Acetaldehyde effects in the brain

The effects of alcohol have been widely studied during the past century as alcohol abuse is a major health problem in Western society. In the last years, a growing body of evidence indicates that acetaldehyde, the first oxidation product of ethanol, is one of the mediators of peripheral and central effects of ethanol. Indeed, acetaldehyde has been recently taken into account as the mediator of the rewarding properties of alcohol. The role of acetaldehyde in ethanol-related properties has been proved by enzymatic manipulation studies in which the inactivation of acetaldehyde potentially synthesized in the brain produces the same results as blocking the formation of acetaldehyde by inhibiting…

THE LINKAGE BETWEEN UPPER RESPIRATORY TRACT INFECTIONS AND OTITIS MEDIA: EVIDENCE OF THE 'UNITED AIRWAYS CONCEPT'

Upper respiratory tract infection (URTI) is a nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx and larynx and resulting from interplay between microbial load (viral and bacterial) and immune response. Infant and young children are prone to developing upper respiratory tract infections, which often result in bacterial complications especially acute otitis media because of the passage of bacteria (colonizing the nasopharynx) in the middle ear via Eustachian tube.

Management of infants with neural tube defects (NTDs) in NICU

Neural tube defects (NTDs) are a group of congenital malformations of the central nervous system, which derive from an altered embryological development during neurulation. The different types of NTDs are closely related to their onset in the embryonic period; precocity is an index of greater severity of clinical manifestation. The myelomeningocele is one of the most common pathological conditions which is included into the spectrum of NTDs. It is characterized by the lack of fusion of the vertebral arches, resulting in eversion of the meninges and medullary content; it is the condition which clearly needs more assistance in the neonatal intensive care unit. The management of patients with …

FOLLOW-UP AFTER PEDIATRIC MYRINGOPLASTY: OUTCOME AT 5 YEARS

Aim. The aim of this paper was to evaluate anatomical and functional outcomes 5 years after myringoplasty in children affected by perforated eardrum. To analyze the main differences in the frequency of postoperative complications between patients under and over 9 years of age. Methods. One hundred and thirty-two children, aged from 4 to 15 years, who underwent myringoplasty with or without mastoidectomy, were followed for a five-year period after surgery. The cohort was divided in two groups: children from 4 to 9 years old (G1) and patients older than 9 years (G2); all subjects underwent a pre- and post-operatively clinical exam and were evaluated through audiometry and impedenzometry. Aden…

The influence of sounds in postural control

Postural control is a polisensory system based on the synergism of visual, proprioceptive (kinaesthetic), auditory and labyrinthic (both otolithic and canalar) inputs. Each individual, according to age, organizes different somatosensorial strategies in order to manage postural control. Therefore the prevalence of visual, auditory, proprioceptive and labyrinthic input management varies from subject to subject during growth. It is known that during the first year of age, before the achievement of an erect posture, this latter is mainly managed according to auditory and labyrinthic stimuli, whereas once the bipodalic stance is achieved, afferent proprioceptive information from the foot and fro…

Hearing loss in neonatal intensive care units (NICUS): Follow-up surveillance

Infants admitted to the neonatal intensive care unit (NICU), who represent the 4-8% of all births, present problems such as prematurity, low Apgar scores, infections, hyperbilirubinemia and hearing impairment. In particular significant hearing loss is the most common disorder at birth, occurring in 1 to 2 newborns per 1000 in the general population and 24% to 46% of newborns who are admitted to a NICU. This leads more difficulty to develope verbal skills (learning vocabulary, grammar, word order and idiomatic expressions), language, learning and speech. Hearing impairment influences also cognitive and affective development of infants making consequences in their interpersonal relationships.…

Guide to the management of complications in endoscopic sinus surgery (ESS)

Endoscopic sinus surgery (ESS) is one of the most commonly performed procedures in otolaryngology. ESS complications should be distinguished in minor and major based on the treatment they need and the permanent sequelae they can cause. Over the years it has gone from an incidence of complications in endoscopic surgery of 8% for the major and 21% for the minor to a percentage of 0-1.5% and 1.1-20.8%, respectively. This is due to the considerable diffusion of the technique with a progressive increase over the years of the surgical experience but their presence help to educate otolaryngologists and patients about complication rates in ESS in a modern context. A complication occurs when injurie…

