K Hörmann

Universitätsmedizin Mannheim, Mannheim, Baden-Württemberg, Germany

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Publications (531)551.95 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common type of cancer worldwide. In several tumour entities, the tyrosine kinase receptor c-KIT is associated with tumour transformation in the epithelial tissue in cases of aberrant expression. Furthermore, tumour development and dissemination are a result of dysregulated cellular pathways such as the WNT/β-catenin pathway. β-Catenin is a multifunctional protein within the canonical WNT signalling pathway and a pivotal factor for the stabilization of cell-cell interactions. In malignant tissues, β-catenin triggers tumour proliferation and progression. The aim of this study is to investigate the expression patterns of c-KIT and β-catenin in human papillomavirus-negative and p16-positive SCC and to evaluate the chemosensitivity of the tumour cells to the chemotherapeutical agents docetaxel and 5-fluorouracil (5-FU). We incubated the tumour cell lines with docetaxel (5 μmol/ml) and 5-FU (1 μmol/ml) and detected β-catenin and c-KIT by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) after 48, 72, 120, 192 and 240 h. We found a reliable trend towards decreased β-catenin expression levels in p16-positive and p16-negative tumour cell lines when incubated with docetaxel, in addition to induced apoptotic effect. At best, 5-FU had a slight influence on the alteration of the expression of β-catenin. Dose escalation of docetaxel and 5-FU had no statistically significant effect on the expression of β-catenin or c-KIT. In HPV-negative HNSCC, a reduced expression level of β-catenin and c-KIT was detected in an incubation period-dependent manner. p16-transformed SCC (CERV196) cells were characterized by a reduced susceptibility to docetaxel induced alteration of β-catenin expression. We were unable to confirm the clinically-substantiated increased chemosensitivity of p16-positive tumour cells in vitro. Extended studies and clinical trials are needed to investigate these findings further in HPV-associated HNSCC.
    Anticancer research 06/2013; 33(6):2457-65. · 1.71 Impact Factor
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    ABSTRACT: PURPOSE: Continuous positive airway pressure (CPAP) is the gold standard in the treatment of obstructive sleep apnea (OSA), but its impact on ciliary function is unclear to date. Furthermore, CPAP is associated with numerous side effects related to the nose and upper airway. Humidified CPAP is used to relieve these symptoms, but again, little is known regarding its effect on ciliary function of the nasal respiratory epithelium. METHODS: In this prospective, randomized, crossover trial, 31 patients with OSA (AHI >15/h) were randomized to two treatment arms: nasal continuous positive airway pressure (nCPAP) with humidification or nCPAP without humidification for one night in each modality to assess short-term effects of ciliary beat frequency (CBF) and mucus transport time (MTT) and consecutively for 8 weeks in each modality to assess long-term effects in a crossover fashion. RESULTS: The baseline CBF was 4.8 ± 0.6 Hz, and baseline MTT was 540 ± 221 s. After one night of CPAP with and without humidification, ciliary function increased moderately yet with statistical significance (p <0.05). The short-term groups with and without humidification did not differ statistically significant. Regarding long-term effects of CPAP, a statistically significant increase in ciliary function above the baseline level and above the short-term level was shown without humidification (7.2 ± 0.4 Hz; 402 ± 176 s; p <0.01). The increase above baseline level was even more pronounced with humidification (9.3 ± 0.7 Hz; 313 ± 95 s; p <0.01). There was a statistically significant difference between both groups at long-term assessment with regard to CBF (p <0.01). CONCLUSIONS: Independent of airway humidification, nCPAP has moderate effects on short-term ciliary function of the nasal respiratory epithelium. However, a significant increase in ciliary function-both in terms of an increased CBF and a decreased MTT-was detected after long-term use. The effect was more pronounced when humidification was used during nCPAP.
