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Thomas M, Scheer M, Rampp S, Strauss C, Schönfeld R, Leplow B. Psychological factors and long-term tinnitus handicap in vestibular schwannoma patients after retrosigmoid microsurgery - a cross-sectional study. Int J Audiol 2024:1-8. [PMID: 38613519 DOI: 10.1080/14992027.2024.2339351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/01/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE This study aimed to investigate the connection between psychological factors and postoperative tinnitus in vestibular schwannoma (VS) patients following retrosigmoid microsurgery. DESIGN Cross-sectional study. STUDY SAMPLE Ninety-three VS patients participated, completing questionnaires on demographics, tinnitus severity (THI-12), personality traits (TIPI-G), dizziness impact (DHI), perceived health benefits (GBI), somatisation tendencies (SOMS-2), and psychological distress (HADS-D). Our analysis involved Mann-Whitney U-tests, Spearman's rank-order correlations, and false discovery rate correction. RESULTS Most participants reported postoperative tinnitus (77/93), with 41 experiencing it preoperatively. Emotional stability correlated negatively with tinnitus presence, while tinnitus severity was associated with emotional distress. Preoperative somatisation tendencies were also positively linked to tinnitus severity. Postoperative Tinnitus was further linked to reduced perceived health benefits and increased anxiety and depression levels. Notably, age and gender showed no significant associations. CONCLUSION This study uncovers the interplay between postoperative tinnitus and psychological factors in VS patients, highlighting emotional and cognitive dimensions. Tailored psychological interventions addressing tinnitus's psychosomatic impact may enhance patients quality of life.
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Affiliation(s)
- M Thomas
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Scheer
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
| | - S Rampp
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - C Strauss
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
| | - R Schönfeld
- Department of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - B Leplow
- Department of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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Allera H, Cohu M, Maley K, Crabot D, Karila-Cohen P, Strauss C, Lidove O, Cotto E. [Thoracic calcifications]. Rev Med Interne 2024; 45:176-177. [PMID: 37833151 DOI: 10.1016/j.revmed.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 10/15/2023]
Affiliation(s)
- H Allera
- Service de gériatrie aiguë, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - M Cohu
- Service de gériatrie aiguë, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - K Maley
- Service de gériatrie aiguë, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - D Crabot
- Service de gériatrie aiguë, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - P Karila-Cohen
- Service de radiologie, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - C Strauss
- Service de radiologie, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - O Lidove
- Service de médecine interne, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
| | - E Cotto
- Service de gériatrie aiguë, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
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Strauss C, Fodor KJ, Anker A, Kemper R, Prantl L, Brébant V, Bosselmann T, Geis S. The perfusion index as a noninvasive method for monitoring revascularized and replanted digits. Clin Hemorheol Microcirc 2024; 86:143-152. [PMID: 37980656 DOI: 10.3233/ch-238120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Monitoring replanted digits remains a challenging task in microsurgical units. Previous studies have indicated the perfusion index (PI), a parameter directly proportional to the blood flow, might be a useful tool. OBJECTIVE The PI is evaluated as a monitoring tool in patients with replanted digits. METHODS This prospective, non-interventional study includes 31 patients with revascularized or replanted digits. After successful revascularization or replantation, the PI and peripheral oxygen saturation of the affected finger and its contralateral equivalent were measured simultaneously. The values were detected by the device Radical-97® Pulse CO-Oximeter® (Masimo Corporation, 52 Discovery, Irvine, CA 92618, USA). RESULTS The median PI of affected fingers was 3.5±0.56 for revascularized and 2.2±0.8 for replanted fingers. The difference between the PI values of replanted digits and the healthy contralateral side was highly significant (p < 0.0001). The area under the curve in the receiver operating characteristics was 0.92 for a PI difference > 80.49% and predicted a loss of replant with a specificity of 100% and a sensitivity of 75%. CONCLUSION The assessment of the PI in patients with reperfusion of a vascular compromised digit is a useful tool to continuously monitor peripheral perfusion. The dynamic behavior of the PI is essential to detect perfusion disturbance.
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Affiliation(s)
- Catharina Strauss
- Department of Trauma Surgery, Orthopedics, Plastic and Hand Surgery, University of Augsburg, Augsburg, Germany
| | - Katharina J Fodor
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Alexandra Anker
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Robert Kemper
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Vanessa Brébant
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Talia Bosselmann
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
| | - Sebastian Geis
- Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
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Mauhin W, Brassier A, London J, Subran B, Zeggane A, Besset Q, Jammal C, Montardi C, Mellot C, Strauss C, Borie R, Lidove O. Manifestations pulmonaires des maladies héréditaires du métabolisme. Rev Mal Respir 2022; 39:758-777. [DOI: 10.1016/j.rmr.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022]
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Mauhin W, Belmatoug N, Berger M, Besset Q, Boitiaux J, Brassier A, Douillard C, Gousseff M, Lavigne C, Martis N, Mellot C, Nguyen A, Subran B, Klein E, Strauss C, Guillot E, Lidove O. Accès compassionnel à l’enzymothérapie chez les patients adultes avec déficit en sphingomyélinase acide (Niemann-Pick B) en France : expérience multicentrique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fodor KJ, Anker A, Prantl L, Bosselmann T, Geis S, Strauss C. The perfusion index as a noninvasive method for continuous monitoring of peripheral perfusion: A baseline study to assess the perfusion index in healthy adult volunteers. J Plast Reconstr Aesthet Surg 2022; 75:2001-2018. [PMID: 35277365 DOI: 10.1016/j.bjps.2022.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Katharina J Fodor
- University of Regensburg, Department of Plastic, Hand and reconstructive surgery, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Alexandra Anker
- University of Regensburg, Department of Plastic, Hand and reconstructive surgery, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Lukas Prantl
- University of Regensburg, Department of Plastic, Hand and reconstructive surgery, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Talia Bosselmann
- University of Regensburg, Department of Plastic, Hand and reconstructive surgery, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Sebastian Geis
- University of Regensburg, Department of Plastic, Hand and reconstructive surgery, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Catharina Strauss
- University of Augsburg, Department of Trauma, Orthopedic, Hand and plastic surgery, Stenglinstraße 2, 86156 Augsburg
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Strauss C, Anker A, Klein S, Kemper R, Brebant V, Prantl L, Geis S. Monitoring free flaps and replanted digits via perfusion index -A proof of concept study. Clin Hemorheol Microcirc 2021; 80:363-371. [PMID: 34690135 DOI: 10.3233/ch-211295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early detection and treatment of vascular complications in replanted digits is essential for the survival. The perfusion index (PI) represents a marker of peripheral perfusion as it shows the ratio of pulsatile to non-pulsatile blood flow. OBJECTIVE To evaluate the feasibility and applicability of the PI as a monitoring tool for free flaps and replanted digits by measuring the inter- and intraindividual changes in PI. METHODS Five patients were postoperatively monitored according to intern standards by hourly clinical evaluation. Additionally, a pulse oximeter with SET-technology® (Masimo Radial 7, Masimo Corporation, Irvine, USA) was added with a LNCS® Red TFA-1 SpO2 sensor (Masimo Corporation, Irvine, USA) and respectively a LNCS® Neo-3 neonatal finger clip to evaluate the perfusion via PI and SpO2. RESULTS All patients showed sufficient perfusion in clinical controls. There was no detectable vascular complication during follow-up. Mean perfusion index was 0.93 with a median of 0.44. The patients showed a mean SpO2 of 90.59%with a median of 89.21%. CONCLUSION Our results show a great intra- and interindividual range of PI and SpO2. SpO2 provided an even greater range than PI. Trends in intraindividual PI changes may be a promising monitoring tool for free flaps and replanted digits.
