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Biomedical subjects

W Thumfart

Publications and source records attributed to W Thumfart.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Electroneurography of the laryngeal nerves in the awake patient using electromyography of the larynx under zoom-endoscopic-control (author's transl)].

Electromyography of the larynx in the awake patient using zoom-endoscopy provides an earlier diagnosis of recurrent laryngeal nerve diseases by recording action potentials of the posterior cricoarytenoid muscle. Not in every case the type of nerve lesion (neurapraxy, neurotmesis, axonotmesis) could be determined by the EMG alone. Therefore, neurography of the laryngeal nerves was investigated. With respect to the mixed innervation of the larynx by both the more sensible superior and the motoric inferior laryngeal nerve a reflex arc can be examined. The upper laryngeal nerve was stimulated transcutaneously. The afferent reflex arc leads to the ganglions of the vagus nerve and its central nuclei, its efferent motor neurons conduct reflex activity via the recurrent and upper laryngeal nerves back to the larynx. The reflex potentials can be measured out of the various larynx muscles by electromyography under endoscopic control. The importance of this method is demonstrated in cases of vocal cord palsies.

Action Potentials↗
PubMed1979

Grafting and electrical stimulation of the auditory nerve in cats.

The effect of implanting wire electrodes into the cochlea is limited by the deficit of nerve fibers in most diseases of the cochlea. Therefore, in a series of experiments it was tried, for the first time, to direct new outspreading nerve fibres into the afferent acoustic nerve by grafting a motor nerve to it. A second series of experiments should demonstrate the possibility of direct electrical stimulation of the eighs nerve by implanting wire electrodes via the transoccipital approach. The electrically evoked potentials, recorded at the auditory cortex, were compaired to potentials evoked by auditory stimulation. The answers to acoustic or electric stimulation showed no significant difference.

Acoustic Stimulation↗
PubMed1979

[Concentrations of antibiotics (ampicilline, doxycycline) in the chronic-hyperplastic alterated mucosa of the maxillary sinuses (author's transl)].

Surgical treatment of chronic sinusitis is usually preceeded by the attempt of curing the disease by antibiotic and antiphlogistic therapy. Since no studies on the concentration of antibiotics in chronic-hyperplastic mucosa of the maxillary sinuses could be found in the literature, two groups of each 20 patients were subjected to treatment with ampicilline (Binotal) and doxycycline (Vibramycin) respectively and the concentrations of the antibiotics in the maxillary sinus tissue gained during operation were measured. It was shown that therapy with doxycycline produces higher tissue levels than with ampicilline. So it can be assumed that with doxycycline the treatment of chronic-hyperplastic sinusitis will be more frequently successful than with ampicilline. But, with regard to the tissue concentrations found in the study, also with doxycycline only part of infections (e. g. due to certain grampositive cocci, hemophilic bacteria, Pasteurellae) seems to be controllable. Since bacteria of different species could be isolated from the excided mucosa of about 50% of the patients and, on the other hand, the serum levels especially in case of doxycycline were constantly high, the prophylactic use of this drug before operation is recommended in order to avoid inflammatory complications.

Ampicillin↗
PubMed1979

[Electromyography of the cricoarytenoid muscle in the unsedated patient using the zoom-endoscope (author's transl)].

The EMG enables diagnosis, follow-up and prognosis of vocal cord palsy as well as indications for surgery. Using the zoom-endoscope of von Stuckrad electromyography of the larynx can be performed under topical anaesthesia. With a specially designed instrument the needle electrode can be transorally applied exactly into the posterior cricoarytenoid muscle and into any other muscle of the larynx. As the patient can follow instructions the voluntary muscle activity can be observed on the monitor and stored on tape during inspiration, exspiration and phonation. Replay and electronic summation are possible.

Anesthesia, Local↗
PubMed1979

[Endonasal sinus surgery with endoscopic control for recurrent sinusitis in children (author's transl)].

