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Biomedical subjects

H Rudert

Publications and source records attributed to H Rudert.

At least 91 records · Page 5Linked to original sources
PubMed1986

[Results of the treatment of 197 squamous cell carcinomas of the oropharynx (1964-1982 treatment period)].

197 consecutive patients with squamous cell carcinomas of the oropharynx were treated between 1964 and 1982. The 5 year actuarial survival was 43% (+/- 5%). In patients with stage I and II disease the actuarial survival with combined surgery and radiotherapy was 87% (+/- 16%), but with primary radiotherapy 40% (+/- 28% (p = 0.0250). The results in stage III and IV disease were 59% (+/- 11%) with combined therapy and 29% (+/- 15%) for radiotherapy alone (p = 0.0010). The five year actuarial survival for lymphoepithelial carcinomas (Schmincke) was 71% (+/- 16%) after radiotherapy whilst the patients with undifferentiated carcinomas achieved only 29% (+/- 11%). The survival rate for women (71% +/- 12%) was significantly better than for men (31% +/- 7%), although the proportion of stages was not different in both sexes. Because of these results and because of the minimal chances of controlling recurrent disease we prefer combined treatment not only in stage III and IV disease, but also in stage I and II disease. In these early stages partial mandibulectomy can be avoided. In selected cases transoral surgery can be combined with functional, discontinuous neck dissection. The functional results of surgery are thus minimised in the early stages of oropharyngeal carcinoma.

Adult↗
PubMed1986

[Malignant melanoma in the area of the head and neck].

The incidence of malignant melanoma is rising worldwide. Recognition of the biological types of malignant melanoma (nodular melanoma, superficial spreading melanoma, lentigo maligna melanoma, and acrolentiginous melanoma) have greatly helped to improve the prognosis in recent years. Determination of the depth of invasion in histological serial sections has proved to be of great prognostic value. Melanomas with minimal invasion have an excellent prognosis. Wide excision of the primary tumour is of utmost importance. The excisional margins should be 3-5 cm, but in superficial melanomas the width of excision may be less. Prophylactic neck dissection is unnecessary for superficial melanomas, it is necessary for lesions between 1 and 3.9 mm in thickness, whereas in tumours with a depth of invasion greater than 4 mm the outcome of the disease is not improved by prophylactic neck dissection. In metastasizing malignant melanoma the tumour mass should be reduced by surgical intervention. Survival is sometimes prolonged by several months or even longer when lymph nodes and metastases are excised. A radical neck dissection is indicated therefore when lymph nodes are clinically involved.

Combined Modality Therapy↗
PubMed1984

[From Killian's submucous septum resection and Cottle's septoplasty to modern plastic septum correction and functional septo-rhinoplasty].

Killian's submucous resection of the septum and Cottle's septoplasty are still described in textbooks and journals as alternative methods of treatment for septal deformities. It is the aim of this paper to show that Killian's submucous septal resection and Cottle's "maxilla-premaxilla" approach are only mile stones on the road to the modern plastic surgery of the septum. It is recommended that the names of Killian and Cottle should be dropped, and it would be better to use the terms septoplasty or plastic surgery of the septum, if deformities of the septum should be treated. These techniques also changed the methods of rhinoplasty and lead to functional septorhinoplasty.

History, 20th Century↗
PubMed1984

[Papilloma inversum of the nose and paranasal sinuses. Clinical aspects and histology of 22 personal cases].

Report on 22 cases of inverted papilloma. The common site of origin of the tumours is the lateral nasal wall and with a few exceptions they are benign. They become dangerous if they invade the bony structures of the face skeleton, especially the hard palate and the orbit. The therapy of choice is lateral rhinotomy with an "en bloc" resection of the lateral wall of the nose and the ethmoid of the invaded side. In that case the prognosis is good. The classifications by Schneider and Skolnik only define the size of the tumour but do not give an indication of prognosis; they are, therefore, unnecessary.

Adult↗
PubMed1984

[Flexible fiber endoscopy in ENT].

