I. La Mantia

Audiological range in Turner's syndrome.

Turners syndrome is generally characterised by bilateral gonadal disgenesis, short stature and inadequate sexual development secondary to anomalous karyotype. The purely otorhinolaryngoiatric pathology considerably influences the symptomatological features in Turners subject and this is based on possible morphologically structured anomalies in the external, middle and inner ear, but also on the oral cavity and pharynx. From this there is evidence of otological emergence on a phlogistic infectious basis with remarkable long-term repercussion on the hearing process. Otofunctional evaluation in 21 Turners syndrome patients shows predominance of conductive hearing loss (42.8%), proven through evidence of otitis media (33.3%) and chronic otitis media (9.5%). This, therefore, demands an attentive audiologic monitoring related to the possible development of chronic forms or cholesteatoma and the possible rehabilitative-prothesis procedure.

Normal and altered otoliths of guinea pigs

SummaryNormal morphology and structural alterations of the otoliths were observed in 20 young albino guinea pigs. Ten animals had been exposed to long-term treatment with an aminoglycoside antibiotic and ten others, which had not been treated, have been analyzed as a control group. The observations were carried out using scanning electron microscopy. All the animals survived the period of stabling and treatment. They were sacrificed and the temporal bones were dissected and fixed with 2% osmium tetroxide buffered at pH 7.4. The inner ear was subsequently dehydrated, microdissected, dried with CO2, and coated with gold. Different kinds of deterioration were observed and valued according to the appearance of the otoliths, which looked as if they had been melted, with many pores and wide and prominent cavitations probably due to chemical etching.

Normal and Altered Cytoarchitecture of the Inner Ear

ABSTRACT: Scanning electron microscope gave new insights into real morphology of the inner ear and has enhanced basic research. In fact, during the last twenty years, the cellular system that composes the organ of Corti and the vestibular apparatus has been clearly described by many authors. We now have a better understanding of each cell type and that they have a physiological functioning as ear and vestibular system.

Naso-pharyngo-laryngoscopie et rhinomanométrie avec endoscope flexible dans l’étude de l’hypertrophie adénoïde

RésuméLes auteurs proposent, dans l’exploration de l’obstruction nasale par hypertrophie adénoïde, l’introduction de deux techniques de routine simples, atraumatiques, économiques, bien tolérées par les jeunes patients et en outre complémentaires: la naso-pharyngo-laryngoscopie à fibres optiques et la rhinomanométrie. Les données quantitatives relatives à l’obstruction nasale fournies par la fibroscopie et les données qualitatives procurées par la rhinomanométrie se complètent dans l’exploration prospective pré-opératoire des jeunes patients.SummaryThe Authors propose, in the study of the nose obstruction by adenoid hypertrophy the routinist introduction of two simple techniques, atraumatics, economicals, well tolerated from little patients, and complementary beetwen them: the flexible fiberoptic nasopharyngolaryngoscope and the rhinomanometry. The quantitative objectivity offered by fiberscope and the qualitative objectivity offered by rhinomanometry are useful considering the preoperatory screening of this little patients.ResumenLos autores proponen en la exploración de la obstrucción nasal por hipertrofia adenoide, la introducción de dos técnicas de rutina — simples, atraumáticas, económicas, bien toleradas por los pacientes jóvenes y además complementarias: la naso-faringo-laringoscopia con fibra óptica y la rinomanometria. Los datos cuantitativos relatives a la obstrucción nasal dados por la fibroscopia y los datos cualitativos dados por la rinomanometria se complementan en la exploración prospectiva pre-operatoria de los pacientes jóvenes.ZusammenfassungDie Autoren schlagen zur Diagnostik der nasalen Obstruktion durch hypertrophierte Adenoide die flexible Naso-Pharyngo-Laryngoskopie und Rhinomanometrie als zwei einfache, atraumatische, kostensparende und einander ergänzende Methoden vor, die zudem von den jungen Patienten gut toleriert werden.RiassuntoGli autori propongono l’introduzione, nello studio dell’ostruzione nasale secondaria ad ipertrofia adenoidea, di due tecniche di routine semplici, complementari, non invasive, di basso costo, ben tollerate dai giovani pazienti: 1a naso-faringo-laringoscopia a fibre ottiche e la rinomanometria. Le informazioni riguardanti dati quantitativi sull’ostruzione nasale ottenute con il fibroscopio e qualitativi ottenuti con la rinomanometria si integrano a vicenda nella esplorazione pre-operatoria di questi giovani pazienti.

