Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 31
Filter
1.
Ann Otol Rhinol Laryngol ; 120(4): 249-54, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21585155

ABSTRACT

OBJECTIVES: The aim of the study was to assess the extent of the potential nerve damage following prolonged contact with a piezoelectric device. METHODS: The study was conducted with 30 patients; all of the patients had cervical metastatic lymph nodes at levels II, III, and IV (N2b) and a negative evaluation for metastatic disease (MO). The patients underwent radical neck dissection. After its skeletonization, the spinal nerve was exposed directly to ultrasonic activation with a piezoelectric device for various times (5, 10, and 20 seconds) and with different inserts (OP3 insert and OT7 insert). The axonal damage was graded from 0 to 3 as follows: 0, no damage; 1, minor axonal damage; 2, severe axonal damage but not covering the entirety of the nerve fascicles; 3, severe axonal damage covering the entirety of the nerve fascicles. RESULTS: Histologic examination showed no evidence of damage to the perineurium and axons after 5 and 10 seconds of exposure to ultrasonic activation with each insert. CONCLUSIONS: Our histologic data highlight the selective action of the piezoelectric device, which reduces the risk of accidental nerve damage in otolaryngological bone surgery.


Subject(s)
Axons/pathology , Spinal Nerves/pathology , Ultrasonics/instrumentation , Female , Humans , Lymphatic Metastasis , Male , Neck Dissection , Signal Processing, Computer-Assisted , Software , Time Factors
2.
Eur Arch Otorhinolaryngol ; 268(9): 1279-82, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21327729

ABSTRACT

Piezosurgery® is a recently developed system for cutting bone with microvibrations. The objective of this study was to compare the severity of pain over the first 10 postoperative days in a group of 70 patients who underwent intact canal wall mastoidectomy, with the piezoelectric device, and to compare the results with traditional method by means of microdrill (70 patients). The subjective perception of pain was evaluated on a scale from 0 to 10, such that 0 represented no pain and 10 represented maximum pain; the severity was recorded as null when the score was 0; slight, when it was 1-4; moderate, when it was 5-7; or severe, when it was 8-10. Compared with microdrill, the patients that underwent surgery with the piezoelectric device showed a significant (P < 0.05) lower postoperative pain on day 1 (52 vs. 26 patients presented a slight pain, 12 vs. 37 presented a moderate pain, and 6 vs. 7 presented a severe pain) and day 3 (68 vs. 44 patients presented a slight pain, 2 vs. 23 presented a moderate pain, and 0 vs. 3 presented a severe pain). These results highlight as the piezoelectric device is a safe and minimally invasive tool.


Subject(s)
Mastoid/surgery , Osteotomy/instrumentation , Otologic Surgical Procedures/instrumentation , Pain, Postoperative/physiopathology , Surgical Instruments , Adolescent , Adult , Aged , Cohort Studies , Equipment Design , Equipment Safety , Female , Follow-Up Studies , Humans , Male , Middle Aged , Osteotomy/methods , Otologic Surgical Procedures/methods , Pain Measurement , Time Factors , Treatment Outcome , Vibration/therapeutic use , Young Adult
3.
Eur Arch Otorhinolaryngol ; 268(11): 1671-7, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21448610

ABSTRACT

This study wants to show the diagnostic value of vestibular evoked myogenic potential (VEMP) in the diagnosis of vestibular neuritis (VN), independently of the caloric test results. Twenty patients were enrolled with acute vertigo caused by VN. VEMP was tested with the binaural simultaneous stimulation method. Surface electromyographic activity was recorded in the supine patients from symmetrical sites over the upper half of each sternocleidomastoid muscle, with a reference electrode on the lateral end of the upper sternum. During the acute attack, 8 days, 1 month and 3 months after the beginning of the acute attack, all the patients underwent the following examinations: Dix-Hallpike manoeuvre, Pagnini-McClure manoeuvre, head shaking test, pure-tone audiometry, tympanometry, caloric labyrinth stimulation according to the Fitzgerald-Hallpike method and VEMP. At the last visit, the 11 patients diagnosed with superior branch vestibular neuritis did not show any improvement at the caloric labyrinth stimulation and presented VEMP on both sides with normal amplitude and latency; in the 9 cases diagnosed with inferior branch vestibular neuritis, there was an improvement of the VEMP reflex and normal caloric test. Our experience highlights that VEMP recording is applicable for patients with VN as a screening test.


