0000000000065301
AUTHOR
Alessandro De Stefano
showing 23 related works from this author
Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?
2011
Abstract Objective The aim of the study was to evaluate the true incidence, diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV) arising after whiplash injury and to distinguish this type of posttraumatic vertigo from other types of dizziness complained after trauma. Methods This was a retrospective study comprising patients referred to our center after whiplash injury. The patients were evaluated with neurotologic examination including bedside and instrumental tests. A Dizziness Handicap Inventory evaluating the symptoms of patients was submitted before and after treatment and was evaluated. The BPPV patients were separately evaluated from those with cervicogenic vertigo…
Otoneurological management of petrous apex cholesterol granuloma
2009
Objective: The aim of the study is to review the management of petrous apex cholesterol granuloma. The surgical approaches for drainage or total removal and the wait and see policy were analyzed, and outcomes were evaluated. Methods: Retrospective charts of 27 patients managed for petrous apex cholesterol granuloma with a minimum follow-up of 12 months were analyzed in a quartenary skull base center. Presenting symptoms and signs were recorded, and radiologic imaging was evaluated. Management options included wait and see policy and surgery by several approaches. Results: The mean age of patients affected by the lesion was 38.8 years. The mean follow-up was 56.7 months. Patients complained …
Chronic otitis caused by heterotopic brain tissue in pterygopalatine fossa
2007
Summary Heterotopic brain tissue is a rare is congenital anomaly, it may present at any age but it is frequently in infancy. This anomaly can occur most frequently in nasal region, although rests elsewhere in the digestive tract, in facial tissue or in lungs have been reported. Heterotopic brain tissue has been defined as a mass composed of mature brain tissue, outside the cranial cavity or spinal canal. We present a 9 years old girl with history of left chronic otitis and nasal obstruction caused by heterotopic brain tissue in pterygopalatine fossa.
Changes in Speech Range Profile Are Associated with Cognitive Impairment
2021
Background and Purpose The aim of this study was to describe the variations in the speech range profile (SRP) of patients affected by cognitive decline. Methods We collected the data of patients managed for suspected voice and speech disorders, and suspected cognitive impairment. Patients underwent an Ear Nose and Throat evaluation and Mini-Mental State Examination (MMSE). To obtain SRP, we asked the patients to read 18 sentences twice, at their most comfortable pitch and loudness as they would do in daily conversation, and recorded their voice on to computer software. Results The study included 61 patients. The relationship between the MMSE score and SRP parameters was established. Increas…
Treatment of sudden sensorineural hearing loss with transtympanic injection of steroids as single therapy: a randomized clinical study.
2011
The aim of this study was to verify the efficacy and the safety of transtympanic dexamethasone to treat sudden sensorineural hearing loss as first and single drug method. Considering ethical implication of performing a mininvasive procedure on middle ear, we matched such proposed treatment with systemic prednisone administration that represents the widest adopted protocol. Randomized prospective study was conducted. The inclusion criterion was a sudden sensorineural hearing loss of at least 30 dB across three contiguous frequencies over a period of 24 h. Group A received transtympanic steroid injections; Group B received oral administration of steroids. 25 patients were treated with transty…
Comparison of repositioning maneuvers for benign paroxysmal positional vertigo of posterior semicircular canal: advantages of hybrid maneuver.
2012
Objective: The prevalence of benign paroxysmal positional vertigo (BPPV) is becoming more frequent in elderly population. The presence of comorbid factors has to be considered before assessment as well as before commencing any repositioning treatment. Our aims were evaluation of the maneuvers efficacy and evaluation of the applicability of hybrid maneuver (HM) in patients with physical limitation. Study design and setting: This is a randomized study in 2 tertiary referral centers. Intervention: This is a therapeutic intervention. Patients: All consecutive patients with diagnosis of BPPV of posterior canal matching the inclusion criteria were enrolled. Patients underwent treatment soon after…
Oropharyngeal dysphagia in elderly population suffering from mild cognitive impairment and mild dementia: Understanding the link
2020
Abstract Purpose To evaluate the prevalence of oropharyngeal dysphagia in elderly patients suffering from minimal or mild cognitive decline. Patients and methods We retrospectively collected the data of patients suffering from mild cognitive impairment or mild dementia and were undergoing management for suspected oropharyngeal dysphagia, in our department. All our patients were subjected to Mini Mental State Examination test, MD Anderson dysphagia inventory and caregiver mealtime and dysphagia questionnaire. We performed a mealtime observation study and endoscopic evaluation of swallowing in all our patients. Following evaluation, we then analysed the data statistically. Results Out of 708 …
Imaging of Vestibular Schwannoma With Prevalent Cystic Component
2009
Not available
Solitary Vestibular Schwannoma: Decision Making of Treatments
2012
Therapeutic strategies of vestibular schwannomas treatment are changed in the last years. The improvement of surgical equipments and skills allowed increasing the numbers of successful operations in the last 10 years. The results improved in terms of survival, quality of life, recurrences, facial nerve function, and hearing preservation. Also the age of operated patients, once a restriction, becomes progressively a relative limitation to surgical indication. However the progressive widening of MRI availability give to the Otoneurologist the possibility to follow-up the patients with a relative simple radiological examination, delaying the decision to treat surgically the neoplasm only in ca…
Are postural restrictions necessary for management of posterior canal benign paroxysmal positional vertigo?
