Two cases of aberrant internal carotid arteries and three cases of high bulb of the internal jugular veins located in the middle ear cavity are presented. Preoperatively the patient should be questioned about dependence of the bruit on situations altering the blood-pressure. With regard to the differential diagnosis of glomus jugulare tumours, vascular abnormalities must be taken into account - even though they are rare. CT findings should be interpreted critically.

Adult↗

PubMed1987

[The "window-fistula symptom" in lesions of the round and oval window].

22 tympanoscopies in suspected perilymph fistulas with clinical symptoms such as sudden hearing loss, tinnitus, vertigo, fluctuating hearing etc., histories and intraoperative findings were registered. In some cases a remarkable interval between the implicated event and the clinical manifestation of the symptoms was noticed. Besides on case history and audiometric data the diagnosis was based on vestibular investigations. In 14 of 22 cases the window-fistula-symptom was positive. The window-fistula-symptom is defined as a provocation nystagmus with maximal intensity in the lateral head position lying on the affected ear and in the head hanging position with the head rotated to the affected side. After abandoning these positions the nystagmus is decreased. Mostly the nystagmus is directed to the healthy side. With regard to the preoperative and postoperative findings a generous indication for tympanoscopy in suspected fistulas of the round and oval window membrane is recommended.

Cochlea↗

PubMed1987

[Aspects of infant and child tracheotomy].

A series of 57 tracheotomies in infants and children was subdivided into two categories. Group A consisted of patients who primarily suffered from severe obstruction of the upper airway. The results demonstrated that tracheotomy was an effective procedure in handling these cases. 30 patients were placed into group B. In this series the upper airway was primarily not involved. Considering the severe cardiac, central and nephrogenic underlying diseases tracheotomy did not play a significant role in the healing process except in few cases. Patients in group B had a higher complication rate and death rate than those in group A. Altogether two patients died because of tracheotomy-related complications (haemorrhage and displacement of cannula). For decreasing the complication rate proper surgical technique and regular endoscopic controls are necessary. "pro and contra" of tracheotomies in children are discussed.

Adolescent↗

PubMed1987

[Stridor in the neonatal period in heterotopic gastric mucosa of the hypopharynx].

A newborn girl suffered from recurrent respiratory distress and swallowing disturbances. With coughing or belching a grape-like tumor appeared in the oral cavity, which was affixed like a pendulum in the hypopharynx. Histological examination revealed a polypoid hamartoma of the hypopharyngeal wall and ectopic gastric mucosa. Various theories of embryogenesis of this very rare condition in the head and neck region are presented. No associated anomalies are reported. Complete surgical excision is curative.

Choristoma↗

PubMed1987

[Visual recovery following orbital and optic nerve decompressions].

The cause of visual impairment must always be clarified as soon as possible. During the last 6 years visual loss in 60 selected patients was caused by infectious processes, mucoceles, benign tumours, endocrine ophthalmopathies, head traumas etc. The comparison of preoperative and postoperative visual function in 48 cases treated by decompression of the orbit and in 12 cases treated by decompression of the optic nerve demonstrated visual improvement in 68 per/cent. Surgically we preferred the transethmoidal route and in some cases the lateral osteoplastic approach. In respect of the success of the surgical therapy, a correlation with the interval between the time of manifestation of visual loss and the time of surgery was found. Furthermore, the results depended on the basic diseases.

Humans↗

PubMed1986

[Preventive cesarean section].

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Cesarean Section↗

PubMed1986

[Experiences using open rhinoplasty].

In our opinion the procedure recommended by Goodman is very appropriate for modern rhinoplastic surgery. From our own experience of 34 cases we present 3 examples of an asymmetric nasal tip, a hanging columella and a wide saddle nose. The most obvious advantage of the external septorhinoplasty was the excellent exposure, especially of the nasal tip. We used nasal autografts only for the correction of the deformities.

Humans↗

PubMed1985

[Pregnancy in a representative Swiss population (study of pregnancy and newborn infants in Aarau). 3. Diseases and drugs in pregnancy].

