[Intraoral voice recording-towards a new smartphone-based method for vocal rehabilitation. German version]. / Die intraorale Sprachaufnahme ­ die Perspektive einer neuen Smartphone-basierten Methode zur stimmlichen Rehabilitation.

After laryngectomy, a new voice is needed. We present the first steps in the development of a smartphone-based method. A microphone is placed in the mouth to record the pseudo-whispering voice of laryngectomized patients. This recording is analyzed by voice recognition software followed by voice synthesis. Eventually, this will be performed on a smartphone. We placed a microphone at 10 different places inside and outside the mouth (two in front of the mouth (at 2 and 20 cm), five on the palate and three on the lower jaw) and made voice recordings in eight healthy men. These recordings were analyzed by voice recognition software. The text generated by the software was compared with the original text. Over all positions, the correct detection of words recorded in the mouth was 19.3% vs. 75.2% (p = 0.01) outside the mouth. In the mouth, recording taken on the maxilla (22.8%) was much better than on the mandible (13.5%) (p = 0.01). The optimum position for a microphone on the maxilla was at the highest point of the palate with 31.9% correct word identification there (p = 0.028). Further investigations have to be undertaken with forthcoming development of smartphone processing power and with development of a smartphone-based voice recognition application.

Intraoral voice recording-towards a new smartphone-based method for vocal rehabilitation.

After laryngectomy, a new voice is needed. We present the first steps in the development of a smartphone-based method. A microphone is placed in the mouth to record the pseudo-whispering voice of laryngectomized patients. This recording is analyzed by voice recognition software followed by voice synthesis. Eventually, this will be performed on a smartphone. We placed a microphone at 10 different places inside and outside the mouth (two in front of the mouth (at 2 and 20 cm), five on the palate and three on the lower jaw) and made voice recordings in eight healthy men. These recordings were analyzed by voice recognition software. The text generated by the software was compared with the original text. Over all positions, the correct detection of words recorded in the mouth was 19.3% vs. 75.2% (p = 0.01) outside the mouth. In the mouth, recording taken on the maxilla (22.8%) was much better than on the mandible (13.5%) (p = 0.01). The optimum position for a microphone on the maxilla was at the highest point of the palate with 31.9% correct word identification there (p = 0.028). Further investigations have to be undertaken with forthcoming development of smartphone processing power and with development of a smartphone-based voice recognition application.

Age-corrected hearing loss after chemoradiation in cervical cancer patients.

OBJECTIVE: This study aimed to evaluate subjective and objective hearing loss in cervical cancer patients after chemoradiation with cisplatin (mono). PATIENTS AND METHODS: A total of 51 cervical cancer patients with indication for chemoradiation were included. Pure tone and impedance audiometry were performed before and after chemoradiation. Hearing loss was scaled according to ASHA criteria. Subjective hearing was assessed with the Oldenburger Sentence Test. To consider age-dependent changes, hearing loss was corrected for age and the time interval between measurements. RESULTS: Median age at diagnosis was 46 years, 46% were active/former smokers (n = 24), 28 (54%) patients were never-smokers. Median total weekly cisplatin dose was 70 ± 14.2 mg. Cumulative doses of cisplatin during chemoradiation ranged between 115.2 and 400 mg cisplatin (mean 336.1 mg, median 342 ± 52.7 mg). The median interval between last chemotherapy and second audiometry was 320 ± 538 days (35-2262 days). Changes in hearing threshold ≥20 dB were experienced by 32/52 patients (62%) following chemoradiation, 55% of them for frequencies ≥6000 Hz. No statistically significant hearing loss remained after chemoradiation upon correction for age and time interval. Patients >40 years had a higher risk of hearing loss than younger patients. Objective data on hearing function did not correlate with subjective hearing loss and did not impair daily activity in any patient. CONCLUSION: Chemoradiation with cumulative cisplatin doses up to 400 mg did not lead to significant impairment of objective or subjective hearing. For cervical cancer patients undergoing chemoradiation, standard audiometry is not indicated.

Devitalisation of human cartilage by high hydrostatic pressure treatment: Subsequent cultivation of chondrocytes and mesenchymal stem cells on the devitalised tissue.

