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Biomedical subjects

G Magliulo

Publications and source records attributed to G Magliulo.

At least 37 records · Page 2Linked to original sources
PubMed1998

Petrous bone cholesteatoma and facial paralysis.

This paper describes a series of patients with a petrous temporal bone cholesteatoma paying particular attention to the complications and their management. Sixteen patients who underwent surgery in our department were reviewed. Topographically, the petrous bone cholesteatomas were grouped into five categories according to the classification proposed by Sanna et al. There were five massive labyrinthine; five infralabyrinthine; one apical; four supralabyrinthine; and one infralabyrinthine-apical. Clinically, the presenting symptom of these lesions were facial nerve paralysis (10 patients) and unilateral deafness (13 patients). Total removal of the cholesteatomas was achieved in all patients using different surgical approaches according to their site and extent. Recurrences were observed in two patients after 8 months and 24 months, respectively. The facial nerve was infiltrated and compressed by the cholesteatoma in eight patients. Seven were managed with cable grafts using sural nerve. One of these patients was treated using a facial-hypoglossal anastomosis because of the failure of the graft. In the remaining patient, a baby-sitter procedure was employed. In the other two patients, the preoperative facial paralysis was due to compression by the cholesteatoma, and its removal allowed partial recovery of facial function. The rationale of the surgical management of petrous bone cholesteatoma is its radical and total removal. Our present policy is to prefer approaches which result in a closed cavity obliterating the eustachian tube and closing the auditory canal as a blind sac. Facial nerve function is the main complication of these lesions, Facial nerve involvement requires rapid management because the duration of the paralysis is directly related to poor recovery of facial function.

Adult↗
PubMed1998

Encephalocele with spontaneous CSF otorrhea.

Spontaneous encephalocele of the temporal bone is an uncommon condition (37 cases to date) associated with cerebrospinal fluid otorrhea. It results from a congenital dehiscence of the tegmen tympani and tegmen mastoideum. The AA. report 3 additional cases and review methods for diagnosing and surgical treatment.

Aged↗
PubMed1998

[Taste and lacrimation after acoustic neuroma surgery].

AIM OF THE STUDY: Postoperative sensory component of the facial nerve after acoustic tumor surgery has received little attention in the literature. The object of the present investigation was to review this specific topic analyzing the postoperative frequency of taste and lacrimation (crocodile tears or dry eye) abnormalities. MATERIAL AND METHODS: 54 patients who underwent acoustic tumor removal were selected for this study. Each of these patients was recalled and pre and postoperative evolution of the sensory dysfunction were assessed. The latters were correlated with the facial function evaluated according to the House-Brackmann classification. RESULTS: Postoperative taste dysfunction (reduced or changed sensation) was complained by 38.5% of the patients. After surgery, 42.3% of the cases had crocodile tears, while in 59.6% altered tearing occurred. DISCUSSION: The present study, according to the Irving et al's experience confirmed a significant incidence of postoperative abnormal function of the sensory facial nerve. The influence of the motor component on these outcomes was variable. Lacrimation worsened when facial function was poor. On the other hand, grades V or VI did rarely manifest crocodile tears. Clinically, these findings implies the importance of a preoperative counseling of such particular aspect in the candidates to surgery of acoustic neuroma in order to adequately motivate them and, at the same time, to reduce their psychological discomfort.

Adult↗
PubMed1998

Cerebrospinal fluid leak management following cerebellopontine angle surgery.

OBJECTIVE: Postoperative cerebrospinal fluid leak (CSF) is a serious complication of the cerebellopontine angle surgery. In the current literature, CSF leak rates vary from 8.1 to 20%. The various options in managing this troublesome complication include conservative treatment or invasive surgical repair. The focus of this report is to retrospectively analyze our experience on this specific topic reviewing the incidence of CSF leak and the outcomes of its treatment in a group of patients who underwent surgery for different pathology of the cerebellopontine angle. METHOD: Eighty-five patients who underwent primary surgical procedures performed by a single neurologist were selected for this study. There were 70 surgical removals of acoustic neuromas, and 15 other cerebellopontine lesions. RESULTS: The overall incidence of CSF leak in the total group analyzed was 17.6%. There were five CSF rhinorrheas and 10 wound CSF leaks. Ten acoustic neuromas and five other cerebellopontine angle lesions exhibited this complication. The leak was cured in 53.3% of the cases using a continuous lumbar cerebrospinal fluid drainage (CLCFD). In two patients, the leak was treated with an extradural repair. CONCLUSIONS: Although CLCFD is not routinely used in the treatment of the CSF leak, it proved to be an efficacious and safe option, confirmed by no meningitis observed in our patients treated with this method.

