Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?

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…

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…

Clarithromycin in the Management of Chronic Rhinosinusitis: Preliminary Results of a Possible Its New Use

The aim of this study is to evaluate the efficacy and safety of prolonged therapy with low-dose clarithromycin in patients with chronic rhinosinusitis with polyps (CRSwP) after endoscopic sinus surgery (ESS). A total of 10 patients with CRSwP were identified and subjected to bilateral ESS. In post-operative patients they were treated with nasal wash with saline solution and steroid sprays (beclomethasone). During follow-up, after 30–40 days after the operation (M = 35.4 SD = +4.33), patients reported a worsening of symptoms with onset of nasal obstruction; reduction/loss of smell; headache; onset of viscous secretions and therefore all patients continued therapy with saline nasal irrigation…

Impiego della Sleep Endoscopy nella diagnostica preoperatoria OSAHS

turbinate surgery by radiofrequency for sleep-disordered breathing

Tumours of Nasal Septum: A Retrospective Study of 32 Patients

Objective: Tumours of the nasal septum are a rare and heterogeneous group of lesions in the sinonasal tract. The management of the different lesions of this site is debated. The aim of this study is to share our experience on a rare clinical condition and stimulate other centres to publish theirs. Methods: We retrospectively analysed the databases of sinonasal tumours treated at the Sections of Otolaryngology (ENT) of two University Hospitals (Palermo and Genova) between 2012 and 2020. Results: From the two databases, a cohort of 32 patients with tumours of nasal septum were selected. All patients underwent an endoscopic examination. Large tumours underwent preoperative computed tomography …

Sleep-disordered breathing:Evaluation of dynamic patterns of the upper airways in obese subjects

Sarcoma di Kaposi laringeo del ventricolo di Morgagni: caso clinico

Criteri di selezione dei pazienti affetti da OSAS da sottoporre a palatofaringoplastica

Sialoendoscopy in the management of the salivary gland disorders

BACKGROUND: The aim of this study was to determine the long-term (> 6 month) outcome of patients suffering from obstructive sialadenitis treated by sialoendoscopy. METHODS: Between 2009 and 2013 seventy-six subjects underwent sialoendoscopy under local anesthesia at the University Hospital P. Giaccone of Palermo. RESULTS: The mean age of presentation was 50.5 years for male (56.6%) and 44.7 years for female (43.4%). The presenting symptoms were frequent pain in 72% of cases, frequent purulent secretions in 65% of cases, frequent swelling in 62% of cases and frequent bitter taste in 44% of cases. Affected glands were in 54 cases the submandibular unilaterally, in 21 cases the parotid unilate…

Mastoidectomy in surgical procedures to treat retraction pockets: a single-center experience and review of the literature

Abstract Purpose Retraction pocket (RP) is a common event affecting the middle ear when a negative pressure within it causes a retraction of a single part of the tympanic membrane (TM). Patients can be asymptomatic or can experience hearing loss, fullness feeling and/or ear discharge. RP can be stable or develop a cholesteatoma; aim of the study was to investigate if mastoidectomy may play a role in the surgical management of patients suffering from RP, both reporting our experience and discussing the existing literature. Methods Fifty-one patients affected by RP were referred for surgery and randomly divided into two groups. Patients of G1 group underwent tympanoplasty with mastoidectomy, …

Management of pharyngeal collapse in patients affected by moderate obstructive sleep apnoea syndrome

This study reports our experience in a selected cohort of patients affected by mild-moderate OSAS, without tonsillar obstruction, and treated with pharyngoplasty.In a case-control retrospective study, we compared modified expansion sphincter pharyngoplasty (MESP) to modified barbed reposition pharyngoplasty (MBRP) in adult patients with oropharyngeal transversal collapse with a BMI ≤ 30 kg/mWe enrolled 20 patients: 10 treated with MESP and 10 treated with MBRP. Mean apnoea-hypoapnoea index (AHI) was 22.8 (± 5.63). We observed in both groups a significant reduction of AHI and oropharyngeal obstruction (p = 0.01), with a success rate, according with Sher's criteria, of 90% for MESP and 80% fo…

Uvulopalatofaringoplastica associata a tonsillectomia nel trattamento dell'OSAS severa

