M Ellies

Georg-August-Universität Göttingen, Göttingen, Lower Saxony, Germany

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Publications (35)33.66 Total impact

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    Maik Ellies, Rainer Laskawi
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    ABSTRACT: BACKGROUND: Diseases of the salivary glands are rare in infants and children (with the exception of diseases such as parotitis epidemica and cytomegaly) and the therapeutic regimen differs from that in adults. It is therefore all the more important to gain exact and extensive insight into general and special aspects of pathological changes of the salivary glands in these age groups. Etiology and pathogenesis of these entities is still not yet fully known for the age group in question so that general rules for treatment, based on clinical experience, cannot be given, particularly in view of the small number of cases of the different diseases. Swellings of the salivary glands may be caused by acute and chronic inflammatory processes, by autoimmune diseases, by duct translocation due to sialolithiasis, and by tumors of varying dignity. Clinical examination and diagnosis has also to differentiate between salivary gland cysts and inflammation or tumors. CONCLUSION: Salivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach. The rareness of salivary gland tumors is particularly true for the malignant parotid tumors which are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy.
    Head & Face Medicine 02/2010; 6:1. · 0.98 Impact Factor
  • Rainer Laskawi, Maik Ellies
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    ABSTRACT: In this review article different relevant applications of botulinum toxin type A are demonstrated in patients with head and neck cancer. Patients with head and neck cancers of different etiologies often suffer from disorders concerning their musculature (for example, synkinesis in mimic muscles) or gland secretion in the head and neck region. This leads to many problems and reduces their quality of life. The application of botulinum toxin type A can improve movement disorders like synkinesis following reconstructive surgery in patients with cancers of the parotid gland, spasms of the pharyngo-esophageal musculature following laryngectomies and disorders of the autonomous nerve system like hypersalivation, hyperlacrimation and pathological sweating. The application of botulinum toxin type A is a helpful and minimally invasive treatment option in different functional disorders improving the quality of life in patients with head and neck cancers of different etiologies. Side effects are rare.
    Current Opinion in Otolaryngology & Head and Neck Surgery 05/2007; 15(2):112-6. · 1.73 Impact Factor
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    ABSTRACT: Facial pain syndromes can be very heterogeneous and need individual diagnosis and treatment. This report describes an interesting case of facial pain associated with eczema and an isolated dyskinesia of the lower facial muscles following dental surgery. Different aspects of the pain, spasms and the eczema will be discussed. In this patient, persistent intense pain arose in the lower part of her face following a dental operation. The patient also exhibited dyskinesia of her caudal mimic musculature that was triggered by specific movements. Several attempts at therapy had been unsuccessful. We performed local injections of botulinum toxin type A (BTX-A) into the affected region of the patient's face. Pain relief was immediate following each set of botulinum toxin injections. The follow up time amounts 62 weeks. Botulinum toxin type A (BTX-A) can be a safe and effective therapy for certain forms of facial pain syndromes.
    Head & Face Medicine 02/2007; 3:32. · 0.98 Impact Factor
  • Klinische Neurophysiologie - KLIN NEUROPHYSIOL. 01/2007; 38(04).
  • Klinische Neurophysiologie - KLIN NEUROPHYSIOL. 01/2007; 38(04).
  • Maik Ellies, Wolfgang Steiner
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    ABSTRACT: Because of the increasing use of laser surgery for tumors of the upper aerodigestive tract, there is also a discussion in peri- and postoperative complications of this kind of surgery. It was the aim of the present investigation, based on a great number of treated patients, to point out the complications of laser surgery and give a hint for possible dangers. Altogether, 1528 patients suffering from tumors of the upper aerodigestive tract were investigated. The peri- and postoperative complications were assumed in respect to localization and stage of tumor. The different evidence of complications depended on the localization and stage of tumor. It was pointed out that postoperative bleeding is the main complication after laser surgery of tumors of the upper aerodigestive tract. Overall, there were low complication rates especially after surgery of glottic carcinomas in early stages. Peri- and postoperative complications after laser surgery of tumors of the upper aerodigestive tract are relatively seldom events. Because of the fact that postoperative bleeding is the most common complication, every clinic that performs laser surgery should have a clear concept of management for this complication. Also, strategies to avoid these complications should be developed.
