Luca Muscatello - Academia.edu (original) (raw)

Papers by Luca Muscatello

Indian Journal of Thoracic and Cardiovascular Surgery, 2020

Cervical necrotizing fasciitis (CNF) is the name for a group of bacterial infections characterize... more Cervical necrotizing fasciitis (CNF) is the name for a group of bacterial infections characterized by necrosis of the fascia and subcutaneous cellular tissue of the neck. Descending necrotizing mediastinitis (DNM) is a well-known and feared complication of CNF that severely affects the prognosis. Abdominal involvement is rare. The mainstay of treatment is prompt and aggressive medical therapy and surgical debridement of all involved sites. The role of video-assisted thoracoscopic surgery (VATS) in this setting, even if already reported in the literature, is not universally adopted. We present a case of CNF complicated by DNM and pre-peritoneal involvement, treated with open surgical drainage of the neck and video-assisted thoracoscopic debridement of the mediastinal space.

Cranio : the journal of craniomandibular practice, Jan 14, 2018

To investigate the association between volumetric measurements of craniofacial morphology and tem... more To investigate the association between volumetric measurements of craniofacial morphology and temporomandibular disorders (TMDs). Computerized tomography (CT) scans of 20 individuals aged 18 to 40 with (TMD group) or without TMJ pain (control group) were gathered based on a case-control design. Three-dimensional reconstructions were performed to evaluate the gonial angle, condylar volume, and the distance between the posterior edge of the condyle and the sigmoid notch. The gonial angle was significantly larger (8% difference) in the TMD group with respect to controls, whereas the condylar volume was significantly higher in the control group (15.2% difference). No significant difference was found in the linear distance. There is an association between the presence of TMJ pain and some features of craniofacial morphology. Individuals with TMJ pain have a lower condylar volume and a tendency towards hyperdivergent growth.

Annals of Otology, Rhinology & Laryngology, 1999

The results of the carbon dioxide (CO2) laser debulking procedure for obstructing endolaryngeal c... more The results of the carbon dioxide (CO2) laser debulking procedure for obstructing endolaryngeal carcinoma were analyzed in terms of efficiency, complications, secondary tracheotomy rate, and peristomal recurrence rate in a series of 50 patients consecutively managed at our department. The CO2 laser was used to reestablish a safe airway without resorting to tracheotomy and without performing a transoral resection. Our series included 42 patients in a pre—definitive treatment group (group 1) and 8 patients in a palliation group (group 2). Complications included death, pneumonia from inhalation, and cutaneous burns in 2 patients, 1 patient, and 1 patient, respectively. Thirty-two percent of patients required a repeat laser treatment to maintain the airway. Overall success rates of 92.8% and 87.5% were achieved in group 1 and group 2 patients, respectively. None of the variables under analysis could predict the success of the CO2 laser debulking procedure. The overall incidences for sec...

Annals of Otology, Rhinology & Laryngology, 2004

The authors present a new method of mandibular reconstruction with frozen autologous mandibular b... more The authors present a new method of mandibular reconstruction with frozen autologous mandibular bone. Vascular supply to the neomandible is ensured by the periosteal layer of a microvascular radial periosteal fasciocutaneous free flap, placed so as to envelop the bone and cover the surgical defect. The use of the periosteal layer of the radius to provide new blood vessels to the frozen mandible is an original technical feature that we describe. We describe 2 cases of oral carcinoma involving the mandible, treated with mandibular resection and reconstruction. This technique allows good functional and aesthetic results, avoiding more serious complications related to the use of composite free flaps harvested from distant anatomic donor sites.

Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP), 2011

The larynx is considered a secondary sexual organ. To demonstrate that sex hormones can directly ... more The larynx is considered a secondary sexual organ. To demonstrate that sex hormones can directly influence laryngeal function, specific receptors in the vocal cord must be identified.

