Sindrome dell’acquedotto vestibolare largo: esperienza personale e revisione della letteratura

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…

Recessive hearing impairment in three birth cohort in western Sicily

Single-Center-Single-Blinded Clinical Trial to Evaluate the Efficacy of a Nutraceutical Containing Boswellia Serrata, Bromelain, Zinc, Magnesium, Honey, Tyndallized Lactobacillus Acidophilus and Casei to Fight Upper Respiratory Tract Infection and Otitis Media

Some nutraceuticals have been studied as supportive treatment for fighting upper respiratory tract infection and middle ear disease. Our study aims at evaluating the effect of a specific oral supplementation in the treatment of pediatric otits media. The subjects were randomly assigned by the physician (single-blinded study) to one of three groups: Control Group (CG), Treatment Group 1 (TG1), or Treatment Group 2 (TG2). Both TG were treated with Flogostop Duo (for 20 days—TG1 or 30 days—TG2) in combination with the standard treatment, while CG underwent standard treatment only. The standard treatment was nasal aerosol with Fluticasone and Mucolytic, and nasal washing with hypertonic solutio…

Exposure to ototoxic agents and hearing loss: A review of current knowledge

Several experimental and clinical studies have shown that a variety of ototoxic agents (such as drugs, industrial chemicals and noise) can cause sensorineural hearing loss. The most common ototoxic drugs used in clinical practice include: aminoglycoside and macrolide antibiotics, quinoline anti-malarials, platinum analog antineoplastics, loop diuretics, and acetylsalicylic acid. Among chemical agents with potential ototoxic properties are: organic solvents, heavy metals, organotins, nitriles, asphyxiants, and pesticides/herbicides. Acoustic exposure to high intensity and/or prolonged noise can also cause permanent threshold shifts in auditory perception. Ototoxic agents can influence audito…

Sordità neurosensoriale non sindromica: genotipi della Cx26 (GJB2) in famiglie siciliane

Epidemiologia, aspetti genetici e clinici nei neonati con familiarità per ipoacusia: esperienza di un centro di terzo livello

INTRODUZIONE Rilievo frequente nei soggetti affetti da ipoacusia neurosensoriale (SNHL) è un' anamnesi familiare positiva per sordità, correlata a mutazioni genetiche, non sempre facilmente individuate, responsabili del deficit uditivo. L'eziologia genetica costituisce complessivamente il 50-60% di tutte le cause di sordità. Si distinguono forme sindromiche e non sindromiche, queste ultime classificabili secondo le differenti modalità di trasmissione. Nel 50-80% dei casi è riscontrabile una mutazione interessante il gene della connessina 26 (GJB2) localizzato sul cromosoma 13 che oramai è noto, codifica per una proteina chiamata in causa nei processi di trasduzione dello stimolo sonoro. La …

VEMPs: applicazioni cliniche ed esperienza personale.

Aim. Among the various techniques to examine the functioning of the vestibular apparatus, the vestibular evoked myogenic potentials (VEMPs) represent a universally accepted methodical and offers significant clinical applications. Methods. The authors studied 93 patients (55 females, 38 males) from 22-83 years (medium age 52.5 years) with cocleovestibular sphere disturbances: deafness, tinnitus and vertigos. All the subjects underwent I and II level audiological examinations: history, clinical observation, tonal liminar audiometry, impedencemetry, acufenometry, clinical and instrumental vestibular exams, acoustics evoked potentials (ABR) and VEMPs. The subject were divided into groups accord…

Tecniche di intelligenza artificiale nella diagnosi delle sindromi genetiche con ipoacusia

A genotype-phenotype correlation in Sicilian patients with GJB2 biallelic mutations

The aim of this work was to study the genotype distribution of Sicilian patients with biallelic GJB2 mutations; to correlate genotype classes and/or specific mutations of GJB2 gene (35delG-non-35delG) with audiologic profiles. A total of 10 different mutations and 11 different genotypes were evidenced in 73 SNHL subjects; 35delG (90.36 % of cases) and IVS1+1 (13.69 %) were the most common mutations found in the cohort with a significant difference in the distribution between North and South Sicily. Audiological evaluation revealed a severe (16/73) to profound (47/73) hearing loss (HL) in 86.13 % of cases without significant difference between the degree of HL and the province of origin of t…

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.

Treatment of chronic pain associated with bruxism through Myofunctional therapy

<p> </p><p><span> </span>Temporomandibular disorders such as bruxism may cause painful clinical conditions and over time lead to chronic facial pain. A combination of therapeutic strategies that are usually undertaken by dentists and gnathologists to reduce bruxism episodes and consequently pain, are myofunctional therapy, pharmacological treatment, intraoral interventions and behavioural treatments. The aim of this work was to understand if myofuntional therapy alone can be a useful therapy for the reduction of chronic facial pain. 24 patients, 9 male and 15 female, age ranging between 25 and 45, were treated with a myofunctional therapy for 9 month. Each pati…

Parietal subdural empyema as complication of acute odontogenic sinusitis: a case report

Introduction: To date intracranial complication caused by tooth extractions are extremely rare. In particular parietal subdural empyema of odontogenic origin has not been described. A literature review is presented here to emphasize the extreme rarity of this clinical entity. Case presentation: An 18-year-old Caucasian man with a history of dental extraction developed dysarthria, lethargy, purulent rhinorrhea, and fever. A computed tomography scan demonstrated extensive sinusitis involving maxillary sinus, anterior ethmoid and frontal sinus on the left side and a subdural fluid collection in the temporal-parietal site on the same side. He underwent vancomycin, metronidazole and meropenem th…

Analisi delle mutazioni del gene Cx26 (GJB2) in famiglie siciliane con sordità neurosensoriale non sindromica

The scholastic integration process of the imparied child in the province of Palermo: a cognitive survey

Fascite cranio-cervicale, dal quadro clinico al trattamento: esperienza personale

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, …

Emangiopericitoma Vs Tumore glomico

OBIETTIVI I tumori che originano dalle cellule di supporto dei vasi, i periciti, appartengono alla vasta categoria dei tumori dei tessuti molli che sono lesioni generalmente frequenti nel distretto testa-collo. La trasformazione in senso neoplastico dei periciti è comunque poco frequente e può dare origine a due gruppi neoplastici: i tumori glomici e l’emangiopericitoma. Gli autori presentano in seno alla stessa famiglia due casi clinici rispettivamente di tumori glomico timpanico e di emangiopericitoma del condotto uditivo esterno. MATERIALI I tumori glomici timpanici e giugulari sono rare neoformazioni ipervascolarizzate, a lenta crescita, che si sviluppano nell’ambito dell’orecchio medio…

Audiologic and psychological approach to patients with tinnitus: Preliminary findings

Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: The role of subclinical BPPV

Studio osservazionale sui fattori di rischio che causano residual dizziness dopo il trattamento della vertigine parossistica posizionale benigna: il ruolo della VPPB subclinica.Alcuni pazienti, dopo il trattamento della vertigine parossistica posizionale benigna concluso con successo, possono lamentare un disequilibrio residuo. La possibile spiegazione potrebbe essere: la persistenza di otoliti canalari insufficienti a provocare un nistagmo clinicamente evidente, una disfunzione utriculare, coesistenza di altri disordini del sistema vestibolare. Abbiamo condotto uno studio osservazionale prospettico caso-controllo, focalizzando l’attenzione sul ruolo di fattori di rischio che possono causar…

Neonatal Hearing Screening: Three years of experience in Western Sicily

ASSESSMENT AND REHABILITATION PROGRAM IN DIZZINESS PATIENTS PRESENTING VERTEBRAL FRACTURE

Vertebral fragility fractures, usually occurring in elderly people affected by osteoporosis, due to bones resistance alteration, produce balance disorders [1].Balance is the correct connection between the subject and the surrounding environment [2]. Neuro-physiological, biomechanical, emotional, psychological and relational factors have an important influence in posture assessment and balance maintenance, because of the universally recognized role of “polisensorial system.” A preferential motor-sensorial strategy is always present with possibility of readaptation during life, especially after a central or peripheral injury, establishing neuro-plastic processes and compensation mechanisms to…

