53 research outputs found
rehabilitation protocol for unilateral laryngeal and lingual paralysis tapia syndrome comment about a challenging case of tapia syndrome after total thyroidectomy by ildem deveci mehmet surmeli and reyhan surmeli
Tapia syndrome is a rare complication after surgery, with ipsilateral paralysis of vocal cord and tongue due to extracranial involvement of recurrent laryngeal and hypoglossal nerves. Tapia's case report is extremely interesting for both the rarity of the reported cases and for the importance of an early rehabilitation. In a previous work, we reported a case of Tapia syndrome after cardiac surgery for aortic aneurysm, and the protocol of logopedic rehabilitation adopted. In the postoperative period, he developed severe dyspnea and dysphagia that required a tracheostomy and a logopedic rehabilitation therapy that led to a fast and efficient swallowing without aspiration after 47 sessions (less than 4 months). The progressive recovery of the function suggests aprassic nerve damage. However, the logopedic therapy is recommended to limit the possibility of permanent functional deficits and quickly recover swallowing and phonation
Nasal, pharyngeal and laryngeal endoscopy proceduresduring COVID‐19 pandemic: available recommendations from national and international societies
The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), also known as COVID-19, pandemic is engaging clinicians around the world in an unprecedented effort to limit the viral spread and treat affected patients; the rapid diffusion of the disease represents a risk for healthcare providers who have a close contact with the upper aerodiges- tive tract during medical, diagnostic and surgical procedure
Cerebrospinal Fluid Leak During Stapes Surgery: The Importance of Temporal Bone CT Reconstructions in Oblique Anatomically Oriented Planes.
Stapes gusher is a massive flow of perilymph and cerebrospinal fluid leak that fills the middle ear immediately after surgical opening of the labyrinth, such as during stapedectomy. Stapes gusher usually occurs as the result of a congenital malformation that causes an abnormal communication between the perilymphatic space and the subarachnoid space involving the internal auditory canal or the cochlear duct. To date, the potential risk of stapes gusher cannot be assessed preoperatively, as there are not pathognomonic signs suggestive of this complication. However, high-resolution computed tomography scan (HRCT) of the temporal bone can provide information that may help recognizing patients at risk. Recently, an anatomic evaluation of the inner ear with oblique reformation at HRCT has been described. This reformation offers a new and more detailed topographic vision of temporal bone structures compared to the classic axial and coronal planes and may help identifying anatomical alterations otherwise not visible. In this article, we present a case of stapes gusher and the role of preoperative HRCT with oblique reformation in its prevention
Ambulatory Phonation Monitoring in Prelingual and Postlingual Deaf Patients after Cochlear Implantation
Recurrence of non-hydropic sudden sensorineural hearing loss (SSNHL): a literature review
Recurrent non-hydropic SSNHL is unfrequent, differential diagnosis is essential to distinguish idiopathic forms from those symptomatic: the clinician should pay attention to vascular disease and retrocochlear neoplasm. Recurrent SSNHL has a poorer prognosis than a single episode of sudden hearing loss. The aim of this paper was to evaluate the incidence and the risk factors of recurrent non-hydropic SSNHL in the literature
Pleomorphic adenoma of the parotid gland and ipsilateral thyroid incidentaloma: report of a rare case with review of literature
Background: Pleomorphic adenomas are benign
tumors of the salivary glands that mainly affect the lower
pole of the superficial lobe of the parotid gland. The term
"pleomorphic" refers to the epithelial and connective
origin of the mass. The clinical presentation is typically
that of asymptomatic swelling which increases in volume.
Therapy consists in surgical removal of the tumor mass by
parotidectomy with nerve preservation.
Case details: This clinical case describes an
interesting case of pleomorphic adenoma of the parotid
gland in a 62-year-old patient. The patient presented with
a long history of an asymptomatic mildly worsening
swelling of the left parotid region. The peculiarity of the
clinical case is the dimension of the adenoma (9x5x9 cm)
and the presence of a thyroid incidentaloma (TI),
consisting of a thyroid multinodular goiter composed of
nodules, the largest of which measured 8 cm in diameter.
This mass dislocated the laryngotracheal axis, compressed
the larynx and caused the reduction of the respiratory
space, making orotracheal intubation difficult and
determining the need to perform a tracheotomy.
Conclusion: Benign pleomorphic adenomas can
potentially reach large sizes if untreated. Socio-economic
problems may be the reason for late diagnosis
Drug-induced Sleep Endoscopy (DISE) with Simulation Bite to Predict the Success of Oral Appliance Therapy in Treating Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)
Study objectives: Oral appliances
have gained their place in the treatment of
obstructive sleep apnea (OSA) where custom-made
titratable mandibular advancement devices (MAD)
have become the oral appliance of choice. This study
aimed to asses the value of the drug-induced sleep
endoscopy (DISE) using a MAD in the prediction of
treatment outcome for OSAHS
Methods: This is a prospective, single-center
cohort study that enrolled sixty-six consecutive
patients with diagnosed OSA (5 events/h < apneahypopnea index (AHI) < 50 events/h) to be treated
with a custom-made titratable MAD. The patients
were evaluated polysomnographically with the MAD
in situ after the adaptation and titration period of 3
months. The associations between findings during
DISE and treatment outcome were assessed
Results: The subjects showed a wide range of
severity of OSAHS pre-treatment: median AHI was
43.10 with a range from 20.13 to 66.07. The
simulation bite was associated with a significant
increase in cross-sectional area at level of the
velopharynx, tongue base and epiglottis. MAD
treatment response in the studied population was
91%, with a mean AHI improving from 43.10 to
12.93.
Conclusions: Drug-induced sleep endoscopy
with simulation bite is an acceptably reproducible
technique for determining the sites of obstruction in
OSAHS subjects; it thus offers possibilities as a
prognostic indicator for treatment with MA
Dietary restriction for the treatment of Meniere’s disease
Meniere's disease (MD) is an idiopathic inner
ear disorder characterized by spontaneous recurrent
vertigo, fluctuating sensorineural hearing loss (SNHL),
aural fullness and tinnitus. Endolymphatic hydrops (EH)
of the inner ear is currently considered the
pathophysiological mechanisms that underlies typical
symptoms of MD. MD diagnosis is based on the criteria of
the Baràny Society. There are many therapeutic options
for MD, but none is considered effective by the scientific
community. The first-line treatment commonly includes
dietary modification, as low salt diet and reduction of
alcohol and caffeine daily intake.
Although some studies showed a positive effect of
these dietary restrictions, even in the prevention of
recurrences, currently there is no uniform consensus on
their usefulness.
New dietary approach, such SPC-flakes, are being
evaluated: further assessments will be needed to validate
their use in clinical practice
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