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Biomedical subjects

G Rettinger

Publications and source records attributed to G Rettinger.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Removal of acoustic neuromas of the cerebellopontile angle with transtemporal approach by the middle cranial fossa].

The enlarged transtemporal middle fossa approach to the cerebello-pontine angle is adequate for complete removal of acoustic neuromas up to 4.0 cm in diameter (sizes B and C according to Fisch). A description of the surgical technique and the results of 63 operations are presented (13, 23 and 27 tumours of sizes A, B and C respectively). 51 tumours were completely removed, 6 had a voluntary palliative incomplete resection for medical reasons or on the only remaining hearing ear. Only 6 patients (one in the last 40 consecutive cases) had an incomplete resection due to the limited exposure of the tumour. In 44 ears the cochlear nerve could be preserved, 28 of which showed postoperative hearing function (8 size A, 10 size B, 10 size C). There was no operative mortality, no severe hemorrhage nor any permanent neurological complication. The facial nerve function was well preserved in 48 of 56 patients followed up.

Adolescent↗
PubMed1985

[Angiomatous malformation of the inner auditory canal with the leading symptoms of vertigo and tinnitus].

A case of a rare arteriovenous malformation in the internal auditory canal is reported. It caused unilateral tinnitus, facial weakness, trigeminal hypesthesia, and vertigo with lateropulsion. The audiological and otoneurological findings together with air-cisternography a CT scan had indicated an intrameatal tumor. An extended trans-temporal exposure of the internal auditory canal demonstrated an angiomatous lesion compressing the adjacent seventh and eighth cranial nerves. It could be removed safely by a second-stage lateral suboccipital approach to the cerebello-pontine angle.

Diagnosis, Differential↗
PubMed1984

[Therapy of benign diseases of the parotid gland by instillation of a resorbable protein solution into the duct system].

Non-neoplastic disorders of the parotid gland like chronic recurrent parotitis, asymptomatic gland enlargement or salivary fistulae present a therapeutic problem. Surgical removal of the gland is often difficult as scar tissue may be present in these benign diseases. Therefore alternative methods are suggested to eliminate parenchyma by inducing atrophy. This goal can also be attained by intraluminal duct occlusion. The principle consists of instillation of a resorbable protein solution into the duct system, a procedure similar to sialography injection. In animal experiments marked atrophy of parenchyma and complete reabsorption of the instilled substance within four weeks could be demonstrated histologically. The clinical experiences in 33 cases of major salivary gland diseases and three year follow up data are reported. The main advantages of the new method described are a simple technique, rapid onset of atrophy and preservation of facial nerve function.

Animals↗
PubMed1984

Computerized tomography examination for the detection of positional changes in the temporomandibular joint after ramus osteotomies with screw fixation.

Changes in the position of the temporomandibular joint following sagittal splitting osteotomy of the mandibular ramus with screw fixation were examined using computerized tomography. Ten patients were involved in the study. Rotational movement of the condyle-bearing fragment was most commonly seen in the transverse computer tomograms. However, the use of screw fixation seems to cause no major malpositioning of the condyle-bearing fragment.

Bone Screws↗
PubMed1984

[Computerized tomographic demonstration of the nerves and blood vessels of the cerebellopontile angle. Results of pneumocisternomeatography in comparison with intraoperative findings].

Disorders of the 8th cranial nerve such as sensori-neural hearing loss, tinnitus or vertigo may be of vascular origin. Pulsation of arteries can cause compression of, or traction on the nerve, and surgical "decompression" using a modified transtemporal approach may be helpful for these cases. The investigations are based on modern computerized tomography techniques combined with air-cisterno-meatography. The nerves can be demonstrated routinely, while the imaging of vessels is not always possible. This different appearance of arteries may be caused by their pulsatile motion, as shown by phantom studies. The effect of this motion is discussed on the basis of a comparison between preoperative CT-findings and the topography of the vessels verified at operation.

Angiography↗
PubMed1984

[Sclerosing of the parotid gland using a protein solution for instillation in the excretory ducts. Long-term results of animal experiments].

The histological changes of the parotid gland after instillation of a resorbable protein solution into the excretory ducts were investigated by animal experiments. The glands of eleven rabbits were examined twelve months or more after occlusion of the duct system. Atrophy of parenchyma, fibrosis of interstitial tissue and recanalisation of the ducts was found. The epithelial lining of the excretory ducts showed metaplasia, and sometimes even dysplasia. This histological feature is also seen in "necrotizing sialometaplasia" but has no tendency to undergo malignant transformation. The aim of the method described is elimination of secretory parenchyma. It depends on three mechanisms: suppression of secretion, chemical influence of the solution on tissue, and diminution of acinar blood supply. Complications such as abscesses or fistula occurred after paraductal instillation of the solution, or when the recanalization of the ducts was disturbed. Compared to ligation of Stensen's duct this method has some advantages in the treatment of chronic recurrent parotitis, sialadenosis, salivary fistulae or sialorrhea.

Animals↗
PubMed1983

[Microsurgical neurolysis of the 8th cranial nerve in cochleo-vestibular disorders using an extended transtemporal approach].

