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M Tisch

Publications and source records attributed to M Tisch.

At least 19 recordsLinked to original sources
PubMed2007

[Epidemiology, diagnosis, and treatment of giant pleomorphic adenomas of the parotid gland].

Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80 years 20 cases of giant pleomorphic adenomas (weight 1.2-26.5 kg) have been reported. These tumors occurred predominantly in women (90%). The mean period from initial clinical manifestation until definitive surgical treatment was 20.7 years. The mean age of the patients at the time of surgery was 58.9 years. Malignant transformation occurred in 15.8% of cases. It is likely that the reasons for delayed treatment are the patient's fear of surgery on the one hand, and insufficient medical advise on the other. We report on a 77 year old female who had a 40-year history of a growing parotid tumor that weighed 3.9 kg after resection. The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature on these unusual parotid tumors, are presented.

Adenoma, Pleomorphic↗
PubMed2007

[Genotoxic effects of insecticides in current use on mucosal epithelial cells from human tonsil tissue].

BACKGROUND: Vector control is of critical medical importance in disease prevention, as reflected in sections 17 and 18 of the German Protection Against Infection Act. In the past, a large number of biocides were found to be hazardous to human health and were banned from the market, subsequently being replaced by new active ingredients and galenic forms. Many of these new insecticides are available in spray or nebuliser form. Whether these preparations have genotoxic effects on mucosal epithelial cells of the upper aerodigestive tract has thus far not been investigated. MATERIALS AND METHODS: We used the comet assay, as a well-established genotoxicity test, to investigate whether malathion, diazinon, pyridostigmine bromide, piperonyl butoxide, silafluofen, and fipronil had genotoxic effects on tonsil specimens taken from 85 patients. RESULTS: All substances tested proved to have a strong genotoxic effect on mucosal epithelial cells taken from human tonsil tissue. We found clear differences between substance groups. CONCLUSIONS: Sufficient doses of a wide range of insecticides are indispensable in many areas of human life, especially for the prevention of diseases. Depending on the method of application, however, ingestion or inhalation of these substances can damage mucosal epithelial cells of the upper aerodigestive tract. Further epidemiological studies should be undertaken to investigate whether this involves potential health hazards in at-risk populations.

Adolescent↗
PubMed2006

[Leiomyosarcoma of the larynx].

Leiomyosarcoma is usually found in the female genital tract, retroperitoneum, the wall of the gastrointestinal tract and subcutaneous tissues. An appearance of this malignant tumor in the larynx is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report on a 64-year old male with a supraglottic leiomyosarcoma who was treated with supraglottic laryngectomy and postoperative radiotherapy. After 19 months the patient was well and free of disease. The most commonly used diagnostic and therapeutic procedures are analysed in a review of the 46 published cases of laryngeal leiomyosarcoma.

Combined Modality Therapy↗
PubMed2006

[Can preoperative fine-needle aspiration of parotid tumors pose problems for a definitive histological diagnosis?].

INTRODUCTION: Fine-needle aspiration cytology (FNAC) is a minimally invasive procedure that offers high specifity and acceptable sensitivity in the preoperative diagnosis of parotid tumors. FNAC provides information that can be particularly valuable in surgical planning and patient education. In some cases, it may even help prevent unnecessary surgery. After an FNA procedure, on rare occasions, morphological changes in the tumor may be observed and can make a definitive histological examination difficult or even impossible. METHODS: Histopathological changes in parotid tumors after preoperative FNAC are described on the basis of a case report and a survey of the literature. RESULTS: In rare cases, puncture-induced histopathological changes, such as hyalinization of the subepithelial stroma, necrosis and squamous metaplasia, so extensive that a definitive histological diagnosis is difficult, are observed. In the present case report, fine-needle aspiration of a 3 x 2 cm tumor, which had been classified as malignant on the basis of cytological findings, resulted in complete necrosis and made a definitive histological diagnosis impossible. Similar cases have been described by other authors in recent years. DISCUSSION: In rare cases, histological changes in the tumor tissue can occur after an FNA procedure, making a definitive histological examination difficult or even impossible. When a preoperative FNAC is performed, the pathologist in charge should be advised accordingly. In addition, patients should be informed about this infrequent risk before undergoing the procedure.

Aged↗
PubMed2006

[Malignant external otitis].

Malignant external otitis or skull base osteomyelitis and osteoradionecrosis of the skull base and the skull are potentially life-threatening conditions. The standard methods of treatment involve the use of antibiotics, local treatment and, where necessary, surgical excision of necrotic tissue. These approaches do not provide a complete cure in many cases. Severe functional deficits and even death can occur in advanced stages. We conducted a long-term retrospective follow-up study and report on a multimodal approach that we have been using with great success since 1987. The four cornerstones of this treatment are surgical debridement, combinations of antibiotics, specific immunoglobulins, and adjunctive hyperbaric oxygen therapy. This multimodal treatment approach has proved to be highly effective in improving the survival and quality of life of the patients concerned. These excellent outcomes justify the high costs that this therapy admittedly involves.