Effects of salso-bromo-iodine thermal water in children suffering from otitis media with effusion: a randomized controlled pilot study

BACKGROUND Otitis media with effusion (OME) is an ear disorder defined by the presence of fluid in the middle ear without signs or symptoms of acute infection. The aim of this randomised and controlled pilot study was to evaluate whether the treatment with a watery salsobromo- iodine solution, administered by nasal douche, could induce ear healing better than isotonic saline in children with OME. METHODS The study was randomized, single-blind, and controlled. Study group (40 children) was treated with salso-bromo-iodine thermal water solution and Control group (40 children) was treated with isotonic saline; both compounds were administered by nasal nebulization with Rinowash nasal douche twice/day for 10 days a month for 3 consecutive months. Tympanogram and audiometry were performed at baseline and after treatment. RESULTS Salso-bromo-iodine therapy shows better and statistically significant trend after treatment when compared to control group both for tympanogram results with greater improvement (represented by type C tympanogram; p = 0.031) and healing (represented by type A tympanogram; p < 0.001) and audiometric results, with higher presence of patients with normal hearing (p = 0.029) and lower among patients with moderate hypoacusis (p = 0.014). CONCLUSIONS The current randomized-controlled pilot study demonstrated that watery salso-bromo-iodine solution was effective in the treatment of children with OME.

Sténoses laryngées: Traitement endoscopique au laser CO2

RésuméLes sténoses du larynx posent des problèmes complexes. Aucune technique ne s’est révélée totalement satisfaisante dans le traitement des différentes variétés de sténoses. Ľemploi du laser CO2 dans le traitement endoscopique des sténoses du larynx a conduit dans le Département O.R.L. de ľUniversité de Catania, à traiter avec succès des sténoses congénitales et acquises.Trois échecs ont été enregistrés au niveau de sténoses sévères de longue date, ďétiologie inflammatoire et associées a un important remaniement cartilagineux, justifiant le recours à une intervention chirurgicale par voie externe.Comparée aux méthodes traditionnelles, la technique endoscopique présente plusieurs avantages : éxérèse non hémorragique, nette diminution des processus inflammatoires secondaires, réépithélialisation précoce et morbidité faible, tous consécutifs à la technique même de la chirurgie endoscopique sous laser CO2.SummaryStenosis of the larynx presents perplexing problems. No technique has proved totally satisfactory in the management of all varieties of stenosis. The use of CO2 laser in the endoscopic management of stenoses of the larynx has allowed in the E.N.T. Department of Catania University, to treat successfully congenital or acquired stenoses.Three failures have been recorded from severe longdated stenoses with inflammatory etiology and large cartilaginous involvement for which an external surgical procedure is required.Compared with the traditional systems the advantage are due to the bloodless exeresis, to the great reduction of secondary inflammatory processes, to the early reepithelisation, to the low morbility which are the elements connected with endoscopic surgery with CO2 laser.

Traitement endoscopique au laser CO2 du cancer des cordes vocales

Résumé23 patients atteints de carcinome des cordes vocales, sans atteinte de leur mobilité (T1N0) ont été traites par cordectomie endoscopique au laser CO2 dans le Département O.R.L. de ľUniversite de Catania.En comparaison avec les méthodes chirurgicales traditionnelles, les cordectomies endoscopiques au laser CO2 presentent des avantages ďun point de vue technique : large acces visuel a la lesion et remarquable précision grâce à la micro-chirurgie ; du point de vue biologique : réduction des risques de diffusion néoplasique possible ; du point de vue clinique : traumatisme minime, absence de complications infectieuses, absence ďcedeme et de processus inflammatoires secondaires.Afin ďatteindre ces bons résultats du traitement, il faut avoir la possibilité ďune exposition adéquate du larynx et il importe de respecter correctement les indications chirurgicales.Summary23 patients with vocal cord carcinoma, presenting no changes in the cord motility (T1N0) have been treated in E.N.T. Department of Catania University with an endoscopic surgical cordectomy with CO2 laser.Compared with the traditional surgical systems, endoscopic cordectomies with CO2 laser have advantages in the technical field : the wide vision of the lesion and the remarkable precision by using a surgical microscope ; in the biological field : reduction of risks coming from a possible neoplastic spreading ; in the clinical field : little traumatism, absence of œdema and secondary inflammatory processes.To get good results from this surgical treatment it is necessary to have the possibility of an adequate exposure of larynx and to respect surgical indications.