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ABSTRACT: Nicht therapierte pleomorphe Adenome der Gl.parotis können über lange Zeiträume hinweg gigantische Ausmaße erreichen und
mit einer erheblichen kosmetischen und funktionellen Beeinträchtigung der betroffenen Patienten einhergehen. Die in den letzten
80 Jahren publizierten Fälle (n=20) von derartigen Riesenadenomen (1,2–26,5kg Tumorgewicht) zeigen, dass zu 90% Frauen betroffen
sind. Der Zeitraum von der klinischen Manifestation des Tumors bis zur Therapie betrug durchschnittlich 20,7Jahre. Das Durchschnittsalter
der Patienten zum Zeitpunkt der Operation lag bei 58,9 Jahren. Eine maligne Entartung trat in 15,8% der Fälle auf. Die Gründe
für die verzögerte Therapie sind wahrscheinlich einerseits in der Angst der Patienten vor dem Eingriff, andererseits in einer
unzureichenden ärztlichen Beratung zu sehen. Am Fallbeispiel einer 77-jährigen Patientin mit einem 3,9kg schweren, über 40Jahre
gewachsenen Tumor der linken Gl.parotis und einer Literaturübersicht werden die Besonderheiten der Diagnostik und Therapie
von Riesenadenomen der Ohrspeicheldrüse dargestellt.
Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and
disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80years 20 cases
of giant pleomorphic adenomas (weight 1.2–26.5kg) have been reported. These tumors occurred predominantly in women (90%).
The mean period from initial clinical manifestation until definitive surgical treatment was 20.7years. The mean age of the
patients at the time of surgery was 58.9years. Malignant transformation occurred in 15.8% of cases. It is likely that the
reasons for delayed treatment are the patient’s fear of surgery on the one hand, and insufficient medical advise on the other.
We report on a 77year old female who had a 40-year history of a growing parotid tumor that weighed 3.9kg after resection.
The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature
on these unusual parotid tumors, are presented.
HNO 05/2012; 55(10):812-818. · 0.40 Impact Factor
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ABSTRACT: Penetrating head and neck injuries often present with vascular lesions and airway compromise and may be life-threatening. Thus controlling bleeding and airway stabilisation take priority in emergency treatment. High-velocity projectiles, fragmentations from improvised explosive devices (IEDs) and shrapnel can cause severe tissue injury, representing a challenge for the head and neck surgeon. Since several organ structures, such as the eyes, midface, pharynx, larynx, trachea, esophagus, nerves, vessels and vertebral spine can be injured at the same time, patients should be referred to a specialized trauma center for interdisciplinary treatment following emergency treatment. High-speed ballistic injuries were once confined to the battle field and have been uncommon in Europe since World War II. For this reason, experience among civilian head and neck surgeons is at present limited. With the increased incidence of terrorism and the use of IEDs as the preferred weapon in terrorism it has become important for civilian head and neck surgeons to understand the role of ballistic injuries in mass casualty events. The present paper discusses current viewpoints in the diagnosis and treatment of penetrating head and neck injuries.
HNO 08/2011; 59(8):765-82. · 0.40 Impact Factor
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ABSTRACT: Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80 years 20 cases of giant pleomorphic adenomas (weight 1.2-26.5 kg) have been reported. These tumors occurred predominantly in women (90%). The mean period from initial clinical manifestation until definitive surgical treatment was 20.7 years. The mean age of the patients at the time of surgery was 58.9 years. Malignant transformation occurred in 15.8% of cases. It is likely that the reasons for delayed treatment are the patient's fear of surgery on the one hand, and insufficient medical advise on the other. We report on a 77 year old female who had a 40-year history of a growing parotid tumor that weighed 3.9 kg after resection. The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature on these unusual parotid tumors, are presented.
HNO 11/2007; 55(10):812-8. · 0.40 Impact Factor
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ABSTRACT: Leiomyosarcoma is usually found in the female genital tract, retroperitoneum, the wall of the gastrointestinal tract and subcutaneous tissues. An appearance of this malignant tumor in the larynx is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report on a 64-year old male with a supraglottic leiomyosarcoma who was treated with supraglottic laryngectomy and postoperative radiotherapy. After 19 months the patient was well and free of disease. The most commonly used diagnostic and therapeutic procedures are analysed in a review of the 46 published cases of laryngeal leiomyosarcoma.