Subject(s)
Caloric Tests/methods , Evoked Potentials, Auditory/physiology , Vestibular Neuronitis/diagnosis , Vestibule, Labyrinth/physiopathology , Acute Disease , Adult , Diagnosis, Differential , Electromyography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of Results , Severity of Illness Index , Vestibular Neuronitis/physiopathology
4.
Am J Otolaryngol ; 31(3): 150-3, 2010.
Article in English | MEDLINE | ID: mdl-20015732

ABSTRACT

OBJECTIVE: Piezosurgery is a recently developed system for cutting bone without necrosis and nonmineralized tissues damage. The aim of this work has been to test Piezosurgery as a new bony scalpel in nasal surgery. METHODS: In this nonrandomized study, we have performed Piezosurgery in the excision of malignant nasal tumors through a paralateronasal approach. We have used Piezosurgery on 10 patients affected by nasal adenocarcinoma. The piezoelectric device uses low-frequency ultrasonic waves (24.7-29.5 kHz); the applied power can be modulated between 2.8 and 16 W and is programmed in accordance to the density of the bone. The equipment consists of 2 hand pieces, 2 inserts, and 2 peristaltic pumps; the microvibrations that are created in the piezoelectric hand piece cause the inserts to vibrate linearly between 60 and 210 mum. RESULTS: In all the patients, Piezosurgery provided excellent control without bleeding and harming effects on the adjacent structures. No patients experienced adverse effects. CONCLUSION: Piezosurgery is a new and revolutionary osteotomy technique using the microvibrations of scalpels at ultrasonic frequency, so that soft tissue will not be damaged even upon accidental contact with the cutting tip. The safety of Piezosurgery as regards soft tissues was confirmed. No adverse effects were detected during unintentional contact with the tumor, nerve, vessel, and mucoperiosteum; this renders the piezoelectric device ideal for this application.


Subject(s)
Adenocarcinoma/surgery , Nose Neoplasms/surgery , Osteotomy/methods , Ultrasonic Therapy/instrumentation , Adenocarcinoma/pathology , Aged , Equipment Design/methods , Equipment Safety , Female , Humans , Male , Middle Aged , Nose Neoplasms/pathology , Osteotomy/instrumentation , Reproducibility of Results , Vibration
5.
Am J Otolaryngol ; 31(6): 442-7, 2010.
Article in English | MEDLINE | ID: mdl-20015801

ABSTRACT

PURPOSE: The aim of this study has been to compare the Harmonic Scalpel (HS) and the "cold knife" dissection in the treatment of snoring by uvulopalatopharyngoplasty (UPPP). MATERIALS AND METHODS: The investigation included 40 adult males with snoring. Patients were assigned to two homogeneous groups (A and B) and UPPP was performed using HS or "cold knife" dissection in groups A and B, respectively. Before and 6 months after surgery, each patient was studied using the apnea-hypopnea index and a visual analogue scale of snore levels. Postoperative assessment of pain was evaluated on postoperative days 1 and 10. All the patients underwent to a perioperative evaluation concerning the duration of surgical dissection, the amount of intraoperative blood loss and days of hospitalization. RESULTS: In group A, the HS provided excellent control without side effects on the adjacent structures and postoperative complications. Harmonic Scalpel's group experienced shorter operation time, lesser blood loss, fewer days of hospitalization and lower postoperative pain. CONCLUSIONS: The use of the HS in UPPP is safe and confers some advantages over conventional methods of UPPP: its use led to diminished bleeding, shorter operation time, lesser pain, and better wound healing in the postoperative period.


Subject(s)
Otorhinolaryngologic Surgical Procedures/instrumentation , Snoring/surgery , Surgical Equipment , Ultrasonic Therapy/instrumentation , Uvula/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Palate, Soft/surgery , Pharynx/surgery
6.
Eur Arch Otorhinolaryngol ; 267(11): 1705-11, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20577753

