Search PubMed⌕ Search

Biomedical subjects

J Constantinidis

Publications and source records attributed to J Constantinidis.

At least 37 records · Page 2Linked to original sources
PubMed2001

DNA amplification on chromosome 7q in squamous cell carcinoma of the tongue.

Squamous cell carcinoma of the head and neck exhibit a highly variable picture of chromosomal aberrations. In the present study the clearly defined anatomical region of the tongue was analyzed for potentially specific patterns of chromosomal alterations. Fresh tumor samples from 18 patients afflicted by squamous cell carcinoma of the tongue constituted the clinical basis of the present investigation. The tumor samples were analyzed on the basis of comparative genomic hybridization (CGH), a molecular cytogenetic FISH-approach. Gains in DNA copy numbers were detected as the predominant imbalance on chromosomes 7q (9/18), 3q (48/18), 16p (7/18) and 20q (7/18). The regions of minimal overlap on these chromosomes were mapped to 7q11.2q11.3 and 3q26. A conspicuous finding was the frequent detection of amplifications in the 7q11 region. Gains in the 7q region have been rarely reported in CGH studies of tumors derived from different regions of the head and neck. Amplifications on 7q could thus be specifically linked with the tongue region and could correlate with specific clinical factors of this tumor entity.

Adult↗
PubMed2001

Therapy of invasive mucoceles of the frontal sinus.

Mucoceles of the frontal sinus that extend into the orbits and the anterior cranial fossa can, in certain cases, be difficult to manage therapeutically and may lead to lethal complications. The surgeon will have to make a decision between an endonasal and an extranasal, transfacial procedure to provide an adequate access. Between 1995 and 1998 we treated 12 patients suffering from invasive mucoceles of the frontal sinus. The mucocele was localized medially in 7 cases and in the lateral part of the frontal sinus in 5 cases. Five of the patients exhibited destruction of the orbital roof and in 7 cases combined destruction of the orbital roof and the floor of the frontal sinus were noted. The posterior wall of the frontal sinus was destructed in 6 patients, with one patient additionally showing partial destruction of the anterior frontal sinus wall. The causes of mucocele formation were previous frontal sinus operations (n = 8) and frontal sinus fractures (n = 3). In one case the cause remained unknown. In 7 cases with a medially localized mucocele the mucocele was marsupialized using an endonasal access. The mucoceles with a lateral localization were osteoplastically operated via an external access. Here we performed median drainage in 3 cases and, in one case each, obliteration and cranialization of the frontal sinus. The follow-up period was 2.8 years on average. All patients were free of complaints immediately after the operation. Mucocele recurrence or other complications did not arise. The cosmetic results were satisfactory in all cases.

Adult↗
PubMed2000

[Identification of a nasopharyngeal carcinoma using Epstein-Barr virus diagnosis].

We report the case of a 36-year-old women who was found to have a malignant tumor extending from the side of her right nasal cavity to the nasopharynx. Magnetic resonance imaging and computed tomography were not able to define the primary site of the tumor. Histologic evaluation demonstrated an undifferentiated squamous cell carcinoma. Because of the different treatment concepts for carcinomas of the nasal cavity and nasopharynx, we tried to identify the primary site by diagnosing Epstein-Barr virus (EBV) infection, which is associated with carcinoma of the nasopharynx. By using immunohistochemistry and polymerase chain reaction EBV could be identified in the cells of the carcinoma. This showed that the primary site of the tumor was located in the nasopharynx and resulted in the patient being treated with simultaneous radiochemotherapy.

Adult↗
PubMed2000

[Functional and esthetically oriented reconstruction of lip defects].

Reconstruction of lip defects presents a challenge to the surgeon. Apart from attaining a good aesthetic result, preserving the function of the oral sphincter is an essential objective. A variety of techniques and modifications of procedures for reconstructing lip defects have been reported in the literature. It is up to the surgeon to select the reconstruction procedure ensuring optimum functional and cosmetic results, depending on the location, size, and depth of the defect. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures. The upper lip is divided into three aesthetic subunits: two lateral subunits and a median subunit, the philtrum. The lower lip constitutes a single subunit. In this study, established reconstruction techniques are discussed and a concept serving to facilitate the appropriate choice of technique is introduced. This concept differentiates between vermilion defects on the one hand, and partial-thickness and full-thickness lip defects on the other hand. For the lower lip, the full-thickness defects are classified as defects involving one-third, one-third to two-thirds of the lower lip width, and between two-thirds and complete loss of lip tissue. For the upper lip, a distinction is made between isolated defects of the central and lateral subunits and combined defects of the central and lateral subunits. Important principles of surgery and the advantages or disadvantages of different reconstruction techniques are discussed.

