Audiology Unit

Milano, Italy

Audiology Unit

Milano, Italy
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Thabet E.M.,Audiology Unit | Zaghloul H.,Audiology Unit
European Archives of Oto-Rhino-Laryngology | Year: 2012

To evaluate the role of oVEMP and multide-tector CT scan in patients with superior canal dehiscence syndrome. Prospective study was conducted on nine patients with superior canal dehiscence syndrome (5 females, 4 males) age ranged 19-49 with mean age of 32.7 ± 9.3 years, complaining of intolerance to loud sounds and/or oscillopsia. The mean duration of illness was 18.7 ± 6.9 months, nine normal individuals as control (age and gender matched) were also included in the study. All of them underwent oVEMP and MDCT scan. Patients were of bilateral normal hearing sensitivity with no conductive impairment. All of the studied subjects (patients and controls) had identifiable contralateral oVEMP responses. MDCT scan showed dehiscence in all the patients. The dehiscence was unilateral (n = 7) and bilateral [n = 2 the other ear had a defect of 2 mm and thus was excluded from the study for fear or false diagnosis of Superior semicircular canal dehiscence syndrome (SCDS)]. Unlike the normal subject (nI = 0.94 μV ± 0.03 and pI = -0.42 μV ± 0.09), with stimulation of the affected side in SCDS, there were augmented amplitude responses (nI = 2.64 μV ± 0.35 and pI = -3.10 μV ± 0.44) in the eye contralateral to the stimulus "contralateral to the lesion". Mean oVEMP threshold for SCDS ears were 82.5 ± 7.55 dBnHL compared to 100 ± 5.77 dBnHL of the control ears. We concluded that combination of physiological and anatomical information from oVEMP and MDCT increased accuracy for diagnosis of dehiscence of superior semicircular canal. © Springer-Verlag 2011.


Quriba A.S.,Audiology Unit
Laryngoscope | Year: 2016

Objectives/Hypothesis: Evaluate the effect of topical application of autologous platelet-rich plasma (PRP) in primary repair of complete cleft palate and then compare the result with another group of patients using the same surgical technique, without application of PRP with regard to the incidence of oronasal fistula, velopharyngeal closure, and grade of nasality. Study Design: Case control study. Methods: This study was carried on 44 children with complete cleft palate with age range from 12 to 23 months. The children were divided into two age- and gender-matched groups: All children were subjected to the same technique of V-Y pushback repair of the complete cleft palate. In group A (22 children), the PRP prepared from the patient was topically applied between the nasal and oral mucosa layer during palatoplasty, whereas in group B (22 children) the PRP was not applied. Results: All cases were recovered smoothly without problems. In group A, no oronasal fistula was reported, whereas in group B three patients (13.6%) had postoperative fistulae and two patients (9.1%) needed revision palatoplasty. At 6 months postoperative assessment, group A (with PRP application) showed significantly better grade of nasality (P = 0.024) and better endoscopic velopharyngeal closure (P = 0.016) than group B. Conclusion: Usage of autologous PRP in complete cleft palate repair is simple; effective; can decrease the incidence of oronasal fistula; and also significantly improves the grade of nasality and velopharyngeal closure, which decreases the need of further surgical intervention in cleft palate patients. Level of Evidence: 3b. Laryngoscope, 2015 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.


Baracca G.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Cantarella G.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Forti S.,Audiology Unit | Pignataro L.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | And 2 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2014

