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Einleitung: Persistierende, einseitige Paukenergüsse mit ipsilateraler, cervikaler LK-Vergrößerung lassen an Entzündungen und Tumore denken. Die Tuberkulose stellt eine Differenzialdiagnose dar. Fallbericht: Ein 38-jähriger Mann mit protrahiertem Krankheitsverlauf bei Paukenerguss links und initial unauffälligem Nasenrachenraum entwickelte ein Jahr nach Erstvorstellung eine derbe Halsschwellung links. Kernspintomographisch zeigten sich ein LK-Konglomerat der Level II und V sowie ein malignitätsverdächtiger Prozess der Schädelbasis links mit Verlegung der Tuba eustachii. Unter hochgradigem Neoplasieverdacht erfolgte die Panendoskopie und Neck dissection. Durch den Nachweis von mykobakterieller DNA wurde die Diagnose einer LK-Tuberkulose gestellt. Eine pulmonale Beteiligung wurde ausgeschlossen. Es wurde eine tuberkulostatische Therapie eingeleitet. Unter dieser entwickelte der Patient einen Retropharyngealabszess, welcher auch der Tuberkulose zugeordnet werden konnte. Diskussion: 20% aller Tuberkulosefälle in Deutschland manifestieren sich extrapulmonal, ca. die Hälfte davon in Lymphknoten, vorzugsweise cervikal. Somit ist die Manifestation im Kopf-Hals-Bereich eher atypisch und sollte aber in Zeiten zunehmender Patientenmigration auch bei eindeutigem Neoplasieverdacht differentialdiagnostisch bedacht werden. Bei unklarem Entstehungsmechanismus wird unter anderem eine Primärinfektion mit Eintrittspforte im Bereich des Pharynx diskutiert. Die Diagnosesicherung und damit die Abgrenzung zu einer Neoplasie werden nicht selten erst durch ein operatives Vorgehen möglich und häufig mittels PCR gestellt. Wie in unserem Fall zeigt sich in ca. 30% der Fälle unter der tuberkulostatischen Therapie ein Befundprogress. Auch dann ist das chirurgische Vorgehen eine oft notwendige Option. Der Erstautor gibt keinen Interessenkonflikt an., GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery; 13:Doc258

A nonlocal InSAR filter is proposed that avoids the staircasing effect, which is especially troubling for DEM generation as it leads to terrace-like artifacts for hilly terrain. The sources of the staircasing effect for InSAR filtering are presented and the proposed filter is evaluated with simulations and test data, which show that the noise reduction and detail preservation are comparable to a state of the art nonlocal filter.

BACKGROUND: Injuries of the head and neck with suicidal intention might create serious situations that require rapid and interdisciplinary treatment. METHODS AND PATIENTS: Twenty-seven patients with suicidal head and neck injuries were treated at the Department of oto-rhino-laryngology, head and neck surgery, University of Wurzburg/Germany, between 1991 and 2002. The medical histories were analyzed retrospectively. RESULTS: Twenty-three of them were male, 4 female. Mean age at time of attempted suicidal was 48 years (18 - 90). One patient was already treated for a psychiatric disorder. None of the patients had a suicidal attempt in the history. Nine patients suffered from a pharynx or larynx trauma after strangulation. Four out of seven patients with cutting or stabbing injuries showed a perforation of the upper airways. Nine patients had gunshot traumas, one of them with perforation of the pharynx. Thirteen patients underwent immediate endoscopy under general anaesthesia followed by a neck exploration in 3 patients. Six patients received a temporary tracheotomy. All patients were considered suicidal for the duration of stay in the ENT-department resulting in a permanent supervision. All patients were transferred to a psychiatric unit as soon as possible for further treatment. A statistically significant accumulation was observed during the last third of a year. Over the period of 11 years, suicidal injuries of the head and neck tend to occur more frequently. CONCLUSIONS: The presented study emphasizes the need of immediate surgical and intensive care treatment of patients with head and neck injuries due to suicide attempts as well as an adequate psychiatric supervision during as well as after the surgical treatment. German language)

Background: Second primary tumors are of great importance for diagnostics, therapy and prognosis in patients suffering from squamous cell carcinomas of the upper aerodigestive tract. The clinical observation of an increase of second primaries was the reason for analyzing all patients with head and neck cancer treated for a certain period of time at our institution. Methods: The hospital charts of 576 patients treated for squamous cell carcinoma of the oral cavity, the oropharynx, the hypopharynx and larynx treated from 1993 till 1996 at the Department of Otolaryngology, Head and Neck Surgery of the University of Wurzburg were reviewed retrospectively. Results: 10.1 % of all patients developed a second primary tumor. The rate was highest for patients with carcinoma of the oral cavity (17.5%), followed by tumors of the hypo- and oropharynx (11.7% and 11.5%) and the larynx (6.4%). Besides the location, younger age was detected as a risk factor for the formation of second malignancies. The latency between first and second primary tumor was 2.9 years in average. 31 % of the second primaries were detected synchronous, 39% metachronous. Conclusion: The results demonstrate that younger patients and patients with carcinomas of the upper digestive tract need a consequent follow-up. The development of second primaries even years after the first malignoma demonstrates the necessity of lifelong follow-up and oncological care.