Fabian Sommer’s research while affiliated with Ulm University and other places

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Publications (150)


Figure 3. Demonstrative case of a 58-year-old woman with a nonfunctioning pituitary adenoma who presented with corticotropic insufficiency. Presented are T2 and contrast-enhanced T1 coronal sections of the sella. The preoperative MRI demonstrates a Knosp IV lesion with encased left ICA (A). The intraoperative MRI shows the resection cavity in the sella with a tumor remnant marked with the arrow (B). Further tumors could be removed after the intraoperative MRI leading to a gross total resection with no obvious remnant in the MRI after 3 months (C) and 1 year (D). No adjuvant treatment was administered.
Patients and tumor characteristics.
Endocrine outcome after transsphenoidal adenomectomy.
Detailed characteristics of Knosp 0-2 and Knosp 3-4 subgroups.
Detailed characteristics of quality of life measurements.
Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection
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  • Full-text available

January 2025

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28 Reads

Neurology International

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Background: Endoscopic pituitary surgery might yield better endocrine outcomes compared to microscopic resection. We conducted a prospective, randomized, single-blinded study to compare the endocrine outcome and quality of life (QoL) of patients with newly diagnosed pituitary adenoma who underwent either endoscopic or microscopic transsphenoidal surgery (NCT03515603). Methods: Due to slow recruitment, this study had to be stopped prematurely. Out of 170 transsphenoidal pituitary surgeries performed during the study period, 36 patients were enrolled in this study. The primary endpoint was based on the development of a new hypopituitarism. Secondary endpoints included the extent of resection, complications, and QoL. Results: Endoscopic surgery was performed in 47.2% (n = 17). A new hypopituitarism was found in 8.3% (n = 3). All these cases underwent microscopic resection. Arginine vasopressin deficiency was found in 2.7% (n = 1) after microscopic resection. Gross total resection was achieved in 94.4% (n = 34). No surgical complications or new neurological deficits were observed. QoL improved significantly after the surgery, as measured by EQ-VAS (p = 0.003). According to EQ-5D3L, QoL improved or remained unchanged in almost all patients. No significant difference was found in QoL between the endoscopic and microscopic groups. Conclusion: The endoscopic technique appears to offer benefits in the treatment of pituitary adenomas, particularly in terms of achieving a favorable endocrine outcome.

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Umfrage zum Einsatz von Nasentamponaden in der sinunasalen Chirurgie

September 2024

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34 Reads

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1 Citation

Laryngo-Rhino-Otologie

Zusammenfassung Hintergrund Die Ambulantisierung rhinochirurgischer Eingriffe wird derzeit intensiv diskutiert und insbesondere von politischer Seite stark propagiert. Viele Fragen zur Stratifizierung in ambulante oder stationäre Durchführung sind unklar. Insbesondere ist das Vorgehen bei Anwendung von Nasentamponaden bisher nicht ausreichend diskutiert. Material und Methoden Deutschlandweite Umfrage unter niedergelassenen und in Kliniken tätigen Hals-, Nasen-, Ohrenärzten zur Verwendung von Nasentamponaden in der Rhinochirurgie und zum Auftreten von Komplikationen in Zusammenhang mit einer Tamponade. Ergebnisse 85,6% der Antwortenden verwenden eine Nasentamponade zumindest manchmal bei der Chirurgie von Septum und Nasenmuscheln/lateraler Nasenwand, 44,2% grundsätzlich. Bei der Nasennebenhöhlenchirurgie sind dies 94,1% bzw. 49% der Antwortenden. Überwiegend wurde die Anwendung von sich nicht auflösenden Tamponaden angegeben. Die am häufigsten beobachteten Komplikationen waren eine Blutung unter liegender Nasentamponade (>50% der Antwortenden) und eine Dislokation nach dorsal (24% der Antwortenden), die ein notfallmäßiges Eingreifen erforderte. Eine Todesfolge wurde bei 5 Patienten beschrieben. Ein Patient erlitt eine dauerhafte Hirnschädigung nach Hypoxie. Schlussfolgerungen Die Anwendung einer sich nicht auflösenden Nasentamponade mit Okklusion der Nasenhaupthöhle kann zu einer relevanten Gefährdung der Patienten führen, die ein notfallmäßiges Eingreifen erforderlich macht und deshalb die stationäre Überwachung erfordert.