Singers constitute a specific population that is particularly sensitive to vocal disability, which may have a higher impact on their quality of life compared to non-singers. A specific questionnaire, the Singing Voice Handicap Index (SVHI), was created and validated aimed to measure the physical, social, emotional and economic impacts of voice problems on the lives of singers. The aim of this study was to validate the Italian version of the SVHI. The validated English version of the SVHI was translated into Italian and then discussed with several voice care professionals. The Italian version of the SVHI was administered to 214 consecutive singers (91 males and 123 females, mean age: 32.62 ± 10.85). Voice problem complaints were expressed by 97 of the singers, while 117 were healthy and had no voice conditions. All subjects underwent a phoniatric consultation with videolaryngostroboscopy to ascertain the condition of the vocal folds. Internal consistency of the Italian version of the SVHI showed a Cronbach's α of 0.97. The test-retest reliability was assessed by comparing the responses obtained by all subjects in two different administrations of the questionnaire; the difference was not significant (p = ns). The SVHI scores in healthy singers was significantly lower than the one obtained in the group of singers with a vocal fold abnormality (29.26 ± 25.72 and 45.62 ± 27.95, p < 0.001, respectively). The Italian version of the SVHI was successfully validated as an instrument with proper internal consistency and reliability. It is a suitable instrument for the self-evaluation of handicaps related to voice problems in the context of singing. © 2013 Springer-Verlag.


Gilbey P.,The Otolaryngology Head and Neck Surgery Unit | Gilbey P.,Bar - Ilan University | Kraus C.,Audiology Unit | Ghanayim R.,Audiology Unit | And 2 more authors.
International Journal of Pediatric Otorhinolaryngology | Year: 2013

Objective: Unidentified hearing loss at birth can adversely affect speech and language development as well as academic achievement and social-emotional development. Historically, moderate-to-severe hearing loss in young children was not detected until well beyond the newborn period. Around 0.5 to 5 in every 1000 neonates and infants have congenital or early childhood onset sensorineural hearing impairment. When identification and intervention occur at no later than 6 months of age, the infants perform much higher on school-related measures. Therefore, early detection is vitally important. Toward the end of 2009, the Israeli ministry of health issued a directive establishing a universal newborn hearing screening program in all hospitals in the country from 01.01.10. The objectives of this study are to evaluate a newly established universal newborn hearing screening program, to assess performance and to compare measurements of performance to performance benchmarks representing a consensus of expert opinion. The benchmarks are the minimal requirements that should be attained by high-quality early hearing detection programs. Methods: As specified by the ministry of health, a two-stage screening protocol was implemented using otoacoustic emissions and automated auditory brainstem response. Screening results of all neonates born from the initiation of the program on 15th March 2010 until the end of 2011 were reviewed. Results: The total number of live births during the study period was 5496. Of these, 5334 (97%) started screening for hearing loss but only 5212 completed the screening process, giving a screening coverage of 94.8%. Of the 5212 neonates completing the screening process, 270 (5.18%) were referred for full diagnostic testing. Conclusions: The newly established universal newborn hearing screening program at the Ziv Medical Center in Zefat closely approaches, but does not yet meet the minimal requirements that should be attained by high-quality early hearing detection programs. Every effort should be made to complete the screening tests before discharge from hospital. Screening staff should actively encourage parents to participate in all stages of early detection. © 2012 Elsevier Ireland Ltd.


Borghi C.,Internal Medicine Unit | Cosentino E.R.,Internal Medicine Unit | Rinaldi E.R.,Internal Medicine Unit | Brandolini C.,Audiology Unit | And 5 more authors.
BMC Medicine | Year: 2011

Background: The complex mechanism responsible for tinnitus, a symptom highly prevalent in elderly patients, could involve an impaired control of the microcirculation of the inner ear, particularly in patients with poor blood pressure control and impaired left ventricular (LV) function.Methods: In order to define the relationship between the presence of tinnitus and the severity and clinical prognosis of mild-to-moderate chronic heart failure (CHF) in a large population of elderly patients (N = 958), a cross-sectional study was conducted with a long-term extension of the clinical follow-up. Blood pressure, echocardiographic parameters, brain natriuretic peptide (BNP), hospitalization, and mortality for CHF were measured. Multivariate logistic regression analysis was used to assess the association between the presence of tinnitus and some of the prognostic determinants of heart failure.Results: The presence of tinnitus was ascertained in 233 patients (24.3%; mean age 74.9 ± 6 years) and was associated with reduced systolic and diastolic blood pressure (123.1 ± 16/67.8 ± 9 vs 125.9 ± 15/69.7 ± 9; P = .027/P = .006), reduced LV ejection fraction (LVEF%; 43.6 ± 15 vs 47.9 ± 14%, P = .001), and increased BNP plasma levels (413.1 ± 480 vs 286.2 ± 357, P = .013) in comparison to patients without symptoms. The distribution of CHF functional class was shifted toward a greater severity of the disease in patients with tinnitus. Combined one-year mortality and hospitalization for CHF (events/year) was 1.43 ± 0.2 in patients with tinnitus and 0.83 ± 0.1 in patients without tinnitus, with an adjusted hazard ratio (HR) of 0.61 (95% confidence interval (CI): 0.37 to 0.93, P <.002).Conclusions: Our preliminary data indirectly support the hypothesis that tinnitus is associated with a worse CHF control in elderly patients and can have some important clinical implications for the early identification of patients who deserve a more aggressive management of CHF. © 2011 Borghi et al; licensee BioMed Central Ltd.