ABSTRACT

Piezosurgery is a recently developed system for cutting bone with microvibrations. The objectives of the present study were to report our experience with the piezoelectric device in the intact canal mastoidectomy, and to compare the results with traditional method by means of microdrill. A non-randomized controlled trial was undertaken on 60 intact canal wall mastoidectomy performed using the piezoelectric device (30 patients) or the microdrill (30 patients). Before 1 month and 1 year after surgery, all the patients underwent the following instrumental examinations: otomicroscopic evaluation of the tympanic membrane and external auditory duct, bone conduction threshold audiometry, tympanometry, transient-evoked otoacoustic emissions with linear click emission, distortion product otoacoustic emissions, auditory brainstem response (ABR) by MK 12-ABR screener with natus-ALGO2e (Amplifon, Milan, Italy), and electronystamographic recording. The piezoelectric device is proved to be effective in sclerotic and pneumatic mastoid, with an excellent control and without side effects on the adjacent structures of the middle and inner ear (lateral sinus, facial nerve, and/or dura mater). The operation time has been the same as compared with microdrill, and the average hospital stay was significantly (p < 0.05) shorter. Postoperatively, all patients had uneventful recovery with no evidence of audiovestibular deficit or side effects. Our experience highlights the safety of the piezoelectric device on the anatomic structures of the middle and inner ear, and demonstrates its efficiency in terms of cutting precision and healing process.


Subject(s)
Cholesteatoma, Middle Ear/surgery , Mastoid/surgery , Otologic Surgical Procedures/instrumentation , Acoustic Impedance Tests , Adult , Aged , Audiometry , Evoked Potentials, Auditory, Brain Stem , Female , Humans , Male , Middle Aged , Osteotomy , Otitis Media/surgery , Otoacoustic Emissions, Spontaneous , Treatment Outcome , Vibration
7.
Eur Arch Otorhinolaryngol ; 267(8): 1313-8, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20052587

ABSTRACT

The aim of this study was to evaluate the efficacy of an oral ribosomal immunotherapy in the management of children with recurrent acute adenoiditis (RAA). 60 children with RAA were included and randomly assigned into two groups (group A and B). Group A children underwent ribosomal prophylaxis, while group B received a placebo. Before, at the end and 6 months after start of the therapy, children underwent medical history, ENT examination, plasma levels of immunoglobulins class E, A, G, M (IgE, IgA, IgG, IgM), tympanometry, active anterior rhinomanometry and VAS scores by children' parents. After the treatment and at the end of the study, in the group A, the serum concentration of IgE was significantly (P < 0.05) lower than in group B (77.34 +/- 6.23 vs. 95.49 +/- 7.07 mg/dl; 74.82 +/- 6.26 vs. 94.44 +/- 7.44 mg/dl), IgA titers were significantly (P < 0.05) higher than in group B (312.04 +/- 18.41 vs. 213.20 +/- 11.82; 309.07 +/- 18.33 vs. 211.73 +/- 11.54 mg/dl) as well as serum concentration of IgG (1401.12 +/- 118.81 vs. 1101.81 +/- 109.64 mg/dl; 1412.19 +/- 116.43 vs. 1144.06 +/- 103.58 mg/dl). At the end of the study, comparison between the two groups showed, in group A: 77% of children (n = 23), versus 23% (n = 7) of group B, with a type A tympanogram; significant (P < 0.05) nasal flow decrease at the rhinomanometric measures; VAS scores were significantly (P < 0.05) improved (1.8 +/- 0.22 vs. 5.1 +/- 0.59) and frequency, severity and social impact of RAA episodes were significantly (P < 0.05) lower than group B. Our results show the therapeutic effectiveness of this approach in the prophylaxis of recurrent acute adenoiditis.


Subject(s)
Adenoids , Antigens, Bacterial/therapeutic use , Immunologic Factors/therapeutic use , Nasopharyngitis/drug therapy , Acoustic Impedance Tests , Adolescent , Antigens, Bacterial/adverse effects , Child , Double-Blind Method , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Immunoglobulin E/blood , Immunoglobulins/blood , Immunologic Factors/adverse effects , Male , Nasopharyngitis/immunology , Pain Measurement , Rhinomanometry , Secondary Prevention
8.
Eur Arch Otorhinolaryngol ; 267(2): 207-11, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19597738

