Biomedical subjects
Publications and source records attributed to T Brusis.
A 46-year-old patient is described who presented with a pea-sized painless tumor in the upper eyelid. Surgical excision and histologic diagnosis revealed a proliferating spindle cell tumor with an inflammatory reaction, which was identified as nodular fasciitis. Differential diagnosis, incidence of such tumors in the orbit and treatment are discussed.
Attempts to instil an antibiotic ointment into the right maxillary sinus led to the development of a granuloma of the lower eyelid and orbit and the tumour had to be resected. Retroposition of the rectus inferior muscle was carried out by the ophthalmologist to eradicate double images caused by scars. The injection of antibiotic ointments into the maxillary sinus is dangerous.
In view of the fact that objective methods as employed in the past have not been suitable in judging the clarity of speech of laryngectomised persons, a grading system has been developed based on analytical criteria of speech (sound, clarity of speech, fluency, articulation, modulation, number of syllables, secondary murmur). The degree of understanding is graded from one to five (very good to poor). Tests were performed with 69 oesophageal speakers. Young people seem to learn oesophageal speech better than elderly persons. Most authors agree that learning and quality of oesophageal speech depend on the age of the patient. For this reason, elderly laryngectomised patients should receive more intensive care, so that they may develop an oesophageal speech of superior intelligibility.
The number of severely disabled with official acknowledgement is nowadays estimated at over four million and is going to mount to six or seven million shortly. In the future that means an additional activity for the ENT-specialist concerning the medical opinion handling the law of severely disabled. In this study registration procedure, course of law and questions in giving the medical opinion (signs of old age, hearing impairment, disequilirium, neoplasm) are described. Also findings and results of 38 medical opinions for social courts are described.
The use of human biologic glue makes an optimal adaptation of the loosened superficial skin of the ear and an exact restoration of its profile possible. Traumatising mattrass suture can be avoided. An antibiotic therapy and a clinical treatment are unnecessary. In addition this study contains a tabulation of the up to now known indications for the use of human biologic glue in ENT.
The industrial noise-deafness is often combined with other hearing-impairments. For the "MdE" (reduction of work capacity)--assessment, the expert has not only to think about the pure medical differential diagnosis, but also about juridical relationships and the damage "before" and "afterwards". In this study definitions of the damage "before" and "afterwards" and principles for consideration of MdE-measurements are given. The opinion is represented, that the damage "before" is not only the disease, which existed before noise-exposition. But, the important date for judgement is the occurrence of the event insured. Questions about the over-all judgement for limitable and unlimitable forms of hearing-impairment are explained by examples from the experts experience.
In order to avoid multiple neuralgic complaints after operations of maxillary sinus the following advice for cautions operative procedures is as follows: 1. A vertical incision in the mucosa of the fossa canine behind the eye-tooth instead of the usual horizontal section. 2. A small dorsolateral fenestration in a part of less nervous ramification in the facial bone layer of the antrum of High-more. 3. The limitation of resection of the mucous membrane in pathological areas of the sinus. 450 operations of the maxillary sinus were done in this way, which resulted in a lower rate of postoperative neuralgic complaints. Another advantage was the minimized intraoperative bleeding and the absence of postoperative swelling and haematoma formation of the cheek.
The SISI-test has gained increased recognition during the past few years and can now be considered as the most important recruitment hearing test. In addition to the positive, negative and not determinable result there are frequent cases of incorrect negative interpretation. A "negative" SISI-test can be the result of insufficient or excessive hearing loss, missing adaptation, pathological threshold shift, aggravation, psychogenic deafness, cerebral sclerosis, imbecility etc. A negative result always requires additional audiometric differential-diagnosis.
The expertise appraisal of noise deafness takes a great amount of experience for granted, since faulty interpretations are very numerous. Considering possible errors and false interpretations the following points will be discussed: anamnesis-elevation, interpretation of noise-measurements, audiometric examination including aggravation, execution of conversational speech hearing examination and its possible sources of error, tone audiogram, language audiogram and SISI-test, the coupling of the degree of deafness and the MdE (reduction of work capability), overassessment and underestimation, consideration of tinnitus and recruitment, separation of war-connected and skull-traumatic hearing loss, the "retroactive clause", substantial worsening as well as re-examination dates. Furthermore, some examples of typical faulty medical opinions will be reported upon.
Prior to tonsillectomy 57 selected patients were given 1 g azidocillin i.v. in the form of a 10% aqueous solution. Serum samples were drawn at different times after the injection and both the serum and the tonsils were examined for azidocillin activity. The results of examination of 133 serum samples and 111 tonsils were evaluated, in addition to 74 paired values for tonsils and serum. Serum levels attained a maximum of 230 microng/ml and remained within measurable range for at least six hours. Tonsil levels reached a maximum of 17 microng/g and after three hours began to drop below measurable range. The quotient for distribution between tonsils and serum rose during the first hour to 20-25% (average approx. 10%) and was about 3-6% three to four hours after injection.
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This is a report about the new electro-acoustic speech-aid which can be worn unnoticed with a chain around the neck by laryngektomized patients. The battery and electronic parts of the apparatus is underneath the clothing. The hand must not be held on the level with the neck, compared to other apparatus, therefore the new apparatus allows to give a maximum convenience in movement. The use of the apparatus remains unnoticed, which is also an advantage.
For about a year postnasal space packing made of synthetic foam has been used. This fits the contours of the epipharynx, causes no mucosal damage and is better tolerated by the patient than the traditional packing. In 50 cases of postadenoidectomy bleeding, uncontrolled epistaxes and bleeding from epipharyngeal tumours we have been convinced of the usefulness of this synthetic foam.
Report of an unusual intubation in a patient who had had resection of maxilla and exenteration of the orbits. Because of a lock jaw the intubation had to be performed through the orbita.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.