PubMed Health⌕ Search

Biomedical subjects

G Magliulo

Publications and source records attributed to G Magliulo.

At least 19 recordsLinked to original sources
PubMed2005

Expression of neurotransmitters and neurotrophins in human adenoid tissue.

Mucosae-associated lymphoid tissues are richly innervated and the mucosae contain peptidergic nerve endings associated with different types of cells and macrophages. The lymphatic tissue is known to interact with the nervous system and several organs, implicated in the host response to a wide range of stressors, and is also richly innervated. We focussed our attention on the immune organs with particular regard to the human adenoid lymphatic tissues in order to investigate the neuroimmune links and the possible existence of relationships among different neurotransmitters and lymphocytes, macrophages, epithelial cells and nerve fibers by testing the expression of certain neurotransmitters and neurotrophins (NTs) with their own receptors.

Adenoids↗
PubMed2005

Extended parotidectomy.

Malignant tumours of the parotid gland represent a group of relatively rare lesions. The medical records of 363 patients with parotid swelling treated between 1974 and 2003 at the "G. Ferreri" Department of Otorhinolaryngology, "La Sapienza" University in Rome were retrospectively analysed. Clinical presentation, pre-operative investigations, surgical procedure, histopathology report, post-operative complications, and the oncological results of 19 patients who underwent extended radical parotidectomy for malignant neoplasm of the parotid gland are discussed. Extended radical parotidectomy, reserved for neoplasms in an advanced stage, involves the removal of the entire parotid gland, with sacrifice of the facial nerve and the resection en bloc of the adjacent structures affected by neoplastic infiltration, such as the temporal bone, the mandibular bone, the skin, blood vessels and nerves. In addition to this surgical treatment, a cycle of adjuvant radiotherapy is also necessary. The overall rate of survival at 10 years depends mainly on the histological characteristics of the tumour, and, in this series, is reported to be approximately 58%. These data indicate that total extended radical parotidectomy combined with post-operative radiotherapy, represents the best therapeutic approach with regard both to quality of life and life expectancy, in patients with an advanced stage of malignant neoplasm of the parotid gland.

Adult↗
PubMed2004

Osteopetrosis of temporal bone with blockage of the eustachian tube. A case report.

Osteopetrosis is an inherited disorder characterized by bone sclerosis. One of the more predominant feature of the disease in the temporal bone is conductive hearing loss due to anomalous bone formation in the middle ear and to otitis media. A 55-year-old woman affected by the adult type of osteopetrosis was referred to our department with a long history of otitis media. CT study demonstrated a narrowing of Eustachian tube due to abnormal deposition of sclerotic bone; this condition was confirmed during surgery. Tubotomy was performed during tympanoplastic surgery and there were no relapse of otitis after 12 months of follow up. Timpanoplastic surgery should be considered in those cases where medical treatment has failed in dealing with otitis media. In our experience an enlargement of Eustachian tube shuld be performed in this kind of patients, thus helping the functional recovery and the potential well-being of the patient as we observed in our case.

Constriction, Pathologic↗
PubMed2004

Early diagnosis of endolymphatic hydrops with distortion. Product otoacoustic emissions.

The present investigation was specifically designed to evaluate the ability of the glycerol test combined with pure-tone audiometry, distortion-product otoacoustic emissions (DPOAEs) to diagnose endolymphatic hydrops early and to identify patients who may evolve toward Meniere's disease. This investigation consisted of 43 consecutive patients with daily episodes of tinnitus with duration exceeding few hours or with continuous tinnitus who received no treatment. These were the unique symptoms reported by the patients. Each patient underwent glycerol testing measured with conventional pure tone audiometry and with distortion product otoacoustic emissions (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 positive result. For the DPOAEs glycerol testing, a smaller positive difference (5 dB) for at least three frequencies was interpreted as a significant fluctuation. Twenty four patients showed negative glycerol test both with pure tone audiometry and DPOAEs. In 7 cases the improvement was concurrently observed. In 9 patients post-glycerol changes appeared only in the DPOAEs outcomes. Finally the remaining three patients had two different patterns. Two had different ameliorations of the DPOAEs and pure-audiometry on the left and right sides respectively, and in the last one only post-glycerol, audiograms recovered. The present study re-confirms the potentiality of DPOAEs associated with glycerol test in diagnosing endolymphatic hydrops precociously. The possibility of these patients degenerating into Meniere's disease should not be underestimated.

Adult↗
PubMed2003

Multiple paragangliomas of the head and neck.

Multiple paragangliomas of the head and neck are rare conditions. The incidence of multiple paragangliomas is reported to the approximately 10% of the total patients, but in familial cases it increases up to 35-50%. In the head and neck region, the most common association is represented by bilateral carotid body tumors or by carotid body tumor associated with tympanic-jugular glomus. The presence of three synchronous glomus tumors is really rare, as well as association with vagal glomus and carotid body. In this paper the authors present a patient affected ipsilaterally by a carotid body tumor and vagal paraganglioma, focusing on the diagnostic options offered by imaging techniques (CT and MRI).

