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Biomedical subjects

F A Salzano

Publications and source records attributed to F A Salzano.

11 recordsLinked to original sources

Frontal sinus osteoma and palpebral abscess: case report.

Osteomas of the paranasal sinuses are slow-growing, benign tumours most frequently found in the frontal sinus with an incidence that varies from 47% to 80% of the cases; there are often no symptoms and they are diagnosed by chance during an x-ray examination. The symptoms are usually headaches and those secondary to ocular or neurological complications. The therapy to be preferred is surgery. The authors describe a case of frontal osteoma complicated by frontal sinusitis and palpebral abscess.

Abscess↗

Management of nasal septal abscess in childhood: our experience.

UNLABELLED: A nasal septal abscess is usually the result of an infected hematoma of the septum. A secondary septal abscess may be the result of infections extending from any of the neighbouring tissues. The necrosis of septal cartilage may lead to nasal deformities and severe impairment of nasal patency and growth. OBJECTIVES: Assess if the drainage of the abscess and the immediate reconstruction of the destroyed nasal septum in the acute phase is the best treatment to prevent short- and long-term effect on nasal and midface growth. METHODS: Three pediatric patients treated with drainage and immediate implantation of homologous bank cartilage prior to 1990 and four treated with mosaic plastic using small pieces of residual septal cartilage assembled with fibrin glue. RESULT: No complication were observed in the follow-up and any deformities in the long-term controls. CONCLUSIONS: The drainage and immediate reconstruction of the nasal septum are the golden standard in the treatment of the septum infected haematoma.

Abscess↗

A multicenter trial of specific local nasal immunotherapy.

OBJECTIVE: To assess the efficacy and safety of specific local nasal immunotherapy (LNIT) in powder form in patients with allergic rhinitis, using subjective and objective parameters. STUDY DESIGN: A double-blind randomized multicenter trial of 102 patients with allergic rhinitis who were treated with specific LNIT for 8 consecutive months. METHODS: After identifying allergens with the skin prick test and sensitization threshold dose with the specific nasal provocation test, 102 patients were selected, of whom 55 were allergic to mites and 47 were allergic to Graminaceae or Parietaria pollen. The specific treatments were self-administered using an insufflator in two phases (phase 1: increasing doses; phase: 2, maintenance dose). Patients were evaluated before and after 32 weeks of treatment by subjective analysis of their self-reported symptoms and by objective analysis of nasal provocation test, nasal resistance by anterior rhinomanometry, and mucociliary clearance time. RESULTS: Clinical efficacy of LNIT for allergy to mites and pollens was confirmed by the differences in the symptoms score between the active group and the placebo group. The nasal provocation test results confirmed that this difference was statistically significant. The rhinomanometric analysis gave positive results for the treated group mainly in LNIT for mites. No differences in mucociliary clearance time were found. CONCLUSIONS: Specific LNIT is effective for allergic rhinitis and appears to offer considerable advantages over other hyposensitization methods. It can be done at home, patient compliance is good, and the treatment is safe.

Administration, Intranasal↗

[Mucociliary clearance after aerobic exertion in athletes].

The Authors studied the modifications in nasal mucociliary clearance times before and after aerobic exertion in athletes. A total of 60 athletes with high-level training (age range 18-37 years) were selected for this study. Persons who smoked or had allergies, nasal sinus phlogosis or tumors, altered nasal cavity morphology (i.e. deviation of the septum and/or hypertrophy of the turbinates), fever or who were taking topic and/or systemic drugs or had previously undergone head and neck surgery were all ruled out of the study. The authors then studied the mucociliary clearance time (MCCT) in these subjects using the saccharin test. This test involves placing a small amount of saccharin on the medial face of the lower turbinate, approximately 1.5 cm from the anterior end and then evaluating the time that elapses before the patient perceives the sweet taste. This test was performed: in 30 subjects one hour prior to and 15 minutes after physical aerobic exertion; in the remaining subjects (controls) the test was performed twice with a 75 minute interval between them. The results showed that the mucociliary clearance time increased after exertion which was, on the average, 11.29 minutes. On the basis of these data, the Authors discuss the likely causes for the detected increase, and correlate it to changes in ventilation and nasal secretion viscosity during physical exercise. According to previous research, these variations are also found in untrained subjects who undergo physical exertion; for this reason, the Authors conclude that nasal clearance is not significantly affected by training.

Adult↗

Olfactory groove meningioma with paranasal sinus and nasal cavity extension: removal by combined subfrontal and nasal approach.

A very unusual case of olfactory groove meningioma with recurrence extending into the paranasal sinuses and nasal cavities, 15 years after the first transcranial operation, is described. The patient was successfully treated by a combined subfrontal and nasal approach. Large downward extension of an olfactory groove meningioma into the nasal cavities is a rare event, with no or isolated cases reported even in large series of these tumours. The nasal extent of these meningiomas is more often asymptomatic, although signs of sinus obstruction and epistaxis have been described. Although small paranasal sinus extensions of the meningioma may be removed by the transcranial route, a combined subfrontal and nasal approach is necessary in cases with large tumour masses extending into the nasal cavities, as in our own one.