Sinonasal respiratory epithelial adenomatoid hamartoma: A report on three cases

Respiratory Epithelial Adenomatoid Hamartoma (REAH) is a rare benign lesion that may occur in the nasal cavity and paranasal sinuses. Histology is essential for the differential diagnosis with other lesions that could affect the sinonasal region. Our report focuses on three cases of male patients that were 46, 66 and 73 years old, diagnosed with REAH of the sinonasal region. All cases presented a nasal obstruction and hyposmia, and in one case cephalalgia. The definitive diagnosis of REAH was supported by the endoscopic, radiological and histological examinations. The patients underwent surgical excision with an endoscopic approach and did not experience a local recurrence at the time of wr…

Personal experience on inverted papilloma surgical treatment

Localization of the atrial natriuretic factor in the human inferior turbinates. An immunohistochemical study

In man, the architecture of the turbinates is able to modify some of the physiochemical characteristics of the air inhaled. These modifications depend on the nervous system and on the action of neurotransmitters such as vasoactive intestinal peptide. Substance P, calcitonin gene-related peptide and other neuropeptides. As atrial natriuretic factor has been detected in the trachea and lung, the present immunohistochemical study was carried out to establish the presence and localisation of the atrial natriuretic factor on the inferior turbinates of the human being. The findings show atrial natriuretic factor to be present in the serous epithelial cells and in some cells of the tonaca propria …

Sonografic examination of epiaortic vessels in patients with peripheral vertigo

Abstract Introduction: To evaluate the utility of echo-color-Doppler ultrasonography (CDU) of extracranial brain-supplying vessels in patients with peripheral vertigo of unknown origin. Materials and methods: One-hundred-fifty-six patients (study group; 42 male and 114 female; mean age 61.86 14.14) and 161 patients (control group; 80 male and 81 female; mean age 62.31 13.69) were prospectively evaluated with CDU of extracranial brain-supplying vessels. Plaques in common and/or internal carotid artery (CA), arterial wall intima-media thickness (IMT) of common CA and peak systolic velocity (PSV) and resistive index (RI) of vertebral arteries (VA) were evaluated. Parametric (t-test) and non-pa…

Pattern dinamico delle VAS nei grandi obesi mediante manovra di Muller

Uvulopalatoplasty by radiosurgery

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…

Valutazione della funzione neuroautonomica nella Malattia di Ménière

Cardiovascular consequences of sleep disordered breathing: the role of CPAP treatment

CPAP treatment decreases BP in OSA patients, especially in severe OSA, and in patients with poorly controlled BP. OSA adversely affects heart function and remodelling, but its role in the pathogenesis of HF remains unclear. Similarly, the impact of CPAP is uncertain, and results of the ongoing ADVENT-HF trial will provide more information. Several experimental studies in animals and humans indicate a central role of intermittent hypoxia in atherogenesis through multiple mechanisms. However, randomised controlled trials (RCTs) in patients with CAD and OSA found no difference in outcomes between CPAP-treated and untreated patients. The negative results of secondary prevention RCTs may be the …

Radiosurgery in the treatment of the glottic plane carcinoma

Abstract During the last 20 years, various conservative surgical techniques have been proposed to treat larynx cancer. On the basis of our various experiences and of the ultrastructural data on the tissues treated with radiowaves, we decided to also use radiosurgery in operations under direct microlaryngoscopy. We select 18 patients suffering from epidermoid carcinoma. These patients had been referred to our ENT clinic at the Polichnico of Palermo between 1999 and 2001. The authors describe the surgical procedures used and emphasize the advantages of radiosurgery in the treatment of larynx cancer.

Disturbo di panico e sistema vestibolare

L'ELETTROMIOGRAFIA PREOPERATORIA DEI MUSCOLI NASALI

Advances in the Role of Pharyngeal Surgery in the Treatment of OSAS

The American Academy of Sleep Medicine and the American Academy of Otolaryngology–Head and Neck Surgery recommend surgery as an option for the treatment of OSAS, when noninvasive treatments such as CPAP or oral appliances have not been successful or are not tolerated. A gradual and logical approach must be taken into account when a patient seeks a surgical solution, and it is a fundamental requirement that the patient find a surgeon who understands both the pathophysiology of sleep apnea and anatomy of the upper airways (UA) to guarantee the best chances of success. The surgical options aim to solve the obstructive problem according to two ways, the first is the reduction of the content, an…