Basal Cell Carcinoma↗
PubMed2000

[Diagnosis and therapy of pseudotumors of the orbits].

Orbital pseudotumor is a nonspecific inflammatory process of unknown etiology that can be divided histopathologically into three basic types: granulomatous, lymphoid, and sclerosing. Between 1995 and 1998, 12 patients with pseudotumor orbitae were treated in the ENT Department of the University of Saarland. Histopathological examination showed granulomatous type of pseudotumor in six, lymphoid in three, and sclerosing in three patients. In seven cases the pseudotumor orbitae were medially located and in four cases laterally. In one patient nearly all orbital structures were infiltrated. Diagnostic biopsy was taken endonasally in six cases, via medical orbitotomy in two cases, and via lateral orbitotomy in four cases. Due to their good delimitation lymphoid and sclerosing tumors were extracted completely during diagnostic biopsy and patients were free of complaints after a few weeks. The six patients with granulomatous pseudotumor were treated primarily with steroids after the diagnosis had been definitely confirmed by histology. In three of those six cases a second course of steroid therapy had to be given, with positive results in two cases. Follow-up was between 6 and 28 months (mean 16 months). There were no postoperative complications. The clinical and radiographic presentation of the pseudotumors can vary greatly. Therefore, the differential diagnosis of specific infections or neoplasms can only be established through diagnostic biopsy. Different rhinosurgical approaches provide clear biopsy results and in some cases the pseudotumor is even completely removed.

Adult↗
PubMed2000

[Morphological and functional changes in nasal mucosa after nCPAP therapy].

BACKGROUND AND OBJECTIVE: The treatment success of nCPAP therapy (nasal continuous positive airway pressure) depends partly on the relief of symptoms and partly on long-term patient acceptance and the related avoidance of complications. Nasal complaints constitute the most frequently reported side effects and, together with problems of mask application, are among the primary factors causing an nCPAP-therapy to be prematurely discontinued. PATIENTS/METHODS: To assess the morphological changes of the nasal mucosa during nCPAP-therapy, we excised specimens of nasal mucosa tissue in twelve patients with obstructive sleep apnea syndrome (OSAS) both before and 3-10 months after establishing nCPAP-mask acceptance. The specimens were examined by electron microscopy. RESULTS: In all these patients, acceptance of the CPAP mask marked the initial part of therapy. In addition, mucociliary clearance was assessed by the saccharin test before and after therapy. In all patients, the nasal epithelium underwent fundamental changes upon CPAP therapy, which became manifest as modifications in the shape of epithelial cells, conglutination and clumping of the microvilli, and the appearance of immunocompetent cells. Once patients were nCPAP mask compliant, mucociliary clearance was distinctly prolonged in all cases. CONCLUSIONS: A successful therapeutic concept should provide normalization of room temperature and air humidity once nCPAP mask compliance has been achieved, and include regular assessment of the condition of the mucosa in the upper respiratory tract. Only by these measures can nasal complications be countered or therapy be applied at an early stage.

Aged↗
PubMed2000

[Pharyngolaryngoscopic findings in patients with obstructive sleep apnea syndrome and primary snoring].

BACKGROUND AND OBJECTIVE: The localization of an upper airway collapse in snorers and patients suffering from obstructive sleep apnea was a subject frequently discussed in the last few years. Pharyngolaryngoscopy during sleep or drug-induced sleep allows evaluation of upper airway conditions. PATIENTS/METHODS: A total of 324 patients suffering from snoring or obstructive sleep apnea underwent flexible pharyngolaryngoscopy while awake and under propofol-induced sedation in the course of routine diagnostic procedures in the sleeping lab. In this study, the results of pharyngolaryngoscopy are compared to results of the Müller maneuver and polysomnographic recordings. The therapeutic consequences of this additional investigation are discussed. RESULTS: In 95% of cases snoring was observed during drug-induced sleep. A significant discrepancy was seen between results of the endoscopy while being awake (Müller maneuver) and during drug-induced sleep. The degree of collapse differed significantly in the area of the base of the tongue. Severe collapse was seen much more often with pharyngoscopy during drug-induced sleep compared to the results during the Müller maneuver. CONCLUSIONS: The collapsibility in the area of the base of the tongue correlated with higher results in the RDI (respiratory disturbance index) registered with standard polysomnography. Snoring and upper airway collapse were easily surveyed, and the pharyngolaryngoscopy during propofol-induced sleep proved to be a simple, safe, readily controllable and effective supplementary diagnostic device for the diagnosis and treatment of obstructive sleep apnea and snoring.

