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Aldè M, Marchisio P, Folino F, Ambrosetti U, Berardino FD, Barozzi S, Zanetti D, Pignataro L, Cantarella G. Otitis Media With Effusion After the COVID-19 Pandemic: Return to the Past and New Lessons. Otolaryngol Head Neck Surg 2024. [PMID: 38613183 DOI: 10.1002/ohn.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 03/11/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To assess the prevalence of otitis media with effusion (OME) among children who attended a tertiary level audiologic center 2 and 3 years after the COVID-19 lockdown, and to determine the impact of temporary interruption of day care center attendance on chronic OME. STUDY DESIGN Retrospective study. SETTING Tertiary level referral audiologic center. METHODS We assessed the prevalence of OME among children aged 6 months to 12 years in 3 different periods (May-June 2022, January-February 2023, and May-June 2023) and compared the results with those of the corresponding periods before the COVID-19 lockdown. We also compared the disease resolution rates between a subgroup of children with chronic OME who interrupted day care center attendance for a 2-month period (Subgroup A) and a similar subgroup who continued attending day care centers (Subgroup B). RESULTS The prevalence of OME was 38.5% (138/358) in May-June 2022, 51.9% (193/372) in January-February 2023, and 40.9% (149/364) in May-June 2023. No significant prevalence differences were observed between the periods May-June 2019, May-June 2022, and May-June 2023 (P = .78), and between the periods January-February 2020 and January-February 2023 (P = .93). At the May-June 2023 assessment, the children belonging to Subgroup A presented a greater rate of disease resolution (85.7%, 18/21) than the children belonging to Subgroup B (32%, 8/25, P < .001). CONCLUSION This study suggests that the prevalence of OME has returned to prelockdown levels, and that interrupting day care center attendance for a 2-month period could be effective in resolving most cases of chronic OME.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Specialist Surgical Sciences, Audiology Unit, Milan, Italy
| | - Paola Marchisio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Francesco Folino
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Specialist Surgical Sciences, Audiology Unit, Milan, Italy
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Specialist Surgical Sciences, Audiology Unit, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Specialist Surgical Sciences, Otolaryngology Unit, Milan, Italy
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Specialist Surgical Sciences, Otolaryngology Unit, Milan, Italy
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Didier HA, Cappellari AM, Sessa F, Giannì AB, Didier AH, Pavesi MM, Caria MP, Curone M, Tullo V, Di Berardino F, Iacona E, Lilli G, Barozzi S, Aldè M, De Bortoli G, Zanetti D, Arnone F, Bussone G. Somatosensory tinnitus and temporomandibular disorders: A common association. J Oral Rehabil 2023; 50:1181-1184. [PMID: 37335244 DOI: 10.1111/joor.13541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/16/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Although the association between tinnitus and temporo-mandibular disorders (TMD) has been frequently reported, their rate of association in the literature shows a great variability. OBJECTIVE We aimed to investigate the prevalence of TMD in patients with somatosensory tinnitus and, vice versa, the occurrence of somatosensory tinnitus in patients with TMD. METHODS The study included patients with somatosensory tinnitus (audiological group) and patients with TMD (stomatological group), evaluated at the audiologic and stomatologic clinics of the Policlinic Hospital of Milan, Italy. Common causes of tinnitus, such as hearing and neurological disorders, were excluded. A cervicogenic somatic tinnitus was also ruled out. Different TMD symptoms, including joint noise and joint pain, were considered. The collected data were analysed using descriptive statistical methods, and the Pearson's Chi-squared test was performed to study the prevalence of the different symptoms by clinical groups. RESULTS Audiological group included 47 patients with somatosensory tinnitus. Overall, TMD was diagnosed in 46 patients (97.8%), including TMJ noise in 37 (78.7%), clenching in 41 (87.2%) and pain in 7 (14.8%) patients. Stomatological group included 50 patients with TMD, including joint noise in 32 (64.0%), clenching in 28 (56.0%) and TMJ pain in 42 (84.0%) patients. A somatosensory tinnitus was diagnosed in 12 (24.0%) patients. CONCLUSION Our study showed a high prevalence of TMD in patients with tinnitus, as well as a not uncommon occurrence of tinnitus in patients presenting with TMD. The distribution of TMD symptoms, such as joint noise, and joint pain was different between the two groups.
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Affiliation(s)
- H A Didier
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
- Department of Neuroscience, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
- UOC Hospital Pharmacy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Istituto Stomatologico Italiano, Milan, Italy
| | - A M Cappellari
- Department of Neuroscience, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - F Sessa
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - A B Giannì
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - A H Didier
- UOC Hospital Pharmacy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M M Pavesi
- Istituto Stomatologico Italiano, Milan, Italy
| | - M P Caria
- CERISMAS (Research Centre in Health Care Management), Catholic University Milan, Milan, Italy
| | - M Curone
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - V Tullo
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - F Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Iacona
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G Lilli
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - S Barozzi
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - M Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G De Bortoli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - D Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Arnone
- Azienda Ospedaliera Santi Paolo e Carlo, Milan, Italy
| | - G Bussone
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
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Cantarella G, Aldè M, Consonni D, Zuccotti G, Berardino FD, Barozzi S, Bertoli S, Battezzati A, Zanetti D, Pignataro L. Prevalence of Dysphonia in Non hospitalized Patients with COVID-19 in Lombardy, the Italian Epicenter of the Pandemic. J Voice 2023; 37:605-609. [PMID: 33766419 PMCID: PMC7955941 DOI: 10.1016/j.jvoice.2021.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Dysphonia has been described in patients affected by coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the prevalence of dysphonia, and its severity and extent, of voice fatigue and of dysphagia in non hospitalized patients affected by COVID-19 in Lombardy, the Italian region most hit by the first explosive outbreak of COVID-19 in Europe. METHODS Demographic and clinical data of 160 consecutive patients, with COVID-19 diagnosis confirmed by nasal swabs processed by reverse transcription polymerase chain reaction, were gathered by means of telephone interviews performed by physicians in charge of daily follow-up. General and specific symptoms concerning voice and swallowing impairment were investigated. Dysphonia grade and duration were graded on 4-point scales, while voice fatigue was graded on a 5-point scale. RESULTS Dysphonia was reported by 70 (43.7%) patients and was positively associated with voice fatigue (P < 0.001), cough (P = 0.005), rhinitis (P = 0.01), and dyspnea (P = 0.06); it was mild and/or moderate in 69 patients, but its duration was > 2 weeks in 33/70 (47.1%) patients and >1 month in 11/70 (15.7%). Grade and duration of dysphonia were positively associated with cough and rhinitis (all P values < 0.01). Voice fatigue was reported by 43/160 patients (26.8%) and its severity was correlated with dysphonia (P < 0.0001), cough (P = 0.02), rhinitis (P = 0.02), dyspnea (P < 0.001), and loss of appetite (P = 0.01). Dysphagia was encountered in 27/160 patients (16.9%) and was associated with dysgeusia, cough, arthralgia, myalgia and loss of appetite but not with dysphonia. CONCLUSIONS Dysphonia was a highly prevalent and long-lasting symptom in this series; it has been underestimated to date. Further studies might shed light on the pathophysiology of voice disorders in COVID-19 patients.
