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Magyarországon és külföldön megjelent tudományos közlemények
1. Jasper, A., Varga, I., Lichtenberger, Gy.: Nyaki gerincoszlopba fúródott idegentest eltávolításával kapcsolatos tapasztalataink. Fül-orr-gégegyógy. 22: 231-234, (1976)
2. Lichtenberger, Gy.: Tapasztalataink a microlaryngoscopia és microlaryngochirurgia alkalmazása során. VIII. Pest megyei Orvos-Gyógyszerész Napok Tudományos Közleményei. 253-259, (1978)
3. Jasper, A., Lichtenberger, Gy.: Baleset utáni gége- és légcsőkárosodás műtéti megoldása. Fül-orr-gégegyógy. 25: 22-25, (1979)
4. Lichtenberger, Gy.: A laryngomikroszkópiában és az endolaryngeális mikrokirurgiában alkalmazott műszereink és beavatkozásaink ismertetése. Fül-orr-gégegyógy. 25: 215-224, (1979)
5. Lichtenberger, Gy.: Glotticus synechia laryngomikrochirurgiás kialakítása és megoldása állatkísérletekben. Fül-orr-gégegyógy. 26: 13-19, (1980)
6. Lichtenberger, Gy., Jasper, A., Kelemen, S.: Hangréstágító műtéteink eredményei a légzésfunkciós vizsgálatok tükrében. Fül-orr-gégegyógy. 27:179-189, (1981)
7. Lichtenberger, Gy., Dorsch, Gy., Zelen, B.: A kanült viselő gégeműtött betegek kezelése, gondozása és rehabilitációja. Egészségügyi Munka 28: 325-329, (1981)
8. Lichtenberger, Gy.: Laryngomikroszkópos diagnosztika alapján operált malignus gégetumoros eseteink áttekintése. IX. Pest megyei Orvos-Gyógyszerész Napok Tudományos Közleményei. 712-718, (1981)
9. Muskó, A., Konyár, É., Zelen, B., Lichtenberger, Gy.: Ritka lokalizációjú plazmocytoma. IX. Pest megyei Orvos-Gyógyszerész Napok Tudományos Közleményei. 112-116, (1981)
10. Lichtenberger, Gy., Incze, F., Medgyesy, M., Vámos, Z.: A laryngomikroszkópiás beavatkozások intubálás nélküli anaesthesiájáról. I. Gégészeti szempontok. Fül-orr-gégegyógy. 28: 142-157, (1982)
11. Incze, F., Lichtenberger, Gy., Medgyesy, M., Vámos, Z.: A laryngomikroszkópiás beavatkozások intubálás nélküli anaesthesiájáról. II. Anaesthesiológiai módszer. Fül-orr-gégegyógy. 28: 147-150, (1982)
12. Medgyesy, M., Incze, F., Lichtenberger, Gy., Vámos, Z.: A laryngomikroszkópiás beavatkozások intubálás nélküli anaesthesiájáról. III. EKG-vizsgálatok. Fül-orr-gégegyógy. 28: 151-157, (1982)
13. Lichtenberger, Gy.: Kétoldali nervus recurrens bénulás kísérletes kialakítása és a következményes gégeszűkület laryngomikrochirurgiás megoldása. Fül-orr-gégegyógy. 28: 215-222, (1982)
14. Lichtenberger, Gy.: Endo-extralaryngeális tűátnyomó műszer. Kórház és Orvostechnika. 21: 46-48, (1983)
15. Lichtenberger, Gy.: Szozdanie i likvidácija szinehi goloszovoj scseli laryngomikrohirurgicseszkimi metodámi u experimente. Vestnik Otorinolaryngologii (Moszkva) 2: 43-46, (1983)
16. Lichtenberger, Gy.: Vereinfachte Laterofixation der Stimmbänder im Tierversuch. HNO-Praxis (Leipzig), 8: 311-314, (1983)
17. Lichtenberger, Gy.: Endo-extralaryngeal Needle Carrier Instrument. Laryngoscope (St. Louis) 93: 1348-1350, (1983)
18. Lichtenberger, Gy., Kelemen, S., A.: Möglichkeiten der chirurgischen Behandlung von Kehlkopfverengungen und plethysmographische Objektivierung der Resultate. Laryngol-Rhinol. Otol. (Stuttgart) 63: 289-294, (1984)
19. Lichtenberger, Gy., Kotsis, L., Kulka, F. és Frint, T.: Heges nyelőcsőszűkület, gégedeformitás és féloldali n. recurrens bénulás sebészi megoldása. Orv. Hetilap 125: 1637-1644, (1984)
20. Incze, F., Lichtenberger, Gy., Medgyesy, M., Vámos, Z.: Modifiziertes Verfahren der ohne Intubation durchgeführten Anaesthesie bei laryngomikroskopischen Eingriffen. Anaesthesist (Berlin) 33: 276-283, (1984)
Anaesthesist. 1984 Jun;33(6):276-83.
[A modified method of anesthesia without intubation in microsurgical treatment of the larynx]
An anaesthetic method without intubation has been used for the first time in Hungary in 107 laryngomicroscopic operations. The method includes: Vagolytic, analgetic, sedative, vasodilatator, coronary flow enhancing, antihypertensive and antitussive premedication. Administration of the sedative anaesthetic gamma-OH, void of respiratory depression, in doses of 60 mg/kg body weight (given in 2 portions), combined with diazepam, without relaxation and intubation. Supplemental analgesia and inhibition of reflexes by means of mucosal and nerve-block anaesthesia. The premedication, supplemented by endonasal nitroglycerin, reduced the increase of blood pressure, which is a characteristic feature of laryngomicroscopic operations. The combined premedication was found to be effective as well in preventing the usual cardiac arrhythmias, partly reflectory, partly due to the depression of the sinus node (sick sinus syndrome). Nevertheless, the authors emphasize the importance of continuous ECG monitoring. Operation conditions met requirements in 102 cases (intubation had to be performed in 5 patients). The method's primary field of indication includes the microsurgical manipulation of glottic synechiae, as well of lesions in the interarytenoid space or on the vocal processes. Except for the removal of bleeding papillomas, haemangiomas or cysts, the method is expedient for the microsurgical therapy of benign changes, as well as for the topical diagnosis of malignant neoplasms in other laryngeal structures. The advantages of the method are safety, maintenance of normal oxygenation, easy prevention of aspiration, as well as good visibility and photodocumentation of the free operation field, undisturbed manipulation without time limit and, last but not least, simple performance requiring no additional expensive equipment.
