Giovanni Cristalli - Academia.edu (original) (raw)
Papers by Giovanni Cristalli
European Archives of Oto-rhino-laryngology, Feb 20, 2023
Medicina-lithuania, May 24, 2023
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
PubMed, Feb 1, 2013
The objective of this retrospective study was to evaluate risk factors for wound complications af... more The objective of this retrospective study was to evaluate risk factors for wound complications after neck dissection. One hundred and nineteen patients were treated with neck dissection for squamous-cell carcinoma of the upper aerodigestive tract at the National Cancer Institute in Rome between 2006 and 2009. Postoperative wound complications were divided into major or minor and were related to different variables to identify risk factors. Postoperative wound complications were found in 20.2% of patients with an individual patient probability for different risk factors ranging from 2% to 34.1%. Preoperative chemoradiation therapy (CRT) and the type of neck dissection were associated with a higher risk of major complications (p ≤ 0.05). Previous CRT and radical neck dissection/modified radical neck dissection are risk factors for major wound complications in patients with head and neck squamous cell carcinoma undergoing neck dissection. Patients requiring neck dissection after CRT should be informed about the increased risk of the procedure, and selective neck dissection, if oncologically appropriate, should be considered to reduce complications.
Neurosurgical Review, Oct 24, 2006
Spontaneous rhinorrhea due to sellar pathologies is a rare and insidious disease that may represe... more Spontaneous rhinorrhea due to sellar pathologies is a rare and insidious disease that may represent a diagnostic challenge. Since the precipitating cause is not apparent in most patients, delayed diagnosis and/or improper treatments are not uncommon and may be detrimental for the patients. The precise mechanisms of such rhinorrhea are still incompletely understood. Proposed etiological factors include constant cerebrospinal fluid
PubMed, Dec 1, 1996
The purpose of the paper is to better characterise changes occurred in nose cytology in a group o... more The purpose of the paper is to better characterise changes occurred in nose cytology in a group of 50 subjects affected by chronic inflammation of upper respiratory airway. The patients were random shared in two groups: group A 40 subjects treated using sulphurous thermal water and a group B (control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of metaplasy notes in all the cases of group A. No statistical modifications were observed in control group. Moreover were observed a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in chronic inflammation of the nose, throw pharmacological and physical actions, cause an improvement of the chronic inflammation and a normalisation of nose cytology.
PubMed, Dec 1, 1996
The purpose of the paper is to better characterise changes occurred in nose cytology in a group o... more The purpose of the paper is to better characterise changes occurred in nose cytology in a group of 50 subjects affected by chronic inflammation of upper respiratory airway. The patients were random shared in two groups: group A 40 subjects treated using sulphurous thermal water and a group B (control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of metaplasy notes in all the cases of group A. No statistical modifications were observed in control group. Moreover were observed a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in chronic inflammation of the nose, throw pharmacological and physical actions, cause an improvement of the chronic inflammation and a normalisation of nose cytology.
European Archives of Oto-rhino-laryngology, Jun 29, 2022
Purpose Our study aimed to describe recovery of gustatory dysfunction (GD) and olfactory dysfunct... more Purpose Our study aimed to describe recovery of gustatory dysfunction (GD) and olfactory dysfunction (OD) in COVID-19 patients, and to analyze variables associated with early or late recovery. Methods Telephone surveys were administered during an 18-month follow-up after COVID-19 diagnosis. One hundred and thirty-two included patients rated olfactory and gustatory function at each follow-up. Results One hundred and twenty-nine patients reported GD, of whom 91 (70.5%) reported severe GD, and 99 patients reported OD, of whom 84 (84.9%) reported severe OD. Seventy-two/129 (55.8%) and 52/99 (52.5%) patients reported an improvement in GD and in OD during the first 7 days from the onset, respectively. At 3-month follow-up, 110/120 patients (85.3%) recovered from GD, while 80/99 patients (80.8%) recovered from OD. At 18-month follow-up, a total of 120/129 patients (93.0%) recovered from GD and 86/99 patients (86.9%) recovered from OD; while 10 patients (7.0%) still reported GD and 13 patients (13.1%) still reported OD. Severe GD/OD at presentation were associated with late complete recovery of taste/smell (p = 0.019 and p = 0.034, respectively). Improvement over the first 7 days from onset was significantly associated with faster recovery (p < 0.001). Conclusions More than 80% of patients reported complete recovery of olfactory/gustatory function in the first 3 months after symptom onset. At 18-month follow-up, patients reporting complete recovery of gustatory and olfactory function were 93% and 87%, respectively. Severity of chemosensory dysfunction at the onset was negatively correlated to recovery, and improvement of taste and/or smell function within the first 7 days from symptom onset was significantly associated with early resolution.
