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Biomedical subjects

A Staffieri

Publications and source records attributed to A Staffieri.

At least 19 recordsLinked to original sources
PubMed1998

Dynamic behavior of the Provox and Staffieri prostheses for voice rehabilitation following total laryngectomy.

The present study evaluated the differences in aerodynamic behavior between the 1990 Provox and 1986 Staffieri voice prostheses for total laryngectomy patients. Both prostheses were submitted to in vitro laboratory testing to assess their aerodynamic behavior under different conditions of air flow through the valve and tracheal side pressure. In addition, six patients using the Provox and another six using the Staffieri prostheses were submitted to a dynamic study of phonation. This latter study evaluated the intratracheal pressure corresponding to the different intensities at which the vowel sound /a/ was pronounced. In vitro measurements revealed significant differences between the two prostheses, with the best results achieved with Provox. In contrast, the in vivo measurements did not reveal any significant differences between the two groups of patients in the 50-79 dBSPL range, although there was some difference at intensities equal to or greater than 80 dBSPL. Again, in this latter case the best results were achieved with the Provox. However, the ideal prosthesis has yet to be found. In some patients, the so-called low-resistance prostheses fail to maintain their aerodynamic performances, most likely because anatomic resistors interfere with the effort (i.e., pressure) required to produce a voice. At present the choice of prosthesis is best determined on an individual patient-to-patient basis.

Aged↗
PubMed1998

[Effect of sulfur salt-bromine-iodine thermal waters on albumin and IgA concentrations in nasal secretions].

In chronic rhinopharyngotubaric phlogoses, the key pathogenic element sustaining phlogosis is a persistent modification of the biological, rheological features of the nasal mucus. For centuries sulphurous thermal waters have proved effective in clinically curing such phlogoses. In order to evaluate the effect of such sulphurous-salty-bromic-iodic thermal waters a randomized, double blind study was undertaken on a sampling of 50 patients. The effect such waters have on secretory IgA (sIgA) and albumin in the nasal secretions was tested against a placebo made of distilled water. Using the method of radial immunodiffusion, the response in the IgAs (mg/l) and albumin (mg/dl) concentrations in the nasal secretions was measured for 25 patients treated with the thermal waters and 25 patients treated with distilled water. The average concentrations were statistically compared using the Student t-test for paired samples. A significant increase (p < 0.0001) was seen in the mean IgAs concentration in the patients treated with the thermal waters. On the other hand, there was a weak, not statistically significant increase in the same data mean for the group treated with distilled water. The average increase in the albumin concentration in the nasal secretions proved significant in both cases although the significance was much more marked in the group treated with the thermal waters (p = 0.001) vs. the placebo group (p = 0.039).

Administration, Inhalation↗
PubMed1998

[Evaluation of various phonatory parameters in laryngectomized patients: comparison of esophageal and tracheo-esophageal prosthesis phonation].

Today there is increased need for an objective comparison between the various post-total laryngectomy phonatory rehabilitation techniques. This survey involves 20 patients who, after total laryngectomy, underwent rehabilitation using the esophageal voice (n = 10) or through the application of a secondary tracheal-esophageal prosthesis (n = 10). The multivariate analysis indicated that the only phonatory parameter which differed significantly between the two types of voice was the maximum phonation time (MPT) (p < 0.01). The MPT was markedly longer in patients with the tracheal-esophageal prosthesis. In patients with prosthesis, the Mann-Whitney test highlighted better figures for the following parameters: MPT (p = 0.0003), GP (maximum number of words that can be read in one breath) (p = 0.009), maximum intensity level (MIL) (p = 0.019), Shimmer (p = 0.008) and noise-to harmonics ratio (NHR) (p = 0.049). Furthermore, the Spearman test proved there is a relationship between MIL and GP, and between Pitch and Shimmer. Therefore, the tracheal-esophageal prosthesis seems to offer better phonatory energy and phonatory duration for every breath. However, these methods of objective inquiry need to be further developed so that comparison-among the different authors and among the different rehabilitation methods-can be made easier than it is now.

Aged↗
PubMed1998

[Analysis of qualitative voice and speech quality judgments after total laryngectomy].

