Autoimmunity and otolaryngology diseases

Many systemic autoimmune diseases have otolaryngology manifestations that could represent a diagnostic challenge for clinicians, as they often constitute an early sign of an otherwise asymptomatic autoimmune condition and may lead to delayed diagnosis and treatment. In other cases, otolaryngology manifestations can be overlooked in patients with previously diagnosed autoimmune diseases. The pres- ence of concomitant conditions, the heterogeneity of studies available in the literature, and the lack of randomized trials are factors that may limit the prompt diagnosis of otolaryn- gology manifestations in systemic autoimmune diseases, with underestimation of the problem and undertreatment of the related condition

Audio-vestibular symptoms in systemic autoimmune diseases

Immune-mediated inner ear disease can be primary, when the autoimmune response is against the inner ear, or secondary. The latter is characterized by the involvement of the ear in the presence of systemic autoimmune conditions. Sensorineural hearing loss is the most common audiovestibular symptom associated with systemic autoimmune diseases, although conductive hearing impairment may also be present. Hearing loss may present in a sudden, slowly, rapidly progressive or fluctuating form, and is mostly bilateral and asymmetric. Hearing loss shows a good response to corticosteroid therapy that may lead to near-complete hearing restoration. Vestibular symptoms, tinnitus, and aural fullness can be found in patients with systemic autoimmune diseases; they often mimic primary inner ear disorders such as Menière’s disease and mainly affect both ears simultaneously. Awareness of inner ear involvement in systemic autoimmune diseases is essential for the good response shown to appropriate treatment. However, it is often misdiagnosed due to variable clinical presentation, limited knowledge, sparse evidence, and lack of specific diagnostic tests. The aim of this review is to analyse available evidence, often only reported in the form of case reports due to the rarity of some of these conditions, of the different clinical presentations of audiological and vestibular symptoms in systemic autoimmune diseases

Il trattamento chirurgico dei tumori maligni del labbro. Esperienza personale

I tumori maligni del labbro rappresentano circa l’1-2% delle neoplasie cervico-facciali. Tali lesioni sono più frequentemente costi - tuite da carcinomi spinocellulari e basocellulari che nel complesso rappresentano il 25% di tutti i tumori orali. Mentre il carcinoma spinocellulare si localizza soprattutto sul labbro inferiore, il carcino - ma basocellulare si riscontra maggiormente sul labbro superiore .Il sesso maschile risulta essere sensibilmente il più colpito. L’etiopatoge - nesi di queste neoplasie è legata all’esposizione solare, al fumo, alla predisposizione genetica (mutazione del gene soppressore p53), all’e - voluzione di forme di precancerosi, quali radiodermiti, cheiliti croni - che, xeroderma pigmentosum. Inoltre, alcuni Autori enfatizzano il ruolo svolto da diversi agenti virali quali HPV16, HPV24, HSV1 e HSV2. Il trattamento dei carcinomi del labbro è prevalentemente chirurgico ed è fondamentalmente rappresentato dall’escissione della lesione e successiva ricostruzione del labbro. Le tecniche riparative sono numerose e per la maggior parte basate sull’utilizzo di lembi cutanei locali di scorrimento e di rotazione. La ricostruzione del lab - bro comporta un notevole impegno al fine di preservare quanto più possibile forma e funzioni essendo il labbro fondamentale nell’ali - mentazione, nella fonazione e nella mimica espressiva. Gli Autori riportano la loro esperienza riguardo il trattamento chi - rurgico di 19 pazienti, 17 di sesso maschile, di età compresa tra 58 e 84 anni (età media 72 anni), affetti da carcinoma del labbro (16 spi - nocellulari, 3 basocellulari) con prevalenza di forme ben differenziate. Vengono inoltre discusse le principali problematiche ricostruttive ine - renti la preservazione degli aspetti estetici e funzionali delle labbra

Peri-orbital foreign body: a case report

<p>Abstract</p> <p>Introduction</p> <p>Foreign bodies inside the orbital cavity are rare. They can cause more or less serious complications, depending on their nature and size.</p> <p>Case presentation</p> <p>We report a case of a work-related accident involving a peri-orbital foreign body. The patient was a 50-year-old Caucasian man whose face was injured on the right side while he was working with an agricultural machine. On admission, he was fully conscious and did not have any neurological deficits. He had no loss of vision or ocular motility, but had a laceration of the lateral side of his right upper eyelid. A computed tomographic scan revealed a 6-cm-long bended metal object lodged in the lateral bulbar space of the right orbit. The patient recovered well after surgery and a course of antibiotic therapy.</p> <p>Conclusion</p> <p>The original aspects of this case are the singularity of the foreign body and its relative harmlessness in spite of its large size.</p

A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo (Vol 41, Pg 31, 2014)

G dAnnunzio Univ Chieti Pescara, ENT Inst, Dept Oral & Nanobiotechnol Sci, I-74100 Taranto, ItalyUniv Palermo, San Giovanni di Dio Hosp Agrigento, Dept Otorhinolaryngol, I-90133 Palermo, ItalyBritish Hosp Montevideo, Lab Otoneurol, CLAEH Sch Med, Montevideo, UruguayUniv Navarra, Univ Navarra Clin, Dept Otorhinolaryngol, E-31080 Pamplona, SpainSungkyunkwan Univ, Sch Med, Dept Otolaryngol, Seoul, South KoreaUniv Munich, Dept Neurol Ludwig Maximilians, D-81377 Munich, GermanyUniv Brasilia, Dept Otorhinolaryngol, BR-70910900 Brasilia, DF, BrazilUniversidade Federal de São Paulo, Dept Otolaryngol, São Paulo, BrazilKeimyung Univ, Sch Med, Dept Neurol, Taegu, South KoreaKIMS Hosp Kasaragod, Dept Otolaryngol, Kasaragod, IndiaRNT Med Coll Udaipur, Udaipur, IndiaG dAnnunzio Univ Chieti Pescara, Dept Pharm, I-74100 Taranto, ItalyG dAnnunzio Univ Chieti Pescara, Postgrad Sch Publ Hlth & Prevent Med, I-74100 Taranto, ItalyG dAnnunzio Univ Chieti Pescara, Dept Med & Aging, I-74100 Taranto, ItalyUniversidade Federal de São Paulo, Dept Otolaryngol, São Paulo, BrazilWeb of Scienc