[Dysphonia and dysphagia after anterior cervical spine surgery]. / Dysphonie und Dysphagie nach anterioren Zugängen zur Halswirbelsäule.

BACKGROUND: Anterior cervical spine surgery is a common procedure for fusions and/or discectomies. Postoperative dysphonia and dysphagia are known complications. In this study, we examined the frequency and outcomes of these complications in this patient population. MATERIALS AND METHODS: Patients planned to receive anterior cervical spine surgery between 01.03.2010 and 28.02.2011 at the Department of Neurosurgery, St. Gallen were prospectively included. Patients were evaluated using laryngoscopy, fiberoptic endoscopic evaluation of swallowing (FEES), voice field measurements and validated questionnaires. RESULTS: From the 53 patients included in the study, 40 had at least one complete follow-up examination. The frequency of postoperative dysphonia due to recurrent nerve palsy was 4/40 (10 %), although this was temporary in 3 patients. FEES revealed a pathological result in 18.9 % of patients. Postoperative Swallowing Quality of Life Questionnaire (Swal-QoL) scores were significantly lower. CONCLUSION: At a frequency of 10 %, dysphonia due to recurrent nerve palsy is a relevant complication in cervical spine surgery, albeit temporary in most cases. Postoperative dysphagia is common and should be evaluated and treated during follow-up.

[Pustules from the cow barn]. / Pusteln aus dem Kuhstall.

A 54-year-old cattle farmer presented with crusty purulent plaques in the neck area. The clinical picture and microscopical proof of hyphae in the skin smear combined with Wood's lamp testing led to the diagnosis of Tinea barbae, a mycological infection of the skin transmitted by cattle (typically Trichophyton verrucosum). Therapy with itraconazole 200 mg q.d. p.o. and miconazole ointment 1×/day over 2 weeks was successful. This case report and its image are designed to bring attention to this rarely diagnosed pathology.

Herpes zoster-associated trigeminal trophic syndrome: a case report and review.

The case of a 75-year-old Caucasian woman with a trigeminal trophic syndrome (TTS) is presented and discussed. TTS of the ala nasi subsequent to a herpes zoster infection has not been described previously. We provide a review of the literature with insights into the pathogenesis and current therapeutic strategies.

The pathology of the temporal bones of a child with acquired cytomegalovirus infection: studies by light microscopy, immunohistochemistry and polymerase-chain reaction.

STUDY DESIGN: The first case of an acquired cytomegalovirus (CMV) infection of the inner ear is reported in a 3-year-old girl in remission from acute lymphocytic leukemia. METHODS: Horizontal sections of the temporal bones were studied by light microscopy and immunohistological staining by avidin-biotin-complex-technique was performed on selected archival sections. Three sections were processed for detection of the virus genome by the polymerase chain reaction (PCR). RESULTS: By light microscopy the epithelium of the endolymphatic sac, the utricle and the semicircular canals showed deeply stained acidophilic inclusions and the stria vascularis had a loose structure especially in the intermediate layer. The changes were limited to the non-sensory parts of the labyrinth and no CMV type cells were observed in the organ of Corti. There was a loss of inner and outer hair cells and loss of cochlear ganglion cells caused by either the virus or treatment with gentamicin. Standard immunohistochemistry failed to demonstrate staining with CMV antibodies, but PCR, demonstrated CMV-DNA in one section. CONCLUSION: Molecular techniques may be able to detect acquired CMV infections in archival pediatric bones temporal bones. The histologic findings in the labyrinth were milder, however showed some similarity to children with congenital CMV labyrinthitis.