Carotid Arteries↗
PubMed2001

Results and complications of facial reanimation following cerebellopontine angle surgery.

The present study was undertaken to evaluate the results of a group of patients following treatment for cerebellopontine angle lesions who developed postoperative facial palsy and underwent facial nerve repair in order to reanimate the muscles of facial expression. A retrospective study was performed on 23 patients treated between 1988 and 1997 at the 2nd and 4th ENT chairs of University "La Sapienza" of Rome for facial palsy following cerebellopontine angle surgery. Tumors included acoustic neuromas (n = 3). Seventeen patients underwent hypoglossal-facial anastomoses [10 with end-to-end anastomoses, 4 with May's interposition "jump-nerve" grafts and 3 with partial (30%) use of the hypoglossal nerve plus a facial cross-over]. The remaining patients were operated on using a cable graft with the sural nerve (n = 2) and the great auricular nerve (n = 4). Postoperative facial function was determined by the House-Brackmann 6-scale classification The hypoglossal-facial anastomoses resulted in long-term grade III or IV findings. Cable grafts improved facial function from grade VI to grade III. None of the patients operated on with the modfied VII-XII anastomosis developed swallowing disturbances. The ten patients having traditional hypoglossal-facial anastomoses showed different degrees of tongue disability and retention of residue in the oral cavity. Surgical recovery of postoperative facial palsy can be obtained with various techniques according to the availability of the proximal facial nerve stump at the brain stem. Since a traditional hypoglossal-facial anastomosis procedure can be a source of a separate disability for the patient, techniques are preferred that leave the hypoglossal nerve mostly intact and uncompromised.

Anastomosis, Surgical↗
PubMed2001

Modified retrolabyrinthine approach with partial labyrinthectomy: anatomic study.

This study was undertaken to evaluate the feasability of the modified retrolabyrinthine approach (traditional retrolabyrinthine approach plus resection of the posterior semicircular canal) to expose the entire fundus of the internal auditory canal (IAC). This approach is advocated by its proponents to manage acoustic neuromas reaching the lateral IAC and with the preservation of hearing as the goal. Little anatomic data directly estimate the limitations of this exposure. Measurements were recorded from 25 cadaver temporal bones dissected with this modified approach. The distances were taken between the porus acousticus (inferior and superior portions), the dome of the jugular bulb, the midportion of the sigmoid sinus, and the fundus of the IAC (inferior and superior portions). All of the measurements were then compared with those of the translabyrithine approach. The current study shows that despite the sacrifice of the posterior semicircular canal, the superior lateral fundus cannot be completely visualized. There is a distance (on average 1.1 mm) that differentiates the superior area of the IAC accessible with translabyrithine and modified retrosigmoid techniques. This value is smaller than that observed in the classic retrosigmoid approach indicating that the modified technique affords a more adequate, even if not ideal, exposure to minimize the risk of recurrence. The modified retrolabyrinthine approach provided an optimal exposure of the inferior half of the IAC. A superior blind area, smaller than that of the traditional retrolabyrinthine technique, cannot be completely approached via this route. We believe that this approach can be considered as an alternative technique in selected cases especially for tumors involving the inferior vestibular nerve.

Colon, Sigmoid↗
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

Reconstruction of the posterior auditory canal with hydroxyapatite-coated titanium.

There are a variety of techniques for treating chronically discharging radical mastoid cavities. The purpose of this article is to report the preliminary results of an original technique for reconstruction of the posterior auditory canal using a titanium net combined with porous hydroxyapatite coating. Titanium is fixed with two screws to the mastoid tip and zygomatic root to prevent the risk of implant dislocation. Eight patients with chronically discharging radical mastoid cavities that failed medical management underwent reconstruction of the mastoid cavity using this technique. After surgery, all cases had rapid healing and good aeration of the middle ear and mastoid. One tympanic membrane reperforated, and no extrusion of the prostheses were detected clinically or on computed tomography scanning. The minimum postoperative follow-up period has been 12 months (range 12-48 months). To date, there has been no evidence of cholesteatoma recurrence. The preliminary results remain encouraging. Larger series and longer follow-up, however, are advisable to prove real validity.

Adult↗
PubMed2000

Osteomyelitis of the skull base with atypical onset and evolution.

Skull base osteomyelitis arises as a complication of malignant external otitis, but it can be also due to middle ear and/or mastoid infection. Other causes can be infections of the paranasal sinuses or of the mandible or maxilla due to odontic caries. Generally, osteomyelitis involves elderly patients affected by diabetic immunodeficiency or microvascular disease. In this paper, we present 3 new cases of skull base osteomyelitis with atypical onset and evolution. The difficulties of diagnosis and details of the management are discussed.

Adult↗
PubMed2000

External cholesteaoma and fibrous dysplasia of temporal bone.

