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Forlì del Sannio, Italy

Zanoletti E.,Otosurgery Unit | Marioni G.,University of Padua | Lionello M.,University of Padua | Giacomelli L.,University of Padua | And 3 more authors.
Laryngoscope | Year: 2014

Objectives/Hypothesis Temporal bone squamous cell carcinoma (SCC) is an uncommon malignancy accounting for less than 0.2% of head and neck cancers. Despite advances in its early diagnosis, skull base microsurgery, radiotherapy, and integrated treatments, prognosis in advanced SCCs remains dismal. The present study aimed to analyze the clinicopathological variables potentially influencing outcome in a series of temporal bone SCCs. Study Design The prognosis of 41 patients with temporal bone SCC was assessed retrospectively using univariate and multivariate statistical approaches. Patients and Methods Twenty-two women and 19 men consecutively operated for primary temporal bone SCC with a curative intent at a tertiary referral center between 1980 and 2008. Results On univariate analysis, cT stage correlated with disease-free survival in months (DFS) (P=0.037), and pT stage correlated with recurrence rate (P = 0.038), DFS (P = 0.013), and disease-specific survival (DSS) (P = 0.025). Lymph node status (cN0 or pN0 vs. pN+) was associated with DFS (P = 0.025). SCC grading correlated significantly with recurrence rate (P = 0.005), DFS (P = 0.004), and DSS (P = 0.0036). Dura mater involvement was significantly associated with a higher recurrence rate (P = 0.001), a shorter DFS (P = 0.00001), and a lower DSS (P = 0.0001). On multivariate analysis, only dura mater involvement (P = 0.001) and N status (P = 0.012) remained independently prognostic of DFS. Conclusion Recurrences occurred despite obtaining block resections according to the tumor's clinical stage and pathologically free margins in all cases. Further analyses are mandatory to investigate hidden microscopic pathways of tumor diffusion, particularly in bone. Multi-institutional protocols are needed to facilitate comparisons between studies and enable meaningful meta-analyses. © 2013 The American Laryngological, Rhinological and Otological Society, Inc. Source

Background: Ear infection is highly prevalent worldwide. In the older child, long-standing Chronic Supparative Ottitis Media can result in a severe conductive hearing loss with significant drawbacks in learning, communication, and social adjustment. It is associated with hearing impairment, death, and severe disability due to central nervous system involvement in developing countries. Objective: To determine the bacteriological profile and antibacterial resistance of ear infection from patients seen at Ear Nose and Throat clinic of Hawassa University Referral Hospital. Materials and Methods: A cross-sectional study was conducted at clinic of Hawassa University Referal Hospital. Result: A total 117 study subjects included in this study from June 2013 to October 2013. Among these, 57 (48.7%) were male and 53 (45.3%) were children. Bacteria identified from positive ear swabs were: Staphylococcus aureus 24 (20.5%), Pseudomonas aeroginosa 17 (14.5%), Klebsiella species 10 (8.5%), Proteus species 7 (6.0%), Entrobacter species 4 (3.4%), Escherchia coli 3 (2.6%), Citrobacter species 2 (1.7%), and Providentia species 2 (1.7%). The overall sensitivity and resistance profile of antibacterial agent, Amikacin (90.0%) and Gentamycin (89.1) showed high level of antibacterial effect on all identified bacterial species. On other hand, all isolates were highly resistance to ampicilin (87.5%), oxacillin (84.0%), ceftriaxone (82.8%), cephalotin (81.4%), and penicillin G (73.8%). Conclusion: Most of the isolates were resistant to commonly prescribed drug in the area. However, Amikacin and Gentamycin were highly active against the isolated organism, whereas Ciprofloxacilin was moderately active. Therefore, culture and susceptibility test is vital for appropriate management of ear infection in study area. © 2014 Indian Journal of Otology. Source

Toll E.C.,University College London | Nunez D.A.,ENT Unit
Journal of Laryngology and Otology | Year: 2012

Background: Acute otitis media is very common, but diagnostic criteria and treatment recommendations vary considerably. Methods: Medline, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were searched using the key words 'acute otitis media' AND 'diagnosis' OR 'diagnostic criteria' OR 'definition', and by combining the terms 'acute otitis media' AND 'guidelines'. PubMed was searched using the key words 'mastoiditis' and 'prevalence'. Results: The 11 most recently published guidelines unanimously agreed that adequate analgesia should be prescribed in all cases. The majority recommended that routine antibiotic prescription should be avoided in mild to moderate cases and when there was diagnostic uncertainty in patients two years and older. Antibiotics were recommended in children two years and younger, most commonly a 5-day course of amoxicillin (or a macrolide in patients allergic to penicillin). Conclusion: Level 1A evidence shows that selected cases of acute otitis media benefit from antibiotic prescription. © 2012 JLO (1984) Limited. Source

Toraldo D.M.,Respiratory Care Unit | De Nuccio F.,University of Salento | De Benedetto M.,ENT Unit | Scoditti E.,CNR Institute of Clinical Physiology
Acta Otorhinolaryngologica Italica | Year: 2015

Obstructive sleep apnoea syndrome (OSAS) is associated with severe cerebro-cardiovascular morbidity and mortality. It is an independent risk factor for atherosclerosis, arterial thrombosis and metabolic syndrome, and recently has been associated with an increased incidence of cancer and death. A causal link between OSAS and atherosclerosis has been partially established. Recent research on atherosclerosis in OSAS has focused on thrombotic tendency and blood viscosity, providing new insight into disease mechanisms. Hypoxia is a critical pathophysiological element in OSAS that leads to intensive sympathetic activity, in association with inflammation, oxidative stress and procoagulant activity. Hypoxia and the induction of oxidative stress can simultaneously represent an underlying mechanism in the pathogenesis of cancer development and progression. This mini-review will discuss the latest findings on the association and potential relationship between OSA and pathological vascular sequelae. © 2015, Pacini Editore S.p.A. All Rights Reserved. Source

Ibrahim S.I.,National University Hospital Singapore | Nunez D.A.,ENT Unit
Journal of Laryngology and Otology | Year: 2010

Aim: Meningitis is the commonest intracranial complication of suppurative otitis media, and carries the risk of death and life-changing morbidity. This study aimed to estimate the risk of an adult in the UK developing otogenic meningitis.Methods: Adults hospitalised with meningitis in Bristol from 1997 to 2002 were identified retrospectively. Cases confirmed by positive blood culture or cerebrospinal fluid investigation were studied. A case was classified as otogenic if there was coexistent evidence of ear infection.Results: Eighty-seven cases of meningitis were analysed. The overall mortality rate was 5.7 per cent. Acute and chronic suppurative otitis media accounted for 13 and three cases, respectively. The adult population of Bristol at the midpoint of the study was 635 976.Conclusion: In this study, the age-adjusted incidence of otogenic meningitis was 0.42 per 100 000 per year. Copyright © JLO (1984) Limited 2010. Source

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