PubMed Health⌕ Search

Biomedical subjects

E Chiossone

Publications and source records attributed to E Chiossone.

16 recordsLinked to original sources

GJB2 gene mutations in childhood deafness.

The frequency of childhood deafness is estimated at 1:1,000 and at least half of these cases are genetic. Recently, mutations in the GJB2 gene have been found in a great number of familial and sporadic cases of congenital deafness in Caucasians. The most common mutation (70%) is the frameshift mutation of a single guanine in position 35 (35delG). More than 20 mutations in the GJB2 gene are associated with DFNB1, a prevalent type of autosomal recessive non-syndromic neurosensory deafness. Last year we initiated a systematic screening programme to evaluate the causes of deafness in the population of prelingually deaf children who are referred to our cochlear implant programme. All of the deaf children and their parents undergo a comprehensive medical review, directed to identify causes of acquired deafness and manifestations of syndromic hearing impairment. DNA is extracted from the blood of all of the children. The technique AS-PCR (allele-specific polymerase chain reaction) is used for the identification of the mutation 35delG. Screening for other GJB2 gene mutations is carried out by single-strand conformation polymorphisms (SSCP). Our results on the identification of DFNB1 will be presented, as well as a discussion on the implications of an aetiological diagnosis in cochlear implantation.

Child↗

An analysis of a large postlingually deaf family with hereditary non-syndromic profound hearing loss.

We initiated a clinical and genetic linkage study on members of a large Venezuelan family with hereditary hearing loss. A medical history and a physical examination were performed on 30 family members. Audiometry was carried out in 25 subjects, and in 2 additional children auditory brainstem responses were obtained. Additional testing (site-of-lesion, electronystagmography and computed tomography) was also obtained in a few subjects. DNA was extracted from blood samples from 25 family members. The type of deafness in this family is neurosensorial, non-syndromic and postlingual. The average age of onset of deafness is 7 years and there is a rapid progression leading to profound deafness. Deafness is possibly of cochlear origin and there is no associated vestibular pathology. Analysis of the pedigree discloses a maternal pattern of inheritance with a significant female predominance, compatible with a mutation of the mitochondrial DNA. The molecular DNA analysis for the known mitochondrial mutations are discussed.

Adolescent↗

Surgical treatment of the facial nerve in facial paralysis.

This article discusses the surgery for acute facial paralysis of idiopathic, traumatic, infectious, and neoplastic etiologic agents. Indications, results, and details of surgical techniques of facial nerve exploration, decompression, rerouting, and repair are provided.

Decompression, Surgical↗

Preventive tympanoplasty in children: a new approach.

Chronic middle ear effusion with serous or mucus accumulation but without other associated tympanic and middle ear pathology can be successfully treated in many cases with myringotomy and ventilating tubes. But there are cases on which there are atrophic tympanic membrane areas with retraction into the middle ear, tympanic membrane adhesions to the long process of incus and incudo-stapedial joint with or without retraction toward the facial and tympanic recesses and shallow attic retraction pockets, which eventually will lead to cholesteatoma formation. All these minor anatomical distortions are usually asymptomatic, but with a potential to generate cholesteatomas throughout the years and cannot be corrected with a simple myringotomy and ventilation tube insertion. In these particular cases we have developed some types of tympanoplasty procedure that may prevent further progression to cholesteatoma formation. The purpose of this presentation is to describe these preventive tympanoplasty techniques and analyze the short and long term results in 68 surgical procedures.

Adolescent↗

Current status of cochlear implants in Latin America.

In recent years there has been sufficient clinical evidence gathered to show that cochlear implants can benefit a large number of postlingually and prelingually profoundly deaf patients who could not be helped with conventional hearing aids. The number of implanted patients is increasing rapidly around the world in spite of the diverse difficulties in diagnostic, surgical, and rehabilitation procedures involved in this new technology and the controversy among some otologists. Cochlear implant programs started in Latin America more than 10 years ago, and lately the number of cochlear implant teams and implanted patients have increased rapidly. It is the aim of this report to present the results of a recently completed survey regarding the current status of cochlear implant surgery and rehabilitation in Latin America.

Adult↗

Cryosurgery of the inferior nasal turbinates.