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Affiliation(s)
- Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Children's Hospital "Vittore Buzzi", Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli, Milan, Italy; "L. Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy; Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare) Italian Auxologic Institute (IAI), Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy; Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare) Italian Auxologic Institute (IAI), Milan, Italy
| | - Diego Zanetti
- Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Aldè M, Di Berardino F, Ambrosetti U, Barozzi S, Piatti G, Zanetti D, Pignataro L, Cantarella G. Response to: "Audiological and vestibular symptoms following COVID-19 and COVID-19 vaccination in children: Correspondence". Am J Otolaryngol 2023; 44:103794. [PMID: 36716609 PMCID: PMC9876006 DOI: 10.1016/j.amjoto.2023.103794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/15/2023] [Indexed: 01/26/2023]
Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan and Unit of Bronchopneumology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Aldè M, Di Berardino F, Ambrosetti U, Barozzi S, Piatti G, Zanetti D, Pignataro L, Cantarella G. Audiological and vestibular symptoms following SARS-CoV-2 infection and COVID-19 vaccination in children aged 5-11 years. Am J Otolaryngol 2023; 44:103669. [PMID: 36283164 PMCID: PMC9583622 DOI: 10.1016/j.amjoto.2022.103669] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The present study assessed the prevalence of audio-vestibular symptoms following SARS-COV-2 infection or COVID-19 vaccination among children, comparing the two groups. A further aim was to evaluate whether children with pre-existing unilateral hearing loss were more prone to adverse events. MATERIALS AND METHODS This retrospective study included children aged 5-11 years with normal hearing or a proven history of unilateral hearing loss who contracted SARS-CoV-2 or received two doses of COVID-19 vaccine. Tinnitus, hyperacusis, aural fullness, otalgia, otorrhea, new-onset hearing loss, vertigo and dizziness were investigated as possible complications of SARS-CoV-2 infection or the COVID-19 vaccine. RESULTS This study included 272 children (143 boys, 129 girls), with a mean age of 7.8 ± 2.3 years. Among these, 120 were affected by pre-existing unilateral hearing loss. The most common audio-vestibular symptoms reported by children following SARS-CoV-2 infection and COVID-19 vaccination were aural fullness (33/132, 25 %) and dizziness (5/140, 3.6 %), respectively. All symptoms following COVID-19 vaccination resolved within 24 h. Compared to children who received the COVID-19 vaccine, those infected with SARS-CoV-2 had a higher prevalence of tinnitus (p = 0.009), hyperacusis (p = 0.003), aural fullness (p < 0.001), otalgia (p < 0.001), otorrhea (p < 0.001), and vertigo (p = 0.006). Two girls also experienced new-onset unilateral sensorineural hearing loss following SARS-CoV-2 infection. Children with a known history of unilateral hearing loss did not have a higher prevalence of audio-vestibular symptoms than children with normal hearing. CONCLUSIONS Our results suggest that the COVID-19 vaccine is safe and can be recommended for children with unilateral hearing loss without fear of possible audio-vestibular sequelae.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan and Unit of Bronchopneumology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Aldè M, Caputo E, Di Berardino F, Ambrosetti U, Barozzi S, Piatti G, Zanetti D, Pignataro L, Cantarella G. Hearing outcomes in children with congenital cytomegalovirus infection: From management controversies to lack of parents' knowledge. Int J Pediatr Otorhinolaryngol 2023; 164:111420. [PMID: 36563581 DOI: 10.1016/j.ijporl.2022.111420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/27/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Congenital cytomegalovirus (cCMV) is the leading nongenetic cause of sensorineural hearing loss (HL). However, there are no universally accepted approaches to diagnosis, follow-up and treatment. The aim of this study was to evaluate the main characteristics of cCMV-infected children, focusing on their management and long-term hearing outcomes. METHODS This retrospective study included all children with cCMV infection who were referred to a third-level referral audiologic center for a 6-year hearing follow-up. The main information collected from the medical records included gestational age, birth weight, trimester of maternal seroconversion, hearing status at birth and after 6 years, hearing fluctuations, treatment with oral valganciclovir (within the first month of life and for 6 months), use of hearing devices, presence of speech-language delay, motor delay, cognitive delay and balance disorders, awareness of cCMV among parents, and parents' engagement in behaviors that could increase the risk of CMV infection during pregnancy. RESULTS A total of 141 children with cCMV infection (72 males and 69 females; mean gestational age: 37+3 weeks; mean birth weight: 2893 g) were assessed. Overall, 48 children (34.0%) had a diagnosis of speech-language delay, 32 (22.7%) of sensorineural HL (59.4% bilaterally; 50% of profound degree), 18 (12.8%) of motor delay, 16 (11.3%) of balance disorders, and 6 (4.3%) of cognitive delay. Among children with HL, 8 (25.0%) were fitted with hearing aids (5 unilaterally and 3 bilaterally), and 5 (15.6%) had undergone cochlear implantation (1 unilaterally and 4 bilaterally), while a bimodal hearing solution was adopted for 2 (6.3%) patients. Compared