Adult↗

Specific nasal provocation test with powder allergen.

Reported here are the results of a large-scale trial conducted under the guidance of Prof. Giovanni Motta, which I coordinated. A total of 656 patients with nasal hyperreactivity were recruited in 51 Italian centres (18 in the north of Italy, 20 in central Italy and 13 in the south). The trial's results were as follows. 1) A clear clinical prevalence of sensitization to different allergens in the different areas of Italy, which could be roughly classified thus: a) in Northern Italy birch and grasses were in the main species; b) in Central Italy mites prevailed but oleaceae were also significant; c) in Southern Italy parietaria and oleaceae were the prevailing species. 2) Most cases were sensitive to several allergens, although a considerable proportion (22%) actually presented reactions only to one allergen and those responding account of the patients sensitive to only one allergen and those responding to a main allergen, the proportion of patients reacting clinically to only one allergen rises to 64%. 4) The specific nasal provocation test (sNPT) offers specificity comparable to in vivo diagnostic methods such as the prick test, and in vitro methods such as RAST, but is much more sensitive. 5) The sNPT can be done in any season. 6) The sNPT is highly specific below a threshold value of nasal reactivity, which can be identified for each allergen studied and expressed in Allergenic Units. 7) In patients in whom the prick test shows multiple sensitivity, the specific NPT identifies the allergen presumably responsible for the nasal reactions (main allergen). In the light of these findings double-blind specific immunotherapy was started, to last 1 year, in 107 patients (49 given placebo and 58 active treatment), with nasal allergy to grasses, parietaria and mites. The results of this treatment were as follows: 74.1% of patients presented a reduction in nasal resistance, measured by dynamic anterior rhinomanometry, indicating relief of nasal obstruction; mucociliary transport time became normal in 81% of patients, meaning that rhinorrhoea had become less marked; there was significant rise in the nasal reactivity threshold in 74.1% of patients, illustrating the degree of desensitization achieved; nasal IgA increased by 62.5% of patients and IgG in 55.2% indicating improvement in the local immunological picture. No such improvements were detectable in the patients given placebo. In conclusion, therefore, the findings of this trial in allergic rhinitis underline that the specific NPT proved more sensitive than other in vivo and in vitro diagnostic methods and is unquestionably a fundamental investigational approach for assessing nasal allergies, identifying the allergens causing the symptoms and setting up rational local immunotherapy. The sNPT also showed the efficacy of specific intranasal immunotherapy.

Administration, Intranasal↗

[The treatment of allergic vasomotor rhinitis: diagnostic problems and local immunotherapy].

Treatment of allergic vasomotor rhinitis is to be regarded with the factors that modify the symptomatology. In fact must be considered the morphological changes (septum deviation, adenoids, turbinates hypertrophy, polyps) infections (bacteria, chlamydiae, micetes) and specific allergens. Identification of allergens and sensitization threshold is to be studied; then specific hyposensitization will be assessed. In the present study, 68 subjects having nasal reactivity have been observed and underwent to different ways of treatment: 18 with permanent stenosis identified by rhinomanometry and not modified with vasoconstrictors were operated; 25 of the 50 patients with normal nasal cavities showed contemporary infections: after a specific antimicrobic or antimycotic treatment, a clear improvement was obtained documented by rhinomanometry before and after nasal stimulations. The 50 patients with normal morphology underwent a local hyposensitization against the allergens. As a matter of fact: a) in all cases a clear improvement was obtained in phase of increasing; b) after one year of maintainance just 13 over 50 (26%) returned to previous conditions. The Authors remark how local immunotherapy by the nasal way give good possibilities in a high percentage of cases in the following conditions: correct clinical evaluation, especially concerning the identification of factors determining vasomotor rhinitis; employment of precise techniques for diagnosis; observation of clinical data and results turning out from instrumental investigations, especially concerning the nasal provocation test evaluated by rhinomanometry.

Humans↗

Allergic rhinoconjunctivitis: diagnostic and clinical assessment.

In allergic rhinoconjunctivitis not only the nasal mucosa but also the conjunctiva and, in severe cases, the cornea are affected by reactive phenomena. This pathological process is often encountered in clinical practice, its incidence ranging from 10% to 30% of the whole population, as reported by many authors. Up to now, the pathogenetic mechanisms of allergic reactivity are not completely understood. In our opinion this is due to insufficient standardization of the diagnostic procedures; even the clinical picture of such a pathological process seems to be insufficient, especially with regard to the analogies between the nasal and conjunctival pathologies. To a great extent this depends on the different clinical pictures both in otorhinolaryngology and ophthalmology. Our study has been carried out on 98 patients suffering from rhinoconjunctivitis, and presents an accurate documentation with regard to the existence of analogies in reactivity at the immunoallergic level, in both the nose and conjunctiva. These are evident when we refer not only to specific routine allergological tests but, mainly, to local examinations. The evaluation of the selected data enables us to formulate a single classification of allergic rhinoconjunctivitis, taking into account the common reactive phenomena.

Adult↗