    Sleep And Breathing 05/2013; · 2.26 Impact Factor
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    ABSTRACT: Head and neck squamous cell carcinoma (HNSCC) is the most common malignant epithelial tumor in the upper aerodigestive tract. The incidence of HNSCC induced by the oncogenic human papilloma virus (HPV) is rising, indicating a growing importance of the viral etiology. Cell proliferation, migration and tumor vascularization are regulated by a set of angiogenic peptides such as PDGF (platelet-derived growth factor), PDGFRα/β (platelet-derived growth factor receptor α/β) and VEGF (vascular endothelial growth factor). In locally advanced HNSCC docetaxel is used for induction chemotherapy (ICT) combined with platinum-based chemotherapy and 5-fluorouracil (5-FU). This study sought to evaluate the expression of angiogenic factors (VEGF, PDGF and PDGFRα/β) in HPV-positive (CERV196) and HPV-negative squamous cell carcinoma (HNSCC 11A and 14C) and the efficacy of chemotherapy with docetaxel as a potential treatment modality, compared to 5-FU as a single-drug application. Tumor cell lines were incubated with 5-FU or docetaxel at a concentration of 1.0 and 5.0 μmol/ml. Enzyme-linked immunosorbent assay (ELISA) and immunohistochemical analyses were carried out after 48, 72, 120, 192 and 240 hours, in order to identify changes in protein expression of VEGF, PDGF and PDGFRα/β. We demonstrated a significant reduction of VEGF and PDGFRβ expression after incubation with docetaxel by ELISA and of PDGF by immunohistochemistry, irrespective of the HPV status, whereas the application of 5-FU had a significantly weaker impact on the expression of angiogenic peptides. HPV-positive CERV196 cells were characterized by a reduced susceptibility to a docetaxel-altered expression. Although neither of the applied drugs are selective anti-angiogenic agents, docetaxel surprisingly was demonstrated to cause a significant decrease of angiogenic factors in this study.
    Anticancer research 05/2013; 33(5):1951-61. · 1.71 Impact Factor
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    ABSTRACT: Stromal cell-derived factor-1α (SDF-1α), also known as CXCL12, has variable effects on a plurality of cells. CXCR4 has been identified as its corresponding receptor. The SDF-1-CXCR4 axis is postulated to be a crucial key pathway in the interaction between (cancer) stem cells and their surrounding supportive cells in the cancer stem cell niche. We evaluated the expression of CD44 as a cancer stem cell marker and of CXCR4 in human HNSCC tissue samples. Afterwards, we monitored the concentration of SDF-1 in peripheral blood samples of HNSCC patients and healthy donors. We showed that CD44 and CXCR4 are expressed in human HNSCC tissues. Markedly, CD44 showed a high expression in HNSCC cells bordering cancer stromal cells. CXCR4 was mainly expressed in HNSCC tumor nests, but not in the surrounding stromal cells. No significant difference was noted between the SDF-1 concentration in the peripheral blood of HNSCC patients compared to healthy donors. We showed that CD44, as a stem cell marker in HNSCC, is located mainly at the borderline of HNSCC tumor nests with the surrounding cells. In addition, we demonstrated that CXCR4 as the corresponding receptor to SDF-1 is highly expressed in HNSCC tumor nests, but not in the tumor stroma. We collected evidence that SDF-1-CXCR4 interaction may be a crucial pathway in cell trafficking in the cancer stem cell niche of HNSCC, while SDF-1 was not detected in the peripheral blood of HNSCC patients. The SDF-1-CXCR4 axis may play an important role in the cancer stem cell theory of HNSCC. As SDF-1α also exhibits a multitude of functional effects on HNSCC cells, such as migration and polarization, it may be possible that the SDF-1-CXCR4 axis is also involved in the pathophysiology of the progression, recurrence and metastasis of malignant disease. Understanding these interactions may help to gain further insight into these mechanisms and as such help to discover new strategies of therapy.
    Oncology Reports 04/2013; · 2.30 Impact Factor
  • K Hörmann, H Sadick
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    ABSTRACT: Objective: Review of the literature on the role of surgery in the management of head and neck cancer in the era of organ preservation. Method: Literature search based on the essential practice guidelines set out by the US National Comprehensive Cancer Network. Results: Despite the increasing popularity of non-surgical treatment options, the surgeon remains a key figure in the multidisciplinary head and neck cancer team, along with the radiation oncologist, the medical oncologist and the speech and swallowing therapist. Even when organ preservation is successful, early and late toxicity may cause serious complications, including laryngeal dysfunction with a 'frozen larynx'. When organ preservation fails, salvage surgery is often associated with increased complications and reduced survival. Conclusion: There is a definite need to apply more rigorous standards to the use of organ preservation strategies, and to re-evaluate the role of surgery in head and neck cancer treatment.