European Archives of Oto-rhino-laryngology, Jun 9, 2020
Rhinopharyngeal swab collection is used to test patients for COVID-19; unfortunately, the false n... more Rhinopharyngeal swab collection is used to test patients for COVID-19; unfortunately, the false negative rate is around 30% in symptomatic patients, and maybe even higher in asymptomatic ones. A correct swab collection is consequently critical. Swabs are usually performed by dedicated personnel, but at the present moment, the methods for its training are not standardized. In a Letter to the Editor recently published in the European Archives of Otorhinolaringology, Tagliabue et al. describe the training method used in their Institution: the personnel dedicated to swab collection increases its confidence with the procedure by observing endoscopic anatomy, while an otolaryngologist performs rigid endoscopy. Although we found this paper interesting, we think that the author's proposal has timing and financial drawbacks that should be considered in daily activity, especially in an emergency period like the pandemic we are experiencing. In this Letter to the Editor, we discuss some pre-analytic and analytic issues that should be considered while performing rhinopharyngeal swabs, and we propose the use of a mannequin to train personnel, thus reducing the risk of infection for health workers, and patient's discomfort.
PubMed, Sep 1, 1994
People exposed to industrial solvents may suffer from disturbances of different psycho-physiologi... more People exposed to industrial solvents may suffer from disturbances of different psycho-physiological and vestibulo-oculomotor function. Therefore an investigation was performed testing vestibular and oculomotor reactions in workers exposed to solvents. It also seemed to be of interest to study if the auditory pathways were affected in these workers. 53 men aged 27-54 (Md = 37.7) were studied. They had been exposed to aromatic solvents in their work as colour mixers, painters, printers and petrol truck drives. Time of working was between 4-25 (Md = 15.2) years. At the time of this investigation none of the men had been exposed to solvents for at least the last four years. The clinical investigation included cerebellar tests and a general ENT investigation. Electronystagmography was performed and comprised the following functions: 1) spontaneous and caloric vestibular tests; 2) a sinusoidal swing test in darkness, the patient sitting in a rotatory chair; 3) visual suppression test; 4) a saccade test; a slow pursuit eye movement test. In addition all the patients were subjected to an audiological test battery including pure tone threshold, conventional vocal audiometry, speech discrimination used interrupted speech 10 interruptions per second, acoustic reflex thresholds and reflex decay. The clinical investigation showed in 19 patients balance problems in the balance test. The sinusoidal test was normal in all cases. The caloric test showed 8 cases of asymmetry in vestibular reactions. 10 of the patients had pathological spontaneous nystagmus. 17 of the patients had a pathologically decreased ability for visual suppression. The saccades were abnormal in 25 patients. The patients who were subjected to audiological testing all had pure tone thresholds and conventional vocal thresholds as expected with regard to age. 31 patients showed decreased discrimination scores at the interrupted speech. The acoustic reflex thresholds were normal and there was not pathological reflex decay. Results show the prevalently pathologic concern for C.N.S. Authors, last, give prominence to the significant relationship between the exposure time to solvents' vapour and changing of several parameters, connection conditioned by constitution and life habits in predisposing workers to a greater susceptibility at damages caused by organic solvents.
