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Biomedical subjects

C Zini

Publications and source records attributed to C Zini.

At least 37 records · Page 2Linked to original sources
PubMed1990

Primary intratemporal tumours of the facial nerve: diagnosis and treatment.

Benign primary tumours of the facial nerve are uncommon. A slowly progressive facial palsy should be considered the result of a nerve tumour until proven otherwise. Improvements in diagnostic imaging techniques of the temporal bone have increased the possibility of a correct pre-operative diagnosis but facial nerve tumours remain a frequently ignored or misdiagnosed entity as a consequence of their subtle and protean clinical manifestations. A series of 12 cases of primary facial nerve tumours is presented. The clinical features, diagnostic modalities and treatment are discussed in relation to a review of the literature.

Adult↗
PubMed1990

Inner ear cholesteatoma and the preservation of cochlear function.

Labyrinthine destruction by direct cholesteatoma invasion has always been considered a serious threat to the inner ear function. A number of reports in the literature have cited both patients who had preservation of hearing despite widespread erosion of the labyrinth by cholesteatoma and patients who had retained auditory function despite surgical removal of the matrix from the labyrinth. In most cases the vestibular portion of the inner ear was invaded but cases of cochlear involvement have been described as well. Twelve cases with pre-operative auditory function preservation despite extensive labyrinthine destruction treated at our Institution are reported. Seven cases retained cochlear function post-operatively. Possible explanations of this occurrence and implications of related with hearing preservation in the presence of widespread inner ear destruction by chronic inflammatory disease are discussed.

Adult↗
PubMed1988

Retrolabyrinthine versus middle fossa vestibular neurectomy.

The authors' experience in treating incapacitating peripheral vertigo using the middle cranial fossa (MCF) and the retrolabyrinthine (RL) approaches is presented. Among 94 operated cases, 56 have been treated using the MCF approach and 38 the RL approach. In 18 of the RL cases, a simple vestibular neurectomy has been associated with different adjunctive techniques (i.e., drainage of the endolymphatic sac, section of the Wrisberg intermediary nerve, and neurovascular decompression of the eight nerve) in an attempt to influence the disease from a pathogenetic viewpoint. The RL approach has demonstrated to be a valid alternative to the MCF approach, since it allows the same results to be obtained in the control of vertigo, with fewer risks to the facial nerve and hearing functions. Moreover, it allows the association, although still in an experimental way, of the simple vestibular neurectomy and the other "pathogenetic" methods mentioned above.

Adult↗
PubMed1988

Closed versus open technique in the management of labyrinthine fistulae.

A labyrinthine fistula is the most common complication of cholesteatomatous chronic ear disease. Its treatment remains a controversial subject. The present paper reports our approach to the management of this complication. Operations were performed on 1,226 cases of chronic otitis media with cholesteatoma between January 1971 and December 1985. A labyrinthine fistula was detected in 158 cases. We favor intact canal wall tympanoplasty even in the presence of medium or large fistulas: in the latter case, the matrix is not removed but is trimmed to cover only the bony defect and it is left in place. Open procedures with the preservation of the matrix over the fistula are done in an only-hearing ear with fistula, in ears with a wide defect of the posterior canal wall, and in ears with multiple labyrinthine fistulas. The management of the matrix over the fistula and the anatomic and functional results following each type of procedure are presented and discussed.

Cholesteatoma↗
PubMed1987

Facial-nerve and vocal-cord monitoring during otoneurosurgical operations.

We describe a newly developed instrument to monitor facial muscles and vocal-cord function during neurosurgical and otoneurosurgical operations. The device (Myo-Alarm) transforms into acoustic signals the pressure variations that are induced by facial muscles and vocal-cord contractions on air-inflated rubber sensors that are positioned, respectively, beneath the superior lip and between the vocal cords. It represents an effective and dependable method to monitor facial and vocal-cord functional preservation during surgery.

Ear↗
PubMed1987

The surgical management of childhood cholesteatoma.