The role of atopy in otitis media with effusion among primary school children: audiological investigation

The objective of this study was to evaluate the role of atopy in otitis media with effusion (OME) in children attending primary school in western Sicily focusing on the audiological characteristics among atopic and non-atopic subjects suffering from OME. A total of 310 children (5-6 years old) were screened by skin tests and divided into atopics (G1) and non-atopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram and acoustic reflex tests. The parameters considered were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months; presence of B or C tympanogram; absence of ipsilateral acoustic reflex and a conductive hearing loss …

Is there an association between age at first words and speech sound disorders among 4- to 5-year-old children? An epidemiological cross-sectional study based on parental reports

To investigate the role of the period of emergence of the first words and its interactions with other risk factors in predicting the development of speech sound disorder (SSD) among 4- to 5-year-old children.After 373 children underwent otolaryngology and speech pathology examinations, their parents answered a questionnaire about potential risk factors for speech impairment. The presence of SSD was identified by a speech pathologist who administered Fanzago's Articulation Test to each child. Multivariate logistic analysis was used to explore the relationships between variables and outcomes.Mean age at first words was 17.8 ± 6.5 months of life; 25.7% of patients suffered from SSD, and 3.7% f…

Sordità ereditaria recessiva nella Sicilia occidentale: studio epidemiologico su tre coorti

Emissioni Otoacustiche e Screening Neonatale: ieri ed oggi. Emissioni Otoacustiche 30 anni dopo: cosa c’è di attuale e quali prospettive?

Profilo familiare ed individuale come fattore predittivo delle performances verbo-acustiche pre impianto cocleare: esperienza personale

RAZIONALE L’impianto cocleare è oramai il trattamento di scelta in tutti quei casi di sordità preverbale severa/profonda permettendo di ottenere a distanza di 12 mesi una soglia uditiva amplificata integralmente all’interno dello spettro acustico del parlato. Se ciò è dimostrato ampiamente dalla letteratura, è comunque vero che le aspettative familiari e le performances verbo/acustiche sono altamente variabili. Lo scopo del presente lavoro è quello di identificare tramite un accurato studio del profilo familiare ed individuale, tutte le possibili variabili in grado di influenzare i risultati. MATERIALI E METODI Le variabili oggetto del presente studio sono state suddivise in familiari ed in…

Tubal function in divers and non-divers: case control study

Background. The aim of this study was to examine whether recurrent scuba diving during the time and frequent use of Valsalva’s manoeuvre while diving, increase functionality of divers’ Eustachian Tube (ET) comparison with non-divers. Methods. The study included 30 experienced divers (G1), mean age 25,8 years, who were diving from over 10 years. The control group consisted of 30 non-divers (G2), mean age 31,3 years. Each sample underwent clinical examination to identify predisposing conditions to middle ear barotraumas and ET dysfunction. ET function has been investigated by Inflation-Deflation test that shows baseline tympanogram, a second tympanogram shifted of the peak towards positive va…

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…

Potenziali evocati vestibolari miogenici nei deficit uditivi

Con il termine VEMPs (Vestibular Evoked Muscolar Potentials) si designa una particolare tipologia di potenziali muscolari registrabili dal muscolo sternocleidomastoideo (SCM), a seguito di un'intensa stimolazione acustica. La neurofisiotopografia dei VEMPs si racchiude in un breve arco riflesso disinaptico: lo stimolo sonoro agendo sui recettori otolitici sacculari determina l’attivazione del riflesso vestibolo-collico che viene registrato come “variazione di potenziale bioelettrico” ponendo gli elettrodi sulla clavicola, sul muscolo sternocleidomastoideo, e sullo sterno. La metodica quindi rappresenta una strategia non invasiva di esplorazione di entrambi i vestiboli, dei recettori otoliti…

Rara complicanza di un caso di litiasi parotidea

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.…

Neonatal intensive care units (NICUs): Clinical and patient perspectives, levels of care and emerging challenges

From World Health Organization data, the prevalence of hearing impairment among infants varies between 0.5 and 3.0 cases per thousand, but in children hospitalized in the Newborn Intensive Care Unit (NICU) and in those with other risk factors (i.e., anatomically small for gestational age, craniofacial abnormalities, intrauterine infections, family history of hearing loss, ototoxic drugs, mechanical ventilation, etc.), the prevalence is 10-20 times greater. Newborn Intensive Care Unit (NICU) can be defined as an intensive care unit for sick newborns who need specialized treatment. NICU combines equipment and advanced technology with medical staff specially trained in newborn care. The Joint …

Erratum to “Protein supplement consumption is linked to time spent exercising and high-protein content foods: A multicentric observational study” [Heliyon 5 (4) (April 2019) e01508]

Infarto acuto dell'AICA e sordità improvvisa

OBIETTIVI Gli autori descrivono un caso clinico, uomo adulto di 57 anni, di sordità improvvisa come sola manifestazione di infarto della arteria cerebellare antero‐inferiore (AICA) di destra in presenza di un quadro radiologico da interessamento della regione pontina di destra la cui valutazione radiologica, eseguita in urgenza ha permesso l’identificazione del quadro. MATERIALI Il colpo ischemico acuto nella distribuzione dell’AICA conosciuto come “Sindrome AICA” è un quadro clinico patologico che generalmente è accompagnato da una sintomatologia mista di tipo otologica e neurologica; si caratterizza infatti per: sordità improvvisa, vertigini di tipo periferiche e/o centrali da irritazione…

Atypical presentation of ramsay hunt syndrome without facial palsy in an immunocompetent young male

Frequenza e fenotipo delle mutazioni GJB2 in pazienti con ipoacusia neurosensoriale non-sindromica congenita: analisi di una coorte della Sicilia Occidentale

Circa il 60% delle ipoacusie congenite sono associate a cause genetiche nei paesi sviluppati. La sordità genetica è classificata in sindromica (30%) e non sindromica (70%), quest’ultima riconducibile in più del 50% dei casi a mutazioni del gene GJB2. Tale gene, espresso nella coclea, codifica per la proteina gap junction “Connessina 26”, la cui funzione è cruciale per la comunicazione intercellulare. L’obiettivo del nostro lavoro è stato quello di stimare la frequenza delle mutazioni GJB2 e la loro correlazione con il fenotipo audiologico in 102 pazienti siciliani affetti da sordità neurosensoriale congenita non sindromica (NSHL) bilaterale e portatori di almeno una mutazione del gene GJB2.…

Prevalence and risk factors for sensorineural hearing loss: Western Sicily overview.

The objective of this work was to evaluate the prevalence of sensorineural hearing loss (SNHL) and distribution of the main risk factors associated to it focusing on their role in the development of deafness and their interaction. We performed a global audiological assessment (through TEOAE, tympanometry and ABR) in 508 infants at risk studying the main risk factors reported by Joint Committee on Infant Hearing (2007). Fifty-one infants (10.03 %) were diagnosed with SNHL (45 bilateral and 6 unilateral) with a mean hearing threshold of 87.39 ± 28.25 dB HL; family history of hearing impairment (HI) and TORCH infections indicated independent significant risk factors (P < 0.00001 and P = 0.0…

Alcohol abuse and insomnia disorder: Focus on a group of night and day workers

The sleep-wake cycle plays a fundamental role in maintaining the physiological balance of our body. Its alteration favours the genesis of several organic alterations and diseases including sleep disorders and the consumption of several substances of abuse. It has been reported that the work activity, especially that carried out during the night, is able to influence the sleep-wake cycle, promoting the development of insomnia, which, in turn, would subject the worker to a stressful condition such as to encourage adverse behaviour such as the use/abuse of psychotropic substances. Based on the above premises, the aim of our research was to evaluate, in night workers: (i) the pattern of consump…