ABSTRACT

This study wants to show the effects of active middle frequency sonar on a selected group of Italian Navy divers. Ten male divers with normal hearing were exposed to active sonar of the Italian Navy for more than 100 exposures, each of at least 1-h duration, in the course of 6 months. Before, at the end, and six months after the end of noise exposure, we performed pure-tone audiometry, Carhart test, Peyser test, thresholds of discomfort test (TDT), tympanometry, transient evoked otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE), and auditory brainstem response (ABR). At the end of the noise exposure, the audiological tests showed a worsening of the mean air and bone audiometric thresholds at the 2,000 (1/10), 4,000 (7/10), and 8,000 Hz (6/10); a fail status of the TEOAE and DPOAE, which were previously present, in all the divers; temporary threshold shift, at the Peyser test, in 9/10 divers; discomfort for pulse tone presented at the TDT test, in all the divers; no post exposure significant differences at the Carhart and ABR tests, in any of the divers. Six months after the end of noise exposure, all the divers presented a complete recovery of their audio-vestibular functions. Our results show the temporary negative effects of repeated and lasting exposure to active sonar (Hull MF) on the divers; the last control demonstrate the absence of permanent noise-induced hearing loss in divers exposed to active sonar.


Subject(s)
Auditory Threshold/physiology , Diving/physiology , Ear Protective Devices , Hearing Loss, Noise-Induced/prevention & control , Hearing/physiology , Military Personnel , Noise, Occupational/adverse effects , Acoustic Impedance Tests , Audiometry, Evoked Response/methods , Evoked Potentials, Auditory/physiology , Follow-Up Studies , Hearing Loss, Noise-Induced/diagnosis , Hearing Loss, Noise-Induced/etiology , Humans , Male , Otoacoustic Emissions, Spontaneous/physiology
9.
Med Sci Monit ; 15(6): CR269-73, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19478696

ABSTRACT

BACKGROUND: The aim of this study was to evaluate changes in acoustic features of voice after septoplasty and to establish concepts of patient management and a rational therapeutic approach. MATERIAL/METHODS: Before and one month after surgery, phonetically balanced sentences and sustained vowels a, e, and i were recorded and digitalized with MDVP (Multi Dimensional Voice Program, Kay Elemetrics) in all patients for an evaluation of nasal resonance, voice handicap index (VHI), and active anterior rhinomanometry. These parameters were estimated: average fundamental frequency (Fo), jitter percent, shimmer, noise-to-harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voicelessness (DUV), degree of voice breaks (DVB), and peak amplitude variation (vAm). RESULTS: One month after surgery the data showed an improvement in all the acoustic parameters and a normalization of nasalance. CONCLUSIONS: The results highlight the impact of septoplasty on nasalance and voice. In selected cases, such as severe nasal septum deviation, the decision to perform septoplasty depends on its potential effect on speech and respiratory function. An objective evaluation of voice and nasalance helps the specialist in the management of these patients.


Subject(s)
Rhinoplasty/adverse effects , Speech Acoustics , Voice , Adult , Female , Humans , Male , Postoperative Care , Preoperative Care
10.
Otolaryngol Head Neck Surg ; 140(4): 566-72, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19328348

ABSTRACT

OBJECTIVES: The aim of the study was to determine the efficacy of electronystagmography testing in the diagnosis of vertigo in children with migraine equivalent syndrome. STUDY DESIGN: The investigation included 20 children with "migraine equivalent syndrome" (group A), characterized by benign paroxysmal vertigo of childhood. As a control group, 50 healthy children were identified. SUBJECTS AND METHODS: All the subjects underwent rotatory vestibular stimulation by stop test, optokinetic stimulation, and simultaneous postrotatory vestibular and optokinetic stimulations (VVOR). RESULTS: For the analysis of the results, we considered nystagmus mean gain and direction of visual-vestibular-ocular-reflex (VVOR) nystagmus. In group A, all the children presented a VVOR nystagmus homodirectional to vestibular-ocular reflex (VOR). In the control group, all the subjects presented a VVOR nystagmus homodirectional to optokinetic nystagmus (OKN). CONCLUSION: In the healthy patients, VVOR nystagmus is always homodirectional to OKN and indicates the optokinetic system prevalence on VOR. The presence of a VVOR nystagmus homodirectional to VOR indicates the absence of the optokinetic system prevalence due to a central nervous system (CNS) modification and highlights a CNS disease. Our data highlight a possible correlation between CNS disorders and migraine equivalent syndrome.