to children with asymptomatic cCMV infection, symptomatic children had a higher prevalence of neurological and auditory sequelae (P < 0.01) and bilateral (P = 0.003) and severe-to-profound HL (P = 0.004). Overall, 23 children (16.3%) received oral valganciclovir, and only one of them experienced hearing deterioration. Only 14.9% of mothers and 5% of fathers were aware that cCMV could cause progressive or late-onset HL, and 87.9% of parents (248/282) had engaged in behaviors that increased the risk of CMV infection during pregnancy. CONCLUSION This study confirmed the importance of performing a long audiological follow-up in children diagnosed with cCMV infection due to the possible late-onset, progressive and fluctuating nature of HL. Moreover, the study highlighted many current controversies in preventive (poor prenatal education), diagnostic (routine maternal serological screening) and therapeutic (valganciclovir administered to asymptomatic children) approaches to cCMV infection. More efforts should be made to improve prevention strategies and raise awareness of cCMV infection risks among the population.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Eliana Caputo
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan and Unit of Bronchopneumology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Aldè M, Di Berardino F, Ambrosetti U, Barozzi S, Piatti G, Consonni D, Zanetti D, Pignataro L, Cantarella G. Hearing outcomes in preterm infants with confirmed hearing loss. Int J Pediatr Otorhinolaryngol 2022; 161:111262. [PMID: 35947927 DOI: 10.1016/j.ijporl.2022.111262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Premature infants are at high risk for hearing loss (HL). The aim of the present study is to assess the frequency of preterm infants affected by HL who experience hearing improvement over months and evaluate possible factors associated with hearing changes. METHODS This retrospective study was conducted in a third-level referral audiologic center. Preterm infants with a confirmed diagnosis of sensorineural HL within the first 3 months of life were reassessed at 18 months corrected age using the click-evoked auditory brainstem response between January 1, 2012, and June 30, 2020. The frequency of hearing improvement and associations between possible risk factors and hearing changes were evaluated. RESULTS A total of 138 preterm infants (71 male and 67 female; mean gestational age: 30+2 weeks) were assessed. The percentages of hearing improvement and hearing threshold normalization were 58.7% (81/138) and 35.5% (49/138), respectively. We observed a higher frequency of hearing improvement among preterm infants who had received exclusive breastfeeding or mixed feeding compared with those who had received exclusive infant formula (80% versus 29.3%, P < 0.001). CONCLUSION This study confirms the importance of performing a long audiological follow-up and postponing the indication for cochlear implantation in children with a history of preterm birth. Because of the expression of mesenchymal stem cells and high total antioxidant capacity, breast milk might play a protective role in the auditory system of preterm infants. These findings could have important implications for clinical practice, positively impacting the long-term hearing outcomes of preterm infants.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan and Unit of Bronchopneumology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Diego Zanetti
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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8
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Aldè M, Barozzi S, Di Berardino F, Zuccotti G, Consonni D, Ambrosetti U, Socci M, Bertoli S, Battezzati A, Foppiani A, Zanetti D, Pignataro L, Cantarella G. Prevalence of symptoms in 1512 COVID-19 patients: have dizziness and vertigo been underestimated thus far? Intern Emerg Med 2022; 17:1343-1353. [PMID: 35098491 PMCID: PMC8801188 DOI: 10.1007/s11739-022-02930-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/12/2022] [Indexed: 12/16/2022]
Abstract
The relationship between SARS-CoV-2 infection and dizziness is still unclear. The aim of this study is to assess the prevalence and characteristics of dizziness and vertigo among patients with mild-to-moderate COVID-19. Patients discharged from the emergency rooms with a confirmed SARS-CoV-2 diagnosis were assisted by daily telephone calls until nasopharyngeal swab negativization, and specific symptoms concerning balance disorders were investigated through targeted questions posed by experienced physicians. The study included 1512 subjects (765 females, 747 males), with a median age of 51 ± 18.4 years. New-onset dizziness was reported by 251 (16.6%) patients, among whom 110 (43.8%) complained of lightheadedness, 70 (27.9%) of disequilibrium, 41 (16.3%) of presyncope, and 30 (12%) of vertigo. This study analyzed in detail the prevalence and pathophysiological mechanisms of the different types of balance disorders in a large sample, and the results suggest that dizziness should be included among the main symptoms of COVID-19 because one-sixth of patients reported this symptom, with females being significantly more affected than males (20.3 vs 12.9%, P < 0.001). Most cases of dizziness were attributable to lightheadedness, which was probably exacerbated by psychophysical stress following acute infection and mandatory quarantine. Vertigo should not be underestimated because it might underlie serious vestibular disorders, and disequilibrium in elderly individuals should be monitored due to the possible risk of falls.