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Affiliation(s)
- Catharina Strauss
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
| | - Alexandra Anker
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
| | - Silvan Klein
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
| | - Robert Kemper
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
| | - Vanessa Brebant
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
| | - Sebastian Geis
- Department of Plastic, Hand and ReconstructiveSurgery, University of Regensburg, Regensburg, Germany
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Kempa S, Brix E, Heine N, Hösl V, Strauss C, Eigenberger A, Brébant V, Seitz S, Prantl L. Autologous fat grafting for breast reconstruction after breast cancer: a 12-year experience. Arch Gynecol Obstet 2021; 305:921-927. [PMID: 34532758 PMCID: PMC8967754 DOI: 10.1007/s00404-021-06241-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022]
Abstract
Purpose The aim of our study was to examine the surgical outcome and complications (efficiency) as well as the incidence of locoregional recurrence and distant metastases (oncological safety) in patients who underwent autologous fat grafting (AFG) of the breast following breast cancer surgery. Methods In our monocentric cohort study, retrospective and prospective data were collected from all consecutive patients who underwent AFG after breast cancer between 2008 and 2020; a total of 93 patients met the inclusion criteria. Results Our long-term results showed no increase in tumor recurrence and distant metastases in the studied collective when compared to the available literature. We observed 1 local recurrence (1.1%), 2 distant metastases (2.2%), and 1 tumor-related death (1.1%). There was a high degree of patient satisfaction; 67.12% of patients reported adequate satisfaction with autologous fat grafting. Conclusion Currently, to our knowledge, this is the study with the longest follow-up time (mean 6.7 years after AFG and 11.5 years after tumor resection). The results of our clinical study will contribute to improve evidence in the broad field of AFG, adipose stem cell and tumor research. Consistent with our study, the literature review shows a clear tendency of clinical trial results with a low incidence rate of tumor recurrence and metastasis following the use of AFG. AFG seems to be a safe procedure also after breast cancer treatment.
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Affiliation(s)
- Sally Kempa
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Eva Brix
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Norbert Heine
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Vanessa Hösl
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Catharina Strauss
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Andreas Eigenberger
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Vanessa Brébant
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany
| | - Stephan Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, D-93053, Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Aesthetic and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053, Regensburg, Germany.
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Scheer M, Strauss C, Scheller C, Kubelt C, Skalej M, Mawrin C, Prell J. Case report of recurrent anaplastic oligodendroglioma with mixed astrocytic components and pathological discordance of tumor progression. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2021.101195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Strauss C, Rampp S, Scheller C, Prell J, Strauss C, Doerfler A, Engelhorn T. Volumetry and Surgical Grading Systems for Vestibular Schwannoma Size Assessment and their Relationship to Postoperative Facial Nerve Function. J Neurol Surg A Cent Eur Neurosurg 2021; 83:39-45. [PMID: 34100269 DOI: 10.1055/s-0041-1725951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND STUDY AIMS Treatment modalities in vestibular schwannoma (VS) are difficult to compare since different techniques for size measurements are used. The purpose of this study was to evaluate the relation between different tumor size grading systems regarding their compatibility as well as the relationship to facial nerve outcome facilitating comparisons of different studies. MATERIAL AND METHODS In this retrospective study, preoperative magnetic resonance imaging of 100 patients with surgically treated VS was evaluated regarding total tumor volume and anatomical extension based on the Koos and Samii classification, as well as volumetric and maximal diameter measures. Three-dimensional constructive interference in steady state (3D-CISS) and T1 postcontrast volumetric interpolated breath-hold examination (VIBE) sequences were used. Facial nerve function was evaluated according to the House-Brackmann (HB) scale 6 months following complete tumor removal via the retrosigmoid approach. RESULTS Tumor size showed a moderate influence on postsurgical facial nerve function with correlations not exceeding 0.4. Severe palsy was observed mainly in patients with large tumors with Koos grade 4, Samii grade 4b, respectively a volume of at least 6 cm3 or a maximum diameter of 2.4 cm for HB ≥ 3 and a volume of 7.5 cm3 and maximum diameter of 3.2 cm for HB ≥ 4. In regard to volumetry, the Koos and Samii grading systems were highly comparable, whereas the maximal diameter showed consistently lower correlation values. CONCLUSIONS The results of our study allow direct comparison of studies on surgery versus radiotherapy of VS. The data allow for translation of tumor sizes based on different grading systems. Comparison of microsurgical, radiotherapeutic and radiosurgical approaches should concentrate on patients with large tumors. Whereas smaller tumors were rarely associated with severe facial palsy, large tumors did not exclude the possibility of weak or no palsy 6 months after surgery.
