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Biomedical subjects

K F Mattucci

Publications and source records attributed to K F Mattucci.

At least 19 recordsLinked to original sources
PubMed2001

Laryngopharyngeal sensory deficits as a predictor of aspiration.

OBJECTIVE: This study evaluates whether patients with severe sensory deficits in the hypopharynx are at increased risk for aspiration and determines the relationship between pharyngeal muscular weakness and hypopharyngeal sensory deficits. STUDY DESIGN AND SETTING: Forty patients with dysphagia who underwent flexible endoscopic evaluation of swallowing with sensory testing were prospectively divided into 2 groups. One group included patients with severe sensory deficits determined by an absent laryngeal adductor reflex and the other with normal sensitivity. Subjects were given liquid and puree consistencies and were evaluated for aspiration as well as pharyngeal muscle contraction. RESULTS: The differences in incidence of aspiration and pharyngeal muscular weakness between the 2 groups were significant (P < 0.001 Fisher's exact test). CONCLUSION: There is a strong association between motor function deficits and hypopharyngeal sensory deficits. SIGNIFICANCE: The association of sensory loss and motor deficits together with the use of flexible endoscopic evaluation of swallowing with sensory testing can predict those patients who are at highest risk for aspiration.

Adult↗
PubMed1996

Ambulatory tonsillectomy and adenoidectomy.

The performance of tonsillectomy and adenoidectomy in an ambulatory setting is controversial. However, most current studies show that with adequate criteria for patient selection and careful postoperative observation, these procedures can be safely done as outpatient surgery. This study was undertaken to reassess the safety of outpatient tonsillectomy and adenoidectomy surgery and to reevaluate the current recommendations for postoperative care. A prospective study was undertaken to relate the incidence of significant complications, including hemorrhage, protracted emesis, and fever, to each postoperative hour. The study included 534 pediatric patients (age 14 or less) undergoing tonsillectomy with or without adenoidectomy. All 534 patients were observed for 5 postoperative hours, and 175 of the 534 patients were observed for 6 postoperative hours. To assess complications occurring in the first postoperative week, all attending surgeons involved in this study were asked to anonymously report the occurrence of hemorrhage, protracted emesis, and/or fever from the time of discharge through the seventh postoperative day. In this study, no complications were encountered during the fifth or sixth postoperative hours. These results indicate that it is both safe and appropriate to perform tonsil and adenoid surgery in the ambulatory setting. Furthermore, the current recommendation that patients remain under postoperative recovery room observation for 6 hours appears to be excessive. This observation period may be safely reduced to 4 hours.

Adenoidectomy↗
PubMed1995

Middle ear effusion--allergy relationships.

Middle ear effusion (MEE), in its various forms, is one of the most common disorders of childhood. There are several possible etiologies, depending on the makeup of the effusion. However, the common factor in many middle ear effusions is eustachian tube dysfunction, and the role of allergy, although only one of many possible causes, is significant. A relatively large number of children with MEE are found to have atopic disorders. Nonetheless, allergy treatment alone must not preclude the use of conventional medical and surgical therapy. Optimal results will be obtained if recurrent or persistent MEE is managed in a coordinated manner by the otologist, pediatrician and allergist.

Child↗
PubMed1994

Attic cholesteatoma.

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Cholesteatoma, Middle Ear↗
PubMed1990

Tonsillectomy and adenoidectomy: an inpatient or outpatient procedure?

Concern over the rising cost of health care has created a trend toward outpatient surgery. Because adenotonsillectomy is such a frequently performed procedure, there is pressure on many otolaryngologists to do this operation on an ambulatory basis. A prospective study was undertaken to evaluate the incidence and severity of postoperative hemorrhage, protracted emesis, and fever at specified times within the first 24 hours after surgery. Over a 1-year period, 1000 tonsillectomy and/or adenoidectomy patients were studied. There was a 2.1% incidence of serious complications within the first 6 postoperative hours. The incidence of serious hemorrhage, fever, and protracted emesis was 0.7% each. The incidence of significant complications between the 6th and 24th postoperative hours was 1.7%. Hemorrhage occurred in 0.4% of the patients, fever in 0.7%, and protracted emesis in 0.6%. The total incidence of hemorrhage during this time period was 1.1%. There were no deaths. The greatest percentage of complications occurred within the first 6 postoperative hours. Based on this study, outpatient tonsil and adenoid surgery should be followed by at least 6 hours of postoperative observation before discharge. The choice to perform ambulatory tonsil and adenoid surgery depends on the professional judgment of the operating physician based on this and other recent studies, the sophistication of the physician's ambulatory surgery center, and the medical and social background of the patient.

Adenoidectomy↗
PubMed1986

Acute bacterial sinusitis. Minocycline vs amoxicillin.

The efficacy and safety of minocycline were compared with that of amoxicillin in the treatment of 58 patients with acute bacterial sinusitis. The most frequently isolated pathogens were streptococci, staphylococci, and Haemophilus influenzae. After therapy for a mean time of 11 days, clinical cure or improvement and bacterial eradication were evident in 100% of the patients treated with minocycline and in 95% of the patients treated with amoxicillin. Roentgenographic results indicated clearing or improvement in 91% of the minocycline recipients and in 70% of those who received amoxicillin. These differences between treatments were not statistically significant. A low incidence of generally mild adverse clinical experiences occurred in both treatment groups. Thus, minocycline and amoxicillin were equally safe and effective in the treatment of these patients with acute bacterial sinusitis.

Adolescent↗
PubMed1986

The effect of nuclear magnetic resonance imaging on metallic middle ear prostheses.

Nuclear magnetic resonance imaging, a relatively new diagnostic instrument, is a noninvasive imaging method which, among its many advantages, uses no ionizing radiation. There are a few limitations and contraindications to its use. There may be displacement of intracerebral aneurysm clips and metallic implants, and cardiac pacemakers can be disabled because of the high magnetic field created by this device. We studied the effects of a magnetic field on metallic middle ear prosthetics and concluded that nuclear magnetic resonance imaging should offer no risks to hearing or otologic function in patients with nonferromagnetic metallic middle ear prosthetics. Nuclear magnetic resonance imaging is contraindicated in patients with cochlear implants.

Ear, Middle↗
PubMed1986

Necrotizing otitis externa occurring concurrently with epidermoid carcinoma.

Malignant external otitis (necrotizing otitis externa) is an infectious process which occurs most often in middle-aged and elderly diabetic patients and is characterized by cultures positive for Pseudomonas and granulation tissue at the junction of the bony and cartilaginous portion of the external auditory canal. Epidermoid carcinoma of the external auditory canal is also seen most often in the middle-aged and elderly population. To the best of our knowledge, no case of acute necrotizing otitis externa occurring concomitantly with epidermoid carcinoma of the external auditory canal has been documented. A case is presented and discussed here and the importance of biopsy of the external auditory canal is stressed. Theoretical considerations of the possible relationship between these two disorders are discussed. This case illustrates the need to discontinue the use of the term "malignant external otitis" and replace it with the term "necrotizing otitis externa."

Carcinoma, Squamous Cell↗