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Affiliation(s)
- Mirko Aldè
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- grid.414818.00000 0004 1757 8749Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy
| | - Stefania Barozzi
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Federica Di Berardino
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- grid.414818.00000 0004 1757 8749Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Children’s Hospital “Vittore Buzzi”, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli, Milan, Italy
- grid.4708.b0000 0004 1757 2822“L. Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Dario Consonni
- grid.414818.00000 0004 1757 8749Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Umberto Ambrosetti
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marina Socci
- grid.414818.00000 0004 1757 8749Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy
| | - Simona Bertoli
- grid.4708.b0000 0004 1757 2822Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
- grid.414603.4Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases , IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare) Italian Auxologic Institute (IAI), Milan, Italy
| | - Alberto Battezzati
- grid.4708.b0000 0004 1757 2822Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Andrea Foppiani
- grid.4708.b0000 0004 1757 2822Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Diego Zanetti
- grid.414818.00000 0004 1757 8749Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy
| | - Lorenzo Pignataro
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- grid.414818.00000 0004 1757 8749Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Cantarella
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- grid.414818.00000 0004 1757 8749Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Barozzi S, Zanetti D, Di Berardino F, Aldè M, Cantarella G. Acoustic reflex preshoot: A sign of contraction of the tensor tympani muscle? Med Hypotheses 2021; 155:110660. [PMID: 34412022 DOI: 10.1016/j.mehy.2021.110660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
Two tiny muscles are attached to the ossicles of the middle ear: the stapedius, whose role as a protector of the inner ear against loud noise has been widely accepted, and the tensor tympani, which remains a mystery since no valid method of detecting its contraction has yet been developed. However, tonic contraction of the tensor tympani has been associated with a number of otological conditions including fullness, tinnitus, slight hearing loss, and Menière-like findings. Our hypothesis is that an easily recognizable sign in the acoustic immittance testing that is part of almost every basic audiological evaluation indicates the contraction of the tensor tympani. During acoustic reflex assessment, a loud stimulus causes a bilateral contraction of the stapedial muscles and an increase in impedance which appears as a deflection in the tracing of the immittance test results. In the case of a contracted tensor tympani, when an intense sound is sent to provoke the acoustic reflex, the stapedius must overcome its resistance which would otherwise have the opposite effect on the footplate. This effort can be seen as a small peak or "preshoot" preceding the greater negative deflection of the impedance. We report the cases of ten patients with unilateral aural symptoms such as tinnitus, impaired noise tolerance, fullness, ear pressure and/or ear discomfort during chewing; the preshoot was present only in the symptomatic ear. If further studies confirm our hypothesis, this could give rise to new therapeutical strategies aimed at reducing contraction of the tensor tympani and balancing its function.
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Affiliation(s)
- Stefania Barozzi
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Diego Zanetti
- Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Di Berardino
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mirko Aldè
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giovanna Cantarella
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaringology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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10
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Barozzi S, Soi D, Intieri E, Giani M, Aldè M, Tonon E, Signorini L, Renieri A, Fallerini C, Perin P, Montini G, Ambrosetti U. Vestibular and audiological findings in the Alport syndrome. Am J Med Genet A 2020; 182:2345-2358. [PMID: 32820599 DOI: 10.1002/ajmg.a.61796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 01/20/2023]
Abstract
Alport syndrome (AS) is caused by mutations in collagen IV, which is widespread in the basement membranes of many organs, including the kidneys, eyes, and ears. Whereas the effects of collagen IV changes in the cochlea are well known, no changes have been described in the posterior labyrinth. The aim of this study was to investigate both the auditory and the vestibular function of a group of individuals with AS. Seventeen patients, aged 9-52, underwent audiological tests including pure-tone and speech audiometry, immittance test and otoacoustic emissions and vestibular tests including video head impulse test, rotatory test, and vestibular evoked myogenic potentials. Hearing loss affected 25% of the males and 27.3% of the females with X-linked AS. It was sensorineural with a cochlear localization and a variable severity. 50% of the males and 45.4% of the females had a hearing impairment in the high-frequency range. Otoacoustic emissions were absent in about one-third of the individuals. A peripheral vestibular dysfunction was present in 75% of the males and 45.4% of the females, with no complaints of vertigo or dizziness. The vestibular impairment was compensated and the vestibulo-ocular reflex asymmetry was more evident in rotatory tests carried out at lower than higher speeds; a vestibular hypofunction was present in all hearing impaired ears although it was also found in subjects with normal hearing. A posterior labyrinth injury should be hypothesized in AS even when the patient does not manifest hearing disorders or evident signs of renal failure.
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Affiliation(s)
- Stefania Barozzi
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Daniela Soi
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,ASST Nord Milano, Milan, Italy
| | - Elisabetta Intieri
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,UOC Otorinolaringoiatria ASST Valle Olona, Busto Arsizio, Italy
| | - Marisa Giani
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mirko Aldè
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,UOC Audiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Tonon
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lia Signorini
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Paola Perin
- Dipartimento di scienze del Sistema nervoso e del comportamento, Università di Pavia, Pavia, Italy
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Giuliana Bernardo Caprotti chair of Pediatrics, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Umberto Ambrosetti
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,UOC Audiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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11
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Barozzi S, Del Bo L, Passoni S, Ginocchio D, Negri L, Crocetti A, Ambrosetti U. Psychometric properties of the Italian Tinnitus Functional Index (TFI). ACTA ACUST UNITED AC 2020; 40:230-237. [PMID: 32773786 PMCID: PMC7416372 DOI: 10.14639/0392-100x-2432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/13/2019] [Indexed: 11/23/2022]
Affiliation(s)
- Stefania Barozzi
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Italy.,Fondazione Ascolta e Vivi, Milan, Italy
| | | | | | - Daniela Ginocchio
- UOSD Audiology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Umberto Ambrosetti
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Italy.,UOSD Audiology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
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12
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Pizzorni N, Valentini D, Gilardone M, Scarponi L, Tresoldi M, Barozzi S, Corbo M, Schindler A. The Mealtime Assessment Scale (MAS): Part 2 - Preliminary Psychometric Analysis. Folia Phoniatr Logop 2019; 72:182-193. [PMID: 30995652 DOI: 10.1159/000494136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS The Mealtime Assessment Scale (MAS) was developed to assess swallowing safety and efficacy during the meal. The study aims to perform a preliminary validation of MAS by investigating internal consistency, inter-rater agreement, concurrent and known-group validity, and responsiveness. METHODS MAS was tested on 100 persons without dysphagia (group 1) and 100 persons with dysphagia (group 2). Fifty subjects were simultaneously evaluated at mealtime using MAS by two independent clinicians to test inter-rater agreement. For concurrent validity, MAS was correlated with the Mann Assessment of Swallowing Ability (MASA) and American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale. MAS scores of groups 1 and 2 were compared for known-group validity. Responsiveness was tested reassessing 36 patients from group 2 after diet improvement. RESULTS Internal consistency and responsiveness were established for efficacy but not for safety. For inter-rater agreement, an average deviation index <0.66 was found for all items. MAS showed strong correlations with MASA and ASHA NOMS. MAS scores were significantly different between groups 1 and 2. CONCLUSION Preliminary evidence of the validity and reliability of MAS was established, except for the internal consistency and the responsiveness of the safety subscale. Further studies need to complete the validation process.
