nach oben

Indian Journal of Otolaryngology and Head & Neck Surgery

Erschienen in:

02.03.2023 | Original Article

Ayurvedic Drug Triphala in Combination with Providone Iodine Mitigates Radiation-Induced Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response

verfasst von: Suresh Rao, Venkataraman Kini, Sanath Kumar Hegde, Sharake Meera, Pratima Rao, Thomas George, Manjeshwar Shrinath Baliga

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Ausgabe 3/2023

Einloggen, um Zugang zu erhalten

Abstract

Radiation-induced mucositis is a dose-limiting concern in the treatment of head and neck cancers (HNC). This study was conducted to determine the effectiveness of the Ayurvedic drug Triphala in reducing radiation-induced mucositis and influencing tumour control when combined with providone iodine. Data from patient files of HNC patients who received Triphala in conjunction with iodine or iodine alone over the course of curative radiotherapy (> 60 Gy) from May 2013 to February 2015 were extracted for this retrospective chart based study. Data was subjected to statistical analysis, X2 and unpaired t test using the Statistical Package for Social Sciences (SPSS), version 17 (IBM, Chicago, USA). When compared to iodine alone, the group that utilised Triphala gargling was very efficient in delaying mucositis, the extent of weight loss (p = 0.038), the incidence (p = 0.03), and the number (p = 0.02) of treatment breaks. However, it had no influence on the radiation-induced tumour response. According to the observations, Triphala coupled with iodine was more successful in preventing radiation mucositis, and without affecting the killing of tumour cells than iodine gargle alone. According to the authors, this is the first observation to demonstrate the value of combining providone iodine with Triphala in preventing radiation-induced oral mucositis.

Sonis ST, Elting LS, Keefe D et al (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100(9 Suppl):1995–2025PubMed

Peterson DE (2006) New strategies for management of oral mucositis in cancer patients. J Support Oncol 4(2 Suppl 1):9–13PubMed

Kolokythas A (2010) Long-term surgical complications in the oral cancer patient: A comprehensive review. Part II J Oral Maxillofac Res 1(3):e2PubMed

Bossi P, Numico G, De Santis V et al (2014) Prevention and treatment of oral mucositis in patients with head and neck cancer treated with (chemo) radiation: report of an Italian survey. Support Care Cancer 22(7):1889–1896PubMed

Allison RR, Ambrad AA, Arshoun Y et al (2014) Multi-institutional, randomized, double-blind, placebo-controlled trial to assess the efficacy of a mucoadhesive hydrogel (MuGard) in mitigating oral mucositis symptoms in patients being treated with chemoradiation therapy for cancers of the head and neck. Cancer 120(9):1433–1440PubMed

Rosenthal D, Trotti A (2009) Strategies for managing radiation-induced mucositis in head and neck cancer. SeminRadiatOncol 19(1):29–34

Hadjieva T, Cavallin-Ståhl E, Linden M, Tiberg F (2014) Treatment of oral mucositis pain following radiation therapy for head-and-neck cancer using a bioadhesive barrier-forming lipid solution. Support Care Cancer 22(6):1557–1562PubMedPubMedCentral

Nicolatou-Galitis O, Sarri T, Bowen J et al (2013) Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients. Support Care Cancer 21:3179–3189PubMed

Rodríguez-Caballero A, Torres-Lagares D, Robles-García M, Pachón-Ibáñez J, González-Padilla D, Gutiérrez-Pérez JL (2012) Cancer treatment-induced oral mucositis: a critical review. Int J Oral Maxillofac Surg 41:225–238PubMed

10.

Sonis ST (2010) Efficacy of palifermin (keratinocyte growth factor-1) in the amelioration of oral mucositis. Core Evid 4:199–205PubMedPubMedCentral

11.

Panahi Y, Saadat A, Shadboorestan A, Ahmadi A (2016) An updated review of natural products intended to prevent or treat oral mucositis in patients undergoing radio-chemotherapy. Curr Pharm Biotechnol 17(11):949–961PubMed

12.

Ramsay EI, Rao S, Madathil L, Hegde SK, Baliga-Rao MP, George T, Baliga MS (2019) Honey in oral health and care: a mini review. J Oral Biosci 61(1):32–36PubMed

13.

Ong CK, Bodeker G, Grundy C, Burford G, Shein K (2005) WHO global atlas of traditional complementary and alternative medicine. World Health Organization, Kobe, Japan

14.

Booker A, Johnston D, Heinrich M (2012) Value chains of herbal medicines–research needs and key challenges in the context of ethnopharmacology. J Ethnopharmacol 140(3):624–633PubMed

15.

