Anterior palatoplasty: Effectiveness for treatment of simple snoring and mild osas

Positive airway pressure is the treatment of choice among obstructive sleep apnea syndrome patients. Among surgical options, multilevel approach is a good option in patients with an involvement of all tract of first airway. The aim of the present work is to establish the efficacy of anterior palatoplasty in the treatment of selected patients with mild obstructive sleep apnea syndrome or simple snoring, within a multilevel surgery. The group was composed of 16 mild obstructive sleep apnea syndrome adult patients collected from January 2015 to June 2016 at University of Palermo, Ear, Nose and Throat Department. To make diagnosis of obstructive sleep apnea syndrome, we employed polysomnography…

Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial

<b><i>Background:</i></b> Saline nasal irrigation is labelled as an add-on treatment in patients with allergic rhinitis (AR). The primary aim of this study was to compare the efficacy of 21-day use of buffered hypertonic saline (BHS) versus normal saline solution (NSS) on reducing nasal symptoms in children with seasonal AR (SAR). Comparing their efficacy on nasal cytology counts (NCC), quality of life, and sleep quality was the secondary aim. <b><i>Methods:</i></b> In this 21-day,<b> </b>open-label, randomized controlled study, 36 SAR children (aged 6-13 years) with a Total 5 Symptom Score (T5SS) ≥5 received twice-daily BHS or NSS…

Personal experience on inverted papilloma surgical treatment

Functional Nasal Surgery and Use of CPAP in OSAS Patients: Our Experience.

The surgical correction of nasal obstruction is definitely effective and recommended in patients with poor CPAP compliance, often secondary to the high pressures that need to be given in patients with nasal sub stenosis. For this reason, the objective of this study is the evaluation of the effectiveness and effects of the functional nose surgery on adherence to CPAP- therapy in patients (with moderate to severe OSAS with indication of ventilation therapy) poorly compliant with CPAP. The study was performed on a sample of 52 patients, 40 male and 12 female, aged between 29 and 72 years followed by the Otolaryngology Unit of the University Palermo in the period between January 2015 and Januar…

Beclomethasone dipropionate hydrofluoroalkane for the treatment of allergic rhinitis

Allergic rhinitis (AR) is a common respiratory disease, and its prevalence is increasing all over the world, both in adults and in children. Patients experience symptoms that may negatively impact on physical, social and psychological well-being. Hence, if left untreated, allergic rhinitis may significantly affect quality of life. Under current guidelines, intranasal corticosteroids are considered the most effective drugs and they are recommended as first-line therapy. Among the several corticosteroid intranasal sprays available, beclomethasone dipropionate is one of the most prescribed. Recently, new intranasal hydrofluoroalkane-propelled formulations with little or no impact on the ozone …

Treatment of sudden sensorineural hearing loss with transtympanic injection of steroids as single therapy: a randomized clinical study.

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…

Comparative Effect of Beclomethasone Dipropionate and Cetirizine on Acoustic Rhinometry Parameters in Children With Perennial Allergic Rhinitis: A Randomized Controlled Trial.

Background and objectives The effect of intranasal corticosteroids and oral antihistamines on acoustic rhinometry parameters has not been directly compared. The primary objective was to compare the effect of a 21-day course of treatment with nasal beclomethasone dipropionate (nBDP) with that of cetirizine (CTZ) on nasal patency measured using acoustic rhinometry in children with perennial allergic rhinitis (PAR). The secondary objective was to compare the effect of both drugs on nasal cytology, symptom severity, sleep quality, and quality of life. Methods In this 21-day, open-label, randomized controlled study, 34 children with PAR (age 6-14 years) with a Total 5-Symptom Score (T5SS) ≥5 rec…

Sudden Sensorineural Hearing Loss: Results of intratympanic steroids as salvage treatment

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…

Treatment of bilateral vocal cord paralysis following permanent recurrent laryngeal nerve injury.

Bilateral vocal cord paralysis is a serious illness requiring emergency intervention to resolve the potentially life-threatening respiratory distress. Several surgical procedures were proposed to help improve the airway and to eliminate the tracheostoma in those patients with permanent paralysis. All the procedures have their own advantages and disadvantages. We conducted a retrospective study of 30 patients affected by bilateral vocal cord paralysis following total thyroidectomy. All the patients underwent total thyroidectomy for benign thyroid pathology. In 26 patients (86.6%), cord paralysis occurred during the perioperative stage; and in the remaining 4 cases (13.3%), it occurred within…

Familial occurrence of warthin tumour: Our experience and review of the literature

The tumour of Warthin (WT) is the second parotid tumour for frequency after the pleomorphic adenoma, it represents about 2% to 15% of all parotid tumors. The pathogenesis of familial Warthin Tumour is unknown, even if cytogenetic abnormalities have been identified in Warthin Tumour. Among the inducing factors there is the smoke which has an important role. Familial occurrence of Warthin Tumour is rare, only five reports in the literature. Two of them were reported in brothers, two in a mother and son and one in monozygotic twins. We quote a case of familiar Warthin Tumour arisen in two brothers and we present a review of the Literature.

