1,721,000 research outputs found
La collaborazione interdisciplinare nella chirurgia del seno mascellare
No full textNegli ultimi anni le problematiche cliniche correlate alla patologia del seno mascellare si stanno trasformando radicalmente in relazione ai progressi ed alla diffusione delle applicazioni implantologiche. Gli otorinolaringoiatri, i chirurghi maxillo-facciali e gli odontoiatri si trovano oggi ad affrontare complesse problematiche secondarie a complicanze di chirurgia implantologica o pre-implantologica (rialzo del seno) o, specularmente, devono tentare di finalizzare il gesto chirurgico eseguito su una patologia primaria non solo a scopi funzionali respiratori, ma anche in previsione di una riabilitazione funzionale dell’occlusione. Frequentemente il singolo specialista fatica a dominare le differenti tecniche chirurgiche (per via esterna, endoscopiche) e, soprattutto, non può conoscere compiutamente le problematiche legate ad una corretta riabilitazione implanto-protesica. Esempi clinici di quanto sopra accennato possono essere individuati, ad esempio, in sinusiti odontogene con fistola oro-antrale che non siano limitate al solo seno mascellare, oppure in neoplasie con estensione combinata al cavo orale ed al seno mascellare. In queste situazioni spesso i pazienti devono affrontare interventi plurimi, eseguiti da differenti specialisti senza un programma comune ben definito. L’esperienza che gli Autori intendono riportare è invece quella della collaborazione interdisciplinare, volta a stabilire un unico programma terapeutico da affrontare in equipe, minimizzando il numero degli interventi chirurgici. Il video riporta alcuni esempi clinici relativi ad interventi combinati
Italian multicentre study on intrathecal fluorescein for craniosinusal fistulae
No full textCerebrospinal fluid leak (CSF), clinical sign of a dural lesion of the skull base, is a relatively rare event that can present with a variety of symptoms. Every craniosinus fistula should be considered a serious, potentially life-threatening situation (even those cases with hidden CSF leak). Reports of experience concerning diagnosis and treatment of craniosinus fistulae have appeared in the Literature. In the last few years, the endoscopic nasal approach is proving effective as it makes diagnosis much easier and is the least invasive surgical approach, with the greatest percentage of success. Various classifications are being proposed to improve clinical evaluation of CSF leaks and to simplify the diagnostic and therapeutic approach. The most common parameters of classification are: aetiology (traumatic, iatrogenic, non-traumatic, etc.) site, type of flow (high or low pressure) and, as far as concerns treatment, the type of graft used, all of which have contributed to various diagnostic and therapeutic algorithms being proposed. Therefore, the subject seems to be widely schematized and the therapeutic attitude widely agreed. However, one of the diagnostic and therapeutic approaches is now being questioned. For some, it is the heart of the clinical approach, while for others, it is a useful tool yet too dangerous to be used on account of potential side effects: namely, the fluorescein test. This procedure, consisting of intrathecal injection of a colorant (fluorescein), is well known by the Food and Drug Administration (FDA) which neither explicitly prohibits it, nor allows it, intrathecal administration is, therefore, an off label use. As far as the Authors know, authorization of this procedure has not been forthcoming anywhere in the world although the procedure itself is widely employed. As far as concerns the use of intrathecal fluorescein, many scientific papers have been written, clearly supporting its clinical usefulness. One limit to the use of fluorescein derives from frequent reports of complications, often related to the intrathecal administration; such complications are, however, always due to an incorrect dosage. In order to perform correct monitoring of any complication related to the use of intrathecal fluorescein and to investigate in a strictly scientific fashion, the legal problem related to the off label use (intrathecal administration) of an authorised substance, the Authors coordinated an Italian multicentre study aimed at establishig the tolerability of the lumbar intrathecal administration of fluorescein. Aim of the study was to review the literature focusing on CSF leaks, to set up to date diagnostic and therapeutic indications of fluorescein and to report the preliminary results of the Italian multicentre study
Endoscopic removal of an unusual foreign body in the sphenoid sinus : an oral implant
No full textAim: Migration of oral implants displaced in the maxillary sinus toward the sphenoid sinus is an extremely rare event. This case report is focused on the possibility of treating such a rare complication by means of endoscopic treatment through the nasal cavity.
Material and methods: A 45-year-old female patient received one oral implant for the substitution of the left first upper molar, but during the surgical procedure the implant was displaced in the maxillary sinus. Owing to a delay in treatment, a spontaneous migration of the implant in the sphenoid sinus occurred.
Results: The implant was removed endoscopically through the nasal cavity: postoperative recovery was uneventful.
Conclusion: To the authors’ knowledge, this case represents the first report concerning migration of an oral implant into the sphenoid sinus and demonstrates the reliability and safety of an endoscopically driven surgical removal of the foreign body, thus preventing potential complications with extremely low postoperative morbidity
Sphenopalatine endoscopic ganglion block in cluster headache : a reevaluation of the procedure after 5 years
No full textCluster headache (CH) is considered the most painful form of primary headaches. It is characterized by severe unilateral pain, typically associated with autonomic manifestations and may be divided into an episodic and a chronic form. The latter is often resistant to a multitude of medication and is, therefore, very hard to treat. In 2002, our group developed a technique for the endoscopic sphenopalatine ganglion block that was able to ameliorate the symptoms in 55% of drug-resistant chronic CH patients. This paper is intended as an update on the technique as well as a comparison in effectiveness to our prior approach
Unusual case of bilateral maxillary fungus ball
No full textAn otherwise healthy 34-year-old man was referred to our ear, nose and throat (ENT) clinic for a bilateral maxillary radiologic opacity. This condition was accidentally discovered with a panoramic radiography performed during a follow-up visit after a bilateral endodontic treatment. The patient did not report any specific sinonasal symptom such as purulent nasal discharge, loss of smell and cough, apart from an unspecific sinus pressure. The CT scans showed a bilateral inflammatory process into the maxillaryethmoidal sinuses and an iron-like density within the maxillary sinuses, while nasal endoscopy showed purulent discharge in the ostiomeatal complex. The patient underwent functional endoscopic sinus surgery under general anaesthesia and the inflammatory material collected was histologically diagnosed as a rare case of bilateral fungus ball. The patient was dismissed the following day with no complications; there were not any sign of recurrence or symptoms during a 4 month follow-up
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
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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