The present multicentric clinical study involves 19 centres, 16 of them in German-speaking countries, 1 British, 1 Polish and 1 Hungarian. 60 postlingually deafened adults with a mean age of 47.5 years (20–70) and a mean duration of deafness of 5.3 years (0.5–20) have been evaluated with the MED-EL COMBI 40 cochlear implant which implements a high-rate continuous-interleaved-sampling strategy with 8 channels. Safety and effectiveness data have been collected. Speech perception tests include a 16-consonant, an 8-vowel, a sentence and a monosyllabic-word test in all languages and a 2-digit figure test in all languages but English. Test intervals are 1,3,6 months and 1 year after first fitting. 41 of the 60 postlingually deafened adult study patients have completed their 6-month evaluation. While their pre-operative monosyllabic-word score was 0%, their mean monosyllabic-word score 6 months after first fitting was 48% (8–90) with a median of 50%. The mean sentence understanding was 84% (24–100) with a median of 90%. The respective values for the 1-year evaluations with 25 patients are a mean of 50% (5–85), with a median of 60%, for the monosyllables and a mean of 89% (30–100), with a median of 97%, for the sentences.

The allele constitution at codon 72 of the p53 gene (CGC-arginine or CCC-proline) plays a major role in inducing apoptosis in p53 mutant cells. To verify this, we determined GC-status, p53-mutations, and p53-loss of heterozygosity (LOH) in a group of 54 squamous cell carcinomas of the head and neck (SCCHN). A novel approach, using a one-step real-time PCR analysis with fluorescent hybridization probes, was applied to detect the GC status in tumors and corresponding blood samples. p53 mutations in exons 4 to 8 were detected by PCR-SSCP-sequencing analysis. Apoptosis was determined immunohistochemically using antibodies against Fas, FasL, p53, Bcl2, and terminal deoxy-transferase-mediated dUTP nick end labeling (TUNEL) staining. The overall frequency of p53-LOH in SCCHN was 45.2%. In cases of LOH, there was a preferential loss of the proline allele, which was associated with an up-regulation of Bcl2 and lack of co-expression of Fas/FasL and, thus, impaired apoptosis (P < 0.001). Apoptosis was not observed in tumors carrying the arginine allele. p53 mutations were detected in 29.6% of SCCHN and preferentially occurred at the arginine allele (P = 0.01). p53 alterations were more frequently observed in tumors of the oral cavity, oropharynx and hypopharynx, whereas they were rare in larynx carcinomas (P = 0.07). The p53-LOH status was not found to be significantly correlated with sex, age, TNM-status, or tumor grading. We conclude that apoptosis is correlated with the allelic status of codon 72 in SCCHN. Homozygous proline 72 appears to be an important regulator of apoptosis via the Fas/FasL pathway in SCCHN.

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A study was conducted to compare the new MED-EL TEMPO+ ear-level speech processor with the CIS PRO+ body-worn processor in the COMBI 40/COMBI 40+ implant system. Speech tests were performed in 46 experienced subjects in two test sessions approximately 4 weeks apart. Subjects were switched over from the CIS PRO+ to the TEMPO+ in the first session and used only the TEMPO+ in the time between the two sessions. Speech tests included monosyllabic word tests and sentence tests via the telephone. An adaptive noise method was used to adjust each subject’s scores to approximately 50%. Additionally, subjects had to complete a questionnaire based on their 4 weeks of experience with the TEMPO+. The speech test results showed a statistically significant improvement in the monosyllabic word scores with the TEMPO+. In addition, in the second session, subjects showed a significant improvement when using the telephone with the TEMPO+, indicating some learning in this task. In the questionnaire, the vast majority of subjects found that the TEMPO+ allows equal or better speech understanding and rated the sound quality of the TEMPO+ higher. All these objective and subjective results indicate the superiority of the TEMPO+ and are mainly attributed to a new coding strategy called CIS+ and its implementation in the TEMPO+. In other words, based on the results of this study, it appears that after switching over from the CIS PRO+ to the TEMPO+, subjects are able to maintain or even improve their own speech understanding capability.

MSCT data sets allow for generating virtual endoscopic views closely resembling otoendoscopic images. The technique is especially useful when ossicular pathologic changes are present as well as for preoperative and postoperative imaging of otologic procedures.

