Papers by Jan-Dirk Raguse
Craniomaxillofacial Research & Innovation
Study Design Case series Objective By reporting several cases of dislocated foreign bodies, we ai... more Study Design Case series Objective By reporting several cases of dislocated foreign bodies, we aim to make dentists/surgeons aware of possible severe and potentially life-threatening complications. In case of dislocation, the appropriate radiological assessment depending on the foreign body is required if direct removal fails. Material and Methods Electronic and paper record of patients suffering from various dental foreign bodies were analysed. Analysis included history of dislocation, type of foreign object, anatomical region of dislocation, related dental treatment and approach to surgical removal. Results In total, 5 patients with various dental foreign body objects, including fractured root canal instruments (n = 2), a broken dental injection needle (n = 1), a broken Lindemann bur (n = 1) and root filling material (n = 1) are reported. Patient ages ranged from 14 to 54 years. In 4 cases, the foreign body could be salvaged successfully, and one patient refused the surgical thera...
Einleitung: Durch mikrochirurgische Rekonstruktionstechniken stehen eine Reihe von Möglichkeiten ... more Einleitung: Durch mikrochirurgische Rekonstruktionstechniken stehen eine Reihe von Möglichkeiten zur Rehabilitation der Fazialisparese zur Verfügung. Dennoch sind wir zunehmend mit älteren und komorbiden Patienten konfrontiert, bei denen diese aufwendigen und langwierigen Verfahren nicht[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Einleitung: Navigationssysteme haben heute einen festen Stellenwert in der MKG-Chirurgie. Durch i... more Einleitung: Navigationssysteme haben heute einen festen Stellenwert in der MKG-Chirurgie. Durch ihren Einsatz können das chirurgische Ergebnis verbessert und Komplikationen reduziert werden. Bisher gebräuchliche Systeme basieren maßgeblich auf dem Prinzip der optischen Navigation (IR),[for full text, please go to the a.m. URL]
Einleitung: Zur Rekonstruktion knöcherner Defekte nach ablativer Chirurgie im Bereich des Neuro- ... more Einleitung: Zur Rekonstruktion knöcherner Defekte nach ablativer Chirurgie im Bereich des Neuro- und Viscerkraniums stehen neben den vielfältigen Möglichkeiten des autogenen Transfer seit einigen Jahren individuell gefertigte Implantate auf Basis eines 3D-Datensatzes zur Verfügung.[for full text, please go to the a.m. URL]
Einleitung: Die Osteoradionekrose der Kiefer (ONJ) wurde erstmals 1926 beschrieben und stellt die... more Einleitung: Die Osteoradionekrose der Kiefer (ONJ) wurde erstmals 1926 beschrieben und stellt die schwerste Form der Komplikation der Strahlentherapie (RT) eines Plattenepithelkarzinoms im Kopf- und Hals-Bereich (SCCHN) dar. Die ONJ wird durch multiple Faktoren verursacht, wobei zwischen direkten und[for full text, please go to the a.m. URL]
Einleitung: Die Verwendung von Navigationssystemen hat heute einen festen Stellenwert in der MKG-... more Einleitung: Die Verwendung von Navigationssystemen hat heute einen festen Stellenwert in der MKG-Chirurgie. Basis für einen erfolgreichen computergestützten Eingriff ist eine zeitintensive Planung und aufwendige Patientenregistrierung, so dass sie noch keinen Eingang in die Routine gefunden[for full text, please go to the a.m. URL]
Einleitung: Für verschiedene Entitäten konnte in Metaanalysen ein Vorteil des neoadjuvanten Einsa... more Einleitung: Für verschiedene Entitäten konnte in Metaanalysen ein Vorteil des neoadjuvanten Einsatzes der Chemotherapie vor Chirurgie gezeigt werden. Insbesondere verbessert eine durch die Chemotherapie erzielte pathologische komplette Remission die Prognose der Patienten nach Operation signifikant.[for full text, please go to the a.m. URL]
Jährlich erkranken weltweit mehr als 600.000 Patienten an einem Plattenepithelkarzinom im Kopf-Ha... more Jährlich erkranken weltweit mehr als 600.000 Patienten an einem Plattenepithelkarzinom im Kopf-Hals-Bereich, über die Hälfte entwickelt nach primärer Therapie ein lokales oder lokoregionäres Rezidiv. In dieser Situation sind durch zunehmende Tumormassen bedingte Symptome für den Patienten belastend: schwer beherrschbare Schmerzen, die Einschränkung der oralen Nahrungsaufnahme und der daraus resultierende Gewichtsverlust bis zur Kachexie als auch die Einengung der Atemwege bis zum drohenden Tod durch Ersticken. Die bisher mögliche Verbesserung der Lebenserwartung von 3-6 Monaten ohne Therapie auf maximal 6-12 Monaten durch Ausnutzung aller zur Verfügung stehenden Optionen zeigt die dringende Notwendigkeit neuer Therapiestrategien, und sei es in palliativer Intention. Die Radiofrequenztherapie stellt heute einen integralen Bestandteil in der Behandlung verschiedener Tumoren dar, mittlerweile sind über 5000 Artikel zum Einsatz dieser Technik publiziert. Zum zielgerichteten Einsatz bei ...
