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Surgical treatment of middle ear cholesteatoma in children with Down's syndrome
No full textOtol Neurotol. 2005 Sep;26(5):1007-10.
Surgical treatment of middle ear cholesteatoma in children with Down syndrome.
Bacciu A, Pasanisi E, Vincenti V, Giordano D, Caruso A, Lauda L, Bacciu S.
SourceDepartment of Otolaryngology, University of Parma, Parma, Italy. [email protected]
Abstract
OBJECTIVES: To report our personal experience in the surgical treatment of cholesteatoma in children with Down syndrome.
STUDY DESIGN: Retrospective study.
SETTING: Tertiary care otology and skull base centers.
PATIENTS: Nine patients with Down syndrome were surgically treated for cholesteatoma. Two patients had bilateral disease, resulting in a total of 11 ears surgically treated.
INTERVENTION: A canal-wall-up mastoidectomy was performed in two ears; in eight of the ears, a canal-wall-down mastoidectomy was carried out and a modified Bondy procedure was performed in one ear.
RESULTS: Residual cholesteatoma was found in one ear after the canal-wall-up mastoidectomy and recurrent cholesteatoma developed in another ear, also after canal-wall-up mastoidectomy. The recurrence required conversion to canal-wall-down mastoidectomy. One patient developed a perforation of the neotympanic membrane that had to be revised.
CONCLUSIONS: Cholesteatoma in children with Down syndrome is a challenging entity for the otologic surgeon. Otolaryngologists should always suspect a cholesteatoma in each child with Down syndrome presenting warning symptoms such as otorrhea and hearing loss. If there is any doubt on inspection, further imaging studies (high-resolution computed tomography) are necessary. To the best of our knowledge, the current study is the first report to document the surgical treatment of cholesteatoma in subjects with Down syndrome.
PMID: 16151350 [PubMed - indexed for MEDLINE
Modified Bondy's technique: refinements of the surgical technique and long-termresults.
No full textOtol Neurotol. 2009 Jan;30(1):64-9.
Modified Bondy's technique: refinements of the surgical technique and long-term results.
Sanna M, Facharzt AA, Russo A, Lauda L, Pasanisi E, Bacciu A.
SourceGruppo Otologico, Piacenza, Rome, Italy. [email protected]
Abstract
OBJECTIVE: To evaluate the short- (6 mo) and long-term (5 yr) outcomes of modified Bondy technique, with particular reference to hearing results.
STUDY DESIGN: Retrospective study.
SETTING: Quaternary referral otology and cranial base center.
PATIENTS: Two hundred thirty ears of 222 patients were operated on, using a modified Bondy technique between 1983 and 2005. All patients had primary acquired epitympanic cholesteatomas with intact pars tensa and intact ossicular chain in normal or good-hearing ear. Preoperative audiometric results revealed a mean air conduction pure-tone average of 27.7 +/- 9.6 dB (range, 10-65 dB) and a mean bone conduction pure-tone average of 14.2 +/- 6.4 dB (range, 5-50 dB). The mean preoperative air-bone gap was 13.5 +/- 6.7 dB (range, 0-25 dB). The average length of follow-up was 7.8 years (range, 5-16 yr).
RESULTS: There was no recurrent cholesteatoma in the present series. A pearl-like residual cholesteatoma was found in the cavity in 7.4% of ears. Two patients (0.8%) developed stenosis of meatoplasty. Three ears (1.3%) exhibited retraction pockets extending to the attic. Postoperative discharging ear was observed in 3% of cases and was successfully treated with topical drops. At the long-term follow-up, the air-bone gap was unchanged or improved from the preoperative level in 88% of cases. The mean postoperative short- and long-term air-bone gaps were 14.6 +/- 8.5 dB (range, 0-55 dB) and 14.1 +/- 8.2 dB (range, 0-50 dB), respectively. Postoperative high-frequency sensorineural hearing loss with bone conduction worsening between 20 and 30 dB at 4 kHz was observed in 4 cases (1.7%). No dead ears were encountered postoperatively.
CONCLUSION: A modified Bondy operation is recommended in selected cases of epitympanic cholesteatoma in normal or good-hearing ear with an intact pars tensa and ossicular chain. Modified Bondy technique ensures complete eradication of disease while preserving a good preoperative hearing in 1-stage operation
Intracranial facial nerve grafting after removal of vestibular schwannoma
No full textAm J Otolaryngol. 2009 Mar-Apr;30(2):83-8. Epub 2008 Jul 22.
Intracranial facial nerve grafting after removal of vestibular schwannoma.
Bacciu A, Falcioni M, Pasanisi E, Di Lella F, Lauda L, Flanagan S, Sanna M.
SourceDepartment of Otolaryngology, University of Parma, Parma, Italy. [email protected]
Abstract
OBJECTIVE: The objectives of this study were to evaluate outcomes from facial nerve (FN) cable grafting in patients who experienced FN transection during vestibular schwannoma removal and to compare the FN outcomes of patients who underwent FN grafting by using fibrin glue with those of patients who underwent FN grafting by using microsuture.
MATERIAL AND METHODS: We retrospectively evaluated a series of 33 patients in whom FN grafting was achieved either by using microsuture (8 cases) or fibrin glue (25 cases). Immediate repair of the FN was performed in all cases at the time of initial resection. The patients FN function was assessed preoperatively, in the immediate postoperative period, and at 3, 6, 9, and 12 months or more postoperatively using the House-Brackmann grading system. All patients had at least 1-year follow-up.
RESULTS: At 12 months, a House-Brackmann grade III was achieved in 75% of those who underwent cable nerve graft interposition by using microsuture and in 76% of those who underwent cable nerve graft interposition by using fibrin glue. Analysis of final FN function outcomes demonstrated no statistically significant difference in FN outcomes between the 2 groups (P = .891, Mann-Whitney U test; P = .1, Fisher exact test).
CONCLUSIONS: The functional results after FN cable grafting by using fibrin glue exclusively were equivalent to those obtained with microsuture. However, the technique of FN repair by means of fibrin glue is technically simple, less time-consuming, and imparts less trauma on the nerve than does the traditional suture method
Cinque santi a confronto. Analogie e difformità nella costruzione dell'immagine di culto.
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Intracranial facial nerve grafting after removal of vestibular schwannoma.
No full textOBJECTIVE:
The objectives of this study were to evaluate outcomes from facial nerve (FN) cable grafting in patients who experienced FN transection during vestibular schwannoma removal and to compare the FN outcomes of patients who underwent FN grafting by using fibrin glue with those of patients who underwent FN grafting by using microsuture.
MATERIAL AND METHODS:
We retrospectively evaluated a series of 33 patients in whom FN grafting was achieved either by using microsuture (8 cases) or fibrin glue (25 cases). Immediate repair of the FN was performed in all cases at the time of initial resection. The patients FN function was assessed preoperatively, in the immediate postoperative period, and at 3, 6, 9, and 12 months or more postoperatively using the House-Brackmann grading system. All patients had at least 1-year follow-up.
RESULTS:
At 12 months, a House-Brackmann grade III was achieved in 75% of those who underwent cable nerve graft interposition by using microsuture and in 76% of those who underwent cable nerve graft interposition by using fibrin glue. Analysis of final FN function outcomes demonstrated no statistically significant difference in FN outcomes between the 2 groups (P = .891, Mann-Whitney U test; P = .1, Fisher exact test).
CONCLUSIONS:
The functional results after FN cable grafting by using fibrin glue exclusively were equivalent to those obtained with microsuture. However, the technique of FN repair by means of fibrin glue is technically simple, less time-consuming, and imparts less trauma on the nerve than does the traditional suture method
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