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Biomedical subjects

M Russolo

Publications and source records attributed to M Russolo.

At least 19 recordsLinked to original sources
PubMed2002

Betahistine dihydrochloride in the treatment of peripheral vestibular vertigo.

The present study compares the efficacy and safety of betahistine dihydrochloride to that of a placebo in recurrent vertigo resulting from Meniere's disease (MD) or in paroxysmal positional vertigo (PPV) of probable vascular origin. The design was double-blind, multicentre and parallel-group randomised. Eleven Italian centres enrolled 144 patients: 75 of the patients were treated with betahistine (41 MD/34 PPV) and 69 with placebos (40 MD/29 PPV). The betahistine dosage was 16 mg twice per day for 3 months. Compared to the placebo, betahistine had a significant effect on the frequency, intensity and duration of vertigo attacks. Associated symptoms and the quality of life also were significantly improved by betahistine. Both the physician's judgement and the patient's opinion on the efficacy and acceptability of the treatment were in agreement as to the superiority of betahistine. The effective and safe profile of betahistine in the treatment of vertigo due to peripheral vestibular disorders was confirmed.

Administration, Oral↗
PubMed2002

Usefulness of virtual endoscopic three-dimensional reconstructions of the middle ear.

This work uses a new programme for producing 3D radiological images acquired by means of CT which enables the internal surfaces of the examined structures to be visualized. This new method, which is able to navigate inside organs in a similar way to fibreoptic endoscopy, is known as virtual endoscopy. CT examinations of the temporal bone were carried out using spiral equipment and endoscopic 3D processing was carried out on a separate workstation equipped with a volume-rendering programme. Once the technical parameters necessary for obtaining a representation of the internal surfaces had been defined, a simulation of a virtual otoscopy was conducted by moving the virtual endoscope from the external auditory canal through the annulus to the tympanic cavity. The simulation can be obtained either by moving the endoscope by hand, using the mouse, or by defining a path along which the software automatically creates an endoscopic 3D reconstruction. The images thus obtained are projected sequentially to give a "movie" effect, i.e. a continuous progression of the endoscope. The average time required to conduct the procedure ranges from 20 to 30 min. A virtual endoscopic visualization of the middle ear was obtained which, in particular, generated images of the tympanic cavity with the ossicular chain. In our experience, virtual otoscopy shows the anatomy of the structures of the tympanic cavity in excellent detail and may be considered complementary to CT, providing useful images enabling better visual representation and understanding of this complex structure. Although clinical applications of the technique remain to be defined it may have a role to play in presurgical diagnostic evaluation of the ossicular chain, epitympanum and retrotympanum.

Ear, Middle↗
PubMed2001

External osteotomy in rhinoplasty.

OBJECTIVES: To compare external and internal lateral osteotomy in rhinoplasty. STUDY DESIGN: Retrospective review and study on cadavers. METHODS: One hundred forty-two patients who underwent aesthetic rhinoplasty were examined. The following criteria were taken into consideration: edema and ecchymosis around the eyes, the degree of closure of the roof, symmetry and level of fractures, solidity of the bone pyramid, and any scarring at the access point of the osteotome. In the last 25 patients who had surgery, a nasal endoscopy with optical fibers was carried out to evaluate any damage to the mucosa caused by the 2-mm osteotome. Furthermore, to compare the two routes in vivo, for five of these patients a lateral osteotomy was carried out externally for one side and internally for the other. Lateral osteotomy were performed on five cadavers by an external route on one side and by an internal one on the other. A midface degloving procedure was performed to expose the osteotomy sites. RESULTS: Edema and ecchymosis were always much less severe in patients who were treated with external osteotomy. The control of the fracture line was always excellent. Endoscopic evaluation and study on cadavers revealed damages to the mucosa caused from the internal osteotomy and a better control of fracture line in external osteotomy. CONCLUSIONS: External osteotomy is an easy and precise approach. Because the fracture is of a greenstick type, the bone stumps are stable. The reduced bleeding reduces the formation of edemas and ecchymosis around the eyes. The damage to the nasal mucosa is minimal, and the cutaneous scars are virtually invisible a month after surgery.