HNO 04/2006; 54(3):207-14. · 0.40 Impact Factor
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ABSTRACT: Parotid hemangiomas are rare in adults. Whereas both capillary and cavernous hemangiomas are seen in children, only cavernous hemangiomas have thus far been reported in adults. Clinically, cavernous hemangiomas usually present as slowly growing, soft or firm, movable, painless parotid masses. Severe pain and swelling can occur, however, depending on the size of the hemangioma or in particular in the presence of acute hemorrhage or thrombosis. CT and MRI are the diagnostic tools of choice. Prior to surgery, magnetic resonance angiography or intra-arterial digital subtraction angiography should be performed to investigate the vascular supply of the tumor. Surgical excision is the treatment of choice for small lesions. Large cavernous hemangiomas usually require superficial or total parotidectomy. Especially in the case of extended lesions, the facial nerve may be difficult to identify and should be monitored intraoperatively.
HNO 11/2005; 53(10):879-83. · 0.40 Impact Factor
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ABSTRACT: Metanephric adenoma is a rare tumor of the kidney. So far metanephric adenomas were considered to be benign, slowly growing and non-metastasizing tumors with an excellent prognosis. Only recently two cases of metastasized metanephric adenomas were published. Therefore, diagnostic work up, therapy and follow up of this tumor have to be reassessed. We report the case of a 42 year old male with metanephric adenoma. Current literature concerning metanephric adenoma is reviewed.
International Urology and Nephrology 02/2005; 37(2):213-7. · 1.47 Impact Factor
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ABSTRACT: The role of magnetic resonance tomography (MRI) for the diagnosis of chondral lesions of the knee joint is still unclear. The sensitivity of the method ranges from 15% to 96%. The scope of our daily experiences showed that there were considerable deviations between the tomographical and arthroscopical results, which vary from the results of experimental studies. Therefore we have conducted a prospective study to investigate the question of how MRI can replace arthroscopy (ASC) in the diagnosis of cartilage damages in the scope of daily routine. All 195 patients included in this study received a magnetic resonance tomography followed by an arthroscopy. A clear diagnosis of supposition had to be determined before the magnetic resonance tomography. The patients were divided into 3 Groups. Group A (n=86) received a standard Military Hospital Ulm (MH) MRI--sagittal STIR TSE and PD TSE, coronal and transversal T2 FFE (TR=660 ms, TE=18 ms, FA=30 degrees, 512 matrix). In addition, one sub-Group, AK (n=21) was examined with a special cartilage sequence of the cartilage fs T1 W FFE. Neither patients in Group AK nor in Group A as a whole received any contrast medium. Group B (n=88) was examined with an alternate MRI protocol (Radiological Joint Practice, Neu-Ulm--sagittal T1 SE, T2 SE and T2 FLASH (TR=608 ms, TE=18 ms, FA=20 degrees, 256 matrix), coronal PD fs), employing gadolinium as a contrast medium. 156 cartilage lesions were found arthroscopically. In Group A the sensitivity was 33%, the specificity 99%, and the positive and negative prediction values 75% and 98% respectively. Group B reached a sensitivity of 53% and a specificity of 98%. The positive prediction value was 48% and the negative was 98%. Group AK showed a sensitivity of 38% and specificity of 98%; the positive and negative prediction values came to 50% and 97% respectively. In conclusion, our results indicate that the MRI examination techniques recommended in the literature at present are not able to replace the ASC for the diagnosis of cartilage damages of the knee joint. In view of the high specificity (97%-99%) and the high negative prediction value (97%-98%), MRI is suitable for the exclusion of cartilage lesions. For a negative MRI associated with a cartilage injury, a cautious attitude towards an operative cartilage treatment is therefore justified. Because the MRI can not replace the ASC for diagnostic of cartilage damage, the ASC still has to be seen as the method of choice for the evaluation of cartilage damage.