Anti-Bacterial Agents↗
PubMed2005

[Cavernous hemangioma of the parotid gland in adults].

Parotid hemangiomas are rare in adults. Whereas both capillary and cavernous hemangiomas are seen in children, only cavernous hemangiomas have thus far been reported in adults. Clinically, cavernous hemangiomas usually present as slowly growing, soft or firm, movable, painless parotid masses. Severe pain and swelling can occur, however, depending on the size of the hemangioma or in particular in the presence of acute hemorrhage or thrombosis. CT and MRI are the diagnostic tools of choice. Prior to surgery, magnetic resonance angiography or intra-arterial digital subtraction angiography should be performed to investigate the vascular supply of the tumor. Surgical excision is the treatment of choice for small lesions. Large cavernous hemangiomas usually require superficial or total parotidectomy. Especially in the case of extended lesions, the facial nerve may be difficult to identify and should be monitored intraoperatively.

Adult↗
PubMed2005

[Ductal carcinoma of the parotid gland with the clinical picture of obstructive sialadenitis].

Salivary duct carcinoma is a highly malignant tumor. Pain, facial nerve palsy, perineural and lymphatic invasion are common findings, as well as an extensive cervical lymph node involvement and distant metastasis. However, occasionally, as in the case presented, the clinical features of this tumor may resemble obstructive sialadenitis and thus cause a delay in appropriate treatment. Although salivary duct carcinoma exhibits an unpredictable clinical course and a poor overall prognosis, total parotidectomy with neck dissection and adjunctive radiation therapy appear to be appropriate for local and regional control of this aggressive neoplasm.

Adult↗
PubMed2005

Olivocochlear activity and temporary threshold shift-susceptibility in humans.

STUDY OBJECTIVES: Animal studies (guinea pig, cat, chinchilla) have shown that activity of the medial olivocochlear efferents can exert noise-protective effects on the cochlea. It is not yet known whether such effects are also existent in humans. Olivocochlear activity can be estimated indirectly by contralateral suppression (CS) of otoacoustic emissions (OAE). MATERIAL AND METHODS: We measured Input/Output functions of distortion products of OAE (DPOAE), with and without contralateral acoustic stimulation by white noise, in 94 normal hearing young male subjects. Seven stimuli with L2 between 20 and 60 dB SPL and L1 = 39 dB + 0.4 L2 ("scissor paradigm") were used at f2 = 2, 3, 4, 5, and 6 kHz. The measurement was repeated 2 weeks later. In 83 subjects of the same group, pure tone audiometry was registered before and 6 minutes after shooting exercises to evaluate individual susceptibility to develop a temporary threshold shift (TTS). RESULTS: Test-retest repeatability of CS was generally good. CS averaged 0.98 dB SPL (SD 1.19 dB, median 0.56 dB). As expected, CS was greatest at low stimulus levels (median 1.06 dB at L2 = 20 dB, as compared with 0.33 dB at L2 = 60 dB). The smallest average CS was found at 4 kHz, and the greatest CS appeared at 2 kHz. A TTS occurred in 7 of 83 (8.5%) subjects. Statistical analysis did not reveal any correlation between the amount of CS and individual TTS susceptibility. CONCLUSIONS AND OUTLOOK: 1) Measurement of CS of DPOAE using an extensive measurement paradigm revealed good test-retest repeatability, confirming the reliability of this audiologic tool. 2) CS of DPOAE does not predict individual susceptibility to mild TTS induced by impulse noise in humans. Possible explanations for the missing association are discussed. Future perspectives include longitudinal studies to further elucidate the association between medial olivocochlear bundle-activity and permanent threshold shift in humans. The goal is to develop a diagnostic tool for the prediction of individual noise vulnerability in humans, thereby preventing noise-induced hearing loss.

Acoustic Impedance Tests↗
PubMed2004

Increased cancer risk in heavy drinkers with the alcohol dehydrogenase 1C*1 allele, possibly due to salivary acetaldehyde.

