Tumour-induced intraluminal stenoses of the cervical trachea--tumour excision and tracheoplasty.

Three children with stenoses of the cervical trachea caused by tumours are reported on. The first was a 13-year-old girl with a sarcoma of the tracheal wall 20 cm down. We performed partial resection of the trachea and turned a skin flap according to Denecke into the defect. In the second case a capillary haemangioma had caused severe stenosis, requiring resection of the tumour together with the tracheal mucosa. A haemangioma had caused tracheal stenosis in the third case, too; in this child partial tracheal resection and skin flap plasty were performed. The postoperative course was uneventful in all three children. So far, there is no recurrence of the sarcoma 4 1/2 years after operation.

Angioma of the jugular foramen. Case report.

We describe a patient with a neoplasm closely mimicking a glumous jugulare tumour with regard to both clinical and radiological presentation. The tumour was removed by the transmastoid route. Only after histological examination of the excised neoplasm could the diagnosis of angioma be made. No other case of this nature has been found in the literature.

[Surgery of extensive tumors of the petrosal bone and the lateral skull base region (author's transl)]. / Die Chirurgie ausgedehnter Tumoren des elsenbeins und der Otobasis.

Report on the problems in total removal of extensive tumors of the petrosal bone and the skull base in this region. These problems are: 1. Freeing of the tumor involved internal carotid artery from the carotid foramen to the cavernous sinus. 2. Covering the resulting large defects of the dura and covering the new ostium of the Eustachian tube to protect the posterior fossa from infection. 3. Stopping the blood flow during the removal of extensive glomus jugulare tumors. 4. Reconstruction of swallowing and voice in paralysis of the involved vagal nerve. Operative measures for the solution of these problems are described.

[Surgical correction of the severed larynx, associated with severe swallowing disturbances (author's transl)]. / Kompletter Abriss des Larynx mit hochgradiger Schluckstörung. Chirurgische Korrektur.

After complete separation of the larynx from its cranial suspensions, the larynx is displaced caudally and the base of the tongue cranially. This produces an enlargement of the distance between the larynx and the base of the tongue, which can be demonstrated radiographically. Severe dysphagia is the result which may produce complete inability to swallow. Surgical management of this condition consists of mobilization of the laryngotracheal complex and its attachment to the hyoid bone by sutures. Successful results in two cases are described.

[Nineteen years experience with surgical correction of disorders of swallowing and voice following vagus nerve paralysis (author's transl)]. / Plastische Korrektur des Schluckaktes und der Stimme bei Vaguslähmung. 19 Jahre Erfahrung

An operation for the correction of swallowing and voice following paralysis of the vagus nerve is described. The operation is divided into four parts which are performed either in one or two stages. These include: 1. extramucosal myotomy of the pars fundiformis of the cricopharyngeus muscle; 2. correction of vocal cord paralysis by the rotation of the arytenoid cartilage and cartilage implant into the paralyzed vocal cord; 3. resection of the paralyzed wall of the pharynx; 4. fixation of the paralyzed soft palate to the posterior wall of the pharynx. Nineteen years experience with the four different parts of the operation are discussed.

[Greater petrosal nerve surgery in long-term cluster headache (author's transl)]. / Zur Chirurgie des N. petros major bei langjährigem Gesichts- und Kopfschmerz

Report on three cases with cluster headache for a period of 10 to 20 years, respectively. This was healed by resection of the greater petrosal nerve. In these patients the nerve was found in a bony canal of a length of 5 to 6 mm between the geniculate ganglion and the facial nerve hiatus. In this region the nerve was blurred free, luxated from the canal, and resected. Histological control of this part of the nerve revealed a fibrosis of the peri- and epineurium and a degeneration of some nerve fibers. Histological control in a greater number of cases is recommended.

[Reconstruction of tracheal stenosis at thoracic inlet level (author's transl)]. / Tracheaplastik im Bereich der Halsbasis bei besonderen pathologischen Verhältnissen in der oberen Thoraxapertur

Complex operative cases of tracheal stenosis in the region of the thoracic inlet are described. The stenosed tracheas were additionally constricted by: a dislocated osteomyelitic clavicle, which was tethered by scar-tissue; an osteoma of the manubrium sterni; a goitre, which was fixed into the thoracic inlet by scar tissue of an early childhood tracheostomy; and a retrosternal goitre. In two further cases the reconstruction of a long tracheal stenosis at the thoracic inlet was complicated by an existing paraplegia.