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ZusammenfassungEine Hyperplasie der Tonsilla pharyngealis ist als Erkrankung zu bewerten, wenn durch mechanische Obstruktion und/oder chronische Entzündungen des Nasenrachens Krankheitssymptome auftreten. Aus einer chronischen Tubenventilationsstörung können unterschiedliche Mittelohrerkrankungen wie Schallleitungsschwerhörigkeit, Cholesteatom und rezidivierende akute Otitis media entstehen. Während der Inspektion ist das Augenmerk auf das Vorliegen einer Facies adenoidea mit dauerhaft offenem Mund und sichtbarer Zungenspitze zu legen. Bei starken Beschwerden und/oder frustranen konservativen Therapieversuchen erfolgt die Adenotomie in der Regel ambulant. Die herkömmliche Kürettage gilt nach wie vor als etablierte Standardmethode in Deutschland. Bei klinischen Hinweisen auf Mukopolysaccharidose ist die histologische Untersuchung indiziert. Wegen des Blutungsrisikos wird auf den Gerinnungsfragebogen, der obligat vor jedem operativen Eingriff im Kindesalter durchzuführen ist, hingewiesen. Trotz ordnungsgemäßer Adenotomie kann es zu einem Rezidiv der adenoiden Vegetationen kommen. Vor Entlassung in das häusliche Umfeld sollte eine HNO-ärztliche Kontrolle durch Inspektion des Rachens auf Nachblutung und eine anästhesiologische Freigabe erfolgen.

Background The role of ATX-101 in submental fat reduction has been well documented; however, its applicability across multiple anatomic areas is to be explored. Objectives The authors sought to describe the experience with ATX-101 subcutaneous injections for body and jawline contouring and evaluate its safety. Methods This single-arm, single-center observational study included 201 patients who underwent injection adipocytolysis with ATX-101 (area-adjusted dose of 2 mg/cm2) in the jowl, abdomen (upper/lower), thigh (inner/outer/banana roll), arm, anterior periaxillary fat, back (lower/upper/nape/lipoma), knee (anterior/medial), chest, and/or neck. The number of treatment sessions, treatment volumes, doses, injections required for each anatomic area, and associated adverse events were recorded. Results The mean number of treatment sessions conducted was 1.8. Multiple sessions were common for the jowl (mean: 2.0 and mean volume administered varied significantly between persons receiving 1 or multiple sessions [P = 0.005]). The mean volume and mean number of injections per session were highest in the chest (84.7 mL and 423.5, respectively) and lowest in the jowl (0.8 mL and 4.6, respectively). The chest (0.2 mL) and nape (0.2 mL) received the highest mean ATX-101 dose per injection site per session, whereas the inner thigh (0.11 mL) and upper back (0.11 mL) received the least. Adverse events observed were localized to the injection site. All patients experienced edema after each session, whereas numbness, tenderness, bruising, and paresis were experienced by 99.6%, 94.2%, 33.1%, and 2.6% of patients, respectively. Alopecia was not observed. Conclusions ATX-101 was well tolerated for body and jawline contouring. Level of Evidence: 4

Introduction Clinical data on body contouring with injectable poly-L-lactic acid are sparsely reported in published literature. This study describes the lead author's clinical experience using injectable poly-L-lactic acid for body contouring in various anatomic locations. Methods Twenty consecutive patients undergoing body contouring treatments with poly-L-lactic acid were prospectively followed. All treatments were performed at a single clinic between February 2017 and February 2019. Treatment details such as reconstitution, injection volume and dosage were documented. Treatment response was assessed independently by patients and the treating physician. Adverse events were recorded. Results Twenty patients (85% women) received injectable poly-L-lactic acid for body contouring treatments such as buttocks volumization, cellulite and skin quality treatment. In most patients (65%), poly-L-lactic acid was administered to correct postsurgical soft tissue deformities. Overall, patients had a mean of 5.1 treatment sessions in a mean of 1.4 anatomic locations. The most commonly treated anatomic locations were buttocks (58% of treatment sessions), thighs (20%) and abdomen (9%). Dosage and injection volume varied between patients depending on anatomic location and desired outcome. Most treatment sessions (86%) resulted in improvement of the treated area. Adverse events included bruising, oedema, numbness and tenderness. Nodule formation was recorded for one patient (5%). Conclusion According to the lead author's clinical experience, poly-L-lactic acid injection is well tolerated and can achieve good aesthetic outcomes when used for body contouring in appropriate patients. Preliminary data suggest that poly-L-lactic acid injection may be a viable nonsurgical technique for correcting postsurgical soft tissue deformities.