European Archives of Oto-Rhino-Laryngology
Acta Otorhinolaryngologica Italica, 2016
Obiettivo dello studio è stato quello di valutare la sicurezza, l’efficacia e i risultati funzion... more Obiettivo dello studio è stato quello di valutare la sicurezza, l’efficacia e i risultati funzionali della radioterapia intraoperatoria (IORT) seguita dalla radioterapia a intensità modulata (IMRT) nel trattamento di tumori maligni avanzati estesi all’orecchio medio. Sono stati inclusi nello studio in modo retrospettivo 13 pazienti consecutive affetti da tumore dell’orecchio esterno esteso all’orecchio medio. Il follow-up è stato in media di 33 mesi (range 6-133). Cinque pazienti (38%) erano di stadio III e 8 pazienti (62%) erano di stadio IV secondo la classificazione dell’Università di Pittsburgh. Una petrosectomia laterale (LTBR) è stata eseguita in tutti i pazienti, la LTBR è stata associata a parotidectomia in 5 (38%) casi e a svuotamento latero-cervicale associato a parotidectomia in 6 (46%) casi. In tutti i casi si è effettuata asportazione della malattia macroscopicamente evidente. Il trattamento chirurgico è stato completato da IORT (12 Gy) e IMRT (50Gy). Chemioterapia adiu...
Acta Otorhinolaryngologica Italica, 2019
Total laryngectomy with subtotal pharyngectomy is the standard treatment of persistent/recurrent ... more Total laryngectomy with subtotal pharyngectomy is the standard treatment of persistent/recurrent laryngeal and/or pharyngeal cancer. Salvage surgery can be complicated by pharyngo-cutaneous fistula because of previous treatment. The aim of this paper was to verify the feasibility of salvage total laryngectomy with subtotal pharyngectomy with a minimally invasive technique through a lateral cervical approach using the same skin incision used for resection of primary, synchronous neck dissection and pharyngeal flap reconstruction. This approach allowed harvesting of the anterior-myocutaneous flap including skin, subcutaneous tissue, platysma, anterior jugular veins, sterno-and homohyoid muscle in order to preserve as much tissue not involved by the tumour as possible. This technique is feasible and safe; further studies should confirm its advantages in terms of reduction of complications.
Anales otorrinolaringológicos ibero-americanos, 1993
An accurate and systematic myco- and bacteriological appraisal of each case, should comport the l... more An accurate and systematic myco- and bacteriological appraisal of each case, should comport the lowering of wrong diagnosis and also therapeutic failures in those patients. The target of the AA. is to verify the frequency and the identification as well, of bacteria and/or fungi, unique or in association, responsible for the otitis. And the objective is to start with the most appropriate treatment in spite of the laboratory answer and also to schedule a laboratory protocol to follow in suspected cases of otomycosis.
Journal of Personalized Medicine
Nasal polyps (NPs) are rarely reported in childhood and usually represent red flags for systemic ... more Nasal polyps (NPs) are rarely reported in childhood and usually represent red flags for systemic diseases, such as cystic fibrosis (CF), primary ciliary dyskinesia (PCD) and immunodeficiencies. The European Position Paper released in 2020 (EPOS 2020) provided a detailed classification and defined the correct diagnostic and therapeutic approaches. We report a one-year experience of a multidisciplinary team, made up of otorhinolaryngologists, allergists, pediatricians, pneumologists and geneticists, with the aim of ensuring a personalized diagnostic and therapeutic management of the pathology. In 16 months of activity, 53 patients were admitted (25 children with chronic rhinosinusitis with polyposis and 28 with antro-choanal polyp). All patients underwent phenotypic and endo-typic assessment, using proper classification tools for nasal pathology (both endoscopic and radiological), as well as adequate cytological definition. An immuno–allergic evaluation was carried out. Pneumologists ...
No sponsorships or competing interests have been disclosed for this article. Objective. To evalua... more No sponsorships or competing interests have been disclosed for this article. Objective. To evaluate the oncologic results only in T3 glottic and supraglottic cancers regarding supracricoid partial laryn-gectomy (SCPL) not requiring total laryngectomy and to assess functional results by self-evaluation by the patient. Study Design. Case series with medical record review. Setting. Single tertiary care center. Subjects and Methods. Thirty-two patients with laryngeal squamous cell carcinoma, previously untreated, who under-went SCPL with cricohyoidopexy or cricohyoidoepiglotto-pexy were reviewed. Results. At 1, 3, and 5 years, the disease-free survival rates were 96.9%, 89.4%, and 78.2%; overall survival rates were 96.9%, 93.2%, and 87.3%; local control and locoregional con-trol rates were 100%, 96.2%, and 96.2%; and distant metastasis–free survival rates were 100%, 100%, and 88.2%, respectively. Aspiration pneumonia was the most common complication observed. The 3 laryngeal functions (...
