Successful implantation of a cochlear implant in a four-yr-old boy after kidney transplantation: a case report.

Sensorineural hearing loss is common in children with chronic renal insufficiency. The implantation of a CI is performed routinely in children with profound sensorineural hearing loss. A feared complication is a local infection with subsequent meningitis. Because of this risk, a successful implantation of a CI in children under immunosuppression after kidney transplantation has yet to be described. A four-yr-old boy with congenital renal dysplasia and posterior urethral valves, who was successfully transplanted with a kidney from his father at the age of two and a half yr, is presented. The boy had profound bilateral hearing loss before transplantation, most likely due to ototoxic antibiotic medication and long-term furosemide use. A hearing aid was insufficient; therefore, a CI was performed 20 months after the transplantation and no complications occurred in the 24 months of follow-up. This is the first report of a successful CI in a child after kidney transplantation.

[Laryngeal granuloma. Aetiology, clinical signs, diagnostic procedures, and treatment]. / Laryngeales Kontaktgranulom. Atiologie, Symptomatik, Diagnose und Therapie.

Vocal cord granulomas are benign inflammatory lesions of the vocal cords. They are usually located over the vocal process of the arytenoid cartilage. A corresponding ulcer on the contralateral side is a common finding. Clinical signs include foreign body sensation, a need to repeatedly clear one's throat, hoarseness, and reduced voice resilience. Voice abuse and gastro-oesophageal reflux are commonly cited important aetiological factors. Differentiation from malignant lesions is usually possible by history and clinical examination; biopsy is only rarely necessary. The primary treatment is speech therapy or voice counselling, if necessary, supported by antacids. Surgical excision is not helpful because contact granulomas tend to recur. We present two typical cases of vocal cord granulomas and discuss their management.

[Apoplexy, diverticulum or Alzheimer disease? Deglutition disorders in seniors must always be evaluated!]. / Apoplex, Divertikel oder Alzheimer? Schluckstörungen bei Senioren immer abklären!

Problems with swallowing (dysphagia) occur in association with numerous illnesses. In many cases, however, they are either not recognized or considered not to require clarification, since other symptoms are of greater importance. In elderly, often multimorbid patients, neurodegenerative diseases, such as apoplexy, are the most common causes of dysphagia, but medications with central nervous side effects may also impair swallowing. The difficulty may be localized either in the oropharyngeal region or in the esophagus. There is considerable danger that such complications as aspiration pneumonia and malnutrition may occur and thus increase morbidity and mortality. In addition, the quality of life of the patient may also be diminished. The family doctor has the important task of initiating a differentiated diagnosis based on careful history-taking and a clinical examination that should include an inspection of the oral cavity and the nerves supplying the brain. Early treatment, for example, involving a logopedist, can be effective.