PMID: 6476335 [PubMed - indexed for MEDLINE]
21. Kelemen, S., Mohácsi, E., Raffai,I ., Ungor, K., Lichtenberger, Gy.: Eingeschränkte Strömungsverhältnisse bei Patienten mit angio-ödematöser Rhinopathie und Nasenpolypose. Atemw.-Lungenkrkh. 10: 273-275, (1984)
22. Lichtenberger, Gy., Kelemen, S.: Die Behandlung der Kehlkopfverengungen mit der Réthi-Operation und Laryngomikrochirurgie. Objektivierung der Ergebnisse mit der Bodyplethysmographie. Wiss. Zeitschrift der Humboldt Universität zu Berlin, Math. Nat. R. 23: 236, (1984)
23. Lichtenberger, Gy.: A hangszalagok magasságában elhelyezkedő összenövések laryngomikrochirurgiás megoldása. Fül-orr-gégegyógy. 30: 147-152, (1984)
24. Lichtenberger, Gy., Kotsis, S., Kulka, F., Frint, T.: Komplexe chirurgische und mikrochirurgische Behandlung einer narbiger Oesophagus-Stenose, supraglottischer Kehlkopfdeformität und einseitiger Recurrens-Parese. Aktuelles in der Otorhinolaryngologie 1984. Thieme Verlag, Stuttgart. 321-325, (1985)
25. Lichtenberger, Gy.: Laryngomikrochirurgische Behandlung der in Glottishöhe liegenden Synechien. HNO (Berlin) 33: 213-215, (1985)
26. Lichtenberger, Gy.: A bénult hangszalagok egyszerű laryngomikrochirurgiás laterofixációja. Fül-orr-gégegyógy. 31: 10-16, (1985)
27. Lichtenberger, Gy.: Tiersch-lebeny, bioplast és fibrinragasztó alkalmazása hemilaryngektomiáknál. Fül-orr-gégegyógy. 31: 165-170, (1985)
28. Lichtenberger, Gy.: A hangszalagok mozgászavarainak és heges összenövéseinek műtéti korrekciója. Kandidátusi értekezés. (1986)
29. Lichtenberger, Gy.: Az ápolást és a betegek rehabilitációját segítő új légcsőkanül. Orv. Hetilap 127: 93-96, (1986)
30. Lichtenberger, Gy., Deák Gy.: A pajzsporc-lemezek által bezárt szög komputer tomográfiás mérése és szerepe a hangréstágító műtétek típusának megválasztásában. Fül-orr-gégegyógy. 32: 28-32, (1986)
31. Lichtenberger, Gy., Frint, T., Kelemen, S.: Egyoldali n. recurrens bénulás okozta dysphonia kezelése intrachordálisan adott teflonnal. Orv. Hetilap 127: 773-776, (1986)
32. Lichtenberger, Gy.: Verwendung von Bioplast und Fibrinkleber bei Hemilaryngektomien. Aktuelles in der Oto-Rhino-Laryngologie l985. Facultas Universitätsverlag Wien, 1986
33. Lichtenberger, Gy.: Trachealkanüle mit auswechselbarem Sekretbehälter. Laryngol. Rhinol. Otol. (Stuttgart) 65: 410-412, (1986)
34. Lichtenberger, Gy., Frint, T., Jakab, Gy., Kelemen, S.: Korrektionen bei einseitigen Lähmungen und Bewegungseinschränkungen der Stimmbänder. Proceedings of the XIVth UEP-Congress 1987. October, Dresden. 51-53.
35. Lichtenberger, Gy.: Traumás eredetű késői labyrinthogén meningitis. Fül-orr-gégegyógy. 33: 86-89, (1987)
36. Lichtenberger, Gy.: Antibiotikus és műtéti kezelésre gyógyult nekrotizáló "malignus" otitis externa. Fül-orr-gégegyógy. 34: 151-155, (1988)
37. Lichtenberger, Gy., Becske, M., Szilvágyi, A.: Hangprotézis implantációval szerzett első tapasztalataink. Fül-orr-gégegyógy. 35: 15-19, (1989)
38. Lichtenberger, Gy.: Laryngomikrochirurgische Laterofixation gelähmter Stimmlippen mit Hilfe eines neuen Nahtinstrumentes. Laryng. Rhinol. Otol. (Stuttgart) 68: 678-682, (1989)
39. Mészáros, B., Zelen, B., Lichtenberger, Gy.: Subglotto-trachealis lokalizációjú plasmocytoma gyógyítása műtét és sugárkezelés kombinációjával. Fül-orr-gégegyógy. 36: 168-173, (1990)
40. Lichtenberger, Gy., Toohill, R. J.: The endo-extralaryngeal needle carrier. Otolaryngology, Head and Neck Surgery (St. Louis) 105: 755-756, (1991)
Otolaryngol Head Neck Surg. 1991 Nov;105(5):755-6.
The endo-extralaryngeal needle carrier.
Department of Otorhinolaryngology, County Hospital Semmelweis/Rokus, Budapest, Hungary.
A laryngeal needle holder has been devised. This instrument will allow endoscopic insertion of sutures for lateralization of a paralyzed vocal cord or for fixation of endoscopically inserted stents or keels in laryngotracheal stenosis. The suture material is delivered by a curved nontraumatic cutting needle. After the needle is inserted in the desired endoscopic area, the tip protrudes through the anterior neck skin. The needle and distal suture are then pulled through the skin and the needle holder is withdrawn. The proximal portion of the suture is then inserted in the same fashion. Both ends of the suture are then fixed over buttons on the neck. The technique avoids the blind and cumbersome method of placing suture material from the skin to airway and back out to skin again.
PMID: 1754265 [PubMed - indexed for MEDLINE]
41. Lichtenberger, Gy.: Tíz éves tapasztalataink a hangszalagok közötti membránok új laryngomikrochirurgiás kezelésével. Fül-orr-gégegyógy. 38: 195-201, (1992)
42. Lichtenberger, Gy.: Légcsőkanül-adapterR a laryngektomizált betegek posztoperatív kezelésére. Fül-orr-gégegyógy. 38: 155-159, (1992)
43. Lichtenberger, Gy., Németh, T.: A hangszalagok pseudoparalysise okozta gégeszűkület elektromyográfiás diagnosztikája és laryngomikrochirurgiás kezelése. Fül-orr-gégegyógy. 38: 231-235, (1992).