    The Journal of Laryngology & Otology 01/2013; · 0.68 Impact Factor
  • G.M. Bran, K. Hörmann, J. Gosepath
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    ABSTRACT: Die Korrektur komplexer Narben im Gesichtsbereich erfordert individuell angepasste, oft multimodale Therapiekonzepte. Der vorliegende Beitrag erläutert unterschiedliche Techniken zur Korrektur von Kontrakturen, atrophen Narben, Narben in behaarten Gesichtsbereichen und Keloiden im Bereich der Ohrmuscheln. Darüber hinaus werden adjuvante Verfahren innerhalb der einzelnen Themenkomplexe vorgestellt.
    HNO 01/2013; 61(12). · 0.42 Impact Factor
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    ABSTRACT: Stromal cell-derived factor-1α (SDF-1α), also known as CXCL12, has variable effects on a plurality of cells. It is known to have selective effects on cell migration, morphology, survival and cell homing. As such the SDF-1-CXCR4 axis is postulated to be a crucial key pathway in the interaction between (cancer) stem cells and their surrounding supportive cells, the so-called (cancer) stem cell niche. We evaluated the expression of CD44 as a cancer stem cell (CSC) marker and the expression of CXCR4 in the head and neck squamous cell carcinoma (HNSCC) cell line UM-SCC 11A. In addition, we monitored proliferation, formation of podia and migration of UM-SCC 11A cells under the influence of SDF-1α. Whereas SDF-1α induced the formation of podia of CD44+ CXCR4+ UM-SCC 11A cells in a dose-dependent manner and the maximum number of cells exhibiting the formation of podia was observed under the influence of 10 ng/ml SDF-1α (P=5.3x10-6), the highest number of migrating cells was noted using a concentration of 100 ng/ml (P=0.027). Proliferation and survival were not affected by SDF-1α. We showed that UM-SCC 11A cells could be a target for SDF-1α by CXCR4 expression and these cells also showed characteristics of HNSCC CSCs via CD44 expression. We demonstrated that SDF-1α is a chemoattractant for UM-SCC 11A cells, and a maximum directed migration was achieved under the influence of 100 ng/ml SDF-1α. Changes in cell morphology by presenting filopodia or a prominent uropod were noted following treatment of 10 ng/ml SDF-1α. The SDF-CXCR4 axis may play a crucial role in the interaction between CSCs and their supportive cells in the CSC niche. Understanding these interactions may help to gain further insight into the pathophysiology of the progression and recurrence of malignant diseases and thus help to develop novel strategies for therapy.
    Oncology Reports 12/2012; · 2.30 Impact Factor
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    ABSTRACT: Head and neck squamous cell carcinoma (HNSCC) is an aggressive epithelial malignancy. It is known to be the most common neoplasm appearing in the upper aerodigestive tract. The poor 5‑year survival rate has remained unchanged in the last decades even though improved techniques in surgery, radiation and chemotherapy have been established. In contrast to the overall decreasing incidence of head and neck cancer in the US, the incidence of HPV-associated oropharyngeal cancer is increasing, indicating the importance of viral etiology. Furthermore, growth and invasion of HNSCC are strongly influenced by the extracellular matrix (ECM). Matrix metalloproteinases (MMP) have been shown to play key roles in the remodeling of the ECM. Imatinib (STI 571) was originally designed to inhibit the BCR-ABL tyrosine kinase in chronic myeloid leukaemia. But it also has an inhibitory impact, e.g., on the protein-tyrosine-kinase (PTK) receptor c-kit and on its PTK activity in HNSCC. In this study, we incubated the HNSCC cell lines HNSCC 11A and 14C and the p16-positive SCC line CERV196 with increasing concentrations of imatinib or carboplatin. After an incubation time of up to 10 days, we evaluated MMP-2 and -14 expression by ELISA techniques and immunohistochemistry. MMP-2 and -14 expression was demonstrated in all incubated tumor cell lines. Especially incubation with imatinib resulted in a significant decrease in MMP expression in incubated cell lines. Our results indicate that the expression of MMP-2 and -14 is suppressed in the presence of imatinib. Thus, imatinib may exert in part its inhibitory effect on malignant cell growth via the blockage of the signal transduction of PTK receptors. Further studies are warranted, especially keeping in mind the moderate toxicity of imatinib.