Budesonide increases TLR4 and TLR2 expression in Treg lymphocytes of allergic asthmatics

Abstract Background Reduced innate immunity responses as well as reduced T regulatory activities characterise bronchial asthma. Objectives In this study the effect of budesonide on the expression of TLR4 and TLR2 in T regulatory lymphocyte sub-population was assessed. Methods TLR4 and TLR2 expression in total peripheral blood mononuclear cells (PBMC), in CD4+/CD25+ and in CD4+/CD25− was evaluated, by flow cytometric analysis, in mild intermittent asthmatics (n = 14) and in controls (n = 11). The in vitro effects of budesonide in modulating: TLR4 and TLR2 expression in controls and in asthmatics; IL-10 expression and cytokine release (IL-6 and TNF-α selected by a multiplex assay) in asthmati…

Cholesteatoma associated with Kabuki syndrome

Kabuki syndrome (KS), also identified as Kabuki make-up syndrome or Niikawa-Kuroki syndrome, is a multiple malformation/mental retardation syndrome that was described initially in Japan but is now known to occur in many other ethnic groups. The syndrome is characterized by varying degrees of mental retardation, postnatal growth retardation, distinct facial characteristics resembling the Kabuki actor's make-up, cleft or high-arched palate, brachydactyly, scoliosis, and persistence of finger pads. There is no definitive laboratory diagnostic test for KS, thus diagnosis is based on phenotypic presentation and the exclusion of other known syndromes. Familial cases have been reported and autosom…

Glut-3 expression in laringeal carcinoma: is really a prognostic indicator?

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…

Il trattamento della sordità improvvisa mediante cortisonico intratimpanico

Eustachian Tube Function Assessment after Radiofrequency Turbinate Reduction in Atopic and Non-Atopic Patients.

(1) Background: Inferior turbinates&rsquo

Analysis of visually guided eye movements in subjects after whiplash injury

Abstract Objective The aims of present research were to analyze the visually guided eye movements of subjects suffering from the consequences of whiplash injury and the possibility to differentiate patients from feigning subject. We analyzed the role of video-nystagmography for clinical and forensic aspects. Methods It was a prospective case–control study. Detailed history was taken and patients were thoroughly investigated. Smooth pursuit and saccadic eye movements were assessed in 33 patients affected by imbalance following a whiplash injury. A control group of 20 subjects was also evaluated. All tests were executed in neutral neck position and after left and right trunk rotation. Results…

NBI and Laryngeal Papillomatosis: A Diagnostic Challenge: A Systematic Review.

Narrow-band imaging (NBI) represents a valid aid in laryngeal squamous cell carcinoma (LSCC) diagnosis for detecting vascular changes. However, LSCC and laryngeal papillomatosis (LP) show similar vascular patterns that may lead to misdiagnosis and improper treatment. This review aims to deepen this NBI limit in order to stress a careful preoperative evaluation of laryngeal lesions. The research was carried out on PubMed, Web of Science and Scopus databases using specific keywords. The topic of research was assessed by these parameters: accuracy, sensitivity, specificity, and positive and negative predictive values. This review included only five articles: they demonstrated that NBI is bette…

IL-19 as putative biomarker for chronic rhinosinusitis with nasal polyps

Use of intraoperative video endoscopy during anterior inferior hyoid suspension surgery

UTILIZZO DELLE RADIOFREQUENZE NEL TRATTAMENTO CHIRURGICO DEL SIMPLE SNORING

Immunohistochemical expression of CB1 cannabinoid receptor in the laryngeal-tracheal tract in humans suffering from laryngeal neoplasia

Autoimmune ear disease: clinical and diagnostic relevance in Cogan’s sydrome

The autoimmune inner ear disease is a clinical syndrome with uncertain pathogenesis that is often associated to rapidly progressive hearing loss that, especially at the early stages of disease, may be at monoaural localization, although more often it is at binaural localization. It usually occurs as a sudden deafness, or a rapidly progressive sensorineural hearing loss. In this study a particular form of autoimmune inner ear disease is described, Cogan’s syndrome. Cogan’s syndrome is a chronic inflammatory disorder that most commonly affects young adults. Clinical hallmarks are interstitial keratitis, vestibular and auditory dysfunction. Associations between Cogan’s syndrome and systemic va…