European Archives of Oto-Rhino-Laryngology, 2020
Purpose Early persistent/recurrent hypopharyngeal tumours represent a challenge for surgeons who ... more Purpose Early persistent/recurrent hypopharyngeal tumours represent a challenge for surgeons who have to balance the need for oncological radicality and the desire to maintain a functioning larynx with preservation of the patient's quality of life. The aim of this study was primarily to understand the technical feasibility, functional outcomes, and the possibility of obtaining oncological radicality using lateral hypopharyngectomy with laryngeal preservation in early recurrent post-radio/ (chemo)therapy hypopharyngeal tumours. Methods Patients with recurrent T1 hypopharyngeal squamous cell carcinoma were retrospectively selected from our institutional database. The external lateral approach according to Spriano and a modified lateral hypopharyngectomy with laryngeal preservation were used to resect tumours of the lateral pyriform sinus wall. Reconstruction was obtained by direct approximation of the posterior border of the sectioned thyroid cartilage to the posterior hypopharyngeal wall, and this was reinforced with a second layer of vascularised and non-irradiated tissue that was provided by a microvascular fascial anterobrachial flap. Swallowing was assessed 3 weeks after surgery using videoendoscopic evaluation. Results The surgical procedure was technically feasible, and complete resection was obtained in all patients. None of the patients experienced major post-operative complications (salivary fistula, bleeding, aspiration pneumonia). Mild dysphagia was observed in one patient who underwent swallowing rehabilitation. Tracheostomy was closed in all patients. No recurrence was recorded after a median follow-up of 20 months. Conclusion The reported experience shows that, in selected cases, it is possible to radically remove lateral hypopharyngeal cancer with acceptable functional results.
Medicina
Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a freque... more Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a frequent clinical challenge. The middle ear, the mandible, and the temporomandibular joint (TMJ) share several embryological and anatomical connections. Despite that, the role of mandibular malposition and TMJ dysfunction is frequently overlooked in the management of otitis media. In this narrative review, we present current evidence supporting the etiopathogenetic role of a dysfunctional stomatognathic system in the onset of OM and the effectiveness of orthognathic treatment in preventing rAOM and OME. In particular, a focus on the influence of TMJ on Eustachian tube function is provided.
The Laryngoscope
OBJECTIVES Preoperative anterior commissure (AC) evaluation in glottic cancer is crucial for ther... more OBJECTIVES Preoperative anterior commissure (AC) evaluation in glottic cancer is crucial for therapeutic decisions. Endoscopy is often inadequate to precisely detect the presence of cancer in the AC; thus, computed tomography (CT) scan could help. We investigated the relation between AC thickness on CT scan (in mm), AC involvement by cancer at histology, and radiologic signs of anterior paraglottic space (PGS) infiltration. STUDY DESIGN Retrospective observational study. METHODS An experienced radiologist retrospectively measured AC thickness and identified signs of anterior PGS infiltration on pretreatment contrast-enhanced CT scans of 80 patients with primary glottic cancer. The gold standard to define the presence of cancer in the AC was histology. The receiver operating characteristic (ROC) curves were used to determine the potential cut-off values of AC thickness (Youden index method) able to maximize both sensitivity and specificity in identifying the presence of cancer in the AC at histology and PGS infiltration on CT scan. RESULTS AC was significantly thicker in patients with cancer in the AC at histology (P < .001) and in patients with PGS infiltration on CT scan (P < .001). The cut-off values to discriminate the presence of cancer at histology and PGS infiltration on CT scan were 3.62 and 2.6 mm, respectively. We found a substantial agreement between anterior PGS infiltration on CT scan and the presence of cancer in the AC at histology (Cohen Kappa: P = .70). CONCLUSION AC thickness and radiologic signs of PGS infiltration on pretreatment CT scan could represent a method to predict the presence of cancer in the AC at histology. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
Three-dimensional minimally invasive video-assisted thyroidectomy: preliminary report
European Archives of Oto-rhino-laryngology, Feb 20, 2023
Medicina-lithuania, May 24, 2023
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
PubMed, Feb 1, 2013
The objective of this retrospective study was to evaluate risk factors for wound complications af... more The objective of this retrospective study was to evaluate risk factors for wound complications after neck dissection. One hundred and nineteen patients were treated with neck dissection for squamous-cell carcinoma of the upper aerodigestive tract at the National Cancer Institute in Rome between 2006 and 2009. Postoperative wound complications were divided into major or minor and were related to different variables to identify risk factors. Postoperative wound complications were found in 20.2% of patients with an individual patient probability for different risk factors ranging from 2% to 34.1%. Preoperative chemoradiation therapy (CRT) and the type of neck dissection were associated with a higher risk of major complications (p ≤ 0.05). Previous CRT and radical neck dissection/modified radical neck dissection are risk factors for major wound complications in patients with head and neck squamous cell carcinoma undergoing neck dissection. Patients requiring neck dissection after CRT should be informed about the increased risk of the procedure, and selective neck dissection, if oncologically appropriate, should be considered to reduce complications.