European Journal of Radiology, 2021
PURPOSE To evaluate the effectiveness of plain radiography (X-ray. XR), computed tomography (CT) ... more PURPOSE To evaluate the effectiveness of plain radiography (X-ray. XR), computed tomography (CT) and magnetic resonance imaging (MR) in visualising commonly seen foreign bodies. A special focus was put on objects relevant to head and neck surgery. METHOD Thirty-four commonly encountered objects of different compositions including wood, plastic, and glass were embedded in a gelatin gel phantom and imaged using XR, CT and MR. The success rates of radiologists in detecting and correctly identifying the foreign objects were evaluated. Subjective visibility was rated on a 4-point Likert scale. Objective visibility was analysed using region of interest-based contrast for CT. RESULTS Sensitivity in foreign bodies detection was highest in MR (97.1 %) followed by CT (86.0 %) and x-ray (61.8 %). Success rates for the correct identification of the objects and material types were highest in MR (33.3 % and 39.2 %, respectively) followed by CT (25.5 % for both) and XR (16.7 % and 15.7 %). Overall, subjective visibility was rated higher in CT and MR imaging ("good visibility"), as compared to XR ("poor visibility"). Interreader agreement was high across modalities (Kendall's W = 0.935, 0.834 and 0.794 for XR, MR and CT, respectively). CONCLUSIONS Detection and identification of non-ferromagnetic objects was most successful in MR followed by CT imaging in this experimental setup.
Einleitung: Die Herztransplantation (HTX) stellt die einzig kurative Therapie der terminalen Herz... more Einleitung: Die Herztransplantation (HTX) stellt die einzig kurative Therapie der terminalen Herzinsuffizienz dar. Aufgrund des Mangels an Spenderorganen werden ventrikulare Unterstutzungssysteme (VAD) heute sowohl zur Uberbruckung bis zur HTX als auch zur definitiven Therapie bei[for full text, please go to the a.m. URL]
Insights into Imaging, 2021
Open injuries bear the risk of foreign body contamination. Commonly encountered materials include... more Open injuries bear the risk of foreign body contamination. Commonly encountered materials include gravel debris, glass fragments, wooden splinters or metal particles. While foreign body incorporation is obvious in some injury patterns, other injuries may not display hints of being contaminated with foreign body materials. Foreign objects that have not been detected and removed bear the risk of leading to severe wound infections and chronic wound healing disorders. Besides these severe health issues, medicolegal consequences should be considered. While an accurate clinical examination is the first step for the detection of foreign body materials, choosing the appropriate radiological imaging is decisive for the detection or non-detection of the foreign material. Especially in cases of impaired wound healing over time, the existence of an undetected foreign object needs to be considered.Here, we would like to give a practical radiological guide for the assessment of foreign objects in...