Subject(s)
Electronystagmography , Migraine Disorders/complications , Vertigo/diagnosis , Age Factors , Child , Child, Preschool , Cohort Studies , Female , Humans , Male , Migraine Disorders/physiopathology , Nystagmus, Optokinetic/physiology , Reflex, Vestibulo-Ocular/physiology , Reproducibility of Results , Syndrome , Vertigo/etiology , Vertigo/physiopathology
11.
Eur Arch Otorhinolaryngol ; 266(12): 1989-94, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19340448

ABSTRACT

The aim of this study was to evaluate changes in acoustic features of speech and voice after uvulopalatopharyngoplasty (UPPP) with the Harmonic Scalpel (HS), using the multidimensional voice program (MDVP) in conjunction with other tests. Before and 6 months after surgery, phonetically balanced sentences and sustained vowels a, e, i were carried out and digitalized with MDVP in all the patients, as an evaluation of nasal resonance (trough the Glatzel and the Gutzmann tests), speech articulation and voice handicap index (VHI). These parameters were estimated: average of fundamental frequency, Jitter, Shimmer, noise-to-harmonics ratio, voice turbulence index, soft phonation index, degree of voiceless, degree of voice breaks and peak amplitude variation. Six months after surgery, improvements in all the acoustic parameters, in nasalance and VHI were achieved. In our experiences UPPP, with the HS, improves speech and voice in patients affected by snoring and/or obstructive sleep apnea syndrome.


Subject(s)
Palate, Soft/surgery , Pharynx/surgery , Plastic Surgery Procedures/instrumentation , Speech Acoustics , Ultrasonics , Uvula/surgery , Voice Quality/physiology , Adult , Equipment Design , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Snoring/physiopathology , Snoring/surgery , Treatment Outcome
12.
Int J Pediatr Otorhinolaryngol ; 72(5): 653-7, 2008 May.
Article in English | MEDLINE | ID: mdl-18328573

ABSTRACT

OBJECTIVE: Piezosurgery is a new instrument which is able to cut the bone without necrosis and non-mineralized tissues damage. The aim of this work has been to test Piezosurgery as a new and alternative method in cochleostomy. METHODS: We have performed Piezosurgery on nine temporal bone specimens from voluntary bone donors. Piezosurgery was used in the mastoidectomy with posterior tympanotomy approach (three specimens), suprameatal approach (three specimens) and combined approach (three specimens). The piezoelectric device uses low frequency ultrasonic waves (24.7-29.5 kHz), the applied power can be modulated between 2.8 and 16 W, and is programmed in accordance to the density of the bone. The equipment consists of two handpieces, two inserts and two peristaltic pumps: the microvibrations that are created in the piezoelectric handpiece cause the inserts to vibrate linearly between 60 and 210 microm. RESULTS: In all the specimens, Piezosurgery provided excellent control without side effects on the adjacent structures of the middle and inner ear. CONCLUSIONS: Piezosurgery is a new and revolutionary osteotomy technique utilizing the microvibrations of scalpels at ultrasonic frequency, so that soft tissue will not be damaged even upon accidental contact with the cutting tip. The vibration frequency of Piezosurgery is optimal for mineralized tissue and does not cut the adjacent soft tissue, minimizing the risk of harming the adjacent tissues: this renders the piezoelectric device ideal for cochlear implantation in children with ossified, partial ossified cochlea and/or malformation of ear.


Subject(s)
Cochlear Implantation , Mastoid/surgery , Osteotomy/instrumentation , Temporal Bone/surgery , Cochlea/surgery , Ear, Middle , Female , Humans , In Vitro Techniques , Male , Osteotomy/methods , Ultrasonics
13.
Int J Pediatr Otorhinolaryngol ; 72(9): 1377-84, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18614242

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate changes in acoustic features of speech and voice after tonsillectomy with or without adenoidectomy. METHODS: Before and 1 month after surgery the following parameters were estimated: average of fundamental frequency (Fo), Jitter percent (Jitt), Shimmer, noise-to-harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voiceless (DUV), degree of voice breaks (DVB) and peak amplitude variation (vAm); as an evaluation of nasal resonance, speech articulation and voice handicap index (VHI). RESULTS: The results were statistically evaluated using the unpaired t-test. Probability values below 0.05 were regarded as significant. One month after surgery, our data showed significant (P<0.05) improvements of the acoustic and other parameters in the children submitted to adenotonsillectomy: Fo (176Hz vs. 206Hz, after sustained vowels: 206Hz vs. 192Hz; 148Hz vs. 168Hz; 171Hz vs. 161Hz after balanced sentences), Jitt (0.85% vs. 1.81% to 0.82% vs. 1.81%), Shimmer (3.41% vs. 5.81% to 4.89% vs. 5.73%), NHR (0.16 vs. 0.42 to 0.29 vs. 0.39), VTI (0.05 vs. 0.38 to 0.28 vs. 0.37), SPI (14.78 vs. 21.14-19.89 vs. 21.89), DUV (0% vs. 0.44% to 0% vs. 0.48%), DVB (0% vs. 0.42% to 0% vs. 0.42%) and vAm (8.93% vs. 23.89% to 8.89% vs. 24.25%). CONCLUSIONS: The results suggest the role of adenotonsillectomy in the improvement of voice and speech quality and of objective evaluation of speech and voice in the correct management of these children.


