Juri Nadalin

Condition of the anterior part of the middle ear cleft in acquired cholesteatoma.

Conclusion: The high rate of flogistic suffering of the controlateral ear seems to suggest a correlation between tubal dysfunction and acquired cholesteatoma but the low rate of pathological reports regarding the anterior mesotympanic region exclude a eustachian tube dysfunction (EDT) at the time of surgery. These observations support the hypothesis that ETD is not a factor that may influence the evolution of the cholesteatoma. Objectives: To evaluate the role of eustachian tube function in the middle ear secondary acquired cholesteatoma. Patients and methods: This was a case series study. The study group consisted of 72 patients submitted to tympanoplasty for middle ear secondary acquired cholesteatoma. Results: The contralateral ear was normal in 37 subjects (51%) and affected by chronic otitis media in 35 (49%); the anterior part of middle ear cleft was normal in 53 patients (74%). There was no significant relationship between the contralateral ear condition and the status of the anterior region of middle ear (p>0.05). The site of retraction or the presence of tympanic perforation with skin migration was not related to the condition of the protympanum. Otorrhea, cholesteatoma extension, and ossicular chain lesions were not significantly related to the status of the anterior part of the middle ear cleft (p>0.05).

Combined endovascular and surgical treatment of carotid body tumor in a patient with thoracic situs solitus

Chemodectomas of the head and neck are tumors that originate from the neural crest. The authors report a case of carotid body tumor with chronic hypoxia secondary to congenital cyanogenic cardiac malformation, radiologically and surgically treated.

Montgomery Thyroplasty after Cordectomy: Vocal Outcomes.

Objective: Providing good vocal outcomes to vocal fold cancer patients, after open or endoscopic cordectomy, is a hot topic. Several authors compared different phono-surgical techniques focusing their attention on feasibility. The aim of our study was to evaluate objective and subjective vocal outcomes after Montgomery thyroplasty. Method: In 2011, at the I ENT Division of Turin University, 8 patients underwent Montogomery thyroplasty followed by 6 months of speech rehabilitation. Inclusion criteria were: glottic incompetence and 3 years of follow-up after cordectomy. Voice evaluation was performed using videolaryngostroboscopy, Multidimensional Voice Program (MDVP), and VHI-10. Results: Six months after the surgical procedure, the laryngostroboscopy showed an improved glottic closure during phonation even if irregular and incomplete. Preoperative and postoperative MDVP parameters were compared by means of Student t test, observing a statistically significant improvement of all parameters (P < .05). The most relevant improvements were observed in: average fundamental frequency (192 Hz vs 161.7 Hz), absolute jitter (645 µs vs 57 µs), shimmer (2.1 dB vs 0.82 dB), amplitude perturbation quotient (17.6% vs 6.1%), and medium phonation time (3.5 s vs 5.12 s). VHI-10 mean score improved from 33.4 to 25.7 (P < .05). Conclusion: Our data suggest that Montgomery thyroplasty, associated with speech rehabilitation, is an efficient and well- tolerated rehabilitative approach in order to improve vocal outcomes of vocal fold cancer patients treated with open or endoscopic laser cordectomies.