    American Journal of Otolaryngology 01/2007; 28(3):168-72. · 1.23 Impact Factor
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    ABSTRACT: We report on 52 juvenile and adolescent patients with benign and malignant tumors of the salivary glands. Controlled follow-up was carried out to examine outcome and side effects of therapy. The clinical files of 52 patients were evaluated by computer-based methods. Follow-up was comprised of the findings of our clinic as well as those of the primarily consulted physicians and, if possible, up-to-date examinations in our clinic. Benign tumors had their highest incidence in puberty and postpuberty. Forty patients (20 girls and 20 boys; 77%) had benign growths and 12 patients (9 girls and 3 boys; 23%) suffered from malignant neoplasms. After surgery for benign tumors we saw no postoperative recurrences in long-term follow-up. In the group of malignant tumors, 8 patients (66.7%) survived their disease in the long-term follow-up. Salivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. This is particularly true for the malignant parotid tumors that are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy.
    Journal of Oral and Maxillofacial Surgery 08/2006; 64(7):1049-58. · 1.33 Impact Factor
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    ABSTRACT: We wanted to prove the hypothesis that local injections of botulinum toxin A have an influence on the immunoreactivity of neuronal nitric oxide synthase (nNOS) in parotid glands of adult rats. Our group carried out immunohistochemical reaction of neuronal nitric oxide synthase (nNOS) in the parotid gland of female adult Wistar rats, in native (untreated) glands and after intraglandular injection of botulinum toxin A under general anesthesia. The immunoreactivity of nNOS was investigated on different times after injection. Compared with the untreated glands, there was a significant decrease of nNOS in the treated organs that became stronger with extended toxin exposure time. After our laboratory in a pilot study had already shown in general a decrease of nNOS immunoreactivity after injection of botulinum toxin A into the cephalic salivary glands of the rat, the present study shows more explicit data on the effect of botulinum toxin A injection on a higher number of examined parotid glands and analyzes a time course of the effect duration. In our study, it was shown that botulinum toxin A had an influence on the immunoreactivity of neuronal nitric oxide synthase (nNOS) in parotid glands. Participation of nitric oxide (NO) in the regulation of secretion from the parotid gland of the rat seems to be likely. It might be assumed that the influence of botulinum toxin A on nNOS in the parotid gland of the rat is able to explain the sometimes longer duration of toxin effect at the neuroglandular junction than at the motor endplate.
    Journal of Oral and Maxillofacial Surgery 04/2006; 64(3):397-401. · 1.33 Impact Factor
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    ABSTRACT: In our study, we intend to investigate the influence of local injections of botulinum toxin A on the activity of neuronal nitric oxide synthase (nNOS) in submandibular glands of adult rats. Since interest has been focused on the role of nitric oxide (NO) as a possible neuromodulator of secretory regulation processes in the upper aerodigestive tract, it was the aim of the present study to show that the toxin also interferes with the metabolic actions of NO on investigated rat submandibular glands. It is of great clinical interest whether the NO pathway is able to influence salivary gland secretion. Increasing of knowledge in this field maybe helpful to treat sialorrhoea, especially in juvenile otolaryngologic and neurologic patients. We performed immunohistochemical reaction of neuronal nitric oxide synthase (nNOS) in the submandibular gland of female adult Wistar rats, both in native (untreated) glands and after intraglandular injection of botulinum toxin A under general anesthesia. The immunoreactivity of nNOS was investigated on different times after injection. Other than in the untreated glands, there was a significant decrease of nNOS in the treated organs, which became stronger with extended toxin exposure time. The present study shows explicit data on the effect of botulinum toxin A injection on a higher number of examined submandibular glands and is able to analyze a time course of the effect duration. In our study, it was shown that botulinum toxin A had an influence on the immunoreactivity of neuronal nitric oxide synthase (nNOS) in submandibular glands. Therefore, the participation of nitric oxide (NO) in the regulation of secretion from these organs seems to be evident. It might be assumed that the influence of botulinum toxin A on nNOS in the submandibular gland of the rat is able to explain the sometimes longer duration of toxin effect at the neuroglandular junction than at the motor endplate.
