[Inverted papilloma and its association with human papillomavirus (HPV). A study with polymerase chain reaction (PCR)]. / Das inverte Papillom und seine Assoziation mit dem humanen Papillomvirus (HPV). Eine Studie mit der "polymerase chain reaction" (PCR).

Nasal inverted papilloma is usually a benign tumor but is associated with squamous cell carcinoma in about 10% of cases. To determine the etiological role of human papillomavirus (HPV) in inverted papilloma and to clarify the relationship between the different types of human papillomavirus and malignant transformation, we analyzed retrospectively a series of 29 formalin - fixed, paraffin-embedded cases, 3 of which had squamous cell carcinoma. A highly sensitive and specific modification of the polymerase chain reaction (PCR) was used to detect the E6 gene sequences of HPV 6/11, 16 and 18. HPV was present in 20 of the cases (69%), HPV 6/11 in 14 (48%), HPV 16 in 19 (65%) and both HPV 6/11 and 16 in 13 of the specimens (45%). HPV 18 was not identified in any specimen. In all three of the squamous cell carcinomas based on inverted papillomas, HPV 6/11 and 16 were detected. These results were in agreement with other studies. While HPV is related etiologically to inverted papilloma, we suggest that HPV 16 may be involved in its malignant transformation.

[Diagnosis and therapy of seromucous otitis. Experience with 2766 operations on children]. / Diagnostik und Therapie beim Mucoserotympanon. Erfahrungen nach 2766 Eingriffen bei Kindern.

We compared tympanometric patterns with the type of ear effusion on 1693 ears of children with chronic seromucous otitis. There was no exact agreement between the tympanograms and the viscosity of the middle ear effusion. We inserted ventilating tubes in 943 of 2766 ears with SOM. A tube was only used if there was mucus in the middle ear. In cases of thin fluid we used myringotomy alone. A test to find the best tube is discussed. For a child with SOM the insertion of a ventilation tube is so helpful and complications so rare that in our opinion there is no better way of treatment. The complications are probably related more to the underlying disease than to the ventilation tube.

[Benzopyrene (BaP) implants into the glottic mucous membrane of hamsters]. / Benzpyren (BaP)-Implantate in die Glottisschleimhaut beim Feldhamster.

For testing the effect of benzo (a) pyrene (BaP) on glottical epithelium European hamsters were used. With laryngofissure hamsters larynges had been opened and a mixture of tricaprilin, beewax and 1 mg BaP was implanted into a pocket formed by mucous membrane of one vocal fold. Compared to typical histology in smoker's larynx, squamous metaplasia and dysplasia and in one case papillary polyps could be described. No squamous cell carcinomata was found.

[The intratympanic pressure ratio modified by nitrous oxide and dependent upon retrotympanic volume]. / Die Druckverhältnisse in der Pauke unter Lachgaseinfluss in Abhängigkeit vom retrotympanalen Volumen.

We measured the middle ear pressure of patients with intact middle ear during general anaesthesia with Halothane and N2O. The Madsen-Impedance-Measuring-Instrument ZO 73 was used. The planimetric size of the mastoid bone cavity was determined on radiograms in Schüller projection. The pressure in the middle ear space was found dependent from the size of the mastoid bone. The height of the middle ear pressure during tympanoplasty is not without problems, this will be discussed, and the advantages of local-anesthesia will be pointed out as well.

[Intratympanic pressure changes during general anaesthesia (author's transl)]. / Veränderungen des Mittelohrdrucks in Allgemeinnarkose bei Verwendung von Lachgas.

A common observation during otologic surgery under general anaesthesia, notably with nitrous oxide, is tympanic membrane graft displacement due to elevated intratympanic pressure. It can be assumed that nitrous oxide increases the intratympanic pressure. The authors measured the intratympanic pressure changes with the Madsen Impedance measuring instrument Z073. The results of the measurements of 84 ears are discussed and the tendencies of the connection between pressure in the middle ear and the size of the mastoid bone are shown.

