[Balloon dilatation of the canaliculus communis for chronic epiphora]. / Therapie von Canaliculus-communis-Stenosen mittels Ballonkatheterdilatation.

PURPOSE: To examine the clinical outcome of the balloon dilatation in stenosis of the canaliculus communis. METHOD: 18 nasolacrimal ducts with epiphora and proven obstruction of the canaliculus communis by dacryocystography (DCG) were treated with balloon dilatation in local anaesthesia. All patients were treated electively. RESULTS: In 16/18 cases the balloon dilatation was technically successful, in 2 patients the guide wire failed to pass the obstruction and the wire could not be placed in the nasal cavity. There were no complications. Over a mean follow-up of 6 months there were 2 reobstructions, one of these led to an occlusion of the canaliculus communis. 14/18 (77,8%) cases after DCP were treated successful, 11/18 cases were free of symptoms after DCP, in 4/18 cases the epiphora improved. CONCLUSIONS: Until recently in stenosis of the canaliculus communis the only therapeutic option was surgical procedure followed by silicone tube intubation. The results were often disappointing. In contrast to this balloon dacryocystoplasty is a minimally-invasive alternative in the therapy of stenosis of the canaliculus communis resulting in good clinical outcome during follow up.

[Balloon dilatation and Stentimplantation of the nasolacrimal duct for chronic epiphora]. / Minimal-invasive Therapie der Epiphora durch Ballonkatheterdilatation und Stentimplantation.

PURPOSE: To examine the clinical outcome of the ballon dilatation in stenosis and obstruction of the nasolacrimal duct. MATERIAL AND METHODS: 63 patients (69 nasolacrimal duct systems) with epiphora and proven obstruction of the nasolacrimal duct were treated with ballon dilatation, respectively Stentimplantation. In 55 cases there was a pre- or postsaccal stenosis, in 14 cases an occlusion of the nasolacrimal duct system. The diagnosis was established by dacryocystography. RESULTS: Technical success was obtained in 61 cases (n=50/55 stenosis; n=11/14 occlusions). Over a mean follow-up of 6 months patency of the nasolacrimal duct system was achieved in 83,6% (46/55) in stenosis. In occlusion the clinical outcome was 42,9% (6/14). CONCLUSION: Balloon dacryocystoplasty and Stentimplantation are minimal-invasive alternatives, performed in local anesthesia that recover the normal anatomy of the nasolacrimal duct system. They are a good alternative in the treatment of epiphora caused by nasolacrimal duct obstructions.

Cortical blindness: an unusual complication after removal of a ganglioneuroma of the neck.

A 5-year-old girl was operated upon after a huge mass had been found on the left side of her neck. Preoperatively the anatomy was studied using MRI, including 3D-reconstruction of the tumor. The left vertebral artery was seen to cross the tumor, and during the operation the vessel was preserved. Postoperatively it thrombosed and a permanent cortical blindness developed. One year later MRI angiography of the intracerebral vessels was performed and a pre-existing anomaly of the circle of Willis was demonstrated, which had contributed to the development of the cortical blindness.

[The value of computerized tomography in the assessment of chronic osteomyelitis. A radiological, histological and clinical correlation study]. / Der Wert der Computertomographie bei der Abklärung der chronischen Osteomyelitis. Eine radiologische, histologische und klinische Korrelationsstudie.

Twenty-three consecutive CT examinations in cases of chronic osteomyelitis were analyzed and compared to conventional radiologic and surgical findings and histologic examinations of samples taken specifically for the purpose. CT is the most reliable method of detecting sequesters. A detailed structural analysis of the bone in regard to old bone portions and osteomyelitic osteoneogenesis is possible, but osteonecrosis cannot be detected with certainty. Abscesses and fistulae can be demonstrated with a high degree of reliability, using contrast medium if necessary. CT influences the authors' decisions concerning planned revisional surgery in chronic osteomyelitis cases more than any other examination method. It is used in all osteomyelitis diagnoses following removal of the metal.

[Abdominal wall hematoma as a severe complication of anticoagulation. Clinical picture and ultrasonic diagnosis]. / Bauchwandhämatome als schwere Komplikation der Antikoagulation. Klinik und Ultraschalldiagnostik.

In 4 women patients aged over 60 years under anticoagulation, abdominal pain, which was in part clearly localizable, and signs of acute bleeding suddenly occurred. All were under treatment with marcoumar, while one was also in the transitional phase from parenteral to oral therapy with heparin. Initially, apart from pain on pressure, there were no local signs of bleeding. In the acute stage it was impossible to distinguish clinically between abdominal wall bleeding and intraperitoneal bleeding. Ultrasound provided the diagnosis of abdominal wall bleeding in all cases. All of them were successfully treated by conservative means.

[Cytomegalovirus pneumonia in primarily healthy adults]. / Zytomegalievirus-Pneumonie beim primär gesunden Erwachsenen.

The case is reported of an 18-year-old woman hospitalized with severe dyspnea and high temperature. Chest X-ray showed pneumonia with interstitial and air-space consolidation patterns. Serologic tests revealed a cytomegalovirus infection (CMV). The blood findings showed anemia of infectious origin. Liver biopsy was consistent with CMV-hepatitis. CMV-pneumonia in an otherwise healthy patient is extremely rare; a review of the literature revealed only four other cases.

[The place of xerography combined with routine conventional mammography (author's transl)]. / Stellung der Xeroradiographie neben der routinemässig durchgeführten konventionellen Mammographie

Xeroradiography is a valuable supplement to conventional mammography, especially in cases with dense glandular structure. In our patient material this new procedure was necessary for clarification of findings on conventional mammography in 16% of cases and improved diagnostic yield. Indirect and direct signs of carcinoma were more easely recognized with xeroradiography, since more detail is visualized because of greater latitude and edge contrast enhancement. Moreover the area visualized is considerably greater. The soft tissue structures can be seen to the level of the thoracic wall. Viewing the films is less tiring than reviewing conventional mammography films. A relatively greater exposure latitude and short exposure times are further advantages of this method.