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…

VESTIBULAR AND PROPRIOCEPTIVE REHABILITATION STRATEGY IN ACOUSTIC NEURINOMA

Rehabilitation therapy can be used to treat balance disorders via exercises organized into anatomo-pathological protocols. In general, there is an indication for rehabilitation whenever compensation of a patient’s vestibular system fails to adequately resolve spontaneously. Although the therapeutical indications have expanded over time, it is especially useful to treat balance disorders in neurological patients and those with acute damage to the vestibular system. Specifically, it favors and accelerates spontaneous central compensation in a variety of neurological disorders such as Multiple Sclerosis, Parkinson's disease, cerebellar pathologies or in brain tumors like Vestibular Schwannoma …

The role of Leptin in laryngeal squamous cell carcinoma

Leptin is a peptide produced by peptidergic cells or those able to process and secrete peptides. Originally, this function was considered proper and exclusive of certain neurons of the magnocellular and parvicellular hypothalamus. These cells originated from a common precursor, namely neural crest cells, which have the ability to produce hormonal neuropeptides. From this primitive neuroectodermal site, cells migrate to other organs: the gastro-entero-pancreatic system (GEP), the lung, heart, reproductive and urinary systems. Leptin is considered the typical neuropeptide with an anorexic function, and is also called the “satiety hormone” because it plays a key role in the control of ener…

Ewing sarcoma family of tumors: Causes, diagnosis and treatment

The Ewing's sarcoma Family of Tumors (EFT) includes classic Ewing's Sarcoma (ES) of bone, Extraskeletal Ewing's Sarcoma (EES) and malignant peripheral primitive Neuroectodermal Tumor (pNET) of bone and soft tissue. ES is an aggressive tumor with a high incidence of local recurrence and distant metastasis. The skeletal form is more common and typically occurs in the long bones of the extremities. The extra skeletal form occurs in the soft tissues of the lower extremities, paravertebral tissues, chest wall, retroperitoneum and rarely in the head and neck region in about 1-4% of cases. Involvement of the head and neck is usually identified in the nasal or oral cavities, sinuses or soft tissues…

Emerging pharmacological treatments of tinnitus

Tinnitus is not a disease, but rather a symptom or condition characterized by a conscious perception of an unreal sound in the absence of external auditory stimulus. This ontological condition can modify everyday life in different ways: causing distress and annoyance, sleep disruption, anxiety and depression. The World Health Organization (WHO) describes tinnitus as a symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, grinding, hissing, roaring or other noises in the ear. Even if different treatments exist for “tinnitus-related abnormalities” such as cognitive behavioural therapy and/or sound therapy, no effective pharmacological approa…

Effects of tinnitus on postural control and stabilization: A pilot study

Introduction: The aim of this study was to evaluate the tinnitus's impacts on postural control. Material and methods: Sixty-six subjects (age: 46,71 ± 15,12 years, height 166,32 ± 8,88 cm, weight 64,85 ± 12,57 kg) with idiopathic tinnitus were recruited for the study and were tested. Each subject underwent to ‘Romberg test’, ‘Static balance’ and ‘posture analysis’. Static balance and posture analysis were performed two times, with open and close eyes, and were measured through the FreeMed posturography system. Results: showed that subjects had worse Baropodometric performances respect to benchmarks; moreover according to literature the results show that these patients had significant differ…

TREATMENT OF TINNITUS AND DIZZINESS ASSOCIATED VERTEBROBASILAR INSUFFICIENCY WITH A FIXED COMBINATION OF CINNARIZINE AND DIMENHYDRINATE

Seventy-eight consecutive subjects, 43 males and 35 females, ranging from 43 to 87 years of age suffering from dizziness and/or tinnitus due to vertebrobasilar insufficiency without other central nervous system diseases were treated with fixed combination of cinnarizine and dimenhydrinate two times a day and for two months. Data were collected considering the following parameters: age, sex, vestibular symptoms (unsteadiness, staggering, tendency to fall, swaying, vertigo due to change of position, bowing, walking, eye movements), headache, tinnitus, impaired hearing and aural fullness. Patients evaluated their vertigo symptoms and/or tinnitus intensities using a graded 3- point visual analo…

Sudden sensorineural hearing loss, an invisible male: State of the art

Sudden sensorineural hearing loss (SSNHL), identified by Dekleyn in 1944, is a important otological disorder. It is characterized by a hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours, with no identifiable etiology. It is a real sensorineural emergency that can become a permanent handicap if not adequately treated. SSNHL has a prevalence of 5-20 in 100,000 inhabitants. Because of patients recovering rapidly or seeking no medical attention, the true figure might be higher. Sudden hearing loss occurs typically between 50 and 60 years of age and the lowest among 20-30. The prevalence of SSNHL is not significantly different between men and women. There a…