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

(1) Background: Inferior turbinates&rsquo

MENIERE’S DISEASE & NEUROVASCULAR CROSS-COMPRESSION: CASE REPORT

Meniere’s disease is typically characterized by the classic symptomatological triad consisting of vertigo associated with nausea and vomiting, fluctuating but progressive hearing loss, and tinnitus. The main pathophysiological substrate of Meniere's disease is certainly endolymphatic hydrops, the etiology of which is probably multifactorial, but still not completely understood. Recently, it has been shown that vertigo, hearing loss, and tinnitus can be the result of a vascular loop impinging on the VIIIth nerve and giving rise to the symptomatological complex that can been defined as Meniere's disease due to ‘cochleovestibular nerve compression syndrome’ (CNCS). In this cases the surgical t…

Sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSNHL), is an important otological disorder that affects up to 5-20 in 100,000 people. It is characterized by a rapid loss of the hearing, usually unilateral, with a sensorineural hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours and can be associated with tinnitus and vertigo. It is a real sensorineural emergency that can become a permanent handicap if not adequately treated. Because of patients recovering rapidly or seeking no medical attention, the true figure might be higher, even if delaying SHL diagnosis and treatment may decrease the effectiveness of treatment. Sudden Hearing Loss can occur at any age but usua…

Identification of D179H, a novel missense GJB2 mutation in a Western Sicily family

The main purpose of this study was to describe a novel missense mutation (p.D179H) found in a Western Sicily family and to examine the genetic and audiologic profiles of all family members by performing a GJB2 and GJB6 mutations analysis and a complete audiologic assessment. The proband was a 3-month-old infant with a congenital profound sensorineural hearing loss; direct sequencing of the GJB2 revealed the presence of a c.35delG mutation in the heterozygous state and a heterozygous G[C transition at nucleotide 535 in trans; this novel mutation, called p.D179H, resulted in an aspartic acid to histidine change at codon 179. It was also evidenced in the heterozygous state in two members of th…

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 …

Distribution and phenotype ofGJB2mutations in 102 Sicilian patients with congenital non syndromic sensorineural hearing loss

Objective: To evaluate the frequency of GJB2 mutations and their correlation with phenotype in Sicilian non-syndromic sensorineural hearing loss (NSHL) patients. Design: Sequencing of the coding region, basal promoter, exon 1, and donor splice site of the GJB2 gene; screening for the presence of the two common GJB6 deletions. Study sample: A cohort of 102 Sicilian NSHL patients. Results: Fifteen different mutations in GJB2 and seventeen different genotypes were detected. No GJB6 mutations were found. The hearing impairment was profound in the 64.72% of probands (mean PTA 0.25 – 4 kHz of 88.82 26.52 dB HL). A total of 81.37% of patients harboured at least one c.35delG allele; c.167delT and c…

Newborn hearing-screening project using transient evoked otoacoustic emissions: western sicily experience

Summary Objective To study the incidence of congenital sensorineural hearing loss in all newborns introducing a screen test with a protocol no expensive, with a good “screen sensitivity” that could let an earlier identification of hearing impairment beginning early intervention by 2 months of age and increasing the probability of having language development within the normal range of development. Methods The study was conducted in Sciacca hospital from the beginning of 2003 to our days and was carried out with transient evoked otoacoustic emission using the criteria for PASS or RETEST and considering eventual prenatal and perinatal risk factors. All the newborns were divided into four group…

Vascular loops causing otological symptoms and…: esperienza personale

Per conflitto neurovascolare (CNV) si intende la presenza di un contatto tra uno o più nervi cranici nel punto di emergenza dal tronco dell’encefalo e una struttura vascolare, arteriosa o venosa. Tale contatto può configurarsi come una “cross compression”, cioè come una compressione ad angolatura variabile tra le due strutture o come una compressione a “sandwich”, vale a dire un intrappolamento del nervo tra due strutture vascolari. Questo si verifica più frequentemente a livello della root entry zone (REZ), cioè di quella piccola porzione di nervo ubicata nelle immediatezze del tronco encefalico, ancora ricoperta dalla mielina centrale. Il CNV è responsabile dell’insorgenza di diversi quad…

Neuropatia uditiva: incidenza e caratteristiche cliniche in neonati a rischio

INTRODUZIONE La neuropatia uditiva (NU), entità nosografica di recente individuazione, costituisce un’importante causa di ipoacusia di grado variabile dal lieve al severo, ad insorgenza sia nella primissima infanzia che nell’età giovanile, raramente nell’anziano. È riconducibile ad alterazioni di alcune componenti della via uditiva, tra cui le cellule cocleari ciliate interne (le esterne sono caratteristicamente risparmiate), le loro sinapsi con le fibre afferenti del nervo acustico o il nervo acustico stesso. L’eziologia, fatta eccezione per le forme riconducibili a mutazioni del gene OTOF (codificante per l’otoferlina, una proteina espressa dalle cellule ciliate interne cocleari), è stata…

Tinnitus: a vision for research

Tinnitus is classically defined as the perception of sound that has no external source. It was assumed to be primarily a disorder of the ear and has been linked to mechanisms equivalent to phantom pain; a pain sensation located to a no longer existing part of the body. Phantom pain is closely correlated with a cortical plasticity and with a reorganization of the somatosensory cortex. The end result is an alteration of neuronal activity, leading to tinnitus. Over the past decade, however, research on brain mechanisms of tinnitus has progressed rapidly, and insights have emerged into the possible neurological origins of tinnitus without any auditory dysfunction. Identification of the neurosci…

Sordità ereditaria recessiva e consanguineità: studio epidemiologico nella Sicilia Occidentale

Patologia endoteliale e malattia di Ménière

La timpanoplastica aperta: indicazioni e nostri risultati a distanza

OBIETTIVI Le indicazioni per una tecnica aperta sono in primo luogo le otomastoiditi colesteatomatose, le neoplasie, alcune complicanze ed alcune forme di otomastoidite granulomatosa diffusa con totale coinvolgimento della catena ossiculare, specialmente quando esiste una mastoide eburmnea. MATERIALI Nel periodo 1975‐2006 sono state eseguite 4875 timpanoplastiche, di cui 3343 con tecnica aperta. In considerazione dell'esperienza maturata è utile distinguere un periodo compreso tra il 1975 e 1990, nel quale, indipendentemente dalla diagnosi, si eseguiva la tecnica chiusa nel 95% dei casi, mentre la tecnica aperta era riservata al 5% dei casi. Nell'85% delle tecniche chiuse veniva eseguito un…

Sordità neurosensoriale bilaterale da nuova mutazione del gene GBJ2 (D179H): recessiva o dominante? Preverbale o postlinguale?

RAZIONALE La sordità genetica nell’area del mediterraneo presenta valori di prevalenza molto più elevati rispetto ad altre zone ‘endemiche’ e nel 80% dei casi il gene responsabile è il GJB2. La conoscenza della corretta trasmissione genetica (autosomica recessiva, dominante, trasmissione variabile o co-segregazione con il gene GJB6) è di vitale importanza anche per stabilire il rischio percentuale di sordità per la progenie futura. Gli autori allora descrivono una mutazione del gene della connessina 26, parzialmente nuova, dove lo studio genetico familiare è dirimente per una trasmissione recessiva. MATERIALI E METODI In presenza di un soggetto affetto da sordità neurosensoriale bilaterale …

Intratumoral Haemorrhage Causing an Unusual Clinical Presentation of a Vestibular Schwannoma

We present a case of an elderly woman with no history of audiological disease with sudden onset of visual and hearing deficits associated with systemic clinical signs. On examination she had impairment of right CNs from V to X. CT and MR imaging demonstrated a cystic vestibular schwannoma with a rare intralesional fluid-fluid level correlated to a recent bleed. We include high quality MR images to show the acute impairment of the cranial nerves next to the tumour after acute bleeding. Our case report includes a voxel-based morphometry (VMB) analysis of the tumour that, as far as we know, has never been done before for such a tumour. VBM analysis was performed to calculate the hypothesized …

Working Memory Function in Children with Single Side Deafness Using a Bone-Anchored Hearing Implant: A Case-Control Study

The importance of a good hearing function to preserve memory and cognitive abilities has been shown in the adult population, but studies on the pediatric population are currently lacking. This study aims at evaluating the effects of a bone-anchored hearing implant (BAHI) on speech perception, speech processing, and memory abilities in children with single side deafness (SSD). We enrolled <i>n</i> = 25 children with SSD and assessed them prior to BAHI implantation, and at 1-month and 3-month follow-ups after BAHI implantation using tests of perception in silence and perception in phonemic confusion, dictation in silence and noise, and working memory and short-term memory function…

AGE-RELATED HEARING IMPAIRMENT (ARHI): A COMMON SENSORY DEFICIT IN THE ELDERLY

This paper aims to give a broad overview of the scientific findings related to Age-related hearing impairment that is a complex disorder, with both environmental as well as genetic factors contributing to the impairment. The involvement of several environmental factors has been partially elucidated. A first step towards the identification of the genetic factors has been made, which will result in the identification of susceptibility genes, and will provide possible targets for the future treatment and/or prevention of ARHI.

