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Biomedical subjects

W Hosemann

Publications and source records attributed to W Hosemann.

At least 19 recordsLinked to original sources
PubMed2006

[Mondini dysplasia: traumatic cerebrospinal fluid otorrhea with meningitis].

Mondini dysplasia is a rare malformation of the inner ear commonly associated with loss of hearing and vestibular function. Children with Mondini dysplasia are predisposed to developing a spontaneous cerebrospinal fluid (CSF) leak and recurrent meningitis. If there is no CSF leak but a unilateral hearing loss, the condition may go undiagnosed for years. We describe a 65-year-old man with unrecognized unilateral Mondini dysplasia who presented with CSF leak and meningoencephalitis after minor head trauma. Two operative interventions were undertaken to close the defect properly. Patients with Mondini dysplasia or their parents should be cautioned about the potential hazards of any head trauma.

Aged↗
PubMed2006

[Fibrin gel for treatment of tympanic membrane perforations: an experimental animal model].

BACKGROUND: The goal of this study was to evaluate the effects of a fibrin gel on the healing of tympanic membrane perforation in rats. METHODS: Prolonged tympanic membrane perforations in 12 rats were created by application of mitomycin C to the intact tympanic membranes followed by bilateral myringotomy. Repeated applications of a fibrin gel to the perforation site of one tympanic membrane were performed in each animal. Tympanic membranes were observed for a total of 8 weeks. RESULTS: One perforation in each group was already patent at the end of the observation period. The mean healing period of the remaining tympanic membranes was found to be 16.7 days in the fibrin gel group and 19.6 days in the control group. CONCLUSION: A fibrin sheet does not seem to promote the wound healing process of tympanic membranes. However, the sheet might serve as a drug-delivery system for growth factors in the treatment of tympanic membrane perforations, because of its biocompatibility.

Animals↗
PubMed2005

[Traumatic tympanic membrane perforactions. Local application of an alginate matrix loaded with epidermal growth factor in an animal model].

BACKGROUND: The aim of this study was to evaluate the effects of an alginate matrix releasing epidermal growth factor on healing after acute tympanic membrane perforation in rats. METHOD: A total of 20 male rats were divided into two groups. In each animal, a randomly chosen tympanic membrane was perforated by heat. A piece of alginate matrix (control group) or alginate matrix loaded with 0.25 microg epidermal growth factor (EGF group) was then placed on the perforation. The rat ears were examined after days 3, 6, 9, and 14 and every week thereafter for a total of 11 weeks. Each matrix was removed on day 9. To examine the status of the tympanic membranes on day 14, one randomly chosen membrane from each group was histopathologically examined. RESULTS: By day 6, complete closure of the tympanic membrane perforation was achieved in 56% of the EGF group, whereas it was achieved in only 10% in the control group. By day 14, all tympanic membrane perforations were closed in both groups. There were no complications and no significant differences in the histopathologic parameters between the EGF group and the control group. CONCLUSION: An alginate matrix seems to be a useful EGF-delivery system to the tympanic membrane.

Administration, Topical↗
PubMed2005

[Systemic corticoid application in combination with topical mitomycin or dexamethasone. Inhibition of wound healing after tympanic membrane perforation].

BACKGROUND: The purpose of this study was to determine whether systemic glucocorticoid application, in combination with topical mitomycin or dexamethasone, prolongs the patency of a tympanic membrane perforation. METHOD: Bilateral myringotomies were performed on 24 rats. The 48 ears were separated into eight groups. Treatment with combined systemic and topical dexamethasone or mitomycin differed between these groups. After the first 2 weeks, the animals were checked weekly for a total of 12 weeks. RESULTS: A combination of systemic and topical dexamethasone delayed tympanic membrane closure after myringotomy. Perforation size increased in all tympanic membranes treated with mitomycin plus systemic dexamethasone. CONCLUSION: Topical mitomycin plus systemic glucocorticoid may lead to a massive malfunction of tympanic membrane healing.

Administration, Topical↗
PubMed2005

[Interdisciplinary management of severe midfacial trauma].

The anatomy of the craniofacial skeleton is complex, the bones being closely associated with important neurological structures and sensory organs. The face itself is intimately associated with hereditary features and emotional feelings, and, as a consequence, midfacial trauma may lead to important aesthetic, functional and personal problems. Patients suffering from severe midfacial injuries reveal significant concomitant lesions of other body regions in a high percentage of cases. Thus, midfacial trauma patients require an elaborate interdisciplinary regimen of diagnostics and therapy. This paper provides on overview of the interdisciplinary management of midfacial trauma patients. The overlapping multispecialty fields are analyzed with emphasis on the viewpoint of the practicing ENT-surgeon. Assuming that basic principles of trauma care are known, interdisciplinary strategies and specific responsibilities for problem solving are provided. The ENT-surgeon is guided and called upon to play an active and cooperative part in the midfacial traumatology team.

Critical Care↗
PubMed2005

[Changes of the late acoustically evoked potentials in postlingually deaf patients with cochlear implants].

