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Biomedical subjects

U Fisch

Publications and source records attributed to U Fisch.

At least 127 records · Page 7Linked to original sources
PubMed1980

The transotic approach to resection of difficult acoustic tumors of the cerebellopontine angle.

The authors' experience with the transotic approach and permanent forward transposition of the facial nerve in resecting large acoustic tumors of the cerebellopontine angle in twelve patients is reported. Total removal was accomplished in all cases. A total facial nerve paralysis occurred in every case, with good return of function in all patients over a six-month postoperative period. The advantages and disadvantages of this technique are discussed. Two cases are reported in detail.

Adult↗
PubMed1980

Facial nerve reconstruction.

A retrospective study on 21 patients who had a reconstruction of their facial nerve was undertaken by means of a new photographic method of evaluation. The average of recuperation results was 62.38 per cent. Eighty-five per cent of the patients achieved a good or excellent evaluation. The only individual parameter that showed some influence on the outcome of the surgery was the length of the graft. Compared with a short graft (smaller than or equal to 1 cm), the long graft (larger than or equal to 1 cm) is associated with better results. Good and excellent results appeared available for patients whose pre-operative palsy had lasted from 18 to 36 months.

Adolescent↗
PubMed1979

Infratemporal fossa approach to lesions in the temporal bone and base of the skull.

An infratemporal fossa approach for extensive tumors of the temporal bone, clivus, and parasellar and parasphenoid regions features permanent anterior transposition of the facial nerve, resection of the mandibular condyle, and mobilization of the zygoma and lateral orbital rim. Obliteration of the pneumatic spaces of the temporal bone with permanent occlusion of the Eustachian tube and blindsack closure of the external auditory canal avoids the danger of postoperative infection and leads to primary wound healing in the shortest time. Three cases demonstrate selective utilization of the infratemporal fossa approach. Short-term results and complications were observed in 51 patients.

Adult↗
PubMed1979

Extratemporal facial nerve grafting and radiotherapy.

Nineteen patients with extratemporal facial nerve grafting procedures and 13 patients with facial hypoglossal anastomosis were followed up with serial photographs for at least one year. The photographic analysis of the results demonstrates that radiotherapy had a detrimental influence on the return of facial movements after extratemporal facial nerve grafting.

Cranial Nerves↗
PubMed1979

Glomus tumors of the temporal region: surgical therapy.

A series of 23 patients with glomus tumors of the temporal region, treated surgically at the ENT Department, University of Zurich, Switzerland from 1970 to 1977, is presented. A system of classification as to tumor size is described with tympanic, tympanomastoid, infralabyrinthine and intracranial tumors categorized as types A, B, C, and D respectively. A majority of tumors, 12 of 19 were infralabyrinthine (type C), and a surgical approach featuring permanent anterior displacement of the facial nerve, an cavity obliteration, has been employed with the aim of total tumor extirpation. There were five males in this series, with a mean age 22 years younger than for the females and all having infralabyrinthine (type C) tumors. The most frequent clinical presentation included pulsatile tinnitus, hearing loss, and observable tumor mass in the ear. Fifteen of 23 patients had significant hearing loss, of varying types on the tumor side, with one presenting as sudden hearing loss, and another as progressive unilateral sensorineural loss over several years, in the absence, initially, of tinnitus. Ten of 23 patients with type B, C, and D tumors had cranial nerve involvement, seven and tenth being the most frequent. Because of slow growth and tendency to multicentric origin, final conclusions cannot be made regarding treatment in such a recent series of cases. However, the impression gained suggests that radiotherapy is less effective than complete surgical excision, and that partial excision is to be avoided.

Adult↗
PubMed1979

[Long-term results of surgical therapy of hemifacial spasm and blepharospasm (author's transl)].

Between 1965 and 1976, 95 patients with hemifacial spasm and blepharospasm have been operated according to the method developed by Fisch at the ENT-Clinic of the University of Zurich. 69 of the patients were followed over an interval of 1 to 12 years. 80% of the patients with hemifacial spasm and 65% of the patients with blepharospasm were free of symptoms or significantly improved. These results remained unvaried over an observation period of 6 to 12 years. The motility of the face was preserved to a very high degree in spite of extensive resection of peripheral facial nerve branches.

Blepharospasm↗
PubMed1979

[Results from 215 patients with laryngeal carcinoma treated with sole radiotherapy or with a combination of radiotherapy and operation (author's transl)].

Results of radiotherapy alone or in combination with surgery in 215 patients with laryngeal cancer are reported (treatment time between 1963 and 1976). In patients with glottic cancer, the cure rate is about 80% and surgical treatment for persistent/recurrent cancer was necessary only in a few cases. Analysis of tumor dose, tumor control rate and complication rate shows that in cases with glottic cancer a tumor dose between 1900 and 2000 ret is necessary and tolerable. In patients with supraglottic laryngeal cancer, the cure rate is about 55%. Early stages (T1N0M0) were mostly treated by radiotherapy alone, moderately advanced stages (T1N1,T2N0+1) mostly received radiotherapy as a primary treatment and were operated in case of irradiation failure. Advanced stages were primarily treated by a combined therapy, and by radiotherapy alone if they were inoperable. In early cases, who are to be treated by radiotherapy alone, the tumor dose should be about 1900 ret. In moderate cases, treatment by primary irradiation alone is possible, if the patient can be followed up regularly; surgery is indicated, if the patient cannot unequivocally be classified as symptomless. In some of these cases, there is no tumor demonstrable histologically in the excised larynx. In using this treatment policy, there is a better functional treatment result than in using primary combined treatment in moderately advanced cases with supraglottic laryngeal cancer.

Adult↗
PubMed1979

[Surgical results of stapedectomy or stapedotomy (author's transl)].

