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…

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 …

Intratympanic treatment with dexamethasone as first-line or salvage therapy in sudden sensorineural hearing loss: Results of a retrospective study

Aim: Sudden sensorineural hearing loss is a condition of emergency in Otolaryngology. Although there is no universally accepted treatment protocol, corticosteroids, intravenous and oral, are the most common treatment The purpose of this study is to evaluate the efficacy of intratympanic administration of dexamethasone as first line therapy, or as a rescue therapy after treatment with systemic steroids in patients not responders. Methods: The population, consisting of 85 patients referred to our unit from January 2010 to December 2013, was divided into two groups according to the treatment protocol performed. We also analyzed possible variables that may affect the response to treatment such …

Uvulopalatopharyngoplasty with tonsillectomy in the treatment of severe OSAS

Objective: To establish the efficacy of uvulopalatopharyngoplasty with tonsillectomy for treating selected patients with severe obstructive sleep apnea syndrome Methodology: Retrospective study of patients who underwent clinical/instrumental evaluation and surgical treatment. Setting: University ENT division with a tertiary snoring referral center Participants: Twenty-two patients with normal body mass index affected by severe obstructive sleep apnea syndrome- Main outcome measures: Pre and post operative cardiopulmonary monitoring during sleep, daytime sleepiness evaluation, post treatment complication recording. Results: Complete response to therapy was obtained in 78% of patients. Four p…

Sialoendoscopy: state of the art, challenges and further perspectives. Round Table, 101st SIO National Congress, Catania 2014

This draft of the Official Round Table held during the 101(st) SIO National Congress is an updated review on sialoendoscopy, a technique used for diagnosis and treatment of obstructive pathologies of salivary glands in a minimally invasive fashion. This review treats many aspects of salivary gland endoscopy, starting from anatomy to deal with the more advanced surgical techniques and analyses the main decisional algorithms proposed in the literature. In addition, particular attention was directed to the current limitations of this technique and to the potential developments that sialoendoscopy could have in the near future.Questo testo è un estratto della Tavola Rotonda Istituzionale tenuta…

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…

MORBIDITY OF SALIVARY GLAND DIGITAL SIALOGRAPHY USING A NON-IONIC DIMERIC CONTRAST MEDIUM

Sialography is considered a low invasive procedure, due to cannulation of salivary duct orifice. The aim of this study was to evaluate the morbidity of sialography using a nonionic dimeric contrast medium. METHODS: A questionnaire was proposed to 90 patients who underwent parotid and submandibular sialography to reveal related symptoms as: pain, swelling, impairment to daily activities and taste alteration. Pain and swelling intensity was assessed using a visual analogue scale (VAS). RESULTS: Fifty-two out of ninety questionnaires were returned. Sialography was performed in 30/52 patients in the submandibular gland, 22/52 in the parotid gland. Pain during sialography was complained by 28/52…

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 …

Techniques of intratympanic administration

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…

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 …

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

SUMMARY Aim of the present study was to evaluate the effects of obstructive sleep apnoea syndrome (OSAS) on the peripheral and central vestibular system, by means of a case series prospective study at the University referral centre of Otolaryngology Head and Neck Surgery; 45 consecutive patients suffering from OSAS were compared with a control group of 30 volunteer subjects selected from among the department employees. Severity of the disease was evaluated by means of cardio-respiratory function monitoring during sleep; the apnoea-hypopnoea index was calculated. Both groups underwent: 1) head and neck examination; 2) fibre-optic examination; 3) pure tone audiometry; 4) evaluation of eye mov…