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Affiliation(s)
- Catharina Strauss
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Christian Scheller
- Department of Neurosurgery, University of Halle-Wittenberg, Halle, Germany
| | - Julian Prell
- Department of Neurosurgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Christian Strauss
- Department of Neurosurgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Tobias Engelhorn
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
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Plontke SK, Caye-Thomasen P, Strauss C, Kösling S, Götze G, Siebolts U, Vordermark D, Wagner L, Fröhlich L, Rahne T. Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation. HNO 2021; 69:7-19. [PMID: 33044580 PMCID: PMC7862215 DOI: 10.1007/s00106-020-00919-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients. Video online The online version of this article (10.1007/s00106-020-00919-9) includes a video (2D and 3D versions) of the described surgical technique. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under “Ergänzende Inhalte”. ![]()
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Affiliation(s)
- S K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - P Caye-Thomasen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - C Strauss
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - S Kösling
- Department of Radiation Medicine, Clinic for Radiology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - G Götze
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - U Siebolts
- Institute of Pathology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - D Vordermark
- Department of Radiation Medicine, Clinic for Radiotherapy, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - L Wagner
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - L Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - T Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Berry C, Newcombe H, Strauss C, Rammou A, Schlier B, Lincoln T, Hayward M. Validation of the Hamilton Program for Schizophrenia Voices Questionnaire: Associations with emotional distress and wellbeing, and invariance across diagnosis and sex. Schizophr Res 2021; 228:336-343. [PMID: 33540145 DOI: 10.1016/j.schres.2020.12.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/02/2020] [Accepted: 12/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Voice-hearing is a transdiagnostic experience with evident negative effects on patients. Good quality measurement is needed to further elucidate the nature, impact and treatment of voice-hearing experiences across patient groups. The Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) is a brief self-report measure which requires further psychometric evaluation. METHODS Using data from a transdiagnostic sample of 401 adult UK patients, the fit of a conceptual HPSVQ measurement model, proposing a separation between physical and emotional voice-hearing characteristics, was tested. A structural model was examined to test associations between voice-hearing, general emotional distress (depression, anxiety, stress) and wellbeing. The invariance of model parameters was examined across diagnosis and sex. RESULTS The final measurement model comprised two factors named 'voice severity' and 'voice-related distress'. The former comprised mainly physical voice characteristics and the latter mainly distress and other negative impacts. Structural model results supported voice-related distress as mediating the associations between voice severity and emotional distress and wellbeing. Model parameters were invariant across psychosis versus non-psychosis diagnosis and partially invariant across sex. Females experienced more severe and distressing voices and a more direct association between voice severity and general anxiety was evident. CONCLUSIONS The HPSVQ is a useful self-report measure of voice-hearing with some scope for further exploration and refinement. Voice-related distress appears a key mechanism by which voice severity predicts general distress and wellbeing. Whilst our data broadly support interventions targeting voice-related distress for all patients, females may benefit especially from interventions targeting voice severity and strategies for responding.
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Affiliation(s)
- C Berry
- Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland.
| | - H Newcombe
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - C Strauss
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
| | - A Rammou
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - B Schlier
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - T Lincoln
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - M Hayward
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
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Anker AM, Prantl L, Strauss C, Brébant V, Baringer M, Ruewe M, Vykoukal J, Klein SM. Clinical Impact of DIEP Flap Perforator Characteristics – A Prospective Indocyanine Green Fluorescence Imaging Study. J Plast Reconstr Aesthet Surg 2020; 73:1526-1533. [DOI: 10.1016/j.bjps.2020.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/23/2019] [Accepted: 01/05/2020] [Indexed: 11/17/2022]
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Anker AM, Prantl L, Strauss C, Brébant V, Schenkhoff F, Pawlik M, Vykoukal J, Klein SM. Assessment of DIEP Flap Perfusion with Intraoperative Indocyanine Green Fluorescence Imaging in Vasopressor-Dominated Hemodynamic Support Versus Liberal Fluid Administration: A Randomized Controlled Trial With Breast Cancer Patients. Ann Surg Oncol 2019; 27:399-406. [PMID: 31468214 DOI: 10.1245/s10434-019-07758-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Dogmatic denial of vasopressor agents for blood pressure regulation during free-flap surgery is associated with concomitant large-volume intraoperative fluid administration. Yet, the doctrinal banning of vasopressors during microvascular breast reconstruction still is a subject of controversy. Several retrospective observations have recently drawn attention to serious iatrogenic consequences of intravenous crystalloid overload in microsurgery such as thrombus formation and increased flap failure rates. METHODS This prospective randomized controlled trial investigated the potential effects of fluid-restrictive vasopressor-dominated hemodynamic support (FRV) compared with vasopressor-restrictive liberal fluid administration (LFA) on clinically relevant perfusion of the deep inferior epigastric perforator (DIEP) flap via intraoperative indocyanine green (ICG) fluorescence imaging. The primary end point of the study was quantitative assessment of the percentage of insufficiently perfused tissue (NP) on the overall flap. Major complications were assessed as secondary end points. RESULTS In 44 DIEP flap breast reconstructions after mastectomy, FRV circulatory support resulted in no statistically significant difference in total flap perfusion as detected via ICG fluorescence imaging in direct comparison with a traditional LFA strategy (NPFRV, 31.8% ± 12.2% vs NPLFA, 29.5% ± 13.3%; p = 0.559). One flap failure was registered with LFA, whereas no major complication occurred in the FRV cohort. CONCLUSIONS According to the results of this study, neither a norepinephrine concentration of 0.065 ± 0.020 μg/kg/min (FRV) nor fluid administration of 5.1 ± 2.2 ml/kg/h (LFA) has a clinically significant impact on microperfusion in a standard DIEP flap procedure for breast reconstruction. Consistent with the current literature reporting a rise in complications with intraoperative fluid over-resuscitation, one flap failure occurred in the LFA cohort.