    Oncology Reports 07/2012; 28(1):172-8. · 2.30 Impact Factor
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    ABSTRACT: Hintergrund Mit sprachaudiometrischen Untersuchungen lassen sich keine strukturierten Aussagen des Patienten hinsichtlich eines tatsächlichen Nutzens einer Hörgeräteversorgung aus seinem individuellen Erleben heraus erhalten. Diese Lücke wird durch die Anwendung von Frageninventaren geschlossen. Der APHAB (Abbreviated Profile of Hearing Aid Benefit, deutsche Version) ist ein evaluiertes Inventar, das anhand von je 6 Fragen zu vier verschiedenen Hörsituationen die speziellen Probleme eines Schwerhörigen ohne und mit Hörgeräten (HG) ermittelt. Patienten und Methoden 560 Patienten wurden vor und nach einer Hörgeräteversorgung mittels APHAB zu ihrem Hörvermögen befragt. Zudem wurden noch Angaben zu bisherigen Erfahrungen mit HG, der täglichen Verwendungsdauer und dem Grad der Schwerhörigkeit erfasst. Ergebnisse Das Durchschnittsalter der Patienten lag bei knapp 70 Jahren, 84% der Patienten erhielten zum ersten Mal ein HG im Leben, 83% wiesen eine mittel- bis hochgradige Schwerhörigkeit auf. Die APHAB-Ergebnisse der Befragung wurden in Perzentil- und Kontingenztabellen aufbereitet; in Letzterer lassen sich bedingte Wahrscheinlichkeiten für den potenziellen Nutzen eines HG unter Kenntnis der Antworten eines Patienten ohne HG für jede APHAB-Skala ableiten. Schlussfolgerungen Der APHAB kann regelmäßig im Rahmen einer HG-Versorgung zur Beurteilung des Nutzens von HG und zum Erkennen von besonders problematischen Hörsituationen eines Patienten eingesetzt werden. Er ergänzt die bisher gebräuchlichen Methoden, insbesondere den Freiburger Sprachtest, um Angaben aus der Sicht des Patienten, sodass die Qualität von Diagnostik und Therapie für den schwerhörigen Patienten verbessert, der Erfolg einer HG-Versorgung qualitativ erfasst und besondere Problembereiche vorhergesagt und damit die Anzahl ungenutzter Hörgeräte möglicherweise reduziert werden können.
    HNO 07/2012; 60(7). · 0.42 Impact Factor
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    ABSTRACT: Speech audiometry studies do not deliver structured testimony of patients as to the actual benefit of hearing aids based on individual daily life experiences. This deficiency can be resolved by applying structured inventory questionnaires. The APHAB (German version) is an evaluated inventory questionnaire consisting of six questions put to patients with hearing deficiencies with and without hearing aids in four different hearing situations. We collected the APHAB data of 560 patients before and after fitting hearing aids. We also gathered personal data as to age, prior experience with hearing aids, duration of daily use of the hearing aid and degree of hearing loss. The average age of the patients was a little under 70 years, 84% had just received their first hearing aid, and 83% exhibited moderate or severe hearing loss. The APHAB results were classified in percentile and contingency tables. The latter allow one to determine conditional probabilities of the potential success of fitting a hearing aid to a new patient for each APHAB scale. The APHAB can be applied regularly to measure the benefit of fitting a hearing aid to a patient in particular in problematic hearing situations. By registering the personal view of the patients, it expands the scope of the standard methods (e.g., speech audiometry) so that the quality of diagnostics and therapy can be improved. It qualitatively records the success of hearing aid fitting, predicts potential problem areas and thereby may reduce the number of unused hearing aids.
