Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
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In paediatric patients, recurrent febrile pharyngo-tonsillitis is usually due to chronic inflammation of the tonsils and/or adenoids: these episodes are often associated with other clinical manifestations (respiratory obstruction of naso-pharyngeal origin; auricular inflammation, especially effusive otitis media and acute otitis media; streptococcal beta-haemolytic Group A (SBEGA) infection, causing a distant disorder of varying severity and which may, therefore, give rise to serious pathological conditions). A retrospective multicentric investigation has, therefore, been carried out in order not only to further elaborate findings emerging from earlier studies, performed in other countries, in which random methods were used, but also to focus on: 1. the possible association of these clinical manifestations with recurrent febrile pharyngo-tonsillar inflammation in relation to frequency of the condition; 2. results obtained with adenoidectomy or with adeno-tonsillectomy, referring to the overall clinical outcome of the pathological condition, bearing in mind data emerging from the control groups, submitted to strict follow-up, associated with any medical treatment deemed necessary. ⋯ The present investigations confirm previous observations emerging from randomized clinical studies, regarding the possibility to achieve valid prevention of recurrent febrile pharyngo-tonsillar inflammation, also in a large percentage of control patients submitted to watchful waiting; these investigations, however, also demonstrated that, in the control group, the percentage of subjects in whom recovery of other symptoms was achieved was very low compared to that in the groups submitted to surgery. In other words, clearly emerges as far as concerns the overall symptomatological picture of the patients, the efficacy of the surgical treatment, but also the lack of success of the medical treatments in all clinical manifestations associated with recurrent febrile inflammations. Therefore, it is necessary to select and advise the most suitable treatment strategy, not in relation to the Guidelines elaborated on the basis of results emerging from statistical research, that, due to the intrinsic methodology limits cannot be applied to all cases in an acritical fashion, but in relationship to the specific clinical picture of each individual patient.
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Acta Otorhinolaryngol Ital · Aug 2006
Review Case ReportsUnilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature.
Extracranial involvement of the recurrent laryngeal nerve and the hypoglossal nerve is known as Tapia's syndrome. Ipsilateral paralysis of the vocal cord and tongue is present. Lesion of these nerves may be a rare complication of airway management. ⋯ From the data reported in the literature, as in our case, complete recovery of function is generally achieved within the first six months. This progressive recovery of function suggests nerve damage of a neuro-praxic type, which is typical of compression injury. In conclusion, the response of this rare complication confirms the importance not only of the position of the head and patient on the operating table but also the meticulous and correct performance of the routine manoeuvres of airway management.
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Acta Otorhinolaryngol Ital · Aug 2006
Protection against cisplatin ototoxicity in a Sprague-Dawley rat animal model.
Cisplatin (CDDP) is an anti-neoplastic drug extensively used in cases of head and neck cancer. Cisplatin induces numerous untoward side-effects including ototoxicity. In this study, cisplatin ototoxicity in Sprague-Dawley rat animal model has been evaluated and the oto-protection provided by the systemic administration of the antioxidant drug D-methionine has been tested. ⋯ The hearing threshold of the animals was evaluated by electrophysiological procedures as Otoacoustic Emissions and Auditory Brainstem Responses. The effects of protection were evaluated after 72 hours. The data from the Otoacoustic Emissions (in the 4.0-12 kHz band) and Auditory Brainstem Responses recordings suggested that D-methionine can partially protect from Cisplatin ototoxicity.
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"Myiasis" is a parasitic infestation of live human or vertebrate animal tissues or cavities caused by dipterous larvae (maggots) which feed on the host's dead or living tissue, liquid body substances or ingested food. They are extremely rare in Western countries, especially in E. N. ⋯ Although this is not a lethal disorder, knowledge of the disease is necessary from the preventive, diagnostic and curative standpoint. It is important to proceed with identification of the larvae, distinguishing them from other types of myiasis involving different therapeutic implications. Ecology, classification, and treatment of myiasis are reviewed.
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The principle of informed consent, aimed at the lawfulness of health assistance, tends to reflect the concept of autonomy and of decisional autodetermination of the person requiring and requesting medical and/or surgical interventions. This legal formula, over the last few years, has gained not only considerable space but also importance in the doctrinal elaboration and approaches, as well as juridical interpretations, thereby influencing the everyday activities of the medical profession. Informed consent is still the object of continuous explorations, not only asfar as concerns the already confirmed theoretical profile but, instead, the ambiguous practical and consequential aspect. ⋯ The American experience has been very rapidly adopted, by some, without a profound, complete and necessary historical and evolutional analysis aimed at those intertwined principles that have been motifs that have gradually led to the legal references in those emblematic cases referred to, the conclusions of which continue to attract a great deal of attention. In Italy, the legal and doctrinal evolution of informed consent, even if following a little more rapidly the traces, steps, problems and interpretations of the various aspects drawn up, characterized and applied in the United States, has not only occurred at a later time, but, despite reaching the same meaningful objectives, the same considerations, the same importance, and, unfortunately, the same inconveniences, has had quite different aims, approaches and articulations. In this respect, it is enough to focus attention on the different cultural traditions and religious routes, on the different doctrinal background, the particular historical origins and the individual legal aspects, all extremely different one from the other. (ABSTRACT TRUNCATED)