[Carcinoid of the middle ear: a rare tumor with biphasic differentiation. Case report with special reference to immunohistochemistry and electron microscopy]. / Karzinoid des Mittelohres: Seltener Tumor mit biphasischer Differenzierung. Kasuistik unter besonderer Berücksichtigung der Immunhistochemie und Elektronenmikroskopie.

Progressive unilateral sensorineural deafness and tinnitus developed in a 59-year-old woman over a 1-year period. Clinical examination showed a tumor mass which almost completely filled the tympanic cavity, and grew around the auditory ossicular chain. Histological findings revealed the tumor to be a primary carcinoid of the middle ear. Neuro-endocrine differentiation was confirmed immunohistochemically by positivity for neuron-specific enolase, chromogranin, pancreatic polypeptide and synaptophysin. Using electron microscopy, neuroendocrine granules could be visualized. In addition, both light and electron microscopy revealed that cells had an epithelial differentiation with mucin granules while immunohistochemistry showed a positivity for cytokeratins. The detection of intermediary filaments (immunohistochemically with vimentin and under electron microscopy) was unique to this neoplasm and has to be considered in distinguishing the carcinoid tumor from the papillary adenoma of the middle ear. Tumor prognosis is excellent with radical extirpation from the middle ear. In the case presented, there has been no evidence for either recurrence or metastases 10 months after surgical resection.

[Video technique for documentation of endoscopic findings]. / Videotechnik zur Dokumentation endoskopischer Befunde.

We present a method for recording medical findings using a single chip camera, monitor, storage device and a graphic printer. Statistical and functional findings can quickly be determined and recorded by instant graphics. These screen prints are repeatedly accessible at any time for medical records. This simplifies the diagnostic counselling of the patient as well as aiding the pre-operative discussion amongst the medical team.

[Thrombocyte function and problems of blood coagulation and fibrinolysis in head and neck cancer]. / Thrombocytenfunktion und Fragen der Blutgerinnung und Fibrinolyse bei Kopf- und Halscarinomen.

Platelet aggregation induced by ADP and collagen and five parameters of blood coagulation and fibrinolysis, (levels of fibrinogen, fibrinolytic activity of euglobulin, fibrinogen and/or fibrin degradation products, antiplasmin activity and antithrombin activity) were measured in patients with cancer of the head and neck. The results were compared with those from healthy controls. Enhancement of platelet aggregation, hyperfibrinolysis and hypercoagulable state were found in the circulatory blood of patients with cancer of the head and neck.

[Myotomy (pars fundiformis m. cricopharyngei)in the treatment of Zenker's diverticulum. Report on 32 patients treated between 1972 and 1981]. / Die Myotomie (Pars fundiformis m. cricopharyngei) bei der Behandlung Zenkerscher Divertikel. Bericht über 32 in den Jahren 1972 bis 1981 behandelte Patienten mit Hypopharynxdivertikeln.

11 patients were subjected to external operation with invagination of the pouch and myotomy; this procedure was chosen for younger patients, and small pouches with a broad spur. 21 patients were treated by cutting the spur of the diverticulum endoscopically; this intervention was preferred for older patients, and for larger diverticula with a narrow spur. Three of five recurrences were treated endoscopically. There were no complications, stay in hospital was short. Cutting the spur of the diverticulum relieves the cause of the patient's complaints. The endoscopic procedure can be repeated until satisfying results are obtained, even after previous external operations.

Aspects in diagnostics of central neural hearing disorders.

The central neural hearing disorders - in contrast to central cortical lesions - can be concretely defined audiometrically, and they can be localized realiably within the 2nd-4th neurons. For this purpose a definite test program is needed; especially indicative are the behavior of the acoustico-facial stapedius reflex and the results in dichotic discrimination and ERA. SISI and difference limen mostly point to a neural dysfunction, but - in distinct patterns of impairment - they may correspond to the picture of a peripheral hearing disorder as well. A fatigue of hearing apparently only appears if the myelin is damaged, at - perhaps additional - axonal lesions it shows up less clearly or not at all. The deficiency pattern of the stapedius reflex reflects up less clearly or not at all. The deficiency pattern of the stapedius reflex reflects the course of the reflex arc within the brain stem; accordingly, more central lesions of the auditory pathway do not affect the reflex. ERA mostly makes perceivable a lesion of synchronization, which only becomes noticeable at fast repetition rates with ultra short stimuli (1/4 ms), i.e., solely in the responses of the brain stem. The cortical responses, on the contrary, are not impaired more than the subjective threshold renders to be expected, they even show the same values of the pure tone audiogram. The dichotic discrimination is nearly always disturbed unilaterally, at processes of the brain stem homolaterally, at cortical foci predominantly leftside, perhaps because the left hemisphere dominates in speech discrimination. The otologist should know how to make use of the possibility of neuro-otologic diagnostics.

[Connection complex on the cells of Reissner's membrane in freeze-fractured preparations]. / Verbindungskomplexe an zellen der reissner-membran in gefriergebrochenen präparaten

The Reissner membrane of the chinchilla inner ear was studied with the freeze-fracture method. Zonulae occludentes, composed of 2 to 8 strands, seal the intercellular space close to the endolymphatic surface. They are morphologically simialr to those seen between the marginal cells of the stri vascularis, but much less developed than those between the basal strial cells.