Search PubMed⌕ Search

Biomedical subjects

T Verse

Publications and source records attributed to T Verse.

At least 19 recordsLinked to original sources
PubMed2006

Ultrasound-guided mechanical intraductal stone fragmentation and removal for sialolithiasis: a new technique.

BACKGROUND: Not all patients with sialolithiasis can be treated successfully by established minimally invasive techniques. METHODS: A forceps was used under sonographic control to fragment and retrieve salivary calculi in five cases refractory to established minimal invasive approaches. RESULTS: One patient with a sialolithiasis of the Stenon duct, two patients with a stone in the hilum region of the submandibular gland, and one patient with a sialolith in the sublingual gland were cured by this technique. For another patient, only a part of the stone in the hilum region of the submandibular gland could be removed. No relevant side effects occurred. CONCLUSIONS: To the authors' knowledge, this is the first report of a new, simple, and inexpensive minimally invasive technique that proved to be at least partially successful in the treatment of sialolithiasis in cases refractory to other therapies. The technique also seems to be suitable as a primary treatment approach.

Adult↗
PubMed2006

[Comparison of two application forms for isotonic sodium-chloride solution in postoperative sinus-surgery wound care].

BACKGROUND: The recommended postoperative care after sinus-surgery is based on gentle removal of crusts, the regular moistening of the endonasal mucosa, and the application of ointments. The efficacy and the compliance of two different methods of mucosal irrigation are described in a patients series. METHODS: In a randomised study 50 patients who had undergone endoscopic sinus-surgery, 24 patients using a nasal spray and 20 patients using manual irrigation were reviewed. The endonasal degree of obstruction was videotaped at four different locations (nasal floor, middle meatus, maxillary sinus ostium, ethmoidal system) on two different examinations. RESULTS: The only significantly reduced grade of obstruction was found in the ethmoidal system in the group using nasal spray. The results in the other locations showed no difference comparing both irrigation methods. The acception rate was higher in the group of nasal spray users. CONCLUSIONS: Nasal spray seems to be superior to manual irrigation in regard to postoperative wound conditioning, handling, and hygienic aspects.

Adolescent↗
PubMed2005

[Physiology, role and neuropharmacology of yawning].

Yawning is a physiological event that can be divided into three distinct phases: a long inspiratory phase, a brief acme and a rapid exspiration. The reason for yawning is not yet well defined. However this semi-voluntary event increases vigilance and aims to alert when drowsiness occurs. Yawning may have an important role for social communication. The neuropharmacology of yawning is complex and knowledge of its mechanisms is incomplete. While under the control of several neurotransmitters, yawning is largely affected by dopamine. Dopamine may activate oxytocin production in the paraventricular nucleus of the hypothalamus, oxytocin may then activate cholinergic neurotransmission in the hippocampus, and finally acetylcholine might induce yawning via the muscarinic receptors of the effectors. In fact, this scheme is simplified. Many other molecules can modulate yawning, such as nitric oxide, glutamate, GABA, serotonin, ACTH, MSH, sexual hormones and opium derivate peptides.

Acetylcholine↗
PubMed2004

[Dexpanthenol nasal spray in comparison to dexpanthenol nasal ointment. A prospective, randomised, open, cross-over study to compare nasal mucociliary clearance].

BACKGROUND: Recent technical developments in metered pump systems allow the production and use of preservative-free nasal products. The aim of the current study is to compare the tolerability of a preservative-free dexpanthenol (5%) nasal spray with that of the established dexpanthenol (5%) nasal ointment, also without preservatives. The main outcome measure was in vivo mucociliary clearance. METHOD: Mucociliary clearance was assessed by saccharin migration time in 20 volunteers. Wash-out phases were 7 days and the spray or ointment was always applied 20 min before the saccharin test. The study was designed to test for non-inferiority. RESULTS: Saccharin migration time was slightly longer after ointment administration, however, these were not significantly different to nasal spray. The saccharin migration time showed a significant correlation with the age of the volunteers. The upper confidence limit of dexpanthenol nasal spray was markedly less than that of the ointment. Therefore, dexpanthenol nasal spray is at least equal to if not better than dexpanthenol nasal ointment. CONCLUSIONS: Due to its ease of administration, preservative-free dexpanthenol nasal spray offers a valuable therapeutic alternative.

Adult↗
PubMed2004

[De rhoncho dormientium].

