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Biomedical subjects

G Altissimi

Publications and source records attributed to G Altissimi.

At least 19 recordsLinked to original sources
PubMed2005

Balance disorders in headache patients: evaluation by computerized static stabilometry.

OBJECTIVES: The aim of the study was to investigate the occurrence of equilibrium disturbances in headache patients, during the interictal period, by computerized static stabilometry. MATERIALS AND METHODS: Sixty-seven patients were studied: 35 with migraine without aura (MwoA), 12 with tension-type headache (TTH) in the episodic form (ETTH) + MwoA, and 20 with only TTH [10 ETTH + 10 chronic (CTTH)]. The stabilometric parameters considered were: statokinesigram length (L) and surface (S) in open (EO) and closed (EC) eyes conditions with/without occlusal bite, EC with head retroflexion (ECR), and optokinetic stimulation (OKN). RESULTS: The alteration of at least one of the stabilometric parameters was observed in 45 patients (67.2%): 21 MwoA, 8 ETTH + MwoA, and 16 TTH (8 ETTH + 8 CTTH). CONCLUSION: In TTH patients (ETTH, CTTH, ETTH + MwoA), the stabilometric findings show a proprioceptive alteration induced by cervicofacial muscle contraction, which was peripheral in origin. In MwoA patients the alterations appear under OKN and support a control impairment in involuntary oculomotility of central origin.

Adult↗
PubMed2005

[An updated guide on drugs inducing ototoxicity, tinnitus and vertigo].

The argument of the iatrogenic side effects of pharmacological origin that can cause ototoxic effects or only disacustic symptoms like the tinnitus, without consequent degenerative effects, is enlarged in these last years. It is because of the great knowledge based on the careful attention from the pharmaceutical institutions which are responsible for the control of medicines and drugs. In the medical practice and in that specialty field born the need to gather, also in consideration of the possible medico-legal implications, those elements which will suppose the risk of otologic side effects. This will allow the physicians to evaluate the possible clinical advantage of a treatment, in their own field of competence, balancing them with their possible side effects in the otologic field. For this purpose, we have elaborated some updated lists of drugs with possible side effects of ototoxicity, tinnitus and vertigo; furthermore, we considered these drugs as could theoretically have influence on the auditory neurochemical progressing since they have excitatory or inhibitory action on the neurotransmitters and their receptors, but not signaled by the sources of institutional information.

Cochlea↗
PubMed2004

Giant cell granuloma of the maxilla: case report.

Giant cell granuloma is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible. Although it is a benign disease process, it can also be locally destructive. Surgery is the traditional and still the most accepted treatment for giant cell granuloma. The case described here involved the maxilla which was treated with surgical excision, followed by local injection of steroids.

Adult↗
PubMed2004

Treatment of severe epistaxis by superselective embolization: a review of 22 cases.

OBJECTIVES: Epistaxis represents one of the most common ENT emergencies. In this paper, the authors report their experience in treating some cases of severe epistaxis by super-selective embolization of the afferent vessels of the nasal fossae. PATIENTS AND METHODS: A retrospective study of 22 patients with severe recurrent epistaxis (1 anterior and 21 posterior). All patients had been treated unsuccessfully with repeated anteroposterior nasal packing, and presented significant secondary anaemia. Selective embolization procedures were performed under local anaesthesia. An arterial introducer is inserted into the femoral artery -generally the right one- and diagnosis as well as treatment are performed with the same guide catheter. In all cases, the terminal branches of the facial artery and of the internal maxillary artery on the side on which the haemorrhage occurred were embolized. Moreover the contralateral internal maxillary artery was always embolized as well, in order to prevent immediate recurrence of hypervascularisation of the mucosa through anastomotic paths. RESULTS: In all patients, complete devascularisation was achieved in the areas of the embolized arteries at the nasal mucous membranes, arresting the epistaxis. None of the cases experienced complications attributable to treatment. DISCUSSION AND CONCLUSION: Superselective arteriography with embolization can be considered as the method of choice in treating severe epistaxis because it can be performed under local anaesthesia and can easily be repeated if the first procedure is not successful. Moreover, it is at least as effective as ligation of the internal maxillary artery, if not more so, but it has a significantly lower complication rate which is destined to fall as the quality of the materials being used continues to improve.

Adult↗
PubMed2001

Distortion-product otoacoustic emissions and glycerol testing in endolymphatic hydrops.