Knee Surgery Sports Traumatology Arthroscopy 02/2004; 12(1):58-64. · 2.21 Impact Factor
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ABSTRACT: The role of magnetic resonance tomography (MRI) for the diagnosis of chondral lesions of the knee joint is still unclear. The sensitivity of the method ranges from 15% to 96%. The scope of our daily experiences showed that there were considerable deviations between the tomographical and arthoscopical results, which vary from the results of experimental studies. Therefore we have conducted a prospective study to investigate the question of how MRI can replace arthroscopy (ASC) in the diagnosis of cartilage damages in the scope of daily routine. All 195 patients included in this study received a magnetic resonance tomography followed by an arthroscopy. A clear diagnosis of supposition had to be determined before the magnetic resonance tomography. The patients were divided into 3 Groups. Group A ( n =86) received a standard Military Hospital Ulm (MH) MRI — sagittal STIR TSE and PD TSE, coronal and transversal T2 FFE (TR=660ms, TE=18ms, FA=30, 512 matrix). In addition, one sub-Group, AK (n =21) was examined with a special cartilage sequence of the cartilage fs T1W FFE. Neither patients in Group AK nor in Group A as a whole received any contrast medium. Group B (n =88) was examined with an alternate MRI protocol (Radiological Joint Practice, Neu-Ulm — sagittal T1 SE, T2 SE and T2 FLASH (TR=608ms, TE=18ms, FA=20, 256 matrix), coronal PD fs), employing gadolinium as a contrast medium. 156 cartilage lesions were found arthroscopically. In Group A the sensitivity was 33%, the specificity 99%, and the positive and negative prediction values 75% and 98% respectively. Group B reached a sensitivity of 53% and a specificity of 98%. The positive prediction value was 48% and the negative was 98%. Group AK showed a sensitivity of 38% and specificity of 98%; the positive and negative prediction values came to 50% and 97% respectively. In conclusion, our results indicate that the MRI examination techniques recommended in the literature at present are not able to replace the ASC for the diagnosis of cartilage damages of the knee joint. In view of the high specificity (97%–99%) and the high negative prediction value (97%–98%), MRI is suitable for the exclusion of cartilage lesions. For a negative MRI associated with a cartilage injury, a cautious attitude towards an operative cartilage treatment is therefore justified. Because the MRI can not replace the ASC for diagnostic of cartilage damage, the ASC still has to be seen as the method of choice for the evaluation of cartilage damage.
Knee Surgery Sports Traumatology Arthroscopy 12/2003; 12(1):58-64. · 2.21 Impact Factor
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ABSTRACT: The accuracy of magnet resonance imaging in diagnosing cartilage lesions is discussed controversially. The sensitivity of this examination ranges from 15 % to 96 %. Clinical evidence demonstrates that cartilage lesions, diagnosed by MRI, were not confirmed in arthroscopy. The purpose of this prospective study was to analyse the practicability of replacing arthroscopy by MRI in diagnosis of cartilage lesions.
195 patients with acute or chronic knee pain were examined by reason of a pathological clinic result by MRI preoperatively. In group A (n = 86), a standard program was performed in the radiological department of German Army Hospital (sagittal STIR TSE und PD TSE, coronary und transversal T2 FFE [TR = 660 ms, TE = 18 ms, FA = 30 degrees, 512er-Matrix]), in 21 patients (subgroup AK) a cartilage specific sequence (fs T1 W FFE) without gadolinium was added. Patients in group B (n = 88) were examined in a private outpatient clinic (sagittal T1 SE, T2 SE and T2 FLASH [TR = 608 ms, TE = 18 ms, FA = 20 degrees, 256er-Matrix]) with the use of gadolinium. A clear clinical diagnosis had to be performed before MRI examination.
156 lesions of the cartilage were detected arthroscopically. The sensitivity of the examination was in group A 33 %; group B 53 %; group AK 38 %, specificity in group A 99 %; group B 98 % and group AK 98 %. The positive and negative predictive values were in group A 75 %/98 %; group B 48 %/98 % and in group AK 50 %/97 %.
MRI was not able to detect reliable cartilage lesions. Until now, arthroscopy is the golden standard to detect cartilage lesions.