The regeneration of cartilage lesions still represents a major challenge. Cartilage has a tissue-specific architecture, complicating recreation by synthetic biomaterials. A novel approach for reconstruction is the use of devitalised cartilage. Treatment with high hydrostatic pressure (HHP) achieves devitalisation while biomechanical properties are remained. Therefore, in the present study, cartilage was devitalised using HHP treatment and the potential for revitalisation with chondrocytes and mesenchymal stem cells (MSCs) was investigated. The devitalisation of cartilage was performed by application of 480 MPa over 10 minutes. Effective cellular inactivation was demonstrated by the trypan blue exclusion test and DNA quantification. Histology and electron microscopy examinations showed undamaged cartilage structure after HHP treatment. For revitalisation chondrocytes and MSCs were cultured on devitalised cartilage without supplementation of chondrogenic growth factors. Both chondrocytes and MSCs significantly increased expression of cartilage-specific genes. ECM stainings showed neocartilage-like structure with positive AZAN staining as well as collagen type II and aggrecan deposition after three weeks of cultivation. Our results showed that HHP treatment caused devitalisation of cartilage tissue. ECM proteins were not influenced, thus, providing a scaffold for chondrogenic differentiation of MSCs and chondrocytes. Therefore, using HHP-treated tissue might be a promising approach for cartilage repair.

Contribution of human papilloma virus to the incidence of squamous cell carcinoma of the head and neck in a European population with high smoking prevalence.

BACKGROUND: Increases in incidence of oropharyngeal squamous cell carcinoma (OPSCC) in countries with falling tobacco use have been attributed to a growing role of human papilloma virus (HPV) in the carcinogenesis. Trends of HPV prevalence in populations with persistently high portions of smokers are poorly characterised. PATIENTS AND METHODS: Registry data from East Germany were used to determine incidence trends between 1998 and 2011. Data from patients treated at the Charité University Medicine Berlin between 2004 and 2013 (cohort 1, N=436) were used for estimation of trends in HPV prevalence, smoking and survival. HPV prevalence was prospectively confirmed in cohort 2 (N=213) comprising all primary HNSCC cases at the Charité in 2013. RESULTS: Between 1998 and 2011 incidence of both OPSCC and non-OPSCC increased. An increase in HPV prevalence (% of HPV+ cases in 2004-2006 versus 2012-2013: 27% versus 59%, P=0.0004) accompanied by a moderate decrease in the portion of current smokers was observed in OPSCC but not in non-OPSCC. The change in disease epidemiology in OPSCC was associated with significant improvement in overall survival. Increased HPV prevalence in OPSCC (48%) compared to non-OPSCC (11%) was confirmed in cohort 2. CONCLUSIONS: Despite clear differences to the United States in terms of tobacco use, the increase in OPSCC incidence in a European population was also mainly attributed to HPV, and the HPV status significantly affected prognosis. For clinical trial design it is important to consider the large group of smokers within HPV-induced OPSCC.

[The costs for different voice prostheses depending on the lifetime]. / Die Kosten für verschiedene Stimmprothesenmodelle in Abhängigkeit der durchschnittlichen Liegezeit.

Voice prostheses are available in different types of architecture und from different producers. Especially the ones with antifungal properties are characterized by a high pricing. The aim of this paper is to check, whether these prices are reflected by the prosthesis life time.A Benchmarking with usage of mean lifetime and prosthesis costs. Comparing Provox 1, Provox 2, Provox Vega, Provox ActiValve, ESKA-Herrmann, Blom Singer Classic, Phonax, Blom Singer Advantage.The voice prosthesis Provox 1 offers the best price-lifetime-ratio (1.0). It's 6.7-times higher than the one of the Provox ActiValve (0.15). In addition, the classic prostheses Provox 2 (0.53), Blom Singer Classic (0.54) and ESKA-Herrmann (0.72) offer a good ratio compared to Provox 1, too.The mean lifetime of the voice prostheses do not reflect the pricing. The Provox 1 offers the best ratio and should be used as a reference in pricing the prostheses.

[The vocal rehabilitation with ESKA-Herrmann voice prosthesis. a report of a 10 years' experience]. / Die stimmliche Rehabilitation mit ESKA-Herrmann Stimmprothesen. Ein 10-Jahres Bericht (n=201).