2011
Objectives: An important component of management of benign paroxysmal positional vertigo (BPPV) has been the application of postural restrictions after use of a canalith repositioning maneuver (CRM) to prevent the return of otolithic debris into the posterior semicircular canal (PSC). This study was designed to explore the effectiveness of postural restrictions in patients with BPPV caused by otolithic debris in the PSC. Methods: Seventy-four adult patients with unilateral PSC BPPV were enrolled into this study. All patients were managed with a CRM — Either the modified Epley maneuver or the Semont maneuver. The patients were divided randomly into 2 groups: Group A, with postural restrictio…
Sudden Sensorineural Hearing Loss: Results of intratympanic steroids as salvage treatment
2012
Objective: The aim of the present study was to verify the efficacy and the safety of intratympanic dexamethasone to treat sudden sensorineural hearing loss as salvage therapy. Materials and methods: A prospective study was conducted on patients affected by idiopathic sudden hearing loss who were treated before with some systemic therapy, but without recovery of the hearing The patients able to undergo the study, but who refused salvage treatment were considered as control group. A solution of Dexamethasone 4 mg/ml was then injected through the posterior–inferior quadrant filling completely the middle ear. The follow-up in the following 6 months included an audiogram every month. Results: Th…
Corrigendum to “A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo” [Au…
2014
Alessandro De Stefano *, Francesco Dispenza , Hamlet Suarez , Nicolas Perez-Fernandez , Raquel Manrique-Huarte , Jae Ho Ban , Min-Beom Kim , Michael Strupp , Katharina Feil , Carlos A. Oliveira , Andres L. Sampaio , Mercedes F.S. Araujo , Fayez Bahmad Jr., Mauricio M. Gananca , Fernando F. Gananca , Ricardo Dorigueto , Hyung Lee , Gautham Kulamarva , Navneet Mathur , Pamela Di Giovanni , Anna Grazia Petrucci , Tommaso Staniscia , Leonardo Citraro , Adelchi Croce a
Facial nerve schwannoma involving middle cranial fossa: When the unilateral sensorineural hearing loss guide to the correct diagnosis
2011
The Facial Nerve Schwannoma is a rare tumor and it seldom involved the middle cranial fossa. Facial nerve schwannoma has various manifestations, including facial palsy but unfortunately facial nerve is very resistant to compression and often facial nerve paralysis or a facial weakness are not present. We present a case of giant facial nerve schwannoma involved the middle cranial fossa without facial nerve paralysis. In these cases the unilateral hearing loss (if present) guide to a correct diagnosis.
Decision making for solitary vestibular schwannoma and contralateral Meniere's disease.
2007
The existence of dual inner ear pathology such as unilateral Meniere’s disease (MD) with a contralateral vestibular schwannoma (VS) is very rare, but provides the otologist with a significant management dilemma. In this study, we present 5 cases of unilateral disabling MD with a contralateral VS in the better hearing ear. Conservative management of the VS is mandated unless there are impending complications, with management directed toward controlling the vertigo attributed to MD. If and when the VS requires intervention, or the hearing in that ear deteriorates to unserviceable levels, cochlear implant of the ear affected by MD prior to addressing the VS provides optimal management.
Features of biopsy in diagnosis of metatypical basal cell carcinoma (Basosquamous Carcinoma) of head and neck
2012
Metatypical Basal Cell Carcinoma, also known as Basosquamous Carcinoma is a subtype of Basal Cell Carcinoma. It is similar to Basal Cell Carcinoma for the gross aspect and regional recurrences, but it has the capacity to spread and develop metastasis. This terrible characteristic endangers the life of the patient if it is not readily recognized by the physicians. Herein we present a report of two patients affected by BSC originating in the nasal region and external ear that after a series of devastating local recurrences metastasized to the lung and bones in one case. The true incidence of Basoquamous Carcinoma may be higher, with underreporting arising because of rarity of diagnosis and la…
Predictive factors of severity and persistence of oropharyngeal dysphagia in sub-acute stroke.
