[Epidemiology of auricular trauma]. / Zur Epidemiologie von Ohrmuschelverletzungen.

BACKGROUND: Auricular trauma is rare but can seriously reduce self-acceptance and function. Epidemiologic data on the causes of trauma causes and patient characteristics are limited. PATIENTS AND METHODS: The case notes of 141 from 197 patients with ear injuries have been reviewed retrospectively according to trauma cause and to the distribution of age and gender. RESULTS: Two thirds of the documented cases occurred between the age of 11 and 40 years. Men outnumbered women at a ratio of 2 to 1. The most frequent causes for ear trauma were traffic accidents (43 %), accidents at home (33 %), and fights (14 %). CONCLUSIONS: Mainly younger and active groups of the population are affected by ear trauma. Therefore, it is of particular concern in the acute setting to select those therapeutic options that have turned out good aesthetic and functional results in the long-term perspective.

[Auricular reconstruction for severe microtia. Schedule of treatment, operative strategy, and modifications]. / Ohrmuschelrekonstruktion bei hochgradiger Mikrotie. Behandlungsplan, plastische Operation und deren Sonderformen.

The incidence of microtia in Germany is 100-150 per year. These cases require a specific and challenging therapy. All patients need audiologic consultation. If desired plastic reconstruction is performed, which is aiming at achieving a lifelike as possible appearance corresponding to the shape of the opposite ear including an excellent skin color. The present paper describes background information, the interdisciplinary schedule of treatment, and the results of our operative strategy in two to three steps using autologous rib cartilage. Furthermore we expand on anomalous cases of microtia which require a modified procedure. In dystopic microtia, repositioning of the rudiment is necessary before reconstruction. In cases of excessive scar tissue due to injuries or previous operations, a one-step reconstruction using an axial fascia flap can be useful.

[Cutaneous form of sarcoidosis at the auricle]. / Kutane Manifestation einer Sarkoidose an der Ohrmuschel.

Sarkoidosis is a disease of so far unknown etiology that can affect potentially every organ. Sarcoidosis of the lung is the most common form, nevertheless in more than one third of the cases the head and neck area is affected. Manifestations of the disease can be present in lymph nodes of the neck, the middle ear, the pars petrosa of the temporal bone and in the paranasal sinuses as well as in the larynx and pharynx. We would like to present two rare manifestations of sarkoidosis of the ear lobe. The cutaneous form of sarcoidosis is characterized by a spectrum of skin changes. Aside from the physical presentation and observation of the disease progress the diagnosis is confirmed histologically. A multidisciplinary care of the affected patients is needed to diagnose the systemic extend of the disease on one side and to provide the patient with an effective therapeutic regimen that includes surgical and conservative measures on the other.

[Reconstruction after extended partial laryngeal and hypopharyngeal resections. A new method with rib cartilage, chondrosynthesis and free radial transplants]. / Rekonstruktion nach ausgedehnten Larynx- und Hypopharynxteilresektionen. Eine neue Methode mit Rippenknorpel, Chondrosynthese und freien Radialistransplantaten.

UNLABELLED: Partial pharyngectomy combined with subtotal laryngectomy results in permanent tracheostomy and long lasting swallowing difficulties in many cases. Based on our prior experimental and clinical studies on laryngeal chondrosynthesis the objectives of this project were to develop a method for reconstruction of up to two thirds of the larynx and one pyriform sinus. METHOD: The resected laryngeal framework is reconstructed with autogenous rib cartilage and stabilized with plates and screws. In addition a piece of cartilage is used as a buttress for apposition by the remaining mobile vocal cord. A free radial forearm flap covers the reconstructed framework and forms the sulcus of the pyriform sinus. RESULTS: Up to now 7 patients have been operated with this technique. The follow up was 35 months on average. None of the patients has a clinically relevant aspiration. All patients have a well understandable voice and one of them--a teacher--could even resume his speech profession. CONCLUSION: In selected patients these techniques enable functional rehabilitation of swallowing, breathing and speech even after extended partial pharyngolaryngectomy.

Histochemical and immunocytochemical localization of nitric oxide synthase in the central nervous system of the goldfish, carassius auratus.

The distribution of the neuronal type of nitric oxide synthase in the goldfish brain and spinal cord was investigated via NADPH-diaphorase histochemistry and immunocytochemistry using an antiserum raised against the purified mammalian enzyme. Many structures, including magnocellular neurosecretory cells, motoneurons, mesencephalic trigeminal neurons, and radial glial fibers, were stained by the NADPH-diaphorase reaction but were not immunoreactive. This nonspecific NADPH-diaphorase activity was strongly reduced after preincubation of the sections. Therefore, when sections were first reacted for immunofluorescence and, thereafter, stained for NADPH-diaphorase, a corresponding staining pattern was obtained that allowed the reliable localization of neuronal nitric oxide synthase based on both complementary staining methods. In the telencephalon, positive neurons were concentrated in the ventral and posterior parts of the area ventralis. Many intensely stained neurons were present in various diencephalic nuclei, including the nucleus centralis posterior and the ventromedial nucleus of the thalamus, the nucleus tori lateralis, the nucleus recessus lateralis, the nucleus tuberis posterior, and the central nucleus of the inferior lobe. In the midbrain, neurons containing nitric oxide synthase were located in the periventricular zone of the optic tectum, the nucleus vermiformis, and the nucleus reticularis mesencephali. Specific staining in the cerebellum was concentrated in Golgi cells. In the hindbrain, nitroxergic neurons were numerous in all four sensory nuclei of the trigeminus, in the facial lobe, the superior olive, the inferior reticular formation, and the medial general visceral nucleus of the vagus. The dorsal horn of the spinal cord was enriched with positive neurons. A few strongly stained cells were also present in the ventral horn. In conclusion, neurons capable of synthesizing nitric oxide occur throughout the teleost central nervous system. The presence of nitric oxide synthase in projection areas of most afferent nerves suggests a widespread involvement of nitric oxide in sensory information processing. The distribution of nitric oxide synthase-containing neurons in certain areas, e.g., the tectum opticum and the spinal cord, indicates an evolutionarily conserved pattern. Similar to the case in other vertebrates, there appears to be no comprehensive overlap between the distribution of nitric oxide synthase and that of any other chemically characterized neuronal population described thus far. However, strongly positive cell groups in the mesencephalic reticular formation suggest the idea of an evolutionarily conserved mesopontine cholinergic system coexpressing nitric oxide synthase.