Nasopharyngeale Entwicklung bei Patienten mit Lippen-Kiefer-Gaumenspalten

Ziel dieser röntgenkephalometrischen Studie war die Analyse von Einflussfaktoren auf naso- und velopharyngeale Konfiguration bei Patienten mit durchgehender einseitiger LKG-Spalte (uCLP) und gesunden Probanden. Insgesamt wurden 189 FRS-Bilder (66 uCLP-Patienten (LKG-Gruppe), 123 gesunde Probanden (Kontrolle) ausgewertet. Die Kontrolle zeigte altersabhängig komplexe Zusammenhänge zwischen nasopharyngealen Parametern und Schädelbasiskonfiguration, Gesichtsschädelaufbau sowie Oberkiefer-Position. LKG-Patienten zeigten eine maxilläre Retroposition, eine geringere Oberkieferlänge, einen mehr posterioren und kranialen Einbau des hinteren Oberkiefer-Komplexes, eine geringere anteriore Nasopharynxhöhe, einen mehr vertikalen nasopharyngealen Aufbau (Verringerung sagittaler weichgewebiger und knöcherner Nasopharynxdimensionen) und eine kürzere Velumlänge mit ungünstigerer „Need Ratio“. Gesichtsschädelaufbau und Wachstumstyp waren in der LKG-Gruppe mehr vertikal. The objective of this cephalometric study was to analyse influence factors on naso- and velopharyngeal configuration in patients with complete unilateral cleft lip and palate (uCLP) and healthy subjects. In total 189 cephalometric radiographs (66 uCLP-patients (CLP), 123 healthy persons (control) ) were analysed. The control showed age-dependend complex correlations between nasopharyngeal parameters and configuration of the skull base, facial morphology and position of the maxilla. CLP showed a retroposition of the maxilla, reduced length of the upper jaw, a more posteriorly and cranially impaction of the posterior maxillary complex, lower anterior nasopharyngeal height, a more vertical configuration of the nasopharynx ( reduced sagittal dimensions ( bone, soft tissues ) and a shortened velar length with a more unfavourable “need ratio”. Facial morphology and type of growth intended to be more vertical in CLP

Eine klinische prospektive Studie zur objektiven Hypernasalitätsdiagnostik mit dem Nasal-View-System bei Patienten mit Lippen-Kiefer-Gaumenspalten

An 95 Patienten mit Lippen-Kiefer-Gaumenspalte erfolgte eine objektive Hypernasalitätsdiagnostik mit dem NasalView(r)-System durch eine Screening-Messung ( nasaler + nichtnasaler Satz ) und eine ausführlichere Detail-Messung. Es wurde eine gute Reliabilität ( Test-Retest-Fehler < 2 % ) und mit einer Sensitivität von 83,3 % - 86,5 %, einer Spezifität von 87,0 % - 93,1 % und einer Testeffizienz von 84,2 % - 90,5 % eine gute Validität des NasalView(r) ermittelt. Im untersuchten Kollektiv wurden keine statistisch signifikanten geschlechtsspezifischen, altersbedingten oder spalttypbedingten Unterschiede festgestellt. Zwischen Patienten mit und ohne Velopharyngoplastik konnten keine signifikanten Unterschiede ermittelt werden. Patienten, die nach dem aktuellen Münsteraner Therapiekonzept nach Prof. Joos behandelt wurden, wiesen statistisch signifikant niedrigere und damit günstigere Rhinophoniegrade und Nasalanzwerte als die Vergleichsgruppe der nicht nach diesem Konzept therapierten Patienten auf

The impact of hyperbaric oxygen therapy on serological values of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF)