Subject(s)
Adenoidectomy , Speech/physiology , Tonsillectomy , Voice Quality/physiology , Child , Child, Preschool , Humans , Speech Acoustics
14.
Int J Pediatr Otorhinolaryngol ; 72(1): 1-7, 2008 Jan.
Article in English | MEDLINE | ID: mdl-17959256

ABSTRACT

OBJECTIVE: The aim of this study has been to test to determine the diagnostic value of a visual-vestibular test with a rotatory cylindrical chamber in the diagnosis of peripheral and central vertigo in children. METHODS: Ten children affected by posttraumatic and migrainous vertigo were enrolled (group A): as a control group 10 healthy children were identified. All the children underwent to electronystagmography (ENG) recording: the children, head blocked, sat on a "Tonnies rotatory chair Pro model", which was placed in the middle of a rotatory cylindrical chamber (2 m in diameter and 1.9 m in height), and underwent to rotatory vestibular stimulation by Stop test, to optokinetic stimulation and to contemporary rotatory vestibular and optokinetic stimulation (visual--vestibular-ocular-reflex): opening the light on the stop test, by an angular velocity of 90 degrees s(-1) obtained from a chair subliminal acceleration of 0.5 degrees s(-2), and making for 60s the optokinetic stimulation by rotation of the optical contrasts to determinate a nystagmus with a opposite direction to the postrotatory nystagmus and homodirectional to optokinetic nystagmus (in both clockwise and counterclockwise directions). RESULTS: For the analysis of the results we have considered nystagmus mean gain and direction of visual-vestibular-ocular-reflex (VVOR) nystagmus. In group A, all the children presented a VVOR nystagmus homodirectional to vestibular-ocular-reflex (VOR). In control group, all the subjects presented a VVOR nystagmus homodirectional to optokinetic nystagmus. CONCLUSIONS: In the healthy patients, VVOR nystagmus is always homodirectional to optokinetic nystagmus and indicates the optokinetic system prevalence on VOR. The presence of a VVOR nystagmus homodirectional to VOR indicates the absence of the optokinetic system prevalence due to a central nervous system (CNS) modification and highlights a CNS disease. These data show the diagnostic role of our visual-vestibular interaction test in children affected by vertigo.


Subject(s)
Vertigo/diagnosis , Vestibular Function Tests/methods , Child , Electronystagmography , Female , Humans , Male , Nystagmus, Optokinetic
15.
Int J Pediatr Otorhinolaryngol ; 72(11): 1717-22, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18817987

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the efficacy and the effect of sulphurous thermal water inhalations in the treatment of the recurrent upper respiratory tract (RURT) infections in children. METHODS: A total of 100 children with RURT infections were included. All children underwent a 12-day course warm vapour inhalations. For the inhalations, we used sulphurous thermal water in the group A, while physiological solution in the group B. At the beginning, at the end and 3 months after start, all children underwent medical history, ENT examination, plasma levels of immunoglobulins class E, G, A, M (IgE, IgG, IgA, IgM), subjective assessment of symptoms (VAS), nasal mucociliar transport time (NMTT) determination, and evaluation of frequency, duration, severity and social impact of RURT episodes. RESULTS: Compared with group B, after the treatment and at the end of the study, in children treated with sulphurous thermal water, the serum concentration of IgE was significantly (p<0.05) lower (75.13+/-27.1mg/dl vs 96.87+/-41.3mg/dl; 74.23+/-26.2mg/dl vs 98.24+/-42.7 mg/dl), IgA titers were higher (238.14+/-122.1mg/dl vs 218.62+/-115.8 mg/dl; 239.72+/-119.7 mg/dl vs 210.46+/-107.3mg/dl), serum concentrations of IgG and IgM unchanged, VAS scores presented a significant (p<0.05) improvement (1.8+/-0.19 vs 6.8+/-0.54; 1.9+/-0.21 vs 6.9+/-0.61), NMTT was normal (11.15+/-1.59 min vs 17.63+/-2.17; 11.25+/-2.10 min vs 17.77+/-2.19 min) and frequency, duration, severity and social impact of RURT episodes were significantly (p<0.05) lower. CONCLUSIONS: Our findings indicate that, in addition to their known effects, the sulphurous water also have an immunomodulant activity that contributes to their therapeutic effects.