A series of 17 patients suffering from progressive cochleovestibular disturbances (8), severe attacks of Menière's disease (5), progressive or sudden sensori-neural deafness (2), vestibular neuronitis (1) or unbearable tinnitus (1) is reported. The eighth cranial nerve was exposed from its root at the brainstem to its exit into the fundus of the internal auditory canal (CAI), by an extended middle fossa approach. The surgical technique and the intraoperative observations are described. All cases showed morphological abnormalities such as neuro-vascular compression of the nerve by arterial or venous vessels, either at the brainstem or laterally at the CAI. Horizontal or vertical dislocations of the nerve were also noticed. Traction, compression or even strangulation of the nerve fibres or of their accompanying vessels may be co-factors of the functional disturbances. Striking improvement of the vestibular disorders was recorded following neurolysis of the eighth nerve, showing that retrolabyrinthine abnormalities may be possible causes of Menière's disease and other supposedly labyrinthine disorders. The preliminary results regarding hearing and tinnitus were hitherto unsatisfactory. This fact may be explained by the, as yet, imperfect technique of neurolysis.

Humans↗
PubMed1983

[Relevance of computed tomography to the fine-structure analysis of bone. A comparative radiological study].

Computed tomography, a relatively young X-ray imaging modality, has so far been mainly employed for the differentiation and densitometry of soft tissues. By modification of the image reconstruction algorithm spatial resolution was improved significantly such that imaging of fine structures and of high contrast boundaries became possible. The image characteristics of the high-resolution computed tomograms were investigated on petrous bones and lumbar vertebral bodies. In the petrous bone, an exact anatomic reconstruction of the bony structures of the inner ear is achieved. In vertebral bodies, imaging of spongiosa structures with 2 mm slice thickness and thereby an early diagnosis of osteoporosis are possible.

Bone and Bones↗
PubMed1981

[Early diagnosis of acoustic neurinomas with computed tomography and air meatography. A comparison to meatography with lipid contrast medium (author's transl)].

Large acoustic neurinomas invading the cerebellopontine angle can be visualized in the computerized tomogram when intravenous contrast medium is used. Additionally, the filing of both the cerebellopontine angle and internal auditory canal with air has been recommended for the detection of small neurinomas which are limited to the canal. A comparative study was conducted on 54 patients using both air-meatography and cisterno-meatography with a positive lipid contrast medium (Duroliopaque). Eight tumors could be recognized by the method. Although both methods have approximately the same diagnostic value, we prefer the use of computed tomography with air-meatography because of its particular advantages as described.

Cerebellopontine Angle↗
PubMed1981

Rotation of the alar cartilage in collapsed ala.

There are various causes for collapsed ala nasi. In elder people especially, the lateral crus of the alar cartilage is frequently deformed in shape and position. Model experiments show that by rotation of the lateral crus outwards and upwards, the vestibulum is expanded and the tip of the nose raised. On the basis of these experiments, in 19 patients with collapsed ala nasi, the lateral crus of the alar cartilage was rotated dorsally. The longterm results showed a satisfactory functional and aesthetic outcome.

Cartilage↗
PubMed1981

[Early diagnosis of acoustic neuroma by the vestibular tests. Indication for computerized tomography and cisternomeatography (author's transl)].

In a series of 390 cases with suspicion of acoustic neurinomas 78 such tumors could be diagnosed, including 12 early stage neurinomas. This relatively high detection quote of small neurinomas is due to a special diagnostical programme: Every patient with unilateral and sensorineural hearing loss, independent of vertigo anamnesis or of the result of x-rays must be further examined by a vestibular tests. All 78 patients with acoustic neuroma had pathological vestibular findings. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the thermic test: 95% of the patients with a neuroma showed pathological findings in the positional test. Every patient suffering from an unidentified unilateral and sensorineural hearing loss combined with a pathological result in the positional tests must be further checked by a cisternomeatography or computerized tomography using airinsufflation. Every fifth of these patients showed typical signs of an acoustic neuroma in the neuroradiological tests. 68 neuromas are operated today and verified histologically, 10 patients are still waiting for surgical treatment.

Adolescent↗
PubMed1981

[Computerized tomography in ORL-diseases. II. High resolution-CT of the paranasal sinuses].

Computerized tomography of the paranasal sinuses so far was restricted to imaging soft tissue structures. By means of new high resolution algorithms spatial resolution has been improved significantly without any increase in patient dose. Thereby a clear delineation of fine structures and of the transitions from bone to mucosa and air has been achieved. The scope of applications is thus extended to the diagnosis of purely osseous processes like fractures and osteoplastic changes for example. Computerized tomography, therefore, is the method of choice for most diseases of the paranasal sinuses.

Fractures, Bone↗
PubMed1981

[Elimination of major salivary glands by temporary medicamentous occlusion of the excretory ducts (author's transl)].

The treatment of chronic recurrent inflammation of major salivary glands means reduction or elimination of parenchyma. Several operative and non-operative procedures have been described for this purpose. A new method is the instillation of an amino-acid solution which is hardening in the excretory ducts. Histological findings in experiments on animals show an atrophy of parenchyma while the filling mass is completely removed. Some patients were treated successfully by this method up to now.

Amino Acids↗
PubMed1980

[Computerized axial tomography in ORL diseases. Indications and advantages (author's transl)].

Computerized axial tomography enables the accurate diagnosis of acoustic neuromas by non-invasive means, and it should therefore be used after conventional radiological methods. Small neuromas often only show non-specific signs and in these patients contrast cysternography is still necessary. Up to the present glomus jugulare tumours were diagnostically confirmed by angiography. Now the CT scan is recommended not only for diagnosis, but also for after-treatment follow-up and recognition of recurrent tumour growth. Tumours that infiltrate the skull base should be assessed by this method since the extent of the lesion can be exactly measured.

Carcinoma, Squamous Cell↗