Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
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Acta Otorhinolaryngol Ital · Dec 2011
Vestibular and stabilometric findings in whiplash injury and minor head trauma.
Vertigo and postural instability following whiplash and/or minor head injuries is very frequent. According to some authors, post-whiplash vertigo cannot be caused by real injury to vestibular structures; other authors maintain that vestibular damage is possible even in the case of isolated whiplash, with vascular or post-traumatic involvement. Furthermore, many of the balance disorders reported after trauma can be justified by post-traumatic modification to the cervical proprioceptive input, with consequent damage to the vestibular spinal reflex. ⋯ Hence, our study confirms that only in a minority of cases can whiplash cause central or peripheral vestibulopathy, and that this is more probable after minor head injury associated with whiplash. In addition, our data confirm that static stabilometry is fundamental for assessing postural deficits following a cervical proprioceptive disorder. In these cases, in fact, analysis of the different parameters and the indices referring to cervical interference not only permits evaluation of altered postural performance, but also detects and quantifies destabilisation activity within the cervical proprioceptive component.
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Acta Otorhinolaryngol Ital · Aug 2011
Subglottic stenosis following percutaneous tracheostomy: a single centre report as a descriptive study.
Tracheal stenosis is a potential complication of tracheostomy. The present study aimed to describe the epidemiologic profile of subglottic stenosis in a referral medical centre. During a 4-year period, all patients who had been admitted in an Intensive Care Unit of Imam Khomeini Hospital (affiliated to Tehran University of Medical Sciences) and had undergone percutaneous tracheostomy during 7-10 days after endotracheal intubation were enrolled in the study. ⋯ Patients in whom the tracheostomy tube had been removed in the first 3 weeks after tracheostomy did not present tracheal stenosis (n = 3, 15%). The present study revealed that subglottic stenosis is frequent in patients who have undergone percutaneous tracheostomy in the Intensive Care unit setting. However, the stenosis is generally mild and is not associated with serious and/ or life-threatening clinical manifestations.
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Acta Otorhinolaryngol Ital · Jun 2011
Diagnostic and therapeutic iter in paediatric OSAS: personal experience.
Obstructive sleep apnoea syndrome in a child is characterized by prolonged episodes of obstructive hypopnoea and/or apnoea of upper airway leading to morbidity. The most common risk factor is adeno-tonsillar hypertrophy. Obstructive sleep apnoea syndrome diagnosis is based on clinical ENT evaluation and an instrumental approach, such as pulse oximetry or the gold standard overnight polysomnography. ⋯ Of the positive patients, 86% underwent adenotonsillectomy and a control pulse oximetry 6 months thereafter, 96% resulted negative. Pulse oximetry was efficient in order to avoid incorrect surgery indications, improving appropriateness and safety of adenotonsillectomy in children with obstructive sleep apnoea syndrome. Adenotonsillectomy showed a success rate of 96% and there were no episodes of post-surgery complications in particular in those patients at increased risk.
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Acta Otorhinolaryngol Ital · Apr 2011
Predictive role of nasal functionality tests in the evaluation of patients before nocturnal polysomnographic recording.
Obstructive sleep apnoea syndrome is a disease characterized by a collapse of the pharyngeal airway resulting in repeated episodes of airflow cessation, oxygen desaturation, and sleep disruption. It is a common disorder affecting at least 2-4% of the adult population. The role of nasal resistance in the pathogenesis of sleep disordered breathing and sleep apnoea has not been completely clarified. ⋯ The results showed, in all the snoring and Obstructive sleep apnoea syndrome patients, total nasal resistance and increased Muco-Ciliary Transport time compared to standard values. Furthermore, the apnoea-hypopnoea index was significantly higher in patients with higher nasal resistence and significantly different between the groups. These results allow us to propose the simultaneous evaluation of nasal functions by Active Anterior Rhinomanometry, Acoustic Rhinometry, and Muco-Ciliary Transport time in the selection of patients undergoing polysomnography.
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Acta Otorhinolaryngol Ital · Dec 2010
Randomized Controlled Trial Comparative StudyComparing the effects of desflurane and isoflurane on middle ear pressure.
The aim of this study was to determine middle ear pressure changes during the operation performed under anaesthesia induced by isoflurane or desflurane. This was a prospective, case-control study. A total of 38 children with no middle ear pathology scheduled for inguinal hernia surgery were included in the study. ⋯ Increase in the mean middle ear pressure values at the 5(th) and 10(th) minute of the operation was significant different between both groups (2.84 and 5.80 daPa for isoflurane; 59.06 and 72.81 daPa for desflurane; p ≤ 0.05). Desflurane is more increased than isoflurane on intra-tympanic pressure and isoflurane may be used more safely than desflurane in middle ear operations. The low effect of isoflurane on intra-tympanic pressure can be explained by the high blood/gas partition coefficient compared to desflurane.