Ekor M (2014) The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol 4:177PubMedPubMedCentral

16.

Fischer N, Seo EJ, Efferth T (2018) Prevention from radiation damage by natural products. Phytomedicine 47:192–200PubMed

17.

Baliga MS (2010) Triphala, ayurvedic formulation for treating and preventing cancer: a review. J Altern Complement Med 16(12):1301–1308. https://doi.org/10.1089/acm.2009.0633. (PMID: 21138390)CrossRefPubMed

18.

Baliga MS, Meera S, Mathai B, Rai MP, Pawar V, Palatty PL (2012) Scientific validation of the ethnomedicinal properties of the Ayurvedic drug Triphala: a review. Chin J Integr Med 18(12):946–954PubMed

19.

Baliga MS, Meera S, Vaishnav LK, Rao S, Palatty PL (2013) Rasayana drugs from the ayurvedic system of medicine as possible radioprotective agents in cancer treatment. Integr Cancer Ther 12(6):455–463PubMed

20.

Karole S, Shrivastava S, Thomas S, Soni B, Khan S, Dubey J et al (2019) Polyherbal formulation concept for synergic action: a review. JDDT 9:453–466

21.

Deshpande A, Tandon S, Deshpande N (2014) Low resource screening method of pre-cancerous lesions and its reversal by Triphala in teen-age Indian population. Ayu 35(2):160–167PubMedPubMedCentral

22.

Phetkate P, Kummalue T, Rinthong PO, Kietinun S, Sriyakul K (2020) Study of the safety of oral Triphala aqueous extract on healthy volunteers. J Integr Med 18(1):35–40PubMed

23.

Madan PD, Sequeira PS, Shenoy K, Shetty J (2008) The effect of three mouthwashes on radiation-induced oral mucositis in patients with head and neck malignancies: a randomized control trial. J Cancer Res Ther 4(1):3–8PubMed

24.

Jeremic B, Zivic DJ, Djuric LJ, Mijatovic LJ. Carboplatin and radiation therapy for stage IV carcinoma of the head and neck. Preliminary results of a phase II study. J Chemother. 1992;4(3):180–4.PubMed

25.

Ackland SP, Hamilton CS, Joseph DJ, Denham JW (1993) Phase I/II study of concurrent weekly carboplatin and radiation therapy in advanced head and neck cancer. ClinOncol (R CollRadiol). 5(3):133–138. https://doi.org/10.1016/s0936-6555(05). (PMID: 8347534)CrossRef

26.

Pazdur R, Wagman LD, Camphausen K, Hoskins WJ (eds) (2009) Cancer Management: A Multidisciplinary Approach. Medical, Surgical, and Radiation Oncology, 12th edn. CMP Healthcare Media, Norwalk, CT

27.

Reimer RR, Gahbauer R, Bukowski RM, Hewlett JS, Groppe CW Jr, Weick JK, Antunez AR (1981) Simultaneous treatment with cisplatin and radiation therapy for advanced solid tumors: a pilot study. Cancer Treat Rep 65(3–4):219–222 (PMID: 7195303)PubMed

28.

Homma A, Inamura N, Oridate N, Suzuki S, Hatakeyama H, Mizumachi T, Kano S, Sakashita T, Onimaru R, Yasuda K, Shirato H, Fukuda S (2011) Concomitant weekly cisplatin and radiotherapy for head and neck cancer. Jpn J ClinOncol 41(8):980–986

29.

Rao S, Hegde SK, Rao P, Dinkar C, Thilakchand KR, George T, Baliga-Rao MP, Palatty PL, Baliga MS (2017) Honey mitigates radiation-induced oral mucositis in head and neck cancer patients without affecting the tumor response. Foods 6(9):77. https://doi.org/10.3390/foods6090077.PMID:28878156;PMCID:PMC5615289CrossRefPubMedPubMedCentral

30.

Hegde SK, Rao S, Rao P, Raghu SV, Meera S, Baliga MS. Aqueous Extract of Emblica officinalis Linn (Indian gooseberry) in Combination with Iodine is More Efficacious than Iodine Alone in Mitigating Mucositis in Head and Neck Cancer Patients Undergoing Curative Radiotherapy: Retrospective Observations. Indian J Otolaryngol Head Neck Surg. 2022. https://doi.org/10.1007/s12070-021-03059-w

31.

Sroussi HY, Epstein JB, Bensadoun RJ et al (2017) Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med 6(12):2918–2931PubMedPubMedCentral

32.