Cholesteatoma is a disease that involves almost exclusively the middle ear structures and the mastoid bone. In rare cases it involves the external auditory canal. The author would like to present case report of a patient affected by external ear canal cholesteatoma associated to fibrous dysplasia of the temporal bone. The problems related to the pathogenesis and the diagnosis of the disease are presented and discussed.

Adult↗
PubMed2000

Acoustic neuroma: postoperative quality of life.

OBJECTIVE: Evaluating patients who have had surgical management of acoustic neuroma has relied heavily on the surgeon's viewpoint for determining success. However, the perspective of the surgeon may be different from that of the patient. Thus, a recent increased interest in terms of quality of life has been documented by the literature on this specific topic essentially through the use of a questionnaire. The objective of this paper was to review this topic in our series of patients operated on for acoustic neuroma to ascertain the personal and social impact that surgery has had on their lifestyle. DESIGN: This retrospective study was devoted to increasing statistics to provide more detailed and valid information during the counselling phase. METHODS: This study was carried out on 82 patients who underwent surgery for acoustic neuroma between 1988 and 1997. Each patient was recalled and assessed for his/her postoperative quality of life. Detailed information was requested on the initial postoperative facial, vestibular, and hearing functions; their evolution; and their social consequence. Finally, at the end of the interview, each patient was invited to give a final comment on his/her opinion regarding the outcomes of surgery and preoperative information. RESULTS: Facial function showed a grade I-III in 85.4% of cases, with postoperative neurovegetative dysfunction (taste and lacrimation) in 43%. Audiologic abnormalities (worsening hearing and tinnitus) were complained of in 90% and 57% of the cases, respectively. Twenty-three percent of the patients had various degrees of gait instability; 6% reported postoperative headache at 1-year follow-up. Social consequence (reduced work ability, vocational change, new education, state pension, etc.) was not influenced by surgery in 80%. CONCLUSIONS: Our experience is in general agreement with previously reported statistics. It is interesting to note that our patients exhibited more disturbances linked to the sensory component of facial nerve. In contrast, dysequilibrium had a less negative influence. These outcomes suggest the importance of thorough preoperative counselling in candidates for surgery for acoustic neuroma in order to motivate them and, at the same time, to reduce their psychological discomfort.

Adult↗
PubMed1999

Hemangiopericytoma and temporal bone.

Hemangiopericytoma is a vascular tumor arising from the pericyts. The tumor involves usually the muskuloskeletal system and the skin. A hemangiopericytoma of the temporal bone is an extremely rare lesion. This paper describes a case of hemangiopericytoma located in temporal bone, its radiologic diagnosis and its therapeutic options as well.

Adult↗
PubMed1999

[Day surgery and otologic diseases].

The aim of the present work was to check the results obtained in a group of patients suffering from otological pathologies who had undergone day surgery. In addition, to determine the reliability and validity of this form of out-patient surgery in otology, complications were compared with a similar group of patients who had undergone surgery under normal hospital in-patient conditions. The study only viewed patients hospitalized for otological pathologies from January 1995 to April 1998. During this period of time 90 patients with varying degrees of otological pathologies underwent out-patient day surgery. This surgical activity was then compared to the same type of surgery performed under normal in-patient hospitalization. During the post-operative phase of day surgery, only 7 patients (7.7%) had to be fully hospitalized: 5 complaining of dizziness, the other 2 with fever that ruled out discharge in the evening. In all cases, after hospitalization for the night the patient could be safely discharged. In the normally hospitalized in-patients, complications arose in 14 cases (8.6%) with fever being the most common complication (8 patients). On the basis of the results, it appears that nearly all otological pathologies can be treated in day surgery. This solution limits complications and ensures good economic management; it results in savings and improved organization, reduces the waiting lists and rationalizes use of the operating rooms. Moreover, it must be pointed out that the program was highly appreciated by the patients who could better schedule their own activities, both work and social-family obligations. This aspect is quite important in view of a broader outlook on the economics of the national health system as it shows a savings, not only in the health costs, but also in the overall labor costs.

Adolescent↗
PubMed1998

Acoustic neuroma surgery and delayed facial palsy.

Delayed onset of facial palsy is possibly an underestimated but distressing complication of acoustic neuroma surgery. The incidence of this complication reported in the literature has varied from 11.7 to 41%. This study reviewed retrospectively 60 primary acoustic neuroma surgeries performed by a single neurotologist. The delayed onset of facial dysfunction was defined according to the guidelines described by of Lalwani Butt, Jackler, Pitts and Jingling in 1995. They considered either a deterioration of facial function from normal to abnormal or an increased severity of the degree of facial paralysis, which was grouped using the House-Brackmann scale system. Fifteen of the 60 patients (25%) were found to have a deterioration of facial function. The incidence of delayed facial palsy was not influenced by age, sex or tumor size. The majority of the patients had a favorable prognosis. Only three patients had a grade III-IV facial function at 1 year. It is possible that these latter cases might have benefited from intraoperative meatal facial nerve decompression, as advocated by Sargent, Kartush and Graham.

Adult↗