33 research outputs found
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
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
Sub-clinical effects of chronic noise exposure on vestibular system
Aim: to investigate the effect of chronic noise
exposure on vestibular function of subjects without
clinical evidence of vestibular disorders and with
documented cochlear damage from noise.
Subjects and methods: 25 patients with chronic noiseinduced hearing loss (NIHL) and without vestibular
complaints (group A) and 25 matched controls with
sensorineural hearing loss without noise exposure (group
B), underwent audiological and vestibular test including
caloric and cervical vestibular-evoked myogenic
potentials tests (cVEMPs).
Results: In subjects chronically exposed to noise,
similarly to that of the auditory threshold, an increase in
the evocation threshold of VEMPs has been documented,
statistically significant (p<0,05) and independent of the
performance of the auditory threshold. p1-n1 amplitude
values showed a significant difference between group A
and group B. No significant difference for p1-n1 latencies
between the two groups was found.
Conclusion: We have documented the possibility of
vestibular lesion, along with cochlear damage, related to
chronic acoustic trauma
The outcomes of endoscopic dacryocystorhinostomy in children: A systematic review
To systematically review and discuss the published results about the application of endoscopic dacryocystorhinostomy in treating children with nasolacrimal duct obstruction
Prevalence and diagnosis of vestibular disorders in children: a review
To systematically review and discuss the main pathologies associated with vertigo and dizziness in children, paying particular attention to recent advances in diagnosis and therapy
Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review
To systematically review and discuss the published data about treatments and outcomes for children and adolescents affected by nasopharyngeal carcinoma. In April 2015, an appropriate string was run on PubMed to retrieve all relevant articles. A cross-check was performed by two of the authors on abstracts and full-text articles found using the selected inclusion and exclusion criteria. A meta-analysis concerning the rate of reported disease-free survival and overall survival was performed. Fifteen studies were identified comprising a total of 865 subjects affected by nasopharyngeal carcinoma. According to the American Joint Committee for Cancer Staging system, the majority of tumors were classified as Stage IV (57.3 %). All included patients underwent radiotherapy, while 687 (79.4 %) received also some regimen of chemotherapy. On the basis of our statistical analysis, the mean (95 % CI) rate of disease-free survival was 66 % (95 % CI 56-76). The mean (95 % CI) rate of the overall survival resulted 68 % (95 % CI 58-78). On the basis of our analysis, it may be affirmed that the prognosis of juvenile nasopharyngeal carcinoma is still unsatisfactory. New reports on homogeneous populations are needed to better define the most influencing prognostic factors and to evaluate the introduction of possible alternative therapeutic protocols
The role of antibiotic therapy and nasal packing in septoplasty
Both systemic antibiotic therapy and nasal packing are used frequently in septoplasty. Nevertheless, there is still great disagreement among authors around the real advantages with regard to the efficacy of both of these procedures in septal surgery. The aim of the present review was to evaluate the more recent data published on this topic. One appropriate string was run on PubMed to retrieve articles dealing with the topics mentioned above. A double cross-check was performed on citations and full-text articles found using the selected inclusion and exclusion criteria. Overall, the articles we analyzed indicated the poor utility of routine antibiotic therapy and nasal packing during septoplasty, the latter procedure producing more complications than advantages. In conclusion, on the basis of the recent literature, the use of systemic antibiotic prophylaxis and nasal packing in septal surgery seems to be a non-rational procedure
Combined lateral microscopic/endoscopic approaches to petrous apex lesions: pilot clinical experiences
Surgical treatment of lesions involving the temporal bone, petrous apex, or internal auditory canal is usually performed using the classical microscopic approach that necessitates wide external incisions and soft tissue dissection. At present, the main application of endoscopic surgery is in the surgical treatment of middle ear cholesteatoma, but with the natural evolution of the technique, there will be an increasing number of applications in lateral skull base surgery