The present work analyzes subjective judgement of the voice and speech qualities of intelligibility, pleasantness and acceptability expressed for two groups of total laryngectomy patients. The first group was composed of ten patients who had undergone esophageal voice rehabilitation. The second had nine patients with tracheo-esophageal voice rehabilitation. A group of ten listeners was set up to evaluate the voice and language parameters. These were all persons who, because of their jobs (i.e. physicians, nurses, rehabilitation therapists, etc.), had nearly daily contacts with laryngectomized patients. The listeners had to evaluate the acoustic and qualitative features of the voices reproduced on magnetic tape and score them on a specially designed sheet. This study has revealed a significant difference in the voice and speech acceptability scores for the two different groups of patients. In fact, most of the listeners found the tracheo-esophageal voice more pleasant and more acceptable than the esophageal voice.

Humans↗
PubMed1996

Spectrographic differences between tracheal-esophageal and esophageal voice.

In order to evaluate the results of voice and speech rehabilitation after total laryngectomy some acoustic parameters (fundamental frequency, waveform perturbation) were examined in 18 total laryngectomy patients. Eight of these subjects had previously been surgically rehabilitated with a tracheal-esophageal phonatory valve while 10 had been submitted to esophageal speech rehabilitation. Analysis of results has shown that tracheal-esophageal voices are more likely to provide a stable fundamental frequency; there is also a tendency toward more clearly defined harmonics; jitter and shimmer are more similar to the values of normal subjects compared with those observed in esophageal speech. Such results seem to depend on a more regular vibration pattern in the pharyngeal-esophageal segment, due to the more efficient expiratory flow in tracheal-esophageal speech. Moreover we were able to demonstrate a correlation between the objective parameters evaluated and the subjective score on speech acceptability.

Humans↗
PubMed1996

Temporary threshold shift induced by physical exercise.

Several studies have demonstrated how physical exercise can increase noise-induced temporary threshold shifts (TTS), but until now no evidence of TTS exclusively attributable to physical activity has yet been reported. In this study the hearing pure-tone thresholds of 10 subjects were evaluated at rest and at three designated times following the end of a work load corresponding to 50% and 80% of the maximum oxygen uptake (VO2 max). The results obtained demonstrate a definite effect of physical exercise on the hearing threshold at 6000 and 8000 Hz and that the higher the frequency, the greater the chance of detecting a TTS. Evaluation of the variations in some physiologic parameters (VO2 max, blood lactate and blood pressure) could not statistically correlate the same with TTS. The physiopathologic mechanisms responsible for TTS are still unknown and require further studies which should make allowances for the deferred effects of metabolic variations on the cochlear function.

Adult↗
PubMed1983

Tracheostomal recurrences after laryngectomy.

A clinicopathologic study of 681 laryngectomies performed at the Otorhinolaryngology Clinic of the University of Ferrara forms the basis here of a discussion of the etiopathogenesis of the postsurgical tracheostomal recurrence. Special attention is paid to the much debated etiopathogenetic role of preoperative tracheotomy. In all classes of material analyzed, tracheostomal recurrence was more frequent in patients with preoperative tracheotomy, though the percentages varied depending on the class. Morphological analysis of original tumor specimens from preoperatively trachetomized patients who later had tracheostomal recurrence, revealed tumors in 4 out of the 11 usable specimens. Of these, two had submucosal infiltration in a peripheral digitation of the tumor; in the other two cases, no contact was observed between the neoplastic infiltration and the outer border of the original tumor. The authors also reviewed the case histories of patients in whom conservative surgery was followed by total laryngectomy because of endolaryngeal recurrence. The high rate of tracheostomal recurrence in this category of patients suggests that the pathogenetic mechanism may be analogous in the two situations: preoperative tracheotomy/tracheostomal recurrence and inadequate conservative surgery/tracheostomal recurrence.

Humans↗
PubMed1979

Supraglottic surgery in vestibular cancer.

This paper deals with the experience acquired in the E.N.T. Clinic of the University of Ferrara regarding horizontal supraglottic laryngectomy in vestibular cancer. The anatomical background of this functional surgery and the most important principles of the technique are specified. The results regard 121 cases (13 T1 cases, 93 T2 cases and 15 T4 cases) divided into three groups: 1. patients who had only surgery (68 cases); 2. patients who for various reasons also had complementary postoperative radiotherapy (39 cases); 3. patients with extralaryngeal expansion who had preoperative radiotherapy (14 cases). The high overall survival rate for the 121 cases is particularly significant, as is the shortening of the high-risk period to less than the usual 5 years. The 4-year cure rate is 78% and remains unchanged right through the 7-year follow-up. The authors feel that these data demonstrate further the validity of supraglottic laryngectomy when its precise indications are rigorously observed.

Female↗