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Affiliation(s)
- Alexandra M Anker
- Center for Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Regensburg, Germany.
| | - Lukas Prantl
- Center for Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Regensburg, Germany
| | - Catharina Strauss
- Center for Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Regensburg, Germany
| | - Vanessa Brébant
- Center for Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Regensburg, Germany
| | - Felix Schenkhoff
- Department of Anesthesiology, Caritas Hospital St. Josef Regensburg, Regensburg, Germany
| | - Michael Pawlik
- Department of Anesthesiology, Caritas Hospital St. Josef Regensburg, Regensburg, Germany
| | - Jody Vykoukal
- Department of Clinical Cancer Prevention and The McCombs Institute for the Early Detection and Treatment of Cancer, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Silvan M Klein
- Center for Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Regensburg, Germany
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Abstract
BACKGROUND Vestibular schwannoma (VS) is a benign tumor that develops in the internal auditory canal and the cerebellopontine angle, potentially diminishing hearing or balance. Most VS tumors arise from one of two vestibular branches: the superior or inferior vestibular nerve. Determining the specific nerve of origin could improve patient management in terms of preoperative counseling, treatment selection, and surgical decision-making and planning. The aim of this study was to introduce a novel scoring system that was designed to determine the nerve of origin. METHODS The nerve of origin was predicted based on video head impulse assessments of all semicircular channels, together with cervical/ocular vestibular-evoked myogenic potential tests. The acquired data were entered into a scoring system developed to allocate the tumor origin. Finally, the nerve of origin was definitively determined intraoperatively. RESULTS The novel scoring system was applied to 5 consecutive patients undergoing surgical VS treatment. In one case, no determination was possible. In all other cases, the preoperatively predicted tumor origin was the same as the origin determined during surgery. CONCLUSION The scoring system predicts the nerve of origin and will be evaluated in a larger prospective cohort study of VS patients in the near future.
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Affiliation(s)
- T Rahne
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
| | - S Plößl
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
| | - S K Plontke
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
| | - C Strauss
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Abstract
This article presents a case of malignant transformation of vestibular schwannoma 13 years after stereotactic radiation therapy, which lead to an acute life-threatening condition. Although the observation is currently only based on case reports, an increasing number of these support the hypothesis that there is a relevant risk of malignant transformation in the long-term course of previously irradiated vestibular schwannomas. Therefore, long-term MRI follow-up should be considered.
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Affiliation(s)
- S Simmermacher
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland.
| | - D Vordermark
- Klinik für Strahlentherapie, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - T Kegel
- Klinik für Hämatologie und Onkologie, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - C Strauss
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland
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Anker AM, Miranda BH, Prantl L, Kehrer A, Strauss C, Brébant V, Klein SM. 50 Shades of Red: The Predictive Value of Closed Suction Drains for the Detection of Postoperative Bleeding in Breast Surgery. Aesthetic Plast Surg 2019; 43:608-615. [PMID: 30903252 DOI: 10.1007/s00266-019-01345-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/21/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND While closed suction drains (CSDs) are still frequently employed in clinical practice, the supporting evidence is limited with some studies demonstrating a failure of routine CSD use in preventing hematoma or seroma. Nonetheless, CSD quantity and quality fluid assessment is still appreciated by clinicians to detect postoperative bleeding. This study investigates the value of routine CSD use, in breast surgery, to predict postoperative bleeding. METHODS A retrospective, intra-individual analysis, of CSD fluid volumes between the hematoma side and the unaffected contralateral breast, was undertaken in patients (n = 20) with unilateral postoperative bleeding following bilateral breast surgery (2003-2018). Statistical analysis was undertaken to establish a minimum cutoff fluid volume that might assist in the detection of postoperative bleeding. To determine the usefulness of quality assessment of CSD fluid output by visual inspection, surgeons (n = 56) prospectively matched six eligible hemoglobin concentrations corresponding to pre-filled CSDs. RESULTS Statistical analysis did not yield a clinically reliable cutoff fluid volume indicating postoperative bleeding. All six eligible hemoglobin concentrations were completely successfully matched to pre-filled CSDs by 30.4% (17/56) of surgeons. CONCLUSIONS This study questions the significance of routine CSD use to assist in the decision-making process to return to the theater and address postoperative bleeding. Quantity as well as quality analysis of CSD fluid output failed the reliability and diagnostic validity tests. Hemoglobin measurements in drain fluid specimens via blood gas analysis might contribute to the detection of postoperative bleeding. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- A M Anker
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - B H Miranda
- Plastic and Reconstructive Surgery Department, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, NW3 2QG, UK
| | - L Prantl
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A Kehrer
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - C Strauss
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - V Brébant
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - S M Klein
- Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
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Aung T, Heidekrueger P, Geis S, Von Kunow F, Taeger C, Strauss C, Wendl C, Brebant V, Broer P, Prantl L, Hillmann A. A novel indication for indocyanine green (ICG): Intraoperative monitoring of limb and sciatic nerve perfusion during rotationplasty for sarcoma patients. Clin Hemorheol Microcirc 2019; 70:441-447. [DOI: 10.3233/ch-189309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- T. Aung
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
- Department of Orthopedics, University of Medicine Mandalay, Mandalay, Myanmar
| | - P.I. Heidekrueger
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
| | - S. Geis
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
| | - F. Von Kunow
- Klinik und Poliklinik für Orthopädie der Universität Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Deutschland
| | - C. Taeger
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
| | - C. Strauss
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
| | - C. Wendl
- Department of Neuroradiology, Regensburg University Medical Center, Regensburg, Germany
| | - V. Brebant
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
| | - P.N. Broer
- Department of Plastic Surgery, Klinikum München Bogenhausen, München, Germany
| | - L. Prantl
- Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Germany
| | - A. Hillmann
- Klinik und Poliklinik für Orthopädie der Universität Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Deutschland
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Bauer M, Wickenhauser C, Haak A, Pazaitis N, Siebolts U, Mawrin C, Strauss C, Rickerts V, Stoevesandt D, Cornely OA, Meis JF, Hagen F. Case report: A fatal case of cryptococcosis in an immunocompetent patient due to Cryptococcus deuterogattii (AFLP6/VGII). JMM Case Rep 2018; 5:e005168. [PMID: 30479782 PMCID: PMC6249430 DOI: 10.1099/jmmcr.0.005168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 09/07/2018] [Indexed: 12/14/2022] Open
Abstract
Introduction Cryptococcosis in immunocompetent adults is a rare disease in Europe, mostly induced by members of the Cryptococcus gattii species complex. The diagnosis can be challenging due to its rarity, unspecific symptoms and long symptomless latency. Case presentation A 49-year-old woman with a three weeks history of headache was admitted to the hospital due to discrete ataxia and impaired vision. Cranial magnetic resonance imaging (MRI) showed a contrast-enhancing mass in the cerebellum. Further investigations detected a slight leukocytosis and a single subpleural nodule in the right inferior lung lobe. The cerebral lesion was surgically removed, and a direct frozen section only showed an unspecific inflammation. In the course of her admission she developed non-treatable cerebral edema and died ten days after surgical intervention. Histopathological examination of the surgical specimen and postmortem evaluation of the lung and the cerebrum demonstrated fungal elements. Molecular identification of the fungal elements in formalin-fixed paraffin-embedded tissue lead to the diagnosis of cryptococcosis induced by C. gattii sensu lato. Molecular genetic analysis identified the involved cryptococcal species as genotype AFLP6/VGII, recently described as Cryptococcus deuterogattii, which is known to be endemic to the west-coast of Canada and the USA. Additional heteroanamnestic information revealed that she had spent her holidays on Vancouver Island, Canada, two years before disease onset, indicating that infection during this stay seems to be plausible. Conclusion Cryptococcosis due to C. deuterogattii is a rarely encountered fungal disease in Europe, not particularly associated with immunodeficiency, and infection is likely to be contracted in endemic areas. Due to its rarity, long symptomless latency, unspecific symptoms and misleading radiological features the diagnosis can be challenging. Physicians need to be aware of this differential diagnosis in immunocompetent patients, as early adequate therapy can be lifesaving.