Child's Nervous System, 2011

Rathke cleft cysts (RCCs) are malformative, benign lesions located in the sellar and/or suprasell... more Rathke cleft cysts (RCCs) are malformative, benign lesions located in the sellar and/or suprasellar space; they are thought to arise from remnants of the Rathke pouch, where embryonic cells which are going to form the adenohypophysis join the nervous component that will become the neurohypophysis. These remnants may enlarge causing pituitary dysfunction and visual impairment. Cyst content may be a mucinous material of varying texture; the wall of the cyst is characterized by a well-differentiated, ciliated columnar epithelium. Magnetic resonance imaging (MRI) has increased sensitivity in RCCs radiologic diagnosis, even if symptoms related to the cyst are absent, so incidental findings are not unusual; in such cases, surgical therapy is questionable or not indicated. The prevalence of Rathke cleft cysts in children is considered lower than in adult population, in spite of their malformative nature, and young patients are mostly asymptomatic. We report a little series of symptomatic RCCs observed in children during an interval time of 4 years (2005–2008).

Head & Neck, 2002

Background. Radiotherapy is often chosen as the definitive treatment for early stage laryngeal ca... more Background. Radiotherapy is often chosen as the definitive treatment for early stage laryngeal carcinoma. Total laryngectomy is the main procedure for failures. Endoscopic treatment of recurrences by CO 2 laser has found limited application. Partial laryngectomy through an external approach has been proposed as salvage surgery, and the vertical partial laryngectomy (VPL) is the most mentioned surgical technique in the literature, although there are, to date, very few reports regarding the use of the supracricoid partial laryngectomy (SCPL) as salvage surgery after radiation failure. Objectives. The aim of the study is to check the feasibility of SCPL with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) in patients with laryngeal recurrence after radiation failure and to evaluate the oncologic results, morbidity, and functional outcome. Methods. Fifteen consecutive patients were treated with salvage intent by SCPL from January 1992 to December 1998. CHEP and CHP were performed in 11 and 4 patients, respectively. Five patients underwent homolateral surgical neck dissection, and one underwent bilateral neck dissection. All patients had a temporary tracheostomy, and two patients required percutaneous endoscopic gastrostomy (PEG) to ensure feeding. Functional rehabilitation started 2 weeks after the operation. Results. The results have been evaluated in terms of oncologic outcome and functional preservation. Twelve patients are alive with a minimum follow-up of 36 months and 3 patients died after 36 days, 6 and 14 months after surgery, the first and second patient from heart failure and the third from lung metastasis. Respiratory function was recovered in all cases. Oral intake began 12 days after surgery, and in 14 cases satisfactory swallowing was recovered 30 days after surgery. An acceptable quality of the voice was achieved by most patients, and a high rate of local immediate complications was solved in all cases. Conclusions. SCPL represents an effective technique as salvage treatment of laryngeal cancer after exclusive radiotherapy; there is a good functional recovery with acceptable morbidity and good oncologic long-term control.

European Archives of Oto-Rhino-Laryngology, 2021

Purpose To evaluate the functional and oncologic outcomes of adjuvant (chemo)radiation [(C)RT] af... more Purpose To evaluate the functional and oncologic outcomes of adjuvant (chemo)radiation [(C)RT] after open partial horizontal laryngectomies (OPHLs). Methods Multicenter retrospective evaluation of 130 patients (116 males, 14 females) submitted between 1995 and 2017 to OPHL Types II and III for laryngeal cancer and receiving adjuvant (C)RT for one or more of the following risk factors at histopathologic examination of the surgical specimen: pT4a and/or > pN2a categories, close/positive resection margins, or presence of both perineural (PNI) and lympho-vascular invasion (LVI). The primary study endpoints were evaluation of the presence of tracheostomy and/or gastrostomy at last follow-up, and calculation of laryngo-esophageal dysfunction-free survival (LEDFS). Results Mean age of the study cohort was 60.8 ± 8.9 years (median, 62; interquartile range [IQR], 13). Mean follow-up was 50.7 ± 39.4 months (range 24-188; median, 38; IQR, 51). Adjuvant therapy consisted of CRT in 53 (41%) patients, and RT alone in 77 (59%). Five-year LEDFS was 85%. Overall survival was 71.5%, while 13% of patients remained tracheostomy-and 3% gastrostomy-dependent at the last follow-up. The only significant variable in predicting survival (p = 0.020) was tracheostomy dependence: it was maintained in 7.5% of subjects after OPHL Type II and in 34% of those submitted to OHPL Type III (p < 0.001). Conclusions In selected patients affected by advanced laryngeal cancer, OPHLs Type II and III have a relatively good laryngeal safety profile and provide favorable oncologic outcomes even in case of need for adjuvant (C)RT.