Die Tamponade der Nase gehört zur täglichen Arbeit des HNO-Arztes, sei es bei Epistaxis oder nach operativen Eingriffen. Die zunehmende Vielfalt der verfügbarenMaterialien lässt es notwendig erscheinen, Vor-und Nachteile der verschiedenen Tamponaden zu erörtern und die individuelle Tamponadenwahl von ihren Eigenschaften abhängig zu machen. Die folgende Übersicht soll helfen, Risiken bei der Tamponadenanwendung zu minimieren und die für die jeweilige Indikation optimale Tamponadenform zu bestimmen. Nasentamponaden Es gibt bisher keinen Standard zur postoperativen NasentamponadeDie Tamponade der Nase dient in erster Linie der ᭤ Blutstillung bei Nasenbluten und nach operativen Eingriffen in der Nase wie Septumplastik, Conchotomie sowie Nasennebenhöhlenoperationen, weiterhin zur inneren Stabilisierung bei Eingriffen am knorpelig-knöchernen Nasengerüst. Neben der Blutstillung soll die eingebrachte Tamponade Synechien oder Restenosierungen insbesondere nach Nebenhöhlenoperationen verhindern helfen. Letzteres geschieht vor allem durch eine längere Liegedauer der Tamponade [111] und die Verwendung speziell geformter Platzhalter [111, 113]. Ein allgemein akzeptierter Standard, welches Material zur Tamponade verwendet wird, wie lange die Tamponade liegen und bei welchen Indikationen diese erfolgen soll, besteht nicht [24, 48, 111]. Insbesondere nach endonasalen Nebenhöhlenoperationen ist die ᭤ Vielfalt der Vorgehensweisen groß. So verzichten viele Autoren, sofern keine starke Blutung während oder nach der Operation auftritt, gänzlich auf die Anwendung von Tamponaden. Alternativ wird die Tamponade für den Operationstag oder bis zu 5 Tagen nach der Operation belassen [111]. Die am häufigsten eingesetzten Nasentamponaden sind Gummifingerlinge, Schaumstofftamponaden und mit Salben getränkte Baumwollgazestreifen ᭤ Baumwollgazestreifen unterscheiden sich in der Breite der Tamponadestreifen, der Größe der Maschen und der Fertigung der Fäden. Die Baumwollgaze kann in ihrer Reinform als Tamponade verwendet werden oder mit Medikamenten getränkt sein. Hierbei kommen meist einfache Vaseline oder antibiotikahaltige Salben zur An-᭤ Blutstillung ᭤ Vielfalt der Vorgehensweisen ᭤ Baumwollgazestreifen HNO 2000 · 48:240-256

Recent studies have shown that most Dutch families with atypical multiple-mole melanoma (FAMMM) have a 19bp germline deletion (p16-Leiden) in exon 2 of the p16 gene (p16 [MIM 600160]) (Gruis et al. 1995; van der Velden et al. 1999van der Velden et al. , 2001. Incomplete penetrance and variable clinical expression in p16-Leiden carriers point to the fact that other genetic mechanisms can compensate for the p16 loss of function (Gruis et al. 1995). Indeed, van der Velden et al. (2001) reported in the Journal that variants in the melanocortin-1 receptor modify the risk of melanoma in p16-Leiden carriers. It is interesting that, apart from reports on simultaneous pancreatic tumors, other cancer types have never been found in such families with p16- Leiden (Gruis et al. 1995).Recently, we found a hereditary heterozygous p16-Leiden mutation in a man who neither smoked more than five cigarettes daily nor abused alcohol, initially diagnosed at age 54 years, who simultaneously developed three carcinomas of the pharynx and oral cavity. The patient showed a familial accumulation of tumor diseases. Both of his parents and his only sister died of cancer very early (the mother of gynecologic cancer, the father of liver carcinoma, and the sister of leukemia). Dutch relatives are not known.DNA from tumors and blood was extracted according to a standard protocol (Sambrook et al. 1989). Mutation analysis of exon 1 and exon 2 of the p16 gene was done by PCR-SSCP sequencing as described by Schneider-Stock et al. (1998).The p16-Leiden mutation was found in the heterozygous constitution in all three tumors and in the blood of the patient. We investigated all DNA samples for p16 promotor methylation to check the status of the retained wild-type allele and, thus, to assess the real functional significance of this finding. The methylation status of the p16 promotor was determined by methylation-specific PCR (Herman et al. 1996). The primer sequences for the unmethylated reactions were (sense) 5 -TTA TTA

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