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Biomedical subjects

F Rosanowski

Publications and source records attributed to F Rosanowski.

51 records · Page 3Linked to original sources
PubMed1996

[In situ sound pressure measurement in a professional violinist with bilateral tinnitus].

BACKGROUND: A case of a professional violinist suffering from a bilateral tinnitus is presented. The musician reported the tinnitus to be louder and more straining when playing his Vuillaume violin (France 1840) as compared with his Carcassi violin (Italy 1763). CASE REPORT: In the 42-year-old musician, audiometry revealed a normal hearing threshold in the right ear and a slight hearing loss in the left ear of up to 20 dB between 2 kHz and 8 kHz. Transitory evoked otoacoustic emissions could only be measured in the right ear. The tinnitus could be masked (distance type); residual inhibition was only seen in the right ear. By sound intensity measurements in both external auditory canals, the different sound spectra of both violins could be demonstrated. When playing with "forte" intensity, sound pressure reached peaks of over 90 dB. The tinnitus was ameliorated by lidocaine infusions. DISCUSSION AND CONCLUSIONS: The different sound spectra of both violins may be the reason for the enhancement of the musician's tinnitus. Interference of air and bone-conducted sound could lead to a cochlear overlap and thus influence the tinnitus although such a phenomenon can not be verified. It was previously reported that high-pitched instruments may cause tinnitus sensations in performing musicians. A review of the literature surprisingly reveals that although professional musicians are exposed to sound pressure levels that may cause hearing impairment, only very few do develop one. This fact has to be taken into account whenever an occupational disease is suspected.

Adult↗
PubMed1996

[Juvenile xanthogranuloma of the auricle].

BACKGROUND: Juvenile xanthogranulomas are rare benign tumors of histiocytic origin with cutaneous manifestation predominantly in the head and neck. A case of a 12-month-old girl is presented. CASE REPORT: A tumor of the inferior crus of the left auricle had been noticed three weeks after birth. It was of yellowish color, bosselated and firm, and not mobile. During operation the tumor seemed lipomatoid and affected both cutis and subcutis. Histologically cutaneous structures were regular. Subcutaneously, cell-rich connective tissue with foamy histiocytes and Touton giant cells were observed as characteristic features of a juvenile xanthogranuloma. DISCUSSION: The pathogenesis of this tumor is unclear. The definite diagnosis is established by histological examination. Histological differentiation should include malignant tumors of histiocytic origin (dermatofibro-sarcoma protuberans, histiocytoma, atypical fibrous histiocytoma, fibro-xanthosarcoma) and malignant melanoma. Surgery is the treatment of choice only in cases in which the clinical diagnosis is doubtful, since juvenile xanthogranulomas usually heal spontaneously.

Diagnosis, Differential↗
PubMed1996

[Metastases of germ cell tumors to the ENT area--a rare differential diagnosis of lymph node metastases in unknown primary tumor].

BACKGROUND: Germ cell tumors of the testis usually metastasize to retroperitoneal lymph nodes, lungs, and liver. Other lymphatic or organ metastases especially in the head and neck are rare. CASE REPORTS: The cases of two men, ages 21 and 35, are presented. In both cases, the histologic examination of cervical lymph node specimen lead to the correct tumor diagnosis of testicular cancer. Multimodal urooncologic therapy led to long-lasting complete remissions in both cases. CONCLUSIONS: In young men between 20 and 35 years of age with cervical metastases of tumors of unknown primary site, germ cell tumors must be suspected. Histologic findings of non-squamous epithelial metastases (seminoma, embryonal carcinoma, chorionic carcinoma, teratoma, yolk sack tumor, and their combined forms) with or without retroperitoneal, mediastinal, or lung metastases; elevated tumor markers (human-chorionic gonadotropin, alpha-feto-protein, placental alkaline phosphatase, lactate dehydrogenase); and palpable intratesticular mass lead to the correct tumor diagnosis. Early detection of the disease is essential for successful therapy and long-term remission.

Adult↗
PubMed1995

[Multimodal carotid occlusion test for determining risk of infarct before therapeutic internal carotid artery occlusion].