Ambulante Durchführung rhinochirurgischer Operationen unter Berücksichtigung des Einsatzes von Nasentamponaden Positionspapier der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie, der Arbeitsgemeinschaft Rhinologie/Rhinochirurgie (ARHIN) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie und des Deutschen Berufsverbandes der HNO-Ärzte

September 2024

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39 Reads

Laryngo-Rhino-Otologie

Zusammenfassung Hintergrund Die Ambulantisierung rhinochirurgischer Eingriffe wird derzeit intensiv diskutiert und insbesondere von politischer Seite stark propagiert. Viele Fragen zur Stratifizierung in ambulante oder stationäre Durchführung sind unklar. Insbesondere das Vorgehen bei Anwendung von Nasentamponaden ist bisher nicht ausreichend diskutiert. Material und Methoden Entwicklung einer Checkliste zur ambulanten Durchführung rhinochirurgischer Operationen unter Berücksichtigung der aktuellen Literatur. Ergebnisse und Schlussfolgerungen Nach umfassender Auswertung der Literatur und Analyse von Risikofaktoren wird eine Liste von stationär durchzuführenden rhinochirurgischen Operationen definiert. Es wird eine Checkliste für die ambulante oder stationäre Durchführung rhinochirurgischer Operationen vorgelegt, die soziale, allgemeine medizinische und spezifische operationsbedingte Gründe berücksichtigt und hierbei die Anwendung von Nasentamponaden einschließt. Sie wird ergänzt durch eine Checkliste, anhand derer Kriterien die Entlassungsfähigkeit von Patienten nach einer ambulant geplanten rhinochirurgischen Operation bewertet wird.


Intraoperative use of virtual reality decreases anxiety during surgery under local anaesthesia in the head and neck region

September 2024

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72 Reads

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1 Citation

The availability of virtual reality (VR) in the medical field has been rapidly increasing in the past years. Here we investigate to which extent the VR headset can lead to a reduction in anxiety and pain in patients during surgical procedures under local anesthesia in the head and neck region. Patients were divided into a study group (N = 67) and a control group (N = 28). The study group used a VR headset during surgical procedures in the head and neck region under local anaesthesia. Before and after surgery, the influence of the VR headset on perioperative anxiety was assessed using the State-Trait-Anxiety-Inventory (STAI) in both groups. The use of a VR headset leads to a significant reduction in perioperative anxiety. The anxiety scores measured by means and ranks of the STAI were significantly decreased (p = .002). However, 14/67 (20.9%) of the patients wearing the VR headset also reported higher intraoperative tension. No technical complications occurred intraoperatively. 48/67 (71.7%) of the patients would be less apprehensive about a future operation when using a VR headset and 58/67 (86.6%) would further recommend the use of a VR headset to other patients. In addition to a trusting surgeon-patient relationship and the use of sufficient local anaesthesia, the use of a VR headset as a method of distraction can further reduce the intraoperative anxiety of patients.


