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Biomedical subjects

M Giudice

Publications and source records attributed to M Giudice.

At least 19 recordsLinked to original sources
PubMed2005

An unusual tonsillolithiasis in a patient with chronic obstructive sialoadenitis.

Concretions in the tonsil or peritonsillar area are an infrequent entity in clinical practice. Some patients have no symptoms or they can present with fetor oris or odynophagia. The lesions are often detected incidentally during radiographic examination. This pathology can be related to lithiasis in other regions of body. The authors describe a tonsillolith accidentally detected in a patient with a lithiasis of left submandibular gland. We review published cases of tonsilloliths and analyse the causes of stone formation in peritonsillar and tonsil regions.

Female↗
PubMed2005

Endoscopic dacryocystorhinostomy: personal experience.

Data are reported on a series of 52 endoscopic procedures of dacryocystorhinostomy, performed in the Department of Otorhinolaryngology of the Hospital of Varese, between May 1999 and February 2003. The study population comprised 42 patients (32 female, 10 male. mean age 57 and 51 years, respectively) with naso-lacrimal obstruction. In all cases, pre-operative diagnosis consisted in irrigation of the lacrimal pathways, confirmed on dacryocystography; in selected cases, an additional computed tomography examination was carried out. All procedures were performed under general anaesthesia and surgical times were recorded; mean time for primary dacryocystorhinostomy was 30 minutes. A silicone tube was inserted in all patients for a period of 3 months. The procedure was successful in 81% of primary dacryocystorhinostomy cases and in 75% of revision dacryocystorhinostomy cases. Personal clinical and surgical experience, focusing on surgical techniques used in dacryocystorhinostomy, is described.

Adult↗
PubMed2003

Atypical carcinoid tumour of the larynx treated with CO2 laser excision: case report.

A case of atypical laryngeal carcinoid tumour of the right aryepiglottic fold is described in a 56-year-old female. The patient presented a 4-year history of dysphagia, occasional dyspnoea and pain originating in the right tonsillar fossa and radiating to the ear. A sessile, submucosal neoplasm of about 1 cm in diameter and apparently benign appearance was detected endoscopically in the supraglottic region. An excisional biopsy was collected by CO2 laser during direct microlaryngoscopy from which a diagnosis of atypical carcinoid tumour of the larynx was made, and later confirmed by histochemical and immunohistochemical staining. Post-operative course was uneventful, with return to a normal diet per os on the first post-operative day. Histopathological evaluation of the excised specimen revealed the presence of a neoplasm in proximity of the surgical margins, which were not, however, directly involved by the tumour. The close endoscopic follow-up was, nonetheless, implemented in order to promptly detect any evidence of relapse of the disease. After 18 months, a lesion, suspected of being a recurrence, was found, in the site of the original tumour. CO2 laser excision was again carried out, this time allowing for wider margins on the surgical resection. The post-operative diagnosis confirmed the clinical hypothesis of recurrence of atypical carcinoid tumour. The patient is presently alive and free from disease 7 years after the second endoscopic procedure. The difficult aspects of clinical and histopathological diagnoses, the surgical treatment as well as endoscopic and instrumental follow-up of this rare condition are discussed.

Carbon Dioxide↗
PubMed2002

[Laryngeal carcinoma associated with congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a case report].