[Study on clinic and etiology of human laryngoceles by help of Silopren -casts (author's transl)]. / Untersuchungen über Klinik und Atiologie menschlicher Laryngocelen anhand von Kunststoffausgusspräparaten.

In different papers the statistical number of the finding of a laryngocele is changing. This perhaps should be related to the fact that there is no equal definition. Therefore an own definition for the examination of 50 Silopren -casts from laryngeal autopsies is given. In 64% of the cases one or more sacculi laryngis were found. The sex-distribution was about 50%. By looking at the clinical history it seems that exogenic factors have an influence on the extent of laryngoceles.

[A contribution to diagnosis, specificity and treatment of rhinoscleroma (author's transl)]. / Zur Frage der Diagnostik, Spezifität und Therapie des Rhinoskleroms.

As a disease with a peculiar geographical distribution rhinoscleroma is a kind of chronic inflammation which may cause some diagnostic difficulties in non-endemic regions. In general, the diagnosis based on histological features and the microbiological identification of the causative agent. In case where a definite microbiological identification could not be achieved the diagnosis should be expressed in the following terms: "rhinosclerotic granuloma with features of specificity". The diagnosis is facilitated by the aid of cytological methods which are easy to perform and do not hurt the patient. The characteristic cells of the Mikulicz type may be observed in the smear. This paper presents the case of a 25-year old man with a rhinosclerotic granuloma of the larynx which caused dyspnea and aphonia. The diagnostic procedure was done by cytological, histological and ultrastructural methods. The patient was treated by surgery and by applications of antibiotics.

[Classification of laryngeal papillomas and papillomatosis (author's transl)]. / Klinische und histologische Klassifizierung der Larynxpapillome und Papillomatosen.

The clinical behavior of laryngeal papillomas is discussed by literature and by own 130 cases. Laryngeal papillomatosis is an epithelial proliferative lesion. Without prejudice to viral aetiology it can be interpreted in some cases as a dysplastic epithelial Tumor with the risk of cellular change to carcinoma. A histologic and cytologic classification of laryngeal dysplastic papilloma is described. The basic knowledge has been gained by the experiences in the diagnosis of oral-carcinom, portio-carcinoma and larynx-carcinoma. This classification is used for 48 selected cases of multiple and recurrence laryngeal papillomatosis in which sometimes also elder histological preparations were still available. The results and clinical value are discussed.

[The anatomy of the laryngeal ventricle and its importance in carcinoma of the vocal cords (author's transl)]. / Zur Morphologie des Sinus Morgagni und seine Bedeutung für das Stimmlippen-Karzinom.

An anatomical study was made of the sinus of Morgagni (laryngeal ventricle) in 10 normal larynges and 15 larynges with vocal cord carcinoma. The most striking difference in those patients with malignancy was the relatively greater goblet cell population found. It is assumed that these anatomical changes reflect a disturbed function of the laryngeal ventricle. The epithelial metaplasia and the high goblet cell count probably indicate an increased risk of vocal cord carcinoma.

[Laryngeal leukoplakias (author's transl)]. / Leukoplakien des Kehlkopfes. Histologisch-zytologische Klassifizierung.

A histologic and cytologic classification of laryngeal dysplastic leukoplakias is described. The basic knowledge has been gained by the experience in the diagnosis of portio-carcinoma. Histologic and cytologic illustrations of different dysplastic stages are shown. The final classification including the clinical description is achieved by cytology and histology.

A new approach to the treatment of laryngeal papilloma in adults.

Twenty-six cases of multiple laryngeal papillomatosis were treated by a newly developed grafting technique. The larynx was opened in the midline under local anaesthesia and the tumour mass was surgically resected. Mucous membrane along with the lamina propria was taken from patient's upper jaw and grafted over the wound, with the help of plain catgut on an atraumatic needle. Although our patients have been observed for only a short period of 5 years from 1972, no recurrence has been seen and good vocal cord function has remained.

[Radiologic examination of the larynx with exposures around 180 kV (author's transl)]. / Röntgenuntersuchungen des Larynx mit Aufnahmespannungen um 180 kV.