Adult↗
PubMed1998

Giant cell tumor and temporal bone.

Giant cell tumor is a tumor consisting of osteoclastic multinucleated giant cells surrounded by mononuclear round, oval cells. This tumor rarely occur in the skull base, usually originating in the sphenoid bone. This report describes a case of giant cell tumor of temporal bone and lateral skull base with diagnosis and therapeutic options.

Giant Cell Tumors↗
PubMed1997

Physical treatment of horizontal canal benign positional vertigo.

In recent years many methods of physical therapy have been proposed for the treatment of benign paroxysmal positional vertigo due to otolithic debris in the horizontal semicircular canal. All these methods have attempted to promote displacement of debris from the canal to the utricle. This paper reports our experiences with maneuvers advocated by Lempert and Vannucchi et al. Eighteen patients suffering from benign paroxysmal positional vertigo of the horizontal canal were evaluated in the present study. All seven patients treated with the Vannucchi maneuvers resolved their vertigos. Ten of the remaining patients were managed with Lempert's maneuver and responded successfully. The physical therapy used failed in only one patient. Current experience has shown that both maneuvers are particularly valid and efficacious.

Adult↗
PubMed1997

Intra-operative facial nerve monitoring. Its predictive value after skull base surgery.

PURPOSE: Facial nerve monitoring can be used to predict post-operative facial function after skull base surgery. In this study three methods of prediction of facial function were compared. These methods utilize various parameters of the evoked electromyographic monitoring. MATERIAL AND METHODS: Twenty-three patients who underwent surgery for skull base diseases were retrospectively reviewed. Amplitude of ongoing electromyographic activity, stimulation current thresholds and amplitude of evoked response were analysed. The predictive value of the three methods was correlated with post-operative facial nerve function. RESULTS: The method that used only the stimulation thresholds predicted the final post-operative facial function in 86.9 per cent of the patients. The second employed a mathematical ratio which combined the amplitude of evoked response and the stimulation current thresholds and confirmed the prediction of the facial function in 91.3 per cent of the patients. The last method does not consider the stimulation thresholds greater than 0.05 mA and failed to predict the final VIIth nerve function in patients in whom the stimulation was greater than 0.05 mA. CONCLUSION: Analysis of prognostic value demonstrates that the first two methods had the smaller degree of variation showing the better sensitivity.

Adult↗
PubMed1997

Distortion-product otoacoustic emissions and glycerol on the guinea pig hydropic ear.

OBJECTIVE: The aim of the present work was to investigate the therapeutic effects of glycerol on the distortion-product otoacoustic emissions in guinea pigs in which experimental endolymphatic hydrops had been surgically induced. METHODS: Thirty albino guinea pigs were used. The experimental protocol considered three groups of guinea pigs (10 animals each). Group 1 received no drug treatment, while group 2 and 3 were given glycerol orally 0.75 and 0.50 g/kg of body weight once a day for 24 days. RESULTS: The animals treated with glycerol showed an improvement of the distortion-product emission responses in the middle frequencies. This effect was not observed in the higher frequency region. This effect was evident 7 days after glycerol administration in the guinea pigs treated with a dose of 0.75 g/kg. The 0.50 g/kg dosage gave evidence of ameliorating effects 14 days after treatment. CONCLUSION: Glycerol given orally resulted in an improvement of distortion-product otoacoustic emissions in the guinea pig. Further studies are necessary before the effect of such a treatment can be assessed in humans.

Acoustic Stimulation↗
PubMed1997

Functional hearing results in revision stapes surgery.

OBJECTIVE: The object of our study was to review the results of 63 revision stapes surgeries performed from 1978 to 1994. RESULTS: The most common cause of failure was the displacement of the prosthesis, followed by ossicular chain problems and oval window fibrosis. Postoperative hearing improvement within a 20-dB air-bone gap was achieved in 58.7% of the patients. Hearing gain was closely linked to the operative findings. Better results occurred when prosthesis problems were found. Evaluation of the hearing results by using Glasgow benefit plot gave evidence of symmetric normal hearing in only 40% of the cases. CONCLUSIONS: Prevention of the cause of failure during the primary stapes surgeries, lessening the surgical trauma, seems to provide the most favorable hearing results.

Adult↗
PubMed1997

Labyrinthine fistula as a complication of cholesteatoma.

