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Biomedical subjects

S Bacciu

Publications and source records attributed to S Bacciu.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Recurrent cholesteatoma after combined approach tympanoplasty: pathogenesis and prevention].

Over the last few years, we have increasingly reduced the use of open techniques in favour of combined approach tympanoplasty by adopting a strategy enabling the prevention of genuine recurrences of cholesteatoma. Recurrences due to the development of a residual cholesteatoma moving outwards towards the meatus can be considerably reduced by a careful eradication at the time of exeresis, and by early screening and exeresis of the residual cholesteatoma by a practically systematic second-look operation (two-stage tympanoplasty). To prevent further penetration of the skin into the new middle ear, an effective barrier has to be created between the skin and the mucosa (repair of the wall of the attic, reconstruction of the tympanum by a xenograft (Parmatymp), and proper drainage and airing the new cavity must be assured. To help with the proper regeneration of the mucosa and the maintenance of the drainage and airing pathways within the cavity, the use of silastic proved to be fundamental. This new strategy has enabled us to treat, with the combined approach, 84% of the 1,465 cases of cholesteatoma operated upon between 1975 and 1989.

Adult↗
PubMed1991

[Pathogenesis and prevention of recurrent cholesteatoma following closed tympanoplasty].

The use of the closed tympanoplasty in the treatment of cholesteatoma has been abandoned by many surgeons in the last years. In contrast, as well as other authors we have increasingly limited the use of open techniques. Our attitude towards the closed tympanoplasty is strictly connected with an accurate prevention strategy of recurrent cholesteatoma. The recurrent cholesteatoma takes origin from two following mechanism: 1--the residual cholesteatoma which exteriorizes towards the external auditory canal; 2--the new immigration of the skin into the middle ear through a new perforation or depending on a retraction pocket. The incidence of recurrent cholesteatoma due to the first cause may be considerably reduced by: a--complete eradication of disease during exeresis (complete removal of structures in contact with the cholesteatoma matrix); b--early detection and removal of residual cholesteatoma by an almost planned second look (staged tympanoplasty). In order to prevent new epithelial immigration into the middle ear it is necessary: a--to reconstruct a new barrier between skin and mucous lining [repair of the attic wall, reconstruction of the tympanic membrane by using xenografts (Parmatymp)]; b--to permit the drainage and aeration of the new tympanic cavity at the level of the bony Eustachian tube including the isthmus (performing, if necessary, the tubotomy and/or tuboplasty techniques). The same must be obtained at the level of the tympanic isthmus by enlargement of the epitympanic recesses in order to create a tunnel over the new ossicular chain and by a posterior tympanotomy in order to create a tunnel under the ossicular chain. The use of silastic sheeting is extremely important in order to allow a correct regeneration of the new mucous lining and an efficient drainage-aeration function into the new middle ear cavity (from the mastoid to the tubal isthmus).

Cell Movement↗
PubMed1989

[The visual fixation test in the study of visual-vestibular interactions. General aspects and results in normal subjects and patients].

Whenever we need to study visual-vestibular interactions, our method of choice among the ones based on thermal stimulation is the visual suppression test. In the vestibular laboratory of the II E.N.T. Clinic of the University of Parma the V.S.T. has been employed since 6 years systematically in all patients undergoing Electronystagmography. Our study was based on 10 normal patients and on 30 patients suffering from different pathologies. These patients were divided into groups according to the site of the lesion. The results we obtained are interesting: this test gives us important clinic data that we cannot obtain using other methods and allows us to discriminate the central or the peripheral site of the vestibular system lesion.

Adolescent↗
PubMed1985

Molded tympanic heterograft. An eight-year experience.

Between 1974 and 1983 the molded tympanic heterograft has been employed in over 1500 cases of tympanic membrane reconstruction at the Second ENT Clinic of the University of Parma, Italy. The results obtained in 1042 patients operated on from July 1974 to December 1981 are reported herein. The tympanic heterograft offered our patients a 90% chance of cure and anatomic restoration of the middle ear; a functional recovery and serviceable hearing can be expected in more than 85% of cases. The heterograft is available in sealed sterilized vials that can be stored at room temperature; its sterility can be maintained for up to five years. There is no need for a graft bank because the heterograft can be kept in the operating theater among the other prostheses that are readily available to the surgical team.

Animals↗
PubMed1984

Management of the labyrinthine fistula in cholesteatoma surgery.

The presence of a labyrinthine fistula has remained one of the major problems in cholesteatoma surgery. Confronted with this problem, the surgeon may ultimately base his choice of procedure on four basic conditions: the size of the fistula, its location in the ear, the condition of the other ear, and the cochlear function. Our attitude has been changing, and currently we prefer to perform a staged closed tympanoplasty. When a closed technique is performed, we either remove the cholesteatoma matrix and then cover the fistula immediately or we leave the matrix in situ and re-explore the mastoid process 5 or 6 months later. The series consists of 88 cases out of a total of 701 patients with cholesteatoma operated on between January 1971 and June 1982. In 20 patients the matrix was left over the fistula at the first stage. The results suggest that a staged operation, i.e. closed tympanoplasty, is to be preferred even in cases with an extensive labyrinthine fistula.

Cholesteatoma↗
PubMed1984

Failures with Plasti-Pore ossicular replacement prostheses.

Plasti-Pore ossicular prosthesis failures found in our series of 246 patients with regular follow-up are reported and analyzed. Extrusions as well as poor functional results (postoperative air-bone gap greater than 25 dB) of the prostheses with and without cartilage on top have been reviewed. The overall extrusion rate was 9.3%: a higher extrusion rate occurred with prostheses without cartilage (18.4%) than with cartilage (4.4%). Thirty-six patients among those with poor postoperative hearing improvement have undergone revision surgery: the main causes of failure were a short prosthesis, a fixed stapes or footplate, adhesions of the prosthesis to surrounding structures, and the displacement of the prosthesis.

Cochlear Implants↗
PubMed1982

Enhanced biofunctionality of plastipore ossicular prostheses with the use of homologous cartilage.

Functional results with Plastipore prostheses inserted in 150 staged intact canal wall tympanoplasties at our Clinic are reported. Two groups of patients have been reviewed: The first group consists of those cases in which the prosthesis is directly in contact with the tympanic graft (77 cases); the second one comprises all cases with interposition of homologous cartilage between the head of the prosthesis and the tympanic graft (73 cases). The aim of this article is to see whether extrusion rate and audiometric and impedance result differences exist between the two groups. We have found a 15.4 percent extrusion rate in the group without cartilage but only a 1.9 percent rate in the group with cartilage (9.3 percent is the overall extrusion rate). There were no substantial differences in functional results between the two groups. It is valuable to outline the different functional results between the two types of prosthesis: TORPs got 56.8 percent excellent results and 78.4 percent good results, while PORPs had only 47.7 percent excellent results and 60 percent good results. Normal compliance (static compliance greater than 0.3 cc) was found in 61.6 percent of cases without cartilage and in 46.7 percent of cases with cartilage.

Biocompatible Materials↗
PubMedDate not supplied

Molded tympanic heterografts. Histologic evaluation.

The histologic appearance of the molded tympanic heterograft developed at the ENT Clinic of the University of Parma, Italy, is investigated with light and electron microscopy. Evaluation of the graft before insertion disclosed a unique structure of interwoven collagen bundles. Examination of grafted tympanic membrane showed a structure closely resembling the normal human tympanic membrane. The fate of the heterologous material and the host reaction to it are discussed in relation to histologic findings.

Bioprosthesis↗