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Affiliation(s)
- M Bauer
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - C Wickenhauser
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - A Haak
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - N Pazaitis
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - U Siebolts
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - C Mawrin
- Institute of Neuropathology, Otto-von-Guericke-University, Magdeburg, Germany
| | - C Strauss
- Department of Neurosurgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - V Rickerts
- FG 16, Consultant Laboratory for Cryptococcosis, Scedosporiosis and Imported Systemic Mycoses, Robert-Koch-Institute, Berlin, Germany
| | - D Stoevesandt
- Institute of Radiology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - O A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
| | - J F Meis
- Department Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - F Hagen
- Department Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
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20
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Anker A, Prantl L, Strauss C, Brébant V, Heine N, Lamby P, Geis S, Schenkhoff F, Pawlik M, Klein S. Vasopressor support vs. liberal fluid administration in deep inferior epigastric perforator (DIEP) free flap breast reconstruction – a randomized controlled trial. Clin Hemorheol Microcirc 2018; 69:37-44. [DOI: 10.3233/ch-189129] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- A.M. Anker
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L. Prantl
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - C. Strauss
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - V. Brébant
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - N. Heine
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - P. Lamby
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S. Geis
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - F. Schenkhoff
- Department of Anaesthesiology, Caritas Hospital St. Josef, Regensburg, Germany
| | - M. Pawlik
- Department of Anaesthesiology, Caritas Hospital St. Josef, Regensburg, Germany
| | - S.M. Klein
- Center for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
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Abstract
BACKGROUND Surgical procedures in the cerebello-pontine angle (CPA), e. g. for vestibular schwannoma, have an increased risk for damage to the cochlear nerve. Consequently, hearing deterioration up to complete deafness may result with severe impact on quality of life. Methods for intraoperative monitoring of function may minimize such risks. OBJECTIVE Review of current methods for intraoperative monitoring of the cochelar nerve and summary of new developments. MATERIALS AND METHODS Analysis and summary of literature, discussion of new methods. RESULTS Early auditory evoked potentials using click stimuli remain the standard method for intraoperative monitoring of cochlear nerve function. Amplitude and latency changes indicate a risk of postoperative hearing deterioration; however demonstrate only limited further differentiation of hearing quality. As novel methods, near-field recordings may allow faster feedback and auditory steady state responses potentially enable frequency specific testing. CONCLUSIONS Intraoperative monitoring of the cochlear nerve is an integral component of CPA surgery. It enables detection of potential nerve damage and thus contributes to avoiding postoperative functional deficits. Development and implementation of novel and additional approaches may further improve its clinical value.
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Affiliation(s)
- S Rampp
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinik Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
| | - T Rahne
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik Halle (Saale), Halle (Saale), Deutschland
| | - S K Plontke
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik Halle (Saale), Halle (Saale), Deutschland
| | - C Strauss
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinik Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
| | - J Prell
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinik Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
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Strauss C, Brix E, Anker A, Prantl L, Brébant V, Aung T. Perfusion control of a partial revascularized hand via application of Indocyanine green (ICG) and Near-infrared Fluorescence Imaging. Clin Hemorheol Microcirc 2017; 67:215-219. [PMID: 28869456 DOI: 10.3233/ch-179202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Intra- and postoperative assessment of perfusion with near-infrared fluorescence imaging is commonly used among plastic surgeons to evaluate the quality of a microsurgical anastomosis in free flaps. OBJECTIVE As microsurgical anastomosis can be monitored with near-infrared fluorescence imaging there is potential concerning revascularized fingers and hands with soft tissue depths not exceeding 7 mm above anastomosis. In a case of a severe crush injury of the hand more information about the perfusion was necessary as clinical assessment suspected loss of perfusion. METHODS A 49-year old male suffered from a severe crush injury of his left hand with dissection of the ulnar superficial palmar arterial arch and a lesion of median nerve. After revascularization and reconstruction of the nerve, the patient developed postoperatively a loss of perfusion of thumb and index finger. An evaluation of the perfusion status was obtained by fluorescence imaging after intravenous application of ICG. RESULTS After intravenous application of ICG the near-infrared imaging showed a delayed but sufficient perfusion of the hand so that a salvage surgery was not indicated. CONCLUSIONS In scenarios of critical perfusion in revascularized fingers and hands, the perfusion control via application of ICG and near-infrared fluorescence imaging can be a helpful tool.
