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Biomedical subjects

G Bertino

Publications and source records attributed to G Bertino.

13 recordsLinked to original sources
PubMed2002

[Preliminary results in the use of polydimethylsiloxane textured elastomers (Bioplastique) in the treatment of leakage around tracheoesophageal voice prosthesis].

Leakage around the prosthesis is one of the worst problems afflicting patients fitted with tracheoesophageal (TE) voice prosthesis. Removing the prosthesis for a few days can reduce the size of the fistula, or the leakage may be eliminated simply by replacing the prosthesis. In cases that are refractory to such treatment, the perifistular injection of different types of autologous, heterologous or alloplastic substances has been proposed. A new kind of silicone, previously available abroad, has recently appeared on the Italian market as well; constituted by polydimethylsiloxane textured elastomers (Bioplastique) for soft tissue implants, it appears to guarantee excellent standards of long-term safety and stability. Three patients fitted with Provox2 tracheoesophageal voice protheses who had been experiencing leakage for about 4 months underwent Bioplastique implant procedures. The correction of the fistula size was easy to accomplish and well tolerated by the patients. There was no sign of inflammation, formation of granulomas or other pathological modifications, and the size of the fistula, together with its fluid-tightness, remained stable in time. From our point of view, the Bioplastique implant appears to provide valid and effective treatment of gaping TE fistulas.

Coated Materials, Biocompatible↗
PubMed2001

Voice restoration after circumferential pharyngolaryngectomy with free jejunum repair.

Speech restoration after circumferential pharyngolaryngectomy with free jejunal repair for advanced tumors of the hypopharyngo-esophageal tract remains a difficult problem to solve. We report here the results of secondary voice restoration in six patients who received a Provox 2 type prosthesis and intensive speech therapy after circumferential pharyngolaryngectomy with free jejunum repair. No patient had operative or post-operative complications due to insertion of the prosthesis. No patient had to have the prosthesis removed during the follow-up (8 to 14 months). Analysis of some acoustic parameters of voice (fundamental frequency, waveform perturbations) and qualitative characteristics of speech (intelligibility, pleasantness and acceptability) demonstrated that all the patients were able to produce satisfactory speech after tracheojejunum puncture and speech therapy and were satisfied with their own ability to communicate. Our results are reassuring and we therefore advise that in patients undergoing free jejunum flap reconstruction of the hypopharyngo-esophageal tract voice restoration should be attempted by placing a voice prosthesis through a secondary tracheo-esophageal puncture and providing intensive speech training.

Esophageal Neoplasms↗
PubMed2001

Acoustic analysis of voice quality with or without false vocal fold displacement after cordectomy.

Conventional cordectomy by means of a laryngofissure is one of the therapeutic options for treatment of early glottic cancer. To improve the poor voice quality related to this kind of operation, many authors have developed different techniques to repair the mucosal defect. We analyzed voice quality acoustically and compared it after cordectomy alone and after cordectomy with the reconstruction of the vocal cord in a group of 14 patients affected by T1 glottic carcinoma. All the patients underwent postoperative speech therapy. Three patients who underwent cordectomy with reconstruction showed the presence of diplophonia, while two patients without reconstruction showed the presence of bitonality. The differences of the acoustic parameters (jitter, shimmer, harmonic-to-noise ratio) between the two groups of patients were not statistically significant. Reconstruction of the vocal cord does not seem to improve voice quality after cordectomy even in combination with postoperative speech therapy.

Aged↗
PubMed2000

Laryngeal leiomyosarcoma.

We report one case of leiomyosarcoma (LMS) of the larynx occurring in a patient with a history of immunosuppressive therapy, and offer a critical review of the literature. Epstein-Barr virus (EBV) genome was not identified in the neoplastic cells. The patient was treated with endoscopic resection and post-operative radiotherapy. Lung metastasis and thyroid infiltration became evident 14 months following treatment despite the absence of laryngeal recurrence. Progressive decline occurred and the patient died 15 months after diagnosis.

Adult↗
PubMed2000

[Mini-invasive surgical approach for obstructive sleep apnea syndrome (OSAS). A case report].

It is well known that the obstructive sleep apnea syndrome (OSAS) is caused by the collapse of the pharyngeal walls and subsequent reduction in the diameter of all viscera. It is possible to increase the antero-posterior diameter by shifting the genioglosso muscle forward and suspending it; on the other hand the latero-lateral diameter can be achieved by sectioning the hyoid bone along the midline and through lateral fixation of the resulting stumps to the mandibula. This paper presents a clinical case of OSAS which underwent surgery using a procedure combining suspension of the genioglosso muscle and sectioning and suspension of the hyoid performed using a REPOSEa kit.

Humans↗
PubMed1999

Functional MR with use of FLASH sequences in the evaluation of the phono-articulatory tract.

The aims of this study are to determine visualization of normal phonation structures with the use of MR fast sequences and anatomical reference indices which can be used in evaluating upper resonator pathologies. A total of 12 normal subjects were studied, a 1 T system, a volumetric receiving head and neck coil and FLASH sequences for one sagittal and two coronal scans. Each subject was instructed to take a deep breath and then to produce the vowel sounds for the entire duration of the scan. The movement of the following anatomical structures were considered: lips, tongue, soft palate, pharynx and epiglottis. For each subject sagittal scans were used to measure the minimal palate tongue distance (p-t), the minimal anterio-posterior diameter of the mesopharynx (mp), and the epiglottis excursion angle (ep) with respect to the plane determined by the false vocal cords. Our results were compared with a diagrammed representation of tongue movements (vocal trapezium). This study underlines the validity of MR imaging techniques in the study of the phono-articulatory tract, because MR provided good detail of the phono-articulatory structures enabling an overall functional evaluation. MR would appear useful in evaluating defects in the velum and palate, in staging of oropharyngeal neoplasms and in surgical reconstructions of the tongue.

