Biomedical subjects

T Lenarz

Publications and source records attributed to T Lenarz.

At least 217 records · Page 12Linked to original sources

PubMed1986

Ofloxacin in oral chemotherapy of acute and chronic otitis media.

After ascertaining the bacterial spectrum in 210 patients with Otitis media acuta, Otitis media chronica mesotympanalis and Otitis media chronica epitympanalis, the clinical efficacy of oral therapy with ofloxacin in 40 patients from each of these groups was assessed. The clinical results are comparable with those following conventional local, oral and intravenous antibiotic therapy. The microbiological analysis of the ear secretions revealed Staphylococcus aureus, Streptococcus pyogenes and Haemophilus influenzae to be the main infectious agents of acute otitis media, whereas in chronic otitis media Pseudomonas aeruginosa and Proteus sp. could be detected in most of the cases. Ofloxacin levels of ear secretions, mucosa specimens of the middle ear and serum were measured in some patients by means of HPLC. In most cases, drug levels exceeded the MICs for the bacteria mentioned above. The correlation with the clinical results is discussed. On the basis of these preliminary results, ofloxacin can be considered as a highly efficient oral substance which is effective against S. aureus and P. aeruginosa, two important pathogens of middle ear infections.

Acute Disease↗

PubMed1986

Clinical evaluation of 40-Hz middle-latency responses in adults: frequency specific threshold estimation and suprathreshold amplitude characteristics.

40-Hz responses were evaluated for objective threshold estimation and frequency specificity at 500, 1,000, 2,000, and 4,000 Hz and compared to normal middle-latency response (MLR) recordings. Disturbing influences were examined. Stimulus-intensity-dependent amplitude characteristics were investigated. 30 adults with normal hearing and 45 with sensorineural hearing loss were included. On the whole, 40-Hz responses gave better threshold estimation than MLR as compared with pure-tone audiograms. In about 80%, deviation was less than 10 dB. For both the 40-Hz method and the MLR, myogenic potentials and changes in the level of vigilance are disturbing influences which cause amplitude variations. Amplitude-intensity functions can be described and their possible contribution to an objective identification of recruitment was examined. Additionally, an improvement of threshold estimation was achieved by narrow-band filtering of the response curve around 40 Hz.

Adult↗

PubMed1986

Treatment of tinnitus with lidocaine and tocainide.

The efficacy of lidocaine and tocainide in the rational treatment of tinnitus aurium was evaluated in a double-blind randomized cross over study against saline as placebo. Forty patients with severe long lasting (more than six months) tinnitus and sensorineural hearing loss were included in the study. In 24 patients treated with lidocaine (loading dose: 3 mg/kg body weight in 10 min; maintenance dose: 1 mg/kg in 20 min), in 19 patients treated with tocainide infusion (750 mg in 30 min), and 10 patients treated with tocainide orally (400 to 2,400 mg per day), tinnitus intensity was reduced by more than 50%, compared with placebo (designated as a positive result). In some patients, ABRs showed prolongation of interpeak latencies (IPLs) indicating a retrochlear site of drug action. This hypothesis is supported by our own animal experiments with lidocaine in rabbits. IPLs showed a dose dependent reversible prolongation without hearing loss.

Administration, Oral↗

PubMed1986

[Nuclear magnetic resonance tomography in the diagnosis of head and neck tumors. A comparison of methods].

36 patients with carcinomas of different ENT regions were investigated by means of MRI, CT and B-mode ultrasonography (US). The images were evaluated by parameters of clinical importance: tumour detectability marginal appearance, internal architecture, regional extension, and artifact degradation. The results were compared with the clinical tumour staging in accordance with the TNM system. In MRI, a multiplanar imaging of tumour extension with horizontal, frontal and sagittal sections is possible. Together with a good contrasting of the tumour against the surrounding structures, these are major advantages over CT in the imaging of carcinomas of the tonsils, the hypopharynx and the larynx. For both methods, tumours of the tongue base and the floor of the mouth are a real challenge. Lymph node metastases can be visualised with MRI, but US is the method of choice for the evaluation of cervical lymph nodes.