    HNO 07/2012; 60(7):626-36. · 0.42 Impact Factor
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    ABSTRACT: The objective of the study was to assess the short-term efficacy of radiofrequency volumetric tissue reduction (RFVTR) of the inferior turbinates in patients with nasal obstruction caused by turbinate hypertrophy. The study is a prospective, randomized, single-blinded, placebo-controlled, crossover trial. A total of 22 patients (age range 21-72 years; median age 41 years) were randomized into two treatment arms. Using a bipolar radiofrequency system, the first group (VP-group) received RFVTR (verum = V) first (at t1) followed by a placebo treatment (P) 6-8 weeks later (at t2). The PV-group was treated with placebo first at t1 and received RFVTR at t2. Subjects in both groups underwent identical procedures in an office-based setting. Delivery of radiofrequency energy was the only difference between the two groups. The outcome measures assessed were rhinomanometry, physician's evaluation of the degree of hypertrophy of the inferior turbinates and patients' estimation of nasal obstruction. Physician and patient evaluations were documented using a score ranging from 0 = none to 4 = severe. Evaluation was performed 6-8 weeks after every intervention. No intraoperative or postoperative complications occurred. Inferior turbinate hypertrophy improved significantly in both groups after RFVTR was performed (VP-group: p < 0.001; PV-group: p = 0.002). Nasal obstruction also decreased only after RFVTR (VP-group: p = 0.004, PV-group: p = 0.002). This study confirmed the safety of bipolar RFVTR as an office-based treatment of nasal obstruction due to inferior turbinate hypertrophy. We could prove that RFVTR is superior to placebo for reduction in turbinate hypertrophy and subjective improvement in nasal obstruction. To our knowledge, this is the first level I study proving the short-term efficacy of a bipolar radiofrequency system. Level of evidence 1b.
    Archives of Oto-Rhino-Laryngology 06/2012; · 1.29 Impact Factor
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    ABSTRACT: A 73-year old man presented with a lesion inferior to his left medial canthus with discharge and headache. Fifteen years previously, the patient had undergone reduction of an orbital fracture and reconstruction of the orbit with silicone. An orbitocutaneous fistula was found to originate from the implant which was displaced in the ethmoid, obstructing frontal sinus outflow. Symptoms disappeared after explantation of the implant, reconstruction of the orbit with a titanium plate and frontal sinus surgery. Although the use of silicone in facial trauma has declined, complications have to be expected even years after implantation.
    HNO 06/2012; · 0.42 Impact Factor
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    ABSTRACT: To perform functional magnetic resonance imaging (fMRI) studies with olfactory stimulation, the stimulation device requires special properties including those of being non-conductive and non-magnetic. It should also be easily portable and should be small enough to be stored easily when not in use. However, presently only a limited number of devices fulfill these criteria; additionally, they are typically associated with high costs. The aim of the study was to investigate whether a newly developed and relatively simple and inexpensive stimulation device would be suitable for fMRI measurements. Our stimulation device was made of standard industrial and laboratory components, has open-source software and consists of 3 core compartments namely: 'the air inlet, control and distribution section', 'the odorant-section', and 'the delivery-section'. The device was tested in an fMRI study using 21 healthy normosmic subjects who were stimulated with two odors, d-limonene and terpinen-4-ol. Results from this trial suggest that the stimulation device is capable of creating adequate stimulation suitable for fMRI sequences. In general we describe how all sections of the olfactometer are optimized for the needs of fMRI studies.
    Journal of neuroscience methods 06/2012; 209(1):189-94. · 2.30 Impact Factor
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    ABSTRACT: Urticaria describes a heterogeneous group of diseases, whose cardinal symptoms are itching wheals. With a high life time prevalence of 25%, this disease is of major relevance, and the ENT specialist should be familiar with this disease. The most common type is spontaneous Urticaria in which the wheals seem to arise without provocation. Its subtypes are acute and chronic. The mechanism of wheal formation is the activation and degranulation of mast cells. However, the etiology of the wheals is multifaceted. In case of acute spontaneous urticaria, the underlying cause does not have to be verified. It is treated symptomatically by its self-limiting course of disease. The chronic spontaneous, less frequent form of urticaria is treated curatively by identification and elimination of underlying causes, such as autoimmune processes, intolerance to food additives and chronic infections. The chronic subtype can persist for years and thus has an extensive socioeconomic impact. This article overviews the clinical symptoms, diagnostic methods and therapeutic options for both acute spontaneous and chronic spontaneous urticaria, and refers to the current international EAACI/WAO and German DGAKI/DDG S3 guidelines.
