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Biomedical subjects

R Grossenbacher

Publications and source records attributed to R Grossenbacher.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Results of a prospective open study of therapy of sudden deafness with flunarizine].

The treatment effect of the lipophilic calcium antagonist flunarizine on the recovery of sudden hearing loss was evaluated in a prospective phase-II study. Thirty-seven patients presenting with recent and sudden onset of unilateral sensorineural hearing loss were treated with 50 mg flunarizine intravenously for the first two days followed by 10 mg flunarizine orally for four weeks. Pure-tone audiometry was done before the beginning of the treatment and after one and four weeks. The absolute and relative hearing gains after one and four weeks were compared to those of 67 similar patients previously treated with saline infusions and placebo tablets in the same institutions during a double blind study (Probst et al. Acta Otolaryngol. 112 (1992) 435-443). The mean absolute hearing gains of the flunarizine group was 17 dB and 21 dB, after one and four weeks respectively (placebo group: 16 dB and 24 dB). The corresponding relative hearing gains (defined as absolute gain divided by initial hearing loss) were 35% and 43% for the flunarizine group and 33% and 42% for the placebo group. We conclude that flunarizine treatment does not improve the recovery of sudden hearing loss.

Administration, Oral↗
PubMed1992

[Biopsy of the temporal artery in polymyalgia rheumatica].

Biopsy of the temporal artery is still the most important component in the diagnosis of polymyalgia rheumatica and giant cell arteritis. Although this is a minor surgical intervention, certain vascular complications must be considered. Therefore, preoperative Doppler sonography should be performed. Finally, to prevent false-negative results, the temporal artery should be excised bilaterally and not shorter than 4 cm.

Aged↗
PubMed1992

Laser surgery in the oral cavity.

As a cutting instrument, the CO 2 laser is the most suitable type of laser currently available for medical applications. It has proved particularly advantageous in surgery of the upper aerodigestive tract, as its energy-absorbing properties, which do not depend on dyes, allow its effect in tissue to be controlled accurately. Additionally, the slight degree of postoperative edema is invaluable, especially in the region of the upper respiratory passages.

Adolescent↗
PubMed1992

[Clinical aspects and therapy of skin malignancies in the head and neck area].

A retrospective study of 199 surgically treated skin carcinomas showed that the majority of the insufficiently resected tumors had a maximum diameter of 10 mm. A surgical concept is presented which allows reliable histological control of the tumor margins and an exact resection of any residual carcinoma. This therapeutic approach is also indicated in the management of small skin malignancies.

Biopsy↗
PubMed1991

Correlative histological and ultrastructural study of unusual changes in human tracheobronchial epithelium.

In tracheostomy patients with chronic bronchitis, scanning electron microscopy reveals detailed surface changes in the tracheobronchial mucosa. The principle of intermicroscopic correlation, i.e., the sequential examination of a specimen by different microscopic procedures, is illustrated with giant cilia. After re-embedding the scanning electron microscopic specimens and precisely locating a ciliary convolution by light microscopy in semithin section, the giant cilia were studied in ultrathin sections by transmission electron microscopy. The cilia were shown to be at least 9 microns long (normal ciliary length = 4-6 microns). Central and peripheral microtubular axonemal structures with a 9 + 2 arrangement were clearly shown in both longitudinal and cross section. Giant cilia, thus, most closely resemble outgrowths of normal cilia. If they are motile at all, they seem unlikely to effect a transport function coordinated in direction and time.

Bronchi↗
PubMed1990

Resection of palatal tumours with the CO2 laser.

On the basis of the authors' experience with 20 patients, CO2 laser resection of palatal tumours has proved to be a good alternative to conventional surgical resection. The CO2 laser beam permits precise resection, due to only slight intra-operative bleeding coupled with use of the operating microscope. Wound healing is good and post-operative pain remarkably little.

Adolescent↗
PubMed1989

Cholesterol granuloma of the paranasal sinuses.

Cholesterol granulomata of the middle ear occasionally accompany chronic middle-ear diseases with diminished ventilation. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature. Disordered ventilation and impaired drainage are decisive pathogenic factors in the causation of cholesterol granuloma. Views remain divided on the source of the cholesterol and on the importance of bleeding in the development of cholesterol granuloma. Two patients with a cholesterol granuloma of the frontal sinus are presented and discussed.

Adult↗
PubMed1989

[The value of endoscopic CO2 laser surgery in subglottic stenoses].

There are two basic approaches in the management of subglottic stenosis, namely, the endoscopic and the external approach. The possibilities and limitations of the endoscopic approach using the CO2 laser are presented. Success can be anticipated only in carefully selected cases with relatively circumscribed stenosis, if the so-called submucous resection with micro-trapdoor flap technique is employed.

Adolescent↗
PubMed1988

Effects of tracheostomy on human tracheobronchial mucosa: a scanning electron microscopic study.

The protective functions missing in the upper airways of tracheostomy patients lead to functional and morphological changes in the lower respiratory tract. To obtain detailed data from the surface of the tracheobronchial mucosa, a scanning electron microscopic study was performed. Mucosal biopsies were taken from different sites of the tracheobronchial tree in 5 healthy control subjects, 5 patients with tracheostomy after laryngectomy, and 5 tracheostomy patients not affected by a history of smoking. Following scanning electron microscopic examination, the specimens were evaluated morphometrically. The percentage ciliary border and the individual mucosal surface changes depended on the biopsy site and the degree of previous damage. Individual structural alterations consisted of squamous metaplasia, giant cilia, compound cilia, and microplicae. Giant cilia represented an impressive form of differentiation in chronic bronchitis recognizable by scanning electron microscopy.