Zentralblatt für Chirurgie 11/2002; 127(10):822-7. · 1.02 Impact Factor
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ABSTRACT: In einer prospektiv angelegten, arthroskopisch kontrollierten Studie wurde bei 58 Patienten mit akuter Kniegelenkverletzung
präoperativ durch manuelle Sonometrie das vordere Kreuzband (VKB) auf eine eventuelle Verletzung hin untersucht. Zusätzlich
erfolgte eine klinische Untersuchung (Lachmann-Test, Pivot-shift-Test nach McIntosh, 90°-Schublade), eine gehaltene Röntgenaufnahme
sowie eine gehaltene Sonometrie (Scheuba-Apparat). Intraoperativ zeigte sich 9mal eine Teilruptur und 38mal eine komplette
Ruptur des VKB. Für die präoperativ richtig gestellte Diagnose VKB-Ruptur erzielte die manuelle Sonometrie eine Sensitivität
(Sn) von 85%, eine Spezifität (Sp) von 91% sowie einen positiven Vorhersagewert (pV) von 98%. Klinische Untersuchung, gehaltene
Sonometrie sowie die gehaltene Röntgenaufnahme waren im direkten Vergleich insgesamt weniger aussagekräftig (Sn 92% – 79%
– 53%, Sp 56% – 90% – 86%, pV 89% – 97% – 95%). Die manuelle Sonometrie ermöglicht gerade beim frisch traumatisierten, schmerzhaften
Kniegelenk eine rasche und sichere Diagnose, so daß die Weichen für das weitere therapeutische Vorgehen frühzeitig gestellt
werden können.
A prospective, arthroscopic controlled study was performed to evaluate the usefulness of mancal sonometry of the knee in the
diagnosis of acute rupture of the anterior cruciate ligament (ACL). In 58 patients with an acute knee injury, a maximum of
30 days elapsed between accident and clinical examination (Lachmantest, pivot-shift/ McIntosh, 90° anterior translation),
manual sonometry and functional X-ray examination. Afterwards all patients were examined by arthroscopy. Nine patients showed
a partial, 38 patients a total rupture of the ACL. If the ACL was completely ruptured, the average difference in anterior
translation between the contralateral and the injured knee was 3.3 mm (p≤0.001). Statistical analysis showed high sensitivity (85%), specificity (91%) and positive predictive value (98%) for manual
sonometry. Clinical examination, apparative sonometry and functional X-ray were, overall, less effective than manual sonometry
in detecting ligament rupture. Manual sonometry proved to be a good and practicable method for assessing acute rupture of
the ACL.
Der Unfallchirurg 04/1997; 100(4):280-285. · 0.61 Impact Factor
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ABSTRACT: A prospective, arthroscopic controlled study was performed to evaluate the usefulness of mancal sonometry of the knee in the diagnosis of acute rupture of the anterior cruciate ligament (ACL). In 58 patients with an acute knee injury, a maximum of 30 days elapsed between accident and clinical examination (Lachmantest, pivot-shift/ McIntosh, 90 degrees anterior translation), manual sonometry and functional X-ray examination. Afterwards all patients were examined by arthroscopy. Nine patients showed a partial, 38 patients a total rupture of the ACL. If the ACL was completely ruptured, the average difference in anterior translation between the contralateral and the injured knee was 3.3 mm (p < or = 0.001). Statistical analysis showed high sensitivity (85%), specificity (91%) and positive predictive value (98%) for manual sonometry. Clinical examination, apparative sonometry and functional X-ray were, overall, less effective than manual sonometry in detecting ligament rupture. Manual sonometry proved to be a good and practicable method for assessing acute rupture of the ACL.
Der Unfallchirurg 04/1997; 100(4):280-5. · 0.61 Impact Factor
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ABSTRACT: Between 1984 and 1994, 27 men and 4 women with primary spontaneous pneumothorax were treated surgically by excision of the bullae, without pleurectomy. The purpose of the present study was to establish by computed tomography (CT) of the lung whether the excision permanently eliminated the cause of pneumothorax. The median follow-up was 72 (21-127) months. There were two patients with recurrences (6.4%) who were operated on again. Sixteen of 31 patients had new blebs in the apex of the lung as documented by postoperative CT. The study indicates that simple excision of the bullous area cannot prevent the recurrence of blebs.