Neurosurgical Review, Oct 24, 2006
Spontaneous rhinorrhea due to sellar pathologies is a rare and insidious disease that may represe... more Spontaneous rhinorrhea due to sellar pathologies is a rare and insidious disease that may represent a diagnostic challenge. Since the precipitating cause is not apparent in most patients, delayed diagnosis and/or improper treatments are not uncommon and may be detrimental for the patients. The precise mechanisms of such rhinorrhea are still incompletely understood. Proposed etiological factors include constant cerebrospinal fluid
PubMed, Dec 1, 1996
The purpose of the paper is to better characterise changes occurred in nose cytology in a group o... more The purpose of the paper is to better characterise changes occurred in nose cytology in a group of 50 subjects affected by chronic inflammation of upper respiratory airway. The patients were random shared in two groups: group A 40 subjects treated using sulphurous thermal water and a group B (control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of metaplasy notes in all the cases of group A. No statistical modifications were observed in control group. Moreover were observed a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in chronic inflammation of the nose, throw pharmacological and physical actions, cause an improvement of the chronic inflammation and a normalisation of nose cytology.
PubMed, Dec 1, 1996
The purpose of the paper is to better characterise changes occurred in nose cytology in a group o... more The purpose of the paper is to better characterise changes occurred in nose cytology in a group of 50 subjects affected by chronic inflammation of upper respiratory airway. The patients were random shared in two groups: group A 40 subjects treated using sulphurous thermal water and a group B (control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of metaplasy notes in all the cases of group A. No statistical modifications were observed in control group. Moreover were observed a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in chronic inflammation of the nose, throw pharmacological and physical actions, cause an improvement of the chronic inflammation and a normalisation of nose cytology.
European Archives of Oto-rhino-laryngology, Jun 29, 2022
Purpose Our study aimed to describe recovery of gustatory dysfunction (GD) and olfactory dysfunct... more Purpose Our study aimed to describe recovery of gustatory dysfunction (GD) and olfactory dysfunction (OD) in COVID-19 patients, and to analyze variables associated with early or late recovery. Methods Telephone surveys were administered during an 18-month follow-up after COVID-19 diagnosis. One hundred and thirty-two included patients rated olfactory and gustatory function at each follow-up. Results One hundred and twenty-nine patients reported GD, of whom 91 (70.5%) reported severe GD, and 99 patients reported OD, of whom 84 (84.9%) reported severe OD. Seventy-two/129 (55.8%) and 52/99 (52.5%) patients reported an improvement in GD and in OD during the first 7 days from the onset, respectively. At 3-month follow-up, 110/120 patients (85.3%) recovered from GD, while 80/99 patients (80.8%) recovered from OD. At 18-month follow-up, a total of 120/129 patients (93.0%) recovered from GD and 86/99 patients (86.9%) recovered from OD; while 10 patients (7.0%) still reported GD and 13 patients (13.1%) still reported OD. Severe GD/OD at presentation were associated with late complete recovery of taste/smell (p = 0.019 and p = 0.034, respectively). Improvement over the first 7 days from onset was significantly associated with faster recovery (p < 0.001). Conclusions More than 80% of patients reported complete recovery of olfactory/gustatory function in the first 3 months after symptom onset. At 18-month follow-up, patients reporting complete recovery of gustatory and olfactory function were 93% and 87%, respectively. Severity of chemosensory dysfunction at the onset was negatively correlated to recovery, and improvement of taste and/or smell function within the first 7 days from symptom onset was significantly associated with early resolution.