Bronchi↗
PubMed1988

[Mastoid brain herniation following a cholesteatoma operation].

In the pre-antibiotic era a herniation of brain tissue into the mastoid was a fairly frequent event following the transmastoid drainage of brain abscesses. Since the introduction of antibiotics and refinement of operative techniques a brain hernia into the mastoid has nowadays become very rare. Two almost identical cases of brain hernia in a radical mastoidectomy cavity were recently observed by the author. The surgical management is presented and the literature discussed.

Adult↗
PubMed1988

[Condition of the tracheobronchial mucous membrane in patients with long-term tracheostomy. A scanning electron microscopy study].

In patients with tracheostomy and lacking or non-patent larynx the nose has no longer any climatic function for the lower airways. The comparison of mucosal alterations in the tracheobronchial tree of 5 laryngectomized patients, 5 tracheostomized patients without chronic bronchitis prior to the operation, and 5 otherwise healthy persons, who served as a control group, allows conclusions on the protective function of the intact upper airways. The specimens obtained from the right upper lobe bronchus, the main carina, the middle third of the trachea and below the stoma are examined by means of a scanning electron microscope (SEM). The percentage of the ciliated components of the epithelium is evaluated with a semi-automatically functioning image analyser. In healthy subjects the ciliated cells are clearly reduced close to the main carina. After laryngectomy a reduction of cilia along the entire tracheobronchial tree is observed, whereas at the main carina they are more or less lacking. In patients without preexisting chronic bronchitis the ciliary carpet is also almost totally absent near the carina and the stoma, while it is qualitatively better in the right upper lobe bronchus and the middle trachea. The method presented here, with evaluation of the distribution and ciliary surface morphology, allows quantification of the tracheobronchial mucosal condition under various anatomical and clinical circumstances. If the protective function of the upper airways is missing, the alterations of the tracheobronchial mucosa depend on the extent of the preexisting damage and on the level where the specimen is taken.

Adolescent↗
PubMed1987

[Polyposis of the nasal cavity and sinuses].

In spite of many recent advances in basic science, the etiology and pathogenesis of nasal and paranasal polyps have still not been clarified. Well defined causal factors are hereditary diseases such as cystic fibrosis and primary ciliary dyskinesia. Allergic and non-allergic processes of the airways, particularly intrinsic asthma and intolerance to non-steroidal antiinflammatory drugs (NSAID), are implicated in the development of nasal polyposis. Histopathological studies of polyp tissue do not allow etiologic or prognostic conclusions, but are indispensable for the classification of structures involving clinical signs similar to nasal polyps. Causal antiallergic therapy is confined to the rare cases with an evident clinically relevant nasal allergy. Topical corticosteroids are effective in the treatment of nasal polyposis, but in extensive and obstructive polyps surgery is required. In severe polyposis of the ethmoid sinus endoscopically controlled endonasal ethmoidectomy is the surgical treatment of choice.

Ethmoid Sinus↗
PubMed1987

A randomized study of methotrexate, bleomycin, hydroxyurea with versus without cisplatin in patients with previously untreated and recurrent squamous cell carcinoma of the head and neck.

The value of a combination of methotrexate, bleomycin and hydroxyurea with vs. without cisplatin was randomly examined in 62 evaluable patients with previously untreated (44 patients) and recurrent (18 patients) squamous cell carcinoma of the head and neck. Methotrexate (30 mg/m2) and bleomycin (15 mg) were given intravenously weekly, hydroxyurea (1000 mg/m2) per os 3 times per week for 4 weeks. Cisplatin (60 mg/m2) was added on Day 1 every month. A higher overall response rate was observed with the cisplatin-containing regimen (66%, included 17% complete) as compared with 27% (3% complete) with the 3-drug combination (P value 0.0025). The cisplatin-containing regimen was more active in both previously untreated patient group and in the group recurrent patients. Toxicity was more pronounced in the cisplatin regimen and necessitated frequently reduced drug dosages. No survival difference was observed between the treatment groups. Median survival in previously untreated patients was 16.2 months and 7.2 months in patients who failed conventional local treatment. It is concluded that a cisplatin-containing regimen is more effective in advanced head and neck carcinoma than the same combination without cisplatin.

Adult↗
PubMed1987

[Surgical therapy of severe carotid sinus syndrome].

A 76 year old female, suffering from a severe carotid sinus syndrome, is presented. Conventional therapeutic measures with medication, radiation and implantation of a pacemaker did not influence her syncopal attacks. She sustained several syncopes daily and was forced to almost permanent bedrest. Only with an operative procedure, consisting of bilateral microsurgical carotid sinus denervation, the patient could finally be relieved from her syncopal attacks.

Aged↗
PubMed1986

[Difficult intubation due to an unusual anomaly of the larynx].

A patient, scheduled for an ophthalmic operation could not be intubated in spite of various different attempts. The cause of the difficulties was a cartilagineous thickening of the right ary-epiglottic fold, which was lying like a second epiglottis over the entry of the glottis. The importance of ventilation-management by mask and close cooperation with a laryngologist is stressed.

Aged↗