Der Chirurg 04/1997; 68(3):255-8. · 0.70 Impact Factor
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ABSTRACT: Between 1984 and 1994, 27 men and 4 women with primary spontaneous pneumothorax were treated surgically by excision of the
bullae, without pleurectomy. The purpose of the present study was to establish by computed tomography (CT) of the lung whether
the excision permanently eliminated the cause of pneumothorax. The median follow-up was 72 (21–127) months. There were two
patients with recurrences (6.4 %) who were operated on again. Sixteen of 31 patients had new blebs in the apex of the lung
as documented by postoperative CT. The study indicates that simple excision of the bullous area cannot prevent the recurrence
of blebs.
Im Zeitraum von 1984 bis 1994 wurde bei 27 Männern und 4 Frauen (Durchschnittsalter 28 Jahre) wegen eines primären Pneumothorax
lediglich eine atypische Keilresektion des Blasenbefunds an der Lungenspitze vorgenommen. Die Nachuntersuchung mittels Dünnschicht-CT
der Lunge nach einem Intervall von durchschnittlich 72 (21–127) Monaten sollte die Rezidivrate ermitteln und die Frage klären,
ob diese operative Maßnahme die Blasen dauerhaft beseitigt hatte. Das Durchschnittsalter der Patienten betrug zu diesem Zeitpunkt
34 (22–46) Jahre. Es traten zwei operationspflichtige Rezidive auf (6,4 %). Bei 16 von 31 Patienten wurden in der postoperativen
CT erneut Blasen gefunden. Die Studie zeigt, daß die atypische Keilresektion der Lungenspitze beim jungen Patienten die Ursache
des Pneumothorax nicht dauerhaft eliminieren kann.
Der Chirurg 02/1997; 68(3):255-258. · 0.70 Impact Factor
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ABSTRACT: To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients.
303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes.
The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%).
Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time.
RöFo - Fortschritte auf dem Gebiet der R 05/1996; 164(4):269-74. · 2.76 Impact Factor
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ABSTRACT: We report the case of a female patient with persisting bilio-bronchial and bilio-cutaneous fistulae originating in the right liver lobe. The causative factor was a subphrenic liver abscess which had been adequately and successfully treated. No biliary obstruction was detectable on admission. Because of her previous medical history the patient was considered to be a high surgical risk. Therefore the described endoscopic (ERC) approach was chosen. Here we describe the first successful attempt to close such a fistulous system by repeated fibrin and histoacryl-sealing through an endoscopically guided catheter. The success of this innovative procedure may be helpful, in the management of similar cases in the future.
Zeitschrift für Gastroenterologie 11/1995; 33(10):605-9. · 0.90 Impact Factor
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ABSTRACT: To find reliable data of the incidence of different variations of the spine.
Standardised radiographic examinations of 10,922 young, healthy pilot aspirants of the German air force were made. Radiographic examination included the whole spine in a.p. and lateral projection, the cervical spine in oblique projection and in a subunit of 5781 men the lumbar spine in oblique projection.
The following incidences were found: mild habit scoliosis: 80.4%, structural scoliosis: 9%, severe thoracal kyphosis without severe lumbar lordosis: 5.1% and together with severe lumbar lordosis: 30.8%, mild forms of kyphosis of adolescence: 23.3%, severe forms: 2.1% and cuneiform deformation of vertebral body: 4.9%, sacralization: 7.8%, lumbarization: 5.9%, spondylolysis: 6.2%, spondylolisthesis: 4.3% and lumbar chondrosis: 2.1%. Chondrosis of the thoracal and cervical spine, osteochondrosis and coalescent vertebral bodies were found in less than 0.8% each.
In only 2.6% were there no pathological findings. This shows importance of radiological spine examinations especially for industrial and preventive medicine.