The range of visual examination and therapeutic procedures in the field of ear, nose and throat surgery has been expanded by the combination of the flexible fiberscope with the rigid telescope. The following are the advantages of the flexible fiberscope: 1. Increased accessibility, 2. less patient discomfort, 3. easier insertion technique, 4. low incidence of the accidental injuries, 5. simplified documentation by photography. In addition, these procedures can be performed on a routine and outpatient basis.

Adolescent↗
PubMed1984

[Uncommon injuries of the larynx following intubation. Recurrent paralysis, torsion and luxation of the cricoarytenoid joints].

19 laryngeal injuries are reported. 16 were secondary to orotracheal intubation and 3 were sequelae of gastroscopy, laryngoscopy and a nasogastric tube. In 6 patients, the trauma followed prolonged nasotracheal intubation, 10 cases followed a single endotracheal intubation. The main symptom was hoarseness. In 6 cases dislocation of an arytenoid cartilage was diagnosed, in 1 case a vocal cord paresis and in the other cases contusion or distortion of the arytenoid joint. In the cases of subluxation the arytenoid cartilage was dislocated posterolaterally, with the cord in the abducted position. For treatment we recommend closed reduction and injection of Cortison-Crystal-suspension into the joint. The outcome is good after single endotracheal intubation, but bad in prolonged nasotracheal intubation because of ankylosis of the cricoarytenoid joint.

Adult↗
PubMed1984

[Reversible inner ear hearing loss in middle ear tuberculosis].

Middle ear tuberculosis in a female teacher aged 29 is reported. White necrotic areas were found on the skin of the remaining tympanic membrane and the auditory meatus, that stood out clearly against the healthy skin of the auditory meatus. The patient also had inner ear deafness. The function of the inner ear returned to normal after antituberculous therapy: a comparable course of this disease could not be found in the literature.

Antitubercular Agents↗
PubMed1983

[2d interim evaluation of a chemotherapy study on patients with squamous cell carcinomas of the head-neck area. A comparison of 2 therapy regimens: cis-diamminedichloroplatinum (II) and bleomycin versus methotrexate and vindesine].

52 patients with epidermoid cancer of the head and neck region were either treated with cis-DDP and bleomycin (arm A) or with methotrexate and vindesine (arm B). In case of resistance patients were further treated with the alternative regimen (A leads to B or B leads to A). Treatment results are superior in arm A. Complete and partial remission were in A: 54%, in B: 31%, after crossover 46% and 0%, respectively. Status of pretreatment (operation and/or radiotherapy) is of minor importance for arm A than for the "soft" treatment of arm B. Preliminary analysis of survival and remission duration shows no significant difference in regard to A or B and status of pretreatment. However, those patients resistant to B and further treated with A have an increase of median survival from 3 to 9 months (p = 0.02). With primary chemotherapy inoperable tumors can be made operable with curative intention.

Adult↗
PubMed1983

[Experiences with the CO2 laser with special reference to the therapy of vocal cord carcinoma].

From July 1979 until December 1982 91 patients have been treated with 143 applications of a Coherent CO2-laser at the ENT Department of Kiel University. At the beginning the laser was applied to the majority of microsurgical indications in the larynx and pharynx. But at the end only some selected indications proved true: the treatment of papillomas, the ablation of the tonsil of the base of the tongue, the ablation of the lateral bands and of laryngeal webs. In the treatment of cancer debulking of large obstructive tumours of the larynx by laser vaporization can be used palliatively or prior to laryngectomy, obviating the need for tracheotomy. Own experiences in the treatment of 23 carcinomas of the vocal cord, considering also the literature, proved that the CO2-laser may be an alternative treatment of early glottic cancers of the middle third of the vocal cords. In the other malignant lesions of the vocal cords the laser may be an additive treatment after failure of radiotherapy and if surgical treatment is not possible.

Adult↗
PubMed1983

[Monosymptomatic onset of Menière's disease].