HYPOTHESIS: The objective of this study was to present the authors' experience in the management of labyrinthine fistula caused by cholesteatoma. METHODS: The clinical charts of 92 patients who underwent surgical procedures for cholesteatoma complicated by labyrinthine fistula between 1979 and 1975 were reviewed retrospectively. In this period, 1,205 patients were operated on for cholesteatoma. In each patient, the site and size of the fistula were evaluated during surgery and the hearing thresholds were compared before and after surgery. RESULTS: The fistula involved the lateral semicircular canal in 71 patients. Multiple fistulas were observed in nine patients. Postoperative hearing levels were unchanged or improved in 83.7% of patients. Comparison between hearing outcomes and size of the fistula showed better findings when smaller size fistulas were found. No significant differences between open and closed techniques were detected. Favorable outcomes were obtained in patients treated with surgical obliteration of the interrupted labyrinth. CONCLUSIONS: The current study confirmed that careful manipulation of the labyrinthine fistula is mandatory to preserve hearing functions for these patients. According to the authors' experience, the future trend for fistula treatment could be directed toward less conservative techniques compared with the previous indications favoring methods of interruption and subsequent obliteration of the semicircular canals.

Adolescent↗
PubMed1996

Glomus tumor in pediatric age.

Glomus tumor of the middle ear and mastoid is exceedingly rare in children. This report details our management of a 13-year-old boy affected by tympanic glomus complicated by chronic middle ear infection that obscured the tumor. A review of the English literature revealed only 12 other patients suffering from glomus tumor in pediatric age. Diagnosis, therapy and the differential characteristics of pediatric glomus are discussed.

Adolescent↗
PubMed1996

Medial meatal fibrosis: current approach.

Medial meatal fibrosis is a rare entity which is linked to inflammatory and traumatic factors. This pathology significantly benefits from surgical management. Criteria for achieving successful results are strict and concern the complete removal of the fibrous tissue and covering of the bony canal with skin graft. The aim of this paper is to present our experience with this rare pathology and to discuss current approaches.

Adult↗
PubMed1996

Facial neuroma and magnetic resonance imaging.

The aim of this paper is to present a new case of facial neuroma. Its clinical appearance was uncommon, displaying symptoms characterized by sudden facial paralysis. Diagnostic armamentarium is discussed emphasizing the importance of magnetic resonance imaging (MRI). Therapeutical strategy with the techniques of facial rehabilitation are contemplated.

Adolescent↗
PubMed1996

[Experimental endolymphatic hydrops and distortion otoacoustic emission].

The present investigation was designed to measure distortion-product otoacoustic emissions (DPOAEs) in a group of guinea pigs with endolymphatic hydrops in order to obtain normative data in this particular field. The-DPOAE's results were compared with compound action potential (CAP) outcomes to analyze the value of DPOAE measurements in audiologic screening. Thirty albino guinea pigs were used. Recording sessions were performed before the hydrops and 10,17 and 24 days thereafter. DPOAE measurements showed specific patterns of alteration providing quantitative data of the severity of the impairment and the specific frequencies involved. The close relationship of the functional effects of hydrops on the results of CAPs and DPOAEs suggests the potential contribution of DP testing to monitor the progression of the cochlear dysfunction of the hydropic ear.

Acoustic Stimulation↗
PubMed1996

Growth inhibition of human colon carcinoma cells by combinations of anti-epidermal growth factor-related growth factor antisense oligonucleotides.

GEO is a well-differentiated colon cancer cell line that coexpresses the epidermal growth factor-like growth factors CRIPTO (CR), amphiregulin (AR), and transforming growth factor alpha (TGF-alpha). Antisense 20-mer phosphorothioate oligodeoxynucleotides (AS S-oligos) directed against CR, AR, and TGF-alpha mRNAs were equipotent in their ability to inhibit both the anchorage-dependent growth and the anchorage-independent growth (AIG) of GEO cells, with a 50% inhibitory concentration of about 5 micrometer in the AIG assay. A supraadditive effect was observed when a combination of S-oligos was used. For example, a combination of two different AS S-oligos (either AR + CR, or TGF-alpha + CR, or TGF-alpha + AR) at a concentration of 1 micrometer each (total concentration, 2 micrometer) resulted in 50% inhibition of GEO cells AIG, whereas the use of each AS S-Oligo at a 1 or 2 micrometer concentration resulted respectively in about 10 and 20% growth inhibition. A combination of the three AS S-oligos was even more effective, resulting in about 60% inhibition of GEO cells AIG at a concentration of 1 micrometer each (3 micrometer total concentration). The AS S-oligos were also able to inhibit specifically the expression of either AR, CR, or TGF-alpha proteins in GEO cells, as assessed using immunocytochemistry or Western blot analysis. Finally, a supraadditive growth inhibitory effect of the AS S-oligos and an epidermal growth factor receptor-blocking antibody (monoclonal antibody 528) was observed. These data suggest that the use of a combination of AS S-oligos directed against different growth factors and antibodies directed against their receptors might result in an efficient inhibition of colon carcinoma cell growth.

Amphiregulin↗