Use of Interferon-Alpha in Recurrent Respiratory Papillomatosis: 20-Year Follow-up

Objectives: The aim of this study was analysis of the results of use of interferon-α (IFN-α) in patients with recurrent respiratory papillomatosis (RRP) and correlation of the results with human papillomavirus (HPV) type. Methods: A multicenter prospective series (42 patients from 22 hospitals) yielded 20 years of follow-up of patients with RRP and HPV typing who were treated with IFN-α in doses of 3 MU/m2 3 times per week. Results: During long-term follow-up (mean ± SD, 172 ± 36.8 months), the rate of event-free survival evaluated by Kaplan-Meier analysis was 42.8%, and the overall survival rate was 82.6%. The HPV typing revealed an association of HPV 11 with a more aggressive disease cour…

Dysphagie ohne klinisch erkennbares pathologisches Korrelat: Zum Ausschluss eines Tumorgeschehens des Mundbodens und des Zungengrundes ist die Ultraschalldiagnostik obligat

In patients suffering from dysphagia, a tumour of the tongue and its base must be excluded. This is not always possible by means of endoscopy and palpation. In contrast it is possible to visualize deep-seated structures of this region by ultrasound. Unfortunately, this technique is rarely used, as shown in the cases demonstrated. We present five patients suffering from dysphagia for a long period of time (up to 30 years) where ultrasound was not performed and a tumour of the floor of the mouth and the base of the tongue was overlooked. Thus, adequate therapy was delayed, which proved to be especially relevant in three patients suffering from a malignoma. Three patients suffered from a malig…

Zur Geschichte der Kopf-Halssonographie

Although today ultrasound is well accepted in the diagnosis of head and neck diseases, often little is known about the young history of this technique. Many pioneers, physicians and engineers were involved in the development of the technique. In this article the history of ultrasound in general and of ultrasound of the head and neck is reflected.

Die sonographische Beurteilbarkeit des Hypopharynx und des extrathorakalen Ösophagus: Möglichkeiten und Grenzen für Staging und Therapieplanung

Hintergrund und Fragestellung: Die Sonographie von Tumoren des Hypopharynx und des daran anschliesenden extrathorakalen Anteils des Osophagus kann sich aufgrund der anatomischen Voraussetzungen als schwierig gestalten. Eine korrekte Beurteilung dieser Region setzt entsprechende sonographische Kenntnisse voraus. Vielerorts wird als Bildgebungsverfahren der ersten Wahl eine CT oder MRT durchgefuhrt. In Kombination mit dem endoskopischen Befund wird dann die Operation geplant. Redundanzen von Endoskopie und Bildgebung werden unbewusst in Kauf genommen. Wenn sich die Aussage von Endoskopie plus Ultraschall dieser Region derart erganzen, dass eine suffiziente Operationsplanung moglich ist, konnt…

[Construction and reaction of the mucosa-associated-lymphatic tissue (MALT) in the middle ear, the Tuba Eustachii and the larynx of the rat].

Verbesserte Orts- und Kontrastauflösung in der Ultraschalldiagnostik durch Nutzung Harmonischer Frequenzen

Background: The aim of new techniques in head and neck sonography is to increase the sensitivity and the specificity of the examination, With tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) new techniques are available which allow increased contrast and resolution in head and neck sonography as well as a better detection of small blood vessels. Methods: We studied whether these techniques improve sonographic detection of head and neck lymph nodes and primary tumours of the upper aerodigestive tract. Results: The results indicate that THI allows a better detection of cervical lymph nodes. Furthermore, intranodal structures and the borders of the lymph node can be better det…

Der interessante Fall Nr. 42

Epistaxis is a symptom and one of the most frequent medical emergencies. In most cases haemorrhages concern the anterior parts of the septum, in particular the Locus Kiesselbachi. Thus they are harmless and therapy is easy to handle, We report a case of a 55-year-old lady with relapsing epistaxis due to a pseudoaneurysm after surgery of a meningioma of the sphenoid bone. This type of epistaxis is rare and may culminate into a life-threatening event. The case demonstrates the importance of an exact differential diagnostic evaluation by use of modern imaging techniques for severe and life-threatening symptomatic nose-bleeding.