BioMed Research International, 2017
Background. Even though branchial cleft cysts are currently accepted as a congenital anomaly, the... more Background. Even though branchial cleft cysts are currently accepted as a congenital anomaly, there is often a long delay until clinical presentation; branchial cleft cysts classically appear in the second to fourth decade of life. Our observation of their occurrence in three pregnant women encouraged us to contemplate a possible hormonal influence. Methods. Immunohistological analysis was performed for the evaluation of the estrogen receptor alpha (ERα) in paraffin-embedded tissue specimens of 16 patients with a diagnosis of branchial cleft cyst, with three of them being pregnant. Results. Expression of ERα was detected within epithelial cells only in branchial cleft cysts in pregnant females; moreover, higher growth fractions (Ki-67/Mib1) were found. Conclusion. The fact that the estrogen receptor was expressed only in pregnant women, in contrast to 13 investigated cases, may suggest that the high level of estrogen in pregnancy is a possible explanation for the spontaneous growth ...
Journal of Clinical Oncology, 2016
e17512Background: Cetuximab is the single targeted therapy approved for the treatment of head and... more e17512Background: Cetuximab is the single targeted therapy approved for the treatment of head and neck cancer (SCCHN). Predictive biomarkers have not been established in the clinical setting and patient stratification based on molecular tumor profiles has not been possible. Since EGFR pathway activation is pronounced in basal subtype, we hypothesized this activation could be a predictive signature for an EGFR directed treatment Methods:: From our patient derived xenograft platform of head and neck cancer, 28 models were subjected to Affymetrix gene expression studies on HG U133+ 2.0. Based on the expression of 821 genes, the subtype of each of the 28 models was determined by integrating gene expression profiles through centroid-clustering with previously published gene expression data by Keck et al.,CCR 2015. The models were treated in groups of 5-6 animals with docetaxel, cetuximab, carboplatin and 5-fluorouracil. Response was evaluated by comparing tumor volume at treatment initiation and after three we...
Journal of Clinical Oncology, 2016
6035Background: TPF induction chemotherapy (IC) is a reasonable treatment for locally advanced (L... more 6035Background: TPF induction chemotherapy (IC) is a reasonable treatment for locally advanced (LA) squamous cell carcinoma (SCC) of the head and neck. Substantial toxicity may compromise complianc...
Journal of Clinical Oncology, 2019
6031 Background: Copanlisib is a highly selective, pan-class I PI3K inhibitor with preferential a... more 6031 Background: Copanlisib is a highly selective, pan-class I PI3K inhibitor with preferential activity against the p110α and p110δ isoforms that lead to downregulation of PI3K signaling. Copanlisib has been approved for the treatment of follicular lymphoma in the US. Here, we explored the anti-tumor activity of copanlisib in head and neck squamous cell carcinoma (HNSCC), where Pi3K signaling has been defined as alternate signaling in cetuximab resistant tumors. Further, TCGA data show up to 56% of HNSCC display either amplification or mutational changes in the Pi3K pathway making Pi3K an attractive target. Methods: Using a mouse-clinical trial set-up we profiled 20 patient derived HNSCC xenograft models for their sensitivity to cetuximab or copanlisib as single agent as well as in combination. Models were selected from our HNSCC PDX platform based on Pi3K mutational status, with 6 models harboring hot spot mutations, HPV positivity (n=3) and/or cetuximab resistance based on previo...
Journal of Clinical Oncology, 2015
e17042 Background: TPF induction chemotherapy (IC) is a reasonable treatment option for locally a... more e17042 Background: TPF induction chemotherapy (IC) is a reasonable treatment option for locally advanced (LA) squamous cell carcinoma (SCC) of the head and neck (HN). However, substantial toxicity may compromise compliance and thereby also treatment efficacy. ICRAT is a randomized 3-arm phase 2 trial evaluating efficacy and safety of two TPF-IC regimens followed by bio-radiation (BRT) vs. concurrent PF chemoradiation (CRT) for chemo-/radiation-naive LASCCHN. Methods: Stage IV oro-/hypopharynx/oral cavity LASCC were randomly assigned to either 3 cycles of standard TPF-IC (arm A) with TP (75 mg/m2, each day 1) and F (750 mg/m2/24h days 1-4) or split-course TPF-IC (arm B) with TP (40 mg/m2, each days 1 and 8) and F (1500 mg/m2/24h days 1 and 8) vs. PF-CRT alone (arm C). Progression after first cycle of TPF-IC in arm A or B led to cross over to BRT with 72 Gy. Responders (complete: CR; partial: PR) and stable disease patients received 3 cycles of TPF-IC followed by weekly cetuximab (250 mg/m2, initial loading...
