Biomedical subjects
Publications and source records attributed to H Hildmann.
A method of filling cavities after radical mastoid operations is reported. Autologous bone chips are used in cases when insufficient tubal function does not permit the reconstruction of the posterior meatal wall. Indications and contraindications of this technique are discussed.
The middle ear mucosa of rabbits was studied experimentally. After tympanoplasty inflammatory changes were observed together with an epithelial metaplasia, and the appearance of ciliated and goblet cells was noted. These changes disappeared very slowly over the course of a year when almost normal epithelium was found. Epithelial metaplasia in cholesteatoma was similar to that found following surgery.
Based on an experience over two years with 316 cases the principles of general anaesthesia with controlled hypotension in ENT surgery are described and discussed. Indications, contraindications and methods of application are outlined. The method reduces bleeding considerabley and proved to be useful for rhinoplasties, major sinus surgery as well as parotid gland and necksurgery.
Protein and mucopolysaccharide metabolism was studied in the auditory ossicles of rabbits after administration of tritiated amino acids to three and of S35 to two animals. No differences between S35 and aminoacid turnover was seen, indicating a parallelmetabolism of proteins and mucopolysaccharides of the intercellular substance. The tissue, cartilage and bone, shows a metabolism on the molecular level. Areas of cartilage ground substance adjacent to the incudomalleolar joint and the interglobular spaces are not labelled by the radioactive substances. They are excluded from metabolical turnover, while the adjacent cells remain vital. This observation indicates a change of cellular properties, from cartilage to bone cell. The subperiostal bone has lower metabolism than the underlying skeinlike bone. Few osteones were found.
After operation three consecutive phases can be observed: 1. thickening of epithelial cell layer with development of edema in the submucosa, 2. metaplasia of epithelium with formation of ciliated and goblet cells, concomitantly round cells are found in the submucous tissue, 3. regression of inflammation and epithelial metaplasia. After 6 months goblet and ciliated cells disappear and eventually a slightly irregular monolayer epithelium is seen. If cholesteatoma is present the second phase persists. Remarkably epithelial and subepithelial changes are not concentrated in the vicinity of cholesteatoma but are seen in the whole middle ear. By autoradiography it was demonstrated, that the subepithelial tissue of cholesteatoma has a normal metabolic rate. It can be concluded that high metabolic activity postulated by other authors cannot be responsible for inflammation.
By means of autoradiography metabolic exchange on the molecular level is demonstrated. Mucopolysaccharides and proteins of the intercellular substance are incorporated in the same manner. The interglobular spaces however are excluded from metabolic turnover and do not show radioactivity. The adjacent cells resembling cartilage cells incorporate like osteocytes. Comparing the way of incorporation to cartilage cells of other areas of the otic capsule we find support of Manasse's theory that the cells of the globuli ossei of the adult orginate from cartilage cells.
Preserved homograft bone chips were implanted into the middle ears of 12 rabbits with close contact of the graft with the bony wall of the bulla. Bone new formation was observed in all grafts, but remodelling was incomplete after a year. The bone chips were connected to the graft bed by new host bone. The homograft was identified by radioactive labelling. For bone new formation the intercellular substance of the transplant was removed by thost tissue and was partly reused in bone new formation.
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