The results of treatment of 124 cases of childhood cholesteatoma are reported in the present study and compared with an adult group of patients. Intact canal wall tympanoplasty was performed in over 90 per cent of cases in children and the procedure was staged in nearly 80 per cent of cases. The children had a 43.8 per cent incidence of residual cholesteatoma and an 8.8 per cent incidence of recurrent cholesteatoma in intact canal wall tympanoplasty cases. Intact canal wall tympanoplasty remains the technique of choice in our hands for the treatment of childhood cholesteatoma; pre-planned staging of the operation is mandatory for the detection and elimination of residual cholesteatoma which occurs more frequently in children.

Adolescent↗
PubMed1987

Hearing preservation in acoustic neuroma surgery. Middle fossa versus suboccipital approach.

Over the past few years there have been reports discussing the preservation of hearing after the removal of acoustic neuromas through the middle cranial fossa or the suboccipital approaches. This is a complex issue with many facets and controversies. In an attempt to answer at least some of these controversies, this article reviews the experience of our group. Preservation of hearing was attempted in thirty-four cases out of 220 acoustic neuromas. In twenty cases the middle fossa approach was used: All tumors were less than 2 cm from the fundus, and in four patients the tumor was bilateral. In sixteen of the twenty (80%) the cochlear nerve was spared; in ten of twenty (50%) measurable hearing was retained, but in only four (20%) was the postoperative hearing serviceable according to the 50/50 rule. In fourteen cases the suboccipital approach was used: All but two of the tumors were smaller than 2 cm. In three patients the tumor was bilateral. The cochlear nerve was preserved in ten of the fourteen cases (71.4%). Measurable hearing was present in four of fourteen cases postoperatively (28.6%); none had serviceable hearing according to the 50/50 rule. Hearing was not preserved in any bilateral tumor case. The middle fossa and the suboccipital approaches are discussed as well as the relative merits of each procedure in preservation of hearing.

Adult↗
PubMed1986

Regenerated middle ear mucosa after tympanoplasty. Part I. Transmission electron microscopy.

The ultrastructural appearance of the regenerated middle ear mucosa--found at the second operation of staged intact canal wall tympanoplasty (ICWT) with mastoidectomy--has been evaluated with the transmission electron microscope. The regenerated epithelium showed all the morphologic characteristics of the normal middle ear mucosa: ciliated cells, nonciliated cells, and secretory cells. All of these (including goblet cells) have been found in the specimens. It is concluded that a normal middle ear mucosa regenerates to cover all denuded bone surfaces after the first operation of staged ICWT with mastoidectomy, when silicone rubber sheeting has been used to prevent adhesions and maintain an air-containing middle ear space.

Biopsy↗
PubMed1986

Regenerated middle ear mucosa after tympanoplasty. Part II. Scanning electron microscopy.

The ultrastructural appearance of the regenerated middle ear epithelium, found at the second operation of staged ICWT with mastoidectomy, has been investigated herein with the scanning electron microscope. The regenerated epithelium consists of flat nonciliated cells, "elevated" nonciliated cells with microvilli, and ciliated cells. Secretory material is present on the surface of the "elevated" nonciliated cells surrounding the ciliated ones. Regeneration of the mucosa occurs following precise topographic differences that mimic the distribution of epithelial cells in the normal middle ear. It is confirmed that a morphologically normal middle ear epithelium regenerates to cover all denuded bone surfaces within 12 months--after first stage ICWT with mastoidectomy--when silicone rubber sheeting has been used to maintain an aerated middle ear and mastoid space.

Cilia↗
PubMed1986

Posterior canal wall atrophy after intact canal wall tympanoplasty.

The present study investigates the occurrence of asymptomatic posterior canal wall breakdowns following intact canal wall tympanoplasty (ICWT) with mastoidectomy. Twenty-four ears out of 501 (4.8%) presented with a posterior canal wall atrophy. A partial defect was found in 15 ears (62.5%), while a subtotal or total atrophy occurred in the remaining nine ears (37.5%). Posterior wall atrophy could be considered among ICWT complications during follow-up visits, but, according to our investigation, its incidence remains low.

Atrophy↗