BACKGROUND: Chronic ethanol consumption is associated with an increased risk of upper aerodigestive tract cancer. As acetaldehyde seems to be a carcinogenic factor associated with chronic alcohol consumption, alcoholics with the alcohol dehydrogenase (ADH) 1C*1 allele seem to be particularly at risk as this allele encodes for a rapidly ethanol metabolising enzyme leading to increased acetaldehyde levels. Recent epidemiological studies resulted in contradictory results and therefore we have investigated ADH1C genotypes in heavy alcohol consumers only. METHODS: We analysed the ADH1C genotype in 107 heavy drinkers with upper aerodigestive tract cancer and in 103 age matched alcoholic controls without cancer who consumed similar amounts of alcohol. Genotyping of the ADH1C locus was performed using polymerase chain reaction based on restriction fragment length polymorphism methods on leucocyte DNA. In addition, ethanol was administered orally (0.3 g/kg body weight) to 21 healthy volunteers with the ADH1C*1,1, ADH1C*1,2, and ADH1C*2,2 genotypes, and 12 volunteers with various ADH genotypes consumed ethanol ad libitum (mean 211 (29) g). Subsequently, salivary acetaldehyde concentrations were measured by gas chromatography or high performance liquid chromatography. RESULTS: The allele frequency of the ADH1C*1 allele was found to be significantly increased in heavy drinkers with upper aerodigestive tract cancer compared with age matched alcoholic controls without cancer (61.7% v 49.0%; p = 0.011). The unadjusted and adjusted odds ratios for all cancer cases versus all alcoholic controls were 1.67 and 1.69, respectively. Healthy volunteers homozygous for the ADH1C*1 allele had higher salivary acetaldehyde concentrations following alcohol ingestion than volunteers heterozygous for ADH1C (p = 0.056) or homozygous for ADH1C*2 (p = 0.011). CONCLUSIONS: These data demonstrate that heavy drinkers homozygous for the ADH1C*1 allele have a predisposition to develop upper aerodigestive tract cancer, possibly due to elevated salivary acetaldehyde levels following alcohol consumption.

Acetaldehyde↗
PubMed2003

[Quality of life for patients after laryngectomy and surgical voice rehabilitation. Experience with the Provox prosthesis].

BACKGROUND: Our study included 52 patients who received follow-up care after laryngectomy; a Provox I prosthesis was used for voice rehabilitation. METHODS: The EORTC Quality of Life Questionnaire was used to assess the postoperative quality of life of these patients with voice prostheses. RESULTS: Of the patients, 36.1% complained of a lack of energy, and 22% experienced sadness suggesting a reactive depression. Of the 55.6% of patients who expressed satisfaction with managing their disease, more than two-thirds were afraid of a potential deterioration of their health. More than 90% of the patients received extensive support from family and friends. As many as 52.8% expressed themselves satisfied with their current life, which is perhaps attributable to the successful rehabilitation of their voice. Eating problems, i.e., varying degrees of dysphagia as a result of treatment, were experienced by 47.3% of the patients. CONCLUSIONS: After the laryngectomy, 11% continue to smoke and 46% regularly consume alcohol. For this reason, rehabilitation measures should place more emphasis on patient education and on programs designed to help patients stop smoking and drinking alcohol.

Adult↗
PubMed2003

[The treatment of necrotizing otitis externa with a combination of surgery, antibiotics, specific immunoglobulins and hyperbaric oxygen therapy. Results of the Ulm Treatment Concept].

BACKGROUND: Even today, necrotizing otitis externa is still a life-threatening condition. The standard treatment concepts based on antibiotic therapy, topical treatment and--if necessary--surgical debridement of necrotic tissue, remain ineffective in many cases. In advanced stages, necrotizing otitis externa can therefore be expected to result in severe functional impairment or even a fatal outcome. PATIENTS AND METHODS: We describe our experience with a multimodal treatment concept that we have been using with great success at the Federal Armed Forces Hospital in Ulm since 1987. This treatment is based on four pillars: 1. Surgical debridement, 2. Use of a combination of antibiotics, and 3. Administration of specific immunoglobulins, accompanied by, 4. Hyperbaric oxygen therapy RESULTS: Over a period of more than 5 years 16 of the 22 patients treated on the basis of this multimodal concept remained free of recurrences. In addition, significant reductions in analgesic use and in the insulin doses needed by diabetic patients were possible. CONCLUSIONS: The treatment concept under scrutiny has proved particularly successful. The various modes involved and the results of this combined therapy are discussed.

Acinetobacter Infections↗
PubMed2003

[Mouth dryness and burning sensation of the oral mucosa: causes and possibilities for treatment].

Both sets of complaints, mouth dryness and a burning sensation of the oral mucosa, can have a variety of causes. Local and regional as well as systemic causes can be responsible for burning mouth syndrome. Diseases of the oral mucosa can have genetic, inflammatory, or neoplastic origins. Autoimmune diseases and allergies as well as different afflictions relating to internal medicine can be accompanied by a burning sensation in the oral mucosa. Neurological and psychiatric illnesses must be clarified during interdisciplinary diagnostics in order to identify idiopathic forms. The causes of mouth dryness are similarly complex. In addition to inadequate fluid intake, particularly in elderly patients, drug side effects or systemic diseases are frequently also responsible. Treatment is directed at the underlying disease; in ambiguous cases, symptomatic therapy can provide relief for medical complaints.