Journal of Clinical Oncology, 2015
e17034 Background: We recently established a panel of 65 head and neck squamous cell carcinoma (H... more e17034 Background: We recently established a panel of 65 head and neck squamous cell carcinoma (HNSCC) patient-derived xenografts (PDX) for exploration of novel treatment approaches and biomarker e...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, Dec 1, 2017
Objective To assess the feasibility of detecting signature volatile organic compounds in the brea... more Objective To assess the feasibility of detecting signature volatile organic compounds in the breath of patients with oral squamous cell carcinoma. Study Design Prospective cohort pilot study. Setting University hospital. Subjects and Methods Using gas chromatography and mass spectrometry, emitted volatile organic compounds in the breath of patients before and after curative surgery (n = 10) were compared with those of healthy subjects (n = 4). It was hypothesized that certain volatile organic compounds disappear after surgical therapy. A characteristic signature of these compounds for diseased patients was compiled and validated. Results Breath analyses revealed 125 volatile organic compounds in patients with oral cancer. A signature of 8 compounds that were characteristic for patients with oral cancer could be detected: 3 from this group presented were absent after surgery. Conclusion The presented results confirmed the hypothesis of an absence of cancer-associated volatile organic...
Dental Traumatology, 2016
Intermaxillary fixation is a standard procedure for the treatment of mandibular fractures or in o... more Intermaxillary fixation is a standard procedure for the treatment of mandibular fractures or in orthognathic surgery. Pre-drilling for screws poses the risk of accidental tooth-root injury, potentially leading to further pathological processes. Limited evidence about accidental tooth injury during intermaxillary fixation is available due to heterogenous study designs. The aim of this study was to evaluate the risk of root trauma using pre-drilled transgingival fixation screws and the clinical consequences for the affected teeth. In this retrospective study, the data of open reduction and internal fixation surgery files with intraoperative application of pre-drilled intermaxillary fixation screws were analysed. The postoperative radiographic images were evaluated for the occurrence of tooth root injury. Patients diagnosed with root injury were clinically followed-up with respect to the dental health for the affected teeth. A total of 133 radiologically diagnosed tooth root injuries were recorded (12.5% of screws). The median follow-up interval was 16 months (range: 3-77 months). The return rate was 49.5% of all patients. Of these, four of the injured teeth (3%) needed endodontic treatment. No toothache was reported, no tooth was lost and no negative impact on periodontal health was clinically evident. Intermaxillary fixation with pre-drilled transgingival screws is a safe way to manage mandibular fractures. The incidence of tooth root injury is not uncommon, but the adverse side effects are rare and the health of the affected teeth is mostly not compromised. This article is protected by copyright. All rights reserved.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, Jan 12, 2016
The aim of the present study was to evaluate changes in the marginal bone level of dental implant... more The aim of the present study was to evaluate changes in the marginal bone level of dental implants in irradiated and nonirradiated patients and to identify possible influential factors. Thirty-six patients with 194 implants were involved in the study (7 women and 29 men). The mean age of the patients was 65.8 years (39 to 90 yr). In all patients, a squamous cell carcinoma in the floor of the mouth involving the mandible or tongue was surgically removed. In 17 patients, adjuvant radiochemotherapy was completed a minimum of 6 months before implant placement. Mean crestal bone changes using standardized orthopantomographs were evaluated. The Spearman rank-order correlation coefficient and Mann-Whitney U test were used to determine correlations between bone crestal changes and age, gender, radiation therapy (yes vs no), augmentation (yes vs no), and type of superstructure. In total, 194 implants were placed (73 in the maxilla and 121 in the mandible). Mean amounts of peri-implant bone l...
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Papers by Jan-Dirk Raguse