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Biomedical subjects

Alberto Staffieri

Publications and source records attributed to Alberto Staffieri.

50 records · Page 3Linked to original sources
PubMed2003

Recovery of swallowing disorders in patients undergoing supracricoid laryngectomy with botulinum toxin therapy.

In recent decades, functional laryngeal surgery has become a widespread method of treating glottic and supraglottic neoplasms, since it ensures an oncological outcome comparable to that of radical surgery and functional results that are conducive to a good quality of life. The most common postoperative complaints for this type of surgery are swallowing disorders, which can thwart good surgical results, especially when severe. Five supracricoid laryngectomees with swallowing disorders unresolved by speech therapy were treated by percutaneous injection of botulinum toxin under electromyographic control. All patients presented marked improvement in their complaints. A single session of botulinum toxin type A treatment resolved the dysphagia in all cases.

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PubMed2003

Facial nerve paralysis secondary to Warthin's tumour of the parotid gland.

Facial nerve paralysis associated with a parotid gland tumour classically denotes malignancy. Only a few case reports have indicated benign parotid tumours as a cause of facial nerve palsy. We present a new case of facial nerve paralysis secondary to Warthin's tumour of the parotid gland. It is important for clinicians to be aware that, on rare occasions, facial nerve dysfunction may result from benign parotid disease.

Adenolymphoma↗
PubMed2002

Contractile properties and myosin heavy chain isoform composition in single fibre of human laryngeal muscles.

In the present study we aimed to determine the functional properties and the myosin heavy chain (MHC) isoform composition of single chemically skinned fibres from the vocal muscle of four adult men (age: 55-67 years). Single fibres, dissected from the bioptic samples, were chemically skinned and isometric tension (P0) and maximal shortening velocity (V0) were measured at pCa 4.6. MHC and myosin light chain (MLC) composition of fibre segments and MHC distribution of the biopsy samples were analysed by SDS-poly-acrylamide gel electrophoresis (SDS-PAGE) and densitometry. Four MHC isoforms (1, 2A, 2X and a fourth isoform, provisionally called L) and five MLC isoforms (MLC1s, MLC1f, MLC3f, MLC2f, MLC2s) were identified. The major findings of this study were: (1) fast MHC isoforms (in particular MHC-2A) and fast fibres were predominant, (2) one-third of the fibres were mixed or hybrid, i.e. expressed more than one MHC isoform, (3) V0 and P0 values were determined by the MHC isoform composition and mixed fibres showed functional properties which were intermediate between pure fibres; MHC-L was associated with V0 values similar to those of MHC-2A, (4) compared with limb muscles, V0 values of laryngeal fibres were similar to those of limb muscle fibres containing the same MHC isoform whereas P0 values were lower for slow and fast 2X fibres and similar for fibres expressing MHC-2A.

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PubMed2002

Progesterone receptor expression in angioleiomyoma of the nasal cavity.

In recent years sex steroid receptors have been identified in several types of human neoplasia. Angioleiomyoma of the nasal cavity and paranasal sinus is an extremely rare benign neoplasm which is more common in females (3.75:1 female:male ratio). To the best of our knowledge, only approximately 25 cases have been described. We describe a new case of angioleiomyoma of the nasal cavity that was found to be progesterone-receptor positive and oestrogen-receptor negative on immunohistochemical analysis. We suggest that the growth of this tumour may be hormone-dependent.

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PubMed2002

Lymphoepithelial carcinoma of the larynx.

Lymphoepithelial carcinoma is a very rare tumour of the larynx, with an exhaustive review of the literature having disclosed only 33 documented cases. The relationship between lymphoepithelial carcinoma of the larynx and Epstein-Barr virus is still controversial. We describe one new case of this tumour involving the supraglottis. The patient was treated with supraglottic laryngectomy and left modified neck dissection. Three years and 4 months later, the right side of the neck was found positive for metastatic disease and a right modified neck dissection was performed. No evidence of disease was exhibited 4 years after the diagnosis of metastatic disease. The diagnostic problems and therapy associated with this rare tumour are discussed.

Adult↗
PubMed2002

Primary inverted papilloma of the middle ear and mastoid.

OBJECTIVE: Inverted papilloma (Schneiderian-type papilloma), involving the middle ear and mastoid as a primary lesion or as an extension of a sinonasal papilloma, is an extremely rare occurrence. STUDY DESIGN: The study design was a case report format with a review of the literature. Epidemiologic, diagnostic, therapeutic and follow-up problems are discussed. SETTING: Academic, tertiary referral hospital. PATIENT AND METHODS: The patient underwent Wullstein type I tympanoplasty and complete mastoidectomy, revealing obliteration of the pneumatic cells by polypoid tissue. The middle ear was completely filled by polypoid tissue. Histopathologic examination revealed an inverted papilloma of the middle ear and mastoid. CONCLUSION: Literature reports indicate that inverted papillomas of the middle ear and mastoid differ pathogenically and epidemiologically from sinonasal inverted papillomas. Recurrence rates and association with squamous cell carcinoma are higher in Schneiderian-type papillomas of the middle ear than in inverted papillomas of the nose and paranasal sinuses. Long-term follow-up after removal of inverted papilloma of the middle ear and mastoid is mandatory. Magnetic resonance imaging is the first follow-up examination to perform.

Ear Neoplasms↗
PubMedDate not supplied

Supracricoid laryngectomy: is it time to define guidelines to evaluate functional results? a review.