Alcohol and Nicotine Use among Adolescents: An Observational Study in a Sicilian Cohort of High School Students

In recent years, the mode of alcoholic intake known as binge drinking (BD) has become a common practice, especially among adolescents who, due to socio-environmental motives, tend to reach a rapid state of drunkenness. This drunkeness leads to alterations in brain areas responsible for executive functions and cognitive processes, as well as to the genesis of factors that predispose to lasting addiction. Likewise, nicotine leads to a comparable degree of addiction. On this basis, the aim of this research was to evaluate, on a cohort of 349 high school students (15–17 years old) in the province of Palermo, the following: (I) the drinking model of alcoholic beverages; (II) the use of nic…

Multidisciplinary approach in the removal of post-trauma foreign bodies in the head and neck district: cases report and review of literature

Introduction: The management of foreign bodies (FBs) penetrating the head and neck district is a condition rare but at risk for the patient’s life because this district is particularly rich in vital structures. Therefore, their management requires a multidisciplinary approach. Materials and methods: In this study we retrospectively examine two emblematic cases among 183 that occurred in our hospital from January 2008 to December 2017. Results: There were 183 cases of FBs of the head and neck district submitted to extraction with a range of age of between 18 months old and 79 years old. Of 183 patients, 112 were children, 60 were adults. The incidence was prevalent among children, with 112 c…

Le sordità ereditarie

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…

Effectiveness of Rehabilitative Intervention on Pain, Postural Balance, and Quality of Life in Women with Multiple Vertebral Fragility Fractures: A Prospective Cohort Study.

Patients with vertebral fragility fractures often experience chronic pain, postural and balance disorders, and poor quality of life (QoL). Although several studies have investigated the role of rehabilitation in severe osteoporosis, the effectiveness of this intervention in patients with multiple vertebral fractures is poorly known. The aim of our longitudinal cohort study is to evaluate the effectiveness of rehabilitation, including postural training, resistance exercises, and visual stabilization exercises, for a 7-week period, on the pain, postural balance, and QoL of subjects with at least two vertebral fragility fractures receiving denosumab and vitamin D. We investigated, before (T0) …

The Role of Cartilage-perichondrium Tympanoplasty in the Treatment of Tympanic Membrane Retractions: Systematic Review of the Literature.

Abstract Introduction Tympanic retraction is a condition characterized by the displacement of the tympanic membrane toward the structures of the middle ear. Clinically, tympanic retractions can lead to hearing loss, ear discharge and/or ear pain. In most of the cases, however, tympanic retractions are asymptomatic and are found accidentally during an ear, nose, and throat (ENT) examination. This condition has created numerous debates regarding the optimal choice of treatment, especially in the asymptomatic forms. The main controversy is regarding the relationship between retraction and the development of cholesteatoma, which would justify a surgical intervention performed for preventive pur…

Sordità neurosensoriale preverbale profonda isolata & impianto cocleare: esperienza personale

Negli ultimi anni si è assistito ad un crescente aumento delle indicazioni all’impianto cocleare (IC) nei bambini affetti da sordità preverbale profonda ed ad una parallela sempre maggiore precocità dell’intervento. Infatti un intervento precoce permette di ‘sfruttare’ al massimo i meccanismi di plasticità cerebrale e ridurre le alterazioni nello sviluppo dei network cerebrali legati al processamento del linguaggio dovuti alla deprivazione uditiva (principio “use it or lose it”). La valutazione delle capacità percettive verbali nei bambini di età inferiore ai due anni richiede metodologie dedicate a cogliere i prerequisiti o le prime abilità linguistiche. Per tali ragioni sono stati propost…

Otitis media with effusion with or without atopy: audiological findings on primary schoolchildren

Objective: The objective of the study was to evaluate the role of atopy in otitis media with effusion (OME) in children attending primary school, focusing on the audiometric and tympanometric measurements among atopic and nonatopic subjects suffering from OME. Materials and Methods: Three hundred ten children (5-6 years old) were screened in Western Sicily by skin tests and divided into atopics (G1) and nonatopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram, and acoustic reflex tests. The parameters considered were as follows: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months, presence of B or C tympanogram, absence …

Sindrome dell’acquedotto vestibolare largo: esperienza personale e revisione della letteratura

Audiologic profile of OSAS and simple snoring patients: the effect of chronic nocturnal intermittent hypoxia on auditory function

The objective of this work was to study the effect of nocturnal intermittent hypoxia on auditory function of simple snoring patients and subjects affected by OSAS; we compared the audiologic profile with the severity of OSAS to detect early signs of cochlear damage. One hundred-sixty patients underwent overnight polysomnography, micro-otoscopy, multi-frequency audiometry, acufenometry, TEOAE recording and d-ROMs test. All subjects were divided in four groups, based on presence/absence of AHI (simple snoring without OSAS, mild OSAS, moderate OSAS, severe OSAS). Sixty (37.5 %) patients were not affected by OSAS, 58 (36.25 %) presented a mild OSAS, 18 (11.25 %) a moderate OSAS and 24 (15 %) a …

Essential of audiology: screening and postscreening

Newborn hearing screening is a type of screening testfor the early detection of hearing loss. It can recognizewith good accuracy newborns affected by hearingimpairment allowing an early diagnosis and interventionand avoiding cognitive and linguistic deficits [1-6].The incidence of bilateral sensorineural hearing loss(SNHL) in Sicily is 2.35 cases per 1000 newborns; thisvalue increases to 2.95 if we consider also unilateral SNHL[2,3] and to 10 cases per 1000 births among infants at risk[7-9].A correct newborn hearing screening programme isbased on different protocols depending on the presence/absence of audiologic risk factors:† Newborns without risk factors: [1-3]Initial Hearing Screening (…

Risk factors for otitis media with effusion: Case–control study in Sicilian schoolchildren

Objective To identify the prevalence and demographic, maternal and child risk factors for otitis media with effusion (OME) in Sicilian schoolchildren and analyse the results with reference to the review of the literature. Methods Associations of possible risk factors with prevalence of otitis media with effusion (OME) were studied in a cohort of 2097 children, aged 5–14 years. In order to determine OME, otoscopy and tympanometry were performed at 3-monthly intervals beginning at term date. Sixteen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis was performed to examine the association between det…

Cavernous haemangioma of the external auditory canal: clinical case and review of the literature

Although benign vascular lesions are frequent in the head and the neck region, clinical evidence of cavernous haemangioma of the external auditory canal is extremely rare; when present, the lesion invades the middle ear space. Herein, a rare case of a soft mass filling the external auditory canal, not involving the tympanic membrane, in a symptomatic 59-year-old male is described. Clinical and audiological characteristics, imaging studies and surgical treatment with histological evaluation are reported, which led to a diagnosis of a cavernous haemangioma. This is only the seventh case described in the literature, to date, not involving the tympanic membrane and the middle ear space. In addi…

Clinical observations and risk factors for tinnitus in a Sicilian cohort.

