasal mucosa were not observed. Early post-operative epistaxis was found in 5.3% of the patients. Late post-operative epistaxis did not occur.

Adolescent↗
PubMed1996

Securing nasogastric tubes in non-cooperative patients.

To prevent extubation, nasogastric tubes (NGT) were attached to a fine bore polyurethane tube, which loops loosely around the nasal septum. In a prospective study, 124 cases were evaluated for the efficiency and possible complications. On average, a Nasal Septal Loop (NSL) remained 21,2 +/- 1,8 days and a NGT 13,8 +/- 1,1 days. Complications were rare. In 16,9% of the cases NGT had to be replaced after self extubation and in 2.4% extubation occurred more than twice. We think NSL is an easy and useful technique for securing NGT in non-cooperative and/or agitated patients for relatively short term enteral nutrition or gastric decompression.

Adolescent↗
PubMed1995

Surgical management of chronic otitis media with effusion.

Surgical management of chronic otitis media with effusion. One hundred and twenty six children suffering from chronic otitis media with effusion (OME) were operated. Ninety two point eight percent had a satisfactory outcome. Surgical management of chronic OME is discussed.

Adenoidectomy↗
PubMed1994

[Rupture of the round window. Differential diagnosis in sudden deafness and acute vestibular symptoms].

Rupture of the round window has to be considered in the differential diagnosis of sudden hearing loss with or without vertigo. The symptoms of this pathology vary a lot. No clinical examination with a sufficiently high selectivity and sensibility exists. The low therapeutical risk is stressed: exploratory and therapeutic tympanoscopy with grafting of the round and/or oval window.

Evoked Potentials, Auditory, Brain Stem↗
PubMed1994

Fibrous dysplasia in the frontoethmoidal complex: diagnosis and surgical aspects.

Fibrous dysplasia of the paranasal sinuses is rare and often presents a diagnostic challenge. We describe 3 cases of fibrous dysplasia and ossifying fibroma involving the paranasal sinuses. After introduction of the term fibrous dysplasia into the literature in 1938 by Lichtenstein, many authors accepted fibrous dysplasia and ossifying fibroma as one and the same entity. In more recent years most investigators have considered the two lesions as separate and distinct clinical entities. A brief update of the clinical aspects, radiographic appearance, diagnosis and management of craniofacial fibro-osseous lesions is provided.

Adolescent↗
PubMed1994

[Local treatment of otitis media and otitis externa: the role of quinolones].

Patients suffering from suppurative otitis media and externa, and in whom pseudomonas species are present, were treated twice daily by local instillation of ciprofloxacin 0.2%. Treatment resulted in clinical and bacteriological cure in all 17 patients, including patients resistant to previous therapy, within a mean time of six days. There were no adverse effects except one case of local allergy. Audiograms remained unchanged. Local therapy with ciprofloxacin is a welcome addition but should be reserved for cases resistant to other therapy.

Audiometry↗
PubMed1993

Stereolithographic modelling for reconstructive head surgery.

Until now, bounds of model creation of medical objects had to be set because of the limited capabilities of available manufacturing equipment. Recently, stereolithography was developed as an alternative to current milling operations. In this process the surface of a photohardening liquid plastic compound is traced by a laser beam and hardened in layers. The models thus produced are extremely accurate and retain excellent detail. Specific implants can be designed and prepared as is illustrated in a case report. If tissue-compatible plastics are used, custom-made implants could soon be manufactured directly with the technique described.

Child↗
PubMed1993

Surgical or medical treatment of questionable peritonsillar abscess? The use of B-mode ultrasonography.

A prospective study was carried out to evaluate the sensitivity of sonography in the diagnosis of peritonsillar abscesses (quinsy). From 1986 to 1991 all cases of clinically doubtful peritonsillitis were subjected to B-Mode ultrasonography of the tonsils before tonsillectomy. 118 patients were examined. Sensitivity of the method in cases of clinically uncertain peritonsillar abscesses was 87%. The predictive value of the method was calculated to be 0.89; however only five false positive cases ("abscess" in ultrasound but no pus during surgery) were found. We therefore suggest that all patients suffering from questionable peritonsillitis should be examined by ultrasound. If abscess formation is suspected, surgical intervention is indicated. In all other cases I.V. antibiotics should be administered and control sonography should be carried out.

Adolescent↗
PubMed1992

[Methods for simulation of surgical interventions in head and neck surgery].

Preoperative evaluation of the operating site is essential in planning surgical procedures. The relationship of pathology to adjacent tissues and vital anatomical structures needs to be analyzed to determine the intraoperative procedures required. For this the surgeon mentally simulates the procedure planned. For complicated conditions or reconstructive surgery in extensive bony defects, surgery can be simulated with three-dimensional reconstruction on either a monitor screen or on an individually manufactured plastic model of the patient. For this purpose different procedures for 3 D representation and manipulation of tomographic image data have been developed in our departments and the technique of stereolithography used experimentally to create custom-made plastic model of patients. A computerized video image manipulator was also developed for simulation of aesthetic plastic surgical procedures.

Computer Graphics↗