2020
Purpose: This study aims to understand the factors contributing to the severity of oropharyngeal dysphagia and its persistence in the sub-acute phase of stroke. Methods: We retrospectively collected the data of all the patients suffering from a stroke in the last year. The severity of stroke was reported according to the NIHSS score. All the patients were evaluated with the Dysphagia Risk Score and with a FEES. We classified the Dysphagia Risk Score and FEES results using the PAS score and ASHA-NOMS levels. The data were analysed statistically with ANOVA test, Student’s t test and Pearson’s correlation coefficient. Results: A series of 54 patients were evaluated. The ANOVA test did not find…
Malignant paroxysmal positional vertigo
2011
Objective: An insidious percentage of paroxysmal positional vertigo appears to be intractable with canalith repositioning maneuver and also is not self-limiting. This type of positional vertigo is sustained by the action of intracranial tumors that mimics the clinical aspects of benign paroxysmal positional vertigo.Aim of this study is to clarify the features of these forms of positional vertigo, which we indicate as malignant paroxysmal positional vertigo. Methods: We retrospectively reviewed the clinical records of all the patients who presented with vertigo spells and were managed at our tertiary care referral centre over a three years period. Two hundred and eleven patients with diagnos…
Intratympanic gentamicin: a 1-day protocol treatment for unilateral Meniere's disease
2006
Abstract Purpose The objective of this study was to assess the usefulness of low-dose intratympanic gentamicin administration in patients with Meniere's disease (MD). Materials and Methods We carried out a retrospective review of the charts of 55 patients with definite MD in accordance with the AAO-HNS (American Academy of Otolaryngology–Head and Neck Surgery) Diagnostic Scale who were treated at Gruppo Otologico (Piacenza, Rome, Italy). The treatment protocol consisted of 3 intratympanic injections of gentamicin at a 12-hour interval between each administration. Results Results were resumed in accordance with AAO-HNS criteria and showed complete control of vertigo spells in 60% (class A), …
Management of intralabyrinthine schwannomas
2006
Abstract Objectives Our protocol to manage the intralabyrinthine schwannoma (ILS). Methods Retrospective chart review of 7 consecutive patients managed for ILS. Results Five patients underwent surgical removal of the lesions and none experienced significant complications or recurrent disease. One patient refused surgical treatment and was closely followed by serial MRI scans with no signs of tumor growth. One patient is presently managed conservatively due to a good hearing. Conclusions Diagnosis of ILS is based on high resolution MRI scans and should be included in the differential diagnosis of patients investigated for cochleovestibular symptoms. Treatment modality of ILS is controversial…
The prognostic value of subjective nasal symptoms and SNOT-22 score in middle ear surgery
2022
Background: The relationship between nasal functions and middle ear surgery is still under debate. Nasal obstruction is considered as a negative prognostic factor in middle ear surgery. This is based on the theory that it may cause Eustachian tube dysfunction (ETD) by leading to reduced ventilation of the middle ear, as found in several patients with nasal septal deviation, chronic rhinitis and nasal polyps. Objectives: To assess how the subjective feeling of nasal function, evaluated by a preoperative questionnaire, may be predictive of surgical outcome and/or risk of failure in middle ear surgery. Methods: We prospectively evaluated data of patients undergoing middle ear surgery for chron…
Understanding benign paroxysmal positional vertigo: the management of lateral canal involvement
2013
Benign paroxysmal positional vertigo (BPPV) represents the most common cause of peripheral vertigo. The treatment of this apparently intractable disease is actually a physical treatment: performing manoeuvres on the patient to restore the normal condition of the inner ear. However, the following information will help readers who are unfamiliar with BPPV to improve their knowledge of the condition.
Textbook of Vertigo: Diagnosis and Management
2013
Following you will find a brief description of the book done, as accorded with Alessandro De Stefano, to publish in Int Tinnitus J Vertigo: Diagnosis and Management of Jaypee Brother Publisher, is a new book in the field of vestibular disorders. This publication includes several topics ranging from anatomy of vestibular system to the rehabilitation after a vestibular disease. The book, edited by Dr. Francesco Dispenza and Dr. Alessandro De Stefano, had the contribution of about 30 Professors worldwide, experts in the fields of vertigo. The first part of the book includes the information about anatomy, physiology of vestibular system and general approach to the dizzy patients, with a window …
Management of laryngeal precancerous lesions.
2012
Abstract Objective The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required. Methods A prospective study was done on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal liga…