Our Assessment Using Palate Postoperative Problems Score (PPOPS): Tool for the Evaluation of Results in Palatal Surgery Techniques

Obstructive sleep apnoea syndrome is a chronic condition characterized by frequent episodes of collapse of upper airways during sleep. Prevalence of the disease is settled at about 3–7%. Today, palatal surgery is a reference point in OSAHS treatment and there are many different surgical techniques. The purpose of our work is to compare post-operative results of palate surgery techniques used in our practice in OSAHS patients, studying the degree of patients’ satisfaction with a recent score recommended by Rashwan et al. called PPOPS (Palate Post-Operative Problems Score). A retrospective study was performed on a sample of 40 patients subject to different palate surgery techniques for OSAS. …

Abrikosoff's tumour of the tongue:a pediatric case report

Fluticasone furoate maintains epithelial homeostasis via leptin/leptin receptor pathway in nasal cells

Leptin is involved in the lung epithelial homeostasis. Its role in the nasal tract is largely unknown. Allergic rhinitis (AR) is induced by the allergen exposure leading to consequential structural abnormalities in the nasal epithelium. Topical corticosteroids are recommended as first-line therapy in AR. Parietaria pollen is one of the most important allergenic sources in the southern Europe. In vitro, in human nasal epithelial cell line RPMI 2650, we aimed to determine whether allergen stimulation acts on leptin/leptin receptor pathway and how fluticasone furoate (FF) influences this pathway. The effects of the major allergen recombinant Par j 1 (rPar j 1), of FF, of leptin, and of TGF-b1 …

Valutazione del pattern dinamico delle vie aeree superiori nei grandi obesi mediante manovra di Muller

The Role of Modified Expansion Sphincter Pharyngoplasty in Multilevel Obstructive Sleep Apnea Syndrome Surgery

Introduction Obstructive sleep apnea syndrome (OSAS) is a sleep disorder caused by an excessive narrowing of the pharyngeal airway that also collapses during inspiration, with an important role played by the lateral pharyngeal wall in the development of the obstruction. Objective To describe our surgical experience with modified expansion sphincter pharyngoplasty (MESP) in the management of lateral collapse in upper airway multilevel surgery. Methods A total of 20 patients with moderate to severe OSAS were recruited in the Ear, Nose and Throat (ENT) Department of the University of Palermo, Italy. All of the enrolled patients refused the ventilatory therapy. The subjects were evaluated for …

Techniques of intratympanic administration

Impairment of leptin/leptin receptor pathway in nasal epithelium from allergic turbinates

BACKGROUND: Allergic rhinitis (AR) is characterized by a remodeling of nasal epithelium. Leptin adipokine has been already identified as a marker of homeostasis in human bronchial epithelial of asthmatics. TGF-β is a multi-functional cytokine and conflicting findings exist regarding its role in the remodeling responses of the upper airways in allergic rhinitis. OBJECTIVE: We sought to investigate ex-vivo the expression of leptin/leptin receptor pathway and TGF-β in human nasal epithelium. METHODS: 41 biopsies of inferior turbinates obtained from allergic patients with AR (A, n = 20) and from healthy control subjects (C, n = 21) were analyzed for leptin/leptin receptor and for TGF-β 1, 2, 3 …

Analisi video-oculografica degli smooth pursuit in pazienti affetti da schizofrenia e loro consanguinei

Endoscopic septoplasty in combination with functional endoscopic sinus surgery: Our indicatiions

Expression of gelatinases (MMP-2, MMP-9) and cyclooxygenases (COX-1, COX-2) in some benign salivary gland tumors.

Salivary gland tumors, most of which are rare benign tumors, represent a histologically heterogenous group with the greatest diversity of morphological and cellular features. The aim of this study is to analyse the expression and possible interactions between gelatinases (MMP-2, MMP-9) and cyclooxygenases (COX-1, COX-2) in some benign salivary gland tumors. We investigated the expression of gelatinases and cyclooxigenases in control salivary gland, Pleomorphic adenoma and Warthin's tumor through immunohistochemistry and Reverse Transcription – Polymerase Chain Reaction (PCR). We identified the expression of both classes of enzyme in normal samples and in the two types of pathological sampl…