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Affiliation(s)
- Catharina Strauss
- University Center for Plastic, Hand and Reconstructive Surgery, University of Regensburg, Caritas Hospital St. Josef, Regensburg, Germany
| | - Eva Brix
- University Center for Plastic, Hand and Reconstructive Surgery, University of Regensburg, University Hospital, Regensburg, Germany
| | - Alexandra Anker
- University Center for Plastic, Hand and Reconstructive Surgery, University of Regensburg, Caritas Hospital St. Josef, Regensburg, Germany
| | - Lukas Prantl
- University Center for Plastic, Hand and Reconstructive Surgery, University of Regensburg, University Hospital, Regensburg, Germany
| | - Vanessa Brébant
- University Center for Plastic, Hand and Reconstructive Surgery, University of Regensburg, Caritas Hospital St. Josef, Regensburg, Germany
| | - Thiha Aung
- University Center for Plastic, Hand and Reconstructive Surgery, University of Regensburg, University Hospital, Regensburg, Germany
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Abstract
BACKGROUND Except for glucocorticoids there is a lack of neuroprotective medication in neurosurgical interventions. OBJECTIVE An overview of clinical trials investigating administration of the calcium antagonist nimodipine and hydroxyethyl starch (HES) in vestibular schwannoma (VS) surgery is given. Basic research is addressed and potential neuroprotective effect mechanisms are discussed, as are perspectives for application of the concept to other types of surgery with a risk postoperative impairment of nerve function. MATERIALS AND METHODS A selective PubMed search was performed and all 10 clinical trials corresponding to the search criteria were included. RESULTS Four trials with an intraoperative start of the medication showed a positive effect for the preservation of facial nerve function and hearing preservation. A pilot study showed superiority of prophylactic treatment over intraoperative application. There were no significant results in a prospective multicenter phase III trial. After 1 year, postoperative facial nerve preservation rates were excellent in both groups. However, the risk of hearing loss was twice as high in the control group. A combined analysis of the phase III trial with its pilot study showed significant results for better hearing preservation rates in the treatment group (probably by increasing the case load). CONCLUSION Prophylactic nimodipine can be recommended in VS surgery in patients with good preoperative hearing. The effect mechanisms of nimodipine and modifications to prophylaxis should be clarified in basic research.
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Affiliation(s)
- C Scheller
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum, Universität Halle-Wittenberg, Halle (Saale), Deutschland.
| | - E Herzfeld
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum, Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - C Strauss
- Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum, Universität Halle-Wittenberg, Halle (Saale), Deutschland
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25
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Plontke SK, Rahne T, Pfister M, Götze G, Heider C, Pazaitis N, Strauss C, Caye-Thomasen P, Kösling S. Intralabyrinthäre Schwannome. HNO 2017; 65:419-433. [DOI: 10.1007/s00106-017-0361-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Simon M, Mal F, Perniceni T, Ferraz JM, Strauss C, Levard H, Louvet C, Fuks D, Gayet B. Accuracy of staging laparoscopy in detecting peritoneal dissemination in patients with gastroesophageal adenocarcinoma. Dis Esophagus 2016; 29:236-40. [PMID: 25758761 DOI: 10.1111/dote.12332] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite staging laparoscopy (SL) with peritoneal lavage is recommended in US Guidelines in patients with potentially resectable gastroesophageal adenocarcinoma, this procedure is not systematically proposed in French Guidelines. Therefore, we decided to analyze the results of systematic SL in patients considered for preoperative chemotherapy. From 2005 to 2011, 116 consecutive patients with distal esophagus, esogastric junction, and gastric adenocarcinoma ≥T3 or N+ without detectable metastatic dissemination by computed tomography (CT) scan imaging underwent SL before neoadjuvant chemotherapy. Positive and negative SLs were compared according to tumor characteristics. SL was positive in 15 cases (12.9%) including 14 with peritoneal seeding (localized in five, diffuse in nine). SL was positive in 7 (24.1%) of 29 patients with poorly differentiated tumor, in 9 (32.1%) of 28 patients with signet ring cells, in 7 (50%) of 14 patients with gastric linitis tumor, and in 15 (16.3%) of 92 patients with T3 or T4 tumor. All the lesions of distal esophagus extending to the cardia had a negative SL. Among the 14 patients with peritoneal carcinomatosis at SL, nine (65%) had signs of peritoneal seeding on initial CT scan. One (0.8%) patient had a small bowel perforation closed laparoscopically. If systematic SL before preoperative chemotherapy does not seem justified because of its low accuracy, it should be performed in patients with poorly differentiated tumor, signet ring cell, and gastric linitis plastica components on biopsy and when CT scan is suggestive of T4 tumor, ascites, or peritoneal nodule.
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Affiliation(s)
- M Simon
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - F Mal
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - T Perniceni
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - J-M Ferraz
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - C Strauss
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - H Levard
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - C Louvet
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - D Fuks
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - B Gayet
- Department of Digestive Diseases and Department of Oncology, Institut Mutualiste Montsouris, Paris, France
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Strauss C, Ossada V, Hoffmann J, Stepan H. Implementierung der „neuen“ cut offs des sFlt-1/PlGF-Quotienten in die klinische Praxis – erste Ergebnisse. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0034-1375706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bergner M, Thäle V, Haase R, Strauss C, Tchirikov M. Ausgetragene dichorial-diamniote Geminigravidität mit ausgeprägter kindlicher Spina bifida und Hydrocephalus – Eine interdisziplinäre medizinisch-ethische Herausforderung. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Strauss C, Romst�ck J, Fahlbusch R, Nimsky C. Neurophysiologic Mapping of the Floor of the IVth Ventricle Using Direct Stimulation. Skull Base Surg 2015. [DOI: 10.1159/000429791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ossada V, Strauss C, Hoffmann J, Stepan H. Implementierung der „neuen“ cut offs des sFlt-1/PlGF-Quotienten in die klinische Praxis – erste Ergebnisse. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1548677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Strauss C, Benvenisty A, Ravid T, Arbel A, Ben-Porath I, Goldberg M. 378: DNA2 is highly mutated in estrogen-dependent cancers; from a bioinformatics screen to the effect of clinical mutations on cellular growth. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50336-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Prell J, Strauss C, Rampp S. Nervus intermedius influences continuous facial nerve EMG-monitoring. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Garrett A, Strauss C, Saha S. National survey of ICUs in the UK: discharging patients with tracheostomies. Crit Care 2014. [PMCID: PMC4069463 DOI: 10.1186/cc13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Rampp S, Strauss C, Scheller C, Rachinger J, Prell J. A-trains for intraoperative monitoring in patients with recurrent vestibular schwannoma. Acta Neurochir (Wien) 2013; 155:2273-9; discussion 2279. [PMID: 24078065 DOI: 10.1007/s00701-013-1891-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 09/17/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Second surgery of recurrent vestibular schwannoma (VS) after previous surgery, stereotactic radiosurgery (SR) or fractionated radiotherapy (FR) carries an increased risk for deterioration of facial nerve function, e.g., due to adhesions, underlining the need for intraoperative monitoring. Facial “Atrain” EMG activity (“traintime”) correlates with the degree of postoperative facial palsy. Studies investigating A-trains in VS patients with previous surgery, SR or FR are missing. We therefore investigated the value of A-train monitoring in patients undergoing second surgery for VS. METHOD Intraoperative EMG data from patients who underwent second surgery for VS after previous surgery, SR and/or FR at our institution between 2006 and 2012 were retrospectively analyzed. Ten patients were selected (5 male): Seven had previous SR/RT and MS, three previous surgery only. Traintime values and distribution was compared to published thresholds and to 77 patients who underwent first surgery for VS during the same time period. RESULTS A-trains were recorded early after opening of the dura, before facial nerve preparation. Mean traintime was 46.9 s (18.51 s – 80.82 s) in patients with previous SR/RT. In patients with previous MS only, traintime was 0.06 s, 0.99 s and 22.46 s. Compared to the literature, traintime was higher than expected in six patients (four with previous SR/RT, two without), respectively seven compared to the 77 patients with first surgery (5 SR/RT). Seven patients with previous SR/RT and none with previous surgery showed diffuse A-train distributions without significant percentages in single channels, compared to 60 of 77 patients with first surgery (p <0.02). CONCLUSIONS Especially SR/RT, but also previous surgery seems to induce changes in the facial nerve leading to hyperexcitability and exceedingly high traintime values. Based on these findings, A-train monitoring in this specific patient group should be interpreted with caution.