Maria OM, Eliopoulos N, Muanza T (2017) Radiation-induced oral mucositis. front. Oncol 7:89. https://doi.org/10.3389/fonc.2017.00089CrossRef

33.

Elting LS, Chang YC (2019) Costs of oral complications of cancer therapies: estimates and a blueprint for future study. JNCI Monographs. https://doi.org/10.1093/jncimonographs/lgz010CrossRef

34.

Jagetia GC, Baliga MS, Malagi KJ, Sethukumar KM (2002) The evaluation of the radioprotective effect of Triphala (an ayurvedic rejuvenating drug) in the mice exposed to gamma-radiation. Phytomedicine 9(2):99–108PubMed

35.

Jagetia GC, Malagi KJ, Baliga MS, Venkatesh P, Veruva RR (2004) Triphala, an Ayurvedic rasayana drug, protects mice against radiation-induced lethality by free-radical scavenging. J Altern Complement Med 10(6):971–978PubMed

36.

Yoon WS, Kim CY, Yang DS et al (2012) Protective effect of Triphala on radiation induced acute intestinal mucosal damage in Sprague Dawley rats. Indian J Exp Biol 50(3):195–200PubMed

37.

Sandhya T, Lathika KM, Pandey BN et al (2006) Protection against radiation oxidative damage in mice by Triphala. Mutat Res 609(1):17–25PubMed

38.

Takauji Y, Miki K, Mita J et al (2016) Triphala, a formulation of traditional Ayurvedic medicine, shows protective effect against X-radiation in HeLa cells. J Biosci 41(4):569–575PubMed

39.

Shi Y, Sahu RP, Srivastava SK (2008) Triphala inhibits both in vitro and in vivo xenograft growth of pancreatic tumor cells by inducing apoptosis. BMC Cancer 10(8):294. https://doi.org/10.1186/1471-2407-8-294. (PMID:18847491;PMCID:PMC2576337)CrossRef

40.

Russell LH Jr, Mazzio E, Badisa RB, Zhu ZP, Agharahimi M, Millington DJ, Goodman CB (2011) Differential cytotoxicity of Triphala and its phenolic constituent gallic acid on human prostate cancer LNCap and normal cells. Anticancer Res 31(11):3739–3745 (PMID: 22110195; PMCID: PMC3328776)PubMed

41.

Lu K, Chakroborty D, Sarkar C, Lu T, Xie Z, Liu Z, Basu S (2012) Triphala and its active constituent chebulinic acid are natural inhibitors of vascular endothelial growth factor-a mediated angiogenesis. PLoS ONE 7(8):e43934. https://doi.org/10.1371/journal.pone.0043934CrossRefPubMedPubMedCentral

42.

Prakash S, Shelke AU (2014) Role of Triphala in dentistry. J Indian Soc Periodontol 18(2):132–135PubMedPubMedCentral

43.

Shanbhag VK (2015) Triphala in prevention of dental caries and as an antimicrobial in oral cavity- a review. Infect Disord Drug Targets 15(2):89–97PubMed

44.

Safiaghdam H, Oveissi V, Bahramsoltani R, Farzaei MH, Rahimi R (2018) Medicinal plants for gingivitis: a review of clinical trials. Iran J Basic Med Sci 21(10):978–991PubMedPubMedCentral

45.

Prasad S, Srivastava SK (2020) Oxidative stress and cancer: chemopreventive and therapeutic role of Triphala. Antioxidants (Basel). 9(1):72. https://doi.org/10.3390/antiox9010072CrossRefPubMedPubMedCentral

46.

Al Jameel AH, Almalki SA (2020) Effect of Triphalamouthrinse on plaque and gingival inflammation: a systematic review and meta-analysis of randomized controlled trials. Int J Dent Hyg. https://doi.org/10.1111/idh.12444.10.1111/idh.12444CrossRefPubMed

47.

Bajaj N, Tandon S (2011) The effect of Triphala and Chlorhexidine mouthwash on dental plaque, gingival inflammation, and microbial growth. Int J Ayurveda Res 2(1):29–36PubMedPubMedCentral

48.

Naiktari RS, Gaonkar P, Gurav AN, Khiste SV (2014) A randomized clinical trial to evaluate and compare the efficacy of Triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases. J Periodontal Implant Sci. 44(3):134–140PubMedPubMedCentral

49.

Mamgain P, Kandwal A, Mamgain RK (2017) Comparative evaluation of Triphala and ela decoction With 0.2% chlorhexidine as mouthwash in the treatment of plaque-induced gingivitis and halitosis: a randomized controlled clinical trial. J Evid Based Complementary Altern Med. 22(3):468–472PubMed

50.

