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Biomedical subjects

H Hildmann

Publications and source records attributed to H Hildmann.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Ear ossicle transplants for reconstruction of sound transmission in the middle ear. A histologic long-term study].

In this study 130 ossicular middle ear transplants were studied. 33 remained in the middle ear for 10 years or longer, one for 21 years. The majority of the grafts show 5% to 40% bone new formation. Absence of vital bone or subtotal host bone replacement is exceptional. The amount of bone new formation appears independent the implantation time. 75% of the grafts show no bone resorption. In 15% sound transmitting might be impaired due to resorption. Grafts with a high degree of bone new formation show less resorption. 21% of the ossicles have signs of inflammation. Inflammation boosts bone turnover with resorption on one hand and new for resorption. Cholesteatoma is the main cause of resorption and inflammation. The critical phase for resorption of the graft are the first two to three years after transplantation. No considerable difference was found between autografts and allografts (homografts). Histological and metabolical properties of the ossicles seem to be responsible for the stability of the graft. Ossicular grafts have a good longterm stability which makes them very suitable for reconstruction of the ossicular chain.

Bone Resorption↗
PubMed1992

[Abnormal postoperative findings in the external ear canal and tympanic membrane and their treatment].

We describe uncommon complications after tympanoplasty affecting the outer auditory canal and the tympanic membrane such as stenosis of the auditory canal, fistulas, lateralization of the tympanic membrane, anulus cholesteatoma and cholesteatoma of the auditory canal. Typical findings are discussed and explained with the aid of illustrations. Treatment and indications for revision are discussed.

Cholesteatoma↗
PubMed1992

[Indications and surgical treatment of large middle ear abnormality].

Children with atresia of the external auditory canal should undergo hearing assessment and fitting of a bone conduction hearing aid as early as possible to allow speech to develop normally. Surgery is done between 5 and 6 years of age, guided by high-resolution computed tomography, which provides a more precise diagnosis based on the abnormalities seen. The temporomandibular joint lies more posteriorly than normal due to aplasia or hypoplasia of the tympanic bone, so that the middle ear must be approached through the mastoid, resulting in a less favourable coupling to the middle ear structures. In unfavourable cases bone anchored hearing aids, creation of a meatus for fitting a hearing aid or a bone conduction hearing aid must be considered.

Adolescent↗
PubMed1991

[Sinusitis in the child from the ENT specialty point of view].

In the child, acute sinusitis generally accompanies infections of the upper airways, so that, as a rule, treatment of the infection also deals with the sinusitis at the same time. Against this background, clinical diagnosis is adequate, and further diagnostic measures--in particular x-ray examinations, are superfluous. Only if the child feels really ill, or if inflammation spreads to the orbits is a diagnostic x-ray required. Bacterial superinfection, in particular with orbital involvement, necessitates massive antibiotic treatment and, where appropriate, the exclusion of an abscess and/or intracranial complications. In clinically healthy children, radiopacities can often be seen on the x-ray of the paranasal sinuses, in which case, we are dealing with an occult sinusitis. In general, this clears up spontaneously, and only rarely needs treating. Polypous sinusitis in childhood is rare and requires surgical therapy.

Child↗
PubMed1991

[Improvement of hearing function through ear reoperation. The role of tympanic revision for functional indications].

Recurrent middle ear disease may carry a high probability of complications, and there is no doubt of the necessity of revision surgery for either cholesteatoma or tumor. However, failures in function should be individually analyzed before a second procedure is decided upon. A pre-requisite for surgical improvement of hearing is adequate tubal and inner ear function. Chronic suppurative otitis media has a higher tendency for reperforation than cholesteatoma. Adhesive otitis indicates poor tubal function. Tympanosclerosis may cause refixation requiring stapedectomy at a second stage. Middle ear fibrosis recurs in about 50% of cases. Post-operative failures such as extrusion of ossicles, lateralization of the tympanic membrane, and blunting of the anterior tympanomeatal angle as well as failures after stapes surgery are discussed.

Aged↗
PubMed1990

[Removal of foreign bodies from the trachea. Indications for tracheobronchoscopy with a rigid instrument].

Intrathoracic disease is nowadays better investigated by fibreoptic endoscopy than by the use of rigid endoscopes. Nevertheless the use of rigid systems is still indicated for the removal of foreign bodies, especially in children. In this paper diagnostic procedures and techniques are reviewed. Seventy per cent of all inhaled or ingested foreign bodies present in children, 55% of them under 4 years of age. The foreign bodies should be extracted with the patient under general anaesthesia. Since many physicians now perform endoscopy, the foreign body cases should be concentrated in one institution in each region to ensure that one group has sufficient experience with rigid systems.

Adult↗
PubMed1989

[Surgery of chronic suppurative otitis media in childhood].

In this review the indications for surgery are discussed, based on the literature and own publications. In 185 ears of children up to 14 years, 9.1% recurrent perforations were found. Otitis of the ossicles is rarer than in adults and in cholesteatoma in children. Tubal function seems to influence the results. These factors are discussed. Surgery is indicated to improve and to prevent ossicular destruction; furthermore, the children are able to participate in swimming and sports without ear protection. Delay of tympanoplasty is recommended if bad cooperation makes pre- and postoperative treatment difficult, and in cases where a secretory otitis media on the contralateral ear indicates poor tubal function. A persisting perforation after extrusion of a grommet should not be closed immediately.

Adolescent↗
PubMed1988

[Sonography of the neck--indications and value].