Since 1976, 35 transnasal operations of the maxillary sinus with endoscopic control were performed in children as treatment for chronic sinusitis. After luxation of the inferior turbinate, a mucosal flap was developed to expose the lateral bony nasal wall. A sinus fenestra was then created to allow endoscopic control of the antrum during the operation. Gross pathological alterations of the mucosa were removed while most of the lining mucosa was preserved for recovery. 30 of the 35 children were followed from 4--18 months after surgery. 28 were without any discomfort. Although X-ray studies in many of the patients revealed mucosal swelling four weeks after surgery, the maxillary sinuses were well aerated 8 weeks after operation. Transnasal sinusotomy under endoscopic control is considered to be the treatment of choice for chronic sinusitis in adults and can now also be considered to be the treatment for similar disease in children.

Adolescent↗
PubMed1979

[Closure of tracheo-esophageal fistulae after chronic intubation (author's transl)].

Tracheo-esophageal fistulae caused by prolonged intubation can be life-threatening to the patient involved. Older techniques for the closure of these fistulae were generally unsafe in infected tissues, were replete with complications, and had to be done in multiple stages. We describe a single-stage procedure for closure of posterior tracheal wall defects. A partially deepithelialized cervical flap is rotated between the sutured esophagus and the trachea. This reconstructed posterior wall is resistent to the presence of a cannula. In order to prevent recurrence of the fistula (if further respiratory treatment is needed), a small nasogastric tube or a long Penrose drain placed in the esophagus should serve as feeding tubes.

Female↗
PubMed1978

Experimental grafting of the auditory nerve.

The auditory nerve of five cats was sectioned unilaterally. Its proximal stump was immediately sutured to the proximal stump of the simultaneously severed facial nerve to study afferent sensory nerve regeneration. After time intervals of nine to 18 months, the nerve anastomosis was tested by electrical stimulation of the anastomosis and by recording evoked cortical responses at the auditory cortex. Electrophysiologic evidence of both fiber regeneration within the sectioned auditory nerve and of the reestablishment of a functional synapse at the cochlear nucleus was obtained. Further support of the concept of a possible auditory nerve grafting was added by the histologic examination of the nerve anastomosis and of the cochlear nuclei, which showed signs of the outspreading of axons from the facial nerve through the auditory nerve and through the barrier of the brain stem into the areas of the cochlear nuclei.

Animals↗
PubMed1978

Chronic mechanical trauma in the aetiology of oro-pharyngeal carcinoma.

Tumours of the oral cavity and the oropharynx account for 12% of the malignancies in our patient material. The group of patients included a high percentage of smokers (83%), heavy drinkers and persons neglectful of oral hygiene. The majority of the patients mainly male were labourers or (small) farmers. In contrast to other reports in the literature, chronic mechanical trauma due to sharp remaining teeth, less than ideal fillings, badly fitting dentures or unsuitable denture-bearing tissue, and loose anchoring attachments were frequently present. Commensurate with the clinical findings, permanent damage to the covering squamous epithelium was demonstrated histologically. In addition to all forms of inflammation, parakeratosis and hyperkeratosis, dysplasia, including carcinoma in situ, and manifest carcinomas also presented. Surface-inert dentures and regular oral hygiene must therefore be considered an important requirement for the prevention of oral-cavity carcinoma.

Alcohol Drinking↗
PubMed1978

[Clinical testing of impulse-gustometry as a new method of gustometry (author's transl)].

For the first time in clinical routine testings impulse-gustometry was used in comparison to normal chemical or electrogustometric methods. Loss of taste caused by tympanoplasty, radiation of tumors in head and neck and accompanying facial nerve palsies was tested. The exactly defined location of the stimulus is known advantage in electrogustometry. Impulse-gustometry, however, is able to stimulate different taste sensations like the chemical methods. The sensible sensation, therefore, is eliminated. The stimulating pulses ranged between 0,5 and 2,0 ms at frequencies of 10 to 300 cps. Like with Krarup's method in impulsegustometry there is not always a taste sensation.