UNLABELLED: In patients with head and neck carcinoma and extensive cervical metastasis, the topographic and functional relationship of the tumor to the carotid artery is highly important. In case of suspected carotid infiltration, the possibility of a carotid resection or a prosthetic replacement has to be considered preoperatively. Treatment of cavernous carotid aneurysms may also require sacrificing the internal carotid artery (ICA). An interdisciplinary test occlusion of the ICA was performed to assess cerebral collateral circulation prior to permanent carotid occlusion. MATERIALS AND METHODS: Fifty-two patients with cervical tumors (n = 45) or inoperable aneurysms (n = 7) were examined. The endovascular balloon test occlusion (BTO) of the ICA was combined with monitoring of the neurological status, cardiovascular status (EKG, blood pressure), cortical function (EEG), and single photon emission CT (SPECT) imaging of the regional cerebral blood flow (rCBF) with 99mTechnetium-HMPAO. In the last 24 patients, transcranial Doppler sonography (TCD) of the ipsilateral middle cerebral artery (MCA) was added for direct hemodynamic monitoring during BTO. In order to improve the diagnostic value of the test results and to simulate hemodynamic crisis, the cerebrovascular reserve capacity was then evaluated with acetazolamide (Diamox). RESULTS: BTO could be performed without neurological complications or carotid dissection. In eight (15%) patients BTO had to be interrupted previously due to neurological symptoms or a delta-EEG. These patients and patients with highly pathological test results in SPECT imaging (n = 9) or TCD (n = 3) were excluded from permanent carotid occlusion. Ten (19%) patients were definitely occluded without hemodynamic complications, but two patients suffered embolic infarctions, which can not be predicted by this procedure. In two patients with a severe hypoperfusion in SPECT imaging, the ICA had to be ligated under emergency conditions following a carotid rupture. Predictably, a hemodynamic infarction occurred postoperatively in both patients. CONCLUSIONS: The multimodal BTO with brain perfusion imaging (HMPAO-SPECT) and quantitative blood flow monitoring (TCD) allows a hemodynamic stroke risk assessment prior to permanent occlusion of the ICA. The procedure is important for planning of the therapeutic strategy and for the preoperative dialogue with the patient. Embolic ischemic complications can not be predicted.

Adult↗
PubMed1995

[Familial bilateral atresia of the auditory canal with hypertelorism].

The incidence of malformations of the ear is 1:5000, the incidence of stenosis and atresia is 1:12,000. 30% of the malformations are bilateral. In only 0.3% it is the only malformation. Inherited bilateral atresia of the external auditory canal associated with hypertelorism as the only additional malformation has not yet been described. Basing on a case report the way of interdisciplinary rehabilitation of children affected by bilateral hearing impairment is discussed. Special emphasis is on the discussion of the necessity of radiological examinations for the exclusion of cholesteatoma in an atretic ear which could be found in a 5-year old boy of the described family.

Child, Preschool↗
PubMed1995

[Esophagomediastinal fistula and recurrent laryngeal nerve paralysis after radiotherapy of Hodgkin's disease].

The case of a female patient 21 years old at the time of diagnosis is reported. The patient suffered from stage IV Hodgkin's disease of the nodular sclerotic type with head and neck manifestations in cervical lymph nodes and in the esophagus. After radiotherapy; she suffered from an esophageal/mediastinal fistula and unilateral paralysis of the recurrent laryngeal nerve. Fifteen years later, there are no signs of recurrent tumor growth or a secondary neoplasm. Dysphonia was ameliorated by speech therapy, and surgery was not necessary.

Adult↗
PubMed1994

[Immunoscintigraphic detection of metastasis in malignant melanoma in the head and neck area].

The value of immunoscintigraphy in patients with metastatic malignant melanoma of the head and neck is compared with clinical, radiological and histological findings. 25 immunoscintigraphic examinations in 16 patients were evaluated. Scintigraphy was performed during primary and follow-up diagnosis of head and neck melanoma of the skin (n = 8), nose and sinuses (n = 3), petrosal bone (n = 1) and sclera (n = 1) as well as in cervical lymph node metastases of distant melanoma (n = 2) and melanoma of an unknown primary tumour (n = 1). Immunoscintigraphy was performed with 99mTc-radiolabelled melanoma specific antibodies against a melanoma-associated cell membrane-bound antigen (glycopolypeptide). The sensitivity of the method was 88%, specificity was 80%. The prior significance of immunoscintigraphy is based on the detection of occult cervical lymph node metastases not detectable by means of palpation and radiography. Pulmonary and liver manifestations could not be safely identified due to the physiological enhanced blood pool in these organs. The results obtained indicate that immunoscintigraphy may yield more information about the status of pathologically altered tissue and in certain cases may influence the therapeutic procedure.

Adult↗
PubMed1994

[HIV-associated parotid cysts].

20 seropositive HIV patients were examined for the detection of parotid cysts by means of B-mode sonography. In three cases bilateral cysts were found, in three cases unilateral. Only one patient showed clinical symptoms with a bilateral and painless parotideal mass. The cysts were 0.32 to 3.8 cm in diameter. No correlation could be found, neither to the CDC-classification (according to the Center for Disease Control) nor to different HIV-related lesions. Pathogenesis, diagnostic procedure, and clinical relevance of this new entity are discussed. HIV-seropositive patients should be examined sonographically for detection of parotid cysts as indicators for early manifestation of a HIV infection. It is recommended that in patients having cervical sonography for any reasons, a hidden HIV-infection should be excluded once cystic parotideal lesions have been detected.

Adult↗
PubMed1993

[Pre-auricular angiomyxoma in a child].