Adolescent↗
PubMed2000

[Isolated congenital lower lip fistulas].

BACKGROUND: Congenital lip fistulas are very rare and may occur alone or in combination with oral clefts and other dysontogenetic malformations. The etiology of congenital lip fistulas is not yet known. PATIENT AND METHOD: We present a 7-year-old boy with recurrent infections of bilateral congenital fistulas of the lower lip. There were no associated congenital anomalies and a negative family history. An elliptical excision of the fistulas under microscopic control gave satisfactory functional and esthetic results. There was no recurrence two years after surgery. CONCLUSION: Since the possibility of additional severe malformations exists for the patient and the patient's children patients should undergo careful ENT and pediatric assessment, and genetic counselling should be considered. In order to achieve good functional and esthetic results, the corrective operation must be planned carefully taking into consideration important surgical principles.

Child↗
PubMed2000

Upper airway collapsibility in habitual snorers and sleep apneics: evaluation with drug-induced sleep endoscopy.

Increased upper airway collapsibility has been suspected of being involved in the pathogenesis of sleep-related diseases. It is assumed that patients with severe obstructive sleep apnea syndrome (OSAS) show a stronger collapse of the upper airway compared with habitual snorers. It was the objective of this study to analyze the patterns of upper airway collapse in habitual snorers and patients with OSAS and to correlate these results with data from polysomnography. Endoscopy was carried out during drug-induced sleep (with propofol) and collapsibility was analyzed at two major levels (palatal and tongue base). A total of 207 habitual snorers and 117 patients with OSAS underwent endoscopy after overnight polysomnography in our sleep laboratory. In 95% of cases we were able to induce snoring during drug-induced sleep. The collapsibility in the area of the base of the tongue correlated with higher values of the respiratory disturbance index (RDI) as recorded by standard polysomnography. Patients with OSAS showed significantly stronger collapsibility compared with snorers. The difference was more evident at the tongue-base level. We found no significant correlation between the applied CPAP pressure and collapsibility in patients with OSAS. These results show that collapsibility at the tongue-base level is a factor relevant in sleep-related breathing disorders.

Adolescent↗
PubMed2000

Fine-structural investigations of the effect of nCPAP-mask application on the nasal mucosa.

The treatment success of nasal continuous positive airway pressure (nCPAP)-therapy is dependent, on the one hand, on the achieved relief of complaints and, on the other hand, on long-term patient compliance and avoidance of compliance-related complaints. Next to the problem of mask application, nasal complaints comprise the most frequently reported side-effects and are among the primary factors causing nCPAP-therapy to be discontinued prematurely. To assess the morphological changes in the nasal mucosa during nCPAP-therapy, we excised specimens of nasal mucosa tissue from 10 patients with obstructive sleep apnoea syndrome (OSAS) before and 3-10 months after establishing nCPAP-mask compliance. The specimens were examined by electron microscopy. In all these patients compliance with the CPAP-mask marked the initial part of therapy. In addition, mucociliary clearance was assessed by the saccharin test before and after therapy. In all patients the nasal epithelium underwent fundamental changes upon CPAP-therapy, which became manifest as modifications in the shape of epithelial cells, conglutination and clumping of the microvilli, and the appearance of immunocompetent cells. Once patients were nCPAP-mask compliant, mucociliary clearance was distinctly prolonged in all cases. A successful therapeutic concept should provide normalization of room temperature and air humidity once nCPAP-mask compliance has been achieved and include regular assessment of the condition of the mucosa in the upper respiratory tract. Only by these measures can nasal complications be countered or given therapy at an early stage.

Adult↗
PubMed2000

[Cranialization of the frontal sinus. Indications, technique and results].