The roentgenexamination of the larynx with high voltage permits to recognize functional and morphological disorders of the larynx. In seven out of ten patients with laryngeal diseases the subglottic space altered its shape. The method gives similar results as tomographic, but should be easier to apply to serious diseased patients.

[Objective tinnitus and serous otitis media as symptoms of aberrant carotid artery (author's transl)]. / Objektives Ohrgeräusch und Tubenfunktionsstörung mit Mucoserotympanon durch Laterla-Verlagerung der A. carotis interna.

Following a review of the literature a case of a middle ear aberrant carotid artery is reported. To avoid dangerous haemorrhage with surgery auscultation of the external auditory canal is necessary in every case of serous otitis media with a pulsating tympanic membrane. The main symptom in this condition is objective tinnitus.

[Leukoplakias of the larynx (i. clinical and histological classification) (author's transl)]. / Leukoplakien des Kehlkopfes. (I. Klinische und histologische Klassifizierung).

A clinical and histological classification of leukoplakias of the larynx is described. Basis for this classification is the prognostically important systematical, histologic and cytologic knowledge gained in gynecology. The early clinical diagnosis limited to a macroscopic description of leukoplakias is completed by a prognostic attribute won by cytology and/or histology. Thus the final diagnosis of precancerous lesions of the larynx is classified into leukoplakias with low-graded dysplasias, middle-graded dysplasia, highgraded dysplasia and atypical epithelium. The old nomenclature regards dysplasias as facultative precancerous lesions and the atypical epithelium as an obligatory precancerous lesion.

[Improved differentiation of suspected chronic laryngeal lesions by highly dosed antibiotic therapy for a short time and comparing cytology (author's transl)]. / Verbesserte Differnzierungsmöglichkeit verdächtiger chronischer Stimmlippenveränderungen durch kurzzeitig hochdosierte Antibiotikatherapie und vergleichende Zytologie.

The valuation of chronic laryngeal lesions is eased by a combination of a highly dosed antibiotic therapy for a short time and observation of the therapy procedure by cytology. The cytological estimated dyscaryoseindex gives reference if suspicion on a malignant lesion can be kept in mind. Above this the proceeding enables us for exact and useful biopsies respectively for primary diagnostic and therapeutic operations.

[Management of multiple laryngeal papillomas in cases of grown up persons]. / Behandlung der Larynxpapillomatose bei Erwachsenen

The method of grafting autogenous oral mucous flaps for glottic reconstruction allows a very radical resection of multiple laryneal papillomas. In 13 cases of operated grown up persons after a time between 6 and 37 months there has been no recurrence in the transplantated region and the vocal cords are normal in function.

[Oral mucosal grafts in laryngeal reconstruction (author's transl)]. / Operationstechnik der freien Mundschleimhaut-Transplantation in den Kehlkopf

In many laryngofissure procedures large mucosal resections are necessary. Free grafts of oral mucosa have been used in over 50 patients over the past 3 years for glottic reconstruction, and these experiences are reported in detail. Its use in the management of papillomata of the adult larynx is stressed.

[Parameters of trauma at posterior subglottic region by long term translaryngeal intubation (author's transl)]. / Schädigungsparameter an der Ringknorpelplatte bei Langzeitintubation

The mechanical lesion is the beginning of inflammation and destruction in the posterior subglottic region in some cases of long term translaryngeal intubated patients. Beside movement of the tube, it is the pressure upon the posterior cartilage which is dangerous. The circumstances of that danger are studied. Practical proposals for reduction of subglottic complications are discussed.

[Nephropathy and deafness (Alport syndrome) without positive family history (author's transl)]. / Nephropathie mit Innenohrschwerhörigkeit (Alport-Syndrom) bei negativer Familienanamnese

This is a report of a 22-year-old man affected with hereditary nephropathy and deafness (Alport syndrome) without positive family history. The diagnosis is based on the typical clinical history, presence of symmetrical neural deafness, and terminal stage of renal insufficiency, that could not be classified otherwise following renal biopsy. The differential diagnosis and genetics are discussed.