Obstructive sleep apnea (OSA) is a wide spread affliction that affects 4% of men and 2% of women in industrialised countries. Patients complain about disruptive snoring, daytime sleepiness and loss of intellectual power. OSA is associated with increased mortality. OSA has to be distinguished from simple snoring which is socially annoying but physically harmless. History taking, clinical examination, recording of daytime sleepiness, and cardio-respiratory sleep studies are necessary to make a proper diagnosis. In some cases more sophisticated studies are requested. Simple snoring does not harm the physical health. This indicates that the treatment itself may not harm the patient either. Therefore adjuvants or minimally invasive surgical techniques are favoured. The patients bedpartners should be involved to find the proper treatment for simple snorers. In sleep apneics the treatment focuses on the removal of the sleep related breathing disturbances and their health related consequences. Gold standard treatment of OSA is nasally applied continuous positive airway pressure (nCPAP). Unfortunately the longterm compliance of nCPAP is below 70%. Therefore, alternative treatment modalities are used. As conservative approaches oral appliances and conditioning (to avoid supine sleeping position) show promising results. Nasal appliances and transcutaneously performed electrostimulation have shown to be less effective. There are no drugs that have shown to be helpful in patients with sleep related breathing disorders. Surgical treatment complies with the severity of the disease and with the anatomical findings. A variety of surgical approaches to the soft palate, the base of tongue, the tonsils, and the upper and lower jaws have been described. Surgical success rates seem to decrease with increasing body weight and with increasing severity of OSA. Nasal surgery is mainly used to facilitate a necessary nCPAP therapy. Isolated nasal procedures show low impact on the severity of OSA. Modern sleep medicine is an interdisciplinary field which requires co-operation with different specialists in order to cope with our patients complaints.

Combined Modality Therapy↗
PubMed2004

[Multi-level surgery for obstructive sleep apnea. Preliminary objective results].

BACKGROUND: Nasal continuous positive airway pressure (nCPAP) ventilation is the gold standard in the treatment of obstructive sleep apnea (OSA). Unfortunately nCPAP does not exceed long-term compliance rates of much more than 60 percent. Therefore, surgical strategies are of growing interest in this field. Today, so called multi-level surgeries are favored which combine at least one surgical procedure on both the velopharyngeal and the retrolingual section of the upper airway. The Mannheim concept combines at least one surgical procedure to the soft palate (UPPP or Uvulaflap) inclusive tonsillectomy and a hyoid suspension and/or a radiofrequency procedure on the base of tongue. METHODS: In between July 2000 and February 2003, 139 patients with OSA were included in the protocol. By now 46 patients finished the follow-up. Mean age was 51.9 years, the mean body mass index was 28.5 kg m (- 2). All patients underwent as well preoperatively as postoperatively a fully attended polysomnography in the sleep lab using standard criteria. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). RESULTS: Before surgery the mean apnea-hypopnea-index (AHI) was 36.5 +/- 22.2, the mean ESS score was 10.4. Postoperatively the mean AHI decreased to 24.9 +/- 21.6 (p < 0.01) and the mean ESS score to 7.1 (p < 0.05). After surgery 39.1 % of the subjects were regarded as cured (reduction of AHI > or = 50 % and below 15). Another 30.4 % were substantially improved (reduction of AHI > 20 %). Altogether 69.6 % of the patients were counted as responders. Cure rates decreased with increasing AHI and BMI. The hyoid suspension showed a positive effect on the treatment success. CONCLUSIONS: The presented concept shows inferior success rates than other more invasive concepts. This might be due to the abandonment of the mandibular osteotomy with genioglossus advancement.

Adult↗
PubMed2003

[Submental transcutaneous electrical stimulation for obstructive sleep apnea].

BACKGROUND: Transcutaneous electrical stimulation while asleep has been used to treat obstructive sleep apnea (OSA), although without convincing results. Modern strategies consist of electrical muscle training for a number of weeks during wakefulness rather than stimulation during sleep. OBJECTIVE: The purpose of this study was to assess the practicability, safety, and efficacy of a new device, SilentOne (Imperpuls, Chemnitz, Germany). PATIENTS AND METHODS: Fifteen patients with various degrees of OSA used transcutaneous submental electrical stimulation therapy for 4-5 weeks every day, day and night. A patient's diary recorded practicability and potential adverse events. Respiratory parameters were recorded by fully attended polysomnography in the sleep lab. Daytime sleepiness and snoring were assessed by questionnaires. RESULTS: The apnea-hypopnea-index decreased from 29.2 before to 21.2 after therapy (P<0.05). Daytime sleepiness improved significantly (P<0.01) as did snoring (P<0.005). CONCLUSIONS. Transcutaneous electrical stimulation therapy using SilentOne proved to be safe, easy to use, and potent. However, therapy showed a limited cure rate.

