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Background: Ultrasound is an important imaging method in the head and neck area. It is readily available, dynamic, inexpensive, and does not involve radiation exposure. Interventions in the complex head and neck anatomy require good orientation, which is supported by navigation systems., Objective: This work aimed to develop a new ultrasound-controlled navigation system for taking biopsies of small target structures in the head and neck region., Methods: A neck phantom with sonographically detectable masses (size: 8-10 mm) was constructed. These were automatically segmented using a ResNet-50-based deep neural network. The ultrasound scanner was equipped with an individually manufactured tracking tool., Results: The positions of the ultrasound device, the masses, and a puncture needle were recorded in the world coordinate system. In 8 out of 10 cases, an 8‑mm mass was hit. In a special evaluation phantom, the average deviation was calculated to be 2.5 mm. The tracked biopsy needle is aligned and navigated to the masses by auditory feedback., Conclusion: Outstanding advantages compared to conventional navigation systems include renunciation of preoperative tomographic imaging, automatic three-dimensional real-time registration that considers intraoperative tissue displacements, maintenance of the surgeon's optical axis at the surgical site without having to look at a navigation monitor, and working freely with both hands without holding the ultrasound scanner during biopsy taking. The described functional model can also be used in open head and neck surgery., (© 2023. The Author(s).)

Neurootologic disorders of the inner ear associated with symptoms such as tinnitus, vertigo, and hearing loss are common and often cause significant distress to affected patients. Treatment options are usually limited. There are now some indications for which intratympanic drug application is a possible treatment option. Intratympanic drug administration is a simple, inexpensive therapy option with few side effects that can be used on an outpatient basis. Therefore, it should not be disregarded when indicated., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein Erklärung zu nichtfinanziellen Interessen -, (Thieme. All rights reserved.)

Purpose: The established treatment regimen for patients suffering from cancer in the head and neck region often leads to physical and mental health problems and therefore can significantly reduce the quality of life (QoL) in these patients. The available data indicate that additional complementary treatments, such as music interventions, may improve patients' QoL and compliance and reduce symptoms during therapy., Methods: Anonymous data collection using a self-designed questionnaire was conducted in patients suffering from cancer in the head and neck area in our outpatient department. The questionnaire particularly asked the patients about their need and interest in music interventions during therapy., Results: In total, 138 patients were consecutively enrolled in the study. The mean age was 64.9 years, including 68.1% men and 31.9% women. Only 11.5% listened to music regularly during their therapy at the time of data collection, yet 52.2% stated that they would be interested in music interventions. Patients especially conceived the relaxing and encouraging effects from listening to music. Most patients would prefer group therapies (56%) or listening to their own music (36.6%)., Conclusion: Our data suggest that there is a need for music interventions in patients suffering from cancer in the head and neck, as they anticipate they would experience positive effects, including reduced somatic and non-somatic symptoms and improved QoL. The lack of homogenous data emphasizes the need for further trials in the field of complementary music interventions to establish science-based concepts in the future., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Accurate planning of operating times in surgical clinics is essential. Moreover, high-capacity utilization of operating rooms (ORs) is necessary for economic efficiency., Objective: Most planning of operating times is performed by surgeons. Herein, surgeons' estimated times and the objective times for performing surgical procedures were compared to detect sources of error., Materials and Methods: In a retrospective analysis, the durations of 1809 operations using general anesthesia (22 types of surgery) by 31 surgeons (12 specialists and 19 residents) were compared. Comparisons were analyzed by Mann-Whitney U‑tests., Results: The comparison of objective times of surgical action showed significant differences between specialists and residents in 6 of 15 types of surgeries. The post-processing times estimated by specialists deviated from the objective times in 2 out of 22 surgery types, while the post-processing times estimated by residents deviated in 7 of 15 types. Specialists misjudged the incision-to-suture times in 7 of 22 surgery types, and residents misjudged these times in 3 of 15 types. The preparation times estimated by specialists deviated from the objective times in 16 of 22 types of surgeries and in 7 of 15 types estimated by residents., Conclusion: A surgeon's routine must be carefully considered in order to estimate operating times. Specialists generally underestimated preparation and post-processing times and overestimated incision-to-suture times, whereas residents underestimated all three. Preparation and post-processing times must be considered in planning and, ideally, determined together with anesthesiologists and surgical assistants., (© 2021. The Author(s).)

Objective: Intraorbital masses represent a condition that is frequently threatening for the visual system. A rigorous differential diagnosis is essential to promptly initiate appropriate therapy and optimize prognosis., Materials/methods: Narrative review of current literature and expert recommendations. For further illustration we describe the case of a 71-year-old male admitted to our department three months after sinus surgery. Postoperative intraorbital hematoma of the right orbit had been treated conservatively with antibiotics/corticosteroids, leading to a near-complete unilateral visual loss. The immediate surgical intervention aimed at decompression of the orbit and the optical nerve. Due to the delay, the intervention could not prevent formation of a lipogranuloma. Inflammatory phases associated with the lipogranuloma are successfully managed by conservative treatment based on multidisciplinary recommendations., Results: In the case reported, delay of surgical therapy acted as a cause of intraorbital lipogranuloma formation. Literature supports our recommendation of immediate surgical intervention in case of acute retrobulbar hematoma. Besides acute conditions, intraorbital masses can be a sign of systemic disease. In every case, a multidisciplinary therapeutic approach is required for adequate management., Conclusions: Intraorbital masses can occur as a complication of trauma or e.g. sinus surgery. On the other hand they can be a sign of systemic disease. Timely diagnosis and treatment prevents from visual loss. That is why rigorous differential diagnosis is essential for every discipline managing intraorbital lesions., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Due to the limited compliance, the technically correct collection of a pooled nasopharyngeal swab is significantly more difficult in children. Especially during operations in the area of the upper respiratory tract, there is a significantly increased risk of infection with COVID-19 for everyone present in the operating room. The aim of the study is to analyze the validity of SARS-CoV-2 swabs taken preoperatively under suboptimal conditions., Material and Methods: Retrospective comparison of the PCR results of SARS-CoV-2 swaps taken preoperatively and intraoperatively from 62 children in the period from April to July 2020. Median age was 4.49 years. The PCR diagnosis was carried out one or two days preoperatively (in the case of emergency interventions on the same day) and again intraoperatively using a pooled nasopharyngeal swab., Results: All 62 preoperatively taken swabs were negative. Deviating from the preoperative test result, one intraoperatively obtained swab was positive., Conclusions: Due to limited compliance, a correct preoperative swab technique (preanalytics) cannot always be assumed for children. Sufficient protective measures for everyone present in the operating room are therefore imperative. Intraoperative test should be considered if the preoperative test was performed under difficult conditions., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.