Claudio Vicini - Academia.edu (original) (raw)
Papers by Claudio Vicini
Acta Otorhinolaryngologica Italica, 2019
Description of the relationship between NOHL classification in drug-induced sleep endoscopy and i... more Description of the relationship between NOHL classification in drug-induced sleep endoscopy and initial AHI in patients with moderate to severe OSAS, and evaluation of the results obtained with oral appliance therapy Descrizione della relazione tra Classificazione NOHL definita durante la Drug-Induced Sleep Endoscopy e AHI iniziale in pazienti con OSAS da moderato a grave, e valutazione dei risultati ottenuti con dispositivi orali
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2003
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Journal of Clinical Medicine
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Archives of Oto-Rhino-Laryngology, 2021
Purpose This meta-analysis study was designed to analyze endoscopic surgery’s role in treating rh... more Purpose This meta-analysis study was designed to analyze endoscopic surgery’s role in treating rhinogenic contact point headache. Methods We performed a comprehensive review of the last 20 years’ English language regarding Rhinogenic contact point headache and endoscopic surgery. We included the analysis papers reporting post-operative outcomes through the Visual Analogue Scale or the Migraine Disability Assessment scale. Results We provided 18 articles for a total of 978 RCPH patients. While 777 (81.1%) subjects underwent functional nasal surgery for RCPH, 201 patients (20.9%) were medically treated. A significant decrease from the VAS score of 7.3 ± 1.5 to 2.7 ± 1.8 was recorded (p < 0.0001). At quantitative analysis on 660 patients (11 papers), surgical treatment demonstrated significantly better post-operative scores than medical (p < 0.0001). Conclusion At comparison, surgical treatment in patients with rhinogenic contact points exhibited significantly better values at sh...
Journal of Clinical Medicine
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by repeated col... more Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by repeated collapses of the upper airway walls, leading to a complete or partial reduction of airflow [...]
Surgeries
Submandibular gland sialolithiasis can be addressed by gland removal or by stone removal. Intraor... more Submandibular gland sialolithiasis can be addressed by gland removal or by stone removal. Intraoral stone removal has now become the go-to technique to minimize aesthetic and functional sequelae (e.g., marginalis mandibulae injury, visible surgery scar) and, although traditional techniques were first experimented with (intraoral ducotomy), newer techniques drew the interest of the scientific community: sialoendoscopy, TORS-S (TransOral Robotic Surgery Assisted–Sialolithotomy) and VITOM-guided sialolithotomy. In this article, we compare the two newest transoral techniques for transoral sialolithotomy, TORS-S and 3D-4K VITOM-guided sialolithotomy, used to treat bilateral hilar submandibular gland sialolithiasis in the same patient, one technique for each side. Using these techniques, a faster recovery is achievable with almost no anatomical and/or functional sequelae, since they both allow better visualization and manipulation of soft tissues and noble structures (e.g., lingual nerve ...
Laryngeal cancer is one of the most common cancers of the head and neck. The best diagnostic appr... more Laryngeal cancer is one of the most common cancers of the head and neck. The best diagnostic approach is provided by performing a full endoscopic evaluation, appropriate imaging and biopsy. Therapy can thereafter be tailored to pathology, stage of disease, and then individualized. The multidisciplinary tumor board represents an essential requirement in oncologic diagnosis and treatment, often introducing clinical challenges which force us to overcome our personal opinion in solving a case in a specific manner. This book represents a collection of our retrospective analysis of the local weekly tumor board which includes the otorhinolaryngologist, oncologist, radiotherapist, pathologist, radiologist and speech pathologist. We have also included reviews from national and international opinion leaders in the field of laryngeal cancer. The book is organized into three sections: basic science, diagnostic work-up and treatment, with the aim of providing a concise, up-to-date, and appropria...
Oral Oncology, 2020
Trans Oral Robotic Surgery (TORS) is a fascinating new technique that has proved to be a safe and... more Trans Oral Robotic Surgery (TORS) is a fascinating new technique that has proved to be a safe and feasible treatment of oropharyngeal squamous cell carcinoma (OPSCC). The aim of this study is to compare oncological outcomes of OPSCC-patients treated with either TORS (with or without adjuvant therapy) or definitive chemoradiation therapy (CRT). Materials and methods: This study involved 129 patients with OPSCC, treated with TORS or definitive CRT at our Department between 2008 and 2018. Clinicopathological characteristics, treatment specifications and oncological outcomes were evaluated retrospectively. Results: Definitive CRT was administered in 69 patients (53,5%), while 60 (46,5%) were surgically treated with TORS alone or in combination with adjuvant therapy. Patients who underwent adjuvant therapy after TORS received a lower dosages of cisplatin and radiation than the CRT group (p < 0.01). There was no statistical difference in 5-year survival rate and in disease free interval between TORS and CRT groups. Albeit 5-year overall survival in the HPV-related tumours was better, the HPV status did not affect the rate of local and regional recurrence. Treatment groups (TORS vs. CRT) were not found affecting survivals on multivariate analysis. Tube feeding dependency rate was low between both groups (1.7% in TORS vs. 4.8% in CRT groups). Conclusion: The modern management of OPSCC must be tailored to each patient. Although the definitive CRT remains a milestone, TORS is proving to be a valid and safe treatment option. The choice of single therapeutic strategy requires an evaluation by a multidisciplinary team.