    International Journal of Pediatric Otorhinolaryngology 02/2006; 70(1):59-63. · 1.35 Impact Factor
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    ABSTRACT: To determine retrospectively the localization, etiology and treatment of inflammatory diseases of the salivary glands in infants and children and to evaluate treatment outcome. Forty-five patients were treated in our institution in the period 1966-2000. The patients' records were evaluated and the results and side-effects of therapy were documented by a controlled follow-up study. Twenty-five of our patients were females (55.6%) and 20 males (44.4%). Inflammatory disorders figured most prominently in the group of patients between 12 and 16 years (n=14). Inflammation of the submandibular glands was the most common disease with 53.3% (n=24). The most frequent underlying cause in this subgroup of acute and chronic sialadenitis was sialolithiasis of the submandibular gland (40%). All patients were symptom-free in the long-term follow-up and all were symptom-free after surgical intervention. The present study shows that diseases of the salivary glands are rare among infants and children. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach.
    International Journal of Pediatric Otorhinolaryngology 02/2006; 70(1):129-36. · 1.35 Impact Factor
  • Maik Ellies, R Laskawi
    Laryngo-Rhino-Otologie 10/2005; 84(9):647-50. · 0.82 Impact Factor
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    ABSTRACT: The aim of the study was the evaluation of the clinical data of 33 patients who had had drooling attributable to various diseases, salivary fistulas, and sialadenitis and had been treated with injection of botulinum toxin type A (Botox). A controlled follow-up study documenting efficiency, possible side effects, and duration of the effect of treatment was also performed. Retrospective clinical evaluation. Thirty-three patients with drooling attributable to head and neck carcinoma, neurodegenerative diseases, stroke, or idiopathic hypersalivation or with salivary fistula or chronic sialadenitis received injections of 20 to 65 U botulinum toxin type A into salivary glands under sonographic control. The entire salivary flow rate and the output per minute of the salivary analytes thiocyanate, total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A were measured at various times before and after injection. The patients were examined with regard to severity of their symptoms, including sonographic control investigation of their cephalic salivary glands. Twenty-six patients (79% of all patients) reported a distinct improvement of their symptoms after toxin injection. Seven patients noted a return of high salivation rates and requested a second injection after 4 to 7 months. Duration of toxin effect varied widely among individuals. In general, salivary flow rates and thiocyanate output dropped sharply within 1 week after injection and had increased again after a period of 12 to 16 weeks. Conversely, amylase outputs increased during this period, whereas the outputs of the other analytes remained roughly constant. Sonography did not reveal any major changes in salivary gland parenchyma, and side effects were not noted. Reduction of salivary flow in patients with drooling, salivary fistulas, or chronic sialadenitis by local injection of botulinum toxin type A into the salivary glands proved to be a dependable therapy for these disorders, as shown in the present extended report on 33 patients. Side effects were not observed. The effect of toxin application lasted for approximately 3 months. Based on their results, the authors recommend botulinum toxin injection as the therapy of choice in patients with the problem of drooling.
    The Laryngoscope 11/2004; 114(10):1856-60. · 1.98 Impact Factor
  • M Ellies
    Laryngo-Rhino-Otologie 11/2003; 82(10):713-4. · 0.82 Impact Factor
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    ABSTRACT: In this study, we evaluated the clinical data for patients with drooling caused by various diseases, treated by injection of botulinum toxin A. We also present a controlled follow-up study documenting efficiency, possible adverse events, and duration of the effect of treatment. Thirteen patients with drooling caused by head and neck carcinoma, neurodegenerative diseases, or stroke received injections of 50 to 65 U botulinum toxin A (Botox; Allergan, Irvine, CA) in both submandibular and both parotid glands under sonographic control. We measured whole salivary flow rate and the salivary analytes of total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A at various times before and after injection. The patients were examined for severity of symptoms, including sonographic investigation of cephalic salivary glands. All 13 patients reported a distinct improvement of their symptoms within 2 weeks after toxin injection. Three patients noted a return of high salivation rates after 12 weeks. Duration of toxin effect varied widely between individuals. In general, salivary flow rates dropped sharply within 1 week after injection but had risen again after 12 weeks. Conversely, analyte concentrations increased in the first stages of treatment and later decreased, returning to pretherapy levels. Sonography did not reveal any major changes of salivary gland parenchyma, and side effects were absent. Local injection of botulinum toxin A into the salivary glands proved to be a dependable therapy for drooling caused by various etiologies, as shown in 13 patients. Adverse events were not seen. The effect of toxin application lasted for about 3 months. To further clarify this aspect, long-term studies are under way.