Consort diagram displaying patients’ flow in study
Violin plots showing A suture time for barbed and conventional sutures, B suture speed in cm/min, C suture speed for conventional sutures and D suture speed for barbed sutures stratified by training level
Scatter plots show correlation between incision length and suture time for A barbed sutures, B for smooth sutures and C for all devices together. Regression line indicates correlation trend
Barbed suture in neck dissection: a randomized clinical study on efficacy, safety and aesthetic outcome

August 2024

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22 Reads

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1 Citation

European Archives of Oto-Rhino-Laryngology

Purpose The resection of lymph nodes/neck dissection is a typical part of the surgical treatment of head and neck malignancies. The aim of this study was to compare subcutaneous closure using single knotted, braided suture (VicrylTM, standard arm) with continuous self-locking, monofilament barbed suture (V-LocTM, experimental arm). Methods Neck Lock was a randomized clinical trial at a single tertiary referral center. It was conducted from 2016 till 2022 with a follow-up period of 3 months. Assessment of safety and aesthetic outcome was double-blinded. 68 patients were randomized after application of exclusion criteria. Subcutaneous wound closure was performed in an intrapatient randomized fashion for suture technique. The primary endpoint was the duration of subcutaneous sutures. Wound healing and scar formation were recorded at multiple postoperative intervals as secondary endpoints. Results The median age was 61 years, 89.7% were male. 92.6% suffered from a squamous cell carcinoma. There was a significant difference in median subcutaneous suture time (p = 0.024) between the experimental (6:11 ± 2:30 min) and standard (7:01 ± 2.42 min) arms. There was no significant difference in safety when assessing adverse events (AEs). At least one AE occurred in 14.7% vs. 5.9%, for barbed and smooth sutures respectively (p = 0.16). Conclusion For neck dissection of head and neck malignancies, subcutaneous wound closure with self-locking sutures offers significant time savings over the single knot technique with similar safety and aesthetic results. Trial registration information The trial was registered with WHO acknowledged primary registry “German Clinical Trials Register” under the ID DRKS00025831 (https://drks.de/search/de/trial/DRKS00025831).







Citations (18)


... VR has been shown to help in reducing anxiety during surgical interventions. For example, when VR was employed in a pilot trial on patients undergoing head and neck surgery under local anesthesia, perioperative anxiety was significantly reduced, and most patients had a high level of adherence [23]. While VR was reported to be a promising treatment for the management of pain and anxiety in some cardiovascular surgery procedures and interventional cardiology studies, other trials reported no benefit [24,25]. ...

Reference:

A Systematic Review of Virtual Reality’s Impact on Anxiety During Palliative Care
Intraoperative use of virtual reality decreases anxiety during surgery under local anaesthesia in the head and neck region

... However, for LRFM, the measurement was conducted through the nasal cannula, whose relatively rigid texture and nonfixed features could lead to uncertainty in its measurement accuracy. Additionally, the recording intervals were relatively long, thereby limiting the real-time display of the data [21][22][23][24][25][26]. Existing sensors have several limitations, including their considerable size and weight, low accuracy, insufficient sensitivity and poor stability [1,2,32,27,28]. ...

Continuous investigation of the nasal cycle over 48 hours
  • Citing Article
  • December 2023

Rhinology Journal

... Die Rolle von telemedizinischen Methoden in der HNO-Heilkunde wurde bereits in mehreren Übersichtsartikeln dargelegt [3,13,16]. Hierzu ergänzend werden nun Optionen der telemedizinischen Behandlung von Patientinnen und Patienten mit Fazialisparesedargestelltsowieaktualisierte regulatorische und technische Aspekte erläutert. ...

Telemedizin in der HNO-Heilkunde – wirklich ein Allheilmittel?
  • Citing Article
  • November 2022

Laryngo-Rhino-Otologie

... However, for LRFM, the measurement was conducted through the nasal cannula, whose relatively rigid texture and nonfixed features could lead to uncertainty in its measurement accuracy. Additionally, the recording intervals were relatively long, thereby limiting the real-time display of the data [21][22][23][24][25][26]. Existing sensors have several limitations, including their considerable size and weight, low accuracy, insufficient sensitivity and poor stability [1,2,32,27,28]. ...

