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Biomedical subjects

A R Antonelli

Publications and source records attributed to A R Antonelli.

54 records · Page 3Linked to original sources
PubMedDate not supplied

Sphenoid mucocele with intracranial invasion secondary to nasopharyngeal acinic cell carcinoma.

We present a case of sphenoid mucocele with large invasion of the middle cranial fossa, secondary to a nasopharyngeal acinic cell carcinoma, occurring in a 52-year-old man. To the best of our knowledge, this association has not been reported so far. We discuss the importance of imaging techniques in delineating the relationship between the two lesions, as long as the clinical and therapeutic problems related both to sphenoid mucocele and acinic cell carcinoma.

Carcinoma↗
PubMedDate not supplied

The relationship of head and brainstem size to main parameters of ABR in the developmental age and in adults.

In a previous investigation the relationship between head size and main parameters of ABR, i.e. waves absolute latencies and interwave delays, was studied in 55 subjects (1). Significant and positive correlation coefficients were found between I-V I.P.I. and the sum of head circumference, nasion-inion, and intertragal distances in the age range 7 to 11 years only and not in adult age. The purpose of the present study was to verify whether in 11 adults a correlation could be demonstrated between ABR parameters and two axial measures of brainstem length, calculated on MRI views. A positive and significant coefficient was found to exist between these measures and I-V I.P.I. and wave V absolute latency.

Adolescent↗
PubMedDate not supplied

Masking level difference: another tool for the evaluation of peripheral and cortical defects.

Masking level difference (MLD) due to binaural unmasking was measured for speech signals (5-word meaningful sentences) masked by broad-band noise. Tests were carried out in a group of patients with unilateral cerebral lesions of vascular origin and apparently normal pure-tone audiograms (CNS patients), in a control group (normally hearing young adults) and in 5 other groups of patients (conductive symmetrical hearing loss, conductive asymmetrical hearing loss, bilateral presbyacusis, unilateral sudden deafness, Menière's disease). Testing pattern implied three or more S/N ratios in the listening conditions, of SmNm, Sdelta tNo and SmNu (noise correlated), and the speech signal intensity was 70 dB SPL re 20 muPa for the control group, whilst for the pathological cases, speech level intensities were established by means of alternate binaural loudness balance and simultaneous balancing median-plane localization procedures to assess subjective suprathreshold sound image localization at the midline. The results obtained in the control group and in the patients are discussed. With specific reference to the CNS patients, a statistically significant tendency was evident for the binaural condition to produce more MLD when the ear leading in time was ipsilateral to the normal hemisphere. The importance of this and of sensitized speech testing methods in CNS disorders is discussed on the basis of the results obtained in the CNS patients.

Acoustic Stimulation↗
PubMedDate not supplied

Intensity and frequency discrimination monitored by evoked response audiometry: clinical application.

Delta 1 and delta f repetitive stimuli superimposed on continuous 0.5-, 1- and 4-kHz carrier tones were administered to 20 normally hearing persons, 8 adults with sensorineural hearing loss, 10 adults with conductive hearing loss and 22 children subjected to evoked response audiometry (ERA) for assessment of hearing acuity. The intensity modulation depth ranged from + 1 to 10 dB. In the subjects with normal hearing and in the adult patients, three carrier tone levels were used whenever possible: 20, 40, and 60 dB SL. The frequency modulation depth ranged from -1 to -10% of the carrier tone frequency. The same levels for the carrier tone were used: 20, 40, and 60 dB SL. With a carrier tone level of 20 dB SL, a clear-cut vertex response was noted in 80% of the tests carried out in the normal adults with 5-dB delta i stimuli and with delta f stimuli of -3 to -5% in magnitude; the same figures are valid for the patients with sensorineural and conductive hearing loss. The patients with sensorineural hearing loss showed a tendency to give vertex responses with lower delta i stimuli than subjects with normal hearing. However, this difference was not statistically significant. According to our results, the children tested can be roughly divided into two groups, the first including subjects with responses to delta i stimuli of +5 and +10 dB and delta f stimuli of -5% and -10%; the second group including subjects with no clear-cut responses to these stimuli.

Acoustic Stimulation↗
PubMedDate not supplied

[Management of lymph node metastases in well-differentiated and medullary thyroid cancer: retrospective study on 52 cases].

OBJECTIVE: To define the surgical principles of neck dissections as applied to the head and neck squamous cell carcinomas, extending their rationale to treatment of lymph nodes metastases from thyroid carcinomas. MATERIALS AND METHODS: Between January 1994 and June 2002, 52 patients affected by well-differentiated thyroid cancers (1 follicular, 9 medullary, and 42 papillary cancers) underwent uni- or bilateral neck dissections at our Department, for a total of 73 neck dissections. Patients were subdivided into 2 groups: 37 simultaneously treated on the thyroid and the neck (Group A), and 15 operated elsewhere on the thyroid and for a neck recurrence and/or persistence at our Department (Group B). RESULTS: 48 patients underwent a regular follow-up (range: 3-86 months, mean: 38). Among patients alive with disease, 5 in Group A and 4 in Group B had a local-regional recurrence. In particular, 2 patients for each group (2 medullary and 2 papillary cancers) had a regional recurrence on the N site, at the level of one or more lymph nodes "in field" as regards the neck dissection previously performed. Moreover, in all these patients a local recurrence on the T site has been observed. DISCUSSION: Lymph nodes metastases have a minor prognostic impact in well-differentiated thyroid cancers in respect of the rest of head and neck cancers. Nonetheless, when performing a curative or elective neck dissection, the gold standard surgical principles must be the same. As a matter of fact, a 20% incidence of lymph nodes metastases at the V level, often not specifically addressed in neck dissections for thyroid cancers, it is noteworthy. Aim of such an aggressive surgical approach of the neck is to obtain a low incidence of "in field" regional recurrences, which become no more amenable of a subsequent surgical salvage. CONCLUSION: Surgical techniques as lymphadenectomy or "pick-berry procedure" must be abandoned because they do not respect the basic anatomic, physiopathologic, and oncologic principles of neck dissections along cervical fasciae and spaces.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

[Laryngocele: analysis of 18 cases and review of the literature].