Adult↗
PubMed2001

Benign positional vertigo without detectable nystagmus.

OBJECTIVES: To demonstrate that for treatment of benign positional vertigo it is not necessary to identify a positional nystagmus. STUDY DESIGN: Prospective trial of 43 patients with positional vertigo without clinical evidence of positional nystagmus who were treated with a modified canal-repositioning maneuver. METHODS: Results were compared with the results obtained in the treatment of posterior semicircular cupolo-canalithiasis with typical positional nystagmus with the same repositioning maneuver. RESULTS: Treatment of 43 patients with positional vertigo without positional nystagmus resulted in a 60.46% (26/43) complete recovery rate and a 6% (3/43) persistence of disorder rate compared with a 90% complete recovery rate obtained in 90 patients with typical benign positional paroxysmal vertigo (with positional nystagmus). CONCLUSIONS: What is attempted by this work is to confirm that through clinical evaluation based on history and positioning tests alone, one can obtain acceptable results in treatment of supposed canalithiasis without having detected the pathognomonic nystagmus.

Diagnosis, Differential↗
PubMed2001

Surgical treatment of tracheostomal stenosis.

HYPOTHESIS: Stenosis of the tracheostome is a frequent complication following total laryngectomy; the problems created by tracheostomal stenosis are the result of reduced airflow and consequent turbulence. Many authors have studied etiological factors for the onset of stomal stenosis, and a number of procedures have been recommended for the surgical correction of such stenosis. STUDY DESIGN: A prospective analysis of 12 patients who underwent surgical correction of stomal stenosis is presented. METHODS: At the Institute of Clinical Otolaryngology we have recently defined a surgical technique for the correction of stomal stenosis that combines radial incisions, V-shaped flaps, and interposing flaps. This technique enables us to correct all the types of stenosis, and we have treated 12 patients to date. RESULTS: To date, the average follow-up has been 17 months (range, 3-36 mo), and the results are encouraging. Early stenosis of the tracheostoma reappeared in one patient, who had successful repeat surgery with the same technique. CONCLUSIONS: Early results suggest the routine use of this surgical technique in the treatment of stomal stenosis.

Aged↗
PubMed2001

[Bilobed flap in the reconstruction of cheek defects].

The bilobed flap is a reliable means for the reconstruction of facial defects in one stage. This reconstruction technique has been applied on a 69-years-old man affected by carcinoma of the cheek, involving overhanging skin and underlying oral mucosa. Stensen's duct reconstruction was also performed with a vein graft and, 8 months later, deviation of the rima oris was corrected by inserting a goretex strip at the level of the upper lip elevator muscle. The present work considers the bilobed flap as a means for cheek defects reconstruction compared with other reconstruction techniques.

Aged↗
PubMed2000

Modified particle repositioning procedure.

OBJECTIVES: To evaluate the efficacy of modifications to traditional particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo. STUDY DESIGN: Prospective trial of 118 patients with cupolocanalithiasis of the posterior canal treated with three different canal-repositioning techniques. METHODS: Results were compared with the maneuvers employed and the statistical importance of rotating patients by 360 degrees along their longitudinal axis and head shaking on reaching each single position were evaluated. RESULTS: Treatment of patients with our maneuver, which, in comparison with traditional repositioning maneuvers, was modified by breaking the procedure up into seven positions and rotating patients by 360 degrees along their longitudinal axis, gives a higher, but not statistically significant, number of treatment successes (84.5%) than the traditional Parnes maneuver (60%) (P = .154); treatment of a third group of patients with our modified particle repositioning maneuver with the addition of head-shaking on reaching each single position gives a higher (95.6%), statistically significant number of treatment successes than traditional Parnes maneuver (P = .00011). CONCLUSIONS: The success rates achieved from modified particle repositioning maneuvers are statistically significant. Onset or persistence of dizziness, which patients frequently complain of after liberatory maneuvers, affects only 5.6% of the patients treated. This low incidence is statistically correlated to head-shaking.