Congenital tracheobronchomegaly or Mounier-Kuhn Syndrome is a rare disorder of controversial etiology. It is characterized by an abnormal enlargement of the trachea and primary bronchi, because of atrophy or absence of their elastic fibers and smooth muscles. Such alterations lead to the collapse of the respiratory tract during forced exhalation, making expectoration by coughing of little use. Subjects with this disorder are, therefore, predisposed to the development of phlogistic bronchopulmonary pathologies such as bronchitis, emphysema, bronchiectasis and pulmonary fibrosis. The present work reports the case of a 65-year-old man suffering from asymptomatic congenital tracheobronchomegaly which was unknown until preoperative testing was performed (standard chest x-ray, tracheobronchoscopy) following a diagnosis of squamous cell carcinoma of the larynx. The patient underwent total laryngectomy and bilateral neck dissection without any intra- and postoperative complication. This is the first case reported in the literature of an association between laryngeal carcinoma and Mounier-Kuhn Syndrome, although a cause-effect relationship between the two pathologies cannot be advanced at this time. This paper also reports how the patient was managed in terms of anesthesiology and surgical technique, both conditioned by the marked tendency for anteroposterior tracheal wall collapse and its high reactivity to mechanical insults.

Aged↗
PubMed2001

[Laryngeal-tracheal resection in the treatment of thyroid malignancies: description of a case and review of literature].

Well-differentiated thyroid carcinomas infiltrate into the respiratory tract in between 0.9 and 7% of the cases. Laryngeal-tracheal involvement--most often discovered intra-operatively--can substantially modify the surgical approach. It should be evaluated pre-operatively through laryngo-tracheoscopy with a flexible fibroscope and, in some selected cases, using CT or NMR. Thyroidectomy, associated with laryngeal-tracheal resection and termino-terminal anastomosis, ensures good oncological results without any negative effect on the incidence of post-operative complications. The present work reports the case of a 64-year-old patient who, for 5 months, had presented a swelling of increasing consistency in the left hemithyroid, fixed on the deep planes. Echography showed a 5 cm mass in the left lobe and thyroid isthmus, without suspected lymphadenopathy for metastasis. Fine needle cytology was compatible with papillary carcinoma. CT using a contrast medium revealed an infiltration into the left antero-lateral wall of the I and II tracheal ring, with submucosal extension with no significant signs of stenosis of the airway. Esophagogastroscopy was normal while tracheobroncoscopy confirmed the radiological picture and made it possible to perform a tracheal biopsy which proved positive for papillary carcinoma. The patient underwent total thyroidectomy associated with anterior compartment lymphadenectomy and crico-tracheal resection of the cricoid arch and the first 5 tracheal rings. When surgery was completed, the patient was extubated without complications. Post-operative recovery was uneventful and the patient was discharged on the 9th day after surgery. Histopathological examination confirmed the pre-operative diagnosis and made it possible to stage the lesion as pT4N1bM0 because of the presence of one prelaryngeal lymph node metastasis and another one at the right paratracheal space. Complementary I131 therapy was scheduled along with periodic laryngo-tracheoscopic controls. 16 months after surgery the anastomotic line is perfectly healed and the patient is clinically disease free. A review of the literature on the surgical treatment of well-differentiated malignant thyroid neoplasms with respiratory tract involvement through resection and laryngo-tracheal anastomosis has made it possible to trace the indications, limits and results of this type of therapeutic approach.

Anastomosis, Surgical↗
PubMed2001

[Pleomorphic adenoma of the parotid gland in childhood].

BACKGROUND: The authors report the results of ten years' activity at the Pedodontic Surgery Unit in the Institute of Maxillofacial Surgery at the Second University of Naples and analyse the possibility of conservative treatment of pleomorphic adenoma in childhood. METHODS: The study includes 614 cases of salivary gland pathology. The authors illustrate the epidemiological, clinical and therapeutic characteristics of this type of lesion in childhood, emphasising that the data emerging from this study do not differ from the clinical and therapeutic management of pleomorphic adenoma in young patients reported in the literature. RESULTS: In particular, they emphasise that satisfactory therapeutic results can be achieved using conservative techniques, like conservative superficial parotidectomy. CONCLUSIONS: Conservative superficial parotidectomy has the advantage of being less radical and traumatic for a young patient, without provoking a significant increase in recidivation.

Adenoma, Pleomorphic↗
PubMed2001

[Functional results after type I thyroplasty with the Montgomery's prosthesis].