OBJECTIVE Generation of pilot data for planning of prospective BET-studies for treatment of dilatory Eustachian tube (ET) dysfunction in children. STUDY DESIGN Retrospective multicenter analysis. SETTING Nine ENT departments at tertiary care teaching hospitals. PATIENTS 4-12-year-old children with chronic otitis media with effusion (COME) for more than 3 months or more than 3 episodes of acute otitis media during the last year, having failed standard surgical therapy at least once. INTERVENTION BET with or without paracentesis, ventilation tube insertion, or tympanoplasty. MAIN OUTCOME MEASURES Tympanic membrane appearance, tympanometry, and hearing threshold. RESULTS Two hundred ninety-nine ETs of 167 children were treated. Mean age was 9.1 years (95% confidence interval [95% CI]: 8.7-9.4 yr). In 249 ears (83.3%), COME and/or retraction of the tympanic membrane were the indication for BET. Median hearing threshold was 20 dB HL (95% CI: 0-46 dB). One hundred fifty-five ears (51.8%, 95% CI: 46.1-57.4%) showed a tympanogram type B. Treatment consisted of BET without other interventions ("BET-only") in 70 children, 128 ears. Median length of follow-up for 158 (94.6%) children was 2.6 months (95% CI: 0.3-16.1 mo). After treatment, the tympanic membrane appeared normal in 196 ears (65.6%, 95% CI: 60.0-70.8%, p

На сегодня верификация и определение степени злокачественности опухолей орофарингеальной области остается актуальным диагностическим заданием в случае морфологической дифференцировки и сложным вызовом в плане прогноза течения по клиническим данным в каждом индивидуальном случае. Цель работы – сравнение уровня гистологического дифференцирования плоскоклеточных карцином орофарингеальной зоны и их метаболической активности по данным позитронно-эмиссионной томографии для оптимизации предоперационного уровня дифференцировки опухолей. Определение метаболической активности опухолей орофарингеального участка за счет позитронно-эмиссионной томографической диагностики и их сравнения с гистологической дифференцировкой в биопсийном материале. Материалы и методы. С 1 мая 2012 г. до 1 января 2015 г. на базе военного госпиталя Бундесвера (г. Ульм, ФРГ) исследовали 121 случай сквамозноклеточных карцином орофарингеального участка с предоперационным использованием позитронно-эмиссионной томографической (ПЭТ) диагностики. Изучена зависимость между накоплением 2-фтор[18F]-2-дезокси-D-глюкозы и определенными гистологическими критериями. В исследовании оценивали уровень дифференцировки по методике Anneroth et al., 1987 и Bryne et al., 1992. Результаты. После подбора и просмотра биопсийного и операционного материала в зависимости от уровня морфологической дифференцировки опухолей пациентов поделили на три основные группы. В первой, в которую входят высокодифференцированные G1 опухоли – 22 пациента, в группе 2 – умереннодиференцированные G2 – 45, в группе 3 – низкодифференцированные G3 – 54 больных. Все группы морфологически описаны. В дальнейшем в группах оценили результаты ПЭТ по показателю SUVmax. Сравнивая показатели, обнаружили статистически значимую разницу между группами (p < 0,001 по критерию Краскела–Уоллиса для всех показателей). С уменьшением Ме уровня дифференциация SUV max опухолей значительно увеличивается (р < 0,05), а рост SUV max свидетельствует об увеличении степени злокачественности опухолей. Выводы. В результате исследования установлена статистически значимая взаимосвязь SUV max и уровня морфологической дифференциации сквамозноклеточных карцином орофарингеального участка. Продемонстрирована возможность использования метода ПЭТ-диагностики как возможного критерия оценки уровня дифференцировки опухолей, в том числе сложных сквамозноклеточных карцином орофарингеального участка.

Hearing loss is frequently induced by occupational noise exposure and leads to rising hearing thresholds as well as reduced otoacoustic emissions (OAE), mostly caused by metabolic hair cell decompensation.Primary endpoint is the increase in average pure tone thresholds after noise exposure, secondary endpoints are loss of distortion product and click-evoked OAE as well as reduction of their contralateral suppression.The present study design describes the verification of the anti-oxidant and neuroprotective properties of EGb 761® by evaluation of cochlear protection from noise impact as well as its safety and tolerance in 202 healthy male participants distributed equally to verum and placebo groups in a double-blind manner. Participants were assessed, medicated, exposed to noise, and then examined at timepoints up to 10 min and 4 weeks thereafter.This summary of the verification study protocol highlights the complexity of diligent and precise planning according to the European Medicines Agency criteria for controlled trials (EudraCT). Key points are the intervention rationale, definitions of in- and exclusion criteria, estimation of subject numbers, and examination method setting in terms of optimum endpoint description.