Resection of verrucous squamous cell carcinoma of the nasal cavity using advanced radiofrequency

Functional outcomes after supracricoid modified partial laryngectomy

ABSTRACT Open Partial Horizontal Laryngectomy (OPHL) OPHL is a standard surgical procedure consisting of a resection followed by reconnection of preserved structures: cricoid-hyoid-epiglottis (CHEP) in OPHL IIa, or cricoid-hyoid (CHP) in OPHL IIb. The main objective is the preservation of neoglottic functions, such as laryngeal functions in terms of voice quality, swallowing and breathing, restored after physiological rehabilitation. Moreover, no permanent tracheostomy is required after performing an OPHL. The crucial point in this surgical procedure is preserving at least one functional and mobile cricoarytenoid unit, including arytenoid cartilage, cricoid lamina, posterior and lateral cri…

Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Objective. To establish the safety and effectiveness of subtotal petrosectomy with cochlear implantation in patients affected by chronic middle ear disorders to refractory to previous surgical treatments. Methods. A multicentre, retrospective study was conducted on patients affected by recalcitrant chronic middle ear disorders who underwent cochlear implantation in combi-nation with subtotal petrosectomy. Patients’ details were collected from databases of 11 Italian tertiary referral centres. Additionally, a review of the most updated literature was carried out. Results. 55 patients were included with a mean follow-up time of 44 months. Cholestea-toma was the most common middle ear recurren…

Trattamento della canalolitiasi del CSP: nostra esperienza

Role of non cholinergic system components in Chronic rhinosinusitis and nasal polips

Trattamento medico dell'ascesso peritonsillare

Expression pattern of estroprogestinic receptors in sinonasal inverted papilloma

// Agostino Serra 1 , Rosario Caltabiano 2 , Giacomo Spinato 3 , Salvatore Gallina 4 , Salvatore Caruso 5 , Venerando Rapisarda 6 , Paola Di Mauro 1 , Veronica Castro 1 , Angelo Conti 1 , Luisa Licciardello 1 , Luigi Maiolino 1 , Salvatore Lanzafame 2 , Salvatore Cocuzza 1 1 Department of Medical and Surgical Sciences and Advanced Technologies “G. Ingrassia”, ENT Section, University of Catania, Catania, Italy 2 Department of Medical and Surgical Sciences and Advanced Technologies “G. Ingrassia”, Section of Anatomic Pathology, University of Catania, Catania, Italy 3 ENT Department, Rovigo Provincial Hospital, Rovigo, Italy 4 Department of Experimental Biomedicine and Clinical Neurosciences, …

Respiratory epithelial adenomatoid hamartoma: An unusual case report

Respiratory epithelial adenomatoid hamartoma is a rare lesion of the nasal cavity whose etiology and pathogenesis are unknown and symptoms are unspecific. It can be isolated or associated with inflammatory process, first of all nasal polyposis. It’s considered a rare lesion because it’s poorly known and consequently correctly diagnosing is important to a right surgical treatment and follow-up. A 54-year-old man presented with a 10-year history of epistaxis, rhinorrhea and anosmia. Computed tomography showed soft tissue densities in all sinus cavities consistent with nasal polyposis and without bilateral widening of the olfactory cleft >10 mm and without bone erosion. Functional endoscopi…

Uncommon site of Neurofibromatosis type 1 (NF1) involving the external auditory canal (EAC). Case Report

Purpose: Evaluation and discussion of the procedure of the gufoni manoeuvre and its advantages in the treatment of BPPV of LSC Matherial and methods:Prospective study of 58 patients affected by LSC BPPV who where office-treated with Gufoni manoeuvre Results:Seventy-nine percent of ptients so treated had complete resolution of symptons, and 6,9% did not show any improvement in their symptons.The remaining 13,8% had a conversion into posterior semicircular BPPV Conclusions:Gufoni''s manoeuvre is effective in treating patients suffering from BPPV of LSC;it is simple to perform;there are not many movement to execute, it needs low time of positioning, and positionsare confortable to the patient …

The prognostic value of subjective nasal symptoms and SNOT-22 score in middle ear surgery

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…

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…

Carbocysteine regulates innate immune responses and senescence processes in cigarette smoke stimulated bronchial epithelial cells

