Facial reanimation: a proposal to reduce postoperative morbidity.
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Adult↗
Biomedical subjects
Giuseppe Magliulo
Publications and source records attributed to Giuseppe Magliulo.
Leiomyosarcoma of the larynx: case report with pathologic and surgical considerations.
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Aged↗
Exudative laryngeal diseases of Reinke's space: a clinicohistopathological framing.
OBJECTIVE: To establish the relationship between the macroscopic and histologic diagnosis of nodules, polyps, and Reinke's edema of the true vocal folds and to propose a clearer clinical definition of them in the hope of settling the difference of opinion between otolaryngologists and pathologists. DESIGN: Retrospective study SETTING: Otolaryngology Department of "La Sapienza" University of Rome. METHODS: The pathologic reports of 203 patients subjected to direct laryngoscopy were studied. MAIN OUTCOME MEASURES: Examination of the histologic specimen of the epithelium and the chorion. RESULTS: Microscopic examination revealed a high percentage of normal epithelium both for nodules (33.79%) and polyps (40.65%). No dysplasia was observed, whereas dysplasia was present in 10 cases of Reinke's edema (7 laryngeal intraepithelial neoplasia 1 and 3 laryngeal intraepithelial neoplasia II). Five different stages of histologic progression resulted from the examination of the chorion in both nodules and polyps. CONCLUSIONS: Our suggestion is to consider polyps as "older" lesions and nodules as "younger" lesions. A polyp may be defined as an abnormal unilateral growth of vocal folds, a nodule as a bilateral growth situated between the anterior and medium third of the vocal fold, and Reinke's edema as a bilateral wound that extends to the whole of the true vocal fold.
Adolescent↗
Osteopathia striata-cranial sclerosis: otorhinolaryngologic clinical presentation and radiologic findings.
BACKGROUND: Osteopathia striata with cranial sclerosis (OS-CS) is a rare bone dysplasia that presents with variable symptoms mainly due to the associated CS. METHODS: The otorhinolaryngologic clinical presentation and temporal bone computed tomography (CT) findings of a new case of OS-CS are presented. Differential diagnosis is also discussed. RESULTS: Our study confirms the typical appearance of the temporal bone reported in previous CT studies and the utility of CT for evaluating the various etiologies of conductive-mixed hearing loss present in OS-CS. Radiographs of the femur and pelvis revealed the typical striations of OS-CS and allowed us to diagnose this rare form of generalized skeletal dysplasia involving the skull base. CONCLUSIONS: To our knowledge, this is the third reported case of OS-CS in which temporal bone CT evaluation corroborated the smallness of the middle ear cavities, abnormal ossicular fixation, and bone sclerosis of the mastoid cells. Other radiographic studies regarding the whole skeleton may, in combination, be very helpful in the differential diagnosis between the different forms of generalized skeletal diseases with bone sclerosis involving the skull base.
Child↗
Mucoepidermoid carcinoma of the external auditory canal: case report.
This study reports a case of mucoepidermoid carcinoma (MEC) of the external auditory canal, which to date has only been described once in literature. Because the lesion is extremely rare, it is particularly difficult to classify it into stages following normal diagnostic parameters. This obviously limits the possibilities of treatment that consequently are either empirical or based on those of squamous cell carcinoma. The problems in the diagnosis and the possible methods of treatment of mucoepidermoid carcinoma are discussed.
Carcinoma, Mucoepidermoid↗
Leiomyosarcoma of the sinonasal tract: a case report and literature review.
Leiomyosarcoma of the paranasal sinuses is uncommon and has an aggressive clinical behavior. Only 28 cases have been described in the literature, and, of these, only 3 patients treated with surgery had a disease-free survival. In this report, we describe the clinical history of a 57-year-old woman with a leiomyosarcoma of the paranasal sinuses successfully treated with a combination of surgery, radiation therapy, and chemotherapy. We obtained a total response with ifosfamide, doxorubicin, dacarbazine, and epirubicin. This case report emphasizes the possibility of treating this aggressive tumor with chemotherapy in accordance with the same therapy used in the treatment of uterine leiomyosarcomas.
