0000000000963912
AUTHOR
S. Gallina
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…
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…
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 …
Localisation of mediterranean Kaposi's sarcoma in Morgagni's ventricle
Objective: Head and neck involvement in Kaposi’s Sarcoma (KS) is not unusual . However, laryngeal involvement is a relatively infrequent manifestation and ENT specialists should consider it in differential diagnosis in laryngeal lesions of AIDS patients and/or subjects from the Mediterranean area. Methods: Case report and review of the literature in English Clinical Case: Male patient presenting with a three- month history of cough and acute dispnoea. Laryngoscopy identified a laryngeal mass occluding the glottic plane. Tracheotomy was then performed and the laryngeal lesion was removed. Histopathology showed neoplastic spindle cells that were positive to immunostain with CD-31 and CD-34, a…
L'ecocardiografia speckle tracking: Roadmap per la misurazione e l'utilizzo clinico
Speckle tracking echocardiography (STE) has recently emerged as a quantitative technique to accurately estimate myocardial function. By the analysis of the motion of speckles in the two-dimensional ultrasonic image, this technique allows a non-Doppler angle-independent objective analysis of myocardial deformation, with the possibility to quantify thickening, shortening and rotation dynamics of cardiac function. Since this technique does not require Doppler imaging, the analysis is relatively angle-independent and is marginally affected by cardiac in-plane motion artifacts. Data regarding feasibility, reproducibility and diagnostic accuracy appear to be optimal in several clinical contexts. …
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 âsatiety hormoneâ because it plays a key role in the control of ener…
Oxidative stress neuroinflammation and cellular stress response in sensorineural hearing loss: novel nutritional therapeutical approaches
This study is intended to validate the hypothesis that changes in the redox state of glutathione, the major endogenous antioxidant, associated with the abnormal expression and activity of cytoprotective vitagenes, which in normal conditions are expressed only at low level may represent a critical factor, involved in the physiopathological changes associated to degenerative damage occurring in cochlear diseases. Moreover modulation of stress responsive vitagenes by nutritional antioxidants can be an effective therapeutic strategy to minimize consequences of oxidative stress associated to the pathogenesis and course of sensorineural hearing loss. One therapeutic approach can be antioxidant su…
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…
Sonographic examination of epiaortic vessels in patients with peripheral vertigo
To evaluate the utility of echo-color-Doppler ultrasonography (CDU) of extracranial brain-supplying vessels in patients with peripheral vertigo of unknown origin.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-parametric (Mann-Whitney U-test and Kolmogoro…
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…
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) …
Bipolar Quantum Molecular Resonance versus Blunt Dissection tonsillectomy
Bipolar Quantum Molecular Resonance versus Blunt Dissection tonsillectomy. Objectives: This study compared a quantum molecular resonance tonsillectomy (QMRT) to a standard blunt dissection tonsillectomy (BDT) for effectiveness and safety. Methodology: From January 2011 to September 2012, we recruited 80 children (ages 3 to 16 y) with paediatric obstructive sleep apnoea syndrome and/or recurrent tonsillitis. Patients were randomly assigned to receive QMRT (N = 40) or BDT (N = 40). The operating time and blood loss during surgery were evaluated. During the first postoperative week, the patients' parents completed a questionnaire to evaluate bleeding, ear and neck pain, nausea, vomiting, inter…