Carcinoma, Squamous Cell↗

PubMed1986

[Ultrasound diagnosis of benign and malignant parotid tumors].

The value of high resolution real time ultrasound imaging in the preoperative differential diagnosis of focal disease of the parotid gland was evaluated in 35 cases. After description of the ultrasound imaging of the normal gland, the majority of benign and malignant tumours are demonstrated. Ultrasound patterns allow a good differentiation of mixed tumours, warthin's tumours and carcinomas. Differential diagnosis between mixed tumours on the one hand, mucoepidermoid and serous cell adenomas on the other can be difficult or even impossible. This holds true for pathologic lymphomas, too, whereas cysts can be distinguished very well. On the whole, the differentiation between benign and malignant tumours was correct in 28 out of 35 cases. Furthermore, in 21 cases the ultrasound pattern was in accordance with the result of the histologic examination. Compared with sialography, needle biopsy and CT scanning, ultrasonography is a reliable, safe and noninvasive method of high value in preoperative examination of parotid tumours.

Adenolymphoma↗

PubMed1986

[Nuclear magnetic resonance tomography in the diagnosis of parotid tumors. A comparison of methods].

The diagnostic value and the limitations of magnetic resonance imaging (MRI) in the management of large parotid masses were evaluated in a prospective clinical study. The results were compared with computed tomography (CT) and B-mode ultrasonography (US). MRI was performed using a Siemens 1.5 Tesla Magnetom with a RF head coil and surface RF coils. The images were evaluated by the following parameters of clinical importance: tumour detectability and marginal appearance, internal architecture, regional extension, and artifact degradation. MR imaging of parotid masses was superior to CT and US for the following reasons. The marginal appearance of the tumour was sharp and further enhanced in T2 weighted pictures. The extension of the tumour can be well seen by use of transaxial and frontal projections. This is an advantage especially when the mass extends to the retromandibular fossa or even to the pterygopalatine fossa. The position of the jaw, external ear canal, mastoid, skull base, and vessels of the neck are clearly shown without artifact degradation. Benign neoplasms can be well differentiated from malignant tumours which show local infiltration into the adjacent anatomical structures as well as irregularities of their internal structure. However, their appearance in MRI can be identical to that of an acute inflammation of the parotid gland. In summary MRI is the imaging technique of choice for extensive parotid masses, whereas US is effective for small tumours not situated in the retromandibular fossa.

Humans↗

PubMed1986

[Experimental stapesplasty with the CO2 laser].

Perforation of the footplate in otosclerosis can be performed accurately, when the large and high energetic CO2 laser focus is reduced to 0.5 mm in diameter by an aluminium diaphragm. The operation was performed on three dogs. BAEPs were evoked by bone-conducted acoustic stimuli. Hearing threshold was unchanged immediately after operation as well as after 2 and 6 weeks postoperatively. The new method has still to be performed in man.

Animals↗

PubMed1986

[Hearing disorders in Paget's disease].

The audiometric data of 41 patients with Paget's disease of the bone show that hearing loss exceeds the age-related presbycusis in patients with deformities of the temporal bone as demonstrated by X-ray (27%). The usual type of hearing loss is a sensorineural one. 80% of these patients showed hair cell damage, 32% of them a retrocochlear lesion, depending on the degree of deformity of the temporal bone. Conductive hearing loss of the otosclerosis type was found in only 20%. The Paget-related hearing loss can be regarded as a consequence of the deformation occurring both at the bone surrounding the cochlea and at the internal auditory canal.

Acoustic Impedance Tests↗

PubMed1985

New concepts in the treatment of chronic recurrent parotitis.