Oral Diseases, 2020
Several disorders involving submandibular gland such as chronic sialadenitis, sialolithiasis and ... more Several disorders involving submandibular gland such as chronic sialadenitis, sialolithiasis and salivary gland tumours can require a surgical excision. Submandibular gland excision is generally performed through a transcervical approach, a safe procedure that, however, carries few drawbacks. In particular, postoperative skin scar can be cosmetically unappealing, especially in young patients and degenerate into keloid formation. Other possible complications include marginal mandibular branch of the facial nerve, lingual nerve and hypoglossal nerve injuries with an incidence of 1%-7.7%, 1%-4%
The Laryngoscope, 2019
Objectives/Hypothesis: To investigate long-term complications of newer reconstructive palate surg... more Objectives/Hypothesis: To investigate long-term complications of newer reconstructive palate surgery techniques. Study Design: Retrospective case-series analysis. Methods: Retrospective six-country clinical study of OSA patients who had nose and palate surgery. Results: There were 217 patients, mean age = 43.9 AE 12.5 years, mean body mass index = 25.9 AE 4.7, mean preoperative apnea-hypopnea index [AHI] = 30.5 AE 19.1, follow-up 41.3 months. A total of 217 palatal procedures were performed, including 50 expansion sphincter pharyngoplasties (ESP), 34 functional expansion pharyngoplasties (FEP), 40 barbed reposition pharyngoplasties (BRP), 64 modified uvulopalatopharyngoplasties (mUPPP), 11 uvulopalatal flap procedures (UPF), nine suspension pharyngoplasties (SP), eight relocation pharyngoplasties (RP), and one z-pharyngoplasty (ZPP). Complications included were constant and/or felt twice per week; dry throat (7.8%), throat lump feeling (11.5%), throat phlegm (10.1%), throat scar feeling (3.7%), and difficulty swallowing (0.5%). Of the 17 patients who had a dry throat complaint, two were constant (one SP, one RP), 15 were occasional (10 mUPPP, three SP, two BRP). Of the 25 patients with the throat lump feeling, four were constant (three RP, one ZPP), 21 were occasional (10 mUPPP, five SP, five UPF, one BRP). Of the 22 patients with the throat phlegm feeling, four were constant (two SP, two RP), 18 were occasional (10 mUPPP, four BRP, two FEP, two SP). Of the eight patients with throat scar feeling, eight were occasional (four SP, two mUPPP, one FEP, one RP), none were constant. One patient had difficulty swallowing (RP procedure). There was no velopharyngeal incompetence, taste disturbance, nor voice change. Highest symptom complaints were mUPPP, SP, and RP, whereas the lowest symptom complaint was ESP. Conclusions: Newer palatal techniques have shown to have less long-term complications compared to the older ablative techniques.
Sleep Medicine Clinics, 2018
Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airw... more Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airway collapse during sleep. There is still a lack of consensus on the sedation drugs and technique, monitoring of sedation depth, and classification of upper airway collapse for drug-induced sleep endoscopy. Drug-induced sleep endoscopy is useful to improve treatment options selection for patients with obstructive sleep apnea, especially for those who are unable to accept or tolerate continuous positive airway pressure therapy.
International Journal of Environmental Research and Public Health
Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial o... more Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete recurrent episodes of upper airway collapse that occur during the night. The OSA manifests with a reduction (hypopnea) or complete cessation (apnea) of airflow in the upper airways, associated with breathing effort. OSA is a frequent and often underestimated pathology affecting between 2 and 5% of the middle-aged population. Typical nocturnal symptoms are the persistent snoring and awakenings with dyspnea sensation. On the other hand, diurnal symptoms could be sleepiness, headaches, asthenia, neurological disorders, and impaired personal relationships. Surgery of the velo-pharyngeal region had a huge evolution going from ablative techniques (UP3 and LAUP) to remodeling techniques of the pharyngeal lateral walls.