Subject(s)
Mineral Waters/administration & dosage , Respiratory Tract Infections/prevention & control , Sulfur Compounds/administration & dosage , Absenteeism , Administration, Inhalation , Adolescent , Adult , Double-Blind Method , Female , Fever/prevention & control , Humans , Immunoglobulins/blood , Male , Secondary Prevention , Severity of Illness Index , Volatilization
16.
Int J Pediatr Otorhinolaryngol ; 71(8): 1299-304, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17544517

ABSTRACT

OBJECTIVE: The vocal tract, which starts from the glottis and extends to the lips is considered to be a resonator for speech production. Enlarged palatine tonsils may cause hypernasal speech, oral breathing or muffled voice. Changes in the structure of this resonator are assumed to modify the speech characteristics. The aim of this study was to evaluate changes in acoustic feature of speech after adenotonsillectomy in children and to establish concepts of management and rational therapeutic approach. METHODS: Before and after surgery, an acoustic analysis was made to 40 children, aged between 5 and 14 years old, with enlarged palatine tonsils and hypetrophic adenoids. Phonetically balanced sentences were carried out and digitalized with Multi Dimensional Voice Program (MDVP, Kay Elemetrics). As a control group, 40 healthy children were identified. These parameters were estimated: average of fundamental frequency (Fo), Jitt, Shim, noise to harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voiceless (DUV) and degree of voice breaks (DVB). RESULTS: After adenotonsillectomy, our data showed an improvement in all the parameters: the analysis of Fo, Jitt, Shim, NHR, VTI, SPI, DUV and DVB showed a postoperative decrease; comparison with healthy children highlighted a postoperative normalization of NHR, VTI and DVB. CONCLUSIONS: The postoperative improvement of the parameters suggests a reduction of the nasal resonance and the improvement of voice quality. MDVP method may be useful for analyzing speech characteristics, evaluating the effects of surgical excision and therapeutic approach: in selected cases of patients with enlarged tonsils, the decision to perform tonsillectomy depends on its potential positive effect on speech too.


Subject(s)
Adenoidectomy , Speech Acoustics , Speech Disorders/diagnosis , Speech Disorders/epidemiology , Tonsillectomy , Child , Female , Humans , Male
17.
Int J Pediatr Otorhinolaryngol ; 71(2): 257-61, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17126918

ABSTRACT

OBJECTIVE: Although much has been written on how to manage recurrent pharyngotonsillitis, it remains a controversial topic. The composition of normal commensal oropharynx bacteria may be disrupted by frequently using antimicrobials, by inhibiting sensitive organisms and by allowing resistant organisms to overgrowth. This may cause the recurrence of acute episodes. The aim of this study was to evaluate the efficacy of ribosomal immunotherapy in the prophylaxis of recurrent pharyngotonsillitis. METHODS: A total of 160 children aged between 5 and 14 years with recurrent pharyngotonsillitis were ramdomized to receive either ribosomal immunotherapy (group A one tablet a day, 8 days a month for 3 months) or a placebo (group B same dosage for the same period). RESULTS: At the end of the study, each patient treated with Immucytal presented a subjective decrease of symptoms. Compared with group B, group A experienced a significant improvement of some clinical parameters. CONCLUSIONS: The results show that ribosomal immunotherapy causes a significant improvement of both specific and non-specific immunity and may be effective in the prophylaxis of recurrent pharyngotonsillitis and in preventing recurrences without entailing side effects or bacterial resistance.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Antigens, Bacterial/therapeutic use , Pharyngitis/prevention & control , Tonsillitis/prevention & control , Adolescent , Child , Child, Preschool , Female , Humans , Immunoglobulins/blood , Male , Pharyngitis/immunology , Secondary Prevention , Tonsillitis/immunology
18.
Ear Nose Throat J ; 85(3): 160, 162-3, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16615597

ABSTRACT

We conducted a study of the effects of mobile cellular telephone microwave radiation on the auditory system in 20 healthy men. After the subjects underwent baseline measurements of transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR), they participated in three sessions of exposure to an electromagnetic field of 900 to 1,800 MHz produced by a cellular phone. Sessions ranged from 15 to 30 minutes in length. TEOAE and ABR were again measured after or during each exposure. Throughout the study, no significant changes in either measurement were noted. We conclude that the use of cellular phones does not alter the auditory system in the short-term.