Forty-seven patients with irreversible nasal obstruction due to inferior turbinate hypertrophy were treated by cryosurgery, the short and medium term results having been clinically evaluated. Permanent good results in nasal breathing were achieved in 83% of the patients. Failures are mostly related to turbinates hypertrophy due to nasal allergy. The combination of cryosurgery and nasal septoplasty, in cases of hypertrophy associated with deformities of nasal septum, gives an excellent result. Cryosurgery of hypertrophic nasal turbinates is a simple, safe, and reliable procedure to improve nasal breathing in cases of nasal turbinate hypertrophy.

Adolescent↗

Densitometry of implanted allograft ear ossicles.

Densitometry measurements of allograft ear ossicles implanted in humans middles ears for more than 10 years have been performed by means of High Resolution Computerized Tomography and compared with similar measurements made in the opposite normal middle ear ossicles. Eight patients operated for unilateral chronic ear disease were selected for this study. Densitometry findings have been also correlated with histological observations made in allograft ossicles removed after a long-term implantation period.

Cholesteatoma↗

Homograft ossiculoplasty: long-term results.

The use of homograft ossicles and homograft cortical bone has been common practice in chronic ear surgery for reconstruction of the interrupted ossicular chain. However, the possibilities of extrusion, reabsorption, and necrosis of these homografts have jeopardized the fate of such tissue for ossicular reconstruction. This study analyzes the fate of more than 400 homograft ossicles and bone columellas used for ossicular chain reconstruction over more than fifteen years, all of which were previously processed and sculptured in an ear bank. Many of these homografts have been observed for longer than five years. Histologic findings in longstanding homograft ossicles in the middle ear are presented.

Bone Transplantation↗

Surgical management of major congenital malformations of the ear.

Surgical management of major congenital malformations of the ear is a difficult and complex procedure. The risk of damaging middle and inner ear structures because of their frequently aberrant location, the failure to keep a patent ear canal over the long term, and the difficulty in achieving a good hearing result all challenge the otologic surgeon. The purpose of this study was to analyze the results obtained with a surgical technique developed to prevent postoperative stenosis or total closure of the newly formed auditory meatus and to achieve at least serviceable hearing in the majority of cases. Emphasis is placed on the selection of surgical cases based on a classification that evaluates, through x-ray tomograms, the anatomic relation of the glenoid fossa of the temporomandibular joint to the middle ear space. Anatomic and functional results are presented. Comments are made in regard to different possibilities of reconstruction of the sound conducting mechanism.

Adolescent↗

"Three cartilages" technique in intact canal wall tympanoplasty to prevent recurrent cholesteatoma.

Residual cholesteatoma is the consequence of leaving squamous epithelium in the mastoid and middle ear cleft. It has been demonstrated that the only effective way to reduce the risk of epidermoid cyst neoformation is meticulous and radical removal of cholesteatoma matrix and staging of the operation, regardless of whether a closed or open mastoid cavity tympanoplasty technique has been performed. Recurrent cholesteatoma usually occurs after intact canal wall tympanoplasty secondary to middle ear, attic, and mastoid retraction of the graft, especially in cases with destruction of the scutum or absence of malleus and incus; this is still considered a major problem with this surgical technique. During the last five years we have been performing a procedure we have developed to avoid this retraction. Concave autogenous cartilage from the upper part of the concha auriculae trimmed in three pieces to protect attic, mastoid, and middle ear for graft retraction has been successfully used in 106 surgical procedures. This study describes the surgical technique and analyzes the anatomic and hearing results.

Cartilage↗

Importance of en bloc homograft in intact canal wall tympanoplasty.

The incidence of cholesteatoma recurrence using intact canal tympanoplasty has been compared in 2 series of operations. The first group represents cases treated with the conventional conservative technique for attic and middle ear surgery. The second group represents cases on which the concept of 'radical attic and middle ear surgery' has been applied and an en bloc homograft has been used for reconstruction. A preliminary survey has shown a much lower incidence of cholesteatoma recurrence in ears belonging to the second group. The advantages of this surgical technique are discussed.

Cholesteatoma↗

The establishment of an ear bank.

Tympanic membrane and ossicle homografts have been successfully used in reconstructive ear surgery during the last 12 years. Ear banks have proven to be practical to insure a regular supply of high quality homografts for the otologic surgeon. The most important aspects in establishing an ear bank include the procurement of temporal bone cores, the establishment of homograft dissection technique, and attention to preservation and distribution procedures and the problems of maintenance.

Ear↗

Carotidynia.

Explore the source record for details and available documents.

Adolescent↗