Barbed Pharyngoplasty and Sleep Disordered Breathing
Journal of Biological Regulators and Homeostatic Agents, Nov 1, 2020
Acta Otorhinolaryngologica Italica, 2019
Description of the relationship between NOHL classification in drug-induced sleep endoscopy and i... more Description of the relationship between NOHL classification in drug-induced sleep endoscopy and initial AHI in patients with moderate to severe OSAS, and evaluation of the results obtained with oral appliance therapy Descrizione della relazione tra Classificazione NOHL definita durante la Drug-Induced Sleep Endoscopy e AHI iniziale in pazienti con OSAS da moderato a grave, e valutazione dei risultati ottenuti con dispositivi orali
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2003
--
Journal of Clinical Medicine
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Archives of Oto-Rhino-Laryngology, 2021
Purpose This meta-analysis study was designed to analyze endoscopic surgery’s role in treating rh... more Purpose This meta-analysis study was designed to analyze endoscopic surgery’s role in treating rhinogenic contact point headache. Methods We performed a comprehensive review of the last 20 years’ English language regarding Rhinogenic contact point headache and endoscopic surgery. We included the analysis papers reporting post-operative outcomes through the Visual Analogue Scale or the Migraine Disability Assessment scale. Results We provided 18 articles for a total of 978 RCPH patients. While 777 (81.1%) subjects underwent functional nasal surgery for RCPH, 201 patients (20.9%) were medically treated. A significant decrease from the VAS score of 7.3 ± 1.5 to 2.7 ± 1.8 was recorded (p < 0.0001). At quantitative analysis on 660 patients (11 papers), surgical treatment demonstrated significantly better post-operative scores than medical (p < 0.0001). Conclusion At comparison, surgical treatment in patients with rhinogenic contact points exhibited significantly better values at sh...
Journal of Clinical Medicine
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by repeated col... more Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by repeated collapses of the upper airway walls, leading to a complete or partial reduction of airflow [...]
Surgeries
Submandibular gland sialolithiasis can be addressed by gland removal or by stone removal. Intraor... more Submandibular gland sialolithiasis can be addressed by gland removal or by stone removal. Intraoral stone removal has now become the go-to technique to minimize aesthetic and functional sequelae (e.g., marginalis mandibulae injury, visible surgery scar) and, although traditional techniques were first experimented with (intraoral ducotomy), newer techniques drew the interest of the scientific community: sialoendoscopy, TORS-S (TransOral Robotic Surgery Assisted–Sialolithotomy) and VITOM-guided sialolithotomy. In this article, we compare the two newest transoral techniques for transoral sialolithotomy, TORS-S and 3D-4K VITOM-guided sialolithotomy, used to treat bilateral hilar submandibular gland sialolithiasis in the same patient, one technique for each side. Using these techniques, a faster recovery is achievable with almost no anatomical and/or functional sequelae, since they both allow better visualization and manipulation of soft tissues and noble structures (e.g., lingual nerve ...
Laryngeal cancer is one of the most common cancers of the head and neck. The best diagnostic appr... more Laryngeal cancer is one of the most common cancers of the head and neck. The best diagnostic approach is provided by performing a full endoscopic evaluation, appropriate imaging and biopsy. Therapy can thereafter be tailored to pathology, stage of disease, and then individualized. The multidisciplinary tumor board represents an essential requirement in oncologic diagnosis and treatment, often introducing clinical challenges which force us to overcome our personal opinion in solving a case in a specific manner. This book represents a collection of our retrospective analysis of the local weekly tumor board which includes the otorhinolaryngologist, oncologist, radiotherapist, pathologist, radiologist and speech pathologist. We have also included reviews from national and international opinion leaders in the field of laryngeal cancer. The book is organized into three sections: basic science, diagnostic work-up and treatment, with the aim of providing a concise, up-to-date, and appropria...
Oral Oncology, 2020
Trans Oral Robotic Surgery (TORS) is a fascinating new technique that has proved to be a safe and... more Trans Oral Robotic Surgery (TORS) is a fascinating new technique that has proved to be a safe and feasible treatment of oropharyngeal squamous cell carcinoma (OPSCC). The aim of this study is to compare oncological outcomes of OPSCC-patients treated with either TORS (with or without adjuvant therapy) or definitive chemoradiation therapy (CRT). Materials and methods: This study involved 129 patients with OPSCC, treated with TORS or definitive CRT at our Department between 2008 and 2018. Clinicopathological characteristics, treatment specifications and oncological outcomes were evaluated retrospectively. Results: Definitive CRT was administered in 69 patients (53,5%), while 60 (46,5%) were surgically treated with TORS alone or in combination with adjuvant therapy. Patients who underwent adjuvant therapy after TORS received a lower dosages of cisplatin and radiation than the CRT group (p < 0.01). There was no statistical difference in 5-year survival rate and in disease free interval between TORS and CRT groups. Albeit 5-year overall survival in the HPV-related tumours was better, the HPV status did not affect the rate of local and regional recurrence. Treatment groups (TORS vs. CRT) were not found affecting survivals on multivariate analysis. Tube feeding dependency rate was low between both groups (1.7% in TORS vs. 4.8% in CRT groups). Conclusion: The modern management of OPSCC must be tailored to each patient. Although the definitive CRT remains a milestone, TORS is proving to be a valid and safe treatment option. The choice of single therapeutic strategy requires an evaluation by a multidisciplinary team.