Epispadia femminile:la ricerca della continenza

Diagnosis and treatment of Ewing's Sarcoma of the tongue

The Ewing's sarcoma Family of Tumors (EFT) includes classic Ewing's Sarcoma (ES) of bone, Extraskeletal Ewing's Sarcoma (EES) and malignant peripheral primitive Neuroectodermal Tumor (pNET) of bone and soft tissue. ES is an aggressive tumor with a high incidence of local recurrence and distant metastasis. The skeletal form is more common and typically occurs in the long bones of the extremities. The extra skeletal form occurs in the soft tissues of the lower extremities, paravertebral tissues, chest wall, retroperitoneum and rarely in the head and neck region in about 1- 4% of cases. Involvement of the head and neck is usually identified in the nasal or oral cavities, sinuses or soft tissue…

Diagnosis and follow-up of complex congenital malformations/mental retardation (MRA/MR)

Complex congenital malformations, associated in 30% of cases with mental retardation, recognize different etiologies: environmental causes, mendelian disease, chromosomal abnormalities, imprinted anomalies. Frequently complex congenital disorders are rare diseases. Rare diseases are infrequent pathological conditions (prevalence in the general population of less than 1/2.000 live births1), and often poorly understood. Because of their rarity these morbid conditions often either go undiagnosed or are diagnosed late with a negative impact for both the affected person and the family. The birth prevalence is high (2-4% of all births). The diagnosis is essential to program complex and integrated…

Pseudoaneurysm of superior thyroid artery following a transesophageal echocardiography: A case presentation

The pseudo-aneurysm is an encapsulated hematoma of post-traumatic origin which is in communication with the lumen of the artery of relevance. We present a rare case of pseudo-aneurysm occurring after superior thyroid trans-esophageal echocardiography (TEE) and external cardioversion. Singular occurrence in otolaryngology, if not recognized early a pseudo-aneurysm can result in dramatic events such cataclysmic bleeding or acute occlusion of the upper airway.

The role of temporomandibular disorders in the genesis of tinnitus

Temporomandibular disorders (TMD) are musculoskeletal pain conditions characterized by pain in the temporomandibular joint (TMJ) and/or mastication muscles. Patients with TMD are frequently affected by otolaryngological symptoms like tinnitus, with a prevalence ranging from 2% to 59% of cases. There is still a debate in the scientific community about the relationship between tinnitus and TMD and actually the causal connection between them is not well understood. A possible explanation could be found in the ontogenetic development and in the mechanical and neuronal connections of the masticatory system and the middle ear. Additionally a potential role of TMD in tinnitus onset is suggested by…

Pharmacological therapy of newborn babies admitted to the neonatal intensive care unit

Newborn babies who need intensive medical care are often sheltered into a special area of the hospital called Neonatal Intensive Care Unit (NICU). In this structure, babies are regularly subject to conditions that would be considered harmful by older children and adults. In the last years, many clinical researches have paid particular attention to effectiveness of various pharmacological therapies, regularly used in neonatal intensive care that have sharply reduced mortality of newborn and preterm infants. Although there are many classes of drugs used for the treatment of different diseases (sepsis, pain, seizures, pulmonary hypertension and infection), the fledgling population is more diff…

Upper respiratory tract infections in children: From case history to management

Respiratory tract infections are the most common diseases in childhood. The respiratory tract, widely branched system of ducts, is particularly exposed to the action of microorganisms transmitted by air from here the high frequency of infections they face especially in the first years of life. It is usual distinguish: upper respiratory tract infections (URTI) and lower respiratory tract infections (LRTI). In particular, in infections of the upper airways, the inflammatory process, result of the interaction between microbes and the immune response, can be localized to the mucosa of the nose or sinuses (common cold and sinusitis), or the pharynx or larynx (pharyngotonsillitis and laryngitis) …

The minimally invasive sinus surgery technique

The minimally invasive sinus technique, (MIST) is different from minimally invasive sinus surgery. MIST implies a treatment philosophy and surgical model that is quite different from functional endoscopic sinus surgery (FESS). The goals of this article are to discuss the origins of functional sinus surgery as it relates to the evolution of FESS and MIST, define MIST as a philosophy and surgical model, discuss treatment of surgical sinus disease, and challenge the rationale for our departure from Messerklinger's "functional" concepts into what will be referred to as "contemporary FESS. " Many authors address the reduced revision rate (compared with FESS) following initial intervention with M…