Search PubMed⌕ Search

Biomedical subjects

N Stasche

Publications and source records attributed to N Stasche.

At least 19 recordsLinked to original sources

[Clinical experience with the hygienic reprocessing of rigid endoscopes lacking a working channel with reference to practicability in clinical routine].

BACKGROUND: Contaminated medical products may be vectors for infections. A safe disinfection method for the optical instruments used by ENT specialists is undoubtedly needed. So far, a standard method that sufficiently covers the risk of infection for patients and medical staff alike, while serving the need of practicability in daily routine, has not been established. PATIENTS AND METHODS: In the ENT departments of the Mannheim and Kaiserslautern hospitals, a study on the practicability of disinfection rigid optical instruments lacking working channels was conducted using cleaning and disinfection automats. A total of 735 patients were examined (Hopkins 30 degrees and 70 degrees) and the endoscopes subsequently sterilized using a cleaning and disinfection automat. RESULTS: Each cleaning cycle took about 40 min. Examining 70-100 patients a day, a minimum of eight 70 degrees Hopkins endoscopes would be needed. CONCLUSION: The sterilization of medical products such as endoscopes is the best practice, but certain hindrances, such as loss of time and costs involved, complicate its general application.

Endoscopes, Gastrointestinal↗

[Extramedullary manifestation of plasmocytoma in ENT].

Plasmocytomas are non-Hodgkin's tumors which occur with an incidence of 4/100,000. Malignant plasma cells in bone marrow produce monoclonal antibodies which are typically found in urine and blood samples. In rare instances plasmocytoma occur exclusively in extramedullary locations preferring head and neck region. We report about two patients with extramedullary plasmocytoma, one of them with an extremely rare triple manifestation in the upper airway.

Adult↗

[Therapy for sleep-related breathing disorders using positive airway pressure. Data from an HNO sleep laboratory].

BACKGROUND: Computer-assisted cardiopulmonary polysomnography is generally required to differentiate common snoring from serious sleep-related breathing disorders (SRBD) such as sleep apnea. METHODS: This study investigates data from 2,683 diagnostic and therapeutic cardiopulmonary polysomnographies of 1,087 patients over the period 2003-2004. Indications and efficacy of therapy using positive airway pressure (PAP) in SRBD are analyzed as well as alternative procedures. RESULTS: Of the 1,087 patients, 260 (23.9%) needed PAP therapy. In 61% of the patients CPAP-therapy was applied, 19% needed Bi-PAP-ST and 10% Bi-PAP-S-therapy. A total of 91 patients (8.4%) were treated with alternative procedures, partially combined with positive airway pressure. In 760 patients (69.9%) PAP-therapy was controlled or SRBD was excluded. CONCLUSION: There are no generally accepted guidelines for the therapy of SRBD. Indications for conservative and/or surgical procedures in the treatment have to be determined individually, depending on polysomnographic findings, subjective discomfort and physical comorbidities of the patients.

Adolescent↗

[IMOLA -- a new larynx model for surgical training. Education in transoral laser microsurgery of the upper airways].

BACKGROUND: Education in laser microsurgery is generally acquired under the supervision of an experienced surgeon. During training phases, however, increased complication rates may occur. Viable models for training are therefore important. METHODS: Larynx models should be anatomically accurate in size, form and texture, and be able to simulate normal as well as pathological findings. RESULTS: The main component is gelatin. Elasticity and thermal qualities can be modified by additives. We have been able to develop a synthetic larynx model for CO(2)-laser surgery that closely resembles the physical and tactile qualities of human tissue. Further modification of the material produced cutting characteristics for CO(2)-laser similar to human tissue. CONCLUSION: The new larynx model allows the simulation of typical surgical situations. Surgeons in training can practice even difficult surgical procedures at low costs and without putting patients at risk, before carrying out the procedure on patients.

Biomimetics↗

[Diagnostic and therapeutic endoscopy in ENT. Possibilities and limits].

Both flexible and rigid endoscopy have become very common in ENT in the last decade. This has led to an increase in the diagnostic and therapeutic spectrum, and, in particular, quality control. Because the purchasing price of optical systems, as well as their maintenance, can be quite expensive, the expected spectrum of applications should be taken into account in choosing endoscopic equipment. This review provides aid in choosing the right system without defining legally binding parameters.

Endoscopes↗

[Peripheral giant cell reparative granuloma in the area of the nose floor. A review of current literature with a case report].

The following report reviews the rare case of a peripheral giant cell reparative granuloma of the nose. Complete surgical removal of the tumor by midfacial degloving took place after histologic examination. Taking current literature into consideration, the clinical and histopathologic features, diagnostic procedures, including differential diagnostic considerations, and adequate therapy are discussed.

Airway Obstruction↗

[Cardiotoxicity of 5-fluorouracil. Clinical relevance of palliative radiochemotherapy of malignant head-neck tumors].