Cigarette smoke represents the major risk factor for chronic obstructive pulmonary disease (COPD). Cigarette smoke extracts (CSE) alter TLR4 expression and activation in bronchial epithelial cells. Carbocysteine, an anti-oxidant and mucolytic agent, is effective in reducing the severity and the rate of exacerbations in COPD patients. The effects of carbocysteine on TLR4 expression and on the TLR4 activation downstream events are largely unknown. This study was aimed to explore whether carbocysteine, in a human bronchial epithelial cell line (16-HBE), counteracted some pro-inflammatory CSE-mediated effects. In particular, TLR4 expression, LPS binding, p21 (a senescence marker), IL-8 mRNA and…

Laryngeal involvement in relapsing polychondritis: Case report and review of literature

Relapsing polychondritis is a rare multisystem autoimmune disease of unknown origin characterised by recurrent episodes of inflammation and progressive destruction of the cartilaginous structures and connective tissue of the whole body. The diagnosis of relapsing polychondritis is difficult. We present a review of the literature and describe a case of 49-year old woman. Her symptoms began in June 2004 with sore throat, dysphonia, pain in the thoracic wall and some joints, a slightly raised temperature and cough. The objective picture was immediately apparent after carrying out a high definition neck-thorax computed tomography and a laryngoscopy with fiber optics, which showed considerable l…

Swallowing Outcomes in Open Partial Horizontal Laryngectomy Type I and Endoscopic Supraglottic Laryngectomy: A Comparative Study

Background: Effective swallowing represents the main challenge in supraglottic laryngectomy. This study aimed to assess swallowing outcome comparing endoscopic supraglottic laryngectomy (ESL) and open partial horizontal laryngectomy type I (OPHL I). Methods: A retrospective study was carried out on 20 patients that underwent supraglottic laryngectomy from 2015 to 2021: 10 underwent ESL (group A) and 10 underwent OPHL I (Group B). Patients underwent fiberoptic endoscopic evaluation of swallowing (FEES) 3 months and 12 months after surgery and videofluoroscopy swallowing studies (VFSS) 12 months after surgery. A Swallowing Outcome After Laryngectomy (SOAL) questionnaire was administered to pa…

A conservative treatment for chronic obstructive sialoadenitis by intraductal instillation of mucolytic, steroids and antibiotic solution

Abstract Purposes Reporting our experience in treating chronic obstructive sialadenitis with a protocol consisting of sialoendoscopy and intraductal instillation of antibiotics, steroids and n-acetyl-cysteine (NAC) solution. Methods Prospective study of patients with chronic obstructive sialadenitis with no apparent lithiasic obstructions, with recurrent non-lithiasic sialoadenitis and patients with lithiasic sialoadenitis not solved with sialoendoscopy. In all cases, a sialoendoscopy was performed. All the patients affected by lithiasic sialoadenitis where the chronic inflammation was resolved with sialoendoscopy were excluded from the study. The mid-term follow-up was performed at 12 mont…

Increased expression of IL-19 in the epithelium of patients with chronic rhinosinusitis and nasal polyps.

Background : Chronic rhinosinusitis (CRS) is an inflammation of the nose and of the paranasal sinuses. The involvement of the respiratory epithelium in the mechanisms of CRS is poorly understood. Aims : Among proteins expressed by nasal epithelial cells in CRS, IL-19 may have key functions. We here aimed to determine the expression and regulation of IL-19. Methods : Nasal biopsies from normal subjects (n = 12), subjects with CRS but without nasal polyps (NP) (CRSsNP, n = 12) and with CRS with NP (CRSwNP, n = 15) were collected. Human Asthma Gene Array and real-time PCR were used to evaluate gene expression, western blot analysis and immunohistochemistry for protein expression. Results for I…

aspetti etiologici delle linfoadenopatie laterocervicali

Management of benign paroxysmal positional vertigo of lateral semicircular canal by Gufoni's manoeuvre

Abstract Benign paroxysmal positional vertigo (BPPV) of lateral semicircular canal (LSC) is one of the rarer forms of BPPV as compared to posterior semicircular canal BPPV. Various particle repositioning manoeuvres have been described in the literature as a mode of treating this condition. Purpose Evaluation and discussion of the procedure of the Gufoni's manoeuvre and its advantages in the treatment of BPPV of LSC. Material and methods Prospective study of 58 patients affected by LSC BPPV who were office-treated with Gufoni's manoeuvre. Results Seventy-nine percent of the patients so treated had complete resolution of symptoms, and 6.9% did not show any improvement in their symptoms. The r…