ESKA-Herrmann voice prosthesis are available for almost 30 years and are used for the vocal rehabilitation of laryngectomees. Nevertheless there are no studies about this voice prosthesis. Especially because of the smaller external diameter of 5.5 mm differents to other voice prostheses may be expected.We analyzed the 10-year patient documentation in retrospect.67 patients (63 m/4f) got the ESKA-Herrmann voice prosthesis, which could be used with a mean lifetime of 131.4 days. The main reason of changing the prostheses were dislocation (34/119), loss by coughing (34/119) and the leakage around the prostheses. In total a good voice was documented in 83.9% of the prostheses.ESKA-Herrmann voice prostheses are an alternative to other prostheses. Because of the smaller external diameter the dislocation and loss of the prosthesis occur more often than other models. But it's the only model that allows a designated spontaneous closure of the trachea-esophageal fistula after prosthesis removal.

[Recurrent epistaxis of unknown origin. A rare differential diagnosis and its treatment]. / Rezidivierende Epistaxis bei unklarer Blutungsquelle. Betrachtung einer seltenen Differenzialdiagnose und der Therapie.

We present the case report on a 66-year-old male patient who appeared in our clinic with recurrent epistaxis. Anterior rhinoscopy during acute bleeding yielded no information on the origin of hemorrhage. On renewed epistaxis, angiography was performed on which an arteriovenous malformation in the sphenoid sinus could be identified as the cause of epistaxis. Embolization of afferent vessels successfully reduced the malformation and stopped the bleeding. In cases of recurrent epistaxis, especially in combination with an unremarkable anterior rhinoscopy, angiography is recommended for the detection of life-threatening vessel malformations.

[Time course of microbial colonization of different voice prostheses]. / Die mikrobiologische Oberflächenbesiedlung verschiedener Stimmprothesenarten in der Zeitkinetik.

OBJECTIVE: For the vocal rehabilitation of laryngectomized patients, voice prostheses are actually one of the best known methods. Caused by the surface colonisation with bacteria and fungi the life time of the prostheses is limited to 3-4 months. MATERIAL AND METHODS: In a time period of 127 months we analysed the surface colonisation of 118 voice prostheses. RESULTS: The mean life time of the prostheses was 156 days. In reference to the prosthesis model we also recorded different times of usage (ESKA-Herrmann 141, Provox 2 184 and Provox 1 204 days (p>0.05)). In the microbiological examination the dominating bacteria were S. aureus, Klebsiella sp. and Proteus sp. It was possible to cultivate all these bacteria on every type of prosthesis used in the study. In addition C. albicans, C. glabrata, C. krusei and C. tropicalis were the main fungi on the silicone surface. Thereby a more frequent colonisation with C. krusei on ESKA-Herrmann prostheses was measured, caused by the bigger contact area with saliva on this model (p=0.034). CONCLUSIONS: Because of the similar position and way of function, all types of voice prostheses are colonized by almost the same species of bacteria and fungi. But in dependency of the type an affinity of individual species to special prostheses exist. The knowledge of these individual affinities is necessary for the further development of voice prostheses. Furthermore the diversity of bacteria and fungi species showed a level of saturation on the surface. This is caused by the limited space on the silicone prostheses.

[Rare mechanisms of blowout fractures. Discussion of two case reports]. / Seltene Mechanismen von Orbitabodenfrakturen. Diskussion von 2 Fallberichten.

In the emergency room different forms of traumata with resulting insulating orbital blowout fracture are observed. The cause of accident is almost always impact to the central face with a solid object or on a hard surface. The hydraulic pressure theory and buckling force theory in terms of the pathomechanism are valid and accepted explanation models. We report two clinical cases of unusual injury mechanisms, which we discuss with reference to the available literature.

[Devitalization of cholesteatoma on human ossicles by hydrostatic high pressure treatment]. / Devitalisierung von Cholestatomanteilen humaner Ossikel durch hydrostatische Hochdrucktechnik.

BACKGROUND: In cholesteatoma surgery the use of autogenous ossicles for restoration of sound conduction is often limited because of ingrowth of matrix epithelia into the ossicular bone. In an attempt to eliminated these epithelial cells we tested extracorporal high-pressure hydrostatic treatment as a new method for devitalizing the bone but maintaining its structure. METHODS: The inpact of different high hydrostatic pressures either on single cell suspensions of fibroblasts and osteoblasts, or on cells in ex-vivo ossicles chain was examined with different methods (quantitative proceedings, live/dead assay). Additional electron microscopic investigations illustrate the influence of high hydrostatic pressure treatment on cell suspensions of osteoblasts. RESULTS: High hydrostatic pressure between 150 MPa and 250 MPa showed no effect to cellular material. A safe elimination of cell growth was found after an application of pressures at or above 400 MPa. The electron microscopic investigations illustrate clearly the destruction of cellular membranes after high hydrostatic pressure treatment. CONCLUSIONS: These findings give hope that after extracorporal high hydrostatic pressure therapy autogenious ossicles might be used for middle ear recontructions even if they had contact with the cholesteatoma matrix or even were infitrated by keratinized squamous cell epithelia.