PEDIATRIC OSAS TREATED WITH ADENOIDECTOMY: A COHORT STUDY CONDUCTED AT THE UNIVERSITY HOSPITAL OF PALERMO, ITALY

The incidence of Obstructive Sleep Apnea Syndrome (OSAS) in the pediatric population is about 2%. The diagnosis is based on the employment of questionnaires, and polysomnography (PSG) that is the gold standard also among children. The PSG allows to classify OSAS as mild in case of 110. If polysomnography is not available, we need alternative diagnostic tests such as nocturnal oximetry studies and respiratory polygraphy. The risk factors identified are different from adults, first tonsillar hypertrophy wins over others. The symptoms and signs described are similar to adult population, but sleep enuresis, neurocognitive impairment and behavioral problems (attention-deficit/hyperactivity disor…

Linfomas malignos primários nas glandulas salivares

Primary malignant lymphomas in the salivary glands are relatively rare. Clinical presentation is not characteristic and the disease is often overlooked resulting in diagnosis and treatment delays. AIM: To stress the importance of the diagnostic process and combined management, we present a series of eight patients with malignant lymphoma of the parotid who were diagnosed only after surgery and managed with radiation and chemotherapy. METHODS: Retrospective series of patients with primary malignant lymphoma of the parotid gland managed with radiotherapy and diagnostic surgical partial resection. RESULTS: After treatment completion we achieved a loco-regional control rate of 87.5%. Toxicity w…

Anaplastic thyroid cancer: A case series with a wide spectrum of treatment in emergency

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies of the neck, and for the majority of these patients the cause of death is a compromised airway, metastatic disease, superior vena cava syndrome, asphyxiation, or exsanguination. In case of the airway being compromised, emergency treatment is mandatory but not well defined. We report 4 different kinds of acute presentation of complications. Anaplastic thyroid cancer; diagnostic, clinical and prognostic indication, evaluation of choice of treatment are discussed. The spectrum of treatment varies from observation and preservation of the airway from a tracheostomy to extensive surgery. When a potentially curative rese…

Profile of intranasal corticosteroids in italy: Safety, cost/effectiveness, local and systemic adverse effects

Background: Allergic Rhinitis is a common and often debilitating disease that affect, nowadays, not only young people. For this reason an effective treatment is necessary to minimize the impact of allergic rhinitis in general population. Objective: The aim of this review is to inquire intranasal corticosteroids. Results: We have obtained several randomized, double-blind, placebo-controlled clinical trials, by a MEDLINE search. We analyzed the safety profile, the adverse effects described by the authors, the relation between cost/effectiveness. We have made a search for trade profile, dosage and chemical characteristics by on-line handbook. Discussion: Several studies demonstrate that intran…

ASSOCIATION BETWEEN OBSTRUCTIVE APNEA SYNDROME DURING SLEEP AND DAMAGES TO ANTERIOR LABYRINTH: OUR EXPERIENCE.

The obstructive sleep apnea syndrome is a chronic condition characterized by frequent episodes of collapse of the upper airways during sleep. It can be considered a multisystem disease. Among the districts involved, even the auditory system was seen to be concerned. It was enrolled a population of 20 patients after polysomnographic diagnosis of OSAS (Apnea Hypopnea Index > 10) and a control group of 28 healthy persons (Apnea Hypopnea Index < 5). Each patient has been subjected to Pure Tone Audiometry, Tympanometry, study of Acoustic Reflex, Otoacoustic Emissions and Auditory Brainstem Response. Moreover they were submitted to endoscopy of upper airway with Muller Maneuver and Epworth Sleepi…

“SINDROME DI BECHET, CELIACHIA E DIABETE MELLITO DI I TIPO”: ....RARO CASO A TIPIZZAZIONE ANOMALA

La malattia di Behcet è una malattia rara, a genesi autoimmune, multifattoriale ad esordio tra la seconda e la terza decade di vita, a più elevata incidenza nei cosiddetti territori della via della seta (Medio Oriente) oltre che, nel Bacino del Mediterraneo. In Europa la prevalenza è 1:500.000 con maggiore incidenza nel sesso femminile. Clinicamente è caratterizzata da lesioni ulcerose ricorrenti del cavo orale che si accompagnano a ulcere genitali o lesioni cutanee, oculari o Pathergy Test positivo . Il "Behcet's Disease International Study Group" ha identificato nella presenza di ulcere del cavo orale associate a due delle lesioni sovracitate la diagnosi clinica di malattia di Behcet. Nel…

Management of laryngeal precancerous lesions.

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…

On the threshold of effective well infant nursery hearing screening in Western Sicily.

Abstract Objective To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high “screen sensitivity” reducing the number of more expensive secondary level exams. Methods The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 – PASS without risk factor, free to go home; G2 – PASS with risk fact…

ANTERIOR PALATOPLASTY: EFFECTIVENESS FOR TREATMENT OF SIMPLE SNORING AND MILD OSAS

Positive airway pressure is the treatment of choice among obstructive sleep apnea syndrome patients. Among surgical options, multilevel approach is a good option in patients with an involvement of all tract of first airway. The aim of the present work is to establish the efficacy of anterior palatoplasty in the treatment of selected patients with mild obstructive sleep apnea syndrome or simple snoring, within a multilevel surgery. The group was composed of 16 mild obstructive sleep apnea syndrome adult patients collected from January 2015 to June 2016 at University of Palermo, Ear, Nose and Throat Department. To make diagnosis of obstructive sleep apnea syndrome, we employed polysomnography…