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Biomedical subjects

C Zini

Publications and source records attributed to C Zini.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1985

High resolution O2 computed meatocisternography in the differential diagnosis of internal auditory canal pathology.

Recent introduction of O2 computed tomography cisternography and imaging with high resolution program have greatly improved the detection and preoperative evaluation of acoustic neuromas and other possible pathologies of the internal auditory canal. Sixty patients have been evaluated following the diagnostic protocol given in the text. Based on our results and on the experience as reported in literature HRO2CTC proved to be the most reliable method for detection and exclusion of intracanalicular and small extracanalicular acoustic neuromas and other pathologies at the internal auditory canal level.

Adolescent↗
PubMed1985

Autologous fitted incus versus Plastipore PORP in ossicular chain reconstruction.

Hearing results and causes of failure with three types of ossicular reconstruction techniques over an intact stapes, during second-stage intact canal wall tympanoplasty, are reported herein. The three types of reconstruction are: fitted autologous incus (38 cases); Plastipore PORP with cartilage (41 cases); Plastipore PORP without cartilage (32 cases). A residual air-bone gap within 15 dB. was found in 63.2 per cent of fitted includes, in 41.5 per cent of PORPs with cartilage, and in only 37 per cent of PORPs without cartilage. Eighty-four per cent fitted incudes, 63 per cent PORPs with cartilage and 44 per cent PORPs without cartilage yielded a residual air-bone gap within 25 dB. Extrusion has been the main cause of failure among Plastipore prostheses.

Biocompatible Materials↗
PubMed1985

Transmastoid extralabyrinthine approach in traumatic facial palsy.

Our experiences with thirty-six cases of intratemporal facial nerve palsies using the transmastoid extralabyrinthine (TMEL) approach are reported. Palsies were mostly traumatic in origin. The technique, first developed by us and reported in May 1980, spares the labyrinth and has the same indications for use as the middle cranial fossa approach to the seventh nerve. It avoids craniotomy and overcomes the limitations of the classic transmastoid approach, allowing exploration of the nerve from the descending portion to the geniculate ganglion and surrounding regions. When the ossicular chain is already damaged by trauma, surgery is made easier by removal of the head of the malleus and of the incus, which are then transposed at the end of surgery to reconstruct the chain. In particular cases the technique can also leave the chain intact. The TMEL approach has been used in 89% of patients with traumatic palsies due to longitudinal temporal bone fractures, with either an intact or, more often, a disconnected chain. Results of facial nerve and hearing function tests at twelve months are reported in detail. Our approach and similar techniques used by other authors represent an alternative to House's middle cranial fossa and Pulec's combined operations. Morbidity rate is lower and the operation can be performed by the majority of otologic surgeons.

Ear Ossicles↗
PubMed1985

Molded tympanic heterograft. An eight-year experience.

Between 1974 and 1983 the molded tympanic heterograft has been employed in over 1500 cases of tympanic membrane reconstruction at the Second ENT Clinic of the University of Parma, Italy. The results obtained in 1042 patients operated on from July 1974 to December 1981 are reported herein. The tympanic heterograft offered our patients a 90% chance of cure and anatomic restoration of the middle ear; a functional recovery and serviceable hearing can be expected in more than 85% of cases. The heterograft is available in sealed sterilized vials that can be stored at room temperature; its sterility can be maintained for up to five years. There is no need for a graft bank because the heterograft can be kept in the operating theater among the other prostheses that are readily available to the surgical team.

Animals↗
PubMed1985

Surgical treatment of brain herniation into the middle ear and mastoid.

A series of thirty-five patients operated on for brain herniation into the middle ear and mastoid is presented. The etiologic factor was felt to be previous surgery in twenty-six cases, head trauma in four cases, chronic otomastoiditis in four cases, congenital dehiscence of the tegmen in one case, and subdural empyema in one case. Diagnosis and treatment of brain herniation are discussed. The mastoid approach for repair of tegmen defects from below with the use of homologous cartilage or autologous cortical bone is advocated. A combined procedure using the transmastoid approach plus a mini-craniotomy of the temporalis squama is suggested as an alternative treatment to middle cranial fossa repair for larger cerebral hernias.

Adolescent↗
PubMed1984

Management of the labyrinthine fistula in cholesteatoma surgery.

The presence of a labyrinthine fistula has remained one of the major problems in cholesteatoma surgery. Confronted with this problem, the surgeon may ultimately base his choice of procedure on four basic conditions: the size of the fistula, its location in the ear, the condition of the other ear, and the cochlear function. Our attitude has been changing, and currently we prefer to perform a staged closed tympanoplasty. When a closed technique is performed, we either remove the cholesteatoma matrix and then cover the fistula immediately or we leave the matrix in situ and re-explore the mastoid process 5 or 6 months later. The series consists of 88 cases out of a total of 701 patients with cholesteatoma operated on between January 1971 and June 1982. In 20 patients the matrix was left over the fistula at the first stage. The results suggest that a staged operation, i.e. closed tympanoplasty, is to be preferred even in cases with an extensive labyrinthine fistula.

Cholesteatoma↗
PubMed1984

Failures with Plasti-Pore ossicular replacement prostheses.

Plasti-Pore ossicular prosthesis failures found in our series of 246 patients with regular follow-up are reported and analyzed. Extrusions as well as poor functional results (postoperative air-bone gap greater than 25 dB) of the prostheses with and without cartilage on top have been reviewed. The overall extrusion rate was 9.3%: a higher extrusion rate occurred with prostheses without cartilage (18.4%) than with cartilage (4.4%). Thirty-six patients among those with poor postoperative hearing improvement have undergone revision surgery: the main causes of failure were a short prosthesis, a fixed stapes or footplate, adhesions of the prosthesis to surrounding structures, and the displacement of the prosthesis.