Calculi↗
PubMed1997

[Treatment of sudden hearing loss].

A total of 27 patients affected by sudden idiopathic deafness (SID) and 3 with sudden idiopathic anacousia (SIA) were treated within 10 days of onset of the disorder. The treatment consisted of intramuscular or per os administration of corticosteriods for 10 days and the simultaneous administration of carbogene for 5 days. At the 5th day of corticosonic treatment, if audiometry did not reveal complete recovery, the treatment was associated for 7 days with Destrane 500 ml. The cases included neurosensorial deafness of 30 dB or more over at least 3 adjacent frequencies and arising over a 12 hour period. Soft cord deafness was not included in the study. The following variables were analyzed: 1) patient age; 2) extent of the hearing loss: average tone threshold for the frequencies of 500 -1000-2000 Hz equal to or better than 70 dB HL (group A); tone threshold ranging between 71 and 89 dB HL (group B), tone threshold ranging from 90 to 110 dB HL (group C), anacousia (group D); 3) audiometric curve; 4) presence or lack of vertigo. After treatment 25 subjects (83%) indicated a recovery ranging from good to complete. It is significant that among this 83% there were 12 subjects, 9 with profound deafness and 3 with anacousia. The therapeutic association adopted made it possible to achieve two-fold activity: anti-edemagene and hemorheological. The most highly implicated etiology for SID was viral causing not only neural but also endothelial damage and leading to acute microcirculatory insufficiency.

Adolescent↗
PubMed1988

Prognosis and therapy of early acute idiopathic auditory failure.

The prognostic value of some otovestibular parameters was evaluated in 46 cases of acute idiopathic hypoacusis (AIH) and 12 cases of acute idiopathic anacusis (AIA) observed within 7 days of the onset. Recovery in AIH is predicted by some otoneurological parameters as mean pure-tone hearing threshold (PTA) for 500, 1,000 and 2,000 Hz, stapedial reflex and severe vertigo. None of these measures alone seems to have prognostic value. The expected recovery rate also is reflected in the various parameters taken as a whole. Subjects with mean PTA better than 70 dB HL together with stapedius reflex present for 500 and 1,000 Hz, no decay and no vertigo have a very favourable prognosis: 86% had complete or good recovery. On the contrary, subjects with mean PTA worse than 70 dB HL and with pathological stapedius reflex have a generally unfavourable prognosis: 35% had complete or good recovery. Vertigo as a symptom does not seem in itself to have an unfavourable prognostic value. Actually, patients with severe vertigo generally have a poor recovery. Vertigo as a symptom indeed is frequently associated with a more severe sensorineural lesion. Carbogen or heparin-dextran are not an effective treatment: complete-good global recoveries obtained in AIH without any treatment, with carbogen or with heparin-dextran were, respectively, 65, 68 and 62%. As a consequence, an early therapy with these substances has no apparent value. Patients affected with AIA have a very unfavourable prognosis. All of our patients with AIA had poor recovery. For the moment we feel it is easier to reach a satisfactory prognosis rather than to institute an effective or causal therapy in acute idiopathic auditory failure.

Adolescent↗
PubMed1985

Temporal (phase and time) disparities in lateralization.

The topic of this paper concerns the judgement of just noticeable differences (JND) and of complete lateral position for dichotic 1 000-Hz stimuli with phase or onset time or delay differences and for a click. The 1 000-Hz sinusoids had 30 ms steady state with 10 or 50 ms rise/decay time and were presented at 50 dB HL in listeners with normal hearing. For every value of delta phi, delta onset or delay, the presentation consisted of blocks of 20 trials and the JND was determined as the phase or onset time or delay differences producing 80% of correct responses (forced choice). The intracranial 1 000-Hz tone image with long disparities was evaluated for 90, 180 and 270 degrees delta phi, for 250, 500 and 750 microseconds delta onset and for 250, 500 and 750 microseconds delay. Our results demonstrate that the interaural time differences with suitable headphone onset cues have a negligible effect on JND in pure-tone lateralization tests; the JND for a 1 000-Hz tone is based on phase cues only. With 180 and 270 degrees phase shifts, the interaural onset time differences, with 10 ms rise-fall time, become critical and override phase information. The JND for clicks on the contrary is based on time cue only. The intracranial click image with long disparities and duality threshold was evaluated.

