[Histology and morphometry of explanted ear ossicles in man]. / Zur Histologie und Morphometrie explantierter Gehörknöchelchen beim Menschen.

Reoperations of the middle ear enable histological and morphometrical examination of explanted autogenetic or allogenetic ossicles. Histological and morphometric study of such ossicles showed a different osteogenesis. In autogenetic ossicles, angiogenetic and appositional osteogenesis could be seen; in allogenetic ones, angiogenesis was predominant. Connective tissue prevailed in allogenetic ossicles. The histological findings were in accordance with morphometric results and with statements from literature.

[Congenital piriformo-thyroid fistula as a cause of recurrent suppurative thyroiditis]. / Kongenitale piriformo-thyreoidale Fistel als Ursache einer rezidivierenden eitrigen Thyreoiditis.

A previously healthy five year old boy presented with suppurative, febrile thyroiditis of the left lobe with pronounced general and local signs of inflammation, normal thyroid function and lack of thyroid antibodies. Intravenous antibiotic therapy improved the condition quickly. Six and nine months later however recurrent left lobe thyroiditis occurred. Endoscopic examination showed an internal fistula from the left piriform sinus to the left thyroidal lobe which was cut out. The case report confirms previous communications, that recurrent suppurative thyroiditis is nearly always caused by a piriform sinus fistula, probably a fourth pharyngeal pouch remnant which can be cured surgically.

[Therapy of sinusitis in childhood]. / Zur Therapie der Sinusitis im Kindesalter.

Therapy of sinusitis in childhood should be adapted both to various kinds and degrees of inflammation and to the age of the child. Furthermore, aetiology and pathology of the disease should also be taken into account. Especially in chronic disease, an allergy could be the cause; therefore, one should initiate suitable investigations and start adequate treatment. As with all long-term therapy measures, it is essential to persuade both the child and the parents to participate in the treatment and to get their co-operation.

[Actinomycosis of the middle ear]. / Zur Aktinomykose des Mittelohres.

A recent patient with actinomycosis of the middle ear has stimulated us to call attention to this very rare disease. The differential diagnosis, pathophysiology, the pathways of spread, diagnosis and therapy of this disease are discussed. Combined therapy by antibiotics such as ampicillin with clindamycin is the best treatment currently available. Surgery is confined to taking a biopsy for histology and to the draining of inflammatory foci.

[Possibilities and problems of patient education using preprinted forms for standard otorhinolaryngologic operations]. / Möglichkeiten und Probleme der Patientenaufklärung mit Vordrucken für Standardoperationen im HNO-Bereich.

Since six years we have got experiences in patient's instructions by our own form-sheets concerning standard operations in the ENT-region. After having mentioned general problems of the medicolegal situation, the most important aspects of risk instruction by the 21 forms are discussed. Finally the text of all form-sheets is quoted, the final observation--identical in all sheets--is preceding. In conclusion we emphasize that especially the patient's information by form-sheets needs an additional dialogue with the patient too. The written documentation of the complete instruction is absolutely necessary as judgments show.

[Neurogenic sarcoma of the head and neck with contact to the skull base (author's transl)]. / Das neurogene Sarkom im Kopof-Halsbereich mit Kontakt zur Schädelbasis.

The neurogenic sarcoma is a neoplasm found seldom. It descends from the sheaths of peripheric nerves. If this tumor develops from a solitary or multiple neurofibroma, it might also be called a neurofibrosarcoma. All other synonyms, especially that of the malignant schwannoma, should better be abandoned for histogenetic reasons. Today the classification of all tumors of the peripheral nervous system is based on a suggestion of the WHO from 1969. The tabular summary of the literature shows that only a little more than a hundred cases of neurogenic sarcoma of the head and neck were reported during the last 50 years. Differential diagnosis of this malignant tumor includes nearly all other malignant neoplasms of soft tissue, sometimes even anaplastic carcinoma. Histopathology, including electron microscopy, is described in general and also in detail with regard to three cases. Three forms of micro-morphological variants are dealt with, too. For diagnosis histological examination will be absolutely successful only in cases of neurofibromatosis or in cases where the nerve from which the tumor originates may be identified. Otherwise, conventional and computerized X-ray tomography may be helpful. Finally, some therapeutic and prognostic principles are discussed.