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…

Determinants of failure in the reconstruction of the tympanic membrane: A case-control study

Introduction: The recurrence rate after tympanoplasty is variable between 0% and 50%. The causes of failure may be different and frequently interrelated, making the surgical choice difficult and the prognosis not always favourable. In this study, we analysed recurrence rate and the possible causes of failure of tympanoplasty in the treatment of tympanic perforations. Materials and Methods: This prospective case-control study was carried out on patients undergoing tympanoplasty. The main outcome was closure of the tympanic membrane. Results: Among the studied 72 patients, the overall recurrence rate was 19.4%. The average follow-up was 28 months; no recurrence was observed over 12 months of …

Pleomorphic adenoma of the lateral nasal wall: case report.

Pleomorphic adenoma is the most common tumour of the salivary glands. However, it is extremely rare for these to originate in the nose and even when they do so, it is most commonly in the nasal septum. It is important to be aware of the paucity of presenting symptoms (nasal obstruction and epistaxis), as the lesion may not be recognized immediately. Growth is generally restricted locally and the tumour is not known to spread to the neighbouring structures. Surgical resection is the treatment of choice. Recurrences and evolution to malignancy are not frequent, but long-term follow-up is recommended. The case is presented of pleomorphic adenoma arising from the lateral wall of the right nasal…

Body balance and postural control in patients with dizziness

The ability to maintain body balance and postural control is regulated by a central integration process of afferent inputs received from peripheral sensory components such as the somatosensory, visual, and vestibular apparatus, which control the tonic postural system by modulating efferent information. It is widely recognized that stimuli from the visual and the vestibular systems provide information on the position of the head relative to the trunk and contribute to the orientation and the movement of the body in the environment. For these reasons, the vestibular system plays a key role in controlling body balance. Indeed, several studies have shown the presence of imbalance, postural inst…

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…

Postural changes in patients undergoing hyoid surgery for OSAS

The hyoid bone is the only â suspended boneâ in our body, and its suspension system has an important role in posture maintenance. We studied postural modification in a group of patients affected by Obstructive Sleep Apnea Syndromewho had undergone surgical treatment including hyoid suspension. The surgical procedure performed was section of supra- and infrahyoid muscle and mobilization of the hyoid bone through its suspension to the thyroid cartilage. We studied the postural changes with stabilometric tests. In the early post-operative (one week) follow-up, we performed a posturography test with closed eyes and occlusal disjunction, and saw a worsening of the average parameter of the centre…

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…

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…

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…

Endoscopic treatment of maxillary sinus mucocele

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 …

Frontal sinus osteoma complicated by palpebral abscess: case report.

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…

Inferior turbinate surgery