Psoas abscess ten years after ipsilateral nephrectomy for pyonephrosis.

Pyogenic abscess of the psoas muscle is a rare disease. The Authors report a recently observed case which developed 10 years after ipsilateral nephrectomy for pyonephrosis, reviewing the pertinent literature. The culture of the pus extracted only reproduced Proteus mirabilis. The relation between psoas abscess and nephrectomy is unclear. To make diagnosis is important to consider this condition in differential diagnosis in presence of fever and flank tenderness in a nephrectomized patient.

[Pinworm infestation of the appendix]. / Ossiuriasi appendicolare: nostra esperienza.

The Authors present 2 cases of enterobiasis of appendix observed on a total of 186 appendicectomies. Enterobius infestation is an uncommon cause of acute appendicitis. Preoperative diagnosis of pinworm infestation is almost impossible without clinical suspect. Parasites may produce symptoms which resemble acute appendicitis but parasitic infection rarely causes it. It is also important considered in the differential diagnosis cases that mimic Crohn's disease.

Speech recognition in elderly cochlear implant recipients.

The benefits of cochlear implantation in the adult and paediatric populations are well established. Cochlear implantation in the geriatric population still remains controversial because of the misconception that elderly patients might perform poorly. The purpose of this study was to report the speech performance of 16 patients over 65 years of age implanted with a Nucleus multichannel cochlear implant and to compare it with that of a control group of 14 adults aged between 41 and 59 years. At the 12 months postoperative evaluation, no significant differences were detected on speech performances between the elderly patients and the control group. The mean word recognition scores were 72.5% for the elderly group and 82% for the control group. The mean everyday sentence recognition scores were 72.5% for the elderly group and 85.7% for the control group. Overall, the results are encouraging and demonstrate that the elderly population with profound hearing loss obtain significant benefits from cochlear implantation despite the age-related auditory processing problems.

[Primary adenocarcinoma of the second portion of duodenum]. / Adenocarcinoma primitivo della II porzione duodenale.

The authors report a case of primary adenocarcinoma of the second portion of duodenum in a 56-years-old man radically managed by pancreaticoduodenectomy. They remark the rarity of this pathology, the difficulty of making diagnosis peculiar to neoplasms of the small intestine and the difficulty of treatment peculiar to tumours of duodenum. The possible therapy is surgical. Radio and chemotherapy don't significantly improve survival. Better results can be obtained only with an early diagnosis.

[Multi-channel cochlear implant in cochlear ossification]. / L'impianto cocleare multicanale nelle ossificazioni cocleari.

Cochlear ossification, considered until only a few years ago as a contraindication for cochlear implants (C.I.), may now be managed by means of a wide variety of surgical techniques. In cases with massive ossification, the drill-out circummodiolar technique described by Gantz et al. in 1988 and successively modified by Balkany et al. in 1997 may be adopted. The technique of electrode insertion in the scala vestibuli, perfected by Steenerson et al. in 1990, may be used when cochlear ossification has spread no further than the scala tympani. Other methods call for a groove to be drilled along the proximal tip of the basal turn of the cochlea (Cohen and Waltzman, 1993), the insertion of electrodes through the middle cranial fossa (Colletti et al., 2000), or the utilization of a double electrode array (Bredberg et al., 1997, Lenarz et al., 2001). This study reports the experience conducted at the Cochlear Implants Centre of the Otorhinolaryngoiatrics, Otological and Otoneurological Microsurgery Section of the University of Parma in a group of 15 patients who underwent C.I. in the presence of varying degrees of ossification. In 3 cases the ossification was limited to the region of the round window and a few millimetres of the scala tympani; cochleostomy was performed anteriorly and inferiorly to the anterior niche of the round window. In 11 cases (of which 3 of pediatric age), the ossification had spread to the horizontal portion of the scala tympani; in these cases, the electrodes were inserted in the scala vestibuli. The scala vestibuli was opened by drilling anteriorly to the round window and superiorly to the spiral ligament. In the only case of massively ossified cochlea, it was possible to partially insert the electrodes in a circum-modiolar tunnel. In the 12-month follow-up hearing test, the 3 patients with ossification of the round window region and the first millimetres of the scala tympani respectively averaged 61.6% in recognizing 2-syllable words and 59% in recognizing words embedded in phrases. The averages on the 12-month follow-up hearing test in the 8 adult patients who received the implant in the scala vestibuli were 80.6% in recognizing 2-syllable words and 89.1% in recognizing words in phrases. The 3 pediatric patients were classified on the Geers and Moog scale, which situated 2 of them in the 6th category of perception and 1 of them in the 4th category of perception. As regards the only case of massive cochlear ossification, the patient underwent surgery recently, and the sole follow-up available is the one conducted after only 3 months; the vowel identification average was 55%; the average on the VCV test was 31%; and the 2-syllable word recognition average was 20%.

[Spigelio hernia: 5-year experience]. / Ernia di Spigelio: esperienza di un quinquennio.

Spigelian hernia is a rare condition of the abdominal wall; 13 cases occurred in the last five years are here reported. These patients were treated surgically, using direct reconstruction of the abdominal wall in eight cases, while a tension-free hernioplasty was utilized in five cases.

Giant cecal lipoma: a case report.

The Authors report a case recently observed of giant lipoma of the cecum. In according to all radiologic diagnostic procedures and for suspicion of colic neoplasm, they have performed a right emicolectomy.