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Rampp S, Rensch L, Strauss C, Prell J. Frequenzspezifische ASSR für das intraoperative Hörnervenmonitoring. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rampp S, Prell J, Scheller C, Rachinger J, Strauss C. Intraoperatives A-Train-Monitoring der Facialisfunktion bei Patienten mit rezidivierenden Vestibularisschwannomen. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Alfieri A, Prell J, Rampp S, Peschke E, Fleischhammer J, Strauss C. Anatomy, ultrastructure, electrophysiology, and clinical functions of the nervus intermediu. Usefulness in cerebellopontine pathology. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ditsch N, Mayr D, Lenhard M, Kolben T, Strauss C, Gallwas J, Himsl J, Weissenbacher T, Harbeck N, Friese K, Jeschke U. Immunohistochemical correlation of thyroid hormone receptors (TR), retinoid x receptor (RXR), peroxisome proliferators-activated receptor (PPAR), the vitamin D receptor (VDR) and estrogen-/progesterone receptor (ER/PR) in breast carcinoma. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1318576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Scheller C, Vogel AS, Simmermacher S, Rachinger JC, Prell J, Strauss C, Reinsch M, Kunter U, Wienke A, Neumann J, Scheller K. Prophylactic intravenous nimodipine treatment in skull base surgery: pharmacokinetic aspects. J Neurol Surg A Cent Eur Neurosurg 2012; 73:153-9. [PMID: 22241592 DOI: 10.1055/s-0032-1313724] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Nimodipine is primarily used in subarachnoid hemorrhage (SAH). Clinical trials revealed also a beneficial effect of prophylactic nimodipine treatment on cranial nerve functions following vestibular schwannoma surgery. OBJECTIVE The unknown pharmacokinetics of prophylactically administered nimodipine were investigated. METHODS Samples were taken from 27 patients with skull base lesions. Prophylactic intravenous nimodipine infusion was started 5.8-25.8 h (mean 17.9 h) before surgery. Nimodipine concentrations were determined in serum (intra- and postoperatively), cerebrospinal fluid (CSF) (intraoperatively), and tissue samples. RESULTS Wide interindividual differences were observed. Mean concentrations for nimodipine were 46.9 ng/ml (SD: 6.4; min. 4.1 and max. 92.7 ng/ml) in intraoperative serum, 73.2 ng/ml (SD: 16.7; min. 6.6 and max. 253 ng/ml) in postoperative serum and 8.3 ng/ml (SD: 1.5; min. 1.0 und max. 29.7 ng/ml) in intraoperative CSF. The correlation between intra- and postoperative serum (p=0.004, r=0.560) and between intra-operative serum and CSF concentration (p=0.003, r=0.567) were statistically significant. Furthermore the correlation between intraoperative serum concentration and concentrations collected from vestibular nerves was high (r=0.711), but not statistically significant (p=0.178). CONCLUSIONS Interindividually, continously administered intravenous nimodipine produces considerably variable serum levels. Controls of nimodipine serum concentrations may be useful to optimize nimodipine medication in skull base surgery and in the management of SAH. The serum nimodipine level is a useful marker for CSF and intracranial nerve tissue concentrations of nimodipine.
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Affiliation(s)
- C Scheller
- University of Halle-Wittenberg, Department of Neurosurgery, Halle (Saale), Germany.
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Alfieri A, Simmermacher S, Prell J, Strauss C, Scheller C. Epidermoid tumor of the cerebellopontine angle presenting with selective sudden hearing loss. Intraoperative evidence of a pearl tumor infiltrating and compressing the cochlear nerve. J Neurol Surg A Cent Eur Neurosurg 2011; 73:56-8. [PMID: 22076839 DOI: 10.1055/s-0032-1304507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Epidermoid tumors of the cerebellopontine angle are associated with a variety of symptoms, usually attributed to compression and displacement of involved cranial nerves. The authors present a case of a large epidermoid tumor in the left cerebellopontine angle with sudden hearing loss and tinnitus. The intraoperative finding of migration of two tumor pearls into the cochlear nerve was the origin of the clinical sign. The patient improved remarkably after removal of the tumor. This case demonstrates the mechanism for selective hearing loss associated with the large cerebellopontine angle.
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Affiliation(s)
- A Alfieri
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - S Simmermacher
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - J Prell
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - C Strauss
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - C Scheller
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Scheller C, Rachinger JC, Prell J, Alfieri A, Rampp S, Sel S, Scheller K, Strauss C. Intraorbital oculomotor nerve schwannoma affecting only the parasympathetic fibers. J Neurol Surg A Cent Eur Neurosurg 2011; 74:120-3. [PMID: 21960025 DOI: 10.1055/s-0032-1313641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C Scheller
- University of Halle-Wittenberg, Neurosurgery, 06097 Halle Saale, Germany.
