Biomedical subjects

Rudolf Häusler

Publications and source records attributed to Rudolf Häusler.

8 recordsLinked to original sources

PubMed2003

Carcinoma of the parotid gland.

BACKGROUND: The low incidence and heterogeneity of histiotypes of primary parotid carcinomas makes these tumors histologically and epidemiologically difficult to evaluate. The present study reviews a single institution's experience in the treatment of primary parotid carcinomas during the last 10 years. METHODS: The charts of 98 consecutive patients who had a primary parotid carcinoma and who received primary curative treatment were analyzed retrospectively. The tumors were grouped into high-grade and low-grade malignancies. The effect of treatment modalities on locoregional control, the incidence of locoregional recurrences and distant metastases, and survival rates are evaluated and compared between high- and low-grade malignancies. RESULTS: High- and low-grade malignant tumors were observed in 50 and 48 cases, respectively. Lymph node metastases were detected in 25 of 98 (25%) patients, of whom 8 of 22 (22%) clinically NO staged patients underwent elective neck dissection. In 24 of 26 resected facial nerves, a histologic tumor infiltration was confirmed, in 14 high-grade and 10 low-grade tumors. Local recurrence developed in 13 patients and was associated in 7 with high-grade and in 6 with low-grade tumors. All but 1 of the low-grade malignancies with local recurrence did not receive postoperative irradiation. Regional recurrence developed in 11 patients and distant metastases developed in 10, 3 in combination with a neck recurrence and 1 with a local recurrence. The survival rate at 5 years for low- and high-grade carcinomas was 87% and 56% and the disease-free survival rate 72% and 48%, respectively. CONCLUSIONS: The incidence of occult metastases in clinically N0-elective neck dissection was 22%. A routine elective neck dissection in all N0 parotid carcinomas is suggested. There is no statistically significant difference between low- and high-grade tumors as for the rate of local recurrence and, as all except one of the low-grade malignancies with local recurrence did not receive postoperative irradiation, postoperative irradiation is not only suggested for high-grade carcinomas but also for T2 to T4 low-grade carcinomas.

Adolescent↗

PubMed2003

Acute peripheral vestibular deficits after whiplash injuries.

We report 3 patients who had acute peripheral vestibular dysfunction minutes to hours after a car collision with whiplash injury without head trauma. The accident was a frontal collision in 1 case, a rear impact in the second, and lateral in the third. All patients complained immediately of cervicalgia, headache, acute vertigo with a sensation of erroneous body movements, and slipping of image with head movements. A sudden sensation of tilting of the environment when driving, tinnitus, and hyperacusis were also described. The otoneurologic findings showed bilateral canalolithiasis in 1 patient and an acute peripheral vestibular deficit in 2 patients. Tilt of the subjective visual vertical was measured in all patients. Cerebral magnetic resonance imaging yielded normal findings. As angular and linear accelerometers, the vestibular organs are directly exposed to high forces generated by whiplash mechanisms. Vertigo generated by peripheral vestibular lesions is probably underestimated in whiplash injuries and may often be incorrectly attributed to cervical or cerebral lesions.

Accidents, Traffic↗

PubMed2003

Scuba diving with cochlear implants.

We report on a patient with bilateral cochlear implants (a Med-El Combi40 and a Med-El Combi40+), as well as considerable experience in scuba diving with both of his implants. After having been exposed to 68 and 89 dives, respectively, in depths of up to 43 m, both cochlear implants are in working order and the patient continues to receive excellent speech recognition scores with both cochlear implant systems. The presented data show that scuba diving after cochlear implantation is possible over a considerable number of dives without any major negative impact on the implants.

Cochlear Implants↗

PubMed2003

Valuable use of computer-aided surgery in congenital bony aural atresia.

Congenital aural atresia repair is difficult owing to unpredictable anatomy. Benefits may be gained from computer-aided surgery (CAS), but its exact role has yet to be clearly defined. This is a retrospective study of 18 patients with bony type C (Schuknecht classification) congenital atresia. In the first group (n = 9), repair was performed with CAS while in the second group (n = 9), similar intervention was applied without CAS. Intra- and post-operative clinical and audiological findings were compared. CAS computed tomography (CT) images correlated well with intra-operative findings giving the surgeon more security and reducing operative time by 25 minutes. In our estimation, CAS is valuable for type C congenital aural atresia repair. It serves as an educational tool and as a guide for the experienced surgeon in critical situations where anatomical landmarks are distorted and where access is limited.

Abnormalities, Multiple↗

PubMed2002

Electromagnetic interference of bone-anchored hearing aids by cellular phones revisited.

