A New Model of Skull Base Reconstruction following Expanded Endonasal or Transoral Approaches – Long-Term Results in Primates

<i>Objective:</i> The direct endonasal or transoral transclival approaches to the skull base permit effective minimally invasive surgery along the clivus region. Developing consistently effective techniques to prevent cerebrospinal fluid (CSF) leaks and their consequences (infections and healing processes with long and complicated recoveries) remains a major challenge. In this study, we tested over a long period a method of bone reconstruction newly developed by us, which makes use of a specially designed elastic silicone plug that can be employed for bone replacement after minimally invasive skull base surgery without risk of postoperative CSF leaks. After acute testing of plug…

Rifampin-impregnated silicone catheters: a potential tool for prevention and treatment of CSF shunt infections.

Background: Infection continues to be one of the major complications of cerebro-spinal fluid shunting procedures. Recent insights in the pathophysiological mechanism of these foreign body infections have elucidated the difficulty of achieving successful treatment without device removal. The development of a rifampin-impregnated silicone catheter yielded excellent results in infection prevention and treatment in vitro as well as in an animal model. Patients and Methods: Here, we describe the application of this device in two patients with a complicated course of shunt infection. Results: In one patient the rifampin-impregnated shunt system was implanted after external drainage to prevent fur…

Outbreak of Salmonella Enteritidis gastrointestinal infections among medical staff due to contaminated food prepared outside the hospital

Erfassung niedriger Legionellen-Konzentrationen in Badebeckenwasser

The Legionella proof is necessary in pool water according to DIN 19 643 in case of possible aerosol formation. In lab tests it was proven that the direct spatulation of 1 ml water offers high-grade proof with high correlation of the determined concentration to the actual germ content. With very small germ concentrations, however, preceding filtration of larger sample volumes is necessary. During the investigation of routine samples a Legionella proof was possible thereby in individual cases, whereas direct spatulation remained negative.