PURPOSE: Supracricoid laryngectomy (SCL) permits local control and 5-year survival rates similar to total laryngectomy in selected cases of advanced-stage laryngeal carcinoma. Although most of the reports regarding the surgical technique and oncological results have been proposed by European groups, increased interest in SCL has also been shown in recent years by American surgeons. There is still a lack of comprehensive studies about functional outcomes (respiration, deglutition, phonation) after SCL. Materials and methods This report briefly evaluates the functional outcomes of SCL recorded by the Department of Otolaryngology Head and Neck Surgery of Padua University since 1998 and critically reviews recent English-language literature describing SCL functional results. RESULTS: The present review confirms that the available data on functional results were collected using heterogeneous methods, parameters, and evaluation scales. CONCLUSIONS: Every effort has to be made to uniform the format for presenting outcome data, particularly on swallowing and voice parameters. Defining guidelines to evaluate the functional results of SCL may facilitate interstudy comparability.

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PubMedDate not supplied

Leiomyosarcoma of the larynx: critical analysis of the diagnostic role played by immunohistochemistry.

Laryngeal leiomyosarcoma (LMS) is definitely considered a rare occurrence: our exhaustive literature review disclosed to date only 45 cases (including the new case we have reported). The morphological diagnosis of laryngeal LMS may be problematic on conventional light microscopy especially in small laryngeal specimens. In the past, LMSs of the larynx were frequently confused with other spindle-cell malignant tumors. Nowadays, immunohistochemical investigations are considered necessary to distinguishing LMS from other spindle-cell tumors. On immunostaining, LMS is usually positive for muscle-specific actin and negative for cytokeratins and epithelial membrane antigen. In most cases, immunohistochemical study allows reliable diagnosis of LMS, but it can produce ambiguous or inconclusive results when the tumor cells lack specific immunohistochemical reactivity. In these controversial cases, LMS diagnosis has to be substantiated by electron microscopy. Distinguishing laryngeal LMS from other spindle-cell malignancies plays a role not only in academic interest. Confusion in the diagnosis of a spindle-cell laryngeal malignancy could result in inappropriate clinical management and inadequate treatment.

Humans↗
PubMedDate not supplied

The role of botulinum toxin in postparotidectomy fistula treatment. A technical note.

PURPOSE: Parotid fistula is a well-known complication of parotidectomy or penetrating injury of the parotid gland. The management of parotid fistula has been controversial, and numerous conservative and surgical treatment methods have been described. METHODS: We report 3 cases of parotid fistula after partial parotidectomy, which were treated by botulinum toxin injection under electromyographic control into the residual substance of parotid gland. RESULTS: Complete healing of the fistula was achieved with a single botulinum toxin treatment in all patients. No side effects were observed after the treatment. The patients are disease-free after 21, 18, and 14 months, respectively. CONCLUSIONS: In the considered cases, the localized injection of botulinum toxin into the parotid gland resulted to an effective and long-lasting treatment of postparotidectomy fistula.

Botulinum Toxins, Type A↗
PubMedDate not supplied

Delayed facial nerve palsy following uneventful stapedectomy.

Facial nerve palsy is a rare complication of stapedectomy. Its onset may be immediate or delayed by several days. The authors present a case of a 59-year-old man who developed right delayed peripheral facial nerve palsy occurring after uncomplicated ipsilateral stapedectomy. The incidence, treatment and prognosis of this complication are discussed.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Expression of the apoptosis inhibitor protein Survivin in primary laryngeal carcinoma and cervical lymph node metastasis.

BACKGROUND: Survivin is the smallest mammalian member of the inhibitor of apoptosis (IAP) proteins family. The aim of the present study was to determine survivin expression in laryngeal squamous cell carcinoma (SCC) and in neck lymph node metastases. The survivin value in predicting prognosis in laryngeal SCC was also investigated. PATIENTS AND METHODS: Survivin expression was investigated in 37 laryngeal SCCs and in 12 cervical lymph node metastases. RESULTS: A nuclear reaction predominated in laryngeal SCCs. Survivin expression was significantly higher in pN+ laryngeal SCCs than in pN0 (p = 0.017). Survivin expression was higher in cervical lymph node metastases than in correspondent primary laryngeal SCCs (p = 0.002). Survivin expression in laryngeal SCCs that developed loco-regional recurrence was significantly higher than in laryngeal SCCs without recurrence of disease (p = 0.039). CONCLUSION: Nuclear expression of survivin should be studied as a hallmark of higher risk laryngeal SCCs to develop loco-regional recurrences. Higher survivin expression in pN+ laryngeal SCC may suggest elective neck dissection in clinically N0 patients with high survivin expression in primary SCC. The extremely high survivin expression in lymph node metastases may support the use of survivin in the diagnosis of lymph node micro-metastases.

Adult↗
PubMedDate not supplied

Maspin nuclear localization is related to reduced density of tumour-associated micro-vessels in laryngeal carcinoma.

BACKGROUND: MASPIN, a tumour suppressing serpin, is a potent inhibitor of angiogenesis. CD105 is a proliferation-associated protein acting in endothelial cells of angiogenic tissues. For the first time the relation between nuclear MASPIN expression and CD105-assessed micro-vessel density (MVD) in laryngeal carcinoma was investigated. PATIENTS AND METHODS: The sub-cellular distribution of MASPIN and nuclear MASPIN expression were immunohistochemically determined in 35 cases of laryngeal carcinoma. The percentage of the fields occupied by CDl05-assessed micro-vessels was also calculated. RESULTS: MVD was significantly lower in laryngeal carcinomas with MASPIN nuclear staining than in carcinomas with cytoplasmic staining (p=0.02). The mean nuclear MASPIN expression was higher in patients without carcinoma recurrence than in those with recurrence (p=0.06). The mean MVD was significantly higher in patients with recurrence of carcinoma (p=0.024). CONCLUSION: The crucial role of MASPIN nuclear localization in reducing the MVD has been demonstrated. Nuclear MASPIN re-expression should be investigated as a potential therapeutic option in the treatment of laryngeal carcinoma.

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