European Archives of Oto-rhino-laryngology, Jun 9, 2020
Rhinopharyngeal swab collection is used to test patients for COVID-19; unfortunately, the false n... more Rhinopharyngeal swab collection is used to test patients for COVID-19; unfortunately, the false negative rate is around 30% in symptomatic patients, and maybe even higher in asymptomatic ones. A correct swab collection is consequently critical. Swabs are usually performed by dedicated personnel, but at the present moment, the methods for its training are not standardized. In a Letter to the Editor recently published in the European Archives of Otorhinolaringology, Tagliabue et al. describe the training method used in their Institution: the personnel dedicated to swab collection increases its confidence with the procedure by observing endoscopic anatomy, while an otolaryngologist performs rigid endoscopy. Although we found this paper interesting, we think that the author's proposal has timing and financial drawbacks that should be considered in daily activity, especially in an emergency period like the pandemic we are experiencing. In this Letter to the Editor, we discuss some pre-analytic and analytic issues that should be considered while performing rhinopharyngeal swabs, and we propose the use of a mannequin to train personnel, thus reducing the risk of infection for health workers, and patient's discomfort.
PubMed, Sep 1, 1994
People exposed to industrial solvents may suffer from disturbances of different psycho-physiologi... more People exposed to industrial solvents may suffer from disturbances of different psycho-physiological and vestibulo-oculomotor function. Therefore an investigation was performed testing vestibular and oculomotor reactions in workers exposed to solvents. It also seemed to be of interest to study if the auditory pathways were affected in these workers. 53 men aged 27-54 (Md = 37.7) were studied. They had been exposed to aromatic solvents in their work as colour mixers, painters, printers and petrol truck drives. Time of working was between 4-25 (Md = 15.2) years. At the time of this investigation none of the men had been exposed to solvents for at least the last four years. The clinical investigation included cerebellar tests and a general ENT investigation. Electronystagmography was performed and comprised the following functions: 1) spontaneous and caloric vestibular tests; 2) a sinusoidal swing test in darkness, the patient sitting in a rotatory chair; 3) visual suppression test; 4) a saccade test; a slow pursuit eye movement test. In addition all the patients were subjected to an audiological test battery including pure tone threshold, conventional vocal audiometry, speech discrimination used interrupted speech 10 interruptions per second, acoustic reflex thresholds and reflex decay. The clinical investigation showed in 19 patients balance problems in the balance test. The sinusoidal test was normal in all cases. The caloric test showed 8 cases of asymmetry in vestibular reactions. 10 of the patients had pathological spontaneous nystagmus. 17 of the patients had a pathologically decreased ability for visual suppression. The saccades were abnormal in 25 patients. The patients who were subjected to audiological testing all had pure tone thresholds and conventional vocal thresholds as expected with regard to age. 31 patients showed decreased discrimination scores at the interrupted speech. The acoustic reflex thresholds were normal and there was not pathological reflex decay. Results show the prevalently pathologic concern for C.N.S. Authors, last, give prominence to the significant relationship between the exposure time to solvents' vapour and changing of several parameters, connection conditioned by constitution and life habits in predisposing workers to a greater susceptibility at damages caused by organic solvents.