    Journal of Oral and Maxillofacial Surgery 05/2003; 61(4):454-7. · 1.33 Impact Factor
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    ABSTRACT: The purpose of our study was to investigate the possible influence of local injections of botulinum toxin A on the activity of neuronal nitric oxide synthase (nNOS) in cephalic salivary glands of adult rats. The role of nitric oxide (NO) as a possible neuromodulator of vascular regulation and in particular regulation of secretion in the upper respiratory and aerodigestive tract is discussed. We present immunohistochemical evidence of nNOS in the salivary glands of female adult Wistar rats, both in native (untreated) glands and after intraglandular injection of botulinum toxin A under general anesthesia. Other than in the untreated glands, there was a significant decrease in nNOS in the treated organs which became stronger with extended toxin exposure time. After our laboratory had already shown a decrease in acetylcholinesterase immunoreactivity after injection of botulinum toxin A into the cephalic salivary glands of the rat, the present study discusses a possible participation of NO in the regulation of secretion from these organs. As a conclusion, it might be assumed that the influence of botulinum toxin A on nNOS in the cephalic salivary glands of the rat is able to explain the sometimes longer duration of the toxin effect at the neuroglandular junction than at the motor endplate.
    ORL 01/2003; 65(3):140-3. · 1.10 Impact Factor
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    ABSTRACT: The present study investigates the effect of topical injections of botulinum toxin A into the cephalic salivary glands of children with chronic hypersalivation due to neurodegenerative diseases. Five children with hypersalivation due to severe neurological diseases received, under ultrasound guidance, a total of 50-65 units of botulinum toxin A (Botox) into the parotid and submandibular glands on both sides. All injections were tolerated without local anaesthesia. Before and 1, 2, 4, 8 and 12 weeks after toxin injection, salivary flow rates and the concentrations of total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A were measured in the secretions; simultaneously, the patients were clinically examined with regard to severity of symptoms, and their salivary glands were subjected to ultrasound study. A distinct improvement of symptoms within the first 2 weeks following toxin administration were reported by the parents. Sialometry revealed considerably reduced flow rates but sialochemistry showed an increase of amylase activity. Ultrasound examination did not reveal any changes of the salivary parenchyma, and side-effects were absent. Treatment of drooling by topical injection of botulinum toxin A into the salivary glands is a reliable and also side-effect-free therapeutic option for children with neurological disorders. All children involved in our study experienced a distinct improvement of their quality of life.
    Neuropediatrics 01/2003; 33(6):327-30. · 1.19 Impact Factor
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    ABSTRACT: The study investigates the effect of local injections of botulinum toxin type A (Botox) into the major salivary glands of the head in various states of hypersalivation. In particular, we studied pathological states with permanent as well as passing hypersalivation disorders and present new indications for local application of botulinum toxin to the salivary glands. Retrospective clinical investigation. A total of 55 to 65 units of Botox were injected under sonographic control into the left and right parotid and submandibular glands of four patients with hypersalivation resulting from head and neck carcinoma, tracheostomy, and "idiopathic" hypersalivation disorder. At defined time intervals following injection, flow rate, total protein and immunoglobulin A content, and the enzymatic activities of amylase, acid phosphatase, and kallikrein were determined in the saliva. The patients were clinically examined to assess the severity of their symptoms, including sonographic control of the major salivary glands. All four patients reported distinct improvement of their symptoms within 1 week after injection. Salivary flow rate had considerably dropped, whereas the concentrations of the salivary components were much increased. Sonography did not reveal any changes of the salivary gland parenchyma. Therapeutic side effects were absent. Treatment of hypersalivation by local injections of Botox into the salivary glands of the head is a reliable and efficient therapy without side effects for certain otolaryngological diseases, especially if injections are performed under sonographic control. Extension of this therapeutic concept to other indications is suggested.