    HNO 05/2012; 60(5):457-65; quiz 466. · 0.42 Impact Factor
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    ABSTRACT: The pathophysiology of chronic rhinosinusitis (CRS) is unknown, but the majority of patients suffer from eosinophilic infiltration. We hypothesised that doxycycline might alter the eosinophil-associated expression of interleukin-5 (IL-5) and eotaxin-3 in CRS and also the expression of matrix metalloproteinase 9 (MMP-9), being involved in the tissue-remodelling in CRS. After obtaining samples from 10 CRS patients with and without nasal-polyposis undergoing functional endoscopic sinus surgery and two healthy individuals, the expression of IL-5, eotaxin-3 and MMP-9 were evaluated by an ELISA technique. The tested agent was doxycycline at 0.1 or 1 mg/ml. IL-5 levels remained unchanged, but eotaxin-3 levels actually increased under doxycycline treatment. The only marker showing a slight drop was MMP-9, albeit not significant. As first clinical trials with doxycycline in the treatment of CRS produced reasonable results we could demonstrate that the underlying pathology is more complex, and doxycycline affects only a part of the factors believed to support the chronic infection of the respiratory mucosa.
    In vivo (Athens, Greece) 05/2012; 26(3):369-74. · 1.15 Impact Factor
  • K. Hörmann, K. Hirth
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    ABSTRACT: Die Autoren der im Journal of the American Medical Association (JAMA) veröffentlichten Studie kommen zu dem Schluss, dass sowohl die Adenotomie (AT) als auch die Adenotonsillektomie (TEAT) lediglich im ersten postoperativen Jahr zu einer Reduktion der Häufigkeit der Otitiden führt, dieser Effekt in den nachfolgenden Jahren jedoch nicht mehr gesehen wird. Die Autoren folgern daraus, dass aufgrund der Operationsmorbidität sowie Komplikationsrate und nicht zuletzt auch der Kosten auf eine operative Therapie zugunsten einer gezielten Antibiotikatherapie sowie ggf. der Einlage von Paukenröhrchen verzichtet werden sollte. Diese Betrachtungsweise erscheint einseitig und soll im nachfolgenden Beitrag diskutiert werden.
    HNO 04/2012; 48(9):637-638. · 0.42 Impact Factor
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    ABSTRACT: The need for surgical treatment alternatives for obstructive sleep apnea is unchanged. However, recommendations regarding these treatments can often only be given with caution as there are only a limited number of controlled studies available. To perform controlled trials and even more so placebo controlled trials in the field of sleep surgery is challenging, especially in comparison to studies evaluating conservative approaches. Nevertheless, these studies can be carried out also in the field of sleep surgery. In this review we present recent concepts and high-quality surgical trials with innovative study designs. A Medline search revealed 310 studies regarding surgical treatment of sleep apnea. These studies were assessed regarding quality, execution and number of subjects. A total of 12 randomized controlled studies were identified addressing palatal implants, radio-frequency surgery, nasal surgery, maxillomandibular advancement and laser-assisted uvulopalatoplasty (LAUP). Furthermore this review addresses the limitations of surgical studies and the differences compared to trials dealing with conservative approaches. The studies presented in this review demonstrate that high-quality trials regarding surgical treatment of obstructive sleep apnea are feasible and can lead to recommendations with high evidence levels.
    HNO 04/2012; 60(4):294-9. · 0.42 Impact Factor
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    ABSTRACT: In a former study, taste disturbances after tonsillectomy seemed to be more frequent than expected. Eight percent of patients reported subjective taste disorders 6 months after tonsillectomy. Fifteen patients from the initial trial, who reported taste disorders after tonsillectomy, were contacted again for this long-term follow-up. A telephone interview using the same questionnaire addressing the current self-estimate of taste function was performed. At 32 ± 10 months following surgery, two (0.9%) patients still reported suffering from taste disturbance. This long-term follow-up study shows that dysgeusia following tonsillectomy occurs in approximately 1% of patients. These data should be considered when patients are informed about complications after tonsillectomy.