44. Taller, G., Lichtenberger, Gy., Herényi, K.: Postnatalis kétoldali nervus recurrens bénulás okozta gégeszűkület műtéti megoldása infantilis méretű gégében. Fül-orr-gégegyógy. 38: 171-174, (1992)
45. Boronkai, G., Lichtenberger, Gy., Süveges, K.: A supraglotticus horizontalis gégeresectio után kialakult nyelési képtelenség megszüntetése myotomiával. Fül-orr-gégegyógy. 39: 166-168, (1993)
46. Lichtenberger, Gy., Mészáros, B., Taller, G.: Hangpotézis implantáció musculus pectoralis maior myocutan lebennyel rekonstruált hypopharynx tumoros betegen. Fül-orr-gégegyógy. 39: 205-208, (1993)
47. Lichtenberger, G.: Klinische Erfahrungen bei der Anwendung eines neuen Trachealkanülen-Adapters. Zbl HNO 143: 579, (1993)
48. Taller, G., Hajós, M., Lichtenberger, Gy.: Spontán collaris és mediastinalis emphysema. Fül-orr-gégegyógy. 40: 55-58, (1994)
49. Lichtenberger, G, Toohill, R. J.: New Keel Fixing Technique for Endoscopic Repair of Anterior Commissure Webs. Laryngoscope (St. Louis) 104: 771-774, (1994)
Laryngoscope. 1994 Jun;104(6 Pt 1):771-4.
New keel fixing technique for endoscopic repair of anterior commissure webs.
Department of Otorhinolaryngology Szent Rokus Hospital, Budapest, Hungary.
PMID: 8196458 [PubMed - indexed for MEDLINE]
50. Lichtenberger, G.: Zur operativen Behandlung von stenosierenden Erkrankungen des Kehlkopfes. Laryngo-Rhino-Otol. (Stuttgart) 73: 437-441, (1994)
Laryngorhinootologie. 1994 Aug;73(8):437-41.
[Surgical treatment of stenosing diseases of the larynx]
Abteilung fur Hals-, Nasen-, Ohrenkranke, Kopf- und Halschirurgie, Szent Rokus Krankenhauses, Budapest/Ungarn.
The author reports on the methods and results of the last 10 years in the treatment of pseudo-paralysis caused by the adhesions and scars in the interary region and in the commissura posterior-bilateral vocal cord paralysis and severe scarred laryngeal stenoses. During the stated period 68 patients were operated on. 4 patients were treated by an endolaryngeal approach for scarred adhesions developing in the interary region or in the commissura posterior. The operation was successful in all 4 patients. In 4 cases of laryngeal stenoses resulting from bilateral vocal cord paralysis, the Rethi-type operation was performed successfully in each case. In 33 cases, of which 32 could be analysed, the laryngo-microsurgical latero-fixation method was applied, with or without arytaenoidectomy, based on the endo-extralaryngeal suture technique developed by the author in previous animal experiments. In 29 patients the cannula was successfully removed after the endoscopic operations. 27 patients were operated on severe laryngeal stenoses. Of the 27 patients 24 had the cannula removed after the operations. In 3 patients the operations proved unsuccessful, and in these cases further operations are necessary.
PMID: 7945663 [PubMed - indexed for MEDLINE]
51. Lichtenberger, G.: Hygienische Aspekte bei laryngektomierten (laryngopharyngektomierten) Patienten. Laryngo-Rhino-Otol. (Stuttgart) 73: 456, (1994)
Laryngorhinootologie. 1994 Aug;73(8):456.
[Hygienic aspects in laryngectomized (laryngopharyngectomized) patients]
Abteilung fur Hals-, Nasen-, Ohrenkranke, Kopf- und Halschirurgie, Szent Rokus Krankenhauses, Budapest, Ungarn.
PMID: 7945668 [PubMed - indexed for MEDLINE]
52. Lichtenberger, G.: Reconstructive and Postoperative Hygienic Aspect by the Laryngectomised (Laryngo-pharyngectomised) Patients. Choroby hlavy a krku (Head and Neck Diseases), Bratislava, Cislo 3-4: 69-70, (1994)
53. Lichtenberger, Gy.: A bénult hangszalagok egyszerű endoszkópos laterofixációja laser és új varrattechnika segítségével. Fül-orr-gégegyógy. 41: 44-50, (1995)
54. Lichtenberger, Gy.: Sebészi törekvéseink a Heimlaryngectomiák utáni gégeszűkületek megelőzésére. A daganatellenes küzdelem Pest megyei pillanatképei. II. 52-59. (1995)
55. Lichtenberger, Gy.: A Blom-Singer punkciót egyszerűsítő módszer hangprotézis implantációhoz. Fül-orr-gégegyógy. 42: 197-200, (1996)
56. Lichtenberger, Gy.: Simplification of the Blom-Singer puncture. Medicinski Razgledi 1996; 35: Suppl 6: 129-131 (II Kongres Otorinolaringologov Slovenije, Ljubljana, Zbornik predavanj)
57. Lichtenberger, Gy.: Endoscopic management of scars in the posterior commissura. in O. Kleinsasser, H. Glanz and J. Olofson: Advances in Laryngology in Europe. Elsevier Science B.V., Amsterdam, 1997.
58. G. Lichtenberger, R. J. Toohill: Technique of Endo-Extralaryngeal Suture Lateralization for Bilateral Abductor Vocal Cord Paralysis. The Laryngoscope (St. Louis), 107, 1281-1283, 1997.
Laryngoscope. 1997 Sep;107(9):1281-3.
Technique of endo-extralaryngeal suture lateralization for bilateral abductor vocal cord paralysis.
Department of Otorhinolaryngology-Head and Neck Surgery, Szent Rokus Hospital, Budapest, Hungary.
PMID: 9292618 [PubMed - indexed for MEDLINE]
59. Lichtenberger, Gy.: Az inter-ary területen és a commissura posteriorban kialakult heges összenövések endoscopos microsebészeti megoldása. Fül-orr-gégegyógy. 43: 254-261, (1997)
60. Kaszás Zs., Lichtenberger Gy.: Orrgarati vérzést okozó rostasejt haemangiopericytoma műtéti megoldása. Fül-orr-gégegyógyászat 43. 273-276, 1997.