Between January 1999 and October 2000, 16 patients with glottic insufficiency of varying etiologies underwent Montgomery type I thyroplasty at the E.N.T. Department of the University of Brescia, Italy. In 2 cases revision surgery was required for the onset of delayed complication (cutaneous and endolaryngeal exposure of the prosthesis). All subjects underwent a battery of clinical-instrumental tests pre- and postoperatively as well as 2, 6 and 12 months after surgery. These tests included videolaryngostroboscopy, subjective perception analysis using the GRBAS scale proposed by Hirano on vowels, statements and songs, and, using the Multi-Dimensional Voice Program (MDVP), acoustic measurement of the following parameters: jitter (J), shimmer (S), noise to harmonic ratio (NHR) and maximum phonation time (MPT). The patients also filled out a self-evaluation questionnaire to judge the postoperative voice and this was used to calculate the "voice handicap index" (VHI). In order to make the study sample as homogeneous as possible, detailed pre- and postoperative functional data were studied only for the 11 patients with glottic insufficiency subsequent to monolateral vagal or recurrent paralysis. Analysis of these data revealed that, in these patients, postoperative perceptive and subjective evaluation was similar to that found in normal subjects. Videolaryngostroboscopy showed that the glottis closed completely in most cases and objective acoustic analysis parameters were significantly improved after surgery. Despite the small sample, our functional results confirm the validity of the cord medialization technique through an external approach in laryngeal hemiplegia. In cases of glottic insufficiency of various etiologies (trauma, scarring subsequent to external and/or endoscopic surgery and radiotherapy), more accurate selection of the patients is required to reduce the incidence of complications and to improve vocal results.

Adolescent↗
PubMed2001

[False mass in the left atrium... or better: true mass in false atrium].

We report the case of a 59-year-old man who underwent transesophageal echocardiography following a cryptogenic minor stroke. An image of a solid mass of the left atrial appendage, highly suggestive of a thrombus, was observed. The patient was treated for 10 weeks with oral anticoagulants. Because of the absence of changes in the echocardiographic appearance of the mass at follow-up, the patient was submitted to surgery. At surgical exploration no endocavitary thrombus was found, but the left atrial appendage appeared hypoplastic and dysmorphic. A biopsy was taken and the left atrial appendage was plicated. To our knowledge, this is the first report of a case of dysmorphism of the left atrial appendage mimicking a left atrial thrombus in a patient with cryptogenic minor stroke.

Atrial Appendage↗
PubMed1993

[The clinical applications of biomaterials].

The more and more availability of new alloplastic materials in oral and maxillo-facial reconstructions causes the necessity of judging if the biomaterials satisfy the surgical needs. The authors re-examine the main chemical, physical and biological characteristics of following materials: hydroxylapatite, polytetrafluoroethylene, polyglactin 910, polyfluorocarbons, polypropylene and report their experiences.

Biocompatible Materials↗
PubMed1992

[Hypertrophy of the masseter: a rare case associated with hypertrophic cardiomyopathy].

Masseteric hypertrophy is a rare, monolateral or bilateral lesion. The aetiology is often unknown and both congenital and acquired forms are reported in the literature. The authors report a case of masseteric hypertrophy associated with hypertrophic cardiomyopathy. Family history shows two brothers suffering from the same cardiac disease. Echography, computed tomography, EMG test and aspiration biopsy of masseteric muscle were performed. Echocardiography and HLA, B and C antigens of 16 relatives were also performed. In the report case the authors hypothesized a multifactorial background on a genetic basis.

Adult↗
PubMed1990

[The clinical and therapeutic approach in oromaxillofacial pain].

The general outlines and manifold aspects of oromaxillofacial pain are described on the basis of personal experience. Diagnostic difficulties are also outlined with emphasis on the basic features of symptomatic and essential forms. Finally the treatment protocol adopted is described with particular reference to symptomatic neoplastic forms.

Facial Pain↗