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Biomedical subjects

G Rettinger

Publications and source records attributed to G Rettinger.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Palatal sensory impairment after setoplasty].

A certain percentage of patients complain of numbness or pain in the palatine mucosa, posterior to the incisors, following septal surgery. The symptoms arise from lesions of the nasopalatine nerve near the floor of the nose. In order to demonstrate the sequelae of these lesions, we performed a prospective study on 31 individuals undergoing septoplasty. A maxillary-premaxillary approach to the nasal floor was used on one side in a group of 13 patients and on both sides in a group of 18 patients according to the respective unilateral or bilateral septal pathology. Unilateral or bilateral division of the nasopalatine nerves was anticipated. The threshold of sensitivity to a direct current of up to 500 mA with pulses of 100 msec duration was determined preoperatively. The test was repeated 8 days postoperatively at 5 defined points of the palatine mucosa: posterior to both incisors and both canine teeth and at the incisive papilla. In addition, the patients were questioned about distinct palatine sensations 8 days and 3 to 5 months after septoplasty. Neither group showed any significant elevation of the threshold of sensitivity to a direct current 8 days postoperatively, regardless of whether unilateral or bilateral subperiostal tunnels of the nasal floor had been. However, thirteen patients (32%) described disturbances of sensitivity, most frequently numbness or soreness. The symptoms occurred in both groups with equal distribution. After an interval of 3 to 5 months postoperatively, 16% of all operated patients still had some kind of palatine discomfort.(ABSTRACT TRUNCATED AT 250 WORDS)

Cranial Nerves↗
PubMed1995

[Facial injuries caused by dog bite].

Dog bite injuries occur statistically in urban areas every three days. Thirty such injuries to the face were treated at the Ear-Nose-Throat University Hospital, Erlangen-Nuremberg, between 1973 and 1990. The average age of the patients was 15 years. The dogs most frequently involved were the Alsatian wolfhound (43%) and the badger dog (21%). The majority of the victims were family members (59%) or at least known to the owner of the dog (28%). Only in 14% of the cases was no correlation found. Dog bite injuries most frequently happened during playing with the dog (53%) or when the victim bowed to the dog (33%). Dog bites without cause were uncommonly found (7%). Of all facial injuries the nose was most frequently involved (50%) and severely afflicted. In our experience, replantation of the avulsed part always resulted in necrosis. In contrast, the most favorable results were achieved when defects were reconstructed immediately.

Adolescent↗
PubMed1994

Osteoplastic endonasal approach to the maxillary sinus.

A new surgical approach for removal of isolated maxillary sinus pathology, mainly of symptomatic maxillary sinus cysts, is presented. It is based on the principles of osteoplastic sinus surgery and uses the transnasal approach. It allows a safe removal under direct vision or endoscopic control with standard surgical instrumentation. The normal maxillary ostium and healthy ethmoidal cells are not sacrificed and thus the lymphatic pathways as well as the mucociliary transport are not endangered.

Cysts↗
PubMed1993

[Preventive antibiotic administration in rhinoplasty. Tissue level and pharmacokinetics with reference to rhinoplasty techniques].

Prophylactic antibiotics (cefuroxime 1500 mg) were administered during induction of anesthesia to 34 patients undergoing nasal surgery. The infusion ended at the time of mucosa incision (mean infusion time: 22 min). A hemitransfixion incision was followed by elevation of the mucoperichondrium on both sides of the septum. The blood supply of the cartilage was thus diminished essentially. In the septal cartilage, the concentration of cefuroxime 68 min after the administrations of antibiotic was 28.1 micrograms/g; this concentration was 19.8 micrograms/g in the septal bone at 74 min. The mean peak plasma concentration was 158 micrograms/ml and the end half-life elimination time 77 min. High antibiotic concentrations in the cartilage resulted from passive diffusion through the septal mucosa and occurred at a mean time of 22 min. The time between the start of infusion at the induction of anesthesia and interruption of the septal blood supply by separating of the septum from overlying soft tissues was sufficient for developing high antibiotic concentrations. During nasal surgery the routine approach to the septum had no influence on the efficacy of antimicrobial prophylaxis.

Adult↗
PubMed1993

Comparison of carbon dioxide laser and electrosurgery in the treatment of rhinophyma.