BACKGROUND: In the past cardiotoxicity has been increasingly reported as 5-fluorouracil is widely used as well in curative adjuvant as in palliative chemotherapy of malignant neoplasms. METHODS: We report on two cases of 5-fluorouracil-associated cardiotoxicity on palliative treatment of head and neck cancer and evaluate the importance of intensive drug monitoring. RESULTS: 5-fluorouracil-associated cardiotoxicity occurs with an incidence of 1.1-4.5%. Ischaemic cardiopathy due to vasospasms is believed to be the most common manifestation. CONCLUSIONS: Since most patients with head and neck cancer have risk factors for cardiovascular disease, 5-fluorouracil-associated cardiotoxicity should not be underestimated and patients should be monitored carefully.

Antineoplastic Combined Chemotherapy Protocols↗

[Pilot study of disinfection of optical instruments in otorhinolaryngology].

There is undoubtedly a need for a safe disinfection method of optical instruments used by ENT specialists. So far, a standard method that sufficiently covers the risk of infection for patients and medical staff alike while serving the need of practicability in daily routine has not been established. Therefore, in the ENT departments of the hospitals of Mannheim, Kaiserslautern, and Tübingen, studies on the disinfection of rigid optical instruments without working channel were performed between February 1999 and May 1999. Instruments were wiped either with an aldehyde or alcohol (ethanol 80%) and germs were detected by quantitative swab cultures. As discussed in the article, disinfection with ethanol proved to be at least equally efficient if not better than disinfection with aldehyde. Therefore, it fully serves the requirements of a safe method for disinfecting optical instruments without working channels.

Aldehydes↗

[Digital image archiving--concept of digital image and video documentation in ENT. A contribution to quality assurance].

BACKGROUND: Currently normal or pathologic conditions are documental by color slides, photos or videotape. However, it is more difficult to manage large numbers of images and to recall specific pictures or videos at any time. Digital record archives may be a solution for this problem. MATERIAL AND METHODS: We present a digital video and photographic archive that controls documents with a picture archive software designed for use in ENT examination units. RESULTS: Working on this digital unit we have developed a software program that allows the creation and administration of digital pictures and videos using only one program. To avoid mistakes manual recording of data was reduced to a minimum. Filing is done automatically and similar results can be found via self-explained criteria. Due to the pro-user computer software, less trained persons are not afraid to use the system. Hence, the number of documented diagnoses has increased. Present experience shows that material and videos make it easier to work with patients and clinical confidence is increased. Additionally, the physician is protected indirectly. When many persons work with one system, digital photographic archives increase the clinician's ability to refind documents, even after a period of years. The need for quality assurance in medicine will help find more use for a digital archive in ENT.

Computer Systems↗

[Laryngospasm].

Explore the source record for details and available documents.

Botulinum Toxins, Type A↗

[Coincidence of isolated laryngeal sarcoidosis and laryngeal carcinoma].

Isolated sarcoidosis is quite rare, causing non-specific symptoms and possibly not diagnosed because of the large number of other entities with similar presentations. We report the problems of diagnosis of isolated laryngeal sarcoidosis following a localized carcinoma. A 66-year-old patient was seen in the Westpfalz ENT Department after a Le Roux-Robert fronto-latera laryngeal resection for a pT1a N0 M0 vocal cord carcinoma following progressue dyspnea. Laryngoscopy showed laryngeal stenosis due to a neoplastic lesion. However, an epitheloid granulomatosis was found on histopathology with no evidence for recurrent carcinoma. After exclusion of other processes and systemic disease, the diagnosis of isolated laryngeal sarcoidosis was made and long-term corticoid medication was administered, resulting in a rapid regression of the laryngeal stenosis.

Aged↗

[Tracheobronchoscopy and esophagoscopy in otorhinolaryngology. An assessment of current status].

Its is the task of each medical specialty to develop guidelines for diagnosis and therapies. Examinations done by several specialties should follow a common consensus. A randomized survey at 70 German ENT departments investigated the current position of tracheobronchoscopy and esophagoscopy at each institution. Sixty questionnaires were evaluable. Altogether 8,295 tracheobronchoscopies and 10,404 esophagoscopies were performed. Thirty-six percent of all tracheobronchoscopies and 6% of all esophagoscopies were done with a flexible system. Approximately 58% of all tracheobronchoscopies and 55% of all esophagoscopies were performed for tumor staging. Complications during tracheobronchoscopy occurred in 0.8% of cases and in 0.58% of the esophagoscopies. Using these data an interdisciplinary quality assurance concept was developed for tracheobronchoscopy and esophagoscopy. Current experience has shown that a otolaryngologists in Germany mainly perform rigid tracheobronchoscopy and esophagoscopy. Although endoscopy is mostly done in cases with varied anatomic structures, complications are very rare and comparable to flexible techniques. Greater experience with flexible systems also is to be encouraged in ENT departments.

Bronchoscopes↗