Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
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Acta Otorhinolaryngol Ital · Aug 2010
Validity of Italian adaptation of the Dizziness Handicap Inventory (DHI) and evaluation of the quality of life in patients with acute dizziness.
The impact of dizziness on Quality of Life (QoL) can be assessed by the Dizziness Handicap Inventory (DHI), which is used as a discriminative and evaluative tool. Although the DHI is available in several languages, an equivalent version for the Italian population is not yet available. Aim of this study was to translate the DHI into the Italian language (DHI-I), assess its correlation to the Italian version of the Short Form-36 Health Survey and to investigate its reliability in evaluating the QoL of patients with acute dizziness. ⋯ The DHI was culturally and linguistically adapted for its application in the Italian population. The DHI-I demonstrated a good reliability and is recommended as a measure of disability in patients with dizziness and unsteadiness. According to the DHI-I, patients with acute dizziness and with a clinical diagnosis of vestibular syndrome presented a decreased QoL; the physical aspects were the most compromised.
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Acta Otorhinolaryngol Ital · Dec 2009
Surgical approach to retrosternal goitre: do we still need sternotomy?
Retrosternal goitre is defined as a goitre with a portion of its mass > or = 50% located in the mediastinum. Surgical removal is the treatment of choice and, in most cases, the goitre can be removed via a cervical approach. Aim of this retrospective study was to analyse personal experience in the surgical management of retrosternal goitres, defining, in particular, the features requiring sternotomy. ⋯ Surgical removal of a retrosternal goitre is a challenging procedure; it can be performed safely, in most cases, via a cervical approach, with a complication rate slightly higher than the average rate for cervical goitre thyroidectomy, especially concerning hypoparathyroidism and post-operative bleeding. The most significant criteria for selecting patients requiring sternotomy are computed tomography features, in particular the presence of an ectopic goitre, the thyroid gland volume and the extent of the goitre to or below the tracheae carina. In conclusion, if retrosternal goitre thyroidectomy is performed by a skilled surgical team, familiar with its unique pitfalls, the assistance of a thoracic surgeon may be required only in a few selected cases.
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Acta Otorhinolaryngol Ital · Oct 2009
Case ReportsArteriovenous malformation of the base of tongue in pregnancy: case report.
Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. An unusual case is presented of an arteriovenous malformation of the base of tongue in a 32-year-old primigravida at 23.2 weeks of gestation with a history of haemoptysis. The patient was admitted to hospital with 10.7 g/dl of haemoglobin and 32.1% of haematocrit but due to recurrent massive haemoptysis, in the next few days, dropped to 6.7 g/dl of haemoglobin and 20.2% of haematocrit which required immediate blood transfusions. ⋯ A new superselective catheterization of the lingual artery was performed but due to the effect of progesterone, which causes smooth muscle relaxation and leads to arteriovenous malformation dilatation and rupture, the primigravida again presented haemoptysis. In agreement with the gynaecologists, the patient was given betamethasone to induce foetal lung maturation, and induction of labour was planned at 26 weeks, and a healthy baby was delivered naturally. Over the following days, the patient had no further haemoptysis and so far clinical examination showed no evidence of the original mass (slight haemorrhagic suffusion of the right anterior amygdala region).
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Acta Otorhinolaryngol Ital · Jun 2009
Complications of using laryngeal mask airway during anaesthesia in patients undergoing major ear surgery.
Use of the laryngoscope and tracheal tube during general anaesthesia results in many complications such as sore throat, cough, vocal cord paralysis, compulsory injection of muscle relaxants for tube insertion and risky emergence of anaesthesia. This study investigated the use of laryngeal mask airway (LMA) as a safe and complication-free device in patients undergoing ear surgery. This is a retrospective cross-sectional study on a population comprising patients from 3 to 70 years of age who have undergone major ear surgery, in Amir Alam Hospital, from 1999 to 2006. ⋯ No relationship was observed between the occurrence of this complication and duration of surgery (p value = 0.2). Furthermore, no significant relationship was observed between sex and haemodynamic instability. In conclusion, considering the low rate of complications with laryngeal mask airway, replacing tracheal tube with this device in major ear surgery will lead to a noticeable decrease in associated complications.
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Acta Otorhinolaryngol Ital · Aug 2008
Case ReportsAir-collection behind the ear: a rare complication in cochlear implant surgery.
A rare case of cochlear implant surgery complication is described: air collection behind the ear. A 61-year-old male with a 20-year history of progressive bilateral profound sensorineural hearing loss underwent cochlear implant surgery on the left ear with Clarion Hi-Res 90K (Advanced Bionics, Sylmar, CA, USA). Ten days after surgery, the patient presented visible tumefaction behind the ear corresponding to the receiver-stimulator. ⋯ An unusual case is described of a minor complication occurring in an adult cochlear implant patient presenting a swelling behind the ear that was found to be collected air. Although ultrasonography can be useful to evaluate localization of swelling behind the ear and to differentiate between liquid and solid collection, it is not useful for identification of air collection. The Eustachian tube test can show an abnormally patent tube and prevent this complication.