Cantarella G.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Viglione S.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Forti S.,Audiology Unit | Minetti A.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | And 2 more authors.
Auris Nasus Larynx | Year: 2012

Objective: To evaluate postoperative quality of life in patients undergoing microdebrider intracapsular tonsillotomy and adenoidectomy (PITA) in comparison with traditional adenotonsillectomy (AT) and to assess PITA's efficacy in solving upper-airway obstructive symptoms. Methods: 29 children with adenotonsillar hyperplasia referred for AT were included. Patients were divided into two groups: Group 1 (underwent PITA) included 14 children (age 5.1. ±. 1.8 years) affected by night-time airway obstruction without a relevant history of recurrent tonsillitis; Group 2 (underwent AT) included 15 children (age 5.2. ±. 1.7 years) with a history of upper-airway obstruction during sleep and recurrent acute tonsillitis. Outcomes measures included the number of administered pain medications, time before returning to a full diet, Obstructive Sleep Apnea survey (OSA-18), parent's postoperative pain measure questionnaire (PPPM) and Wong-Baker Faces Pain Rating Scale (WBFPRS). Results: Postoperative pain was significantly lower in the PITA group, as demonstrated by PPPM and WBFPRS scores and by a lower number of pain medications used. PITA group also resumed a regular diet earlier (. P<. 0.001). OSA-18 scores proved that both PITA and AT were equally effective in curing upper-airway obstructive symptoms. Conclusion: PITA reduces post-tonsil ablation morbidity and can be a valid alternative to AT for treating upper-airway obstruction due to adenotonsillar hyperplasia. © 2011 Elsevier Ireland Ltd.


Di Berardino F.,Audiology Unit | Di Berardino F.,University of Milan | Cesarani A.,Audiology Unit | Cesarani A.,University of Milan
Laryngoscope | Year: 2012

Objectives/Hypothesis: Wheat is one of the most common food allergens found in patients with Meniere's disease (MD). Gluten from wheat has been identified to have a etiopathogenetic role in celiac disease, IgE hypersensitivity to wheat disease, and recently to gluten sensitivity. The aim of this study was to verify the incidence of gliadin prick test response in patients affected by MD. Study Design: Prospective individual case-control study. Methods: There were 58 adult patients with definite MD, 25 healthy volunteers, and 25 patients with grass pollen rhinoconjunctivitis tested with skin prick test to gliadin. Results: A total of 33 MD patients (56.9%) proved to be sensitive to gliadin, eight of whom were positive to prick test after 20 minutes, 13 after 6 hours, 11 after 12 hours, and one after 24 hours. Conclusions: This is the first report of gliadin skin test response in MD. Further studies are needed to define the relationship between immune response to wheat proteins and MD symptoms. © 2012 The American Laryngological, Rhinological and Otological Society, Inc.


