1,721,017 research outputs found
La valutazione della Patient Satisfaction nelle strutture sanitarie con tecniche statistiche di analisi multidimensionale: un caso studio
No full textHearing rehabilitation in neurofibromatosis type 2 patients: cochlear versus auditory brainstem implantation
No full textAudiol Neurootol. 2008;13(4):273-80. Epub 2008 Feb 7.
Hearing rehabilitation in neurofibromatosis type 2 patients: cochlear versus auditory brainstem implantation.
Vincenti V, Pasanisi E, Guida M, Di Trapani G, Sanna M.
SourceDepartment of Otorhinolaryngology, University of Parma, Parma, Italy. [email protected]
Abstract
OBJECTIVE: We aimed to evaluate and compare the auditory performance of neurofibromatosis type 2 (NF2) patients with bilateral total deafness fitted with cochlear or auditory brainstem implants.
PATIENTS AND METHODS: A retrospective case review was performed. Nine patients suffering from NF2 who underwent hearing rehabilitation by means of cochlear (4 patients) or auditory brainstem (5 patients) implantation participated in the study. Postoperative auditory performance was assessed using closed- and open-set tests.
RESULTS: In the group of patients fitted with a cochlear implant, 3 subjects achieved open-set speech recognition abilities comparable to those of standard adult postlingual implant patients; the remaining patient scored 0% in all open-set format tests, reporting benefits only in environmental sound detection and lip-reading. Among the 5 patients who underwent auditory brainstem implantation, 1 reached good open-set speech recognition skills, scoring 70% in the common phrases comprehension test, and she was able to communicate on the telephone. Two other patients achieved open-set speech understanding (respectively, 33 and 41% in the common phrases comprehension test), reporting daily use of their device. The remaining 2 patients did not achieve any level of open-set speech perception, obtaining only improved access to environmental sound and lip-reading skills.
CONCLUSIONS: Our study confirmed literature data reporting that cochlear implantation may offer open-set speech communication in NF2 patients. In this small cohort, cochlear implant patients performed better than auditory brainstem implant patients, even if variability in auditory performance was observed with both devices. More studies are needed in order to clarify the role and reliability of electrophysiological tests in predicting the residual functionality of the cochlear nerve after tumor removal
Meningioma of the cerebellopontine angle mimicking benign paroxysmal positional vertigo
No full textNot availabl
Evoked potentials suggest cranial nerves and CNS involvement in chronic relapsing polyradiculoneuropathy
No full textBrainstem auditory and visual potentials were recorded from 6 patients with chronic idiopathic polyradiculoneuropathy. Evoked potentials were either completely absent or their latency was prolonged suggesting slow conduction in visual or auditory pathways. The results of our study provide further evidence suggesting subclinical involvement of cranial nerves and central nervous system sensory pathways in chronic inflammatory demyelinating polyradiculoneuropathy
Antiepileptic drugs in migraine prophylaxis: state of the art
No full textAntiepileptic drugs have proven their efficacy in the prophylactic treatment of migraine. Our study comprises a clinical trial that examines the efficacy of gabapentin and topiramate and a description of the pharmacologic characteristics and the efficacy of tiagabine, lamotrigine, levetiracetam and zonisamide. Antiepileptic drugs have multiple modes of action which can explain their efficacy in reducing neuronal excitability which is proven in epilepsy and postulated in migraine. The relationship between epilepsy and migraine has, in fact, been much debated but never convincingly proven. Antiepileptic drugs could be useful in migraine prophylaxis as some of these have determined a reduction in the monthly frequency and intensity of crises in subjects suffering from migraine with and without aura. These are the aims that have been proposed by the U.S. Headache Consortium Evidence-Based Guidelines. Further double-blind placebo-controlled studies are necessary in order to assess their safety and efficacy
Evoked potential evidence of cranial nerve and CNS involvement in chronic relapsing polyradiculoneuropathy.
No full textBrainstem auditory and visual potentials were recorded from 6 patients with chronic idiopathic polyradiculoneuropathy. Evoked potentials were either completely absent or their latency was prolonged suggesting slow conduction in visual or auditory pathways. The results of our study provide further evidence suggesting subclinical involvement of cranial nerves and central nervous system sensory pathways in chronic inflammatory demyelinating polyradiculoneuropathy
Cavitating Lesions around the Cochlea Can Affect Audiometric Threshold and Clinical Practice
No full textThere are several pathologies that can change the anatomy of the otic capsule and that can distort the bone density of the bony structures of the inner ear, but otosclerosis is one of the most frequent. Similar behavior has been shown in patients affected by osteogenesis imperfecta (OI), a genetic disorder due to a mutation in the genes coding for type I (pro) collagen. In particular, we note that otosclerosis and OI can lead to bone resorption creating pericochlear cavitations in contact with the internal auditory canal (IAC). In this regard, we have collected five cases presenting this characteristic; their audiological data and clinical history were analyzed. This feature can be defined as a potential cause of a third-window effect, because it causes an energy loss during the transmission of sound waves from the oval window (OW) away from the basilar membrane
Enlarged translabyrinthine approach with transapical extension in the management of giant vestibular schwannomas: personal experience and review of literature.
No full textOBJECTIVE:
To describe and analyze the main outcomes achieved in a series of patients with sporadic vestibular schwannoma (VS) larger than 40 mm in extrameatal diameter, defined as giant VS, submitted to microsurgery by the enlarged translabyrinthine approach with transapical extension.
STUDY DESIGN:
Retrospective chart review.
SETTING:
Tertiary referral center.
PATIENTS:
A retrospective chart review was conducted on 2,133 patients who underwent surgery for VS from April 1987 to July 2009. One hundred ten cases of giant VS were elected for analysis.
MAIN OUTCOME MEASURES:
Extent of removal, residual or recurrent disease, facial nerve integrity during surgery, long-term facial nerve function, and postoperative complications.
RESULTS:
Total removal was accomplished in 91.8% of cases. In 5 patients (4.5%), total removal was accomplished in 2 stages. Near-total removal was performed in 7 patients (6.3%). The facial nerve was anatomically preserved in 76.4% of cases. Intraoperative facial nerve reconstruction was performed in 8 cases. Facial nerve function after 1 year of follow-up was House-Brackmann grades I to III in 75% of cases. There were no deaths in this series. Neurovascular life-threatening complications occurred in 2 patients. Cerebrospinal fluid leak was present in 1.8% of cases.
CONCLUSION:
Results indicate the enlarged translabyrinthine approach with transapical extension as an elective approach for removal of giant VS. The method permits achievement of a high rate of total removal with low incidence of complications
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