Biomedical subjects

Michelangelo Lacilla

Publications and source records attributed to Michelangelo Lacilla.

4 recordsLinked to original sources

PubMed2006

Auditory steady-state responses and clinical applications.

The auditory steady-state responses to single continuous tones modulated in amplitude have been proposed as an alternative to objective frequency-specific audiometry. The aim of this study was to compare thresholds obtained by pure-tone audiometry (PTA) and by auditory steady-state responses in normal hearing or affected by hearing loss in adults and in order to evaluate the applicability of this objective test in no collaborative hearing-impaired subjects. Eleven people, 6 normal hearing and 5 with hearing loss, underwent PTA and multiple frequency auditory steady-state responses; simultaneous carrier tones (0.5, 1, 2 and 4 KHz) modulated in amplitude at different rates (77-105 Hz) were presented monaurally (TDH 49 earphones) at variable intensities (110-20 dB SPL). The mean threshold difference between PTA and multiple frequency auditory steady-state responses was 28 dB (standard deviation=14.2) and R correlation value at 0.5-1-2-4 kHz was 0.71 (P=0.0012) at the Pearson's test. These differences were significantly smaller considering the hearing-impaired separately (11.7 dB, standard deviation=2.9). The results of this study confirm previous reports showing that the multiple auditory steady-state response method is an accurate predictor of the behavioural audiogram in patients with sensory-neural hearing impairments and can be used as a valid support for behavioural evaluations.

Adult↗

PubMed2006

Tympanic reperforation in myringoplasty: evaluation of prognostic factors.

OBJECTIVES: The most frequent failure in myringoplasty is reperforation. This complication appears at a rate of 7% to 27%. The aim of this study was to evaluate the importance of the principal prognostic factors to the risk of reperforation. METHODS: This is a study of prognosis based on an inception cohort. The prognostic factors considered in the study refer to clinical and surgical aspects; follow-up ranged from 5 to 7 years (mean, 68 months). The study was performed on 212 patients with or without otorrhea who underwent operation for tympanic perforation. All subjects underwent myringoplasty by means of an underlay or overlay technique depending on the size and site of the perforation. RESULTS: Healing of the tympanic perforation was obtained in 182 cases (86%). Age, otorrhea, status of the contralateral ear, and conductive hearing loss did not significantly affect the outcome of surgery. On the other hand, time from surgery, the site of perforation, the type of anesthesia, the approach, the surgical technique, and the type of graft were significantly related to the outcome. CONCLUSIONS: In the analysis of our results, the surgical approach proved to be the principal prognostic factor in the anatomic outcome of myringoplasty. The results obtained suggest that the principal factors influencing the outcome of myringoplasty are technical and not clinical.

Adolescent↗

PubMed2004

The prognostic value of the otoacoustic emission test in low frequency sudden hearing loss.

Low frequency sudden hearing loss (LFSHL) is a frequent finding in the otological practice. Several prognostic indicators have been suggested concerning the prediction of the outcome of sudden hearing loss, but so far there are no proven factors to establish the prognosis. The aim of this study was to assess whether OAEs could be considered as a reliable prognostic test in LFSHL. The study group consisted of 20 patients presenting with a unilateral LFSHL. Each patient was submitted to spontaneous otoacoustic emissions (SOAEs), transient otoacoustic emissions (TEOAEs) and distortion products (DPOAEs) recording and then treated with glycerol administrated intravenously in 3-h intervals for 4 days. Pure tone audiometry (PTA) threshold was evaluated again 1 h after the last administration of glycerol. After osmotic therapy 12 patients (60%) showed a significant PTA improvement with a mean improvement of 11 dB; modifications were significant at the Student's t test for paired data (P<0.0001). The relationship between the pretherapy presence or absence of SOAEs, TEOAEs and DPOAEs and PTA modification was not significant at the exact Fisher's test. In conclusion, even if our study supports that OAEs could be an indicator of the inner ear functional state, they cannot be utilized as a prognostic test in LFSHL in relation to the efficacy of osmotic therapy. Among the other parameters evaluated, only the precocity of therapy seems to be related to prognosis in LFSHL.

Adult↗

PubMed2004

Delayed vertigo after stapes surgery.

OBJECTIVES: Stapes surgery restores partial or total hearing in almost 95% of cases, and in case of failure, revision surgery may often resolve the problem. Delayed vertigo is commonly related to perilymphatic fistula. The aim of this study is to report experience gained in revision stapes surgery in cases of delayed vertigo. STUDY DESIGN: This is an intervention study, before-after trial; it includes follow-up between 12 and 84 months that was based on clinical history and audiometric evaluations. METHODS: The work was carried out in the otologic surgery referral center of Piemonte in outpatient surgery. Nine patients (4 males and 5 females, between 43 and 60 years of age) who presented with delayed vertigo after stapes surgery were retrospectively reviewed. All nine underwent clinical history evaluation, pure tone audiogram, investigation of the vestibular system with a bithermal binaural caloric test, and fistula test. Vestibular tests were performed with electronystagmography recording. In all nine subjects, functional middle ear exploration was carried out by way of a transmeatal approach using local anesthesia. The demonstration of a perilymphatic leak was positive in only three (33%) cases, but the oval window region was filled with fibrin glue in all nine cases. RESULTS: At follow-up, vertigo was resolved in all cases with revision surgery, even though perilymph leak was positive only in three cases. CONCLUSION: From the results obtained, we feel that exploration of the middle ear should be always carried out in cases of delayed vertigo after stapes surgery with suspected perilymphatic fistula.

Adult↗