[Tracheostomy cannulas and voice prostheses]. / Kanülen und Stimmprothesen.

Tracheostomy cannulas and voice prosthesis are mechanical aids for patients, who for different reasons underwent either tracheostomies or laryngectomies. In this review, indications, surgical procedures, and consequencies of the preceeding surgical intervention are reported for a better understanding of the specific requirements for the artificial aids. In spite of the increasing number of percutaneous dilatation tracheostomies, e. g. in intensive care units, a classical tracheostomy with epithelialized connections between trachea and skin still represents the method of choice for all cases, in which a longer lasting access to the trachea is requested. Special tubes made of different materials, offering different physical qualities are used to keep the tracheostomy open and guarantee an easy access to the lower respiratory tract. For each individual patient the most adequate device must be found out. Voice prostheses allow a fast and effective vocal rehabilitation after laryngectomy. As many models are on the market with differences in terms of material, principle and design of the underlying valve mechanism, size etc., again, in each individual patient the most suitable prosthesis has to be chosen. In combination with special heat and moisture exchangers (HME), such prostheses not only allow a good vocal but also pulmonary rehabilitation. The duration of such prostheses depend on material properties but also on formation of biofilms (mostly consisting of bacteria and fungi) that can destroy the valve mechanism. Whenever possible, and additional valve mechanism covering the opening of the tracheostomy should be used in order to avoid the necessity to close this opening manually during phonation. Each doctor taking care of patients with speech prostheses after laryngectomy should know exactly what to do in case the device fails or gets lost.

[Lateral pharyngotomy--a rare method of access for removing foreign bodies from the upper third of the esophagus]. / Die laterale Pharyngotomie--ein seltener Zugangsweg zur Fremdkörperentfernung im oberen Osophagusdrittel.

Esophageal foreign body impaction is a serious emergency. Diagnostic workup includes an exact history and physical examination as well as several imaging modalities. The extraction of an esophageal foreign body can be done using nonflexible or flexible esophagoscopy. We report on a 43-year-old patient with typical symptoms of esophageal foreign body impaction. The x-ray overview upon admission showed the adjustment wires of one component of a metal denture in the area of the upper esophagus. Extraction by nonflexible esophagoscopy was rendered impossible because parts of the denture had speared themselves into the esophageal wall. Safe and uncomplicated removal was then performed through a lateral pharyngotomy.

Temporal bone investigations on landmarks for conventional or endosteal insertion of cochlear electrodes.

CONCLUSION: Our anatomical findings place special emphasis on the requirement to follow an infero-anterior approach to the round window, to expose the scala tympani safely for 'normal' cochlear implantation. It is also known how easily the basilar membrane may be accidentally damaged, despite exercising considerable caution in the approach used. With regard to an 'endosteal electrode' it can be stated that there are no really specific indicators to locate the spiral ligament, or each of the scalae, on the lateral aspect of the tissue layer encasing the cochlea. For the concept of an endosteal electrode, however, the soft tissue layer of the lateral aspect of the cochlea is considered to be sufficiently thick to serve as a physical barrier between the electrode and the inner ear fluid. OBJECTIVES: To re-evaluate surgical techniques of gaining access to the scala tympani for cochlear implantation (cochleostomy, 'fenestration'). There are two reasons for this study. First, recent publications show that in a significant number of patients the electrode array was unintentionally inserted into the 'wrong' scala (sc. vestibuli). Second, dealing with an alternative concept proposed by Lehnhardt for patients with residual hearing ('endosteal electrode'), the anatomical site of the spiral ligament should be known. In a study on human temporal bones the topography of the middle and inner ear is revised with regard to the presence of anatomical or surgical landmarks that may guide the surgeon. MATERIALS AND METHODS: Anatomical examinations were performed on 10 temporal bones (5 fresh specimens and 5 fixed in formalin), in which the bone of the promontory was carefully milled. The consistency of identification and the relative location of specific surgical indicators or landmarks such as 'blue lines' and 'gray lines' were evaluated for 10 temporal bones. Furthermore, the projection of the lateral attachment of the basilar membrane on the promontory was determined with regard to round window anatomy. RESULTS: In all cases, a major blue line indicated the lateral aspect of the basal cochlear turn while milling the promontorial bone. In a limited number of cases (20%), an additional gray line potentially indicated the spiral ligament before the last shell of bone was removed. In 80% of the cases it was possible to remove the bony layer and leave the endosteum intact as a precondition for a potential endosteal electrode insertion. In addition, through the examination of these models, the relative anatomical location of structures, such as the scala vestibuli, scala tympani, spiral ligament, and basilar membrane, is reviewed.