Cosmetic results of rhinophymas treated with carbon dioxide laser or electrosurgery were compared in six patients 2-5 years after surgery. Although the results were comparably good the use of the carbon dioxide laser proved to be more time-consuming and less convenient. Scar formation was observed in both patient groups equally and was related to the depth of tissue removal, independent of the instrument used.

Aged↗
PubMed1991

[Endonasal, endoscopically controlled repair of dura defects of the anterior skull base].

18 patients presenting a circumscribed cerebrospinal fluid (CSF-) leak in the region of the ethmoidal roof, the olfactory cleft or the sphenoidal sinus, were operated on via the endonasal route. Dural laceration could be attributed to paranasal sinus surgery (iatrogenic CSF-leak, N = 11) and to other traumas (N = 6). In one case, no obvious cause was detectable (spontaneous CSF-leak). Using the 70-degree angular optical device, the dural lacerations were closed by autogenous grafts of conchal mucosa with the help of fibrin glue. The average time of postoperative observation was 17 months. No liquorrhoea, meningitis or cerebral abscess was observed postoperatively.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1990

[Blindness caused by central artery occlusion following nasal septum correction].

Visual loss following intranasal injections is extremely rare. A case report of blindness in the only seeing eye after infiltration of the septal mucosa with local anaesthetics and vasopressin is presented. The pathological mechanism and the relationship between different surgical procedures and visual loss are analysed and discussed. Some rules are given to prevent this complication.

Adult↗
PubMed1988

Measuring the size of nasal septal perforations. A simple radiological method.

A simple method of preoperative documentation of nasal septal defects is described. The borders of the defect and the surrounding regions of the nasal septum are marked with an X-ray contrast medium and a lateral radiogram is performed. The perforation is outlined and the image allows evaluation of the size, shape and location of the septal defect. Some clinical examples are presented.

Barium Sulfate↗
PubMed1986

[Management of septal perforations by rotationplasty of the septal mucosa].

A unilateral mucosal flap from the septum with a wide pedicle and an axial blood supply was used for closure of septal perforations. In special cases this procedure was combined with a labial-buccal flap. 18 patients with perforations of different sizes were treated resulting in a permanent and complete closure in 12 cases. Relief of complaints was also noticed in the six patients with residual perforations. We therefore conclude that diminution and shifting of the perforation may be sufficient to relieve symptoms. The technique proved to be a safe and physiological procedure for the patients with septal perforations.

Humans↗
PubMed1986

[Current status of detection and treatment of malignant nasal and paranasal sinus tumors. 1. Pathology, diagnosis and staging of nasal and paranasal sinus tumors].

Malignant tumours of the nasal cavity and paranasal sinuses are uncommon amounting to 0.3-1% of all tumours and 3%-5% of carcinomas of the upper respiratory tract. Modern diagnostic techniques include endoscopy and computer tomography. Prognosis and therapy depend on the histological type, site of origin and extent of the tumour. The variety of possible treatment modalities demands individual therapy planning. A combined surgical and radiotherapeutic approach, possibly supplemented by small volume intracavitary brachytherapy or polychemotherapy in some defined histological tumour types, has been generally accepted, enabling a five year survival rate of 35%-45% to be achieved. The causes for failure are firstly local persistence of tumour (18%) or a local recurrence (37%). The cumulative recurrence rate after one and two years was 76% and 95% respectively. Late recurrences occur in 2.5% of cases. The complication rate with combined-modality therapy reaches 27% with minor complications occurring in 12% and major complications in 15% especially affecting the irradiated homolateral eye. The present statistical results show a number of weak points that cast doubt on their validity. We recommend a controlled, prospective, randomised, multi-centre and multi-disciplinary study to define the prognostic parameters for tumours of the paranasal sinuses and to choose the most effective, individually tailored therapy.

Adenocarcinoma↗
PubMed1986

Studies of paranasal sinus ventilation by xenon-enhanced dynamic CT.

A new method to determine ventilation of the paranasal sinuses is presented. After insufflation of pure stable xenon into the sinus system via the nasal cavity the gas wash-out is detected by means of quantitative dynamic computerized tomography. The measured time density curves allow to derive gas exchange parameters for all paranasal sinuses. We report mean gas exchange times for the maxillary, sphenoidal and frontal sinuses as well as the posterior ethmoidal cells obtained from 17 patient studies. Some clinical examples are discussed in detail. Compared to existing procedures, xenon-enhanced dynamic CT is the only non-invasive quantitative method to determine ventilation of all paranasal sinuses.

Humans↗