Adult↗
PubMed2003

[Magnetic resonance imaging in the evaluation of temperature-controlled radiofrequency volumetric tissue reduction].

BACKGROUND: Due to its minimally invasive character, radiofrequency surgery has become a topic of increasing attention, especially with respect to the surgical treatment of sleep-related breathing disorders. Temperature-controlled radiofrequency volumetric tissue reduction is the most common technique employed in these cases. However, despite the increasingly widespread use of this technique, there is little data available on the induced effects in vivo. The aim of the present study was to investigate whether magnetic resonance imaging could be used in the evaluation of the in vivo effects of radiofrequency surgery at the base of the tongue. PATIENTS AND METHODS: Six patients were treated at the base of tongue with radiofrequency surgery. At 4-6, 8-10 and 24 h after surgery, magnetic resonance imaging was performed using an inversion recovery technique (TIRM) and the lesions created were evaluated. RESULTS: The lesions could be visualised at all postoperative measurement times. They appeared as oval hypointense structures encircled by a hyperintense area. Lesion size diminished slightly over time. DISCUSSION: Lesions induced by radiofrequency surgery can be clearly visualised with magnetic resonance imaging. Lesion size may be assessed in relation to energy application. In the future, the treatment of sleep-related breathing disorders may be further optimised with the help of this technique.

Adult↗
PubMed2003

[Treatment of obstructive sleep apnea with a new vest preventing the supine position].

BACKGROUND AND OBJECTIVE: Prevention of the supine position has for decades been a well known treatment option in positional obstructive sleep apnea. It was the aim of this study to test the efficacy of a recently patented commercially available supine position preventing vest. PATIENTS AND METHODS: The vest is made of linen tissue with a half cylindrical piece of hard foam in its dorsal part. 12 male patients slightly overweight (body mass index 26.5 +/- 2.6 kg/m(2)) and 55.8 +/- 11.6 years old were investigated polysomnographically prospectively. RESULTS: The pretherapeutical respiratory-disturbance index (RDI) was 26.7+/-11.9/h increasing to 39.3+/-16.1/h in the supine position. When using the vest, patients no longer slept on their back and the RDI dropped to 7.6 +/- 5.1/h (p < 0.005). Total sleep time at an oxygen saturation below 90 % was reduced from 11.7 +/- 11.3 % to 1.5 +/- 2.1 %. 9 patients (75 %) were cured (RDI < 10/h and RDI reduction > 50 %), 2 patients (17 %) improved (RDI reduction > 50 %) and only the oldest patient (76 years old) remained unchanged. Even though snoring decreased from 180 +/- 125 minutes to 110 +/- 52 minutes, an increase was observed in 30 % of the patients. Sleep quality and structure did not change considerably. CONCLUSION: The supine position prevention vest is a safe and simple treatment alternative of high efficacy in positional sleep apnea. As a complete remission cannot be predicted, polygraphic or polysomnographic controls are necessary.

Adult↗
PubMed2003

[The protective effect of dexpanthenol in nasal sprays. First results of cytotoxic and ciliary-toxic studies in vitro].

BACKGROUND: In Germany more than 60 million units of nasal decongestants are prescribed or sold over the counter. The cytotoxic and ciliary-toxic potential of alpha-sympathomimetic decongestants is well established. Furthermore, in many of the marketed products preservatives are added, predominantly benzalchonium-chloride, which can lead to a further alteration of cell- and ciliary function. Recently a protective effect of dexpanthenol was found for the human nasal mucosa. The objective of the present studies was to prove the hypothesis that dexpanthenol is able to neutralise the toxic effects of both alpha-sympathomimetic decongestants, in particular those of xylometazoline, and those of benzalconium-chloride. Therefore, systematic cytotoxic and ex vivo in vitro ciliary-toxic studies were performed. METHOD: After exposition to xylometazoline in concentrations of 0.1 % and 0.05 %, the influence of dexpanthenol (5 %) and benzalconium-chloride (0,01 %) was assessed by determination of a) cell growth of FL-cells of human amnion origin, and b) ciliary beat frequency of human nasal mucosa. All tests were performed placebo-controlled. RESULTS: Both hypotheses were confirmed. Dexpanthenol (5 %) reduces statistically significantly the concentration-dependent toxic effects of xylometazoline, and benzalchonium-cloride regarding cell growth and ciliary beat frequency (p < 0.001). The combination of xylometazoline with dexpanthenol, while benzalconium-chloride is eliminated, resulted in a further significant increase of cell growth and ciliary beat frequency (p < 0.001), similar to control. CONCLUSIONS: The additive application of dexpanthenol (5 %) with nasal decongestants and/or with preserved nasal sprays seems to be able to reduce the cell- and ciliary-toxic effects of these substances.