The osteoplastic frontal sinus surgery with obliteration of the sinus has been established in the therapy of frontal sinus diseases that can not be drainaged permanently or healed through an endonasal access. The obliteration of the frontal sinus is endangered in cases of multiple fracturing of the posterior frontal sinus wall or if it has been destroyed by an inflammatory process. In these problematic cases obliteration bears the danger of complications and cranialization of the frontal sinus is therefore the method of choice. We review 8 patients who were operated on using the cranialization technique. Indications for surgery were a combined fracture of the anterior and posterior frontal sinus wall (3), a pyocele of the frontal sinus with extensive destruction of the posterior wall (4) and a large osteoma of the posterior frontal sinus wall (1). The frontal sinus was exposed through a coronal incision, the mucosa and the posterior wall were completely removed and the frontal sinus obliterated with fat tissue. The anterior sinus wall was replaced after obliteration of the sinus or reconstructed with calvarian bone transplants. The follow up period was 1.8 years (11 months to 8 years). All patients underwent postoperatively a clinical ENT-examination and radiological assessment by CT-Scan or MRI. The overall functional and esthetic outcome was excellent. There were no serious complications nor any recurrence. The cranialization of the frontal sinus is a reliable and safe variation of the classical osteoplastic frontal sinus surgery with fat obliteration.

Abscess↗
PubMed2000

Glomangioma of the nasal cavity and paranasal sinuses.

The glomangioma, a benign vascular tumour, derived from the cutaneous glomus bodies, should not be confused with paragangliomas, which are occasionally also referred to as glomus tumours. Up to now, only eleven cases of a glomangioma of the nasal cavity and the paranasal sinuses have been published. We report the case of a patient with a glomangioma of the ethmoidal aircell system. The tumour was completely removed under endoscopic-microscopic vision via endonasal access. A tumour recurrence was not observed over a period of eighteen months. The clinical signs, diagnosis, therapy and histological features will be discussed with reference to the literature.

Aged↗
PubMed1999

[Clinical and diagnostic findings of sialolithiasis].

INTRODUCTION: Sialolithiasis is one of the most common diseases of the salivary glands. Within the scope of a retrospective analysis we report on our clinical and diagnostic findings in the largest patient group suffering from sialolithiasis reported in literature. MATERIAL AND METHODS: Between 1987 and 1997, data from 635 patient histories and follow-up examinations were systematically collected and analysed to look for typical symptoms of sialolithiasis, locations of stones and possible risk factors. RESULTS: Sialoliths predominated among patients aged 30 and 70 years, with no male/female predilection. A total of 78.9% of all calculi were detected in the submandibular ducts and 21.1% in the ducts of the parotid glands. The sublingual gland and the smaller salivary glands were not affected. A simultaneous stone disease of the urinary tract or the bile duct system occurred by chance (4.3%). Even regular medication in cases of other systemic diseases cannot be considered cofactors in pathogenesis. CONCLUSION: Diagnosis of sialolithiasis is the result of careful consideration of patient histories demonstrating typical symptoms and clinical examination. Sonography is the first choice of imaging. Pathogenesis of sialolithiasis seems to be based on local factors within the salivary ducts and glands.

Adolescent↗
PubMed1999

[Acute unilateral deafness and contralateral hearing loss following inguinal hernia repair under controlled anesthesia].

Acute hearing loss following non-otologic surgery and general anesthesia is a rare occurrence. Deafness following anesthesia has more commonly been associated with spinal anesthesia or cardiopulmonary bypass surgical procedures. We present a case with unilateral cochlear dysfunction and sensorineural hearing loss after inguinal hernia operation. The literature is reviewed and the mechanisms causing hearing loss during anesthesia are discussed.

Anesthesia, Inhalation↗
PubMed1999

Functional and aesthetic objectives in the reconstruction of lip defects.

The reconstruction of lip defects presents a challenge to the surgeon. Apart from attaining a good aesthetic result, preserving the function of the oral sphincter is an essential objective. A variety of techniques and modifications of procedures for reconstructing lip defects have been reported in the literature. It is up to the surgeon to select the reconstruction procedure ensuring optimum functional and cosmetic results, depending on the location, size, and depth of the defect. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures. The upper lip is divided into three aesthetic subunits: two lateral subunits and a median subunit, the philtrum. The lower lip constitutes a single subunit. In this study established reconstruction techniques are discussed, and a concept serving to facilitate the appropriate choice of technique is introduced. This concept differentiates between vermilion defects on the one hand and partial-thickness and full-thickness lip defects on the other hand. For the lower lip the full-thickness defects are classified as defects involving one third and one third to two thirds of the lower lip width and between two thirds and complete loss of lip tissue. For the upper lip a distinction is made between isolated defects of the central and lateral subunits and combined defects of the central and lateral subunits. Important principles of surgery and the advantages and disadvantages of different reconstruction techniques are discussed.

Esthetics↗