The release of glandular kallikrein into the interstitium of the parotid gland appears to play an important role in the occurrence of the inflammatory interstitial edema in chronic recurrent parotitis. This provides fresh impetus for the treatment of this parotid disease with a kallikrein inhibitor. In our present study, seven patients with acute exacerbated chronic recurrent parotitis were treated with the kallikrein inhibitor aprotinin (Trasylol, Bayer AG, Leverkusen). With this therapy all patients were free of pain 12 h after the start of the therapy and most salivary gland function had returned to normal by 48 h after beginning treatment. Within this period of time, concomitant swelling of the affected parotid gland disappeared completely in five patients and resolved in the other two patients after 1 week.

Aprotinin↗

PubMed1985

Prognostic factors for postsurgical hearing and facial nerve function in cases of cerebellopontine angle-tumours. The meaning of brain stem evoked response audiometry (BERA).

Presurgical and postsurgical brain stem evoked response audiometry (BERA) examinations were done in patients with tumours of the posterior cranial fossa. A correlation exists between the extent of presurgical BERA-alterations and postsurgical hearing-power and facial nerve function. Small tumours (less than 1 cm) correlate generally with small BERA-alterations and show a good prognosis. Conservation of hearing in cases of larger tumours can only be expected when BERA-alterations are small. Prognosis is generally bad in cases of big tumours (greater than 3 cm). BERA-alterations on the contralateral side point to an additional brain stem compression which can normalize after surgery.

Audiometry↗

PubMed1985

[Antiarrhythmic agents in tinnitus treatment].

The treatment of tinnitus patients is a major problem in ENT. This depends on the fact that no objective parameter exists for this symptom. Therefore, every treatment schedule should meet the criteria of a rational tinnitus treatment. The value of lidocaine in the management of the tinnitus patient was assessed in a randomised blind-controlled cross-over trial. 20 patients with sensorineural hearing loss of different kinds and a well defined tinnitus were treated by an intravenous infusion of lidocaine. 13 patients reported a tinnitus suppression of more than 50 per cent, whereas there was no response with saline. These subjective changes were accompanied by BERA alterations such as a reversible lengthening of central conduction time without hearing impairment. The mechanism of action of lidocaine in tinnitus is discussed according to electrophysiological hypotheses.

Clinical Trials as Topic↗

PubMed1985

[Tinnitus therapy with lidocaine and tocainide].

A randomised clinical cross-over study was performed to evaluate the therapeutic value of lidocaine, tocainide infusion and oral application of tocainide against placebo in the treatment of tinnitus. 40 patients with sensory hearing loss of different origin and otherwise not treatable constant tinnitus were included. Lidocaine infusion showed a tinnitus suppression of more than 50 per cent in about 70 per cent of patients; in comparison, tocainide infusion in 55 per cent of the patients. Oral tocainide therapy was successful only in about 35 per cent of patients. This fact depends partially on the high proportion of side effects. Therefore, tocainide therapy should be used in such patients only, who suffer severely from their tinnitus. Patient selection can be done by the lidocaine test. Oral tocainide therapy is advisable only if the lidocaine test result is positive. The methodical problems in the assessment of the value of drugs in tinnitus treatment are discussed: Evaluation and elimination of placebo effects and spontaneous fluctuations of tinnitus intensity, as well as selection of patients included in the study.

Administration, Oral↗

PubMed1984

[Vascular loop. A contributing factor to vascular cerebellopontile syndrome].

Modern diagnostic methods such as brainstem-evoked response audiometry and CT scanning with positive and negative contrast enhancement represent a major advance in the diagnostic evaluation even of small acoustic neuromas. However difficulties arise in differentiation between tumours and other cerebellopontine angle lesions, as shown by means of a case report. An arterial loop of the anterior inferior cerebellar artery (AICA) between the facial and the eighth cranial nerve was the cause of progredient neural hearing loss, peripheral vestibular dysfunction and hemifacial spasm. Vascular decompression was performed with total relief of spasm and partial restitution of hearing. In differential diagnosis of the pathology of the cerebellopontine angle region and the internal auditory canal the clinical symptoms are important.