61. Lichtenberger, G.: New and Simple Endo-extra Oesophagotracheal Method of Developing the Fistula for the Implantation of a Voice Prosthesis. Diagnostic and Therapeutic Endoscopy 1997; 3: 189-191.
62. Lichtenberger, G.: Open and Endoscopic Surgical Techniques for the Treatment of Scarred Laryngeal Stenosis. Operative Techniques in Otolaryngology-Head and Neck Surgery, (USA, Chicago) 9: 150-153, (1998).
63. Lichtenberger, G., R. J. Toohill: Endo-Extralaryngeal Suture Technique for Endoscopic Lateralization of Paralyzed Vocal Cords. Operative Techniques in Otolaryngology-Head and Neck Surgery, (Chicago, IL, USA) 9: 166-171, (1998)
64. Lichtenberger, Gy.: Strumektómia után kialakult kétoldali hangszalagbénulás endoszkópos műtéti kezelése tracheostomia nélkül. Magyar Sebészet 51: 61-63, (1998)
65. Lichtenberger, Gy.: Kétoldali hangszalagbénulás endoscopos műtéti kezelése egyszerű varrattechnika segítségével tracheostomia nélkül. Fül-orr-gégegyógy. 43: 8-13, (1998)
66. Lichtenberger, Gy., Balatoni, Zs., Horváth, E., Boronkai, G., Vicsi, K.: A myotomia jelentősége hangprotézis implantáció kapcsán. Fül-orr-gégegyógy. 44: 111-115, (1998)
67. Lichtenberger, G.: Reversible immediate and definitive lateralization of paralyzed vocal cords. Eur Arch Otorhinolaryngol 256: 407-411, (1999)
Eur Arch Otorhinolaryngol. 1999;256(8):407-11.
Reversible immediate and definitive lateralization of paralyzed vocal cords.
Szent Rokus Hospital and Institutions, Department of Otorhinolaryngology, Head and Neck Surgery, Gyulai Pal u. 2, H-1085 Budapest, Hungary.
The author reports on glottis dilation operations based on the endoextralaryngeal suture technique he has developed. In all, 101 patients were operated on for bilateral recurrent nerve paralysis using different variations of the above method, of which 73 have had more than 1 year of follow-up. Dilation was performed in 52 patients following tracheostomy, whereas no tracheostomy was performed in 21 patients. In 9 cases irreversible laterofixation without tracheostomy was performed with good results. In 12 patients a reversible glottis dilating operation was carried out without tracheostomy not long after the development of bilateral paramedian position of the vocal cords. Tracheostomy was necessary in 1 of 12 patients, who underwent reversible glottis dilating operations. In this case later reoperation, using a definitive endoscopic glottis dilating operation, was performed with success. Three patients required reoperation using open surgical procedures after irreversible endoscopic laterofixation methods.
PMID: 10525946 [PubMed - indexed for MEDLINE]
68. Lichtenberger, G.: Endoscopic microsurgical management of scars in the posterior commissure and interarytenoid region resulting in vocal cord pseudoparalysis. Eur Arch Otorhinolaryngol 256: 412-414, (1999)
Eur Arch Otorhinolaryngol. 1999;256(8):412-4.
Endoscopic microsurgical management of scars in the posterior commissure and interarytenoid region resulting in vocal cord pseudoparalysis.
Szent Rokus Hospital and Institutions, Department of Otorhinolaryngology, Head and Neck Surgery, Gyulai Pal u. 2, H-1085 Budapest, Hungary.
The author reports his treatment of scars in the interarytenoid region of the larynx and the surgical management of scars in the posterior commissure based on the endoextralaryngeal suture technique and the needle carrier he developed. After the examination by electromyography, the scars are separated endoscopically. To prevent recurrent scarring and adhesions, two procedures are applied to the posterior commissure. When the size of the scars does not exceed 5 mm, both vocal cords are lateralized temporarily once the scars have been separated. In this way, the surfaces of the scars do not touch, thus preventing adhesion. When the scars are larger than 5 mm but less than 10 mm, a soft silicon stent replicating the shape of the lumen is fixed between the scars in the lumen of the larynx using the author's technique and suture device. The laterofixing sutures and silicon stent are removed in the fourth postoperative week. As a result of the operation, the lumen of the larynx has been found to be of adequate width and suitable for normal breathing and sound formation. These procedures have been applied successfully in 12 out of 13 patients.
PMID: 10525947 [PubMed - indexed for MEDLINE]
69. G. Lichtenberger: Recent Aspects, Methods and Devices for Surgical Voice Rehabilitation after Laryngectomy. Med Razgl 2000; 39: S3 63-68
70. Lichtenberger, Gy., Mészáros, B., Boronkai G.: Fejfájást és szájzárat okozó fossa pterygopalatina tályog műtéti megoldása. Fül-orr-gégegyógy. 46: 269-274, (2000)
71. Lichtenberger, Gy.: Egyszerű és biztonságos primer és secunder punkciós módszer hangprotézis implantációhoz. Fül-orr-gégegyógy. 46: 163-168, (2000)
72. Lichtenberger, G.: Diagnostik und Therapie ein- und beidseitiger Rekurrensparesen. Laryngo-Rhino-Otol 2000; 79: 682-683
Laryngorhinootologie. 2000 Nov;79(11):682-3.
[Diagnosis and therapy of uni- and bilateral recurrent laryngeal nerve paralysis]
Szent Rokus Krankenhaus und Institutionen Abt. fur Hals-Nasen-Ohrenkranke, Kopf- und Halschirurgie Gyulai Pal u. 2. 1085 Budapest Hungary.
PMID: 11138515 [PubMed - indexed for MEDLINE]
73. Lichtenberger, G.: Advances and refinements in the surgical voice rehabilitation after laryngectomy. Eur Arch Otorhinolaryngol 258: 281-284, (2001)
Eur Arch Otorhinolaryngol. 2001 Aug;258(6):281-4.
Advances and refinements in surgical voice rehabilitation after laryngectomy.
Szent Rokus Hospital and Institutions, Department of Otorhinolaryngology, Head and Neck Surgery, Budapest, Hungary.