Subject(s)
Auditory Pathways/radiation effects , Cell Phone , Electromagnetic Fields/adverse effects , Microwaves/adverse effects , Adult , Auditory Pathways/physiology , Evoked Potentials, Auditory, Brain Stem/physiology , Evoked Potentials, Auditory, Brain Stem/radiation effects , Humans , Male , Otoacoustic Emissions, Spontaneous/physiology , Otoacoustic Emissions, Spontaneous/radiation effects , Time Factors
19.
Int Tinnitus J ; 11(1): 38-42, 2005.
Article in English | MEDLINE | ID: mdl-16419687

ABSTRACT

The authors propose the existence of a new entity of autoimmune sensorineural hearing loss on the basis of diagnostic study and treatment experience with a series of 30 patients. Immunological mechanisms play an important role in the pathogenesis and natural course of various inner-ear diseases. Patients may present clinically with symptoms resembling Ménière's disease or even with sudden deafness. Currently, no widely used standard protocol for treatment of this autoimmune sensorineural hearing loss exists. Prompted by such observations, we implemented a protocol using a particular kind of heparin--sodium enoxaparin--with a low molecular weight. Patients were randomly assigned to two groups; to those in the first group, enoxaparin was administered subcutaneously at a dose of 2,000 IU twice daily for 10 days; the patients in the second group were treated with placebo. At the beginning and at the end of the therapy period, the patients were evaluated by instrumental examinations. Specifically excluded were patients with abnormal known coagulation. On discharge, all patients treated with enoxaparin presented both a subjective and objective decrease in symptoms. No patient experienced side effects from this treatment. The results indicate that administration of sodium enoxaparin abates sensorineural hearing loss in patients with autoimmune diseases. The clinical response to therapy can confirm diagnosis.


Subject(s)
Anticoagulants/therapeutic use , Autoimmune Diseases/drug therapy , Enoxaparin/therapeutic use , Hearing Loss, Sensorineural/drug therapy , Hearing Loss, Sensorineural/etiology , Adult , Aged , Anticoagulants/administration & dosage , Anticoagulants/pharmacology , C-Reactive Protein/analysis , Enoxaparin/administration & dosage , Enoxaparin/pharmacology , Female , Humans , Immunoglobulins/blood , Injections, Subcutaneous , Male , Middle Aged , Treatment Outcome
20.
Int J Pediatr Otorhinolaryngol ; 68(1): 83-9, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14687691

ABSTRACT

The aim of this study was to compare the efficacy and the safety of a short oral ribosomal immunotherapy (Immucytal) in the prevention of chronic otitis media in children. Seventy-two patients were enrolled in this study, 41 males and 31 females, aged between 6 and 14 years, with an history of recurrent otitis media. Patients were randomised to receive Immucytal (group A) or placebo (group B) according to the following protocol: one tablet daily in the morning 8 days per month for three consecutive months. Immucytal and placebo were identical in shape and size, in order to maintain double-blind conditions. The efficacy parameters were (evaluated before, at the end and 6 months after the beginning of the therapy): clinical score; changes in immunological parameters; patient's parents assessment of symptoms on a scale from 0 (much worse) to 4 (much improved) and hearing tests. Patients of group A, had an improvement of clinical items measured, serum concentrations of immunoglobulins, subjective patient's parents assessment of symptoms and hearing tests. For all evaluations, a significant difference between treatment groups was found. Using this dosage and posology (shorter than others) the beneficial effects of Immucytal were maintained until the end of the 6-month study period.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Antigens, Bacterial/therapeutic use , Otitis Media with Effusion/prevention & control , Ribosomes/immunology , Acoustic Impedance Tests , Adjuvants, Immunologic/administration & dosage , Adolescent , Antigens, Bacterial/administration & dosage , Child , Double-Blind Method , Female , Follow-Up Studies , Hearing/drug effects , Hearing Tests , Humans , Immunoglobulins/analysis , Immunotherapy , Male , Otitis Media with Effusion/immunology , Secondary Prevention , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL