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Biomedical subjects

G Rettinger

Publications and source records attributed to G Rettinger.

At least 37 records · Page 2Linked to original sources
PubMed2001

Heating of air in the nasal airways in patients with chronic sinus disease before and after sinus surgery.

The main goal of this study was to determine the influence of sinus surgery on the heating of inspired air in the nose. Intranasal temperature values of 22 patients with chronic sinus disease were measured after inspiration at different locations in the nasal cavity. Measurements were done before and 6-8 weeks after sinus surgery. The patients were compared to 22 healthy control subjects. Nasal airway temperature did not differ between the two study groups at any location in the nasal cavity. Nasal decongestion was without significant influence on temperature values in the patients and the volunteers. There was no significant difference of nasal airway temperature before and after sinus surgery. Even after sinus surgery the main area of heating of inspired air seemed to be the anterior part of the nose. Sinus surgery in patients with chronic sinus disease does not seem to influence heating of air in the nasal cavity.

Adult↗
PubMed2001

Detection of particles within the nasal airways before and after nasal decongestion.

Cleansing of the air is one of the most important functions of the nose. The aim of this investigation was to determine the influence of decongestion of the nasal mucosa with xylometazoline on the intranasal particle deposition at different sites of the nasal cavity. During respiration of an aerosol of starch particles, the non-deposited particles in the air were laseroptically detected in 10 healthy volunteers by a transnasally placed suction probe at different locations within the nasal cavity. The anterior nasal segment was the main area of intranasal particle deposition before and after decongestion of the nasal mucosa. Particle deposition after nasal decongestion was not significantly different from the values before application of xylometazoline. Decongestion of the nasal mucosa and increase in nasal cavity diameter seems not to influence particle deposition of inhaled and exhaled air within a short period after onset of the maximal decongestive effect of xylometazoline.

Adult↗
PubMed2001

Intranasal temperature and humidity profile in patients with nasal septal perforation before and after surgical closure.

Common complaints of patients with a nasal septal perforation are crusting, dryness and bleeding. As shown previously, intranasal humidity values are significantly lower in patients with a septal perforation compared with healthy volunteers. The aim of this study was to determine the influence of surgical closure of septal perforations on intranasal temperature and humidity, and to evaluate changes in clinical symptoms after surgery. Ten patients with septal perforations were included in the study. Intranasal temperature and humidity were measured at the nasal valve and anterior turbinate areas before and after surgical closure. Clinical symptoms were assessed using a nasal symptom score. The end-inspiratory humidity values were significantly (P < or = 0.05) higher postoperatively than preoperatively. The increase in temperature at the anterior turbinate area was significantly higher postoperatively. The temperature values at the nasal valve area were not significantly different. Recurrent epistaxis and nasal dryness were reduced after surgery. Nasal septal perforations disturb the intranasal temperature and humidity profile. After surgical closure, heating and humidification is improved. This may be responsible for the reduction of frequent complaints such as bleeding and dryness.

Adult↗
PubMed2001

[Rational diagnosis of pediatric pharyngeal abscess].

BACKGROUND: Diagnostic procedures intend to differentiate superficial cervical abscesses from deep abscesses and uncomplicated lymphadenitis. They should provide identification of the causing agent, of the route of infection and of possible underlying diseases. Present techniques for examining pediatric cervical abscesses should be assessed. METHODS: Currently published data on diagnostic procedures in pediatric neck abscess from National Library of Medicine data files were evaluated. Moreover, clinical findings, diagnostic procedures, therapy and outcome of 47 children with cervical abscess treated from 1992-1996 were retrospectively evaluated. RESULTS: Studies providing appropriate evidence on the value of various diagnostic procedures in pediatric cervical abscesses were not found. In 47 patients with confirmed cervical abscess treated at our department, clinical examination, erythrocyte sedimentation rate and ultrasound examination of the neck were sufficient to establish the correct diagnosis. Additional investigations such as MRI or CT-scans, chest X-rays, Mendel-Mantoux test, various virus titres and other laboratory examinations were performed only in selected cases. The route of invasion (tonsil, dental or otogeneous) could be identified in 13 children. In 4 children an infected cervical cyst was found. CONCLUSIONS: Clinical examination, erythrocyte sedimentation rate and sonography are appropriate to establish the diagnosis of pediatric cervical abscess and in accordance with the principles of Managed Care.

Child↗
PubMed2001

Vascular variations of the inner ear.

Vascular anomalies of the inner ear have been documented in only a few isolated case reports. The goal of our study was to describe, qualify and quantify vascular variations of the inner ear in 122 temporal bones from 64 pediatric subjects aged between 0 and 10 years. The average age was 11.6 months. Horizontal sections of the temporal bone, examined by light microscopy, revealed vessels coursing freely through the perilymphatic space of the cochlea, especially in the apical turn. Other findings included abnormally wide vessels in the stria vascularis as well as a vascular malformation of the internal auditory canal. Our study demonstrated more atypical vessels in the cochlea than in the vestibular labyrinth. We found a statistically significant positive correlation between vascular variations of the inner ear and concomitant cardiac anomalies or endolymphatic hydrops. We also discuss the possible etiology and potential significance of these findings in terms of disturbances of the function of the inner ear.

Child↗
PubMed2001

Temperature and humidity profile of the anterior nasal airways of patients with nasal septal perforation.

INTRODUCTION: The most frequent symptoms of patients with nasal septal perforations are crusting and bleeding. The aim of this study was to determine the influence of septal perforations on temperature and humidity of the anterior nasal airways. PATIENTS AND METHODS: Intranasal temperature and humidity were measured in the nasal valve area, the anterior turbinate area and in the nasopharynx during normal respiration. A miniaturized thermocouple and a humidity sensor were used for continuous detection. Ten patients with septal perforations were enclosed into the study. The results were compared to matched healthy control subjects. RESULTS: There were no significant differences of the temperature and humidity values between the left and right side of the nasal cavity in each study group. At the end of inspiration, nasal air temperature did not differ significantly between the two study groups. The humidity values at the end of inspiration were statistically significantly lower in the patient group. CONCLUSIONS: Nasal septal perforations seem to be related to lower humidity in the anterior nasal airways during inspiration. Reduced humidity may contribute to crusting as a main symptom.

Adult↗
PubMed2000

Detection of particles within the nasal airways during respiration.

This study introduces a new experimental setup for particle detection within the nasal airways and describes intranasal deposition of particles at various regions of the nasal cavity and the nasopharynx. During respiration of an aerosol of starch particles the nondeposited particles in the air were detected in 11 volunteers by a transnasally placed suction probe at numerous sites of the nasal cavity and nasopharynx. Another, identical suction probe measured the initial number of inhaled particles at the nostril. The two suction probes were connected to two identical laser particle counters and allowed calculation of particle deposition. Particles 1-3 microm in size were deposited to about 60% within the entire nasal cavity, whereas most of the particles 4-30 microm in size were deposited within the entire nasal cavity. Between 80% and 90% of the particles retained in the nasal cavity were deposited at the anterior nasal segment. Studies on deposition of various drugs within the nasal cavity using this experimental set-up are conceivable.

Administration, Inhalation↗
PubMed2000

[GSTM1 gene polymorphism in patients with head and neck tumors].

BACKGROUND: Glutathione S-Transferase mu (GSTM) is a phase II detoxification enzyme, which rapidly detoxifies carcinogens found in tobacco smoke. The prevalence of this polymorphism is about 50% in the caucasian population. The lack of GSTM1 has been linked with an increased susceptibility of smoking related cancers. A homozygote deletion of the GSTM-gene results in a missing gene product. The objective of this study was to investigate the frequency of the GSTM1 null genotype in squamous cell carcinoma of head and neck, especially the larynx and hypopharynx and to analyse the occurrence with respect to certain anatomical sites of cancer. MATERIAL AND METHODS: The GSTM1 genotypes of 83 patients with head and neck cancers and 60 healthy controls were determined by polymerase chain reaction (PCR) using blood leukocyte DNA. The presence or absence of the PCR-product after electrophoretic separation in an 2.0% agarose gel revealed the positive or negative genotype. RESULTS: The absence of the GSTM1 gene (null genotype) was found in 64% of all head and neck cancer patients and in 48% of the healthy controls (p < 0.05). Separating for cancer site, the null genotype was found in 44% of patients with hypopharyngeal cancer and in 78% of patients with laryngeal cancer (p < 0.05). The protein concentration of GSTM-enzyme correlated with the genotype. CONCLUSIONS: The results suggest that GSTM1 deficiency predisposes to head and neck cancer, especially to cancer of the larynx, which is particularly exposed to tobacco smoke carcinogens.

Adult↗
PubMed2000

[Temperature and humidity profile of the paranasal sinuses before and after mucosal decongestion by xylometazolin].

BACKGROUND: One of the most important functions of the nose is to warm and to humidify air before it reaches the lower respiratory tract. Nasal decongestants as one of the most common drugs used in otorhinolaryngology are often associated with the feeling of a "dry nose". The purpose of this study was to determine the short-term influence of xylometazoline on temperature and humidity in the nasal airways. METHODS: 15 healthy volunteers were enclosed into the study. A miniaturised humidity sensor and thermocouple was used for detection of humidity and airway temperature in the nasal vestibule, at the nasal valve area and in the nasopharynx at the end of inspiration. Measurements were done before and after topical application of xylometazoline. RESULTS: Temperature and relative humidity increase from the anterior parts of the nose to the nasopharynx at the end of inspiration. The temperature and humidity values after nasal decongestion are not significantly different from the values before application of xylometazoline. As a tendency temperature and humidity values after nasal decongestion are even somewhat higher at the nasal valve area compared to the values before application of xylometazoline. CONCLUSIONS: Widening of the nasal airways by mucosal decongestion did not lead to a significant change of the nasal temperature and humidity profile 20-30 min after application of xylometazoline. The use of xylometazoline seems not to influence humidifying and heating of inspired air within a short period after onset of the maximal decongestive effect of xylometazoline.

Administration, Intranasal↗
PubMed2000

Temperature profile in the nasal cavity.

OBJECTIVES/HYPOTHESIS: Inspired air is heated and moistened as it passes the nasal cavity. The temperature increase should be similar to a heated tube model, depending on the airflow. STUDY DESIGN: Intranasal temperature values of 50 volunteers were measured after inspiration at different locations: nasal vestibule, nasal valve area, anterior to the head of the middle turbinate, and the nasopharynx. Temperature values were related to nasal airway resistance data. METHODS: Intranasal temperature measurements were made with a miniaturized thermocouple. Nasal airway resistance was detected by active anterior rhinomanometry. RESULTS: A logarithmic increase of air temperature from the anterior segment of the nose to the posterior part was noted. In the nasopharynx temperature was approximately 34 degrees C. The highest increase in temperature was observed in the nasal valve area. CONCLUSIONS: The temperature increase of ambient air in the nasal airways can be compared with a logarithmic curve of the heating of air passing a heated tube. As the heating of air is important for water transport, the space between the nasal valve and the middle turbinate is of special functional importance. No correlation to the results of rhinomanometry was found.

Adult↗
PubMed2000

Perioperative glucocorticoid treatment does not influence early post-laser stapedotomy hearing thresholds.

OBJECTIVE: The aim of this study was to evaluate the efficiency of prophylactic perioperative glucocorticoid treatment during stapes surgery in preventing damage to the inner ear and reducing the frequency of early postoperative complications. STUDY DESIGN: A prospective, randomized, unblinded study design was selected. SETTING: The study was conducted at an academic tertiary referral center. PATIENTS: Ninety-five consecutive patients undergoing erbium:YAG laser-assisted stapedotomy for otosclerosis between 1996 and 1999 were included. MAIN OUTCOME MEASURES: The preoperative minus postoperative (1-4 days and at least 6 weeks) average pure-tone bone conduction thresholds at 1, 2, and 4 kHz were compared in the prednisolone and control groups by the Mann-Whitney U Test. In addition, the occurrences of sensorineural hearing loss of >10 dB, nystagmus, vertigo, and tinnitus were counted and evaluated by use of the Freeman-Halton or Fisher's exact test, respectively. RESULTS: Prophylactic perioperative prednisolone treatment was not able to improve the early postoperative average bone conduction thresholds or reduce the frequency of early sensorineural hearing loss (p > 0.5). The patients who received perioperative prednisolone treatment experienced postoperative vertigo more frequently than did the control patients (p < 0.05). CONCLUSION: Perioperative cortisone prophylaxis for prevention of inner ear damage during stapes surgery is ineffective and is associated with increased postoperative patient discomfort.

Adult↗
PubMed2000

Humidity and temperature profile in the nasal cavity.

OBJECTIVES/HYPOTHESIS: Adequate air conditioning in the nasal airways is mandatory for respiration and gas exchange in the lower respiratory tract. The aim of the present study was to measure relative humidity and temperature in the airstream at different sites within the nasal cavity for mapping of relative humidity and temperature in the upper airways. STUDY DESIGN: Intranasal relative humidity and temperature of 23 volunteers was measured during respiration at different locations in the nasal cavity. METHODS: The end-inspiratory temperature and humidity data, obtained with a miniaturized thermocouple and a capacitive humidity sensor, were determined. RESULTS: A high increase of humidity and temperature at the end of inspiration, in relation to the environmental conditions, was found in the anterior nasal segment. The further increase of both parameters between turbinate area and nasopharynx was less pronounced in spite of the longer distance. CONCLUSIONS: The anterior part of the nasal cavity contributes within a short nasal passage to air conditioning of inspired air.

Adult↗
PubMed1999

Total, subtotal, and partial surgical removal of cervicofacial lymphangiomas.

OBJECTIVES: To compare different surgical interventions for the treatment of extensive cervicofacial lymphangiomas and to define the minimal extent of surgery necessary to control disease. DESIGN: Retrospective study. Mean +/- SD follow-up was 31+/-4 months after surgery. Surgical procedures were grouped as follows: (1) total removal, (2) subtotal removal (all cystic structures removed, small plaques of cyst walls left attached to vital structures), (3) partial removal (major cysts removed, some partially resected cystic structures left in place), and (4) incision and aspiration with subsequent compression bandage. Control of disease was defined as no recurrent or residual tumor or as recurrent or residual tumor less than 10% of initial tumor size without evidence of growth on several postoperative examinations and without clinical symptoms or aesthetic disfigurement. PATIENTS: Twenty-one patients with cervicofacial lymphangiomas (>3 cm in maximum diameter) without thoracic involvement were evaluated. Fifteen patients were 6 years or younger and 6 were older than 6 years. No surgery was yet performed in 3 patients, for a total of 24 surgical interventions in 18 patients. SETTING: Hospitalized care in 2 referral centers. RESULTS: After total removal, disease was controlled in 5 of 5 cases; after subtotal removal, in 8 of 9 cases; after partial removal, in 1 of 7 cases; and after incision and aspiration with subsequent compression bandage, in 0 of 3 cases. Two complications were encountered-1 fully reversible paresis of the marginal branch of the facial nerve and 1 secondary healing. CONCLUSIONS: Surgical removal of cervicofacial lymphangiomas is a safe treatment modality. Disease control can be achieved if all cystic structures are removed. Small plaques of cyst walls attached to vital structures may be left in place. If small cystic extensions of lymphangiomas are only opened and left in place or if lymphangiomas are only drained following compression bandage, symptomatic residual tumor or recurrence is frequent.

Child↗
PubMed1997

Lipogranulomas as complications of septorhinoplasty.

BACKGROUND: Nasal tumors caused by lipogranulomas are a rare complication of a rhinoplasty; only 1 report of this occurrence was found in the literature. OBJECTIVE: To present a series of 4 patients with subcutaneous nasal tumors after each had undergone a rhinoplasty, together with a review of the literature and the clinical consequences. DESIGN: Case series. SETTING: Hospitalized care at a university ear, nose, and throat department. PATIENTS: Four patients were referred within 6 months from a single department for consultation because of broad nasal pyramids after each patient had undergone a rhinoplasty. The origin of the deformities was not known. INTERVENTIONS: Ear, nose, and throat and ultrasound examinations and computed tomography (ie, bone and soft tissue examinations). Two patients had undergone revision surgery and histological examinations of subcutaneous fibrous tissue. MAIN OUTCOME MEASURE: Search for the origin of the nasal deformity. RESULTS: All 4 patients had wide nasal pyramids. One of the 4 patients also had subcutaneous tumors of the nasal dorsum, glabella, and medial canthus area; this patient had subcutaneous cystic lesions on computed tomography and ultrasound examination and a foreign body reaction around "empty spaces" on histological examination. The tumorlike lesions were the result of displaced ointment from the endonasal packings. Two of the 4 patients with minor deformities did not undergo any surgical revision, and they still had some moderate reduction of the cystic lesions within 1 year after the rhinoplasty. CONCLUSIONS: Lipogranulomas caused by ointments that are used together with nasal packings are most often reported in the orbit after endonasal sinus surgery. The incidence should be more frequent in patients who undergo a rhinoplasty because connections between the endonasal cavity and the extranasal subcutaneous layer are created routinely by osteotomies or removal of a hump. Thus, postoperative deformities (eg, inadequate narrowing of the bony pyramid or supratip thickening [permanent swelling of the nasal tip]) should be examined by use of computed tomography, if lipid ointments were used endonasally. For prevention, no lipid substances should be applied together with pressure from packings. In the case of a lipogranuloma, surgical removal via an open approach is the treatment of choice.

Adult↗
PubMed1997

[Bite injuries in the head and neck area].

In Germany about 8500 dog-bite injuries in the face occur every year; more than 50% of the victims are infants and schoolchildren. Besides dogs, other animals such as cats or horses may be responsible for these accidents. Even human bites are reported. The predominant areas are the nose and the auricles. The tissue defects may be superficial, but they can even cause amputations, including severe vascular and nerve or bony destruction. Systemic antibiotic therapy is needed when the wound is infected. The surgical approach to bite injuries includes local wound cleansing, careful excision of necrotic tissue and primary closure of the wound whenever possible. Regarding the importance of surgery in the head and neck area plastic-reconstructive techniques including autologous transplantations and various local or regional flaps should be used at the time the wound is first repaired.

Animals↗