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Rachinger JC, Koman G, Scheller C, Prell J, Rampp S, Strauss C. Practice in the perioperative prevention of deep vein thrombosis in german neurosurgical departments: is there a trend towards homogenization? ACTA ACUST UNITED AC 2011; 72:115-9. [PMID: 21796579 DOI: 10.1055/s-0031-1280791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE There was no consensus on the most suitable perioperative prophylaxis of deep vein thrombosis (DVT) in neurosurgical patients. The aim of this work was to review the current practice and search for a standard protocol in the prophylaxis of DVT. METHODS AND MATERIAL Questionnaires addressing the routine prophylaxis of perioperative DVT for 4 groups of neurosurgical procedures and the estimation of risks and benefits of perioperative heparin (unfractionated and/or low-molecular-weight) administration were sent to 130 neurosurgical departments in Germany. RESULTS 103 of 130 questionnaires were returned and suitable for analysis. The use of heparin (unfractionated and/or low-molecular-weight) is common, with some variation depending on the type of operation (83.5-99%). In spinal procedures, heparin administration is commonly started early, i. e., between the preoperative and first postoperative day (90.3-97.1%). This differs in intracranial procedures. In most neurosurgical departments heparin administration is stopped at the day of discharge (69.6-77.4% depending on procedure). Enoxaparin is the most commonly used heparin. In spinal as well as in cranial procedures, thrombosis risk reduction is unanimously assumed to be lesser the later administration starts. The estimation of the risks related to heparin injection are considered to be higher in cranial than in spinal operation in the early postoperative period. Most departments use antithrombotic stockings (ATS) irrespective of the type of surgery. However, 11% never use ATS. CONCLUSIONS In spinal surgery, a trend towards homogenization is observed with the early use of heparin. In intracranial procedures, practice is more heterogenous. The heterogeneity is due to the fact that the data available in the literature does not allow for the identification of an optimal protocol.
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Affiliation(s)
- J C Rachinger
- University of Halle-Wittenberg, Neurosurgery, Germany
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Rampp S, Prell J, Rachinger J, Scheller C, Strauss C. Does Electrode Placement Influence Quality of Intraoperative Monitoring in Vestibular Schwannoma Surgery? ACTA ACUST UNITED AC 2010; 72:22-7. [DOI: 10.1055/s-0030-1253350] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rampp S, Prell J, Rensch L, Strauss C. Frequency-specific ASSR monitoring during anesthesia: Preliminary results. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Prell J, Strauss C, Rampp S. Intraoperative protection of the facial nerve by automated categorisation of EMG-activity. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1251011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Scheller C, Rampp S, Rachinger JC, Prell J, Koesling S, Becker S, Strauss C. Contrast Enhancement and Histopathological Findings in Vestibular Schwannoma. ACTA ACUST UNITED AC 2009; 71:35-8. [DOI: 10.1055/s-0029-1225326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lang F, Winkler K, Strauss C, Grimm R, Denschlag JH. Ultracold triplet molecules in the rovibrational ground state. Phys Rev Lett 2008; 101:133005. [PMID: 18851446 DOI: 10.1103/physrevlett.101.133005] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Indexed: 05/26/2023]
Abstract
We report here on the production of an ultracold gas of tightly bound Rb2 triplet molecules in the rovibrational ground state, close to quantum degeneracy. This is achieved by optically transferring weakly bound Rb2 molecules to the absolute lowest level of the ground triplet potential with a transfer efficiency of about 90%. The transfer takes place in a 3D optical lattice which traps a sizeable fraction of the tightly bound molecules with a lifetime exceeding 200 ms.
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Affiliation(s)
- F Lang
- Institut für Experimentalphysik und Zentrum für Quantenphysik, Universität Innsbruck, A-6020 Innsbruck, Austria
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Abstract
The occurrence of a hemorrhage into a vestibular schwannoma is a rare phenomenon. Several reports, however, indicate a risk profile for a subgroup of patients with vestibular schwannoma which show hypervascularity in the histopathological examination. Cystic formation, large size, mixed Antoni type and anticoagulation therapy seem to enhance the risk of tumor hemorrhage. We report on a patient with a large cystic vestibular schwannoma who died from fatal bleeding into the tumor 15 months following stereotactic radiation therapy. Since hemorrhage seems to be a relevant risk in large cystic vestibular schwannomas, a surgical treatment should be preferred whenever possible.
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Affiliation(s)
- O Ganslandt
- Neurochirurgische Klinik und Poliklinik, Universität Erlangen-Nürnberg, Erlangen, Germany.
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Bischoff B, Romstöck J, Fahlbusch R, Buchfelder M, Strauss C. Intraoperative brainstem auditory evoked potential pattern and perioperative vasoactive treatment for hearing preservation in vestibular schwannoma surgery. J Neurol Neurosurg Psychiatry 2008; 79:170-5. [PMID: 17578855 DOI: 10.1136/jnnp.2006.113449] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In vestibular schwannoma surgery, four different intraoperative brainstem auditory evoked potential (BAEP) patterns (stable BAEP, abrupt loss, irreversible progressive loss, reversible loss) can be identified and correlated with postoperative hearing outcome. Patients with reversible loss significantly benefit from postoperative vasoactive treatment consisting of hydroxyethyl starch and nimodipine. The present study investigates the treatment effect in the remaining three BAEP patterns. METHODS A retrospective analysis was performed in 92 patients operated on for vestibular schwannoma between 1997 and 2005. Between 1997 and 2001, only patients with reversible loss of BAEP received vasoactive medication. Subsequently, all patients operated on between 2001 and 2005 received a 10 day course of therapy, regardless of the BAEP pattern. Serial audiological examinations before, after surgery and after 1 year were performed in all patients. RESULTS All 30 patients with reversible loss of BAEP received medication, and postoperative hearing preservation was documented in 21 patients. All 13 patients with stable waves showed hearing preservation, regardless of treatment. In all 24 patients with abrupt loss and in all 25 patients with irreversible progressive loss, postoperative anacusis was documented, regardless of treatment. CONCLUSION In patients with reversible loss of BAEP, a disturbed microcirculation of the cochlear nerve seems to be the underlying pathophysiological factor. In patients with abrupt or irreversible progressive loss, additional mechanical injury of nerve fibres determines hearing outcome. The study provides evidence that for the purpose of hearing preservation, only patients with reversible loss of BAEP benefit from vasoactive treatment.
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Affiliation(s)
- B Bischoff
- Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Bischoff B, Romstöck J, Naraghi R, Fahlbusch R, Buchfelder M, Strauss C. EMG-monitoring of “lateral spread” during microvascular decompression for hemifacial spasm – A forgotten neurophysiological tool. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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