European Archives of Oto-Rhino-Laryngology
Acta Otorhinolaryngologica Italica, 2016
Obiettivo dello studio è stato quello di valutare la sicurezza, l’efficacia e i risultati funzion... more Obiettivo dello studio è stato quello di valutare la sicurezza, l’efficacia e i risultati funzionali della radioterapia intraoperatoria (IORT) seguita dalla radioterapia a intensità modulata (IMRT) nel trattamento di tumori maligni avanzati estesi all’orecchio medio. Sono stati inclusi nello studio in modo retrospettivo 13 pazienti consecutive affetti da tumore dell’orecchio esterno esteso all’orecchio medio. Il follow-up è stato in media di 33 mesi (range 6-133). Cinque pazienti (38%) erano di stadio III e 8 pazienti (62%) erano di stadio IV secondo la classificazione dell’Università di Pittsburgh. Una petrosectomia laterale (LTBR) è stata eseguita in tutti i pazienti, la LTBR è stata associata a parotidectomia in 5 (38%) casi e a svuotamento latero-cervicale associato a parotidectomia in 6 (46%) casi. In tutti i casi si è effettuata asportazione della malattia macroscopicamente evidente. Il trattamento chirurgico è stato completato da IORT (12 Gy) e IMRT (50Gy). Chemioterapia adiu...
Acta Otorhinolaryngologica Italica, 2019
Total laryngectomy with subtotal pharyngectomy is the standard treatment of persistent/recurrent ... more Total laryngectomy with subtotal pharyngectomy is the standard treatment of persistent/recurrent laryngeal and/or pharyngeal cancer. Salvage surgery can be complicated by pharyngo-cutaneous fistula because of previous treatment. The aim of this paper was to verify the feasibility of salvage total laryngectomy with subtotal pharyngectomy with a minimally invasive technique through a lateral cervical approach using the same skin incision used for resection of primary, synchronous neck dissection and pharyngeal flap reconstruction. This approach allowed harvesting of the anterior-myocutaneous flap including skin, subcutaneous tissue, platysma, anterior jugular veins, sterno-and homohyoid muscle in order to preserve as much tissue not involved by the tumour as possible. This technique is feasible and safe; further studies should confirm its advantages in terms of reduction of complications.
Anales otorrinolaringológicos ibero-americanos, 1993
An accurate and systematic myco- and bacteriological appraisal of each case, should comport the l... more An accurate and systematic myco- and bacteriological appraisal of each case, should comport the lowering of wrong diagnosis and also therapeutic failures in those patients. The target of the AA. is to verify the frequency and the identification as well, of bacteria and/or fungi, unique or in association, responsible for the otitis. And the objective is to start with the most appropriate treatment in spite of the laboratory answer and also to schedule a laboratory protocol to follow in suspected cases of otomycosis.
Journal of Personalized Medicine
Nasal polyps (NPs) are rarely reported in childhood and usually represent red flags for systemic ... more Nasal polyps (NPs) are rarely reported in childhood and usually represent red flags for systemic diseases, such as cystic fibrosis (CF), primary ciliary dyskinesia (PCD) and immunodeficiencies. The European Position Paper released in 2020 (EPOS 2020) provided a detailed classification and defined the correct diagnostic and therapeutic approaches. We report a one-year experience of a multidisciplinary team, made up of otorhinolaryngologists, allergists, pediatricians, pneumologists and geneticists, with the aim of ensuring a personalized diagnostic and therapeutic management of the pathology. In 16 months of activity, 53 patients were admitted (25 children with chronic rhinosinusitis with polyposis and 28 with antro-choanal polyp). All patients underwent phenotypic and endo-typic assessment, using proper classification tools for nasal pathology (both endoscopic and radiological), as well as adequate cytological definition. An immuno–allergic evaluation was carried out. Pneumologists ...
No sponsorships or competing interests have been disclosed for this article. Objective. To evalua... more No sponsorships or competing interests have been disclosed for this article. Objective. To evaluate the oncologic results only in T3 glottic and supraglottic cancers regarding supracricoid partial laryn-gectomy (SCPL) not requiring total laryngectomy and to assess functional results by self-evaluation by the patient. Study Design. Case series with medical record review. Setting. Single tertiary care center. Subjects and Methods. Thirty-two patients with laryngeal squamous cell carcinoma, previously untreated, who under-went SCPL with cricohyoidopexy or cricohyoidoepiglotto-pexy were reviewed. Results. At 1, 3, and 5 years, the disease-free survival rates were 96.9%, 89.4%, and 78.2%; overall survival rates were 96.9%, 93.2%, and 87.3%; local control and locoregional con-trol rates were 100%, 96.2%, and 96.2%; and distant metastasis–free survival rates were 100%, 100%, and 88.2%, respectively. Aspiration pneumonia was the most common complication observed. The 3 laryngeal functions (...
