Biomedical subjects

H Rudert

Publications and source records attributed to H Rudert.

At least 109 records · Page 6Linked to original sources

PubMed1977

[The diagnostic value of the Stepping Test of Unterberger (author's transl)].

Of the vestibulo-spinal reactions, the "stepping test" is considered to be the most important, especially for unilateral peripheral vestibular disturbances. Electronystagmography was performed on seven patients after transtemporal neurectomy of the vestibular nerve, 17 patients with a nearly compensated vesitbular defect after vestibular neuronitis, and seven patients after suboccipital removal of acoustic neuromas. These results were then compared to the spontaneous stepping test. The test could not be performed on six of the seven patients with the operated acoustic neuroma, and on three other patients. The test was positive in only ten of the other 22 patients. It was incorrect in five patients and equivocal in seven. A reliable spontaneous vestibulo-spinal reaction with nearly compensated peripheral vestibular defects could not be determined during the present study.

Adult↗

PubMed1977

[Facial palsy in benign tumours of the parotid gland (author's transl)].

Facial paralysis caused by benign parotid gland disease in 2 patients is reported. In one patient there was an acute parotid inflammation and a parotid cyst, to the medial wall of which the facial nerve was adherent. In the other patient the paralysis was assumed due to the toxic effects of a necrotizing lymph node, which was adherent to the nerve.

Adult↗

PubMed1976

[Laminotomy after Réthi. Report of treatment of 8 stenoses and 3 atresias of the larynx (author's transl)].

Eight stenoses and 3 atresias of the larynx were treated by laminotomy after Réthi. The commonest indication was a perichondritis stenosis of the cricoid after prolonged intubation. Stenosis of the cricoid followed subactue laryngitis in two cases. The arytenoids were also ankylosed in 5 cases requiring a further procedure to widen the glottis. The operation may also be used as an additional procedure in selected cases of supraglottic and glottic stenosis. The operation has also proved useful in stenoses and atresias of the laryngo-tracheal junction area. Nearly all cases require an obturator keel for 3-6 months. This is removed endoscopically in cases of closed treatment, while a plastic closure of the laryngotracheal lumen is necessary after open operations. The respiratory function was restored satisfactorily in all but one patient, who developed perichondritis of the thyroid cartilage. The quality of the voice depends on the mobility of the vocal process of the arytenoids.

Adult↗

PubMed1976

[Pseudocaloric nystagmus (author's transl)].

A pseudocaloric nystagmus is, in its strict sense, a spontaneous nystagmus activated by the unspecific stimulus of syringing the auditory canal. 40 patients with a unilateral, peripheral-vestibular defect were examined electronystagmographically. With most patients the 30 degrees caloric stimulation gave an incorrect result of the degree of hypoexcitability with all parameters (duration, maximum frequency and maximum intensity). This incorrect result was most pronounced with patients after neurectomy of the vestibular nerve, who frequently had a heavily reduced reaction of the healthy ear. For quantitative measurement of genuine pseudocaloric effects, by a special method of examination (as for instance by consideration of the "maximum spontaneous nystagmus"), the "real" vestibular excitability was calculated. Data exceeding this value were regarded as genuine pseudocaloric nystagmus. At stimulation temperatures of 44 degrees to 17 degrees C they were so low as to be negligible. They were only found with 5 of the 40 patients and amounted to only 10-20% of the reaction of the healthy ear. However, with ice water there frequently were considerable pseudocaloric reactions. So testing with ice water is not appropriate.

Caloric Tests↗

PubMed1975

[The management of intratemporal facial nerve lesions (author's transl)].

Intratemporal lesions of the facial nerve can be divided into operative lesions, lesions due to birth trauma, trauma through the external auditory canal, gunshot injuries, lesions caused by fractures of the temporal bone and lesions due to intratemporal tumours. Bell's palsy and palsies due to inflammation are not included in this paper. The lesions caused by fractures are discussed in more detail. In longitudinal fractures the nerve is always damaged at the site of the geniculate ganglion and not at the pyramidal segment, as accepted until now. Of the lesions caused by tumours the neurinomas are discussed. A very rare case of a combined extra- and intra-temporal neurinoma is presented. The progress of the electrophysiological findings (nerve excitability test, electroneurography) are most important for the indication for exploration of the nerve, especially in lesions due to fracture. Surgery is necessary only in cases of imminent or complete denervation and not in cases of neuropraxia. The methods of intratemporal facial nerve surgery are: 1. anastomoses (cross-over) between the facial nerve and other cranial nerves (IX, XI, XII), 2. decompression, 3. suture (including rerouting), and 4. nerve grafting. The oldest method of anastomosing with the hypoglossal nerve, is a useful technique if other techniques of nerve repair have failed. Since the introduction of transtemporal surgery of the internal canal decompression can bedone from the stylomastoid foramen to the porus acousticus. The end-to-end suture of a severed nerve gives good results. Nerve defects can be corrected by shortening the nerve bed. The following methods are used: 1: rerouting of the pyramidal segment (Bunnel, Martin), 2. rerouting at the stylomastoid foramen (Mundnich), 3. transtemporal rerouting of the first genu (Ganglion geniculi) with preservation of the labyrinth (one case is demonstrated). 4. transmastoidal-translabyrinthine rerouting in cases of a destroyed labyrinth. Nerve grafting is the method of choice with large defects. In the temporal bone special suture techniques are unnecessary. The approximation of the stumps must be free of tension.

Adult↗

PubMed1975

[Investigations on the vestibular recruitment (author's transl)].

Searching for some kind of vestibular recruitment that might be similar to the audiological recruitment as defined by Fowler, a caloric test was done at 44 degrees, 33 degrees, 30 degrees, 26 degrees, 17 degrees. The parameter of vestibular response was the maximum slow component speed, In total 36 Menière-patients were electronystagmographically examined. Out of the 36 only 16 were analyzed further for the question of vestibular recruitmen, who showed strictly unilateral lesions, who were attack-free since some months and who showed clear audiological recruitment at four different recruitment tests. The following results were obtained: 1. The values obtained for the sound side of Menière-patients correspond to values described as normal in literature. 2. The affected side showed less reaction at all temperatures, in no case there was a tendency to recruitment. 3. With considerable loss of excitability, a "flat curve" was resulting, indicating decruitment.

Audiometry↗

PubMed1975

[Is there a correlation between vestibular and cochlear hypofunction in Menière's disease? (author's transl)].

The vestibular findings in Meniere's disease show large variations. In the attack-free interval, with strict unilateral disease, very often there seems to be a vestibular hypoexcitability. This canal paresis is mostly manifesting itself by a reduction of the velocity of the slow phase, and not so much by the shortening of the duration of a calorically induced nystagmus. With vestibular end-organ-diseases the relative hypoexcitability is most pronounced with strong cold stimuli. The correlation between hearing loss and vestibular function loss of 16 Meniere patients was examined at different caloric stimuli from 44 degrees to 17 degrees C. The generally accepted mode for determining vestibular hypoexcitability (mean value of the 44 degrees and 30 degrees -stimulus) only showed a very slight correlation to hearing loss. The determination of vestibular hypofunction at different caloric stimuli--or, at least, the additional application of a strong cold stimulus--seems to give new and valuable vestibular diagnostic possibilities.

Audiometry↗

PubMed1974