OBJECTIVES/HYPOTHESIS: Aural fullness is a frequent symptom of endolymphatic hydrops. Its evaluation may provide valuable information on the initial stage of development of endolymphatic hydrops. STUDY DESIGN: The present investigation was specifically designed to ascertain the ability of the glycerol test, combined with pure tone audiometry and distortion product otoacoustic emissions (DPOAEs) testing, to diagnose endolymphatic hydrops early and to identify patients who may evolve toward Meniere's disease. For these purposes, patients who complained about aural fullness as their only audiologic symptom were selected. METHODS: This investigation consisted of 19 consecutive patients with unilateral or bilateral aural fullness who received no treatment. Each patient underwent glycerol testing measured with conventional pure tone audiometry and with both DPOAEs. For the traditional pure-tone glycerol test, a hearing improvement of at least 10 dB, at the lower two or three frequencies (125, 250, and 500 Hz), was judged as a positive result. For the DPOAE glycerol test, a smaller positive difference (5 dB) for at least three frequencies was interpreted as an ameliorative fluctuation. RESULTS: The outcomes of the glycerol tests (24 ears examined) showed variable patterns. Seven ears showed no significant changes of either the pure-tone audiogram or DPOAE. In seven other ears, the comparison of the traditional glycerol test and the DPOAE glycerol test indicated an improvement in both measures. Another seven ears showed negative glycerol tests, whereas DPOAE responses gradually recovered reaching levels significantly higher than those recorded before glycerol administration. The three remaining ears showed contrasting results. CONCLUSIONS: Patients with aural fullness in the absence of other associated symptoms may potentially be in the initial stages of Meniere's disease. This notion is confirmed by the present findings showing a high rate (58%) of positive glycerol tests in the selected patients. The importance of DPOAE testing is supported by their ability to detect minimal dysfunction, possibly representing endolymphatic hydrops that goes undetected by routine pure-tone audiometry.

Adult↗
PubMed2001

[Ki67 and p53 in laryngeal epithelial lesions: correlations with risk factors].

Laryngeal carcinoma-the prototype of epithelial tumors in the head and neck region-has been the greatest source of information on the biological behavior of such neoplasms. Many Authors have suggested that smoke, and to a lesser extent alcohol, play a role in the genesis of this carcinoma although the exact biological mechanism for such involvement is still not clear. The present study analyzed two important biological indicators (p53 and Ki67) in benign and malignant epithelial lesions of the larynx in an attempt to obtain information on what mechanism correlates the risk factors with the neoplasm. In a group of 172 patients, an in vivo sampling of cells was taken during microlaryngoscopy. These cells were then tested using the immunocytochemical method and the results showed that the neoplastic tissue was significantly more positive to these markers than the pre-cancerous tissues and benign lesions. Moreover, there was also an interesting correlation between the degree of positivity to p53 and exposure to smoke, and to a lesser extent to alcohol, in the oncological patients. Together with other similar results found in the literature, these results hint at a possible explanation for the carcinogenic power of smoke in the larynx and, in general, in the upper respiratory-digestive tract.

Carcinoma↗
PubMed2000

Distortion product otoacoustic emmissions in Ménière's disease.

Distortion product otoacoustic emissions (DPOAEs) are an objective, non-invasive measure for evaluating outer hair cell (OHC) activity. In this study DPOAEs were measured in 70 patients affected by Meniere's disease (MD). In addition 58 out of 70 patients performed both an audiometric threshold evaluation pre- and postglycerol administration (i.e. glycerol test) and DPOAEs pre- and post-osmotic drug assumption. The purpose of this combined form of testing was to explore the effects of glycerol on the active non-linear mechanisms of the cochlea. More than 60% of the ears with MD emitted DPOAEs despite the presence of an average hearing threshold level above 40 dB (HTL). Changes in the DPOAE baseline measures were observed in 32.4% of cases after glycerol administration. Patients were divided in four groups according to the different pattern of DPOAEs shown after the glycerol test. In particular, three-quarters of cases showed a significant increase in DPOAE amplitude, one-quarter of patients, who initially did not express DPOAEs, eventually did after intake of the osmotic agent, while no decreased DPOAEs were observed in these series. The different expressions of DPOAEs should be associated with the evolutive phases of MD. In addiction, elucidation of the relationship between DPOAEs and the stages of MD was an outcome of this test.

Acoustic Stimulation↗
PubMed1999

[Hashimoto's thyroiditis and thyroid cancer: a report of a clinical case and a review of the literature].