Antineoplastic Combined Chemotherapy Protocols↗
Reinke's edema and risk factors: clinical and histopathologic aspects.
PURPOSE: The purpose of this study was to evaluate retrospectively the distribution of histologic damage and its correlation with various risk factors in a group of patients affected by Reinke's edema. MATERIALS AND METHODS: The study subjects comprised 125 patients with bilateral Reinke's edema consecutively presenting at the Department of Otorhinolaryngology, "La Sapienza" University, Rome. The patients were divided into 4 groups according to Hellquist, Lundgren, and Olofsson's histologic classification and were then further categorized according to the number of cigarettes they smoked daily. Average exposure to cigarette smoke, occupation, habitual voice use, and gastroesophageal reflux were also considered. RESULTS: Fifty-two patients did not exhibit histologic lesions, 64 patients were histologically classified as Group 1 (epithelial hyperplasia and/or keratosis with or without mild dysplasia), and 6 patients exhibited moderate dysplasia (Group 2). In 3 patients, histologic examination showed evidence of unilateral carcinoma in situ (Group 3). Forty-four patients suffered recurrences within the first 2.5 years. Both daily cigarette consumption and duration of exposure to cigarette smoke were found to influence the severity of the histologic lesion. An association with gastroesophageal reflux was observed in 4 patients (3.2%). Prolonged vocal abuse did not prove to be a noteworthy factor in our study. CONCLUSIONS: The main risk factor for Reinke's edema and for its recurrence is tobacco use. Our study results showed that the clinical manifestation of this disease is related to the number of cigarettes smoked daily and the duration of exposure to smoke. Longer durations of exposure to cigarette smoke result in higher degrees of histologic damage.
Adult↗
Value of echo-planar diffusion-weighted MRI in the detection of secondary and postoperative relapsing/residual cholesteatoma.
PURPOSE: To assess the utility of echo-planar diffusion-weighted magnetic resonance imaging (EPI-DWI) in the diagnosis of secondary cholesteatoma of the middle ear and in the differential diagnosis between residual/relapsing cholesteatoma and non-cholesteatomatous tissues (scar, granulation and inflammatory tissue) after conservative mastoidectomy. MATERIALS AND METHODS: Twenty-four patients, who had previously undergone clinical and CT investigation, were prospectively examined by standard and EPI-DWI magnetic resonance imaging (MRI) after conservative mastoidectomy. Secondary cholesteatoma was suspected in 5 patients and residual/relapsing cholesteatoma in 19 patients. Two radiologists, blinded to patient's identity, clinical data and CT findings, reached consensus on the presence of tissue consistent with cholesteatoma in conventional CT and areas of altered signal in EPI-DWI in the petrous bone. All patients underwent mastoidectomy, second time of tympanoplasty or review surgery within 15 days from MR investigation. Sensitivity, specificity and negative and positive predictive values were evaluated separately for standard and EPI-DWI MRI. RESULTS: In EPI-DWI sequences, 11/12 patients with cholesteatoma showed an area of hyperintense signal, whereas patients with non-cholesteatomatous tissue showed no pathologic signal in the petrous bone. In the single case of cholesteatoma undetected on EPI-DWI a cholesteatomatous pearl approx. 2 mm in diameter was visible in the surgical cavity. Sensitivity, specificity, positive and negative predictive values were 92%, 100%, 100%, 92% for EPI-DWI MRI and 92%, 25%, 55%,75% for standard MRI, respectively. CONCLUSIONS: EPI-DWI sequences are useful in the diagnosis of secondary cholesteatoma and in the differential diagnosis between residual/relapsing cholesteatoma and non-cholesteatomatous tissues after conservative mastoidectomy. However, the usefulness of EPI-DWI sequences as a screening test after conservative mastoidectomy requires further assessment.
Adolescent↗