<p>Abstract</p> <p>Background</p> <p>Hyperbaric oxygen (HBO) therapy is an effective adjunct treatment for ischemic disorders such as chronic infection or chronic wounds. It combines hyperoxic effects with the stimulating potential of post-therapeutic reactive hypoxia. As its crucial effects, stimulation of fibroblast growth, induction of collagen synthesis and the initiation of angiogenesis are discussed. Angiogenesis is a multistage process resulting in the growth of blood vessels. It includes degradation of extracellular matrix, proliferation and migration of different cell populations and finally formation of new vessel structures. This complex chain of procedures is orchestrated by different cytokines and growth factors. Crucial mediators of angiogenesis are basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF); their <it>in-vivo </it>function is still not fully understood.</p> <p>Methods</p> <p>Forty-three patients suffering from sudden sensorineural hearing loss or tinnitus were treated with HBO. The therapy included 10 sessions of 90 minutes each, one session a day. Serological levels of bFGF and VEGF were assessed by enzyme-linked immunosorbent assays performed according to the manufacturer's instructions on day 1, 2, 5 and 10 of HBO therapy and were compared to mean values of the control group, related to the patient's age and sex, and their development observed over the ten days of HBO.</p> <p>Results</p> <p>There was no sex- or age dependency of bFGF observed in the present study, whereas under HBO our results showed a significant mitigation of the bFGF concentration. In the present data, there was no connection between the VEGF concentration and the patients' ages. Women showed significantly higher levels of VEGF. There was no significant change of VEGF concentration or the VEGF/bFGF ratio during HBO. All scored results varied within the range of standard values as described in the current literature.</p> <p>Conclusions</p> <p>A significant effect of HBO on serum concentrations of bFGF and VEGF was not verified in the present study. Additional application of exogenous growth factors in conjunction with HBO was not obviously linked by a coherent cause-and-effect chain as far as wound healing is concerned.</p

German S3 guideline "actinic keratosis and cutaneous squamous cell carcinoma" – long version of the update 2023

Actinic keratosis (AK) are common lesions in light-skinned individuals that can potentially progress to cutaneous squamous cell carcinoma (cSCC). Both conditions may be associated with significant morbidity and constitute a major disease burden, especially among the elderly. To establish an evidence-based framework for clinical decision making, the guideline “actinic keratosis and cutaneous squamous cell carcinoma” was updated and expanded by the topics cutanepus squamous cell carcinoma in situ (Bowen’s disease) and actinic cheilitis. This guideline was developed at the highest evidence level (S3) and is aimed at dermatologists, general practitioners, ear nose and throat specialists, surgeons, oncologists, radiologists and radiation oncologists in hospitals and office-based settings, as well as other medical specialties, policy makers and insurance funds involved in the diagnosis and treatment of patients with AK and cSCC

In vitro inhibition of HUVECs by low dose methotrexate - Insights into oral adverse events

Background: With socio-economic changes, dentists and maxillofacial surgeons are more and more faced with medically compromised patients. Especially, the admission of antirheumatic drugs has increased remarkably. So dentists and maxillofacial surgeons should be aware of related adverse reactions that affect the craniofacial region. To identify possible cellular effects of disease modifying antirheumatic drugs (DMARDs) we investigated the influence of methotrexate (MTX) on human umbilical vein endothelial cells (HUVECs). Methods: HUVECs were incubated with various concentrations of MTX, corresponding to serum concentrations found in rheumatoid arthritis (RA) patients. The effect of MTX on cell proliferation, differentiation as well as mitochondrial activity was measured by use of immunostaining, cell counting and 3-(4, 5-dimethylthiazol-2-yl)- 2, 5-diphenyltetrazolium bromide (MTT) assay. Results: All samples incubated with MTX (1-1000 nM) showed significantly decreased cell viability when compared to controls. Cells were less proliferating, but did not lose their ability to synthesize endothelial proteins. A slight dose dependency of inhibiting effects was demonstrated. The observed differences between control and sample groups were rising with longer duration. Conclusion: Because of the crucial role of endothelial cells and their precursor cells in wound healing, a negative influence of MTX on oral health has to be supposed, correlating to clinical observations of adverse reactions in the oral cavity, such as ulcerative or erosive lesions