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Hannover, Germany

Steffen A.,University of Lubeck | Heiser C.,TU Munich | Herzog M.,Universitatsklinik Und Poliklinik For Hals Nasen Ohren Heilkunde | Bergler W.,Hals Nasen Ohren Klinik | And 2 more authors.
Laryngo- Rhino- Otologie | Year: 2015

The stimulation of the upper airway represents an effective treatment option in case of CPAP failure in patients with moderate to severe obstructive sleep apnea. The stimulation with respiratory sensing (Inspire Medical Systems) has shown a high level of evidence in larger cohorts and longer follow-up studies. Whether the results of the stimulation without respiratory sensing (ImThera Medical) can be compared with the therapy with sensing, remains open up to now. Additional data are awaited after the planned phase III study THN#2. To optimize both procedure and to provide long term results, more studies are needed. The workgroup "sleep medicine" of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery supports theses activities with the help of the newly founded task force "Neurostimulation in Sleep Apnea". © 2015, Georg Thieme Verlag KG. Source

Ehlert N.,Leibniz University of Hanover | Muller P.P.,Helmholtz Center for Infection Research | Stieve M.,Hals Nasen Ohren Klinik | Behrens P.,Leibniz University of Hanover
Microporous and Mesoporous Materials | Year: 2010

The immobilization of a model enzyme, alkaline phosphatase (ALP), onto differently modified silica surfaces and coatings was investigated as a test case for the biofunctionalization of implant surfaces. In this context, the influence of silica surface structures and various silane linker molecules on the capacity to bind active proteins were studied. For this purpose, microscope glass slides were coated with unstructured or mesoporous silica films. The binding of the protein to the surface was mediated by trialkoxysilanes with different functional groups like amino, epoxy, and urea functions. The model protein ALP was chosen due to its robustness and the availability of a simple activity assay. This assay showed that all the functionalized trialkoxysilanes tested were able to immobilize active ALP on silica surfaces. Using the 3-aminopropylsilyl modification resulted in the highest activity of bound ALP, especially in combination with a mesoporous surface coating. Interestingly, unstructured silica sol-gel films had only low capacity to immobilize active enzyme whereas both mesoporous silica coatings and plain glass bound higher amounts of active ALP. By using mesoporous coatings functionalized with 3-aminopropylsilyl residues, maximal binding capacities for active ALP were achieved. This combination appears most promising for the further development of bioactive surfaces for practical applications such as surgical implant functionalization. © 2009 Elsevier Inc. All rights reserved. Source

Tasman A.-J.,Hals Nasen Ohren Klinik | Palma P.,Universitatsklinik Varese
HNO | Year: 2010

Background: Over the last two decades, the use of the external approach for primary and secondary rhinoplasties has become increasingly popular. This article illustrates the versatility of endonasal techniques for the correction of nasal tip deformities on the basis of four cases. Patients and Methods: The approach to the nasal tip and the chosen technique as used in 100 consecutive rhinoplasties were reviewed. Results: For primary and revision tip plasty, endonasal approaches were used in 81% of cases. Preferred incisions were the infracartilaginous approach and the transfixion incision. Using these approaches, correction of the tip was achieved by using sutures to reposition and reshape the alar cartilages and the columella without grafts to the nasal tip in most cases. Conclusion: Nasal tip plasty via endonasal approaches using sutures is technically more challenging compared to the external approach with its superior exposure. This drawback is outweighed by less operating time and faster patient recovery. Contrary to the general trend, the authors believe that endonasal tip plasty techniques using sutures can obviate the external approach and grafts in many cases and should form an integral part of the rhino-surgeon's repertoire. © 2010 Springer-Verlag. Source

Waldfahrer F.,Friedrich - Alexander - University, Erlangen - Nuremberg | Iro H.,Friedrich - Alexander - University, Erlangen - Nuremberg | Brevern M.V.,Abteilung Radiologie | Fetter M.,Zentrum fur Neurologie | And 7 more authors.
HNO | Year: 2010

According to German law granting of driving licenses depends on the proof of an adequate driving capability. The corresponding guidelines are at present in the process of being revised. At the moment bilateral deafness and high-grade hearing loss (≥60% in pure tone audiometry) are not exclusion criteria for driving licenses grades A, B and C, while driving licenses grade D and licenses for public transport are generally excluded. In the forthcoming revised edition of the guidelines it has been suggested that the latter group will also not be excluded. The regulations concerning dizziness are wide-sweeping at the moment as no driving license will be granted if dizziness is present but will be more specific in the next issue. In particular a division will be made between single axle and two axle vehicles. An expert assessment about driving suitability can only be made by a certified specialist with qualifications in traffic medicine. © Springer Medizin Verlag 2010. Source

Ehlert N.,Leibniz University of Hanover | Mueller P.P.,Helmholtz Center for Infection Research | Stieve M.,Hals Nasen Ohren Klinik | Lenarz T.,Hals Nasen Ohren Klinik | Behrens P.,Leibniz University of Hanover
Chemical Society Reviews | Year: 2013

In this tutorial review we present the process of the development of functional implants using mesoporous silica. The different steps from chemical synthesis and physicochemical characterization followed by in vitro testing in cell culture assays to clinically relevant in vivo animal studies are examined. Since the end of the 1990s, mesoporous silicas have been considered as biomaterials. Numerous investigations have demonstrated their non-toxic and biocompatible properties. These qualities in combination with the unique properties of high surface area and pore volume, uniform and tunable pore sizes and chemical modifiability are the reasons for the great scientific interest in this field. Here we show that besides bulk materials or mesoporous silica nanoparticles, mesoporous silica films are highly promising as coatings on medical prostheses or implants. We report on the development of functionalized mesoporous silica materials specifically for middle ear applications. Middle ear prostheses are used to restore the sound transmission through this air-filled cavity when the small bones of the middle air (the ossicular chain) have been destroyed by disease or by accidents. In addition to optimal restoration of sound transmission, this technique bears several challenges, e.g. an ongoing bacterial infection or the displacement of the prosthesis due to insufficient fixation. To improve the healing process, a mesoporous silica coating was established on ceramic middle ear prostheses, which then served as a base for further functionalizations. For example, the bone growth factor BMP2 was locally attached to the coating in order to improve the fixation of the prosthesis by forming a bony connection to the remainder of the ear bones. Further, an implant-based local drug delivery system for the antibiotic ciprofloxacin was developed with the aim of fighting bacterial infections. Further possibilities using mesoporous silica nanoparticles as part of a composite on an implant are briefly discussed. © The Royal Society of Chemistry 2013. Source

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