1,721,161 research outputs found
Vestibolo e Sport
No full textLa funzione dell'equilibrio è molto complessa ed è affidata ad un sistema in cui interagiscono numerosi organi ed apparati. L'apparato vestibolare è comunque l'elemento fondamentale del controllo dell'equilibrio statico e dinamico. Una sua lesione provoca prima vertigini e gravi disturbi dell'equilibrio ed in seguito un rimodellamento di tutto il sistema al fine di compensarne gli effetti destabilizzanti. In questo modo un deficit vestibolare finisce per influenzare cronicamente l'atteggiamento posturale statico e dinamico. Nella valutazione del controllo posturale di qualsiasi paziente, ma soprattutto di uno sportivo, è pertanto indispensabile ricercare l'eventuale presenza di una pregressa vestibolopatia. In questo volume vengono suggeriti i criteri anamnestici e clinici più affidabili per questo fine
Endoscopic Ear Surgery
No full textEndoscopic middle ear anatomy, with surgical tecnique and description of ventilation pathways
Endoscopic Middle Ear Anatomy
No full textThe anatomy of the middle ear is very complex. The otologist must have a good knowledge of the structures comprising the tympanic cavity; a clear view of all the subsites of this region is essential to ensure the complete removal of all pathology. The development of endoscopic techniques to access the middle ear has offered the possibility to “look around corners” and explore hidden recesses the microscope cannot reach. Moreover, by leading to a better understanding of the different ventilation pathways of the tympanic cavity, alterations of which may cause pathologies such as cholesteatoma, endoscopy represents a surgical approach aimed toward restoring normal physiology as well as eradicating disease. In this article, we discuss the state of the art of middle ear endoscopic anatomy, describing the different subsites of this small but challenging region
Petrous apex cholesterol granuloma: transsphenoid endoscopic approach
No full textThe transsphenoid approach to the petrous apex, a surgical procedure described for the first time by Montgomery in 1977, is a rarely performed approach for the drainage and ventilation of cholesterol granuloma. We consider this approach to be the technique of choice when the cholesterol granuloma is located in the medial section of the petrous apex abutting and/or prolapsing into the posterior wall of the sphenoid sinus. The transsphenoid approach, unlike other lateral approaches to the petrous apex, is highly conservative and spares cochlear and vestibular function; moreover, it allows simple and adequate post-operative endoscopic follow up as an out-patient, with easier treatment in the case of recurrence
Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience
No full textLearning Objectives: The aim of the present study is to
describe our experience in the management of tympanic
cavity cholesteatoma in pediatric patients, treated with endo-
scopic exclusive transcanal approach.
Objectives: Describe our experience in the management of
tympanic cavity cholesteatoma in pediatric patients treated
with endoscopic exclusive transcanal approach.
Methods: Review of surgical cases performed between
January 2007 and December 2013. Patients presenting with
cholesteatoma of the tympanic cavity with no mastoid
involvement were included in the first group and underwent
an exclusive transcanalar endoscopic approach (TEA).
Patients with mastoid extension of the pathology were
included in the control group and underwent a canal wall
up microscopic technique (CWU).
Results: 59 ears of 54 patients were reviewed. Median age
was 9.6 years (range 4 – 16 years). 31 cholesteatomas under-
went a TEA approach, while 28 underwent a CWU approach,
based on inclusion criteria. No differences from congenital
vs acquired form was made. The ossicular chain was pre-
served in 26.6% of patients (16 ears): 42% of patients (13
ears) undergoing a TEA and 10% of patients undergoing a
CWU approach (3 ears) (P = 0.006). Second look surgery
was executed in 41.6% of patients (25 ears). In partial ossi-
cular prosthesis reconstructions, the mean preoperative
pure-tone average (PTA) was 29.4 dB, while the mean post-
operative PTA was 27.1 dB, with a mean increase of 2.3 dB.In total ossicular prosthesis reconstructions, the mean pre-
operative PTA was 47.8 dB, while the mean postoperative
PTA was 26.5 dB, with a mean increase of 21.3 dB.
Recurrence rate was 12.9% (4 ears) for the TEA group and
17.2% (5 ears) for the CWU approach. Residual disease
was present in 26.6%: 19.3% (6 ears) for the TEA and
34.4% (10 ears) for the CWU approach. The mean follow
up was 36 months (range 8 – 88). Kaplan-Meier analysis at
36 months showed a lower recurrence risk for the TEA com-
pared with the CWU approach, but this data was not statistic-
ally significant (P = 0.58).
Conclusion: TEA represents a feasible, minimally invasive
and conservative technique for the management of pediatric
middle ear cholesteatoma
La chirurgia endoscopica delle lesioni dell’apice petroso e del condotto uditivo interno
No full textLa chirurgia endoscopica delle lesioni dell’apice petroso e del condotto uditivo intern
Surgery of the nasal columella in external valve collapse.
No full textThe authors describe and discuss their experience with the collapse of the external nasal valve, focusing on the role that surgery of the columella plays in solving this problem. Thirty-seven cases were treated. In all but I there had been a previous septorhinoplasty. Seven patients had concomitant internal valve collapse. A modified alarplasty associated with columelloplasty was adopted in the cases with severe collapse. When the reduction of the nostril opening was mild to moderate, the surgical strategy varied depending on the width of the columella base: alarplasty in cases with a narrow to normal columella, and columelloplasty in the presence of a wide columella base. The authors' philosophy tends to minimize intervention on the nasal valve areas. Their results demonstrate that when the collapse and its functional effect are not too severe, a good result can be achieved by working only on the columella, especially if its base is significantly wide
The Epitympanum Revisited: Endoscopic Anatomy
No full textIn contrast to other means of studying the epitymapnum, the endoscope allows unparallel access without disruption of anatomy. The aim of this study is to delineate the anatomy of the epitympanum through transcanal endoscopy. Systematic dissection of anatomic specimens. We performed systematic endoscopic dissection of 20 ears in 10 fresh frozen anatomical specimens. A detailed flow sheet was filled up documenting the status of the lateral attic folds, the tensor fold, the cog and the tensor folds, the supratubal recess, and the patency of the anterior and posterior isthmus. None of the ears showed indication of previous chronic otitis media. The lateral incudomallear fold was intact in all but one ear. The lateral mallear fold was intact in all specimens. The tensor fold was complete in 16 ears and partial in four. Two of these ears belonged to the same specimen. The epitympanic diaphragm was complete in 15 out of 20 ears in 10 anatomic specimens. The endoscope allows for assessment of the attic anatomy and integrity of the diaphragm without undue disruption of anatomy. The epitympanic diaphragm is present in the majority of healthy ears and can in theory serve as the anatomic basis for the isolated attic retraction
In reference to A New Theory on the Pathogenesis of Acquired Cholesteatoma: Mucosal Traction
No full textN/
Letter to the Editor "Is endoscopic ear surgery an alternative to the modified Bondy technique for limited epitympanic cholesteatoma?" by Prasad et al
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