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Biomedical subjects

L Presutti

Publications and source records attributed to L Presutti.

15 recordsLinked to original sources
PubMed2006

Endoscopic removal of ethmoido-sphenoidal foreign body with intracranial extension.

We describe the case of a foreign body lodged into ethmoidal labyrinth and sphenoidal sinus with fracture of the clivus and consequent rhinoliquorrhea removed by an endoscopic technique. We performed a skull base plasty to close the rhino-liquoral fistula with resolution of the rhinoliquorrhea. There were no postoperative complications and there was a good therapeutic result at long-term follow-up.

Cerebrospinal Fluid Rhinorrhea↗
PubMed2005

Oncological outcome after CO2 laser cordectomy for early-stage glottic carcinoma.

This study aims to define indications for micro-endoscopic laser surgery in early glottic carcinoma (Tis, T1a and T1b), to examine patterns of local recurrences and related retreatment methods. A cohort of 79 patients with previously untreated early glottic carcinoma, subjected to endoscopic CO2 laser excision between January 1993 and October 2000, was retrospectively examined. Patients included in data analysis had a mean follow-up of 39 months. Depth and extension of excisions were graded according to European Laryngological Society Classification, and included 5 types of cordectomy. Actuarial overall survival, determinate survival, disease-free survival, ultimate local control, and laryngeal preservation rates, at 3 years, were 97.5%, 98.7%, 89.9%, 92.4%, and 97.4%, respectively. Survival curves for overall and disease-free survival were calculated from the date of diagnosis using the KaplanMeier method. Of the 8 patients with local recurrences, 5 were managed with larynx-sparing treatment: a second endoscopic CO, laser cordectomy was performed in 2 patients, a supracricoid laryngectomy in 2 patients, and one patient was treated with radiotherapy. The remaining 3 patients were submitted to total laryngectomy, one of whom died due to neck metastases. One patient died from other causes. All other patients were alive and disease-free at the last follow-up. Understanding the diffusion pathways and timing of laryngeal glottic cancer is important both for treatment and prognosis. Correct knowledge of the subsites of the larynx and the routine use of pre-operative and intra-operative diagnostic assessment is useful in the selection of the appropriate type of resection. Microendoscopic laser surgery is efficacious for early glottic carcinoma, with oncological results comparable to those observed following radiotherapy or conventional partial laryngectomy, however, in this case, local recurrences have a greater range of re-treatment options.

Aged↗
PubMed2005

Repeated visually-guided saccades improves postural control in patients with vestibular disorders.

One of the most recent and promising theoretical hypotheses for compensation of persistent asymmetry of dynamic vestibulo-ocular gain is sensory substitution. As a switch between oculomotor and vestibulo-ocular systems, saccadic eye movements are engaged in humans to compensate the angular displacement of the head towards the labyrinthine defective side thus preserving the foveal fixation of the target. This study focused on the possibility that saccadic eye movements might also compensate for the impaired vestibulo-spinal reflexes and force the postural system to a more effective control on upright stance and verified whether this sway-stabilizing effect could be applied to patients with vestibular disorders and balance dysfunction. In the first experiment, 27 patients with unilateral labyrinthine hypofunction, 24 patients with central vestibular disorders and 24 healthy volunteers were evaluated by static posturography in 3 different visual conditions: (a) eye open with fixation of a steady target, (b) eye closed, and (c) while performing horizontal visually-guided saccades. The percentage of individuals with a decreased body sway area during the oculomotor task was found to be higher in labyrinthine-defective patients as compared to those with central vestibular disorders and controls. In the second experiment, 46 patients with vestibular disorders both of central and peripheral origin, whose postural control improved by eye-tracking, as assessed by posturography, were later submitted to 12 consecutive training sessions based on repeated visually-guided saccades. Both the saccadic performances and postural control improved in all patients but a more pronounced effect was observed in those with peripheral vestibular disorders. Outcome of this rehabilitation technique was also corroborated by a general reduction of the perceived overall impairment from balance disorders as tested by a specific questionnaire.

Adult↗
PubMed2004

Breast carcinoma metastases in paranasal sinuses, a rare occurrence mimicking a primary nasal malignancy. case report.