Considerable controversy exists concerning the existence of statistically significant relationship between Hashimoto's disease and thyroid cancer, since there is very discordance in the incidence reported in literature, ranging from 0.5% by Crile and Hazard (5) to as high as 22.5% by Hirabayashi and Lindsay (9). Within this context, the authors present a clinical case of a patient who previously underwent lobectomy for a nodular papillary cancer of the thyroid. The histological diagnosis after "totalization" procedure proved to be Hashimoto's thyroiditis on a previous cancer. Starting from this case, an accurate review of the existing literature is carried out and some pathogenetic theories are proposed on the correlation between this two lesions.

Adult↗
PubMed1998

[Sudden idiopathic hearing loss. Case reports in the course of ten years].

The authors present a retrospective case study of 132 subjects with sudden-onset hearing loss who had been observed during the course of 10 years. The results were compared with those available in the literature. These patients were divided into two subgroups based on age: over or under 40. The hearing loss was divided into 4 subgroups according to audiogram morphology. Then the presence, and entity, of any recovery in hearing was evaluated. There was no preference for sex while the greatest incidence was found in the VI and VII decade of life. The audiohistograms obtained when the patients were admitted to the hospital and 2 months later indicated an improvement in the hearing threshold localized above-all in the medium-low frequencies. This confirms a better evolution in those forms localized in the apex of the cochlea. The threshold of 60 dB HL is the dividing line between a totally favorable prognosis and a partially or totally unfavorable prognosis. This indirectly confirms that the intensity of the initial hearing damage is an important prognostic factor. From the morphological point of view the forms with the best evolution appear to be those with a flat or rising morphology. The forms with descending morphology do not present a favorable evolution although those with a threshold around 8000 Hz are worse than those with a threshold of 4000 Hz. As regards age no significant differences were found in the evolution of hearing loss between subjects under and over 40. In conclusion, the essential characteristics of sudden-onset hearing loss are as yet poorly defined. There are so many variables affecting the onset and evolution of hearing loss that it proves impossible to perform any statistically valid analysis which includes them all. To date the elements able to provide some degree of prognostic prediction are the audiogram morphology and the entity of the initial hearing loss.

Adolescent↗
PubMed1998

DPOAE modifications induced by pure tone overstimulation in guinea pigs.

Distortion Product Otoacoustic Emissions (DPOAEs) shows a vulnerability to acoustic overstimulation that is easily detectable by changes in amplitude, frequency distribution and time course. The frequency-specific changes in DPOAE provide more information than the more general changes in click evoked otoacoustic emissions. In this work five anesthetized guinea pigs were examined for changes DPOAE after exposure to pure tones. The noise was a 110 dB SPL pure tones for 45 minutes and the fatiguing tone centered on the geometric mean (GM) of primaries or 2/3 of GM. The most measurable effects were obtained in the latter conditions. The main DP level reduction lasts about one hour after exposure, but the complete recovery is observable only after 24 hours. The frequency distribution of fatiguing effects on the DP- audiogram shows a remarkable fine tuning and a pattern like a low-pass filter. After four hours, in one guinea pig, it is observable an enhancement of the DP amplitude, compared to the pre-exposure level; in another guinea pig, a second overstimulation produced a more extensive and time-lasting effects than the first exposure.

Acoustic Stimulation↗
PubMed1996

Diagnosing nasal hyperreactivity with positional rhinomanometry.

Positional rhinomanometry is a physiologic method for estimating nasal resistance, which is variable, difficult to predict, and linked to vasomotor activity of the functional system culminating in the turbinate valves. Thirty subjects suffering from allergic rhinitis, 25 patients affected by aspecific rhinitis, and 40 healthy controls underwent positional rhinomanometry. Test positions included the seated (baseline), supine, and recumbent (homolateral and contralateral to the nasal fossa under examination). In patients with perennial allergic rhinitis and in those with aspecific rhinitis, positional rhinomanometry elicited two pathologic responses: either an average percentage rise of more than 80% in nasal resistance in the supine and homolateral and contralateral recumbent positions compared with basal values, or a paradoxical fall in the supine and homolateral recumbent positions.

Adult↗
PubMed1996

[Analysis of otoacoustic distortion products in a group of otosclerotic patients].