The EBV-DNA Can be Used as a Diagnostic and Follow-up Parameter of the Rhinopharyngeal Tumors in the Non-Endemic Population of the Western Sicily

To evaluate whether EBV-DNA can be used as a diagnostic and follow-up parameter for nasopharyngeal tumors in a non-endemic population. The study was carried out in a university hospital. A retrospective study was conducted on 40 paraffin samples of histological preparations. EB-DNA was detected by real-time PCR technique. A prospective study was also conducted on a group of 30 patients who underwent nasopharyngeal biopsy for suspected nasopharyngeal carcinoma (NPC) by comparing EBV-DNA concentrations between the histological specimen and the serum. Quantification of genomic copies of EBV-DNA in serum and detection of anti-EBV antibodies was performed. In both groups the presence of high vir…

LA RADIOCHIRURGIA DEI TURBINATI NEGLI INTERVENTI DI RINOSETTOPLASTICA

Obstructive sleep apnoea syndrome(OSAS):effects on the vestibular system

Effects of adenotonsillectomy on neurocognitive and behavioural function in pediatric obstructive sleep apnea syndrome

Effects of adenotonsillectomy on neurocognitive and behavioural function in pediatric obstructive sleep apnea syndrome. Objectives: Aim of this study is to verify the presence of neurocognitive, neurobehavioral or sleep disturbances in children affected by adenotonsillar hypertrophy (ATH) and Obstructive Sleep Apnea Syndrome (OSAS) and verify their improvement after Adeno-Tonsillectomy (AT). Methods: Eighty children suffering from adenotonsillar hypertrophy and OSAS were recruited for AT in the ENT Department of the University of Palermo. All the children underwent clinical evaluation, including rhinofibroscopy for grading the obstruction due to the adenotonsillar hypertrophy (before and 6 …

Radiosurgery in the treatment of laryngeal abductor paralysis

Abstract Abductor true vocal cord paralysis is a complex condition that requires the surgeon to perform an emergency tracheotomy to eliminate the symptom of dyspnea. Throughout the past 20 years, corrective surgery has reverted to techniques using external or endoscopic techniques. For 5 years now, we have used high frequency radiosurgery by Ellman to treat various ENT conditions in our clinic. The experience we have gained has encouraged us to use this method in endoscopic surgery as well, in the treatment of laryngeal abductor paralysis under suspension microlaryngoscopy. Twelve patients were examined between 1999 and 2002. Diagnosis was performed through flexible fiberoptic videolaryngos…

Important Biomolecular Indicators In Locally Advanced Laryngeal Squamous Carcinoma: P16 Mutations

Papel prognóstico da margem de ressecção em cirurgia oncológica aberta de laringe: análise de sobrevida de uma coorte de 139 pacientes com carcinoma de células escamosas

Introduction: The treatment of laryngeal squamous cell carcinoma needs accurate risk stratification, in order to choose the most suitable therapy. The prognostic significance of resection margin is still highly debated, considering the contradictory results obtained in several studies regarding the survival rate of patients with a positive resection margin. Objective: To evaluate the prognostic role of resection margin in terms of survival and risk of recurrence of primary tumour through survival analysis. Methods: Between 2007 and 2014, 139 patients affected by laryngeal squamous cell carcinoma underwent partial or total laryngectomy and were followed for mean of 59.44 ± 28.65 months. Rese…

Prognostic role of resection margin in open oncologic laryngeal surgery: survival analysis of a cohort of 139 patients affected by squamous cell carcinoma

Abstract Introduction: The treatment of laryngeal squamous cell carcinoma needs accurate risk stratification, in order to choose the most suitable therapy. The prognostic significance of resection margin is still highly debated, considering the contradictory results obtained in several studies regarding the survival rate of patients with a positive resection margin. Objective: To evaluate the prognostic role of resection margin in terms of survival and risk of recurrence of primary tumour through survival analysis. Methods: Between 2007 and 2014, 139 patients affected by laryngeal squamous cell carcinoma underwent partial or total laryngectomy and were followed for mean of 59.44 ± 28.65 mon…