Metastatic tumours to the paranasal sinuses are an exceedingly rare event, the large majority being of renal origin. Herein, a case of metastatic breast carcinoma to the right maxilla is described which occurred 4 years after radical mastectomy, clinically and radiologically presenting as a primary sinonasal mass. Only the histopathologic examination together with a broad spectrum of immunohistochemical antibodies were useful in confirming the origin of the neoplasm.

Aged↗
PubMed2004

Anxiety affects vestibulospinal function of labyrinthine-defective patients during horizontal optokinetic stimulation.

Comorbidity of vestibular and anxiety disorders was suggested by epidemiological studies and, recently, new insights into potential neural circuits which subserve both balance control and emotions, appear to support this hypothesis. In particular, disorienting visual surroundings, such as those generated by full-field moving scenes, equally disrupt postural control of patients with vestibular or panic disorders. In the present study, behaviour of body sway was assessed in response to an optokinetic stimulation by means of static posturography in 20 patients with vestibular neuritis (10 patients with normal affect and 10 with generalized anxiety disorders, as diagnosed according to the American Psychiatric Association criteria), and 20 normal subjects who served as controls. Optokinetic responses and vestibulo-spinal function during a full-field, bi-directional horizontal optokinetic stimulation, were recorded simultaneously. Labyrinthine-defective patients with low and high level of anxiety showed a common pattern of asymmetric optokinetic reflexes. On the contrary, body sway was found to be increased more by eye closure and optokinetic stimulation towards the defective labyrinth in patients affected by high level of anxiety as compared to those with normal affect and controls. These data confirm the combined effect of anxiety and labyrinthine dysfunction on vestibulo-spinal function which is disclosed by both visual suppression and disorienting visual contexts.

Adult↗
PubMed2002

Treated Wilm's tumor in childhood as potential risk factor for second thyroid cancer.

The potential risk of a treatment-induced second neoplasia affecting the thyroid is well known after radiation therapy for several types of cancer, but few cases have been related to incidental irradiation for Wilms' tumor. We report a case of a papillary thyroid carcinoma discovered in a young patient 15 years after treatment of a Wilms' tumor. An 18-year-old man was referred to our Endocrinological Department for a single 3 cm nodule in the right lobe of the thyroid. His past medical history included at the age of 2 years surgical resection, chemotherapy (actinomycin-D and vincristine) and cesium radiation therapy to the right side for a Wilms' tumor in stage III: a total dose of 7700 rads was delivered to an area of 17 x 10 cm in the right flank. After fine-needle demonstration of a follicular thyroid lesion, the patient underwent right lobectomy, followed by total thyroidectomy for histologic diagnosis of a follicular variant papillary cancer. Residual thyroid tissue was ablated by iodine-131 administration (3700 MBq), but scanning after therapeutic iodine showed radioactive uptake in the left regional lymph nodes, with elevated serum thyroglobulin off therapy (830 ng/ml). Magnetic resonance imaging confirmed the presence of lymph node enlargements and bilateral neck dissection was performed, followed by radioiodine treatment (3700 MBq) and thyroxine suppressive therapy. After 3-year follow-up the patient is disease-free. Although few cases of thyroid cancer have been reported in the literature after irradiation for a Wilms' tumor during childhood, this association should be considered in the long-term follow-up.

Adolescent↗
PubMed1995

[Endonasal dacryocystorhinostomy].

Dacryocystorhinostomy an endonasal approach is a surgical procedure which permits removal of symptoms related to chronic stenosis of the naso-lacrimal duct without leaving external scars and without presenting risk for the orbital structures. The Author describes the surgical technique employed in 12 surgical cases. Use of the frontal loupe and of the operating microscope allows the surgeon's hands to remain free while all the advantages of binocular vision are maintained. Pre-operative investigation must always include a dacryocystography, a CT of the paranasal sinuses and an endoscopic examination of the nasal cavities.

Adult↗
PubMed1995

[Echo-color Doppler and echo-Doppler in the diagnosis of carotid body tumors].

Echo-Doppler and Color Flow Doppler examinations, are able to combine the advantages offered by echography with those had with the Doppler exam. In the presence of tumours of the carotid body, these exams can furnish morphological data with regard to tumor size, its precise location and its rapport with contiguous organ as well as data regarding blood flow in the mass itself. The color Flow Doppler exam, in particular, can reveal the echographic aspect and the flow toward and away from the sonde all on the same image. This enables a precise diagnosis of a tumor of the carotid body to be reached even without angiography. The personal experience here reported involves ten cases observed during the last seven years.