[Arrosion bleeding of the brachiocephalic trunc - a late complication after percutaneous dilatative tracheostomy in a patient with a cervical rib abnormality]. / Letale Blutung aus dem Truncus brachiocephalicus - Spätkomplikation nach Fehleinschätzung eines Dilatationstracheostomas bei rudimentärer Halsrippe.

BACKGROUND: In the last years percutaneous dilatative tracheostomy was increasingly established in many intensive care units, mostly performed by the anesthesiologists. This method becomes problematic, when it is used in patients requiring long time intubation. It must always be kept in mind that in the course of further rehabilitation the patients may be treated by persons, who are not familiar with the altered anatomy of the upper airways. This bears the risk for severy complications, like bleeding from major vessels. CASE REPORT: Letal arrosion bleeding of the brachiocephalic trunc was observed in a patient, 3 weeks after percutaneous dilatative tracheostomy (technique by Griggs). As an abnormality the patient had a cervical rib. The wrong position of the tracheostomy tube was not noticed because the patient had no dyspnoea, spontaneously breathing through the nose and mouth instead of through the tracheostomy tube. CONCLUSIONS: Particularly in patients requiring long-time intubation it is essential that the tube can be changed safely. We advocate an "epithelialized" tracheostoma with tracheocutaneous anastomosis for these patients. If the position of the tracheostomy tube is not clear, endoscopic control has to be performed.

[Concept and anatomical feasibility study of an "endosteal electrode" for bimodal stimulation in severely deaf ears]. / Konzept eines "endostealen" Cochlear Implant-Elektrodenträgers für Patienten mit Restgehör und Machbarkeitsstudie aus anatomischer Sicht.

BACKGROUND: Many patients with severe hearing loss could benefit from a bimodal stimulation unilaterally: acoustically in the apical region of the cochlea with some residual low frequency hearing and electrically via a cochlear implant in the basal turn with lost high hearing in the high frequency range. As a new concept we introduce the idea of an "endosteal electrode" - to be inserted between spiral ligament and endosteum of the bony wall without opening the fluid-filled inner ear. In this paper the feasibility from the anatomical point of view is to be proven. MATERIALS AND METHODS: In 10 human temporal bone specimens the bone covering the membraneous inner ear is carefully removed in the site of a typical cochleostomy. It should by proven whether or not the soft tissue layer covering the inner ear could be left intact and, furthermore, whether a "dummy-electrode array" could be inserted "endosteally". RESULTS: In 10 of the 10 specimen the preparation could be carried out in the desired way, leaving the spiral ligament intact. The regular site of the "electrode" was morphologically proven after embedding the specimens for histological evaluation. CONCLUSIONS: From the anatomical point of view, an "endosteal cochlear implantation" seems feasible. Further experiments including animal studies must show, whether this concept might succeed functionally.

[Long-term changes in peripheral blood leukocyte and lymphocyte populations in ENT-carcinoma patients. A flow cytometric study in 346 ENT-carcinoma patients and 31 healthy controls]. / Veränderungen von peripheren Blutzellpopulationen bei HNO-Karzinompatienten. Eine flowzytometrische Studie mit 346 akut erkrankten und therapierten Patienten bis 20 Jahre nach Abschluss der Therapie und 31 Kontrollpersonen.