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Affiliation(s)
- Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy, .,Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy,
| | - Debora Valentini
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Marco Gilardone
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Letizia Scarponi
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy
| | - Martina Tresoldi
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy
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13
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Conte G, Caschera L, Tuscano B, Piergallini L, Barozzi S, Di Berardino F, Zanetti D, Scuffi C, Scola E, Sina C, Triulzi F. Three-Tesla magnetic resonance imaging of the vestibular endolymphatic space: A systematic qualitative description in healthy ears. Eur J Radiol 2018; 109:77-82. [PMID: 30527315 DOI: 10.1016/j.ejrad.2018.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/16/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE A detailed knowledge of the normal Magnetic Resonance (MR) anatomy of the vestibular endolymphatic space (ES) could be useful to understand the linkage between endolymphatic hydrops (EH) and Ménière's disease (MD). Our aim was to describe the MR anatomy of the vestibular ES as depicted by MR imaging in healthy ears. METHODS This report describes a single-center retrospective study. Three readers analyzed the healthy ears of 22 consecutive patients who had undergone MRI for unilateral sudden hearing loss. The readers described the vestibular ES based on a delayed post-contrast 3D-FLAIR sequence according to six well-defined planes, three oblique sagittal (lateral, intermediate and medial) planes and three axial (superior, intermediate and inferior) planes. RESULTS On sagittal lateral and intermediate planes, we identified the SSC ampulla combined with the utricle in 22/22 ears. On the sagittal medial plane, the saccule was detectable in 15/22 (68%) ears, having a club shape with the long axis oriented cranio-caudally; in 7/22 (32%) ears, the saccule presented an oval/round shape that appeared more conspicuously on the axial intermediate plane. The ES occupied the half superior portion of the vestibule in 22/22 ears, never contacting the round and oval windows. On the axial plane, in 17/22 cases, the ES showed a Y-shaped arrangement, while in 5/22 ears (23%), the ES presented a more globular shape. CONCLUSION MR imaging represents a valid tool to explore the in vivo anatomy of the vestibular ES and to highlight its variability in normal ears.
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Affiliation(s)
- Giorgio Conte
- Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Luca Caschera
- Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Bruno Tuscano
- Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Lorenzo Piergallini
- Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Stefania Barozzi
- Audiology Unit, Department of Clinical Sciences and Community, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Federica Di Berardino
- Audiology Unit, Department of Clinical Sciences and Community, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Diego Zanetti
- Audiology Unit, Department of Clinical Sciences and Community, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Chiara Scuffi
- Department of Medicine and Surgery, Università degli Studi di Milano, Milan, Italy
| | - Elisa Scola
- Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Clara Sina
- Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy; Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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14
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Conte G, Caschera L, Calloni S, Barozzi S, Di Berardino F, Zanetti D, Scuffi C, Scola E, Sina C, Triulzi F. MR Imaging in Menière Disease: Is the Contact between the Vestibular Endolymphatic Space and the Oval Window a Reliable Biomarker? AJNR Am J Neuroradiol 2018; 39:2114-2119. [PMID: 30337432 DOI: 10.3174/ajnr.a5841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/20/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE No reliable MR imaging marker for the diagnosis of Menière disease has been reported. Our aim was to investigate whether the obliteration of the inferior portion of the vestibule and the contact with the stapes footplate by the vestibular endolymphatic space are reliable MR imaging markers in the diagnosis of Menière disease. MATERIALS AND METHODS We retrospectively enrolled 49 patients, 24 affected by unilateral sudden hearing loss and 25 affected by definite Menière disease, who had undergone a 4-hour delayed 3D-FLAIR sequence. Two readers analyzed the MR images investigating whether the vestibular endolymphatic space bulged in the third inferior portion of the vestibule contacting the stapes footplate. This sign was defined as the vestibular endolymphatic space contacting the oval window. RESULTS We analyzed 98 ears: 27 affected by Menière disease, 24 affected by sudden sensorineural hearing loss, and 47 that were healthy. The vestibular endolymphatic space contacting the oval window showed an almost perfect interobserver agreement (Cohen κ = 0.87; 95% CI, 0.69-1). The vestibular endolymphatic space contacting oval window showed the following: sensitivity = 81%, specificity = 96%, positive predictive value = 88%, and negative predictive value = 93% in differentiating Menière disease ears from other ears. The vestibular endolymphatic space contacting the oval window showed the following: sensitivity = 81%, specificity = 96%, positive predictive value = 96%, negative predictive value = 82% in differentiating Menière disease ears from sudden sensorineural hearing loss ears. CONCLUSIONS The vestibular endolymphatic space contacting the oval window has high specificity and positive predictive value in differentiating Menière disease ears from other ears, thus resulting in a valid tool for ruling in Menière disease in patients with mimicking symptoms.
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Affiliation(s)
- G Conte
- From the Neuroradiology Unit (G.C., E.S., C. Sina, F.T.), Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Caschera
- Postgraduation School of Radiodiagnostics (L.C., S.C.)
| | - S Calloni
- Postgraduation School of Radiodiagnostics (L.C., S.C.)
