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Hintergrund und Fragestellung. Die Verbesserung der Hamorheologie ist bei akuten kochlearen Funktionsstorungen therapeutisches Ziel, wobei Tinnitus analog der akuten Horminderung behandelt wird. In den letzten Jahren wurden neue Therapieregime mit Neurotransmittern vermehrt angewandt. Ziel der Arbeit war es daher, die erzielbaren Resultate bei Tinnitus mit einem abgestuften Therapiekonzept zu evaluieren. Patienten/Methodik. Die Daten von 123 Patienten wurden retrospektiv hinsichtlich der Wirksamkeit und Vertraglichkeit verschiedener Regime ausgewertet und der langfristige Effekt in einer Mailingaktion uberpruft. Ergebnisse. 83,7% der Patienten mit akutem Tinnitus (aT) und 16,1% mit chronischem Tinnitus (cT) erreichten mit Dextran/Procain eine Besserung. Der Effekt trat bei 89% der Patienten innerhalb der ersten 5 Tage ein. Die Neurotransmitterapplikation (Glutamat) erbrachte in 26,5% eine Reduktion des Ohrgerausches, Lidocain-Injektionen in 16,7% (aT) bzw. 38,9% (cT). In der Follow-up-Untersuchung beurteilten 66,7% (aT) bzw. 15,6% (cT) den langfristigen Therapieerfolg als deutlich. Die Vertraglichkeit ist mit 4% reversiblen Nebenwirkungen (non serious side effects) als sehr gut einzustufen. Schlussfolgerungen. Zur Tinnitustherapie empfiehlt sich folgendes Stufenkonzept: 1. Dextran/Procain (5 Tage), 2. Lidocain-Injektion, 3. Neurotransmitterapplikation (3 Tage). Hierdurch konnte insgesamt bei 95,3% der akut und 26,7% der chronisch Tinnitusbetroffenen ein Verschwinden oder eine Linderung der Symptomatik erreicht werden.

Quality of life is extraordinary affected by malignant tumors of the head and neck region as functions of social interaction are disturbed.The influence of surgical treatment and postoperative radio(chemo)therapy (RCT) on the quality of life was studied in patients with head and neck cancer. Twenty patients treated with curative intention completed the questionnaires EORTC QLQ-C30 and EORTC QLQ-HN35 at three time points.In most questions, patients reported poorer quality of life after RCT compared to postoperatively. Most of these differences were not significant. However, global quality of life and overall health was significantly worse after RCT as compared to postoperatively.Both operation and postoperative RCT, lead to decreased quality of life in patients with a head and neck cancer. In comparison, RCT seems to have a more pronounced effect on the quality of life than operative therapy.

On behalf of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, a clinical guideline for adenoids and adenoidectomy was developed in 5 consensus meetings after taking into consideration the current literature. This guideline was released by the presidium on 13 April 2011. Anatomy, pathology and pathophysiology, symptoms, diagnosis, therapy, and course are presented.

Cochlear dysfunction and tinnitus are treated by means of hemorrheological infusions in order to increase the cochlear oxygen supply and restore function of hair cells, neurotransmission and central processing of auditory information.In a retrospective analysis of the charts of 123 patients treated between February 1993 and May 1994, we analyzed effectiveness and safety of a gradual therapeutic regimen, consisting of dextrane/procaine infusions, lidocaine i.v. injection and infusion therapy with the neurotransmitter glutamic acid.Tinnitus decreased in 83.7% of patients with acute tinnitus (AT) and 16.1% of patients with chronic tinnitus (CT) during dextrane/procaine infusion. The majority (89%) experienced their tinnitus relief during the first 5 days. Treatment with glutamic diethylester and glutamic acid resulted in a 26.5% overall improvement. Application of lidocaine intravenously over a period of 10 min diminished tinnitus loudness or frequency in 16.7% (AT) and 38.9% (CT) of cases respectively. The long-term effects of therapy were investigated by a follow-up mailing action: 66.7% of the AT and 15.6% of the CT sufferers stated a clear therapy effect over time. Nonserious side effects were noted in 4% of the treated patients. Therefore safety was excellent.For acute and chronic tinnitus a gradual therapeutic regimen is recommended: (1) infusions with dextrane and procaine over 5 days; (2) intravenous application of 100 mg lidocaine over 10 min; and if necessary (3) administration of glutamic diethylester and glutamic acid for 3 days. This resulted in overall tinnitus relief in 95.3% of the acute and 26.7% of the chronic tinnitus sufferers.

Benign mucous membrane pemphigoid (BMMP) is characterized by immunoglobulin deposits along the basal zone of the skin and mucous membranes, leading to blistering erosions of the involved regions. We report the case history of a 72-year old woman, in whom a cicatricial, supraglottic stenosis caused increasing dyspnea. Through immunohistochemical analysis the diagnosis of BMMP was confirmed. Therapy with cyclophosphamide and steroids led to a remission. Clinical, diagnostic and therapeutic aspects of this laryngologic-dermatologic disease are presented and discussed in the context of the available literature.