    The Laryngoscope 02/2002; 112(1):82-6. · 1.98 Impact Factor
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    ABSTRACT: Hypersecretion disorders of the exocrine glands of the head and neck area are a therapeutic problem in the field of otorhinolaryngology. In the present study, we demonstrate the effectiveness of local injections of botulinum toxin A to block secretions of exocrine glands of the head and neck area. Four patients suffering from hypersecretion disorders received local injections of botulinum toxin A. Two patients suffered from disorders of the salivary glands: one presented an idiopathic hypersialorrhea and another a salivary fistula after parotidectomy. A third patient suffered from epiphora and a further patient presented severe hyperhidrosis on the pilose head region. In a retrospective clinical study, the outcome of therapy was evaluated by clinical examination and chemical parameters. Clear blocking of secretion in the treated glands could be demonstrated in all four cases. Possible side effects of the treatment could not be observed. The present study was able to demonstrate a clear blocking of secretion of the exocrine glands of the head and neck region through botulinum toxin A, offering an improvement in therapy especially for the innovative indication of blocking the salivary glands of the head.
    HNO 11/2001; 49(10):807-13. · 0.42 Impact Factor
  • M. Ellies, R. Laskawi, U. Lux
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    ABSTRACT: ZusammenfassungÜber einen Zeitraum von 10 Jahren wurden an der Universitäts-HNO-Klinik Göttingen insgesamt 98 Patienten bei dem Verdacht auf das Vorliegen eines Fremdkörpers endoskopiert. Bei 54 Patienten (55%) konnte ein Fremdkörper extrahiert werden. Kinder unter 10 Jahren stellten hier eine Risikogruppe dar. Zu den häufigsten Symptomen und pathologischen Veränderungen zählten Husten, pathologische Auskultationsbefunde, Bronchitiden und Pneumonien. Röntgenologisch liessen sich in etwa 80% der Fälle entweder der Fremdkörper oder pathologische Veränderungen darstellen. Die Extraktion der Fremdkörper erfolgte mit einem starren Beatmungsbronchoskop. Als häufigster Fremdkörper liessen sich Nusskerne (44%) nachweisen, die Verweildauer der Fremdkörper variierte von unter 24 h bis zu 98 Tagen. Endoskopisch liessen sich in etwa 65% der Fälle geringgradige oder schwerwiegende Schleimhautveränderungen durch die Fremdkörperaspiration nachweisen, Komplikationen der Endoskopie selbst waren nicht zu verzeichnen. Zusammenfassend sollte nach den Ergebnissen der vorliegenden Untersuchung bei dem Verdacht auf das Vorliegen eines Fremdkörpers eine Endoskopie unter Allgemeinanästhesie durchgeführt werden, da diese Methode eine sichere Fremdkörperentfernung bei gleichzeitig geringer Komplikationsrate zulässt.
    Oto-Rhino-Laryngologia Nova 01/2001; 11(3-4):198-203.
  • Maik Ellies, Rainer Laskawi
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    ABSTRACT: In this patient an auricular abscess formation and perichondritis of the right ear developed following ear acupuncture treatment. Despite initially performed oral antibiotic treatment a surgical intervention and intravenous therapy with ciprofloxacin were necessary. There was only a moderate cosmetic deformity of the right ear. Because of the increasing use of ear acupuncture treatment for chronic pain states in recent years, one must be aware of the possible side-effects, which can include abscess formation and perichondritis leading to deformities of the ear. In conclusion, an absolutely aseptic treatment in ear acupuncture is recommended.
    Oto-rhino-laryngologia Nova - OTO RHINO LARYNGOL NOVA. 01/2001; 11(6):304-305.