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Biomedical subjects

M Sanna

Publications and source records attributed to M Sanna.

At least 109 records · Page 6Linked to original sources

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↗

[Various aspects and problems in surgery of the parotid gland: experience in 70 cases].

The pathology and the relative surgical treatment, performed in all the swellings of the parotid gland observed in our clinic, are reported. Particularly the most important topics and problematics, both of short and long term, connected to the surgical therapy carried out, are described. Finally the actual diagnostic aspects and the necessity of an accurate preoperatory staging are discussed.

Female↗

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↗

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↗

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↗

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↗

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↗

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↗

Distal tubular sodium and water resorption in man.

It is possible to quantitatively estimate Na and water transport by each segment of the human nephron during maximal water diuresis (MWD) with a newly developed technique. The present study describes a new development whereby Na reabsorption by the ascending limb of Henle's Loop can be measured during a test of maximal antidiuresis (TMA) and compared with that obtained in separate experiments during MWD. In experiments performed on eight subjects, Henle's Loop reabsorption, expressed as equivalent volume of solute-free water generated, was 23.9 +/- 3.7 during MWD, 24.5 +/- 2.3 ml/min/100 ml GFR in TMA, p greater than 0.05; r = 0.68, p less than 0.05. Thus, our new method is reproducible and theoretically correct.

Absorption↗

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↗

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↗