18 cases of laryngocele (8 combined, 6 external, 4 internal) treated at the E.N.T. Clinic from January 1968 to December 1989 are reported. The review of the literature is specifically focussed on some controversial issues (i.e. nomenclature, association with laryngeal cancer, pre-operative work-up, surgical procedures). The main symptoms at presentation have proved to be airway obstruction (44.4%), hoarseness (44.4%) and a cervical mass (44.4%). In 12 cases (66.6%) surgical excision was performed by means of an extralaryngeal approach, median thyrotomy was used in 2 cases (11.1%). In 4 cases (22.2%) in which the laryngocele was associated with a laryngeal cancer, a total laryngectomy proved necessary, four patients required a second operation for a recurrence of the laryngocele. Major complications included pyocele (33.3%) and acute airway obstruction (22.2%). CT scan proved to be the most accurate radiological method for defining the spatial relationship between the laryngocele and the laryngeal structures and extralaryngeal soft tissues, in differentiating the laryngoceles from other cystic formations and in identifying the co-existence of a laryngeal cancer. Surgery is the treatment of choice. An extralaryngeal approach, according to Stell and Maran (1975) provides the most adequate exposure of the laryngocele, preserving the integrity of the laryngeal framework. Only in cases of small internal laryngoceles can endoscopic CO2 laser excision be considered a valid alternative. Tracheotomy is usually not indicated.

Adult↗
PubMedDate not supplied

[Distribution of laminin, type IV collagen and fibronectin in normal, dysplastic and neoplastic laryngeal tissue].

The main components, both intrinsic (laminin and type IV collagen) and extrinsic (fibronectin), of the basement membrane (BM) were analyzed by immunohistochemical methods in normal, dysplastic and neoplastic laryngeal mucosa specimens. The material was obtained from 35 patients who had undergone surgery for glottic or supraglottic cancer. Fibronectin proved to be absent from normal mucosa whereas an immunopositivity was observed close to the dysplastic epithelium, especially around inflammatory cells. Positivity increased as the degree of dysplasia increased from LIN I to LIN III. A strong staining was also seen around nests of well and moderately differentiated squamous cell carcinoma. These findings are in agreement with the theories about the main sites of origin for fibronectin, both from plasma and connective tissue. Laminin and type IV collagen showed the same staining characteristics. In normal and mild dysplastic samples a regular and continuous positivity was found at the boundaries between the epithelium and the mesenchymal stroma. Focal discontinuities were present in areas of intense subepithelial inflammation only. Interruptions and reduplications were more evident in severely dysplastic epithelium. In invasive squamous cell carcinomas a strong correlation has been found between the degree of cell differentiation and the pattern of distribution of the intrinsic BM components. Immunostaining was usually evident and continuous around nests of well differentiated squamous cell carcinoma, whereas positivity progressively decreased in moderately and poorly differentiated neoplasms. Furthermore, staining for intrinsic BM components was also related to the pattern of tumor growth: continuous around the "pushing" edge of neoplastic growth and discontinuous when the neoplastic front had an "invading" appearance. These observations tend to support the theory which considers neoplastic growth a cyclic process. BM components are most likely synthesized during the phases of quiescence and reabsorbed during the phase of invasiveness, following shifts in neoplastic cell metabolism.

Basement Membrane↗
PubMedDate not supplied

[Intra-parotid lymph node metastasis of malignant skin neoplasms of the head].

More than 75% of parotid metastases represent a secondary localization in the parotid region lymph nodes of malignancies arising from the skin of the head. Among 94 parotidectomies performed at the Otolaryngologic Clinic of the University of Brescia in the years 1980-1987, 21 were primary malignant growths and of these 5 (23.8%) proved to be intraparotid lymph node metastases of previously resected cutaneous tumors of the face (1 melanoma and 4 squamous cell carcinomas). Parotid metastases were treated by lateral (3 cases) or total parotidectomy (2 cases) with preservation of the facial nerve; in 4 cases a homolateral neck dissection of the functional type was performed in the same session (N+ in 1 case only). Three out of four patients with squamous cell carcinoma were subsequently submitted to Co60 radiation therapy. Four patients died 1 to 22 months after the treatment: in three, death was due to a local recurrence or a distant metastasis; in 1 case to osteoradionecrosis with no signs of relapse of the tumor. One patient only treated with total parotidectomy, functional neck dissection (N-) and postoperative radiation therapy is still alive and free of disease 18 months after surgery.

Aged↗
PubMedDate not supplied

Auditory processing disorders and problems with hearing-aid fitting in old age.

The hearing handicap experienced by elderly subjects depends only partially on end-organ impairment. Not only the neural unit loss along the central auditory pathways contributes to decreased speech discrimination, but also learning processes are slowed down. Diotic listening in elderly people seems to fasten learning of discrimination in critical conditions, as in the case of sensitized speech. This fact, and the binaural gain through the binaural release from masking, stress the superiority, on theoretical grounds, of binaural over monaural hearing-aid fitting.

Acoustic Stimulation↗