The occurrence of monosymptomatic courses of Menière's disease is not generally accepted, although cochlear forms are described in literature. Retrospectively, we evaluated the case histories of 108 patients with Menière disease, who developed the typical trias in the further course of the disease. Among these 108 patients, we found 39 with a true monosymptomatic course, i.e., in each case we could exclude the participation of either the cochlea, or the labyrinth by exact clinical investigations. Two-thirds of the patients first noticed the impairment of hearing, one-third the vertigo. Basing on a time interval of more than one year, there were still 18 patients with a monosymptomatic course. The average duration of the monosymptomatic courses is distinctly shorter than the duration of the typical trias and, consequently, we defined them as equivalents to early forms of the disease. At this early stage a diagnosis is possible by the fluctuating cochlear signs with their typical audiogram configurations, and the attack character of the vestibular symptoms.

Adult↗
PubMed1982

[Light and electron microscopy investigations in Reinke's ("polypoid chorditis")].

In nine cases of Reinkes edema ("polypoid chorditis") the resected mucosa is investigated by light and electron microscopy. The characteristic morphological changes of the disease are observed in the fibrous tissue of the vocal cord. The most important pathological result are extensive walled off spaces. The greater part of these are lined with a layer of mesothelial cell like fibroblasts. The slightly pathological findings at the epithelial cells are in accordance with the clinical result. Inflammatory signs morphologically can not be observed.

Female↗
PubMed1979

[First experiences with voice-rehabilitative laryngectomy, as described by Staffieri and Amatsu (author's transl)].

Report on six cases of tracheo-esophageal shunt-operations as described by Staffieri, and four cases operated according to Amatsu. Both methods hold in common the construction of a slit-like anastomosis between trachea and hypopharynx, respectively upper esophagus. According to Staffieri the anastomosis is made towards the hypopharynx, according to Amatsu towards the upper esophagus. Advantages of the Amatsu-method, as compared to the Staffieri-method, are as follows: 1. no additional hypopharynx-mucosa is required to establish the shunt. Therefore, it is also suited for tumors with loss of pharynx-mucosa, 2. when constructing the anastomosis, mucosa of esophagus, and of trachea, is directly and seamlessly connected so that no granulations or polyps can develop, 3. voice and speech is learned earlier, 4. less aspiration. Both methods have the following disadvantages: 1. for voice-production, the tracheostoma has to be occluded with a finger, 2. a certain amount of aspiration must always be reckoned with, though, up to now, no patient asked for an occlusion of the fistula. At the time being, we are recommending the shunt-method to those patients only who expressly ask for it because of the possibility of early voice-production, and a better quality of speech. Or we recommend it to such patients as would otherwise not consent to laryngectomy.

Aged↗
PubMed1977

[The results of saccotomy in morbus Menière (review of 69 cases) (author's transl)].

The results of saccotomy in Morbus Menière are investigated using two statistics with different postoperative periods. After a short period of observation (10-26 months p.o.) the improvement of vertigo was found in 80%, while after an interval of 18-23 months the improvement was seen only in 50%. The results are better, if the disease is not older than one and a half year (70%). Therefore we recommend the saccotomy in Morbus Menière for cases of a short anamnesis.

Ear, Inner↗
PubMed1977

[Acute isolated vestibular paralysis. A clinical and electronystagmographic follow-up study in 28 patients].

Twenty-eight patients with unilateral acute vestibular paralysis (vestibular neuronitis) were examined after a period of 4-140 months. Seventeen of these patients were examined by electronystagmography with caloric stimuli at 44 degrees, 30 degrees, 17 degrees and 0 degrees C. Most were free of subjective symptoms only one-third had slight unsteadiness after sudden head movement. Subjective symptoms were independent of the presence of permanent canal paralysis or partial recovery of caloric excitability. Spontaneous nystagmus of 3-6,6% intensities was found in 11 of 17 patients. The normal limit for physiological spontaneous nystagmus should therefore be below 3 degrees/s. The most reliable parameter was the maximum velocity of the slow phase, as a mean value of the 4 caloric responses (values corrected for spontaneous nystagmus). The results were: 6 patients with persistent canal paralysis; 4 patients with considerable hypoexcitability; and 7 patients with moderate hypoexcitability. In no patient complete restoration of normal caloric response was found. This is attributed to the described method of caloric testing, which permits exact measurement of small side differences in excitability.

Acute Disease↗