BACKGROUND: The speech recognition performances in postlingually deaf patients, which had a long duration of deafness, seem to be poorer than in patients with a short duration of deafness. The reason could be a functional reorganization in the auditory cortex. A long time of auditory deprivation may decrease neuronal activity in the auditory related cortices. As the late acoustically evoked potentials are generated in this region, we compared the speech recognition performances and also the late acoustically evoked potentials with the individual duration of deafness in a series of postlingually deaf patients. METHODS: In 9 patients (cochlear implant (CI), MED EL) with postlingual deafness the late acoustically evoked potentials and the HSM-set-test on the quiet were measured. Additionally 1 patient with prelingual deafness was examined. The CI-operation was done, when he was 14 years old. The relations between the late acoustically evoked potentials and the speech recognition performances in dependence of the duration of deafness were examined. RESULTS: Typical late acoustically evoked potentials could be measured in 3 patients only. The speech recognition in these patients was very good. The longest time of deafness in these patients was 6 years. In 6 patients the minimum duration of deafness was 12 years. Here were measured the N1-potentials only, the P2- and the N2-potentials were absent. In these patients the scores of the HSM-set-test were lower than in the others. In the 15-years old patient with prelingual deafness the speech recognition was absent. The late acoustically evoked potentials of this patient showed an atypical form. CONCLUSIONS: The results of this study showed a correlation between the duration of deafness, the forms of the late acoustically evoked potentials and the speech perception. The duration of deafness preceding CI-implantation should be very small in deaf children and in postlingually deaf patients.

Adolescent↗
PubMed2005

[The use of the platysma myocutaneous flap for reconstruction in the head-neck area -- a retrospective study].

OBJECTIVE: Following extended tumor resections in the head-neck area options immediate defect reconstruction is needed to reduce healing time and improve rehabilitation. Reconstruction of significant areas of mucosal defects is best accomplished by introduction of a pliable regional transplant. The platysma myocutaneous flap has been used for defect reconstruction in head and neck area since more than 20 years. Its popularity is limited. Since 2001 in our department the platysma mucocutaneous flap is used for such reconstructions. We present a retrospective study evaluating our experience with the platysma myocutaneous flap. METHOD: From 2001-2003 25 patients have been subjected to surgical reconstruction applying the platysma mucocutaneous flap. The primary tumor was located in 16 patients (64 %) in the oropharynx, in 5 patients (20 %) in the hypopharynx and in 4 patients (16 %) in the oral cavity. Evaluation was based on medical records including the operative reports. All patients get a follow up in our outpatient clinic. RESULTS: The platysma flap is easy to harvest and has a low general risk level. Complications are minor and may be avoided by exact preoperative planning. Necrosis of the skin-muscle-flap was observed only after resection of the A. carotis externa (two cases). In these 2 cases an operative revision was necessary (stenting of the pharynx or secondary reconstruction by pectoralis major-flap). The resection of the A. facialis (three cases) did not lead to a serious complication. CONCLUSIONS: Considering the exact indication the platysma flap is suitable for reconstruction of surface defects in the pharynx and oral cavity. A special attention is given to the ipsilateral vascular supply and the length of the muscular pedicel. It proved to be a cost effective method due to the less time and personal expenditure.

Adult↗
PubMed2004

[An improved animal model for chronic perforation of the tympanic membrane].

BACKGROUND: An inexpensive and valid animal model of chronic tympanic membrane perforation is needed. METHOD: Twelve male rats were selected for different surgical procedures (subtotal tympanic membrane perforation with local microflaps, re-perforation without flaps, partial excision of the handle of malleus). The inhibition of spontaneous healing was accomplished by the application of prednisolon or mitomycin directly onto the tympanic membrane. RESULTS: Only by additional partial excision of the handle of malleus followed by local application of mitomycin were we able to achieve a persistent tympanic membrane perforation. CONCLUSION: Chronic tympanic membrane perforation using this procedure may be useful in further investigations of the medical impact of tympanic membrane healing.

Administration, Topical↗
PubMed2004

[Herniation of the soft tissue of the temporomandibular joint into the external auditory canal].

The bone between the external auditory meatus and temporomandibular joint may be destroyed as a result of canaloplasty or malignant otitis externa. This may lead to herniation of the joint capsule into the external auditory canal. Spontaneous herniation through a foramen of Huschke (bony dehiscence in the anterior wall of the tympanic bone) is rare. We present a case of spontaneous herniation with otorrhea.

Cerebrospinal Fluid Otorrhea↗
PubMed2004

[Review: pathophysiology and methodology of nasal packing].

Nasal packing is a frequent procedure to control spontaneous nasal bleeding or postoperative oozing following different types of nasal surgery. It strives for internal stabilization of the nasal framework and for optimizing wound healing by prevention of stenosis or synechia. A lot of different materials is used and there is no accepted standard concerning the type and application. A review on pathophysiology of the packed nose is given together with a survey on customary packing materials focussing on the specific merits, demerits and side-effects including economical aspects.

Biocompatible Materials↗
PubMed2003

[Extended outcome assessment in endonasal sinus surgery].

BACKGROUND: Endonasal optically guided surgery has gained wide acceptance for treatment of chronic sinusitis. However, irrespective to the advent of minimally-invasive techniques, standard outcome assessment has not always reflected the increased technical and conceptual efforts. "Psychometric" instruments offer additional information on patients' perceptions of health. We analyzed the practical value of an extended outcome assessment. METHODS: Standardized interviews were carried out with 103 patients pre- and postoperatively applying several psychometrical instruments ("SF-36" and other valid general health-status instruments besides disease-specific questionnaires, providing 124 items/questions altogether). RESULTS: The diverse changes of subtle health status subscores as a rule paralleled each other and were concordant with traditional self-estimated global ratings of the surgical success by the patient. Significant postoperative changes of the "SF-36" questionnaire were especially seen in the subscale "bodily pain" and "level of energy". With few exceptions only, items reflecting any indirect burden of chronic sinusitis revealed less pronounced improvements postoperatively. CONCLUSION: It appears legitimate to question the special benefits of extended psychometric outcome research in comparison to traditional global ratings for daily surgical practice.

Adult↗