Carotid Body Tumor↗
PubMed1993

[Relapsing polychondritis. Review].

Using a clinical case which was brought to their attention as a starting point, the authors reexamine the problems relating to the nosographic, etiological, pathogenetic, pathoanatomical and clinical aspects of relapsing polychondritis, as well as those concerning its differential diagnosis and therapy. In particular, they review the various theories of immunological pathogenesis related to the alterations in collagen observed in relapsing polychondritis and in other correlated diseases.

Collagen↗
PubMed1991

Jugular bulb diverticula.

Jugular bulb diverticula may extend either laterally in the tympanic cavity or medially towards the petrous pyramid close to the inner ear. In the first case, this leads to subjective symptoms related to the presence of a mass at the level of the tympanic cavity and the external auditory canal and thus to conductive hearing loss and pulsatile tinnitus. In the second case, vertigo, pulsatile tinnitus and sensorineural hearing loss occur. 4 cases of jugular bulb diverticula are described (1 medial type, 3 lateral type).

Adult↗
PubMed1988

[High resolution computerized tomography in the study of traumatic pathology of the temporal bone].

Thirty-five patients with temporal bone fractures were examined; the fractures were sometimes associated with dislocation of the ossicular chain caused by road fatalities. Computed Tomography (CT) was performed either because of the presence of clinical symptoms associated with trauma of the temporal bone, or because of a hemotympanum discovered during a CT scan of the brain. Thirty-three fractures were detected: 19 longitudinal, 6 transverse, and 8 complex. An incudostapedial dislocation was also detected, together with a displacement of a stapedial prosthesis from the lenticular process of incus, and 3 incus-malleus dislocations associated with fractures. High resolution CT allows the precise definition of the course of the fractures, of the associated dislocation of the ossicular chain, and of facial nerve lesion, thus allowing a more accurate surgical intervention. In the examination of the temporal bone, high resolution CT is preferable to pluridirectional tomography because it is easier and faster to perform. Moreover, high resolution CT helps reduce the radiation dose, and yields higher-quality images with more accurate diagnostic information. High resolution CT also allows the brain and the temporal bone to be studied at the same time.

Adolescent↗
PubMed1987

Atypical carcinoid of the larynx: case report.

The authors describe a rare case of laryngeal atypical carcinoid. They discuss the histologic pattern of the neoplasm and the differential diagnosis of laryngeal tumors, particularly with oat-cell carcinoma. These tumors represent a spectrum of neoplasms with endocrine differentiation.

Carcinoid Tumor↗
PubMedDate not supplied

Giant cell tumor of the upper cervical spine: transmandibular-translingual access. Clinical case.

The authors describe the clinical case of a patient aged 18 years affected with giant cell tumor (GCT) at C3 who came to the surgical unit of Orthopaedics and Traumatology at the Ospedale Maggiore in Bologna after being treated by surgery elsewhere. Particular attention is paid to surgical access by means of median transmandibuloglossotomy used in order to obtain a sufficiently wide surgical field that can adequately expose the vertebral segment affected by neoplastic disease. In particular, possible complications that may be observed postsurgery can be compared to other surgical approaches to the upper cervical spine and above all that there are no permanent clinical sequelae.

Adolescent↗
PubMedDate not supplied

[Relapsing polychondritis].

Relapsing polychondritis is a rare disease of unknown origin consisting in recurrent inflammatory episodes of cartilaginous structures as well as other organs such as the eye, the inner ear and the kidney. Symptoms of autoimmune or rheumatic disorders frequently precede those typical of relapsing polychondritis and thus the contemporaneous presence of these diseases is a common observation. Consequently some diagnostic concerns connected to the great variability of the early symptoms and also to the lack of a semiotic test do exist. It is widely recognized that a serious involvement of the tracheo-bronchial cartilage the lumen diameter with a consequent heavy dyspnoea which reduces occurs in relapsing polychondritis. In these cases the study of the thorax area by means of CT was of fundamental importance. Furthermore, histological analysis of bioptic specimens from tissues only apparently not affected, such as the pinna of the ears, better defines the nature of the disease. The Authors present a case report, characterized by the presence of a saddle-nose deformity as well as a dyspnoea caused by a lumen stenosis related to tracheo-bronchial cartilage chondritis.

Autoimmune Diseases↗