Acute Laryngitis in the Rat Induced by Moraxella catarrhalis and Bordetella pertussis: Number of Neutrophils, Dendritic Cells, and T and B Lymphocytes Accumulating during Infection in the Laryngeal Mucosa Strongly Differs in Adjacent Locations

Infectious laryngotracheitis results in fulminant respiratory distress. During the disease, the subglottic mucosa is selectively infected and swollen, the reason for this preference being unknown. Therefore, in the present study the immunoreaction of the laryngeal mucosa was studied in the rat after inhalation of either heat-killed Moraxella catarrhalis (PVG rats) or application of viable Bordetella pertussis (BN rats). The number of neutrophils, macrophages, dendritic cells, and T and B lymphocytes was determined in the mucosa of the supraglottic, glottic, and subglottic area of the larynx as well as in the trachea. After application of the pathogens, the mucosa of the subglottic area was …

Vergleich von Malignitätskriterien in B-Scan- und Farbduplexsonographie mit dem histologischen Erscheinungsbild am Beispiel des experimentell induzierten Plattenepithelkarzinoms

BACKGROUND Malignant tumours of the head and the neck are characterised by typical signs of malignancy in greyscale- and colour-coded sonography. Sometimes, such criteria cannot be verified, and in such cases it remains unclear whether typical changes do not exist or whether we just cannot detect them with our high-end ultrasound units. We therefore compared our sonographical findings with the histology obtained in experimentally induced tumours. METHODS Experimental squamous cell carcinoma was induced subcutaneously in nude mice (n = 18), using four different cell lines. Ultrasound examination of the tumours was performed after 98 and 112 days, respectively, Central necrosis, rupture of th…

Zum Einsatz des Ultraschalls in der Diagnostik von Nase und Nasennebenhöhlen

Ultrasound is commonly performed to diagnose pathological processes of the neck and the salivary glands. In contrast, pathological changes of the sinuses and the bony structures of the face are only rarely examined sonographically. This paper deals with the diagnostic scope of ultrasound in the case of orbital and nasal fractures as well as for cases of sinus pathology excluding acute sinusitis. 51 patients with different diseases of this area were examined using US and X-ray or CT scan. Fractures of the nose could all be diagnosed correctly by ultrasound, which is of clinical importance if children or pregnant patients are examined. Blow-out fractures of the orbit were not detected. In con…

Proliferating macrophages, dendritic cells, natural killer cells, T and B lymphocytes in the middle ear and Eustachian tube mucosa during experimental acute otitis media in the rat

SummaryAlthough many studies focus on the increase of immunocompetent cells within the middle ear mucosa during acute otitis media it is poorly understood how this increase is mediated. The differentiation between two possible causes, i.e. immigration and local proliferation, would help to better understand the pathophysiology of this disease. Therefore, the number of proliferating macrophages, dendritic cells, natural killer cells and T and B lymphocytes was studied during acute otitis media in the rat middle ear mucosa (ME mucosa) and Eustachian tube mucosa (ET mucosa) by labelling proliferating leucocytes with the DNA precursor bromodeoxyuridine (BrdU). By removing the middle ear and Eus…

Sonographische Charakteristika laterozervikaler Raumforderungen

UNLABELLED Sonography of the head and neck mainly focuses on tumours of the lateral neck. Even though most of these masses are enlarged lymph nodes, other tumors have to be considered. AIM To determine whether different pathological cervical masses display a characteristic sonographic morphology. METHOD On the basis of 530 sonographical findings in the neck, typical ultrasound characteristics either in B-scan or in colour coded sonography were demonstrated. RESULTS Apart from enlarged lymph nodes, it was possible to differentiate other occurrences such as branchial cysts, abscesses, laryngoceles, lipomas, neurinomas, glomus tumours, paragangliomas and also fibromas by their specific ultraso…