There is indication that middle ear pathologies can affect otoacoustic emissions (OAE) to varying degrees. In fact, since acoustic emissions are recorded in the outer ear duct, the energy transfer mechanisms both up and downstream of the middle ear must be intact. OAE distortion products (DP) enable one to analyze cochlear response by frequency and to verify the retrograde response as a function of frequency. In the present work this method was used to test otosclerosis patients. A group of 45 patients with otosclerosis was tested to determine whether the OAE-DP could be identified and measured. Subsequently the characteristics of these DPs were analyzed in a group of 18 subjects who had previously undergone stapedectomy. All the results obtained were compared with those from a control group of normal hearing subjects with normal emissions and free of any E.N.T. pathology. In approximately half of the cases (53%) in the otosclerosis patient group it was possible to detect clearly evident DPs. Obviously, the DP-Gram differed greatly and average amplitude was lower than those found in normal subjects. Indeed, there was no signal at all at the lower and middle frequencies reflecting a hearing loss typical of cases of otosclerosis. Most (58%) of the otosclerosis patients who had successfully undergone stapedectomy recorded valid DPs. The DP-Gram frequency range was much broader (750-4000 Hz) than in those who had not undergone surgery. Moreover the lower and mid frequency amplitudes were significantly better. The data obtained are quite encouraging and suggest that DP should be studied in depth in patients with otosclerosis.

Acoustic Impedance Tests↗
PubMed1994

Laryngeal microsurgery under general anesthesia using small-bore endotracheal tubes: blood gas analysis.

This study reports variations observed under general anesthesia through small-bore endotracheal tubes in PO2, PCO2, HCO3, percentage saturation of O2, and pH levels in 39 patients who underwent laryngeal microsurgery lasting from 10 to 100 minutes. The tendency to an increase in PCO2 levels reached statistical significance only at the 100th minute but did not constitute a risk for patients as values remained within the limits of "permitted hypercapnia." PO2, percentage saturation of oxygen, and HCO3 levels did not vary significantly. pH values tended to fall (respiratory acidosis) in correlation to the increase in PCO2. Small-bore endotracheal tubes can safely be used for laryngeal microsurgery when operating times are not longer than 100 minutes.

Anesthesia, General↗
PubMed1990

[Role of the tumor marker TAG-72 in head and neck neoplasms].

The serum glycoprotein TAG-72 level was determined in 34 patients with chronic laryngitis or ENT malignancy. This marker is in widespread use in cases of gynaecological and gastrointestinal malignancy. TAG-72 levels did not differ significantly either from the levels of healthy subjects or in the post-operative follow-up, so that this indicator appears to be of no clinical value in head and neck oncology.

Adult↗
PubMed1989

Post-traumatic paralytic syndromes of the jugular and condylar foramina.

The fact that neoplasms of the cranial base or metastases of nasopharyngeal tumors may cause palsy of nerves which pass through the jugular and anterior condylar foramina has been well documented. On the other hand, very little has been reported about the traumatic causes of these diseases, probably because they are often underestimated or misdiagnosed. In this paper, the Authors report four cases of palsy of the last four cranial nerves caused by various kinds of trauma: glossopharyngeal thermo-rhizotomy, bullet wound, closed cranial trauma, neck surgery. The main symptom immediately following a lesion is mechanical dysphagia which causes inhalation of food and saliva and may sometimes require surgery, such as tracheotomy or cricopharyngeal myotomy. The most lasting symptom is dysphonia, which can only be treated by speech therapy. Because of the importance of these damaged functions, the above symptoms must be studied more thoroughly, also keeping in mind the modern techniques of surgical and non-surgical speech rehabilitation.

Aged↗
PubMed1983

Nasal polyps: a comparative study of morphologic and etiopathogenetic aspects.

16 nasal polyps belonging to 10 male subjects aged between 40 and 70, have been removed during the same number of ethmoidectomies; the polyps have been sectioned and specimens of mucosa corresponding to the pedicle and to the different parts of the body have been collected. During the operation parts of the mucosa of the inferior turbinates were removed. All the specimens have been prepared and observed at the scanning electron microscope. The epithelium of the inferior turbinates, of the small polyps and of the apical part of all polyps were almost normal. Marked alterations of the epithelial layer have been observed in bigger polyps. Surface characteristics of nasal polyps seem to be influenced by their relationship with neighbouring structures and by their position in the nasal cavity, but mostly by their size. On the basis of these findings the authors discuss the most recent etiopathogenetic theories of nasal polyps. They finally describe some peculiar findings concerning the mucosal layer of the polyps and of the inferior turbinates of three confirmed allergic subjects and discuss their possible clinical implications.

Adult↗