The aims of this study were to determine the distribution of risk factors associated with tinnitus analysing their role in the development of tinnitus and the effects of their interaction; to evidence the importance of a suitable and adequate clinical and audiologic assessment to avoid those modifiable risk factors responsible for cochlear dysfunction and tinnitus onset. 46 subjects with tinnitus and 74 controls were studied according to: age, sex, Body Mass Index (BMI), neck circumference, tobacco smoking, feeling fatigue or headache, self reporting snoring, hypertension, diabetes, coronary heart disease, and/or hyperlipidemia, and laboratory finding as lipid profile and levels of reactive…

Stapedotomia V.S. Stapedectomia: nostra esperienza

RAZIONALE La chirurgia della staffa ha visto negli ultimi anni molte innovazioni nel trattamento chirurgico dell'otosclerosi. In particolare, la stapedectomia è stata sostituita sempre più dalla stapedotomia prima con metodo classico e successivamente con metodica invertita, in quanto si ritiene che tali varianti chirurgiche consentano una maggiore riduzione del gap tra via ossea e via aerea per le alte frequenze, una migliore discriminazione vocale oltre che minori complicanze intra e post operatorie. Lo scopo del presente studio è stato quello di confrontare i risultati della stapedotomia con la stapedectomia nei pazienti affetti da otosclerosi e in particolare il miglior recupero uditivo…

The motor development of preterm infants after the neonatal intensive care unit

The extra uterine environment is a hostile environment, due to noises, lights and different biological activities compared to intra uterine environment for infants born preterm or underweight. Stress and painful experiences may also impact developmental outcomes. In addition, developmental delay risks increase with the decrease in gestational age. Thus, those born with immature developed systems may need neonatal intensive care units (NICU) in order to allow a correct growth and body maturation. In general, infants that need NICUs suffer from a slower development compared to their full-term peers. This may translate in a delay in oral, tactile, kinesthetic, vestibular, auditory, olfactory, …

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…

The point prevalence of otitis media with eVusion among primary school children in Western Sicily

The objective of this study is to identify the prevalence of otitis media with effusion (OME) in primary school children and to value the possible predisposing factors focusing on relationship between allergy and OME in Western Sicily. 2,097 children attending primary school were screened from September 2006 to June 2007 in Sciacca. Children underwent pneumatic otoscopy, skin tests, tympanogram and acoustic reflex tests. Audiogram was performed if the child had a type B or a type C tympanogram. The criteria for diagnosis of OME were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months, presence of B or C tympanogram, absence of ipsilateral acoustic r…

Arteriovenous malformation of the base lingua in pregnancy: case report

Arteriovenous malformation (AVM) of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent itself truly as a lethal benign disease. We present here an unusual case of an AVM of the base lingua in a 32year old primigravida at 23.2 weeks of gestation with an history of hemoptysis. The patient was admitted to hospital with 10.7 g/dl of Hemoglobin and 32.1% of hematocrit but due to recurrent massive hemoptysis in the days after dropped to 6.7 g/dl of Hemoglobin and 20.2% of hematocrit which required immediate blood transfusions. To maintain upper airways the patient underwent tracheostomy; during angiography, showing a AVM with it…

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…

Il linfoma non-Hodgkin del seno piriforme: case report e revisione della letteratura

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…

Audiologic profile of infants at risk: experience of a Western Sicily tertiary care centre.

Objective: To identify the incidence of sensorineural hearing loss (SNHL) on infant at risk and to classify the degree and type of hearing loss describing the main causes associated in Western Sicily. To compare single TEOAE and combined TEOAE/ABR techniques studying the referral rate, the false-positive and false-negative rates through concordance test (κ coefficient), sensitivity (TPR) and specificity (TNR) for each protocol. Methods: From January 2010 to June 2011, 412 infants at risk, ranging from 4 to 20 weeks of life, transferred to Audiology Department of Palermo from the births centers of Western Sicily, underwent to audiological assessment with TEOAE, tympanometry and ABR. The foll…

Characteristics of tinnitus with or without hearing loss: Clinical observations in Sicilian tinnitus patients

Objective: To analyze the clinical characteristics of tinnitus both in normal hearing subjects and in patients with hearing loss. Methods: The study considered 312 tinnitus sufferers, 176 males and 136 females, ranging from 21 to 83 years of age, who were referred to the Audiology Section of the Department of Bio-technology of Palermo University. The following parameters were considered: age, sex, hearing threshold, tinnitus laterality, tinnitus duration, tinnitus measurements and subjective disturbance caused by tinnitus. The sample was divided into two groups: Group 1 (G1) subjects with normal hearing; Group 2 (G2) subjects with hearing loss. Results: Among the patients considered, 115 ha…

Post laryngectomy speech rehabilitation outcome in elderly patients

The aim of our work has been to evaluate the different options of tracheoesophageal voice rehabilitation in over 70-year-old patients, who had undergone laryngectomy, assessing advantages and drawbacks of this method of vocal recovery. A retrospective study has been carried out. This has included 40 subjects, all aged more than 70 years old, who have been referred to tracheoesophageal voice rehabilitation. It has been realized a phonatory fistula between trachea and esophagus with prosthesis positioning by means of a primary puncture in 18 cases and it has been realized a secondary puncture in 22 cases. The results gathered in these patients were compared with data obtained from a group mad…

Sindrome dell'acquedotto vestibolare largo ed ossigeno-terapia iperbarica (HBO): caso clinico

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…

Effetti dei campi elettromagnetici sull’udito valutati mediante ABR: risultati preliminari

Association between sensorineural hearing loss and sleep-disordered breathing: Literature review

The cochlea is especially sensitive to circulatory alterations because it is supplied by a single terminal artery and lacks adequate collateral blood supply. To examine the putative association between Sensorineural Hearing Loss (SNHL) and Sleep Disordered Breathing (SDB) through the literature review is very interesting. In fact these medical disorders usually are associated to cerebral circulatory alterations resulting in hypoxia, acute hemodynamic change, and decreased cerebral blood flow, because the Sleep Disorder Breathing (SDB), for example OSAHS (Obstructive Sleep Apnea Hypopnea Syndrome), is characterized by periodic hyposia/reoxygenation. These noxious stimuli can, in turn, activa…

Isolated laryngeal leishmaniasis in a 55-year-old man with dysphonia and rheumatoid arthritis: Case report and literature review

Tinnitus e ipertensione neurogena da conflitto neurovascolare: descrizione di un caso

The term neurovascular conflict (NVC) has been introduced to describe the anatomic situation where a nerve makes contact with a blood vessel, artery or vein, at the exit zone from the brain’s trunk. The NVC between the VIII nerve and a blood vessel is clinically associated with tinnitus, vertigo (disabling positional vertigo, DPV), and unilateral sensorineural hearing loss. The blood vessels which most frequently make contact with the VIII nerve are the anterior-inferior cerebellar artery, then the posterior-inferior cerebellar artery and the basilar artery. The authors present an unusual case in which both vertebral arteries (one of which crosses the midline) create a NVC with left acousti…

Lezioni di Semeiotica ORL

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…

Calcificazione della cartilagine auricolare in un paziente con insufficienza renale: caso clinico

Importanza del ruolo delle OAE nell’accertamento degli acufeni in età infantile.

EMORRAGIA IN TUMOR DA NEURINOMA DELL’VIII N.C. & SIMDROMI PARALITICHE ANTERIORE E POSTERIORE IMPROVVISA: SEMEIOTICA RADIOLOGICA

Gli autori riportano un raro caso clinico di una paziente di 77 anni che giunge alla nostra osservazione in regime di urgenza per vertigine improvvisa associata a nausea e vomito, stato confusionale, atassia, paralisi completa del VI nervo cranico di destra con strabismo convergente, segni di sofferenza del IX, X ed XI nervo cranico omolaterali all’abducente e iniziale comparsa di segni statici e dinamici di paralisi periferica del VII nervo cranico di destra. L’insorgenza improvvisa di Sindromi paralitiche associate, anteriori e posteriori, ha indirizzato verso il sospetto di lesione occupante spazio a sede in fossa cranica posteriore/tronco encefalo richiedendo pertanto l’ausilio della di…

Sudden sensorineural hearing loss as prodromal symptom of anterior inferior cerebellar artery infarction.