468 stapes operations have been performed at the ENT-Department of the University of Zurich between 1970 and 1978. In one half of the cases, a total or partial removal of the footplate with introduction of a wire connective tissue prosthesis has been used. In the other half, the operation consisted in a limited fenestration of the footplate, which was large enough to accept a wire teflon piston of 0.6 mm diameter. Statistical analysis of the results of both methods shows a better bone conduction threshold for the speech frequencies (500, 1,000 and 2,000 Hz) as well as for air conduction at 4,000 cps after stapedotomy. Complete postoperative deafness occurred in one case following stapedectomy (0.3% of patients with primary operation). The advantages of stapedotomy over stapedectomy are the following: 1. Less trauma to the inner ear, 2. better stability of the position of the prosthesis and 3. better adaptation of the length of the prosthesis. The surgical steps used for stapedotomy are described.

Bone Conduction↗
PubMed1978

[Diagnosis and therapy of salivary gland tumors].

The diagnostic and therapeutic approach to tumors of the salivary glands is discussed on the basis of 327 cases of parotid gland tumors seen at the ENT Department of the University of Zurich between 1959 and 1976. In view of the slow growth rate of salivary gland tumors, history and clinical findings cannot be used to identify malignant neoplasms. The histological diagnosis is therefore the prerequisite for correct therapy. Diagnostic errors may result when the total tumor mass is not available for histological investigation. For this reason we advise "surgical biopsy" (total extirpation of the tumor) when a malignant tumor cannot be ruled out by aspiration biopsy or examination of frozen sections. Radical surgical removal plays the major role in the therapy of salivary gland tumors. Highly malignant neoplasms demand a combined oncological approach usually involving surgery and radiotherapy. Familiarity with the temporal bone is necessary for the complete removal of highly malignant tumors of the parotid gland, because of their frequent infiltration of the intratemporal portion of the facial nerve. The application of the modern principles of reconstructive surgery and of microsurgical techniques has widened the scope of radical surgery of salivary gland tumors and considerably reduced the subsequent morbidity.

Adolescent↗
PubMed1978

Infratemporal fossa approach to tumours of the temporal bone and base of the skull.

In spite of the development of a superior (middle cranial fossa) and posterior (translabyrinthine) approach to the temporal bone, tumours situated in the infralabyrinthine and apical compartments of the pyramid and surrounding base of the skull were still a challenge for neurosurgeons and otologists as well. The infratemporal fossa approach closes the existing gap in the surgical management of the most hidden lesions of the temporal bone. The approach features the permanent anterior transposition of the facial nerve, resection of the mandibular condyle and mobilization of the zygoma and lateral orbital rim. Obliteration of the pneumatic spaces of the temporal bone, with permanent occlusion of the Eustachian tube and blind sac closure of the external auditory canal, avoids the danger of post-operative infection and leads to primary wound healing in the shortest time. Three types of infratemporal fossa approach are presented and dicussed on the basis of 51 operated patients.

Adenoma, Chromophobe↗
PubMed1978

'Congenital' cholesteatomas of the supralabyrinthine region.

Twelve cases of congenital cholesteatomas developing in the region of the geniculate ganglion are presented. The diagnosis was made from a radiological sharp-cut erosion of bone found medial to the superior semicircular canal and superior to the internal auditory meatus in presence of progressive facial palsy. The main problems of the surgical treatment of the presented lesions were: 1 the presence of an unsuspected large fistula of the basal turn of the cochlea; 2 the necessity of resecting the superior semicircular canal in order to drain the supralabyrinthine region; and 3 extensive re-routeing and grafting of the facial nerve. The etiology of the presented cholesteatomas is discussed on the basis of the migratory theory and metaplasia of the first epibranchial placode.

Cholesteatoma↗
PubMed1978

[Reconstruction of the ossicular chain (author's transl)].

197 consecutive tympanoplasties involving reconstruction of the ossicular chain were analyzed. After a one-year followup, the interposition of a homologous ossicle between the mobile stapes and the long process of the malleus with intact anterior half of the drum has given a satisfactory result in 93% of the patients. Unsatisfactory results were obtained in 50% of those patients presenting with only the stapes or its footplate intact. Reasons for the failures were: graft lateralisation, fixation, atrophy or displacement of the homologous ossicle used. The twostage tympanoplasty with utilisation of John Shea's TORP prosthesis has considerably improved the hearing result achieved in the second category of patients. One has to await, however, long-term results in order to assess whether or not the TORP Plastipore prosthesis should be recommended in middle ear surgery.

Ear Ossicles↗
PubMed1978

[Laryngotracheal stenosis: results of surgery (author's transl)].

Between 1973 and 1977 seven adults and five children with severe larynx stenosis were operated upon successfully with a modification of Rhéti's technique. The main features of this new technique are: 1. The cricoid and the upper tracheal rings are split longitudinally in their anterior and posterior portion. 2. The stabilisation of the enlarged laryngeal lumen by the interposition of a piece of notched costal cartilage in the posterior wall of the split cricoid.

Adolescent↗
PubMed1978

[Vasoactive drugs and oxygen content in the perilymph (author's transl)].

The effect of different vasodilating drugs on the perilymphatic oxygen content in the cat has been examined by means of the polarographic method. The drugs used such as Papaverin, Rheomacrodex, Ronicol, Praxilen and Lasix have had no significant effect on the oxygen concentration in the perilymph. Histamin, 7% Na2CO3 and 50% glycerol have produced a diminution of the perilymphatic oxygen tension. Only angiotensin has produced a 20% rise of the oxygen pressure in the perilymph. This effect is, however, five times smaller than that reached by inhalation of 5% CO2 and 95% O2.

Angiotensin II↗