    The Laryngoscope 03/2012; 122(6):1265-6. · 1.98 Impact Factor
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    ABSTRACT: Perturbation of semicircular canal function may result in a pathological angular vestibulo-ocular reflex (aVOR). The resulting impairment in gaze stabilization is perceived as "vertigo" or "dizziness" and may occur following receptor function impairment of all three semicircular canals. The head impulse test reveals hidden (covert-catchup) or visible (overt-catchup) saccades in disturbances of semicircular function. Most peripheral vestibular disorders can be treated conservatively. There are surgical treatment options for some diseases, such as intractable benign paroxysmal positional vertigo and superior semicircular canal dehiscence. Vestibular training promotes central reorganization of the VOR. Impaired semicircular receptor function, in particular bilateral vestibulopathy, may affect spatial orientation and cognitive processes. Balance prostheses could serve as a replacement for receptors in the future.
    HNO 03/2012; 60(3):249-59; quiz 260-1. · 0.42 Impact Factor
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    ABSTRACT: To evaluate the efficacy and safety of a phytotherapeutic nasal spray containing Cyclamen europaeum (CE) in the treatment of acute rhinosinusitis (ARS). We performed a randomized, double-blind, placebo-controlled trial of CE nasal spray once daily for 15 days in 99 adult patients with moderate-to-severe ARS who also received amoxicillin 500 mg three times daily for the first 8 days. The primary endpoint was the change in mean total symptom scores (TSS) on day 7. Secondary endpoints included individual symptom scores (nasal congestion, mucus secretion, facial pain, impairment of smell) and endoscopic findings on days 7 and 15 and others. No statistically significant difference in TSS was noted for CE versus placebo on day 7. Moreover, the individual scores were not statistically different between the groups for the ITT-population on day 7. However, both a reduction in facial pain and an improvement in endoscopically-assessed mucosal obstruction significantly favoured CE on day 7. The most common adverse events were nasal burning and mild epistaxis, but no severe adverse events were documented. In summary, this is the first randomized controlled trial on phytotherapy in patients with moderate-to-severe ARS demonstrating clinical safety and some encouraging effects of CE which merit to investigate phytotherapeutic products in further large-scale clinical trials.
    Rhinology 03/2012; 50(1):37-44. · 1.72 Impact Factor

Publication Stats

3k Citations
551.95 Total Impact Points


  • 2009–2014
    • Universitätsmedizin Mannheim
      Mannheim, Baden-Württemberg, Germany
    • Central Institute of Mental Health
      Mannheim, Baden-Württemberg, Germany
  • 1996–2014
    • Universität Mannheim
      Mannheim, Baden-Württemberg, Germany
  • 1995–2014
    • Universität Heidelberg
      • • Faculty of Medicine Mannheim and Clinic Mannheim
      • • Institute of Hygiene
      Heidelburg, Baden-Württemberg, Germany
  • 2013
    • Technische Universität München
      München, Bavaria, Germany
  • 2000–2013
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2012
    • HELIOS Klinikum Berlin-Buch
      Berlín, Berlin, Germany
  • 2011
    • University of Cologne
      • Faculty of Medicine
      Köln, North Rhine-Westphalia, Germany
  • 1997–2010
    • Westpfalz-Klinikum GmbH
      Kaiserlautern, Rheinland-Pfalz, Germany
    • Johannes Gutenberg-Universität Mainz
      Mayence, Rheinland-Pfalz, Germany
  • 2008–2009
    • Asklepios Klinik Harburg
      Hamburg, Hamburg, Germany
  • 2005–2008
    • Universitätsklinikum Münster
      Muenster, North Rhine-Westphalia, Germany
  • 2007
    • University of Münster
      Muenster, North Rhine-Westphalia, Germany
  • 2003
    • Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.
      München, Bavaria, Germany
  • 2001
    • Ruhr-Universität Bochum
      Bochum, North Rhine-Westphalia, Germany
  • 1993–1996
    • Technische Universität Kaiserslautern
      • Department of Physics
      Kaiserlautern, Rheinland-Pfalz, Germany
  • 1987
    • University of Hamburg
      Hamburg, Hamburg, Germany