Sudden sensorineural hearing loss is a clinical condition characterized by a sudden onset of unilateral or bilateral hearing loss. In recent years sudden deafness has been frequently described in association with anterior inferior cerebellar artery (AICA) infarction generally presenting along with other brainstem and cerebellar signs such as ataxia, dysmetria and peripheral facial palsy. The authors report a rare clinical case of a 53-year-old man who suddenly developed hearing loss and tinnitus without any brainstem or cerebellar signs. Computed tomography of his brain was normal, and the audiological results localized the lesion causing deafness to the inner ear. Surprisingly, magnetic re…

Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the early identification of Italian teachers with voice disorders

Abstract Introduction The current Italian law does not include any guidance regarding voice education, prevention of voice disorders and screening in subjects with high vocal loading such as teachers. Objectives We aimed to check the correlation between the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for the evaluation of Italian teachers. In addition, we aimed to investigate whether there are differences in the frequency and intensity of discomfort symptoms in teachers with disabilities comparing vocal tract discomfort symptoms in teachers with high risk (HRVD) and low risk (LRVD) of vocal disorders according to the VoiSS cutoff (> 15.5). Methods We analyzed…

A Patient With Toxoplasmosis as a Cause of Submental Lymphadenopathy.

Submental mass secondary to toxoplasmosis is a rare condition and physicians rarely consider its diagnosis. The presented case reports a 43-year-old woman referred with a constant, painless, edema located in the submental area for 2 weeks. Diagnosis of toxoplasmosis was established by the positive serological finding after an accurate medical history of the infectious disease specialist (the patient had eaten raw meat). The patient underwent antimicrobial therapy with resolution of lymphadenopathy. According to review of literature, the article aims to remind clinicians, maxillofacial surgeons, and otolaryngologists that a neck mass can be related to the infectious cause with involving of l…

Surgical Management of Retraction Pockets: Does Mastoidectomy have a Role?

Abstract Introduction Retraction pocket is a condition in which the eardrum lies deeper within the middle ear. Its management has no consensus in literature. Objective To assess the role of mastoidectomy in the management of retraction pockets added to a tympanoplasty. Methods Prospective study of patients with retraction pocket and referred to surgery. The patients were randomly assigned to two groups: one managed with tympanoplasty and mastoidectomy and the other group with tympanoplasty only. The minimum follow-up considered was 12 months. The outcomes were: integrity of eardrum, recurrence, and hearing status. Results This study included 43 patients. In 24 cases retraction occurred in t…

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…

Hyperbilirubinemia, Auditory Neuropathy and Prelingually Deafness: Evidence Linking

SINDROME DELL'ACQUEDOTTO VESTIBOLARE LARGO E OSSIGENO TERAPIA IPERBARICA. CASO CLINICO

Prevalenza delle mutazioni in GJB2 nella popolazione siciliana affetta da sordità neuro-sensoriale non sindromica

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…

Protein supplement consumption is linked to time spent exercising and high-protein content foods: A multicentric observational study

The main aim of this study is to analyze if protein supplement consumption and food patterns vary across three geographical regions and secondly to identify possible factors that increase the likelihood of ingesting protein supplements.A total of 916 responses from gym users of 3 countries (Italy, Turkey and UK) were entered for analysis. Questions were related to supplement consumption (protein and other supplements), food intake and training habits. A descriptive analysis, analysis of variance (ANOVA), and logistic regression were performed.No differences were found across groups regarding: prevalence of protein supplement consumption, typology of other ingested supplement and food intake…

Tinnitus e Sordità

OBIETTIVI Con il termine di "Acufene" o "Tinnitus" definiamo la percezione di un rumore in assenza di qualunque sorgente sonora esterna al nostro organismo. La presenza di acufeni aumenta progressivamente con l'età (12% dopo i 60 anni), e questo, secondo gli Autori, non è tanto correlato con la senescenza quanto con la concomitante sordità, la cui prevalenza aumenta con l'età. L'obiettivo di questo studio è quello di mettere in evidenza la correlazione fra il tipo di sordità e il tipo di acufene. MATERIALI Lo studio è stato condotto dalla Sezione di Audiologia del Dipartimento di Bio‐technologie dell'Università di Palermo su 197 soggetti affetti da acufene e sordità. I pazienti sono stati s…

Studio sull’efficacia terapeutica dell’Arlevertan in associazione con l’Otofisk in presenza di una sintomatologia vertiginosa e di acufene legati ad un danno delle vie audio-vestibolari (periferiche e centrali) da probabile causa vascolare

Acetaldehyde as the first hit of addictive behaviour

Unhealthy alcohol use is common in the Western society, which puts risk of health consequences, causing multiple behavioural injuries. Increasing evidence focuses on acetaldehyde, the first metabolite of ethanol, as the mediator of the several behavioural actions of alcohol, including its rewarding and motivational effects. In particular, acetaldehyde induces dopamine release in the nucleus accumbens modulating primary alcohol rewarding effect, drug seeking, and relapse behaviour. Recent behavioural studies point at acetaldehyde as a drug of abuse since its oral self-administration is induced and maintained in an operant/conflict paradigm. These findings provide further evidence on the role…

A Multifactorial pattern for the understanding of the psychological development of the child with impaired hearing and its clinical-therapeutic implications

The Authors propose a multifactorial pattern for the understanding of the psychological development of the child with impaired hearing. According to this pattern the psychological development is determined by a variety of factors that can be regrouped intothree categories: • family features • aspects concerning the rehabilitation and the acoustic prosthesis • social and socio-environmental factors. In order to apply an effective action it is necessary to consider the interaction of the different factors and to adapt the therapeutic plan to that particular situation.

Corsa al vaccino

UN RARO CASO DI LEIOMIOMA DEL CAVO ORALE

Speech intelligibility and perception after cochlear implant in deaf children with or without associated disabilities: A review

The ability to make oneself understood is critical to most human interaction, and as such, the failure to develop fully intelligible speech may result in a significant handicap especially in the child in learning phase. World literature has demonstrated improved speech intelligibility and speech perception as well as a good development of communication skills in prelingual profound sensorineural hearing loss (SNHL) children after cochlear implantation. The literature considered as universally-accepted the usefulness/effectiveness of unilateral early cochlear implantation in severely-profoundly deaf children with or without associated disabilities. In fact this procedure, for children implan…

Speech perception outcomes after cochlear implantation in prelingually deaf infants: The Western Sicily experience

Objectives: To describe audiometric characteristics and speech perception performances of prelingually deaf Sicilian children after cochlear implantation; to identify the influence of cochlear implant (CI) user and family's characteristics on speech recognition and intelligibility outcomes. Methods: Twenty-eight infants with a congenital or acquired hearing impairment and implanted before the 3rd year of life were studied; all children suffered from bilateral sensorineural hearing loss (SNHL) with evidence of lack of hearing aids benefit and no evidence of intellectual disability. The study of the main characteristics associated with CI user and family's profile was performed with a clinica…

Audiological Investigation of Otitis Media in Children with Atopy

Otitis media (OM) describes an inflammatory process within the middle ear space that is generally associated with accumulation of fluid and that may lead to hearing loss, learning difficulties, and delays in language development. The pathogenesis of OM is multifactorial, involving the adaptive and native immune system, eustachian tube dysfunction, viral and bacterial load, and genetic and environmental factors. The involvement of IgE-mediated allergic reactions in the pathogenesis of OM has been suggested by clinical observations of a high prevalence of OM among patients with allergies. Evidence from studies involving tympanometric measurements, audiometric measurements, and otoscopic exami…

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…

Investigation of Tinnitus Patients in Italy: Clinical and Audiological Characteristics

Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the impact of tinnitus on subjects' life and where possible the etiological/predisposing factors of tinnitus.Results. There is a slight predominance of males. The highest percentage of tinnitus results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14%) have a hearing deficit (light hearing loss in 37.18% of cases). The hearing impairment results of sensorineural type in 74.62% and limited to the high frequencies in 58.50%. The tinnitus is referred as unilateral in 59.93%, a pure tone in 66.99%…

“SINDROME DI BECHET, CELIACHIA E DIABETE MELLITO DI I TIPO”: ....RARO CASO A TIPIZZAZIONE ANOMALA

La malattia di Behcet è una malattia rara, a genesi autoimmune, multifattoriale ad esordio tra la seconda e la terza decade di vita, a più elevata incidenza nei cosiddetti territori della via della seta (Medio Oriente) oltre che, nel Bacino del Mediterraneo. In Europa la prevalenza è 1:500.000 con maggiore incidenza nel sesso femminile. Clinicamente è caratterizzata da lesioni ulcerose ricorrenti del cavo orale che si accompagnano a ulcere genitali o lesioni cutanee, oculari o Pathergy Test positivo . Il "Behcet's Disease International Study Group" ha identificato nella presenza di ulcere del cavo orale associate a due delle lesioni sovracitate la diagnosi clinica di malattia di Behcet. Nel…

Risk Factors for Sensorineural Hearing Loss and Auditory Maturation in Children Admitted to Neonatal Intensive Care Units: Who Recovered?

Background: Newborns admitted to neonatal intensive care units (NICUs) are at higher risk of developing sensorineural hearing loss (SNHL), which may improve over time. The aim of this study was to describe the prevalence of the main risk factors for SNHL in a NICU cohort, focusing on children who underwent auditory maturation. Methods: An observational study of 378 children admitted to NICUs, who were followed for at least 18 months, with periodic audiologic assessments. Results: Out of 378 patients, 338 had normal hearing and 40 were hearing-impaired; we found a higher percentage of extremely preterm (EPT) and extremely low-birthweight (ELBW) infants in SNHL children (p < 0.05). Sevente…

ACUFENI: EPIDEMIOLOGIA.

Otogenic lateral sinus thrombosis in children: proposal of an experience-based treatment flowchart

Purpose: To describe the prevalent clinical, laboratory, and radiological features of otogenic lateral sinus thrombosis (OLST) in children; to identify clinical predictors of outcome; to propose a management algorithm derived from experience. Methods: A retrospective review was conducted of the clinical records of patients with OLST, treated in a single tertiary care referral center for pediatric disease from 2006 to 2017. The inclusion criteria were pediatric age (0–16 years) and OLST diagnosis confirmed by a pre- and post-contrast CT or venography–MRI scan. Primary outcome measures were early (1–2 months) and late (6 months) sinus recanalization assessed by means of neuroimaging. Results:…

Motivating factors of cephalalgia during the age of development: Personal experience

Clinical evolution of asthma from early childhood to development age

The aim of study was to conduct evaluation over twenty years on patients with relapsing wheezing breathing since their early years of life. The research included a period of observation started in 1978 up to 2002. The follow-up included 381 patients. The enrolment was carried out during the first 15 years, after being evaluated during outpatient or/ and hospitalization the children with a clinical picture resembling asthma (at least three episodes of dyspnea for a year, at least 2 years prior to our first observation). During follow-up the rhole of some risk factors in childhood able to affect the persistency of asthma in adulthood was considered. An early onset of symptoms resulted to be a…

Fatores que influenciam a ocorrência de otite media entre crianças sicilianas com infecções de vias aéreas superiores

ABSTRACT INTRODUCTION: Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. OBJECTIVE: T…

RARO CASO DI IPERPLASIA ANGIOLINFOIDE CON EOSINOFILIA DELLA REGIONE MASTOIDEA

L’iperplasia angiolinfoide con eosinofilia (ALHE) è una rara malattia benigna ad eziologia poco chiara, anche se la malattia viene considerata dalla maggior parte degli autori un processo reattivo o di natura vascolare amartomatosa. Colpisce con leggera prevalenza il sesso femminile tra la III e la V decade ed è caratterizzata da lesioni papulose e nodulari con sede elettiva al capo, al collo e al condotto uditivo esterno, senza linfadenopatia e con lieve eosinofilia periferica. Dal punto di vista istologico è presente una proliferazione vascolare dermica e/o ipodermica accompagnata da un infiltrato in gran parte costituito da linfociti, istiociti ed eosinofili. Gli autori descrivono un cas…

The relationship between moderate hearing loss with balance and postural control

Universal newborn hearing screening in the Italian Region of Sicily in 2018

We have clarified the role of Universal Neonatal Hearing Screening (UNHS) for both early diagnosis and rapid treatment in order to improve the prognosis of the deaf child and reduce patient management costs. Although in Sicily UNHS has been progressively implemented, there is scarce data in the literature on this matter. Therefore, the main objective was to collect in the year 2018 the following data: number of newborns screened for hearing loss, number of infants "referred" to transiently evoked otoacoustic emissions (TEOAE), number of infants with pathologic auditory brainstem response (ABR) and number of infants affected by permanent hearing loss.UNHS monitoring was conducted through the…

Prelingual sensorineural hearing loss and infants at risk: Western Sicily report.

Objective: To evaluate independent etiologic factor associated with sensorineural hearing loss (SNHL) in newborn at risk; to study the role of their interaction especially in NICU infants who present often multiple risk factors for SNHL. Methods: The main risk factors for SNHL reported by JCIH 2007 were evaluated on 508 infant at risk ranging from 4 to 20 weeks of life, transferred to the Audiology Department of Palermo from the main births centers of Western Sicily. After a global audiological assessment, performed with TEOAE, tympanometry and ABR, the prevalence and the effect of risk factors was statistically studied through univariate and multivariate analysis on the total population (n…

The Influence of the COVID‑19 Pandemic Emergency on Alcohol Use: A Focus on a Cohort of Sicilian Workers

The period between the beginning and the end of the COVID-19 pandemic emergency generated a general state of stress, affecting both the mental state and physical well-being of the general population. Stress is the body’s reaction to events or stimuli perceived as potentially harmful or distressing. Particularly when prolonged over time, it can promote the consumption of different psychotropic substances such as alcohol, and thus the genesis of various pathologies. Therefore, our research aimed to evaluate the differences in alcohol consumption in a cohort of 640 video workers who carried out activities in smart working, subjects particularly exposed to stressful situations due to the string…

‘Malformazione artero-venosa del base lingua’ in gravidanza,….mito o realtà: case report

Unilateral sensorineural hearing loss in scholastic age subjects: Psychopedagogical aspects

The Authors want to assess a probable significant relation between the unilateral sensorineural hearing loss and some learning difficulties and language acquisitions, often found, through our observation, in impaired children. The Authors have examined a group of subjects in their scholastic age who have this kind of hearing loss and, through several dialogues with them, they have gathered some relevant data about the difficulties that children have at school, and drawn up a questionnaire.