Myxomas are rare benign tumours in adolescents and adults with a predominant manifestation in the region of the maxillary and mandibular bone. A case of a cystic, slowly growing tumour in the right preauricular region is presented. During operation the tumour was completely encapsulated by connective tissue and showed a lobular shape on the cut surface with small cystic cavities. Histologically a myxomatous tissue was seen with a prominent and reticular capillary system like an angiomyxoma. The pathogenesis remains unclear. The definite diagnosis is established by histology. Histological and immunohistochemical differentiation between different benign mixed tumours should include myxomatous neurinomas and lipomas as well as myxomatous transformed histiocytomas. Surgery is the treatment of choice. After a follow-up for more than two years the patient is free from clinical symptoms.

Child↗
PubMed1991

[HMPAO-SPECT during carotid artery compression (Matas test) in the evaluation of cervical tumor surgery with potential carotid involvement].

For planning the surgical approach in patients with head and neck tumours and extensive cervical metastasis the evaluation of possible vascular involvement is necessary. If the carotid artery is suspected to be infiltrated by the tumour masses its resection or plastic substitute becomes sometimes inevitable. For evaluation of the collateral brain perfusion before a possibly necessary carotid resection we examined 10 patients with neck tumours performing the Matas-Test combined with HMPAO Single-Photon-Emission-Computed-Tomography. During ultrasound-controlled manual compression of the involved common carotid artery 99mTc-labelled HMPAO was injected. The SPECT demonstrated the brain perfusion during the carotid compression time period. 6 patients showed a decreased perfusion of the affected hemisphere with - as far as obtained - normal baseline SPECT-results and balloon occlusion tests. 2 of these patients underwent a carotid artery resection, one of the common carotid artery and one of the internal carotid artery. One patient had a significant perfusion deficit in the SPECT but no pathologic findings in angiography and balloon occlusion test. He suffered from hemiparesis postoperatively. The other patient showed preoperatively a minor decrease in perfusion and had no neurological defects postoperatively. Our findings show that the Matas-Test combined with HMPAO-SPECT is a valuable tool for the preoperative evaluation of the collateral brain perfusion. This technique is not invasive and can be performed in every nuclear medicine department with an ECT camera. The HMPAO-SPECT during carotid compression can add useful information or even replace angiography and the balloon occlusion test.

Aged↗
PubMedDate not supplied

Late-onset sensorineural hearing loss in Coffin-Lowry syndrome.

The Coffin-Lowry syndrome (CLS) is a rare clinical entity where patients present with a characteristic facies, mental retardation and bone abnormalities. So far about 60 cases have been reported. Sensorineural hearing loss is not a characteristic symptom and a late-onset hearing loss has not been reported so far. We report on 4 brothers with CLS, aged 9-17 years, of whom 3 suffered from a severe sensorineural hearing loss with an onset during late childhood and adolescence after a normal hearing during early childhood. CT scans revealed no cochlear abnormalities. The boys were successfully equipped with hearing aids. It is suggested that in all CLS patients the hearing ability should be examined during early infancy and retested regularly in cases with normal hearing as these cases indicate that in CLS a late-onset hearing loss is possible during late childhood and adolescence.

Abnormalities, Multiple↗
PubMedDate not supplied

Severe hearing loss in Pallister-Killian syndrome.

Pallister-Killian syndrome is a rare disorder characterised by a specific combination of anatomic anomalies, mental retardation and lack of speech acquisition due to tetrasomy 12p. Hearing loss does not seem to be characteristic for this syndrome, although it was reported in several cases. We present the case of a girl first seen in our department at the age of 6 months. A severe sensory hearing loss was confirmed by subjective and objective audiometry. The child was successfully equipped with hearing aids. In the literature almost all children with Pallister-Killian syndrome are described as not developing verbal speech. Surprisingly their hearing abilities were not examined systematically. We advise audiological testing of children with Pallister-Killian syndrome.

Abnormalities, Multiple↗
PubMedDate not supplied

Androglottia in a young female adolescent with congenital adrenal hyperplasia and 21-hydroxylase deficiency.

Vocal disturbances in women with congenital adrenal hyperplasia and androgen excess should be extremely rare today since effective substitution with glucocorticoids is available. We present a 17 year-old female with congenital adrenal hyperplasia due to 21-hydroxylase deficiency and severe virilization because of long-term insufficient therapy. Laboratory data showed elevated serum levels of testosterone, 17-hydroxyprogesterone, plasma ACTH and a high excretion of urinary pregnanetriol. The phoniatric aspect showed a masculine voice. We discuss the different effects of androgens on the pubertal larynx and various hormonal disturbances that may cause voice changes as well as therapeutic options of voice therapy. From the pediatric point of view it might be important to perform a phoniatric examination in girls with congenital adrenal hyperplasia during puberty in order to monitor androgen effects.

17-alpha-Hydroxyprogesterone↗