After Blom and Singer reported the construction of the so-called "duck bill" prosthesis in 1980, there have been quite a few newer voice prostheses constructed by other workers and new methods developed to predict the results, such as the insufflation and lidocaine test. Implanting the voice prosthesis with the Blom-Singer method has presented some problems and complications related to the puncture technique, therefore the following simplified esophagotracheal puncture technique is presented. The pharynx is opened with the laryngoscope which is then led up to the entrance of the esophagus. Through the laryngoscope, the distal end of the endo-extralaryngeal needle carrier, developed by the author and modified for mass production by R. Wolf Ltd., Germany, is led into the esophagus. The instrument is pushed forward as long as its distal bent, blunt end is palpable in the upper third of the tracheostoma. The needle with the thread (2/0 prolene) is pushed through from the inside, out in the upper third of the tracheostoma. A double wire forming a loop is led through the pointed metal cone (containing a built-in needle) and the catheter and tied behind a counterfixing pierced ball. The 2/0 prolene leading thread is then knotted with the wire. By pulling the thread and the wire, the pointed end of the metal cone with the needle built-in, perforates the soft parts and pulls the catheter with it (the same procedure will be used for primary puncture as well). After this procedure the voice prosthesis can easily be placed in the fistula in a conventional manner. Using this technique, 59 patients could be implanted without puncture-related complications or problems. Problems, not related to the puncture technique, such as Candida albicans infection etc., were solved using the well-known treatment modalities. To stop leakage around the prosthesis, injection of Bioplastique into the soft tissue surrounding the fistula was used with success.
PMID: 11583466 [PubMed - indexed for MEDLINE]
74. Leitersdorfer, S., Lichtenberger Gy., Kovács I., Boronkai G.: Endoszkópos hangréstágító műtéteink eredményei a légzésfunkciós vizsgálatok tükrében. Fül-orr-gégegyógy. 47: 37-40, (2001)
75. Kaszás Zs., Lichtenberger Gy., Mészáros K.: Az adductor typusú spasmodicus dysphonia kezelése EMG-kontroll melletti Botulinum "A" injektálással. Fül-orr-gégegyógy. 47: 24-27, (2001)
76. Mészáros K., Lichtenberger G., Kaszás Zs.: Spazmodikus dysphonia adduktor típusának foniátriai elemzése Botulinum-toxin intralaryngealis injektálása után. Fül-orr-gégegyógyászat 47: 3, (2001)
77. Lichtenberger Gy., Mészáros B., Leitersdorfer S., Szűcs E.: Sikeres titánium implantálás és endoszkópos laser divertikulotómia Zenker divertikulum eredménytelen külső műtéte után. Fül-orr-gégegyógy. 47: 4. (200l)
78. Lichtenberger, G.: Operations for preservation and correcton of the function by the management of larynx-hypopharynx cancers and their metastases. Tectum Verlag Marburg Metastases in Head and Neck Cancer. Proceedings of the 2nd International Symposium January 25-27, 2001, Marburg, Germany. 287-292 (2001).
79. Lichtenberger, G.: Reversible lateralization of the paralyzed vocal cord without tracheostomy. Ann Otol Rhinol Laryngol. 111: 21-26 (2002)
Ann Otol Rhinol Laryngol. 2002 Jan;111(1):21-6.
Reversible lateralization of the paralyzed vocal cord without tracheostomy.
Department of Otorhinolaryngology-Head and Neck Surgery, Szent Rokus Hospital and Institutions, Budapest, Hungary.
The initial management of bilateral abductor vocal cord paralysis is usually tracheostomy. It is proposed that a reversible endoscopic vocal cord lateral fixation would avoid this morbid procedure. The operation is performed by laryngoscopy utilizing the endo-extralaryngeal suture technique of Lichtenberger. Two polypropylene sutures are looped over one of the paralyzed vocal cords and brought out through the neck skin. A small incision is made, and the sutures are secured in the sternohyoid muscle. If movement of one or both vocal cords returns, the sutures are removed. Sixty-one of 63 cases were successful. In 53 cases, the airway became stable, without return of function. In 8 cases, one or both of the vocal cords became mobile 3 to 4 months after the operation. The reversible endo-extralaryngeal lateralization of the vocal cord using the above suture technique ensures a stable airway immediately. This technique avoids the need for tracheostomy in cases of bilateral abductor vocal cord paralysis.
PMID: 11800366 [PubMed - indexed for MEDLINE]
80. Leitersdorfer, S., Lichtenberger G., Kovács I.: Assesment of the results of glottis- dilating operations using lung function tests. Eur Arch Otorhinolaryngol. (2002) 259: 57-59
Eur Arch Otorhinolaryngol. 2002 Feb;259(2):57-9.
Assessment of the results of glottis-dilating operations using lung function tests.
Szent Rokus Hospital and Institutions, Department of Otorhinolaryngology, Head and Neck Surgery, Budapest, Hungary. ST_ROKUS@FREEMAIL.HU
Our aim was to obtain an objective evaluation of the airway before and after glottis-dilating operations utilizing lung function tests. The charts of 109 patients who underwent either reversible or irreversible glottis-dilating operations by Lichtenberger were reviewed. 64 nonselected cases of these patients, all with irreversible glottis-dilating operations, were studied. Lung function tests that were performed were body-pletysmography, forced inspiratory volume (FIV1), forced expiratory volume (FEV1), peak inspiratory flow rate (PIF), peak expiratory flow rate (PEF) and resistance of the airways (RAW). The FEV1, FIV1, PEF and PIF all improved following irreversible glottis-dilating operations. The RAW was remarkably decreased post-operatively as compared to pre-operatively. In conclusion, the airways of patients undergoing irreversible glottis-dilation operations improved moderately to well following such surgeries. Lung function tests are an objective means of evaluating the airway before and after surgery
PMID: 11954932 [PubMed - indexed for MEDLINE]
81. Lichtenberger Gy., Mészáros B., Huszka J., Boronkai G.: Kiterjedt szupraglottikus daganatok kezelése endoszkóposan laserrel tracheotomia nélkül. Fül-orr-gégegyógy. 48: 213-218, (2002)
82. Zs. Kaszás, G. Lichtenberger, K. Mészáros, J. Falvai: Spasmodic Dysphonia Combined with Insufficient Glottic Closure by Phonation. Eur Arch Otorhinolaryngol 260:418-420 (2003)
Eur Arch Otorhinolaryngol. 2003 Sep;260(8):418-20. Epub 2003 Apr 23. Links
Spasmodic dysphonia combined with insufficient glottic closure by phonation.