BACKGROUND AND AIM: The aim of this investigation was the quantification of leukocyte/lymphocyte populations in the peripheral blood of ENT-carcinoma patients before and long after therapy. PROBANDS AND METHOD: PBL T-lymphocytes and NK-cells were examined in 346 patients and 31 controls using flow cytometry. In 248 participants additional populations of leukocytes, monocytes, granulocytes, lymphocytes in toto, CD4+- and CD8+-lymphocytes, CD4+8+-lymphocytes, B-lymphocytes, activated T-lymphocytes, NK-cells and CD3+56+-T-lymphocytes were studied. RESULTS: We demonstrated a long-term reduction in T-lymphocytes (CD4+-lymphocytes) in patients more than 10 years after receiving therapy, caused mainly, but not solely, by radio/chemotherapy. We also showed a long-term, significant increase in NK-cells after more than 10 years in patients following therapy without renewed carcinoma in comparison to controls, patients prior to therapy or patients with a recurrence of carcinoma. CONCLUSIONS: Due to long-term deficits in CD4+-lymphocytes, and considering the possible protective effect of NK-cells in treated patients, an immune-supportive therapy is recommended.

[In vitro culture of cells from respiratory mucosa on foils of collagen, poly-L-lactide (PLLA) and poly-3-hydroxy-butyrate (PHB)]. / In-vitro-Kultivierung von Zellen der respiratorischen Schleimhaut auf Matrizes aus Kollagen, Poly-L-Laktid (PLLA) und Polyhydroxybuttersäure (PHB).

BACKGROUND: The replacement of respiratory mucosa after surgical resections at different locations in the ENT-field (trachea, nasal septum, sinus maxillaris) seems to be essential or at least of great benefit for patients. Presently a satisfying solution for this challenge does not exist. Therefore we have analysed the growth of cells from respiratory mucosa on different matrices. METHODS: Cell cultures are initiated mainly by growing out cells from tissue pieces but also by seeding of cells after enzymatic dissociation (sequential trypsinization) of mucosa. Cells were cultured with serum-containing and serum-free media on 3 different foils: made of collagen, of Poly-L-lactic acid (PLLA) and Poly-hydroxybutyric acid (PHB). Culturing time was on average about 4 - 5 weeks. RESULTS: On all tested materials fibroblasts and epithelial cells have grown in principle. PLLA was the material with best properties concerning the aim of this study whereas culturing of cells on PHB only happens after surface modification by amino-functionalisation with plasma treatment. Visualisation of cells on materials of collagen could not realised by light-microscopy due to the 3-dimensional structure and the optical properties of this material. Here the cultures were analysed by cell membrane staining and by REM. We could not find a differentiation of epithelial cells with beating cilia 6 weeks after starting the culture. However 20 days after starting the culture on PLLA (good conditions for observation with light-microscope) cells with beating cilia could be observed, in our opinion resulting from dissociated cells from tissue pieces and not from proliferated cells. CONCLUSIONS: In principle the analysed materials are useful for the culturing of cells from respiratory mucosa. However, for obtaining differentiated epithelial cells the culture conditions have to be modified.

[Influence of rhinologic usual and unusual drugs on fibroblasts from nasal polyps in cell culture]. / Verhalten von Fibroblasten aus Nasenpolypen in Zellkultur nach Applikation üblicher Rhinologika und unüblicher Medikamente unterschiedlicher Wirkstoffgruppen.

BACKGROUND: Nasal polyposis is treated by surgery and/or by medication but in parts without permanent remission. Fibroblasts and their proliferation are involved in the complex mechanism of polyp genesis. Therefore we have analysed the influence of 12 medications on fibroblasts from nasal polyps growing in vitro. METHOD: Nasal polyps, obtained during usual surgical procedure, are enzymatically digested and cultured in serum containing media. The growing cells are identified as fibroblasts using flow cytometry with a AS02-FITC antibody (Dianova). The analysis is achieved with 5 - 6 different fibroblast cultures in each medicament tested, mostly using concentrations of the active substance from 0.006 to 1.333 mg/ml. The fibroblasts are cultured 4 days in the presence of active substances or as controls. Finally the cells are trypsinated and counted. RESULTS: Mometason, Beclomethason, Fluticason, Verapamil and Timolol are the group with the strongest reduction of fibroblasts. Mometason shows a reduction to 6 % of controls at a concentration of 30 micro g/ml whereas the reduction at this concentration amounts to 30 - 60 % in the other members of this group. Mesazalin, Methylprednisolone and Pentoxifylline demonstrate the smallest influence; Prednisolon-21-hydrogen-succinate, Pilocarpin, Piroxicam and Diclofenac show an effect on a middle level. CONCLUSIONS: A strong reduction of fibroblasts from nasal polyps in vitro is possible with usual rhinological medicaments but also with unusual substances in this field.