RöFo - Fortschritte auf dem Gebiet der R 08/1995; 163(1):4-8. · 2.76 Impact Factor
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ABSTRACT: Between 1984 and 1989, 108 patients who had chronic lateral instability of the ankle were treated with a modified Evans tenodesis, in which the anterior half of the peroneus brevis tendon was used for reconstruction. Follow up was possible by questionnaire in 75 patients and by clinical examination in 46, after 29-122 months (mean 68 months). Subjectively excellent or good results were achieved in 62 patients (82.6%) while 9 (12%) had fair results and 4 (5.4%) a poor outcome. Pain during physical activity was reported by 27 patients (35%), loss of inversion by 34 (45%) and slight instability by 31 (41%). The X-ray films at follow-up revealed more signs of arthrosis than had been present preoperatively. The stress tests showed an anterior drawer of 7.8 mm preoperatively and 7.0 mm postoperatively (p = 0.03); talar tilt was improved from 7.7 degrees to 4.5 degrees (p < or = 0.01). The outcome reported by the patients and the objective results of the clinical and radiological examinations were at odds. Pain, instability and osteophyte formation after the operation were so frequent because the talus was not fixed when the Evans reconstruction was implemented. Therefore, we suggest that this method should not be used in patients with a high activity level.
Der Unfallchirurg 06/1995; 98(6):333-7. · 0.61 Impact Factor
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ABSTRACT: Anteversion of the femoral neck was measured by MRI in 19 children (37 hips) preoperatively before femoral rotation osteotomies.
The results of this new technique were compared with values for anteversion obtained by CT and ultrasound. The measurements were performed independently by two observers to determine the correlation between the three different methods and to assess their reliability.
It was possible to show a high correlation coefficient (Pearson) between MRI and CT (r = 0.77) as well as MRI and sonography (r = 0.81). The mean angles obtained by CT (34 degrees, range +5 to +82 degrees) and ultrasound (25.6 degrees, range +10 to +40 degrees) appeared larger than the MRI values (mean angle 23.2 degrees, range 0 to +65 degrees), which can be explained by the different measurement techniques. Mean inter- and intra-variability was low for MRI (r = 0.97 and r = 0.97) and CT (r = 0.99 and r = 0.96) but slightly higher for sonography (r = 0.88 and r = 0.88). MRI is a new reliable and precise method to evaluate femoral anteversion that does not require ionising radiation.
MRI is recommended for preoperative planning of paediatric femoral rotation osteotomy patients.
RöFo - Fortschritte auf dem Gebiet der R 04/1995; 162(3):224-8. · 2.76 Impact Factor
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ABSTRACT: This study investigated the effect of anesthesia of the peroneal communis nerve on stress diagnostics in acute ankle ligament rupture. Using a special holding device, the anterior drawer sign was measured under loading of 4 to 15 kg with and without a peroneal nerve block. In 65 patients, we found a highly significant difference between these two conditions. In a total of 110 patients, the measurement of anterior drawer sign was correlated to other diagnostic procedures. Absolute values of mechanical anterior drawer sign had a correlation of 0.479, whereas the difference of the measurements in injured and noninjured feet correlated with 0.582. We suggest anesthesia in stress diagnostics to increase accuracy. The anterior drawer sign alone, even under anesthesia, is not reliable to detect the full extent of the ligament damage.
Foot & ankle 11/1993; 14(8):459-64.
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ABSTRACT: From July 1988 until December 1990 1141 patients with left-sided idiopathic varicocele underwent phlebography of the spermatic internal vein, and percutaneous sclerotherapy with sodium morruate (Varicocid) was intended to be performed. In 125 of these patients sclerotherapy was not feasible. The reasons for this were analysed in a retrospective study. According to the anatomical situation of the spermatic vein, there were significant differences in technical success. In case of incompetent valve of the spermatic vein at the renal origin (type I, 2A, 3, 4A), selective probing and following sclerotherapy was possible in 97%. Anatomic variations with competent valve of the spermatic vein (type 0, 2B, 4B) led to difficulties in selectively probing the vessel, and sclerotherapy was feasible in only 72.7%. In these angiographically difficult cases, spasm of the spermatic vein and/or perforation prevented sclerotherapy in 29 of 125 patients.
RöFo - Fortschritte auf dem Gebiet der R 11/1992; 157(4):355-60. · 2.76 Impact Factor