Baratakke SU, Raju R, Kadanakuppe S, Savanur NR, Gubbihal R, Kousalaya PS (2017) Efficacy of Triphala extract and chlorhexidine mouth rinse against plaque accumulation and gingival inflammation among female undergraduates: a randomized controlled trial. Indian J Dent Res 28(1):49–54PubMed

51.

Divia AR, Nair MG, Varughese JM, Kurien S (2018) A comparative evaluation of Morindacitrifolia, green tea polyphenols, and Triphala with 5% sodium hypochlorite as an endodontic irrigant against Enterococcus faecalis: an in vitro study. Dent Res J (Isfahan). 15(2):117–122PubMed

52.

Ramalingam K, Amaechi BT (2018) Antimicrobial effect of herbal extract of Acacia arabica with Triphala on the biofilm forming cariogenic microorganisms. J Ayurveda Integr Med. S0975-9476(17):30459–X

53.

Naiktari RS, Dharmadhikari C, Gurav AN, Kakade S (2018) Determining the antibacterial substantivity of Triphala mouthwash and comparing it with 0.2% chlorhexidine gluconate after a single oral rinse: a crossover clinical trial. J Indian Soc Periodontol. 22(6):498–502PubMedPubMedCentral

54.

Mazzola R, Fiorentino A, Ricchetti F, Gregucci F, Corradini S, Alongi F (2018) An update on radiation therapy in head and neck cancers. Expert Rev Anticancer Ther 18(4):359–364PubMed

55.

Phetkate P, Kummalue T, U-Pratya Y, Kietinun S (2012) Significant increase in cytotoxic T lymphocytes and natural killer cells by Triphala: a clinical phase I study. Evid Based Complement Alternat Med. https://doi.org/10.1155/2012/239856CrossRefPubMedPubMedCentral

56.

Kumar MS, Kirubanandan S, Sripriya R, Sehgal PK (2008) Triphala promotes healing of infected full-thickness dermal wound. J Surg Res 144(1):94–101PubMed

57.

Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG (2010) Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod 36(1):83–86PubMed

58.

Saxena D, Saha SG, Saha MK, Dubey S, Khatri M (2015) An in vitro evaluation of antimicrobial activity of five herbal extracts and comparison of their activity with 2.5% sodium hypochlorite against Enterococcus faecalis. Indian J Dent Res 26(5):524–527PubMed

59.

Srinagesh J, Pushpanjali K (2011) Assessment of antibacterial efficacy of Triphala against mutans streptococci: a randomised control trial. Oral Health Prev Dent 9(4):387–393PubMed

60.

Prabhakar J, Balagopal S, Priya MS, Selvi S, Senthilkumar M (2014) Evaluation of antimicrobial efficacy of Triphala (an Indian Ayurvedic herbal formulation) and 0.2% chlorhexidine against Streptococcus mutans biofilm formed on tooth substrate: an in vitro study. Indian J Dent Res 25(4):475–479PubMed

61.

Padiyar B, Marwah N, Gupta S, Padiyar N (2018) Comparative evaluation of effects of Triphala, garlic extracts, and chlorhexidine mouthwashes on salivary Streptococcus mutans counts and oral hygiene status. Int J ClinPediatr Dent 11(4):299–306

62.

Alizadeh E, Orlando TM, Sanche L (2015) Biomolecular damage induced by ionizing radiation: the direct and indirect effects of low-energy electrons on DNA. Annu Rev Phys Chem 66:379–398PubMed

63.

Naik GH, Priyadarsini KI, Bhagirathi RG, Mishra B, Mishra KP, Banavalikar MM, Mohan H (2005) In vitro antioxidant studies and free radical reactions of Triphala, an ayurvedic formulation and its constituents. Phytother Res 19(7):582–586PubMed

64.

Nariya M, Shukla V, Jain S, Ravishankar B. Comparison of enteroprotective efficacy of triphala formulations (Indian Herbal Drug) on methotrexate-induced small intestinal damage in rats. Phytother Res. 2009;23(8):1092–8. https://doi.org/10.1002/ptr.2744. PMID:19170156

65.

Sharma A, Sharma KK (2011) Chemoprotective role of Triphala against 1, 2-dimethylhydrazine dihydrochloride induced carcinogenic damage to mouse liver. Indian J ClinBiochem 26(3):290–295. https://doi.org/10.1007/s12291-011-0138-yCrossRef

66.