Administration, Intranasal↗
PubMed2001

Unusual neck mass in an adolescent: benign basal cell adenoma of the minor salivary glands of the piriform sinus.

With an incidence of less than 3%, salivary gland tumors are rare in the head and neck. The percentage of basal cell adenomas within the group of salivary gland tumors is even less (0.2-2%). Salivary gland tumors occur very rarely in adolescents. The basal cell adenoma commonly affects older persons and occurs most frequently in the major salivary glands. We present the unusual case of a benign basal cell adenoma of the minor salivary glands of the piriform sinus in a 14 year old male patient. Unusual are the age of the patient, the histological type, size and localisation of the tumor.

Adenoma↗
PubMed2001

[Current aspects on diagnosis of sleep-related breathing disorders].

Various diagnostic procedures are available to diagnose sleep-related breathing disorders. The present review examines the amount of diagnostics necessary for daily routine. Concerning taking patients' history, the medical examination and nasal parameters, no new recommendations derive from this review. On the other hand,the detection of the site of pharyngeal obstruction seems to have become less important than it was a couple of years ago.Today, the upper airway is considered to be a complex, functional unit. The classification of the obstruction site into retropalatal and retrolingual seems to be oversimplified. A fully attended, complete polysomnography in the sleep laboratory no longer seems to be necessary in every case of suspected sleep-related breathing disorders. Under certain conditions, ambulatory recording units provide cost-effective alternatives.

Humans↗
PubMed2001

[Postoperative management following rhinosurgery interventions in severe obstructive sleep apnea. A pilot study].

BACKGROUND: Patients with severe obstructive sleep apnea (OSA) treated by nasal continuous positive airway pressure (CPAP) often undergo rhinosurgery to improve nasal ventilation and comply with CPAP therapy. The use of nasal packing postoperatively may worsen the severity of their sleep-related breathing disorders, even leading to death. For this reason, postoperative surveillance with CPAP ventilation is recommended. An oral connection piece offers the possibility to continue CPAP therapy. PATIENTS AND METHOD: Five patients with OSA were enrolled in this pilot study. All patients underwent a septorhinoplasty with nasal packing for 2 days. CPAP ventilation was guaranteed postoperatively by using an oral connection piece. The object of the study was to evaluate the feasibility, effectiveness, and acceptance of CPAP ventilation with this oral connection piece in patients with nasal packing. Therefore, the blood oxygenation of the patients was observed by pulse oximetry pre- and postoperatively. RESULTS: None of the patients with nasal packing showed apneas or hypopneas with arterial blood oxygen saturation below 92%. Application of oxygen was not necessary. Cardiorespiratory or neurological complications were not observed. CONCLUSION: The oral connection piece offers a feasible and effective opportunity to continue CPAP ventilation therapy after rhinosurgery in patients with OSA. The acceptance of the method is satisfactory.

Adult↗
PubMed2001

New developments in the therapy of obstructive sleep apnea.

This review of the literature summarizes new trends in the diagnosis and treatment of obstructive sleep apnea (OSA) over the last 3 years. A literature search in Medline on 5 March 2000 using the keywords "OSA" and "OSAS" identified 123 papers. Another 86 articles were added from the references of the first 123 papers. New trends were observed concerning measurements of quality of life. There are new developments regarding conservative treatment, for example, nasal continuous positive airway pressure (nCPAP) therapy and oral devices. With regard to surgical treatment of OSA new surgical procedures, the radiofrequency technique, and the concept of multilevel surgery are discussed. After more than 25 years of interdisciplinary sleep medicine there still are some new developments of interest for ears, nose, and throat surgeons, which indicate the need for the involvement of otorhinolaryngologists in modern sleep medicine.

Electric Stimulation Therapy↗