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Eleftheriadou A.,General Hospital of Rethymnon | Skalidi N.,General Hospital of Rethymnon | Velegrakis G.A.,University of Crete
European Archives of Oto-Rhino-Laryngology | Year: 2012

Ever since the introduction of Cawthorne- Cooksey exercises, vestibular rehabilitation (VR) has been gaining popularity in the treatment of the dizzy patient. Numerous studies support the effectiveness of VR in improving balance/walking skills, eye-head coordination and the quality of life of the patient. Different rehabilitation protocols have been used to treat patients with peripheral and central vestibular disorders. Assessment of the patients' progress is based on the patients' selfperception of dizziness and their functional skills. Factors such as age, medication, time of onset of vertigo and home based VR have been evaluated on their effect on the rehabilitation's outcome. The aim of this review is to evaluate rehabilitation strategies and discuss the factors that affect the outcome. © Springer-Verlag 2012.

Giotakis E.,National and Kapodistrian University of Athens | Eleftheriadou A.,General Hospital of Rethymnon | Ferekidou E.,National and Kapodistrian University of Athens | Kandiloros D.,National and Kapodistrian University of Athens | And 2 more authors.
B-ENT | Year: 2010

Background: Endoscopic sinus surgery has become popular for the management of sinonasal inverted papillomas (IP). Objective: The purpose of this report is to review our 13 years of experience in managing IPs. Methods: Retrospective chart study. Sixty-seven patients with sinonasal IPs were treated in our department from 1991 to 2004. Seventeen were managed using an endonasal non-endoscopic approach, 39 endoscopically, 8 through external techniques, and the remaining 3 using a combined approach. Results: After 1994, as we gained experience using endoscopic sinus surgery, most cases were treated endoscopically. In only 3 cases, where the tumour attachment site was in the lateral / anterior wall of the maxillary sinus and in the lateral wall of the frontal sinus, could the lesions not be accessed by extended endoscopic techniques, and an appropriate combination with external methods was required. The mean follow up period was 91 (range, 36-146) months. The recurrence rate was 59% using an endonasal non-endoscopic approach, 12.5% using an external incision, and 12.8% using endoscopic techniques. Average time to recurrence was 15 months. Conclusion: Our findings suggest that endoscopic sinus surgery for sinonasal IP is a viable approach, with a low rate of recurrence and minor morbidity. Complete tumour resection at the site of attachment, including a surrounding rim of normal mucosa and drilling the underlying bone, is the key to successful treatment when it is combined with the preservation of healthy tissue. Non-endoscopic endonasal surgery is no longer a treatment option because the recurrence rate is too high.

Iacovou E.,National and Kapodistrian University of Athens | Chrysovergis A.,National and Kapodistrian University of Athens | Eleftheriadou A.,General Hospital of Rethymnon | Yiotakis I.,National and Kapodistrian University of Athens | Kandiloros D.,National and Kapodistrian University of Athens
Acta Otorhinolaryngologica Italica | Year: 2011

The case is presented of a 73-year-old male with a history of right-sided nasal obstruction, hyponasal speech and three episodes of recurrent epistaxis. On examination, there was a tumour in the right nasal cavity. Computed tomography showed a mass in the right nasal cavity extending to the right maxillary sinus, ethmoidal cells and right sphenoid sinus. The patient underwent a functional endoscopic removal of the tumour. Biopsy revealed a small cell neuroendocrine carcinoma. This is an extremely rare tumour of the nasal cavity and sinuses. Because of the aggressive behaviour of this tumour, he was also treated with combined chemotherapy and radiation. Ten months later, he remains free of disease.

Chara L.,General Hospital of Rethymnon | Eleftherios V.,George Papanikolaou General Hospital | Maria M.,University General Hospital | Anastasia T.,George Papanikolaou General Hospital | Chryssoula S.,Aretaieion Hospital
Indian Journal of Anaesthesia | Year: 2014

Background and Aims: Difficult airway assessment is based on various anatomic parameters of upper airway, much of it being concentrated on oral cavity and the pharyngeal structures. The diagnostic value of tests based on neck anatomy in predicting difficult laryngoscopy was assessed in this prospective, open cohort study. Methods: We studied 341 adult patients scheduled to receive general anaesthesia. Thyromental distance (TMD), sternomental distance (STMD), ratio of height to thyromental distance (RHTMD) and neck circumference (NC) were measured pre-operatively. The laryngoscopic view was classified according to the Cormack-Lehane Grade (1-4). Difficult laryngoscopy was defined as Cormack-Lehane Grade 3 or 4. The optimal cut-off points for each variable were identified by using receiver operating characteristic analysis. Sensitivity, specificity and positive predictive value and negative predictive value (NPV) were calculated for each test. Multivariate analysis with logistic regression, including all variables, was used to create a predictive model. Comparisons between genders were also performed. Results: Laryngoscopy was difficult in 12.6% of the patients. The cut-off values were: TMD ≤7 cm, STMD ≤15 cm, RHTMD >18.4 and NC >37.5 cm. The RHTMD had the highest sensitivity (88.4%) and NPV (95.2%), while TMD had the highest specificity (83.9%). The area under curve (AUC) for the TMD, STMD, RHTMD and NC was 0.63, 0.64, 0.62 and 0.54, respectively. The predictive model exhibited a higher and statistically significant diagnostic accuracy (AUC: 0.68, P < 0.001). Gender-specific cut-off points improved the predictive accuracy of NC in women (AUC: 0.65). Conclusions: The TMD, STMD, RHTMD and NC were found to be poor single predictors of difficult laryngoscopy, while a model including all four variables had a significant predictive accuracy. Among the studied tests, gender-specific cut-off points should be used for NC.

Gkoulioni V.,Surgery Academy | Eleftheriadou A.,General Hospital of Rethymnon | Yiotakis I.,National and Kapodistrian University of Athens | Ferekidou E.,National and Kapodistrian University of Athens | And 3 more authors.
Anticancer Research | Year: 2010

Aim: To study the potent efficacy of the immunomodulatory agent imiquimod when applied on dysplastic lesions of the oral mucosa. Materials and Methods: Carcinogen (DMBA) was applied to the mucosa of the left buccal pouch of 26 male Wistar rats for 8 weeks, until dysplastic lesions were observed and histologically diagnosed. At the second phase of the experiment, 5% imiquimod cream was applied to these dysplastic lesions for 16 weeks. Biopsies were taken before and after treatment. Results: The histological effect of imiquimod was the regression of mild dysplasia to hyperplasia for all the samples. In one case, a well-differentiated squamous cell carcinoma was converted to a papilloma-like squamous neoplasm with a benign morphology. Conclusion: Our results indicate that imiquimod may be effective in treatment of precancerous lesions of the oral mucosa and thus inhibit the progress of carcinogenesis.

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