Cochlear Implants↗
PubMed1984

Histology of extruded Plasti-Pore ossicular prostheses.

Twenty-three Plasti-Pore ossicular prostheses removed from the human middle ear following partial or total extrusion were investigated by light microscopy. No specific tissue reaction other than the ingrowth of histiocytic cells elicited from the porous Plasti-Pore was found. The only histologic feature typical of extruded prostheses was the presence of granulocytes in all parts extruded. In our opinion this finding was the inflammatory reaction following the ischemic necrosis of tissue grown inside the pores and the superimposed bacterial colonization. We concluded that no histologic feature supports a biologic cause of extrusion, and that extrusion instead is related to biofunctional characteristics.

Cochlear Implants↗
PubMed1984

"Congenital cholesteatoma" of the middle ear. A report of 11 cases.

This article is based on a report presented at the Second International Conference on Cholesteatoma and Mastoid Surgery, in Tel Aviv, in March 1981. The principal aim is to illustrate our personal experience with the so-called congenital cholesteatoma of the middle ear, that is, a cholesteatoma growing inside the tympanic cavity affecting subjects with no inflammatory processes in their clinical history and a perfectly normal eardrum. Eleven cases out of a total of 429 cases with cholesteatoma (2.56%) operated on at the Otorhinolaryngology Clinic II of Parma are reported. All patients--nine children and two adults--underwent a combined-approach closed tympanoplasty. The diagnostic stages are analyzed in particular, as well as the clinical and impedance audiometric data, which are correlated with surgical findings. Pathogenetic mechanisms are discussed briefly. The need for screenings to be carried out in schools and an accurate evaluation of all unilateral impairments in hearing conduction are emphasized with a veiw to early diagnosis.

Adult↗
PubMed1984

Residual and recurrent cholesteatoma in closed tympanoplasty.

There are actually two principal approaches to the surgical treatment of middle ear cholesteatoma, a subject very much debated. First, the cholesteatoma can be exteriorized and treated with an open technique (classic or modified radical mastoidectomy, open tympanoplasty); and second, the radical removal of the cholesteatoma is also possible in the majority of cases by closed tympanoplasty. In this article we examine 283 patients (forty-four children and 239 adults) operated on by the closed technique to review and discuss the postsurgical cholesteatoma problem (residual and recurrent). Total incidence of residual cholesteatoma is 13.43 percent. It is higher in children (25 percent) than in adults (11.72 percent) and is more frequently localized in the mesotympanum (47.54 percent) than in the epitympanum (40.98 percent) or in the mastoid (6.56 percent). Recurrent cholesteatoma, with a total incidence of 7.77 percent, is much less frequent when staged tympanoplasty has been performed than when a one-stage operation has been done. No endotemporal or endocranial complications (labyrinthine fistula, facial nerve paralysis) have been noticed in cases of postsurgical cholesteatoma. These data confirm the opinion that staged tympanoplasty with Silastic sheeting and reconstruction of the erosions of the posterior wall is the technique of choice for surgical therapy of middle ear cholesteatoma.

Adult↗
PubMed1982

Regenerated middle ear mucosa after tympanoplasty.

The surgeon's attitude towards the diseased middle ear mucosa during intact canal wall tympanoplasty has remained a controversial problem. Our approach consists of the complete removal of the irreversibly diseased mucosal lining. A planned staged operation has been carried out in most cases of tympanoplasty with the use of Silastic sheeting. At the time of the second operation, the middle ear and mastoid process appear to be lined by the regenerated mucosa and pneumatized. 54 mucosal biopsies taken during the second stage of the operation showed a normal flat, cuboidal and pseudostratified ciliated epithelium with functional features (secretory granules, microvilli and cilia). It is concluded that the diseased middle ear mucosa can be removed whenever necessary during staged closed-tympanoplasty operations because under the Silastic sheeting the mucosa will be regenerated within 12 months.

Biopsy↗
PubMed1982

Enhanced biofunctionality of plastipore ossicular prostheses with the use of homologous cartilage.

Functional results with Plastipore prostheses inserted in 150 staged intact canal wall tympanoplasties at our Clinic are reported. Two groups of patients have been reviewed: The first group consists of those cases in which the prosthesis is directly in contact with the tympanic graft (77 cases); the second one comprises all cases with interposition of homologous cartilage between the head of the prosthesis and the tympanic graft (73 cases). The aim of this article is to see whether extrusion rate and audiometric and impedance result differences exist between the two groups. We have found a 15.4 percent extrusion rate in the group without cartilage but only a 1.9 percent rate in the group with cartilage (9.3 percent is the overall extrusion rate). There were no substantial differences in functional results between the two groups. It is valuable to outline the different functional results between the two types of prosthesis: TORPs got 56.8 percent excellent results and 78.4 percent good results, while PORPs had only 47.7 percent excellent results and 60 percent good results. Normal compliance (static compliance greater than 0.3 cc) was found in 61.6 percent of cases without cartilage and in 46.7 percent of cases with cartilage.

Biocompatible Materials↗
PubMed1979

[On laryngectomy reconstructive according to Labayle (author's transl)].

The Authors bring out the results of 8 patients on laryngectomy reconstructive according to Labayle. The Authors think that this type of operation with the precise indication will be positive without fail regarding the function of formation and deglutition. The don't think to express their opinion with regarding the neoplastic disease, because the time is relatively short from the time of operation.

Adult↗