Laryngo-rhino-otologie最新文献

The treatment of orbital masses often requires an interdisciplinary approach. Ophthalmological surgical approaches include the anterior transcutaneous approach for removal of dermoids or taking biopsies. Anterior transconjunctival orbitotomy is suitable for masses of the inferior orbit or the intraconal compartment, but is inappropriate for masses of the orbital apex. The lateral transosseous orbitotomy often fits for masses of the lateral or intraconal compartment, especially for neoplasms of the lacrimal gland e.g. pleomorphic adenoma. Cryoextraction is often the technique of first choice for cavernous haemangiomas of all localisations. Transfrontal approaches are suitable for the resection of tumours of the optic nerve and of the orbital apex.

Literature already reports on positive effects of complementary medicine music interventions on anxiety, depression, pain and stress. These symptoms are frequently observed in patients with acute vestibular vertigo. However, there are no studies on the effect of music interventions in terms of quality of life (QoL) and reduction of symptoms in these patients. The present study aims to investigate these effects, particularly on vertigo symptoms and health-related QoL.Patients with acute unilateral vestibulopathy confirmed by diagnostic tests were enroled in a prospective intervention study approved by the local ethics committee. The intervention group was asked to listen to music for 60 minutes daily. They recorded their dizziness intensity in a diary over the 14-day observation period using a numerical rating scale (NRS). QoL was assessed using the Dizziness Handicap Inventory (DHI) on days 1, 3 and 14 after the start of the intervention.A total of 25 patients were included, 13 in the intervention and 12 patients in the control group. On day 14, mean DHI score was significantly lower in the intervention group at 16.92 points than in the control group at 24.17 points (p = 0.01). The dizziness intensity determined using the NRS tended to be lower in the intervention group at the end of the music intervention, but without being statically significant (p > 0.05).A positive effect of music intervention in acute unilateral vestibulopathy was found, especially at the end of the intervention. Due to their ubiquitous availability, passive music interventions can be easily implemented in clinical practice and could be a useful additional component in the treatment of acute peripheral vestibular vertigo.

Osteomyelitis of the temporal bone (OTB) is a rare inflammatory disease that can spread from the ear canal to adjacent soft tissue and bone structures. This expansion is challenging to treat and thus can become life-threatening. The detection of the causative pathogen is crucial for successful therapy. Current studies have revealed a diverse spectrum of pathogenic microorganisms in OTB. The aim of our study was to compare the microbiological background of our OTB-patients with data in recent literature.In this retrospective, single-center study patients diagnosed with OTB over a 10-year period were included (n=39). We analyzed the microbiological spectrum, clinical symptoms, radiological findings and course of the disease.Most common symptoms were otalgia (n=29, 74.4%) and otorrhea (n=24, 61.5%). Microbiological assessment showed most frequently P. aeruginosa (n=21, 53.8%) and the detection of this pathogen was associated with increased CRP levels (p<0.05). Computed tomography showed a washed-out bone texture of the petrous bone in 38 patients (97.4%). During the follow-up period 10 patients (25.6%) reported an improvement of symptoms, whereas 23 patients (59.0%) described their persistence. Four patients (10.3%) died.In contrast to recently published data, in our patient cohort P. aeruginosa remains the most common and challenging causative pathogen of OTB. Therefore, when selecting an empirical therapy attention should always be given to its efficacy against this pathogen.

With the increasing clinical relevance, training in head and neck sonography becomes also more important. In Germany, the training regularly takes place as part of certified courses. To date, there is no prescribed standard for assessing competence as part of these courses. So-called direct observations of procedural skills (DOPS) represent a possible form of practical skills assessment. This paper describes their integration into corresponding courses and the evaluation by the course participants.A total of seven DOPS on various topics were carried out in five courses over a period of around 18 months and evaluated by the participants using a predefined questionnaire. The participants' performance was assessed in a structured and standardized manner using a predefined examination form.The DOPS were evaluated positively by the participants across all courses. The participants certified a high didactic benefit of the DOPS and spoke out in favor of increased use in education and training. Overall, high scores were achieved. Although there was a tendency towards a higher overall score for participants in the advanced/final courses compared to participants in the basic courses, this was not statistically significant.DOPS offer a didactically useful option for testing the acquired ultrasound skills as part of corresponding courses. Further validation and standardization should be sought.