Szent Rokus Hospital and Institutions, Department of Otorhinolaryngology and Head and Neck Surgery, Gyulai Pal u. 2., 1085 Budapest, Hungary. orl.rokus@mailbox.hu
The authors describe the case history of a patient who suffered from symptoms deriving from two different origins. The patient's voice was spasmodic dysphonia-like interrupted and pressed. At the same time, his voice was powerless, too. The reason for this was that besides the spasmodic dysphonia caused by hyperkinesis, an incomplete closure of the vocal cords during phonation in the middle third was present. It was caused by the atrophy of the vocal cords. In order to eliminate the symptoms, initially we injected 25 IU Botox into the left vocal cord transcutaneously under the direction of EMG control. It resulted in a fluent, though breathy voice. In order to manage the closing insufficiency during phonation, we performed lipoaugmentation on the left vocal cord under high-frequency jet anaesthesia. The result of the two-step procedure was a fluent and clear voice. The speech without interruption lasted for 5 months, until the drug was eliminated. Of course, to prolong the result, the Botox injection should be repeated.
PMID: 12709812 [PubMed - indexed for MEDLINE]
83. Boronkai G., Lichtenberger Gy., Mészáros B., Reményi Á.: Az inszufflációs teszt szerepe a hangprotézis implantáció eredményeinek előrejelzésében. Fül-orr-gégegyógy. 49:1, (2003)
84. Lichtenberger, G.: Comparison of endoscopic glottis-dilating operations. Eur Arch Otorhinolaryngol, 260: 57-61 (2003)
Eur Arch Otorhinolaryngol. 2003 Feb;260(2):57-61. Epub 2002 Sep 4.
Comparison of endoscopic glottis-dilating operations.
Szent Rokus Hospital and Institutions, Department of Otorhinolaryngology, Head and Neck Surgery, 1085 Budapest, Gyulai Pal u. 2., Hungary. orl.rokus@mailbox.hu
Endoscopic glottis-dilating operations were first utilized in 1948 by Thornell, who performed an endolaryngeal arytenoidectomy. The real breakthrough in these operations was reported by Kleinsasser in 1968. There have been many modifications of the endoscopic glottis dilating operations by other authors over the past 30 years or more. These methods have brought great progress in relieving airway obstruction. However, some disadvantages have reduced the effectiveness of these operations. This study will compare the advantages and disadvantages of the previous methods and compare them to the methods based on the endo-extralaryngeal suture technique by Lichtenberger in the hope that some of the previous ineffectiveness of glottis-dilating operations can be eliminated. These recent endo-extralaryngeal suture techniques consist of two operations. The first operation performed on patients whose vocal cords were paralyzed is an irreversible operation. This was performed with and without arytenoidectomy. These operations were successful in 89 out of 94 patients. The second operation was reversible endo-extralaryngeal lateralization, which was carried out in 37 patients; of these operations, 35 were successful. The operation was performed, and, if the cords remained paralyzed, the suture was not removed. If there was evidence of a return of vocal cord function, the suture was removed, eliminating the need for further dilating operations. The author feels that these two operations are quite successful, because the medial mucous membrane of the vocal cord is preserved, and this avoids the scar and granuloma formation that are characteristic of most other glottic dilating operations.
PMID: 12582779 [PubMed - indexed for MEDLINE]
85. Lichtenberger, G.: Simple and Safe Puncture Technique for Voice Prosthesis Implantation. Otolaryngology, Head and Neck Surgery (St. Louis), 128: 835-840 (2003)
86. Reményi Á., Lichtenberger Gy., Pólus K.: Laryngectomia és partialis pharyngectomia utáni szabadlebenyes pótlást követő aphonia kezelése hangprotézissel és stomaszeleppel. Fül-orr-gégegyógy. 49, 141-144, (2003)
87. Lichtenberger, Gy.: Pajzsmirigy műtétek a gégeidegek felkeresésével EMG vezérelt neuromonitoros kontroll mellett. Magyar Orvos 11: 37, (2003)
88. Lichtenberger, G.: Prevention and management of bilateral vocal cord paralysis by and after thyroid surgery. Otolaryngologia Polska (1) 165-171, 2004
Otolaryngol Pol. 2004;58(1):165-71.
Prevention and management of bilateral vocal cord paralysis by and after thyroid surgery.
Department of Otorhinolaryngology, Head and Neck Surgery, Szent Rokus Hospital and Institutions, Budapest, Hungary. orl.rokus@mailbox.hu
Following the great tradition established in the Szent Rokus Hospital and Institutions by author's predecessor Prof. Aurel Rethi, there have been more than 300 patients operated on for treatment of laryngotracheal stenosis. The vast majority of the cases referred to the department suffering from bilateral vocal cord paralysis were the consequences of thyroid surgery and its complications. Confronted with this challenging clinical scenario, the author became determined to focus not only on reconstruction but also on prevention. For example, all thyreoidectomies are performed with identification and preservation of the recurrent nerves. As the author's department is a center for laryngotracheal reconstruction, patients from different institutions were treated with larynx dilating operations, benefiting from the newly developed additional techniques. With the goal of refining alternatives to previous glottis dilating operations, new methods have been worked out for the management of bilateral vocal cord paralysis based on our endo-extralaryngeal suture technique. These recently popularized approaches consist of two operations, an irreversible one and a reversible one. The first operation is performed on patients whose vocal cords are paralyzed. This irreversible operation can be performed with and without arytenoidectomy. These operations were successful in 94 out of 99 patients. The second operation was the reversible endo-extralaryngeal lateralization, which was carried out in 63 patients, 61 of which were successful. In the reversible technique the suture was not removed if the cords remained paralyzed. If there was evidence of return of vocal cord function, the suture was removed, thus eliminating the need for further dilating operations. The author feels that these two operations are quite successful because the medial mucous membrane of the vocal cord is preserved, avoiding scar and granuloma formation. The operations may be performed without any kind of tracheostomy. These are significant advantages over most other glottic dilating operations.