Decreased postural control in people with moderate hearing loss

Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling. The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region. Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear −60 ± 21 dB; Left ear −61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric…

Tubercolosi laringea: caso clinico

Raro caso di papilloma invertito del sacco lacrimale con invasione dell’orbita

ACUFENI E INSTABILITA' ASSOCIATI AD INSUFFICIENZA VERTEBROBASILARE

Evolution of migraine vertigo in overlapping syndrome with ménière’s disease: Prognostic role of instrumental examination

Migraine vertigo (MV) and Ménière's disease (MD) share several signs and symptoms such as tinnitus, fullness, photophobia, phonophobia, headache and vertigo spells lasting hours.The aim of the present study was to prospectively observe patients with MV with a sporadic audiological symptom evaluated with clinical examination, Vestibular Evoked Myogenic Potentials (VEMPs), ECochG and v-HIT.The finding of VEMP asymmetry, according to our cut-off of 33% of difference between sides, resulted in 20 cases, of which 6 had asymmetry of both c-VEMPs and o-VEMPS, all with development of fluctuating hearing during follow-up. ECochG was positive for endolymphatic hydrops in 12 patients.The evolution of …

E-ABR in Patients with Cochlear Implant: A Comparison between Patients with Malformed Cochlea and Normal Cochlea

Objectives This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. Materials and methods A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compare…

Comparison of Electrocochleography and Video Head Impulse Test findings in Vestibular Migraine and Ménière Disease: A Preliminary Study

OBJECTIVES: To evaluate electrophysiological findings among patients with vestibular migraine (VM) and to compare them with those of patients suffering from definite Ménière disease (MD) without migraine. MATERIALS and METHODS: Twenty-one consecutive patients suffering from VM were enrolled; all subjects were selected according to the criteria proposed by the Bàràny Society for Neuro-otology. Each patient underwent a careful otological and neurotological examination. After completing a questionnaire regarding migraine and vertigo complaints, they were assessed by audiometric testing, video head impulse test (vHIT), and elec-trocochleography (EcochG). Data were compared with those of 21 pati…

Efficacy and pharmacological appropriateness of cinnarizine and dimenhydrinate in the treatment of vertigo and related symptoms

Vertigo is not itself a disease, but rather a symptom of various syndromes and disorders that jeopardize balance function, which is essential for daily activities. It is an abnormal sensation of motion that usually occurs in the absence of motion, or when a motion is sensed inaccurately. Due to the complexity of the etiopathogenesis of vertigo, many pharmacological treatments have been tested for efficacy on vertigo. Among these drugs, cinnarizine, usually given together with dimenhydrinate, appears to be the first-line pharmacotherapy for the management of vertigo and inner ear disorders. Based on these considerations, the present non-interventional study aimed to investigate the clinical …

Management of laryngeal precancerous lesions.

Abstract Objective The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required. Methods A prospective study was done on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal liga…

Otite media atelettasica, adesiva, timpanosclerotica: update medico e chirurgico

Otitis media secretive is one of the most common ear diseases characterized by frequent sequelae and complications; in particular the authors describe middle ear atelectasis with pocket retraction of tympanic membrane, pocket retraction limited to pars tensa or to pars flaccida, adhesive otitis media, partial or total myringosclerosis and tympanosclerosis. For each disease the Authors comment the best surgical approaches to preserve and restore conductive hearing loss. As for middle ear atelectasis, adhesive otitis media, myringosclerosis and partial tympanosclerosis it was evidenced a significant hearing gain while in total tympanosclerosis there was an initial hearing improvement in a sho…

Difensil immuno reduces recurrence and severity of tonsillitis in children: A randomized controlled trial

Oral supplements (OS) support the immune system in fighting upper airways infection. This study aimed to analyze the effect of Difensil Immuno (DI) on the recurrence of tonsillitis and fever in children. A multicentric randomized clinical trial was conducted. One-hundred and twenty children with chronic tonsillitis were randomly assigned to group A, B or control. Patients in group A were treated with 10 mL of DI for 90 consecutive days, patients in group B underwent treatment with 15 mL of DI for 45 consecutive days. The following data were collected at baseline (T0), T1 and T2: tonsillitis and fever episodes, tonsillar volume, blood test results. One-way ANOVA was used to analyze within an…

Managment clinico e chirurgico delle infezioni profonde del collo

La fascite necrotizzante (FN) è un’infezione dei tessuti molli caratterizzata da necrosi diffusa a rapida progressione dei tessuti sottocutanei e delle fasce ad essi annessi, potenzialmente letale. L’incidenza varia a seconda della localizzazione e tra tutte quella cranio-cervicale (FNCC) si presenta in 4/1000 casi di FN l’anno. Se pur rara negli ultimi anni si è assistito ad una maggiore evidenziazione clinica; ciò è da ascrivere ad una transitoria immunodepressione legata a malattie sistemiche in grado di compromettere i meccanismi di fagocitosi; I processi flogistici in grado di evolvere in FN sono prevalentemente infezioni dentarie (23%), ascessi peritonsillari (15%) ed infezioni a live…

Mobile phone and auditory system: update

The aim of this study is to asses the non-thermal effects of the electromagnetic fields generated by 915 MHz GSM cellular phones on the human cochlear activity using transient evoked otoacoustic emissions (TEOAE). The study was carried on 205 young and healthy volunteers (age 18-30 years) with normal hearing which were randomly divided into two samples consisting of 85 (Gcase) and 120 (Gcontrol) respectively. The first one was exposed to genuine 10 minutes of GSM electromagnetic fields while the second, undergone sham exposure, was considered as control group for the statistical investigations. All the participants were blind to the genuine or sham exposure. The TEOAEs were measured in the …

Orofacial muscles activity in children with swallowing dysfunction and removable functional appliances

Swallowing dysfunction is a frequent disorder among children and refers to an altered tongue posture and abnormal tongue movement during swallowing. Removable functional appliance is one of the treatments applied by dentistry to correct this disorder. The aim of this study was to evaluate any differences on orofacial muscles activity in children with swallowing dysfunction with and without removable functional appliances. 68 children were eligible for the study and divided into the orthodontic group (OG) and the no-orthodontic group (NO-OG). Both groups performed a dental occlusion-class evaluation, a swallowing function test and a myoscan analysis in order to measure perioral forces (i.e. …

Assessing audiological, pathophysiological and psychological variables in tinnitus patients with or without hearing loss

The aim of this work is to study the characteristics of tinnitus both in normal hearing subjects and in patients with hearing loss. The study considered tinnitus sufferers, ranging from 21 to 83 years of age, who were referred to the Audiology Section of Palermo University in the years 2006–2008. The following parameters were considered: age, sex, hearing threshold, tinnitus laterality, tinnitus duration, tinnitus measurements and subjective disturbance caused by tinnitus. The sample was divided into Group1 (G1), 115 subjects with normal hearing, and Group2 (G2), 197 subjects with hearing loss. Especially for G2, there was a predominance of males compared to females (P = 0.011); the highest…

Medical therapy of Autoimmune deafness

Prevalenza delle mutazioni in GJB2 nella popolazione siciliana affetta da sordità neurosensoriale.

On the threshold of effective well infant nursery hearing screening in Western Sicily.

Abstract Objective To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high “screen sensitivity” reducing the number of more expensive secondary level exams. Methods The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 – PASS without risk factor, free to go home; G2 – PASS with risk fact…

Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes?

Objective: To investigate the relationship between haematological routine parameters and audiogram shapes in patients affected by sudden sensorineural hearing loss (SSNHL). Design: A retrospective study. All patients were divided into four groups according to the audiometric curve and mean values of haematological parameters (haemoglobin, white blood cell, neutrophils and lymphocytes relative count, platelet count, haematocrit, prothrombin time, activated partial thromboplastin time, fibrinogen and neutrophil-to-lymphocite ratio) of each group were statistically compared. The prognostic role of blood profile and coagulation test was also examined. Study sample: A cohort of 183 SSNHL patient…

Raro caso di corpo estraneo tiroideo

Diagnostica di base: test psicoacustici, impedenzometria.

L'AUDIOMETRIA COMPORTAMENTALE RAPPRESENTA L’INSIEME DI METODICHE ATTRAVERSO LE QUALI E’ POSSIBILE VALUTARE SOGGETTIVAMENTE LA CAPACITA’ UDITIVA DEL BAMBINO, MEDIANTE L’OSSERVAZIONE DELLE VARIAZIONI, RIFLESSE O VOLONTARIE, DEL SUO COMPORTAMENTO IN PRESENZA DI STIMOLI SONORI ADEGUATI

Rara complicanza di un caso di litiasi parotidea. (poster).

Massiva emorragia intratumorale causa di atipica presentazione clinica di un neurinoma cistico del cui: caratteristiche TC ed RM e analisi morfovolumetrica.

Poster per congresso nazionale AINR. Padova, 19-22 Ottobre 2011