As part of an overall study, a cohort of 996 Swiss mothers was interviewed upon admission to the labour ward regarding illnesses, disorders and the use of drugs during pregnancy. The data are presented and compared with analogous data on the entire female population of the same age group in Switzerland, and with epidemiologic reviews of pregnancy events from other countries. Somatic illness, particularly the common cold, were reported by 55%, and complaints of a more psychosomatic character by 47%. Illness related to pregnancy was found in more than 40% of the women. Only 16% reported no illnesses or complaints during the course of pregnancy. On the other hand, 33% of the mothers had taken no medication during pregnancy. Compared with studies from other countries the use of medication in this group of women was lower, particularly self-medication for minor complaints. The women reported an average intake of 1.6 drugs. In the offspring of these mothers only a few minor somatic effects were demonstrable. The Brazelton behavioral assessment did, however, reveal some significant correlations.

Adult↗

PubMed1985

[The course of pregnancy in a representative Swiss population (the Aarau Pregnancy and Newborn Infant Study). I. Social medicine aspects].

Excluding multiple births, a cohort of 996 Swiss mothers was interviewed upon admission to the labour ward regarding the overall course of pregnancy, illnesses, disorders, use of drugs, and nicotine and alcohol consumption. During the postnatal stay at the hospital additional information on socioeconomic background, mental and physical stress and the pattern of medical care during pregnancy was obtained. The data are presented and compared with analogous data on the entire female population of the same age group in Switzerland and with epidemiologic reviews of pregnancy events from other countries. This group of pregnant women represents a cross-section of the average mixed small town and rural population of German-speaking Switzerland. The socioeconomic conditions for motherhood appear favorable, though the percentage of women from lower socioeconomic classes was lower than in the general population. Employment during pregnancy had no influence on birthweight and neonatal morbidity, in contrast to chronic physical and emotional stress. On average the women had eight medical checkups during pregnancy.

Adolescent↗

PubMed1985

[Gamma-glutamyltransferase and alcohol drinking in pregnancy].

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Alcohol Drinking↗

PubMed1985

[Rare tumors of the base of the tongue and their therapy].

Five rare tumours of the base of the tongue are reported. Diagnosis and therapy of a tuberculoma, an amyloid tumour, a mucoepidermoid carcinoma, a pleomorphic adenoma, and an angioleiomyoma are illustrated. The frequency and other possible sites of these tumours are discussed based on a review of the literature. The standard surgical approaches to the base of the tongue are described, favouring lateral pharyngotomy. The need for careful planning of the operation is stressed including difficulty in intubation and control of bleeding after operation.

Adolescent↗

PubMed1985

[Rehabilitation following laryngectomy from the viewpoint of the affected patients].

This study is based on a questionaire sent to members of the German laryngectomee association. The analyses of the answers provide important positive and negative information concerning the rehabilitation: Generally the patient was reintegrated into the family without incident. 59.2% learned oesophageal voice, but 28% acquired no effective substitute voice. 39% of patients and 51% of their relatives did not become acquainted with first-aid for neck-breathers (mouth to neck resuscitation). 19.5% resumed their former work. During the preoperative course, 36% of the patients waited 3 to 6 months from the beginning of their complaints to the first medical consultation. In 51% of the cases the interval from first complaints to the surgical treatment was more than three months. These results demonstrate shortcomings in rehabilitation which require attention.

Attitude to Health↗

PubMed1985

[Posturography in the principle of vestibular diagnosis, interpretation and clinical results].

A force platform technology using bonded strain gauges was developed to analyse postural sway as a function of time. Physiologically, the human body is in a state of balance--independent of the position of head, neck, hip, arms or legs and despite permanent oscillations, as long as the centre of gravity projected onto the base of support falls within a limited area. Some examples demonstrate the principles and interpretation of measurements. The method is clinically appropriate to discover ataxias and to manifest Romberg's sign. The diagnostic scope is extended by including a tilting platform in a short test battery of various degrees of difficulty. In contrast to 20 healthy persons, 20 patients with Menière's disease showed an obviously reduced ability to remain standing during the attack-free interval.

Humans↗

PubMed1984

[Clinical experiences with the vertical writing test].

The performance of the vertical "X" sign test in 180 patients suffering from peripheral or central lesions was analysed and compared with the findings in 150 healthy persons. Typical features of peripheral diseases were obvious directed deviations in 75.3%. In contrast to this result persons with central lesions showed undirected variant deviations of the vertical X-sign series in 65.6%. This aspect may be helpful in differential diagnosis.

Adult↗