PMID: 15101276 [PubMed - indexed for MEDLINE]
89. Lichtenberger, G: Development of a new method and device for securing haemostasis during tansoral surgery: in vitro and cadaver experiments. Eur Arch Otorhinolaryngol. 261: 409-410 (2004)
Eur Arch Otorhinolaryngol. 2004 Aug;261(7):409-10. Epub 2003 Nov 4.
Development of a new method and device for securing haemostasis during transoral surgery: in vitro and cadaver experiments.
Department of Otorhinolaryngology and Head and Neck Surgery, Szent Rokus Hospital, Gyulai P.u.2, 1085 Budapest, Hungary. orl.rokus@mailbox.hu
The objective of this study is to present cadaver and model experiments of an instrument and technique that may overcome the problems of achieving hemostasis after tonsillectomy and surgery of the tongue base. The safety and the reduced need for microclips in surgeries in these areas can be accomplished by introducing the "ligature" device, which makes it possible to pass a suture under a blood vessel or other diffuse areas of bleeding with a single movement. This technique may also be applied to operations on the supraglottic larynx, oropharynx and hypopharynx. Utilization in the larynx may be more limited. This new instrument and technique for the ligature device has the potential to be applied successfully in other fields of surgery. The main advantages of this technique are its simplicity and safety.
PMID: 14598176 [PubMed - indexed for MEDLINE]
90. N. Sapundzhiev, B.M. Lippert, G. Lichtenberger, J.A. Werner: Reversible Surgery for Glottis Enlargement in Bilateral Vocal Fold Paralysis in Adduction. Otorhino-laryngologia. (Bulgaria) 7/8: 7-13 (2004)
91. Lichtenberger, Gy.: A funkciómegőrzés, -helyreállítás, illetve korrekció szempontjai a gége- algarati tumorok és metasztázisainak kezelése során. Fül-orr-gégegyógy. 50: 47-54, (2004)
92. Lichtenberger, Gy.: Nyelvgyök, garat, gége és algarati vérzések transzoralis csillapítására szolgáló módszerek és műszer kísérletes kialakítása. Fül-orr-gégegyógy. 50: l42-145, (2004)
93. Reményi A., Lichtenberger Gy., Kovács V., Bihari A.: A hangprotézis implantáció eredményének javítása myotomiával. Fül-orr-gégegyógy. 50: 221-223, (2004)
94. B.B. Lőrincz, G. Lichtenberger, A. Bihari, J. Falvai et al.: Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice-prosthesis. Eur Arch Otorhinolaryngol. (2005) Jan; 262 (1): 32-4.
Eur Arch Otorhinolaryngol. 2005 Jan;262(1):32-4. Epub 2004 Feb 18.
Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice prosthesis.
Department of Otorhinolaryngology and Head and Neck Surgery, Szent Rokus Hospital, Gyulai Pal utca 2, 1085, Budapest, Hungary. orl.rokus@mailbox.hu
Having a voice prosthesis provides a good possibility for speech rehabilitation after total laryngectomy has been performed, especially if common complications such as leakage around the valve can be reduced effectively. The early applications of a voice prosthesis-which was originally invented and applied by Mozolewski in 1972, was further developed by Blom and Singer and became an internationally available implantable instrument by 1980- already made clear not only the typical benefits, but also the complications, such as possible leakage around the implanted valve. Remacle proposed the injection of collagen into the surrounding tissues in order to stop leakage. Knowing that collagen is usually resorbed as time goes by, new substances that can be tolerated by human tissues must be found. This article reports the experiences of the authors in the search for such an injectable material that cannot be resorbed and does not migrate. In order to solve the above-mentioned problem, Lichtenberger introduced the injection of Bioplastique into the perivalvular tissues. This delivered the best results ever achieved in this field at our department. During the past 2 years, Bioplastique augmentation was performed for seven laryngectomized and speech-rehabilitated patients in order to reduce periprosthetical leakage. All procedures were successful in terms of either eliminating or reducing the leakage, and also the non-resorbable property of Bioplastique has been proven.
PMID: 14986020 [PubMed - indexed for MEDLINE]
95. S. Leitersdorfer, G. Lichtenberger, A. Bihari, I. Kovács: Evaluation of the lung function test in reversible glottis dilating operations. Eur Arch Otorhinolaryngol (2005) 262: 289-293
Eur Arch Otorhinolaryngol. 2005 Apr;262(4):289-93. Epub 2004 Jul 2.
Evaluation of the lung function test in reversible glottis-dilating operations.
Department of Otorhinolaryngology and Head and Neck Surgery, Szent Rokus Hospital and Institutions, Gyulai Pal u.2., 1085 Budapest, Hungary. orl.rokus@mailbox.hu
Our aim was to obtain an objective evaluation of the airway before and after reversible glottis-dilating operations using the lung function test. Bilateral abductor vocal cord paralysis remains mostly a complication of thyroid surgery. After thyroid surgery, the paralysis is potentially reversible, and the patient has a chance for recovery mostly in the first 6 months. According to these considerations, a reversible vocal cord laterofixation procedure was used instead of tracheostomy. The operations were performed endoscopically using high-frequency JET ventilation and the special endo-extralaryngeal suture technique by Lichtenberger. This technique was used in 92 cases. The pre- and postoperative data of reversible glottis-dilating techniques could be compared in 23 non-selected patients. Lung function tests that were performed were forced inspiratory volume (FIV1), forced expiratory volume (FEV1), peak inspiratory flow rate (PIF), peak expiratory flow rate (PEF) and resistance of the airways (Raw). For the evaluation of the functional results, we used the body-pletysmograph. Our aim was to obtain a quantitative evaluation of the results. These values allow us to compare the results achieved by using different glottis-dilating methods. The FEV1 (forced expiratory volume) improved 25%, and the FIV1 (forced inspiratory volume) improved 39% after the operations on average. PEF (peak expiratory flow rate) and PIF (peak inspiratory flow rate) improved 37 and 45% after glottis-dilating surgery on average. The Raw (resistence of airways) was 271.5% on average before the operations, and after reversible glottis-dilating operations decreased to a level of 200.6%.