The anatomical structures of the neck as shown by ultrasound are described. The B-scan technique is of primary importance for evaluation of the thyroid gland and the major salivary glands too. B-scan ultrasound is the premier method of diagnosis of thyroid gland disease. Therefore the otolaryngologist interested in this region needs profound knowledge of the ultrasound findings of thyroid disease including lymphomas, other types of tumor and vascular lesions. At the moment ultrasound is the "missing link" between palpation of the neck and endoscopy because of its ability to display the underlying structures.

Diagnosis, Differential↗
PubMed1987

An immunological study of otitis media with effusion. Antibodies directed against coagulase-negative staphylococci in the effusion fluid.

From 14 chronic middle ear effusions (MEEs), 17 strains of coagulase-negative staphylococci (CS) were isolated. We then used an ELISA method to determine the antibody titers against these microorganisms in the corresponding effusion fluids and the blood sera of the patients and compared them to the antibody titers against a group of standard CS. In most cases, no specific immune response could be detected against the infecting CS in either the effusion fluids or in the sera. Our results can be explained by the inability of most CS strains to provoke a specific immune response in chronically inflamed middle ears due to their inhibition by non-specific antibodies, which reach the middle ear cavity by plasma leakage. The non-specific antibody titer against Staphylococcus hominis, however, seems to be much lower than against the other CS species. We found a high specific antibody titer against the infecting CS in the effusion fluid of a single case, but not in the serum. This finding supports the hypothesis that the middle ear mucosa has the ability to produce autonomous, local antibodies which are independent of a systemic immune response.

Adolescent↗
PubMed1987

A bacteriological study of otitis media with effusion. Concurrent coagulase-negative staphylococcal infections in the middle ear.

We investigated the bacteriology of 50 chronic middle ear effusions from 30 children (mean age, 5 years 4 months) and compared this with the microorganisms present in the external ear canals and adenoids of each patient to distinguish pure middle ear bacteria from probable contaminations. Coagulase-negative staphylococci (CS), formerly considered to be non-pathogens, were the most frequently isolated bacteria in the middle ear effusions and were followed in incidence by alpha-hemolytic streptococci and group D streptococci. CS were found in 24% of all effusions and in 44% of the infected effusions. Most of the CS strains belonged to the species of Staphylococcus epidermidis. Although the majority of CS isolated from the middle ear effusions studied proved not to be contaminants, the populations of CS in the middle ear and external ear canal showed similar biochemical reaction patterns, antimicrobial susceptibilities, and in vitro production of mucus. No correlation was found between the bacteria present in adenoidal tissue and middle ear effusions.

Adolescent↗
PubMed1987

[Lymphoscintigraphic studies of regional lymph vessels in patients with head and neck tumors].

Lymphatic drainage was followed with Tc lymphoscintigraphy. Micrometastases in head and neck cancer cases cannot be detected. The drainage pattern is highly variable and does not allow prognostic conclusions in tumors as demonstrated for the parasternal pathways. The method helps to determine the side and extent of a neck dissection prior to surgery as well as follow-up postoperatively. The development of lymphedema can be detected early in order to start treatment by manual lymph drainage.

Head and Neck Neoplasms↗
PubMed1986

An autoradiographic study of bone grafts in small animals.

Bone remodelling was studied in allografts and isografts by means of autoradiography. Collagen and proteoglycans of the organic bone matrix were labelled with H-3 amino acids and S-35 sodium sulphate. The principles of primary bone formation are followed in graft remodelling as well. Matrix breakdown and reformation are carried out by mononuclear cells. Components of the original matrix can be seen in osteoclasts, perivascular cells, osteoblasts, young osteocytes, and in new bone. The label allows tracing of these components and proves their reuse.

Amino Acids↗
PubMed1985

Tympanoplasty in children and anatomical variations of the epipharynx.

Short-term results or post-operative check-ups after tympanoplasties in children and adults are compared. There is no higher incidence of recurrent perforations in children. The distribution of air cells in adults and children does not vary, indicating that anatomic variations, rather than disease, are responsible for the sclerosis in the mastoid. Anatomic variations of the epipharynx might influence ventilation. Correlations between the width of the epipharynx and the distance between molars and premolars are shown, as is an inverse relation between the height of the palate and the height of the septum. These observations might be important for a prognosis in patients with ear disease.

Adolescent↗
PubMed1985

[Indications for surgical intervention in occult paranasal sinusitis in the child].

Sinus surgery, including antroscopy, is rarely indicated in children because radiological changes and their histological correlates often disappear spontaneously. In this paper we report the follow up of 17 children who underwent sinuscopy for an occult sinusitis with radiologic opacity of the maxillary sinuses. Even though considerable inflammatory reactions were seen normal x-rays were found in 68% one year after endoscopy.

Child↗
PubMed1985

[Submucous turbinate resection].

This article describes the authors' experiences on submucous resection of the turbinate bone in chronic hypertrophic lower turbinates. Similar to the procedure in septoplasties, this surgery preserves the mucosa and its physiological properties. The technique is facilitated by an amazingly low tendency to bleeding. 70 patients were followed up post-operatively. More than 70% reported a marked improvement of nasal breathing. No serious complications were seen.

Adolescent↗
PubMed1984

[Intratympanic course of the internal carotid artery as an accidental finding of ear surgery and as a roentgen diagnostic problem].

The rare anomaly of an intratympanic course of the internal carotid artery is, like the equally rare aneurysm of this artery, a differential diagnosis of tumours of the middle ear. A biopsy would lead to obvious complications. Petrous bone tomography, even using the most modern spiral type of movement, is of limited value because of the difficulty in interpretation and plays little part in the diagnosis as compared with arteriography.

Adult↗