| | - S Barozzi
- Audiology Unit (S.B., F.D.B., D.Z.), Department of Clinical Sciences and Community, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - F Di Berardino
- Audiology Unit (S.B., F.D.B., D.Z.), Department of Clinical Sciences and Community, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - D Zanetti
- Audiology Unit (S.B., F.D.B., D.Z.), Department of Clinical Sciences and Community, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - C Scuffi
- Departments of Medicine and Surgery (C. Scuffi)
| | - E Scola
- From the Neuroradiology Unit (G.C., E.S., C. Sina, F.T.), Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C Sina
- From the Neuroradiology Unit (G.C., E.S., C. Sina, F.T.), Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Triulzi
- From the Neuroradiology Unit (G.C., E.S., C. Sina, F.T.), Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.,Pathophysiology and Transplantation (F.T.), Università degli Studi di Milano, Milan, Italy
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15
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Conte G, Lo Russo FM, Calloni SF, Sina C, Barozzi S, Di Berardino F, Scola E, Palumbo G, Zanetti D, Triulzi FM. MR imaging of endolymphatic hydrops in Ménière's disease: not all that glitters is gold. Acta Otorhinolaryngol Ital 2018; 38:369-376. [PMID: 30197428 PMCID: PMC6146579 DOI: 10.14639/0392-100x-1986] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/01/2018] [Indexed: 11/23/2022]
Abstract
Ménière's disease (MD) is a chronic condition characterised by fluctuating hearing loss, intermittent vertigo, tinnitus and aural fullness. Its anatomical and pathological counterpart is represented by endolymphatic hydrops (EH). Recent development and progress in magnetic resonance (MR) imaging techniques has enabled visualisation of EH in living human subjects using a 3 Tesla (T) scanner and gadolinium-based contrast-agent (GBCA) via intravenous (IV) or intra-tympanic (IT) administration. Data emerging from the literature about MR imaging of EH in MD patients are limited, and we therefore reviewed the most common MR imaging findings in the study of the endolymphatic space in both MD and non-MD patients.
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Affiliation(s)
- G. Conte
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F. M. Lo Russo
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - S. F. Calloni
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - C. Sina
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S. Barozzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - F. Di Berardino
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Audiology Unit, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E. Scola
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G. Palumbo
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - D. Zanetti
- Audiology Unit, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F. M. Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Scarponi L, de Felicio C, Sforza C, Pimenta Ferreira C, Ginocchio D, Pizzorni N, Barozzi S, Mozzanica F, Schindler A. Reliability and Validity of the Italian Version of the Protocol of Orofacial Myofunctional Evaluation with Scores (I-OMES). Folia Phoniatr Logop 2018; 70:8-12. [DOI: 10.1159/000488027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/27/2018] [Indexed: 11/19/2022] Open
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Abstract
BACKGROUND In Tinnitus Retraining Therapy (TRT) sound stimulation is conventionally performed with low-level broadband sound generators; since the patient has to receive it for many hours in a day, it is important that the sound is tolerable and agreeable to the patient. A clinical trial was undertaken to evaluate the effect of different colour sound generators on tinnitus. The colour of a sound refers to the power spectrum of the signal. The sound generators used in this study provide the option to choose the preferred or most acceptable sound among white, red and pink noise. METHODS AND FINDINGS Changes in Tinnitus Handicap Inventory and Numeric Rating Scales were measured in 20 patients after 3 and 6 months following the fitting of ear-level multi-colour sound generators. The outcomes were compared to a similar group of 20 participants receiving the same management except through conventional white noise sound generators. Significant improvements were obtained in both groups following 3 and 6 months after fitting. No significant difference was found between the two groups using one or the other type of sound. Two thirds of the patient preferred white noise, making it the most appealing amongst the options. The rest of the patients indicated red noise as the preferred sound given that it reminded them of soothing noises like shower or rainfall. No one chose pink noise. CONCLUSIONS TRT with different colour sound generators is effective in reducing the discomfort caused by tinnitus in normal hearing patients. Enabling the patients to choose their preferred sound after short trial periods achieved higher patient satisfaction. This practice could help tailor individualized treatment for each patient.
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Affiliation(s)
- Stefania Barozzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Pace, Milano, Italy.,Fondazione Ascolta e Vivi, Via Foppa Milano, Italy
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Pace, Milano, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Thomas Behrens
- Centre for Applied Audiology Research, Oticon A/S, Kongebakken, Smørum, Denmark
| | | | - Luca Del Bo
- Fondazione Ascolta e Vivi, Via Foppa Milano, Italy
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Zaninetti C, Santini V, Tiniakou M, Barozzi S, Savoia A, Pecci A. Inherited thrombocytopenia caused by ANKRD26 mutations misdiagnosed and treated as myelodysplastic syndrome: report on two cases. J Thromb Haemost 2017; 15:2388-2392. [PMID: 28976612 DOI: 10.1111/jth.13855] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Indexed: 08/31/2023]
Abstract
Essentials Thrombocytopenia 2 (THC2) is an inherited thrombocytopenia (IT) with dysmegakaryopoiesis. Physicians often do not suspect the genetic origin of thrombocytopenia in patients with THC2. We report two THC2 patients misdiagnosed with myelodysplasia and treated with chemotherapy. IT should be always considered in patients with isolated thrombocytopenia and dysmegakaryopoiesis. SUMMARY Thrombocytopenia 2 (THC2) is an autosomal-dominant disorder caused by point substitutions in the 5'UTR of the ANKRD26 gene. Patients have congenital thrombocytopenia, normal platelet morphology and function, and dysmegakaryopoiesis. Thrombocytopenia is frequently discovered only in adulthood and physicians often do not suspect its genetic origin. We describe two unrelated patients referred to two different institutions for investigation of thrombocytopenia. Based on the finding of dysmegakaryopoiesis at bone marrow examination, patients were diagnosed with myelodysplastic syndrome (MDS) (refractory thrombocytopenia) and treated with several courses of 5-azacytidine. Subsequently, demonstration of thrombocytopenia in their relatives eventually led to molecular diagnosis of THC2 in both families. These cases highlight that patients with THC2 are at risk of being misdiagnosed with MDS and receiving undue myelosuppressive treatments. Because dysmegakaryopoiesis is a feature also of other forms of inherited thrombocytopenia, a genetic disorder must always be considered when a patient presents with isolated thrombocytopenia and dysmegakaryopoiesis.