Di Berardino F.,University of Milan | Forti S.,Audiology Unit | Cesarani A.,University of Milan | Cesarani A.,Audiology Unit
Annals of Otology, Rhinology and Laryngology | Year: 2012

Objectives: The aim of this study was to design a complementary speech audiometry test using verbal tasks and motor responses (VTMR) to assess the ability of a subject to understand and perform simple motor tasks with 3-dimensional objects, to describe its construction, and to show the preliminary results of a pilot study on the Italian version of the test. Methods: The items used in the test setting included 1 base, 1 hammer, 1 wooden structure with 4 sticks, and 5 rings of different colors and 20 lists with 5 verbal tasks per list. The VTMR test and bisyllabic speech audiometry were evaluated in normal-hearing subjects with and without cognitive impairment and in subjects with sensorineural hearing loss. Results: All normal-hearing subjects without cognitive impairment performed the VTMR tasks (100%) correctly at 35 dB sound pressure level. In subjects with sensorineural hearing loss, the percentage of correct answers was significantly higher for the VTMR test than for bisyllabic speech audiometry above 50 dB sound pressure level. This percentage was higher for the VTMR also in normal-hearing subjects with poor cognitive skills. Conclusions: The VTMR might make it easier to check patients' ability to understand verbal commands than does traditional speech audiometry, in particular in those patients with poor test-taking skills. © 2012 Annals Publishing Company. All rights reserved.


Forti S.,Audiology Unit | Amico M.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Zambarbieri A.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Ciabatta A.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | And 4 more authors.
Journal of Voice | Year: 2014

Objective Time consuming is an important aspect in assessing dysphonic patients. So, the English version of the Voice Handicap Index (VHI-30), a self-administered questionnaire consisting of 30 items used to evaluate patients' self-perception of voice problems, was reduced to 10 items (VHI-10) for clinical purposes. In 2010, an Italian version of VHI-30 was validated, now the aims of this study were to analyze the psychometric properties of an Italian version of VHI-10 and to evaluate its validity in a cohort of patients affected by organic or functional dysphonia. Study Design Cross-sectional study. Methods The Italian version of the VHI-30 was submitted to 372 dysphonic participants and 120 healthy control subjects and was conducted again 2 weeks later. The 10 items constituting the VHI-10 were extracted from the VHI-30. For 73 dysphonic patients, the questionnaire was also administered after treatment. Results The scores of the control group were significantly lower with respect to all diagnostic subgroups (P < 0.001). The Cronbach's α, test-retest, and Pearson's correlation index demonstrated high reliability and validity of the Italian VHI-10. The ratio of the VHI-10 and VHI-30 scores was higher than 0.333 in all subgroups. Conclusion This study demonstrated that the Italian VHI-10 is a robust tool that can adequately represent and replace the VHI-30. The reported results support the use of the VHI-10 for the Italian population in clinical settings owing to its validity and rapid and simple use. © 2014 The Voice Foundation.


Crocetti A.,Fondazione Ascolta e Vivi | Forti S.,Audiology Unit | Del Bo L.,Fondazione Ascolta e Vivi
Auris Nasus Larynx | Year: 2011

Objective: Previous studies report that enhanced power in the delta range (1.5-4. Hz) and reduced power in the alpha frequency band (8-12. Hz) were most pronounced in the temporal regions. These studies referred to the 8-12. Hz activity as tau activity, and they created a new neurofeedback protocol to treat tinnitus using a temporally generated tau rhythm (8-12. Hz) and slow waves in the delta range (3-4. Hz) for feedback. This study aims to repeat this protocol and to evaluate its effect on tinnitus. Methods: Fifteen normal-hearing patients with tinnitus were treated with the neurofeedback protocol. The Tinnitus Handicap Inventory and Visual Analogue Scales were administered before and after treatment and at 1, 3 and 6 months post-treatment. Results: After therapy, all questionnaires scores were significant improved, and the improvements persisted throughout the followup period. Moreover, an increasing trend in the tau/delta ratio was observed; specifically, the trend was more stable respect of the pre-recording measure. However, only in some subjects may the signal alone be enough to develop the correct behaviors. Conclusion: Further studies are necessary to characterize the tinnitus subjects who recovered from and adapted to this psychophysical condition and, therefore, responded to neurofeedback therapy. © 2011 Elsevier Ireland Ltd.

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