The electromagnetic interference of the recently introduced bone-anchored hearing aid (BAHA) model "BAHA Compact" by digital cellular phones is investigated and compared with that of the older "BAHA Classic 300" model. Measurements with two different digital cellular phones in a laboratory setting indicated that the noise level due to electromagnetic interference was at least 10 dB lower for the BAHA Compact device than for the BAHA Classic 300. To compare the experience of patients using the BAHA Compact with those using a BAHA Classic 300 in an earlier study, a survey was performed. Six users of a BAHA Compact who used digital cellular phones participated in the survey. Four patients did not hear any noise associated with the use of a digital cellular phone. Two patients reported hearing quiet sounds when they were on the telephone, but not when somebody else in the vicinity used a digital cellular phone. These findings confirm that the susceptibility to electromagnetic interference of the BAHA Compact device is low.

Cell Phone↗

PubMed2002

Menière's disease in the elderly.

OBJECTIVES: To assess the prevalence, presentation, treatment, and evolution of Menière's disease in elderly patients (> or = 65 yr old). STUDY DESIGN: Retrospective clinical study and case report. SETTING: A neuro-otology referral center at the university hospital in Bern, Switzerland, and a neurotologic practice in Geneva, Switzerland. PATIENTS: Patients were selected from the hospital clinic and otolaryngologic practice registers. Among 8423 neurotologic checkups performed between 1988 and 1998, 432 (5.1%) patients had definite Menière's disease and 66 (15.3%) of these patients were > or = 65 years old. INTERVENTION: The files of these 66 patients were analyzed. RESULTS: Menière's disease in the elderly had 2 modes of presentation: reactivation of longstanding Menière's disease (40.9%) and de novo Menière's disease (59.1%), where the first dizzy spells, tinnitus, and hearing loss appeared after 65 years of age. Drop attacks occurred in 11.1 and 25.6% of the cases, respectively, and could be responsible for misdiagnosis of strokes of the brainstem. The patients were treated by mild antivertiginous drugs (betahistine, cinnarizine). Twenty-seven patients (41%) underwent surgery: transtympanic ventilation tubes (19 patients), sacculotomy (4 patients), vestibular neurectomy (3 patients), surgical labyrinthectomy (1 patient). The vertigo spells disappeared in 73.3 to 100% of the cases according to the type of surgery performed. CONCLUSION: Our study shows that Menière's disease in the elderly is not at all uncommon. It can appear as a de novo disease or as a reactivated longstanding disease. Drop attacks are more frequent than reported in general patient populations with Menière's disease and can mimic a stroke of the brainstem. Medical and surgical treatments have to be cautious because many of these elderly patients are fragile.

Aged↗

PubMed2002

Intra- and intersubject comparison of cochlear implant systems using the Esprit and the Tempo+ behind-the-ear speech processor.

A patient with bilateral profound deafness was implanted with a Nucleus CI24M cochlear implant (CI) and used an Esprit behind-the-ear (BTE) speech processor. Thirteen months later, the implant had to be removed because of a cholesteatoma. As the same electrode could not be reinserted, a Medel combi40s CI was implanted in the same ear, and the patient used a Tempo+ BTE processor. After 1 year of use of the Combi40s/Tempo+ system, speech recognition was better and was rated better subjectively than with the CI24M/Esprit system. Speech recognition and subjective ratings were also assessed for two matched groups of nine CI users each, using either an Esprit or a Tempo+ processor. On average, speech recognition scores were higher for the group of Tempo+ users, but the difference was not statistically significant. Users of the Esprit processors rated their device higher in terms of cosmetic appearance and comfort of wearing.

Acoustic Stimulation↗

PubMed2002

Present state and future perspectives of computer aided surgery in the field of ENT and skull base.

BACKGROUND: CAS technology has emerged in the last 10 years and is more and more used for surgery of the anterior and lateral skull base. Endoscopic and microscopic CAS systems are available. The endoscopic key hole or minimal invasive procedure is used increasingly not only for treatment of inflammatory disease, but also for tumour surgery. The integration of CAS systems into these procedures raises the level of their safety and efficiency. In addition, they allow the distance to the bone border on the CT slices to be previewed and measured. OBJECTIVE: Review of the present state of CAS systems, our own experience as a research centre and as users of the systems, demonstration of new navigational devices, microscope integration and a new registration procedure developed for the "Bernese" frameless optical navigation system (SurgiGATE ORL@1000, medivision, [Synthes, Stratec-medical], CH-4436 Oberdorf). MATERIAL AND METHODS: The optical CAS system with microscope integration (VM 900@1000, Möller-Wedel, Germany), new devices and new matching procedure; accuracy tests on a cadaver skull and on the patient's head. RESULTS: The practical accuracy on the cadaver skull with the pointer system has a mean average error of 0.79 mm, and the clinical accuracy is between 0.5 mm and 2 mm. CONCLUSION: CAS-microscope integration, new CAS technical devices and new noninvasive CAS-registration procedures support the surgeon in more minimally invasive surgical procedures of the paranasal sinuses and the skull base. Future perspectives will be discussed.

Humans↗