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Affiliation(s)
- C Zaninetti
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - V Santini
- Division of Hematology, Careggi Hospital and University of Florence, Firenze, Italy
| | - M Tiniakou
- Division of Hematology, Department of Internal Medicine, University of Patras Medical School, Patras, Greece
| | - S Barozzi
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - A Savoia
- Department of Medical, Surgical and Health Sciences, IRCCS Burlo Garofolo and University of Trieste, Trieste, Italy
| | - A Pecci
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
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Mozzanica F, Ginocchio D, Barillari R, Barozzi S, Maruzzi P, Ottaviani F, Schindler A. Prevalence and Voice Characteristics of Laryngeal Pathology in an Italian Voice Therapy-seeking Population. J Voice 2016; 30:774.e13-774.e21. [DOI: 10.1016/j.jvoice.2015.11.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
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20
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Monticelli M, Conca DV, Albisetti E, Torti A, Sharma PP, Kidiyoor G, Barozzi S, Parazzoli D, Ciarletta P, Lupi M, Petti D, Bertacco R. Magnetic domain wall tweezers: a new tool for mechanobiology studies on individual target cells. Lab Chip 2016; 16:2882-2890. [PMID: 27364187 DOI: 10.1039/c6lc00368k] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In vitro tests are of fundamental importance for investigating cell mechanisms in response to mechanical stimuli or the impact of the genotype on cell mechanical properties. In particular, the application of controlled forces to activate specific bio-pathways and investigate their effects, mimicking the role of the cellular environment, is becoming a prominent approach in the emerging field of mechanobiology. Here, we present an on-chip device based on magnetic domain wall manipulators, which allows the application of finely controlled and localized forces on target living cells. In particular, we demonstrate the application of a magnetic force in the order of hundreds of pN on the membrane of HeLa cells cultured on-chip, via manipulation of 1 μm superparamagnetic beads. Such a mechanical stimulus produces a sizable local indentation of the cellular membrane of about 2 μm. Upon evaluation of the beads' position within the magnetic field originated by the domain wall, the force applied during the experiments is accurately quantified via micromagnetic simulations. The obtained value is in good agreement with that calculated by the application of an elastic model to the cellular membrane.
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Affiliation(s)
- M Monticelli
- Department of Physics, Politecnico di Milano, Milan, Italy.
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21
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Alpini DC, Bavera PM, Di Berardino F, Barozzi S, Cecconi P, Farabola M, Mattei V, Mendozzi L, Pugnetti L, Cesarani A. Bridging the gap between chronic cerebrospinal venous insufficiency and Ménière disease. Veins and Lymphatics 2016. [DOI: 10.4081/vl.2016.5687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ménière disease (MD) is a chronic illness of the inner ear that affects a substantial number of patients every year worldwide. Because of a dearth of well-controlled studies, the medical and surgical management of MD remains quite empirical. The main reason is that it is very difficult to investigate patients affected with Certain MD due to the post-mortem criterion necessary for this diagnostic grade. Although Endolymphatic Hydrops (EH) is the worldwide accepted mechanism of MD, the causes that induce it are still not clear. In fact MD has been correlated mostly to a wide and different disturbances ranging from trauma to sleep disorders. It is nowadays sufficiently demonstrated that Chronic Cerebro Spinal Venous Insufficiency (CCSVI) is very frequent in MD. Even if CCSVI may potentially induce EH through a pure hydraulic mechanism CCSVI, per se does not explain how the various disorders correlated with MD may interact with CCSVI and provoke EH. The aim of this review is an attempt to approach MD into the context of the more recent findings about the global brain waste clearance system, to which inner ear is anatomically and functionally connected, in order to build a reasonable model of MD pathogenesis. The major part of the diseases correlated to MD may act on the inner ear disturbing the Glymphatic (GS) and/or Brain Lymphatic System (BLS) activity. The venous system interplays with GS and BLS. In this model CCSVI is considered more than a direct cause of MD rather the anatomical predisposition to develop the disease. In this model EH, and then MD, is the consequence of a failure of the compensation of the congenital venous abnormalities, anatomical compensation as collateral pathways and/or functional compensation as GS and BLS. In this model the major part of the disturbances correlated to MD and the various treatment proposed find their appropriate placement.
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22
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Barozzi S, Del Bo L, Crocetti A, Dyrlund O, Passoni S, Zolin A, Panicucci E, Mancuso A, Kaur M, Searchfield GD. A Comparison of Nature and Technical Sounds for Tinnitus Therapy. ACTA ACUST UNITED AC 2016. [DOI: 10.3813/aaa.918971] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Paglialonga A, Barozzi S, Brambilla D, Soi D, Cesarani A, Spreafico E, Tognola G. Analysis of subtle auditory dysfunctions in young normal-hearing subjects affected by Williams syndrome. Int J Pediatr Otorhinolaryngol 2014; 78:1861-5. [PMID: 25193583 DOI: 10.1016/j.ijporl.2014.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 08/08/2014] [Accepted: 08/09/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess if young subjects affected by Williams syndrome (WS) with normal middle ear functionality and normal hearing thresholds might have subtle auditory dysfunctions that could be detected by using clinically available measurements. METHODS Otoscopy, acoustic reflexes, tympanometry, pure-tone audiometry, and distortion product otoacoustic emissions (DPOAEs) were measured in a group of 13 WS subjects and in 13 age-matched, typically developing control subjects. Participants were required to have normal otoscopy, A-type tympanogram, normal acoustic reflex thresholds, and pure-tone thresholds≤15 dB HL at 0.5, 1, and 2 kHz bilaterally. To limit the possible influence of middle ear status on DPOAE recordings, we analyzed only data from ears with pure-tone thresholds≤15 dB HL across all octave frequencies in the range 0.25-8 kHz, middle ear pressure (MEP)>-50 daPa, static compliance (SC) in the range 0.3-1.2 cm3, and ear canal volume (ECV) in the range 0.2-2 ml, and we performed analysis of covariance to remove the possible effects of middle ear variables on DPOAEs. RESULTS No differences in mean hearing thresholds, SC, ECV, and gradient were observed between the two groups, whereas significantly lower MEP values were found in WS subjects as well as significantly decreased DPOAEs up to 3.2 kHz after adjusting for differences in middle ear status. CONCLUSIONS Results revealed that WS subjects with normal hearing thresholds (≤15 dB HL) and normal middle ear functionality (MEP>-50 daPa, SC in the range 0.3-1.2 cm3, ECV in the range 0.2-2 ml) might have subtle auditory dysfunctions that can be detected by using clinically available methods. Overall, this study points out the importance of using otoacoustic emissions as a complement to routine audiological examinations in individuals with WS to detect, before the onset of hearing loss, possible subtle auditory dysfunctions so that patients can be early identified, better monitored, and promptly treated.