Baskaran UL, Martin SJ, Mahaboobkhan R, Prince SE (2015) Protective role of Triphala, an Indian traditional herbal formulation, against the nephrotoxic effects of bromobenzene in Wistar albino rats. J Integr Med 13(2):115–121PubMed

67.

Deep G, Dhiman M, Rao AR, Kale RK (2005) Chemopreventive potential of Triphala (a composite Indian drug) on benzo(a)pyrene induced forestomach tumorigenesis in murine tumor model system. J Exp Clin Cancer Res 24(4):555–563PubMed

68.

Srikumar R, Parthasarathy NJ, Manikandan S, Narayanan GS, Sheeladevi R (2006) Effect of Triphala on oxidative stress and on cell-mediated immune response against noise stress in rats. Mol Cell Biochem 283(1–2):67–74PubMed

69.

Dhanalakshmi S, Devi RS, Srikumar R, Manikandan S, Thangaraj R (2007) Protective effect of Triphala on cold stress-induced behavioral and biochemical abnormalities in rats. Yakugaku Zasshi 127(11):1863–1867PubMed

70.

Sabina EP, Rasool M (2008) An in vivo and in vitro potential of Indian ayurvedic herbal formulation Triphala on experimental gouty arthritis in mice. Vascul Pharmacol 48(1):14–20PubMed

71.

Kalaiselvan S, Rasool M (2015) Triphala exhibits anti-arthritic effect by ameliorating bone and cartilage degradation in adjuvant-induced arthritic rats. Immunol Invest 44(4):411–426PubMed

72.

Ingale DR, Kulkarni PG, Koppikar SJ, Harsulkar AM, Moghe AS, Jagtap SD (2018) Reduced synovial inflammation and inhibition of matrix metalloproteinases explicates anti-osteoarthritis activity of polyherbal formulations. Indian J Pharmacol 50(1):22–29PubMedPubMedCentral

73.

Sprung CN, Ivashkevich A, Forrester HB, Redon CE, Georgakilas A, Martin OA (2015) Oxidative DNA damage caused by inflammation may link to stress-induced non-targeted effects. Cancer Lett 356(1):72–81PubMed

74.

Khodamoradi E, Hoseini-Ghahfarokhi M, Amini P et al (2020) Targets for protection and mitigation of radiation injury. Cell Mol Life Sci 77(16):3129–3159PubMed

75.

Penmetsa GS, B V, Bhupathi AP, Rani P S, B V S, M V R (2019) Comparative evaluation of Triphala, aloe vera, and chlorhexidine mouthwash on gingivitis: a randomized controlled clinical trial. ContempClin Dent 10(2):333–337

76.

Sireeratawong S, Jaijoy K, Soonthornchareonnon N (2012) Evaluation of anti-inflammatory and antinociceptive activity of Triphala recipe. Afr J Tradit Complement Altern Med 10(2):246–250PubMedPubMedCentral

77.

Belapurkar P, Goyal P, Tiwari-Barua P (2014) Immunomodulatory effects of Triphala and its individual constituents: a review. Indian J Pharm Sci 76(6):467–475PubMedPubMedCentral

Titel: Ayurvedic Drug Triphala in Combination with Providone Iodine Mitigates Radiation-Induced Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response
verfasst von: Suresh Rao
Venkataraman Kini
Sanath Kumar Hegde
Sharake Meera
Pratima Rao
Thomas George
Manjeshwar Shrinath Baliga
Publikationsdatum: 02.03.2023
Verlag: Springer India
Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe 3/2023
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI: https://doi.org/10.1007/s12070-023-03516-8

Neu im Fachgebiet HNO

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Ayurvedic Drug Triphala in Combination with Providone Iodine Mitigates Radiation-Induced Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response

Abstract

Neu im Fachgebiet HNO

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

Update HNO

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2023

Modified Mustardé Flap for Lower Eyelid Reconstruction in Basal Cell Carcinoma: Revisited

A Comparative Study of Endoscopic Assisted Powered Adenoidectomy Versus Conventional Adenoidectomy

Correction to: Protocol for Evaluation and Management of Hearing Loss After Meningitis

Loosening of Teeth, an Unusual Presentation of Mucormycosis in COVID-19 Infected Patients

Latissimus Dorsi and DIEP Flaps for Pharyngeal Reconstruction: A Novel Indication

Incidence and Possible Predictive Factors of Facial Nerve Paralysis after Superficial Parotidectomy for Benign Tumours: Our Experience

Neu im Fachgebiet HNO

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

Update HNO