Selected ENT symptoms in functional disorders of the upper cervical spine and temporomandibular joints.

This paper discusses otorhinolaryngological symptoms associated with functional disorders of the upper cervical spine. Hints aimed to avoid misdiagnoses of cross-organ otorhinolaryngological symptoms as phobic or psychogenic disorders are presented. Clinically relevant neuroanatomical convergence of the upper cervical spine (occiput to C3) is fundamental for the interpretation of functional otorhinolaryngological symptoms. Based thereon, evidence for the most common cervical differential diagnoses of dizziness, tinnitus, dysphagia, and craniomandibular dysfunction is presented separately. The corresponding therapeutic options and their contraindications are discussed in the concluding chapter. The importance of interdisciplinary cooperation in related fields is emphasized.

[Selected otorhinolaryngological symptoms in functional disorders of the upper cervical spine and temporomandibular joints]. / Ausgewählte HNO-Symptome bei funktionellen Störungen der oberen Halswirbelsäule und der Kiefergelenke.

This paper discusses otorhinolaryngological symptoms associated with functional disorders of the upper cervical spine. Hints aimed to avoid misdiagnoses of cross-organ otorhinolaryngological symptoms as phobic or psychogenic disorders are presented. Clinically relevant neuroanatomical convergence of the upper cervical spine (occiput to C3) is fundamental for the interpretation of functional otorhinolaryngological symptoms. Based thereon, evidence for the most common cervical differential diagnoses of dizziness, tinnitus, dysphagia, and craniomandibular dysfunction is presented separately. The corresponding therapeutic options and their contraindications are discussed in the concluding chapter. The importance of interdisciplinary cooperation in related fields is emphasized.

Paranasal mucous cyst: a rare finding following septorhinoplasty.

Postoperative niucous cysts of the facial soft tissue are a rare complication after septorhinoplasty. We present a case of postseptorhinoplasty mucous cyst with a paranasal localisation. According to the literature available to us this localisation is extremely rare and has not been described before. Aetiology and possibilities to decrease the risk of such complications are discussed.

[Angiosarcoma of the nasal septum]. / Angiosarkom des Nasenseptums.

This is a report on a female patient, 37 years old, with a polypous, sessile tumor on the nasal septum covered by smooth mucous membrane. She was treated with local excision. The histological diagnosis was an angiosarcoma, confirmed by immunohistological stain with factor VIII-like antigen, thrombomodulin, and UEA. She currently remains free of the disease 12 months after diagnosis. Angiosarcoma in the head and neck area and especially the localization in the nasal septum are extremely rare. Prognosis, differential diagnosis, metastasis formation, and therapy of this tumor are presented.

Computed tomographic criteria and survival rate for patients with acute subdural hematoma.

OBJECTIVE: Computed tomographic data from 174 patients with acute subdural hematoma were analyzed statistically to identify parameters that could be evaluated independently of clinical and neurological status to estimate outcome. METHODS: This retrospective study was made necessary by the fact that the patients admitted usually had been treated with intubation, sedation, and artificial ventilation, which precludes neurological examination. RESULTS: In surgically treated patients, the hematoma thickness ranged from 5 to 35 mm and the midline shift was 0 to 33 mm. In 81 patients (46.6%), the hematoma thickness was greater than the midline shift; in 24 patients (13.8%), the hematoma thickness equaled the midline shift; and in 69 patients (39.6%), the midline shift exceeded the hematoma thickness. Of the patients, 52% died after surgery, for 29% we obtained good or satisfying results, and 19% were in poor condition after therapy. The Kaplan-Meier survival analysis proved that the survival rate was only 50% for a hematoma thickness of approximately 18 mm and a midline shift of 20 mm. The survival function dropped markedly for midline shifts of more than 20 mm and converged to 0% for midline shifts of more than 25 mm. If the midline shift exceeded the hematoma thickness by 3 mm, the survival function was 50%; when the midline shift exceeded the hematoma thickness by 5 mm, the survival function was 25%. The Glasgow Outcome Scale scores were correlated significantly with these parameters. The parameters, which are the measured hematoma thickness, the midline shift, and the difference between the hematoma thickness and the midline shift, allow robust/adequate estimation of survival function and outcome for patients suffering from acute subdural hematoma. CONCLUSION: Based on these data, indications for surgery could be assessed by means of video conferencing, i.e., without personal examination of the patients.