Re-evaluating the nasal cycle by long-term rhinoflowmetry: most individuals demonstrate a “mixed” nasal cycle
  • Citing Article
  • August 2021

Rhinology Journal

... This condition adversely impacts the nasal cavity's ventilation, temperature regulation, and humidification functions (2,3). Septoplasty, a widely utilized surgical intervention for symptomatic deviated nasal septum, has been shown to have favorable outcomes in multiple studies (4,5). Notably, a randomized controlled trial by van Egmond et al. demonstrated that septoplasty is more effective than nonsurgical management in alleviating nasal obstruction in adults with septal deviation (6). ...

Treatment success after rhinosurgery: an evaluation of subjective and objective parameters

European Archives of Oto-Rhino-Laryngology

... Patients of the main group (n=49) have fewer recurrences of nasal septal perforation compared to patients of the control (retrospective) group (n=31) (9 (18%) and 21 (68%), respectively, p<0.001). Comparative analysis of the main (prospective) and control (retrospective) groups revealed a statistically signifi cant improvement in the average volume of inhaled air in the postoperative period (846.5 cm 3 and 620.8 cm 3 , respectively, p<0.001); aerodynamics of the incoming fl ow of inhaled air (50.1% and 34.8%, respectively, p<0.001); restoration of the symmetry of the inhaled air (0. 1 [1]. Хирургическая техника постоянно совершенствуется, улучшаются дооперационные методы обследования и предоперационная подготовка, появляются новые комбинации различных методов закрытия перфораций перегородки носа, а в ход операции внедряется более совершенное оборудование [2,3]. ...

A contemporary review of “realistic” success rates after surgical closure of nasal septal perforations
  • Citing Article
  • April 2021

Auris Nasus Larynx

... Technological advancements are compensating for endoscopic imagery's limited depth cues. 3D endoscopic systems, while accurate, are often sidelined due to cost and complexity [14]. Monocular systems prevail since they are affordable and easily integrated into surgical setups, despite depth perception limitations [3]. ...

3D endoscopy shows enhanced anatomical details and depth perception vs 2D: a multicentre study

European Archives of Oto-Rhino-Laryngology

... The correction of the crooked nose is very complex and requires the use of a wide range of surgical techniques: closed or open access, modified septoplasty, extracorporeal septum reconstruction ["L-Strut"], complete detachment of the infrastructure from the fixating soft tissue, various osteotomies including intermediate osteotomy as well as osteotomy of the nasal root, bony wedge resection, resections of cartilage, cartilaginous transplants such as spreader grafts [uni-or bilateral], batten grafts, asymmetrical hump resections, suture techniques and camouflage with cartilaginous grafts. The intricacy and variety of crooked nose deformities make the most appropriate treatment strategy debatable, despite the fact that multiple techniques have been described for crooked nose surgery [3] . ...

Anthropometric Evaluation of Photographic Images Before and After Functional Nasal Surgery in Patients With Deviated Noses
  • Citing Article
  • December 2020

American Journal of Rhinology and Allergy

... This device features a mechatronic holding arm and is driven by a foot pedal that can be precisely controlled. The surgeon can maintain bimanual instrumentation, which allegedly facilitated the dissection, but the report remains very preliminary 48 . A minimally-invasive alternative procedure is transcanalicular microdrill dacryoplasty: this is a variation of the external laser DCR where, under GA, the use of a 0.38 mm microdrill was reported to yield an 84% success rate with a very low rate of complications (0.2% of heavy postoperative bleeding) and 57.5% of patients presented full resolution of symptoms 49 . ...

Nasolacrimal duct stenosis—Surgery with a novel robotic endoscope positioning system

International Journal of Medical Robotics and Computer Assisted Surgery

... Also mentioned is the medial maxillary antrostomy, with the possibility of enlarging the natural ostium to achieve mega-antrostomy, extending from the pterygoid process to the lacrimal duct, while preserving it [1]. These approaches adequately expose the medial and posterior sectors of the maxillary sinus. ...

Radikalität der Kieferhöhlenoperation und Größe des KieferhöhlenfenstersRadicality of maxillary sinus surgery and size of the maxillary sinus ostium
  • Citing Article
  • May 2020

HNO