PMID: 15235798 [PubMed - indexed for MEDLINE]
96. Lichtenberger Gy., Kaszás Zs., Reményi Á.: EMG, Mitomycin-C és endo-extralaryngealis varrattechnika jelentősége a commissura posterior stenosis kezelésében. Fül-orr-gégegyógy. 51: 2, (2005)
97. Kovács V., Lichtenberger Gy., Bihari A., Boronkai G.: Laser dermabrasio a rhinophyma kezelésében. Fül-orr-gégegyógy. 51: 64-67, (2005)
98. G. Lichtenberger: Therapie von Stimmbandlähmungen. HNO-Aktuell 13, 337-342, (2005)
99. G. Lichtenberger: Development of a new method and device for adaptation and suture of tissues during transoral surgery: In vitro and cadaver experiments. Otolaryngology - Head and Neck Surgery (2005) 133, 62-65
Otolaryngol Head Neck Surg. 2005 Jul;133(1):62-5.
Development of a new method and device for adaptation and suture of tissues during transoral surgery: in vitro and cadaver experiments.
Department of Otorhinolaryngology, Head and Neck Surgery, Szent Rokus Hospital and Institutions, Budapest, Hungary.
OBJECTIVE: The objective of this study was to present cadaver and model experiments of a technique using an instrument that may overcome the problems of achieving adaptation and suture of mucous membrane and other tissues during transoral surgery in narrow anatomical circumstances. STUDY DESIGN: The following interventions were carried out on cadavers: adaptation and suture of mucous membrane by uvulopalatopharyngoplasty (UPPP); release and anteroposition of the epiglottis and fixation to the vallecula or to the base of the tongue; denudation and closing the lumen of the larynx; release and retroposition and fixation of the epiglottis to the posterior part of the larynx; creation, adaptation, and suturing of mucosal flaps in the posterior part of the larynx; craniolateral mobilization and fixation of the vocal cord; submucous excision of excess tissues; and adaptation and suture of the edges of the mucosa. RESULTS: The safety and reduced need for microclips in surgeries in these areas can be accomplished by introducing the Ligature-Suture device, which makes it possible to pass a suture under the tissues with a single movement. CONCLUSIONS: This new technique and instrument for the Ligature-Suture device has the potential to be applied successfully in other fields of surgery. The main advantages of this technique are its simplicity and safety.
PMID: 16025054 [PubMed - indexed for MEDLINE]
100. Lichtenberger Gy.: A kétoldali hangszalagbénulás megelőzése pajzsmirigy műtétek során, illetve a kialakult hangszalagbénulás mikrosebészi kezelése. Orvosi Hetilap 147: 293-299, (2006)
101. Lichtenberger Gy.: Jelölő módszerünk a cricotrachealis és trachea szűkületek rekonstrukciójához. Fül-orr-gégegyógy. 52: 104-107, (2006)
102. A. Bihari, K. Mészáros, A. Reményi, G. Lichtenberger: Voice quality improvement after management of unilateral vocal cord paralysis with different techniques. European Archives of Oto-Rhino-Laryngology DOI:10.1007/s00405-006-0116-9
Eur Arch Otorhinolaryngol. 2006 Aug 9; [Epub ahead of print]
Voice quality improvement after management of unilateral vocal cord paralysis with different techniques.
Department of ORL and Head and Neck Surgery, Szent Rokus Hospital and Institutions, Gyulai Pal u.2, 1085, Budapest, Hungary, bihari_adel@freemail.hu.
The aim of this study was to objectively evaluate the voices of patients suffering from unilateral vocal cord paralysis, before and after endoscopic augmentation and thyroplasty. In the past, we used injectable Teflon to treat this condition; later techniques included collagen injection and Isshiki thyroplasty. In the last 7 years, preferred treatment methods have included Bioplastique injection and lipoaugmentation of the vocal cords as well as medialization thyroplasty using a titanium implant according to Friedrich. Pre- and postoperative data was evaluated and compared to 25 patients. Appropriate glottic closure of the vocal cords was achieved in every case, in most cases after the first intervention. We used voice range profile measurements to evaluate the results. An objective evaluation was performed using the Friedrich dysphonia index. Significant improvements were found: the dysphonia index decreased in every case, from an average of 2.47, preoperatively, to an average of 1.18 postoperatively. In agreement with earlier studies, voice pitch range was the only parameter that not significantly improved. There was no statistical difference between the lipoaugmentation and thyroplasty according to Friedrich. We concluded that both endoscopic methods and thyroplasty can be used to achieve an optimal result. Cases must be evaluated individually so that the best technique, or combination of methods can be determined.
PMID: 16896756 [PubMed - as supplied by publisher]
103. Falvai J., Lichtenberger Gy., Reményi Á., Bihari A: A hangprotézis körüli szivárgás kezelése VOX-"implantatum" injektálásával. Fül-orr-gégegyógy. 52, 37-40. 2006.
104. Reményi Á., Lichtenberger Gy.: A trachea és a nervus laryngeus recurrensek traumás ruptúrájának kezelése anasztomózissal és laterofixációval. Fül-orr-gégegyógy. 52: 184-188, (2006)
105. P. Pogány, E. Szűcs, G. Lichtenberger, L.Vass: Diagnosis of human myiasis by fine needle aspiration cytology. Acta Cytologica (Accepted for publication) 2006
106. G. Lichtenberger: Diagnosis and Management of Unilateral Vocal Cord Paralysis. Journal of Indian Voice Association, vol 1. number 3, 8-14. 2006
107. G. Lichtenberger: DNew method developed in Cadaver experiment and Introduced int he Clinical Practice to control serious Hemorrhage by Transoral Operations. Journal of Indian Voice Association, vol 1. number 3, 3-7. 2006
108. G. Lichtenberger: A New Ligature-Suture Technique and Instrument to Control Difficult Pgaryngeal and Laryngeal Hemorrhage. Otolaryngology & Head and Neck Surgery. 136, 486-488, 2007
109. G. Lichtenberger, C. Sittel: Transkutane identifikation cricotrachealer und trachealer Stenosen. (Epub ahead of print) HNO 2006 DOI 10.1007/s00106-006-1492-6
110. G. Lichtenberger, C. Sittel, A. L. Merati, Á. Reményi: "How I do it" Endoscopic technique to mark the site of the stenosis for tracheal resection. (accepted for publication - The Journal of Laryngology & Otology-hoz)
111. Kovács V., Konrády A., Lichtenberger Gy.: "Myxödéma a gégében kétoldali hangszalagbénulás mellett. Fül-orr-gége¬gyógy. 53: 18-24, (2007)
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