Ear, nose, & throat journal, 2011

Clear cell adenocarcinoma is an extremely rare tumor of the head and neck region. We report a cas... more Clear cell adenocarcinoma is an extremely rare tumor of the head and neck region. We report a case of a 75-year-old Caucasian woman with a 10-day history of hemoptysis but with no pain or other significant symptoms. A head and neck computed tomography scan with contrast medium showed an irregular, soft-tissue-like, irregularly enhanced lesion of the base of the tongue extending to its posterolateral portion. The tumor reached the lateral wall of the oropharynx, which showed a nonhomogeneous aspect. The patient underwent resection of the tumor via a conservative transmandibular approach. A clear cell adenocarcinoma of the base of the tongue is rarely a primary malignant lesion; it is more frequently a secondary lesion from a metastatic renal tumor. Because of this neoplasm's relatively slow growth rate and low incidence of metastasis or local recurrence, the gold standard of treatment is complete excision of the tumor with a sufficient tumor-free margin.

Rhinology, 2009

Mucocoeles usually involve the frontal sinus and can extend to the orbit or intracranially. In th... more Mucocoeles usually involve the frontal sinus and can extend to the orbit or intracranially. In this case symptoms and radiological findings were typical of a left frontal mucocoele with intracranial extension. Intraoperative findings were compatible with a left frontal mucocoele communicating with an arachnoid cyst of the anterior cranial fossa.

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2005

Data are reported on a series of 52 endoscopic procedures of dacryocystorhinostomy, performed in ... more Data are reported on a series of 52 endoscopic procedures of dacryocystorhinostomy, performed in the Department of Otorhinolaryngology of the Hospital of Varese, between May 1999 and February 2003. The study population comprised 42 patients (32 female, 10 male. mean age 57 and 51 years, respectively) with naso-lacrimal obstruction. In all cases, pre-operative diagnosis consisted in irrigation of the lacrimal pathways, confirmed on dacryocystography; in selected cases, an additional computed tomography examination was carried out. All procedures were performed under general anaesthesia and surgical times were recorded; mean time for primary dacryocystorhinostomy was 30 minutes. A silicone tube was inserted in all patients for a period of 3 months. The procedure was successful in 81% of primary dacryocystorhinostomy cases and in 75% of revision dacryocystorhinostomy cases. Personal clinical and surgical experience, focusing on surgical techniques used in dacryocystorhinostomy, is desc...

The Annals of otology, rhinology, and laryngology, 1998

Fourteen patients with severe Frey's syndrome (occurring after conservative parotidectomy) ma... more Fourteen patients with severe Frey's syndrome (occurring after conservative parotidectomy) managed with intracutaneous injection of botulinum toxin type A were prospectively evaluated. Results were analyzed for effectiveness, complications, and adverse effects. Complications were not encountered. The only adverse effect noted was a temporary and slight partial paresis of the upper lip of 3 months' duration in 2 patients. Permanent paresis was not encountered. Frey's syndrome was always controlled within 2 days following the intracutaneous injection of botulinum toxin A. Frey's syndrome recurrence was not encountered with a follow-up duration that varied from 3 to 9 months (mean follow-up 7 months). This preliminary report confirmed that in patients who have Frey's syndrome after conservative parotidectomy, the intracutaneous injection of botulinum toxin is a valuable treatment option that should be further investigated.

Anticancer research, 2014

Electrochemotherapy (ECT) is proposed as an innovative treatment for cutaneous and subcutaneous p... more Electrochemotherapy (ECT) is proposed as an innovative treatment for cutaneous and subcutaneous primary and secondary malignancies. Its actual application is limited to palliative treatment but recent experience predisposes for its utilization as neoadjuvant and first-line treatment. We explored the clinical application of ECT in a population of patients with head and neck cancer and we critically analyzed our results. Nine patients (four females; mean age=62.7 years) with recurrent or persistent squamous cell cancer in the head and neck area were treated with electrochemotherapy (ECT), with the aim of controlling local neoplastic growth and diminish local symptoms (pain, bleeding). Our results in terms of local control and impact on quality of life were evaluated: among 14 lesions assessable for the study, 6/14 lesions exhibited a partial response, 4/14 a complete response, and in four cases we observed progression of the disease. Our personal experience in a heterogeneous, small g...