Ear, Middle↗
PubMed1978

[The indications for revision radical maxillary sinus surgery (author's transl)].

Surgery of the maxillary sinus is one of the commonest in otorhinolaryngology. The classical Caldwell-Luc procedure however is not infrequently followed by infraorbital or some other facial neuralgia or discomfort. In 1976,246 patients were assessed for revision maxillary sinus surgery, and the symptomatology, clinical, transnasal endoscopic and radiological (polytomography) findings were documented. 59 revision operations were performed and a critical analysis of the preoperative, operative and postoperative findings are presented. Polytomography together with sinus endoscopy is a very valuable assessment of the need for revision surgery. Careful sublabial periosteal wound closure is emphasized, and as an alternative to the Caldwell-Luc procedure the intranasal antrostomy under endoscopic control is recommended.

Endoscopy↗
PubMed1977

[Primary covering of oropharyngeal defects after block resection of large malignant tumors (author's transl)].

The covering of defects in ablative oral surgery is associated with particular problems because, in order to avoid the formation of salivary fistulas, a primary closure should be aimed at. Between 1973 and 1975 86 carcinomas of the floor of the mouth, the tongue or the oropharynx were treated by block resection including radical neck dissection without preoperative radiation in 28 Cases the forehead flap and in 20 cases the tongue flap were employed. While the foreheaded flap necessitates the preservation of the ipsilateral A. carotis externa, the tongue flap can be used even if the ipsilateral lingual artery is sacrified. The tongue flap has functional and cosmetic advantages in comparison to the forehead flap. The temporarily transsected mandibula was refixed by compression plates without intermaxillary wiring.

Forehead↗
PubMed1977

[The neck after radical neck-dissection. A follow-up study (author's transl)].

In 200 patients with uni- or bilateral neck dissections the long range cosmetic results, subjective complaints, and the neurologic status were studied at postoperative time intervals between 3 months and 10 years. The main disorders were related to both the absence of resected, tumor-involved structures and to hyperesthesia of the lateral neck skin. The function of the muscle portions of the shoulder was less disturbed than expected, and recovered with some time and training. Cases with bilateral neck dissections showed postoperative edema of the head, being resorbed, with a little persisting submental edema. Postoperative irradiation gave rise to an increasing number of neuralgiform symptoms.

Arm↗
PubMed1977

[Olfactometry after transethmoidal surgery for cerebrospinal fluid rhinorrhoea and after head injury (author's transl)].

After transethmoidal exposure and closure of the dural defect olfactory assessments were made on 26 patients with frontal dural dehiscence. Different methods for both unilateral and bilateral assessment were applied. The incidence of abnormalities were evaluated and these were compared with a second group of 52 patients who had suffered head injury without cerebrospinal fluid rhinorrhoea. There was no significant difference in the frequency of anosmia. The practical advantage of the transethmoidal approach to the floor of the anterior cranial fossa is emphasized.

Cerebrospinal Fluid Rhinorrhea↗
PubMedDate not supplied

Ciliary beat frequency, olfaction and endoscopic sinus surgery.

We assessed prospectively changes in olfaction and ciliary beat frequency (CBF) after functional endoscopic sinus surgery (FESS) in 70 patients with chronic sinusitis. CBF was measured by the microscopic-photometry technique 2, 4 and 6 months after FESS. Olfaction was evaluated by the Erlangener Smell Identification Test. Preoperative CBF was markedly reduced due to the infectious process. CBF was significantly improved (p < 0.001), reaching normal values 6 months postoperatively despite the endoscopic examination revealing normal nasal mucosa at around 3 months. The pattern of improvement of CBF was linear being more rapid between months 4 and 6. After operation olfactory-impaired patients were improved subjectively and objectively (p < 0.001 and p = 0.003). We conclude that impaired olfactory ability and CBF are significantly improved after FESS, and FESS demands longer postoperative follow-up periods for at least 6 months even if the clinical evaluations were normal.

Adolescent↗