[Somatosensoric tinnitus]. / Somatosensorischer Tinnitus.

Tinnitus can be caused or triggered by functional disorders of the cervical spine, temporomandibular joint or any other musculoskeletal structure of the neck or head. This special form of tinnitus is called somatosensory tinnitus and represents a discrete subgroup among the different kinds of tinnitus. Distinctive for this kind of tinnitus are alterations in volume and frequency during movement or the stimulation of certain muscles and joints. This can be evaluated using a structured testing method. To be able to easily perceive tinnitus modulations, the test must be performed in total silence. Effective treatment modules are physiotherapy, osteopathy, neural therapy, and Qigong for self-help.

[Metastasis of benign pleomorphic adenoma]. / Zur Metastasierung gutartiger pleomorpher Adenome.

A case of metastasing pleomorphic adenoma of the parotid gland, which was definitely benign, is reported. 11 years after the first operation of the tumour, which is suspected to have been removed insufficiently, there was a second local recurrence. In routine x-ray of the thorax the metastasis was seen peripherally in the thorax. Using DNA-Cytophotometry the benign character of both specimens could be confirmed. The fact that such a tumour can even produce metastases, proves its easy implantability. This leads to a critical discussion of each intervention, which is not definitive, including fine needle aspiration biopsy. There are only few indications for preoperative invasive interventions.

[Prophylactic administration of glucocorticoids prior to microlaryngoscopies?]. / Prophylaktische Glukokortikoidgabe vor Mikrolaryngoskopien?

Intravenous glucocorticoids before direct laryngoscopy? The necessity of a preventive injection of corticoids before direct laryngoscopy was determined in a prospective, double blind study. 51 patients, who underwent direct laryngoscopy under general anaesthesia, received either 250 mg methylprednisolone in 10 ml NaCl 0.9% (corticoid group) or 10 ml NaCl (NaCl group) intravenously one hour before laryngoscopy. Oedema formation and the degree of inflammation in the pharynx and hypopharynx were examined on the day prior to surgery and three to four hours postoperatively. Complications of the airways were noted in the immediate postoperative phase and at the time of the second examination. Direct laryngoscopy did not induce any significant change in oedema formation or degree of inflammation in both groups. However, there was a correlation between the duration of surgery and the degree of increase in oedema and inflammation in the NaCl group but not in the corticoid group. No difference between the groups was noted with regard to postoperative complications of the airways. Based on the present study, routine application of corticoids to prevent oedema after direct laryngoscopy cannot be recommended.

[Effect of preventive glucocorticoid administration on edema formation and inflammation susceptibility after microlaryngoscopy]. / Einfluss einer prophylaktischen Glukokortikoidgabe auf die Odembildung und Entzündungsneigung nach Mikrolaryngoskopie.

51 patients, who underwent direct laryngoscopy under general anesthesia, received either 250 mg Methyprednisolone or 10 ml NaCl 0.9% intraveneously in a prospective, double blind study. 4-5 hours after microlaryngoscopy they were examined in regard to edema and size of redness of certain anatomical structures of the larynx and hypopharynx. Findings were compared to the results which had been found on the eve of the operation. There was no statistically significant difference between the two groups. However, in the NaCl-Group there was a direct correlation between the edema formation and inflammatory reaction on one hand and the duration of surgery on the other hand. Routine prescription of Cortisone before mikrolaryngoscopy is not necessary, but is recommended, when the operation is expected to take a long time, around more than 30 min.

[Inner ear changes in fetal asphyxia]. / Innenohrveränderungen bei fetaler Asphyxie.

Deafness following complications of pregnancy and obstetrics occurs frequently. The temporal bones of stillborn or neonates who died several days after delivery have often been examined, and haemorrhage and serous labyrinthitis have been found in infections, diabetes and trauma. In this study, pathological findings in the temporal bones of foetuses who died of chronic asphyxia in utero are described. 7 out of 15 cases had no labyrinthine pathology. Four had haemorrhage into the tissue or into perilymphatic or endolymphatic spaces. Likewise, four had developed eosinophilic precipitates in the liquid spaces of the inner ear. If the foetus survives such phases of hypoxia in utero, this might be the morphological correlate of developing deafness. Similar findings in infections such as rubella or cytomegalovirus infection are discussed.

[Diagnosis of para-laryngeal tumors using computerized tomography]. / Diagnostik paralaryngealer Tumore mit Hilfe der Computertomographie.

Computed tomography of the larynx is generally recommended for carcinoma, laryngoceles, and laryngeal trauma. On the basis of several case examples, in which dysphagia and hoarseness were caused by a submucosal thickening of the arytenoid and aryepiglottic fold, the authors propose that these unclear symptoms also be regarded as indication for larynx CT. It must be borne in mind that the underlying process may be one of the rare tumors in the space between the thyroid cartilage and elastic cone, often called the paraglottic space (or paralaryngeal space, by many American authors).

[Clinical aspects of laryngopathia gravidarum]. / Zur Klinik der Laryngopathia gravidarum.

Laryngopathia gravidarum is a rare complication during pregnancy which often is associated with pre-eclampsia. In the literature different degrees of the disease are described which range from simple hoarseness to dangerous states of extreme shortage of air. Based on several cases seen in recent years we discuss the association with pre-eclampsia and document for the first time photographically how quickly morphological and functional findings disappear after the end of pregnancy.

[Hearing impairment and earache as initial symptoms of Wegener's granulomatosis]. / Hörminderung und Ohrenschmerzen als Initialsymptome einer Wegenerschen Granulomatose.

Wegener's Granulomatosis occurs rarely. It is an autoimmune disease and as such it is a special form of panarteriitis nodosa. Manifestations are seen in various organs. Granulomatous lesions in the nose, paranasal sinuses and pharynx are very characteristic and often mark the beginning of the disease. However, a painful otitis media with combined hearing loss may also be the first sign of this generalised rheumatic disease. By describing three cases we document clinical constellations of results and summarise them in tabular form. The knowledge of these constellations prevents confusing this disease with otitis media, tuberculosis and sudden deafness.

[Sonographic diagnosis of mesothelial cyst of the diaphragm]. / Sonographische Diagnostik einer Mesothelzyste des Zwerchfells.

We present a case of a female patient of 65 years of age, who was referred to our clinic for surgery because of a suspected intrahepatic cyst, and who was suffering from upper abdominal complaints. Detailed sonographic examination revealed a cystic process outside the liver, the respiratory shift of structures during the sonographical examination being the criterion. However the final diagnosis of a mesothelial cyst of the diaphragm was possible only after laparotomy and histological examination.