Adult↗
PubMed1999

A review of heterotopia and associated salivary gland neoplasms of the head and neck.

Salivary tissue neoplasms may involve normal, accessory and heterotopic salivary gland tissue. A case of Warthin's tumour originating from heterotopic salivary gland tissue of the upper neck is reported. The radioactive uptake of 131I, evidenced in the neck mass in its pre-diagnostic assessment, suggested a diagnosis of cervical node involvement from a primary malignant thyroid neoplasm. A critical review of the literature on heterotopic salivary gland tissue neoplasms of the head and neck is also presented.

Adenolymphoma↗
PubMed1998

Dynamic behavior of the Provox and Staffieri prostheses for voice rehabilitation following total laryngectomy.

The present study evaluated the differences in aerodynamic behavior between the 1990 Provox and 1986 Staffieri voice prostheses for total laryngectomy patients. Both prostheses were submitted to in vitro laboratory testing to assess their aerodynamic behavior under different conditions of air flow through the valve and tracheal side pressure. In addition, six patients using the Provox and another six using the Staffieri prostheses were submitted to a dynamic study of phonation. This latter study evaluated the intratracheal pressure corresponding to the different intensities at which the vowel sound /a/ was pronounced. In vitro measurements revealed significant differences between the two prostheses, with the best results achieved with Provox. In contrast, the in vivo measurements did not reveal any significant differences between the two groups of patients in the 50-79 dBSPL range, although there was some difference at intensities equal to or greater than 80 dBSPL. Again, in this latter case the best results were achieved with the Provox. However, the ideal prosthesis has yet to be found. In some patients, the so-called low-resistance prostheses fail to maintain their aerodynamic performances, most likely because anatomic resistors interfere with the effort (i.e., pressure) required to produce a voice. At present the choice of prosthesis is best determined on an individual patient-to-patient basis.

Aged↗
PubMed1998

[Analysis of qualitative voice and speech quality judgments after total laryngectomy].

The present work analyzes subjective judgement of the voice and speech qualities of intelligibility, pleasantness and acceptability expressed for two groups of total laryngectomy patients. The first group was composed of ten patients who had undergone esophageal voice rehabilitation. The second had nine patients with tracheo-esophageal voice rehabilitation. A group of ten listeners was set up to evaluate the voice and language parameters. These were all persons who, because of their jobs (i.e. physicians, nurses, rehabilitation therapists, etc.), had nearly daily contacts with laryngectomized patients. The listeners had to evaluate the acoustic and qualitative features of the voices reproduced on magnetic tape and score them on a specially designed sheet. This study has revealed a significant difference in the voice and speech acceptability scores for the two different groups of patients. In fact, most of the listeners found the tracheo-esophageal voice more pleasant and more acceptable than the esophageal voice.

Humans↗
PubMed1996

Spectrographic differences between tracheal-esophageal and esophageal voice.

In order to evaluate the results of voice and speech rehabilitation after total laryngectomy some acoustic parameters (fundamental frequency, waveform perturbation) were examined in 18 total laryngectomy patients. Eight of these subjects had previously been surgically rehabilitated with a tracheal-esophageal phonatory valve while 10 had been submitted to esophageal speech rehabilitation. Analysis of results has shown that tracheal-esophageal voices are more likely to provide a stable fundamental frequency; there is also a tendency toward more clearly defined harmonics; jitter and shimmer are more similar to the values of normal subjects compared with those observed in esophageal speech. Such results seem to depend on a more regular vibration pattern in the pharyngeal-esophageal segment, due to the more efficient expiratory flow in tracheal-esophageal speech. Moreover we were able to demonstrate a correlation between the objective parameters evaluated and the subjective score on speech acceptability.

Humans↗
PubMed1996

Temporary threshold shift induced by physical exercise.

Several studies have demonstrated how physical exercise can increase noise-induced temporary threshold shifts (TTS), but until now no evidence of TTS exclusively attributable to physical activity has yet been reported. In this study the hearing pure-tone thresholds of 10 subjects were evaluated at rest and at three designated times following the end of a work load corresponding to 50% and 80% of the maximum oxygen uptake (VO2 max). The results obtained demonstrate a definite effect of physical exercise on the hearing threshold at 6000 and 8000 Hz and that the higher the frequency, the greater the chance of detecting a TTS. Evaluation of the variations in some physiologic parameters (VO2 max, blood lactate and blood pressure) could not statistically correlate the same with TTS. The physiopathologic mechanisms responsible for TTS are still unknown and require further studies which should make allowances for the deferred effects of metabolic variations on the cochlear function.

Adult↗
PubMed1987

Delta infection in eastern Sicily.

Sera from 619 HBsAg+ subjects living in eastern Sicily, consecutively collected from 1975-1985, were tested for markers of delta virus (HDV) infection: delta antigen (HDAg), antibodies to delta (anti-HDIg), and also for antibodies to HBcore of IgM type (anti-HBcIgM) and for the system HBe-anti-HBe. The subjects included 210 asymptomatic carriers, 238 patients with acute hepatitis and 171 patients with chronic liver disease. HDAg was not found in any of the samples. Anti-HD was found in 28/171 (16.3%) patients with chronic liver disease, in 13/210 (6%) asymptomatic HBsAg carriers and in 13/238 (5.4%) patients with acute hepatitis. None of our patients were drug addicts. One had a history of blood transfusion, and nine came from the same family unit. The prevalence of HDV infection in eastern Sicily is lower than in other areas of Sicily possibly because of the lower percentage of HBsAg carriers in the local population. Parenteral transmission of HDV does not seem to play a major role in our area, while the familial clustering suggests close body contact as an important way of spread.

Adolescent↗