Oral Diseases, 2020
Several disorders involving submandibular gland such as chronic sialadenitis, sialolithiasis and ... more Several disorders involving submandibular gland such as chronic sialadenitis, sialolithiasis and salivary gland tumours can require a surgical excision. Submandibular gland excision is generally performed through a transcervical approach, a safe procedure that, however, carries few drawbacks. In particular, postoperative skin scar can be cosmetically unappealing, especially in young patients and degenerate into keloid formation. Other possible complications include marginal mandibular branch of the facial nerve, lingual nerve and hypoglossal nerve injuries with an incidence of 1%-7.7%, 1%-4%
The Laryngoscope, 2019
Objectives/Hypothesis: To investigate long-term complications of newer reconstructive palate surg... more Objectives/Hypothesis: To investigate long-term complications of newer reconstructive palate surgery techniques. Study Design: Retrospective case-series analysis. Methods: Retrospective six-country clinical study of OSA patients who had nose and palate surgery. Results: There were 217 patients, mean age = 43.9 AE 12.5 years, mean body mass index = 25.9 AE 4.7, mean preoperative apnea-hypopnea index [AHI] = 30.5 AE 19.1, follow-up 41.3 months. A total of 217 palatal procedures were performed, including 50 expansion sphincter pharyngoplasties (ESP), 34 functional expansion pharyngoplasties (FEP), 40 barbed reposition pharyngoplasties (BRP), 64 modified uvulopalatopharyngoplasties (mUPPP), 11 uvulopalatal flap procedures (UPF), nine suspension pharyngoplasties (SP), eight relocation pharyngoplasties (RP), and one z-pharyngoplasty (ZPP). Complications included were constant and/or felt twice per week; dry throat (7.8%), throat lump feeling (11.5%), throat phlegm (10.1%), throat scar feeling (3.7%), and difficulty swallowing (0.5%). Of the 17 patients who had a dry throat complaint, two were constant (one SP, one RP), 15 were occasional (10 mUPPP, three SP, two BRP). Of the 25 patients with the throat lump feeling, four were constant (three RP, one ZPP), 21 were occasional (10 mUPPP, five SP, five UPF, one BRP). Of the 22 patients with the throat phlegm feeling, four were constant (two SP, two RP), 18 were occasional (10 mUPPP, four BRP, two FEP, two SP). Of the eight patients with throat scar feeling, eight were occasional (four SP, two mUPPP, one FEP, one RP), none were constant. One patient had difficulty swallowing (RP procedure). There was no velopharyngeal incompetence, taste disturbance, nor voice change. Highest symptom complaints were mUPPP, SP, and RP, whereas the lowest symptom complaint was ESP. Conclusions: Newer palatal techniques have shown to have less long-term complications compared to the older ablative techniques.
Sleep Medicine Clinics, 2018
Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airw... more Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airway collapse during sleep. There is still a lack of consensus on the sedation drugs and technique, monitoring of sedation depth, and classification of upper airway collapse for drug-induced sleep endoscopy. Drug-induced sleep endoscopy is useful to improve treatment options selection for patients with obstructive sleep apnea, especially for those who are unable to accept or tolerate continuous positive airway pressure therapy.
International Journal of Environmental Research and Public Health
Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial o... more Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete recurrent episodes of upper airway collapse that occur during the night. The OSA manifests with a reduction (hypopnea) or complete cessation (apnea) of airflow in the upper airways, associated with breathing effort. OSA is a frequent and often underestimated pathology affecting between 2 and 5% of the middle-aged population. Typical nocturnal symptoms are the persistent snoring and awakenings with dyspnea sensation. On the other hand, diurnal symptoms could be sleepiness, headaches, asthenia, neurological disorders, and impaired personal relationships. Surgery of the velo-pharyngeal region had a huge evolution going from ablative techniques (UP3 and LAUP) to remodeling techniques of the pharyngeal lateral walls.
Barbed Pharyngoplasty and Sleep Disordered Breathing
Journal of Biological Regulators and Homeostatic Agents, Nov 1, 2020