Biomedical subjects
Publications and source records attributed to J Hartwein.
Spondylosis hyperostotica is described by means of a case report. It may cause dysphagia by massive ventral exostoses of the cervical spine. Therapeutic aspects are discussed.
PURPOSE: The "crowncork tympanoplasty" is a technique for the total reconstruction of the tympanic membrane. It is recommended in cases of ear malformation, blunting phenomena, and total deficiency of the membrane caused by chronic otitis media. PATIENTS AND METHODS: The records of 12 patients undergoing "crowncork tympanoplasty" were reviewed. This includes 5 patients who were operated on because of middle ear malformation, 6 cases with a blunting phenomena following prior tympanoplasty, and 1 patient with chronic otitis media. RESULTS: In each case an intact tympanic membrane was achieved. The air bone was reduced to 17, 19, 16, and 11 dB in the frequency 500, 1,000, 2,000, and 4,000 Hz. CONCLUSION: The use of cartilage for tympanoplasty has been useful despite the comparatively worse vibration characteristics of the rigid material. Total reconstruction of selected problem cases using this "crowncork technique" has resulted in good healing with favorable hearing results and should be incorporated into the routine of the skilled otosurgeon.
INTRODUCTION: At the time of this writing, it is unclear whether metastasis to the parotid gland necessitates a radical surgical approach, including removal of the facial nerve, which results in a great loss of the patient's quality of life. MATERIALS AND METHODS: The clinical course of patients who underwent parotid surgery in the ENT clinic of Hamburg University during the period 1982-1992 as a result of metastasis of a malignant melanoma or squamous cell carcinoma was studied. Either the lateral portion of the gland was removed (laterofacial parotidectomy) or the whole gland, thereby preserving the facial nerve (total parotidectomy) or removing it (radical parotidectomy). RESULTS: Metastasis to the parotid gland occurred in 17 patients (17/347). All 10 patients with metastasis of a malignant melanoma developed further metastasis and 7 of these patients, independent of the radicality of parotid surgery, died within the first postoperative year. Of the 7 patients with metastasis of a squamous cell carcinoma, 5 developed further metastasis and 4, independent of the radicality of parotid surgery, died within 16 months after the operation. CONCLUSION: Radical parotid surgery, which involves a great loss of quality of life for the patient, does not positively influence life expectancy. Moreover, the long-term prognosis is influenced by the type of the tumor and the stage at which the disease is first diagnosed.