Cerebellopontine Angle↗

PubMed1984

[Cervically-induced symptoms of the Klippel-Feil syndrome].

Klippel-Feil syndrome is a congenital deformity disease caused by disturbances of the growing together of the mesenchymal preliminary vertebrae which are mostly located in the regions of the cervical spine and shoulder. Short neck and wryneck (torticollis), as well as limited motion of the neck and reduced mobility of the cervical spine, are the most striking findings on clinical examination. Vertigo, disturbed sound conduction and perception, as well as combined loss of hearing, tinnitus and paralysis of the facial nerve can occur although otoscopic findings may be normal. Differential diagnosis is effected by means of the typical x-ray film of the cervical spine and the vertebrobasilar transition. Functional anomalies of the vertebral arteries are determined via x-ray angiography. Neuro-otological syndromes can be explained by congenital deformities of the middle ear, cochlea, peripheral vestibular organs and internal auditory canal; mainly, however, by a "vascular" cervical syndrome, which, in this particular case, explains the cochlea symptoms. Vertigo and dizziness can also be caused by a pathological irritation of cervical proprioceptive sensory organs through deformities of the skeleton.

Audiometry, Pure-Tone↗

PubMed1984

[Glandular kallikrein in chronic recurrent parotitis].

Salivary kallikrein was measured in the parotid saliva of 11 patients suffering from chronic recurrent parotitis and 15 healthy control persons. While in the control group kallikrein levels from 1-4 U/l could be registrated, the results obtained from patients were significantly elevated and varied between 23,45 U/l and 89,41 U/l. Release of kallikrein from destroyed duct cells is suggested to be the origin of the elevated salivary levels of this enzyme in chronic recurrent parotitis. A leakage of glandular kallikrein into the interstitial fluid and thereby release of kallidin from kininogen is discussed as a possible mechanism in the development of this disease.

Adult↗

PubMed1984

[Kearns-Sayre syndrome from the otorhinolaryngologic viewpoint].

External ophthalmoplegia, retinal pigmentary degeneration and heart block constitute the trias of Kearns-Sayre's syndrome. The aetiology of this disorder of oxidative metabolism is unknown. This syndrome must be more frequent than described. In the ENT field there is an extensive lack of differentiated data. Central neural and peripheral hearing disorders and vestibular disorders are in fact significant, as are also dysphagia, hoarseness and dysarthria in consequence of central and peripheral disorders in muscular function. The authors report on ENT findings in 4 patients with verified Kearns-Sayre's syndrome. Progression of central disorders enhances an unfavourable prognosis. Histochemical, biochemical and electron microscopic data are still lacking for the proper grading and assessment of clinical findings.

Adolescent↗

PubMed1984

[Effect of membrane-effective drugs (anti-arrhythmia agents) on acoustically evoked brain-stem potentials].

Lidocaine, Mexiletine, Procainamide, and Phenytoin were administered intravenously to anaesthesized rabbits. BERA alterations showed two different patterns. If the intoxication dose was exceeded, amplitude depression, threshold elevation, desynchronization, and severe cumulative prolongation of all latencies and interpeak latencies appeared. Below this dose Lidocaine and Mexiletine induced a single, reversible, dose related, cumulative prolongation of all latencies and interpeak latencies. Procainamide induced counterrelated shiftings of interpeak latencies I-III and III-V, whereas Phenytoin showed no influence. One should, therefore, take into account these effects when BERA is used clinically, since otherwise serious errors can occur. On the other hand, there are diagnostic and therapeutic aspects for the tinnitus patient.

Animals↗

PubMed1983

[Neuro-otologic early symptoms of Camurati-Engelmann disease].

Camurati-Engelmann disease is a rare generalized progressive bone affection which causes combined hearing loss, facial palsy and vestibular dysfunction. Differential diagnosis against bone affections is possible because of typical x-ray findings, pseudo mixed hearing loss, myopathy and growth disorders.

Adult↗