European Archives of Oto-Rhino-Laryngology, 2020
Purpose Early persistent/recurrent hypopharyngeal tumours represent a challenge for surgeons who ... more Purpose Early persistent/recurrent hypopharyngeal tumours represent a challenge for surgeons who have to balance the need for oncological radicality and the desire to maintain a functioning larynx with preservation of the patient's quality of life. The aim of this study was primarily to understand the technical feasibility, functional outcomes, and the possibility of obtaining oncological radicality using lateral hypopharyngectomy with laryngeal preservation in early recurrent post-radio/ (chemo)therapy hypopharyngeal tumours. Methods Patients with recurrent T1 hypopharyngeal squamous cell carcinoma were retrospectively selected from our institutional database. The external lateral approach according to Spriano and a modified lateral hypopharyngectomy with laryngeal preservation were used to resect tumours of the lateral pyriform sinus wall. Reconstruction was obtained by direct approximation of the posterior border of the sectioned thyroid cartilage to the posterior hypopharyngeal wall, and this was reinforced with a second layer of vascularised and non-irradiated tissue that was provided by a microvascular fascial anterobrachial flap. Swallowing was assessed 3 weeks after surgery using videoendoscopic evaluation. Results The surgical procedure was technically feasible, and complete resection was obtained in all patients. None of the patients experienced major post-operative complications (salivary fistula, bleeding, aspiration pneumonia). Mild dysphagia was observed in one patient who underwent swallowing rehabilitation. Tracheostomy was closed in all patients. No recurrence was recorded after a median follow-up of 20 months. Conclusion The reported experience shows that, in selected cases, it is possible to radically remove lateral hypopharyngeal cancer with acceptable functional results.
Medicina
Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a freque... more Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a frequent clinical challenge. The middle ear, the mandible, and the temporomandibular joint (TMJ) share several embryological and anatomical connections. Despite that, the role of mandibular malposition and TMJ dysfunction is frequently overlooked in the management of otitis media. In this narrative review, we present current evidence supporting the etiopathogenetic role of a dysfunctional stomatognathic system in the onset of OM and the effectiveness of orthognathic treatment in preventing rAOM and OME. In particular, a focus on the influence of TMJ on Eustachian tube function is provided.
The Laryngoscope
OBJECTIVES Preoperative anterior commissure (AC) evaluation in glottic cancer is crucial for ther... more OBJECTIVES Preoperative anterior commissure (AC) evaluation in glottic cancer is crucial for therapeutic decisions. Endoscopy is often inadequate to precisely detect the presence of cancer in the AC; thus, computed tomography (CT) scan could help. We investigated the relation between AC thickness on CT scan (in mm), AC involvement by cancer at histology, and radiologic signs of anterior paraglottic space (PGS) infiltration. STUDY DESIGN Retrospective observational study. METHODS An experienced radiologist retrospectively measured AC thickness and identified signs of anterior PGS infiltration on pretreatment contrast-enhanced CT scans of 80 patients with primary glottic cancer. The gold standard to define the presence of cancer in the AC was histology. The receiver operating characteristic (ROC) curves were used to determine the potential cut-off values of AC thickness (Youden index method) able to maximize both sensitivity and specificity in identifying the presence of cancer in the AC at histology and PGS infiltration on CT scan. RESULTS AC was significantly thicker in patients with cancer in the AC at histology (P < .001) and in patients with PGS infiltration on CT scan (P < .001). The cut-off values to discriminate the presence of cancer at histology and PGS infiltration on CT scan were 3.62 and 2.6 mm, respectively. We found a substantial agreement between anterior PGS infiltration on CT scan and the presence of cancer in the AC at histology (Cohen Kappa: P = .70). CONCLUSION AC thickness and radiologic signs of PGS infiltration on pretreatment CT scan could represent a method to predict the presence of cancer in the AC at histology. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
Three-dimensional minimally invasive video-assisted thyroidectomy: preliminary report