Adult↗
PubMed1983

Lateralization, impedance, auditory brain stem response and synthetic sentence audiometry in brain stem disorders.

Applied individually, the conventional audiometric tests are unsatisfactory in the diagnosis of retrocochlear disorders. An accurate identification of a retrocochlear lesion, however, is not always possible using a single test, and only an appropriate test battery provides the basis for correct prediction of a retrocochlear lesion. Because of this observation, lateralization tests, impedance studies, auditory brain stem responses and speech audiometry with synthetic sentences have been applied to patients affected with retrocochlear disorders (acute nucleoreticular vestibular syndrome, multiple sclerosis and focal lesions). Analysis of the results has demonstrated the value of the tests employed, but the various tests were not strongly correlated and are therefore complementary.

Acoustic Impedance Tests↗
PubMed1982

Comparison between central tonal tests and central speech tests in elderly subjects.

A battery of tonal tests investigating the performance of the central auditory pathways (auditory lateralization, temporal order, auditory pattern) has been applied, together with a battery of central speech tests (sensitized speech and synthetic sentences), to a group of 50 subjects aged from 60 to 80 years, affected only with presbycusis. The results demonstrate that the speech tests undergo a considerable reduction of the performance-intensity function with age whereas the tonal tests remain within the values obtained in younger subjects. The topodiagnostic implications of these data are discussed.

Aged↗
PubMed1976

Oscilloscopic analysis of the stapedius muscle reflex in brain stem lesions.

An oscilloscopic analysis of several features of the stapedius muscle reflex was carried out in a group of normal subjects and in patients affected by dysfunction at the brain stem level due to a pathologic lesion or temporary reduction by small doses of barbiturates. Under these conditions, the increased latency and reduced amplitude of the reflex, but particularly the reduced velocity and, not infrequently, the step-like pattern of the tracings, are considered to be data of considerable value in disorders of the brain stem structues.

Brain Diseases↗
PubMed1976

Directional hearing, temporal order and auditory pattern in peripheral and brain stem lesions.

Tests have been applied to the following subjects: (1) 25 normal individuals; (2) the same individuals during temporary impairement of the brain stem by barbiturate (3 mg/kg); (3) 32 patients affected by acute nucleo-reticular vestibular syndrome; (4) 7 patients affected by unilateral Menière's disease, and (5) 1 patient affected by acoustic neuroma with well preserved hearing. Directional hearing was tested by changing the delta i and delta t of two pure tones 400 and 600 Hz) presented through earphones or two fixed loudspeakers placed at +/- 30 degrees from the azimuth and with balanced intensity: temporal order and auditory patterns were tested with the same frequencies by changing the delta t or the order of presentation of the stimuli at fixed intensity. On the basis of the results obtained in the normal subjects, a distinction can be made between the patients affected by brain stem impairment and those affected by Menière's disease. In these patients it was very difficult to obtain reliable discriminations due to the failure of the affected cochlea, especially during an acute phase of the disease, to perform adequate time, intensity and frequency analysis. In brain stem patients, spontaneous or pharmacological, the directional hearing judgments were impaired whereas temporal order and auditory pattern discrimination were normal. It is suggested, therefore, that these various central-hearing tests do not investigate analogous performances, but on the contrary different ones. This difference can be attributed to different structures, or to different performance along the same pathways but also to an identical structure of different sensitivity to the noxious agents.

Auditory Pathways↗