Burning Mouth Syndrome↗
PubMed2002

Angioneurotic edemas of the upper aerodigestive tract after ACE-inhibitor treatment.

There are rare cases in which inhibitors of the angiotensin-converting enzyme can cause an angioneurotic edema of the upper aerodigestive tract. The pathomechanism of this side effect depends on an interaction of the drug with hormones regulating vascular permeability, such as the kallikrein kinin system and the prostaglandin system. Angioedema is characterized by subcutaneous or submucosal swellings, which usually affect the lips, soft palate, tongue and larynx. Pathomechanisms, differential diagnosis and treatment of ACE-inhibitor-induced edema of the upper aerodigestive tract are described in three case reports.

Angioedema↗
PubMed2002

[Genotoxic effect of PCP and lindane on human epithelial tonsil cells].

BACKGROUND AND OBJECTIVE: Experimental and epidemiological studies have provided evidence that pentachlorophenol (PCP) and gamma-hexachlorocyclohexane (lindane) may pose a potential carcinogenic risk for human epithelial cells of the upper aerodigestive tract. In the past, these two substances have been used for military and nonmilitary purposes, e.g., for impregnation of textiles and uniforms. In this study, we investigated the genotoxic effect of PCP and lindane on human mucosal tissue from the tonsils. METHODS: In epithelia obtained from the tonsillar mucosa removed during surgery, cell viability was evaluated by trypan blue staining. The specimens were incubated for 60 min with PCP (0.3, 0.75, and 1.2 mM) and lindane (0.5, 0.75, and 1.0 mM). The induction of DNA damage (single- and double-strand breaks) caused by PCP and lindane was measured using single-cell microgel electrophoresis. Evaluation was performed with an image analyzer enhanced by fluorescence microscopy. RESULTS: After exposure to PCP and lindane, strong genotoxic effects are apparent. The DNA migration rose from 26 micrometer in the control solution up to nearly 90 micrometer after incubation with PCP and lindane ( p<0.0001). CONCLUSIONS: This study could demonstrate for the first time genotoxic effects of PCP and lindane on human tonsillar epithelium. It has to be considered that chronic exposure to both agents might increase the risk for cancer of the upper aerodigestive tract.

Cell Transformation, Neoplastic↗
PubMed2002

[Risk of postoperative hemorrhage in tonsillectomy. A comparison between general anesthesia and local anesthesia].

BACKGROUND: Postoperative bleeding after tonsillectomy is still a life-threatening problem. The incidence of postoperative bleeding, as well as many factors (kind of surgery, hemostasic problems) affecting this risk have been investigated. A possible factor that has not been well studied is the used anaesthetic procedure. METHODS: A prospective study was completed comparing the risk of postoperative bleeding in patients operated in local vs. general anaesthesia. RESULTS: The study enrolled 1063 patients, who consecutively underwent tonsillectomy. In 16 (4.12%) of 388 patients operated under general and 51 (7.55%) of 675 patients operated under local anaesthesia postoperative bleeding occurred. After local anaesthesia postoperative bleeding was seen mainly at the day of operation (46 of 51), there was no late bleeding after the 6th postoperative day. After general anaesthesia in 6 of 16 cases postoperative bleeding occurred after the 6th postoperative day. DISCUSSION: Postoperative bleeding occurs more frequent in patients who underwent tonsillectomy in local anaesthesia. The risk of late postoperative bleeding however is higher with tonsillectomy in general anaesthesia.

Adolescent↗
PubMed2002

[Occupational hazardous substance exposure and nutrition. Risk factors for mouth, pharyngeal and laryngeal carcinomas?].

BACKGROUND AND OBJECTIVE: A case-control study was conducted to investigate occupational and other risk factors for squamous cell carcinoma of the oral cavity, the pharynx and the larynx. The study included 209 male cancer patients and 110 male control persons without known malignant disease, matched for age, alcohol consumption and tobacco consumption. PATIENTS/METHODS: Cases and controls were interviewed using a standardized questionnaire which has been used before in the Heidelberg case-control studies. RESULTS AND CONCLUSIONS: The educational level in the cancer group was significantly lower (p < 0.001). 17.2% of the cancer patients and 7.3% of the control persons had not completed their professional training. The percentage of so-called "blue-collar workers" was significantly higher in the cancer group (20.9% vs. 7.3%; p < 0.002). An increased cancer risk was observed for workers exposed to asbestos (OR = 8.7; p = 0.004) and cement dust (OR = 12.9; p < 0.001). A frequent consumption of various vegetable food like carrots (OR = 0.17; p < 0.001), fruits (OR = 0.38; p < 0.001) or green salad (OR = 0.25; p < 0.001) was associated with a significant reduction of cancer risk.

Adult↗