HNO
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This article gives an overview about the main nasopharyngeal pathologies and incidental findings, which a radiologist could be confronted with in daily practice. These include nasopharyngeal cysts, lymphoid hyperplasia, juvenile angiofibroma, carcinomas and non-Hodgkin lymphoma. Typical radiological findings, possibilities for making a specific diagnosis, differential diagnosis and description of the spread of a neoplasm are the central points. Investigation techniques and clinical signs are briefly summarized.
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Review Case Reports
[Significance of emissary veins in surgical treatment of temporal paragangliomas].
With the surgical removal of temporal paraganglioma, possible changes of the cerebral blood pathways of the Circle of Willis should be considered. If the cerebral blood drains dominates unilaterally and the pathway of drainage over the Bulbus venae jugularis is inadequate due to vessel malformation or variations or by intraluminal tumor growth, as for instance of temporal paragangliomas, collateral emissary vessels can take over this function by an extraordinary large lumen extension. ⋯ A presurgical angiography is, therefore, indicated. In case of vessel malformations or variations the use of computer-assisted surgery could be helpful to preserve such native emissary veins at the bony skull base, such as the condylar emissary vein in the case of a transcondylar infralabyrinthine approach.
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Positive airway pressure (PAP) is the therapy of choice for most sleep-related breathing disorders. A variety of PAP devices exist (continuous PAP, bi-level PAP, automatic PAP, adaptive servo-ventilation) and must be carefully considered before application. ⋯ PAP treatment is very effective in eliminating obstruction-related sleep diseases and symptoms. However, because it generally has to be used throughout the patient's life, the optimal PAP device must be carefully selected, taking into account side effects that influence compliance.
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A consequence of the ongoing advances in medical navigation is the development of so-called mechatronic assistant systems. Up to now, medical navigation had been used only for additional intrasurgical orientation. But improvements in accuracy in imaging and medical navigation can exceed the surgeon's possible manual accuracy of surgical manipulation. ⋯ The development and possible use of such mechatronic assistant systems in the head and neck, as well as improvements in the accuracy of medical navigation, are the focus of several working groups. For coordinating and adapting the various research projects, different research groups were called to present their current projects and results in the context of ASKRA (working group for skull-base and craniofacial surgery of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery) workshops at the German Society for Computer- and Robot-Assisted Surgery (CURAC) convention on 14 October 2006 in Hanover. Different projects were presented, with topics including navigated controlled assistant systems for the frontal and lateral skull base, possibilities for sonographic-induced bone measurement, and requirements for high-precision surgery of the skull base.
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Review
[Challenge prevention. From curative to preventive medicine-strategic and operational challenges].
The potentials of preventive medicine to reduce the costs of illness have been inadequately exploited to date. Even if there is still massive dissent regarding the legal setup of a prevention law, prevention should play a significantly higher role in practice. ⋯ Prevention as a new strategic business segment allows a directed reaction to the demands of the payment system and opens up enormous value-added potential at the same time. Those who seize the chance to integrate prevention into their medical services portfolio and into the structure and processes of their respective hospitals will develop an important competitive advantage for the future.