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Affiliation(s)
- Alessia Paglialonga
- National Research Council of Italy (CNR), Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), Piazza Leonardo da Vinci 32, I-20133 Milano, Italy.
| | - Stefania Barozzi
- Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy
| | - Daniele Brambilla
- Audiology Unit, IRCCS Eugenio Medea, via Don Luigi Monza 20, I-23842 Bosisio Parini, Lecco, Italy
| | - Daniela Soi
- Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy
| | - Antonio Cesarani
- Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy
| | - Emanuela Spreafico
- Audiology Unit, IRCCS Eugenio Medea, via Don Luigi Monza 20, I-23842 Bosisio Parini, Lecco, Italy
| | - Gabriella Tognola
- National Research Council of Italy (CNR), Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), Piazza Leonardo da Vinci 32, I-20133 Milano, Italy
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Barozzi S, Ginocchio D, Cesarani A. Exacerbation of audiovestibular symptoms in a patient with Ménière's disease and choroidal melanoma. Am J Otolaryngol 2014; 35:676-7. [PMID: 24882750 DOI: 10.1016/j.amjoto.2014.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/26/2014] [Indexed: 11/28/2022]
Abstract
We report the case of a man affected by a unilateral Ménière's disease who, after being free from vertigo spells and tinnitus for more than ten years, manifested an exacerbation of symptoms just before the diagnosis of a choroidal melanoma. Melanoma is an aggressive form of cancer derived from neuroectodermal melanocytes. Melanocytes are present in the inner ear where they contribute to the production of endolymphatic potentials and to the maintenance of normal volumes of the inner ear fluids. A possible autoimmune connection between the exacerbation of audiovestibular symptoms and melanoma is discussed.
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Affiliation(s)
- Stefania Barozzi
- Audiology Unit Department of Clinical Sciences, Community Health Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Pace 9, Milan, Italy.
| | - Daniela Ginocchio
- Audiology Unit Department of Clinical Sciences, Community Health Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Pace 9, Milan, Italy
| | - Antonio Cesarani
- Audiology Unit Department of Clinical Sciences, Community Health Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Pace 9, Milan, Italy
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25
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Verver E, Pecci A, De Rocco D, Ryhänen S, Barozzi S, Kunst H, Topsakal V, Savoia A. R705H mutation of MYH9 is associated with MYH9-related disease and not only with non-syndromic deafness DFNA17. Clin Genet 2014; 88:85-9. [PMID: 24890873 DOI: 10.1111/cge.12438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 05/18/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
MYH9-related disease (MYH9-RD) is a rare autosomal dominant disease caused by mutation of MYH9, the gene encoding for the heavy chain of non-muscle myosin IIA (NMMHC-IIA). MYH9-RD patients have macrothrombocytopenia and granulocyte inclusions (pathognomonic sign of the disease) containing wild-type and mutant NMMHC-IIA. During life they might develop sensorineural hearing loss, cataract, glomerulonephritis, and elevation of liver enzymes. One of the MYH9 mutations, p.R705H, was previously reported to be associated with DFNA17, an autosomal dominant non-syndromic sensorineural hearing loss without any other features associated. We identified the same mutation in two unrelated families, whose four affected individuals had not only hearing impairment but also thrombocytopenia, giant platelets, leukocyte inclusions, as well as mild to moderate elevation of some liver enzymes. Our data suggest that DFNA17 should not be a separate genetic entity but part of the wide phenotypic spectrum of MYH9-RD characterized by congenital hematological manifestations and variable penetrance and expressivity of the extra-hematological features.
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Affiliation(s)
- E Verver
- Department of Otorhinolaryngology and Head & Neck Surgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A Pecci
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - D De Rocco
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - S Ryhänen
- Clinic for Hematology, Oncology and Stem Cell Transplantation, Hospital for Children and Adolescent Helsinki University Central Hospital, Helsinki, Finland
| | - S Barozzi
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - H Kunst
- Radboud university medical center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - V Topsakal
- Department of Otorhinolaryngology and Head & Neck Surgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A Savoia
- Department of Medical Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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Barozzi S, Socci M, Soi D, Di Berardino F, Fabio G, Forti S, Gasbarre AM, Brambilla D, Cesarani A. Reliability of postural control measures in children and young adolescents. Eur Arch Otorhinolaryngol 2014; 271:2069-77. [PMID: 24557440 DOI: 10.1007/s00405-014-2930-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 02/03/2014] [Indexed: 11/26/2022]
Abstract
Although many studies have been carried out regarding postural stability during pediatric age, reliable information and a complete analysis of all age groups are still lacking. The purpose of this study was to verify the test-retest reliability of posturographic parameters in four sensory conditions and provide normative values for children and young adolescents. 289 subjects, aged 6-14 years, were assessed by means of the static posturography system SVeP. 173 elementary school pupils (114 males and 59 females, aged 6-10 years; mean age 8.80 ± 1.53) and 116 middle school students (60 males and 56 females, aged 11-14 years; mean age 12.6 ± 0.9) underwent static posturography in two consecutive trials with four testing conditions: eyes open and eyes closed with and without foam pads. The participants were divided into nine age groups. Thirty healthy young adults were also recruited for comparison. The analysis of test-retest reliability demonstrated an excellent reliability of velocity measurement and a moderate reliability of area measurement. Velocity and area decreased significantly with age in all sensory conditions, indicating an improvement in postural control from childhood to adolescence. Postural stability had not reached the adult level by the age of 13-14 years. Reliable information regarding postural stability can be obtained in children and young adolescents by means of stabilometric parameters. These data can be used as a reference for early detection of atypical postural development and for the assessment of dizziness and balance disorders in children.
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Affiliation(s)
- Stefania Barozzi
- Audiology Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy,
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27
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Barozzi S, Soi D, Gagliardi C, Selicorni A, Bedeschi MF, Forti S, Di Berardino F, Cesarani A, Brambilla D. Balance function in patients with Williams syndrome. Gait Posture 2013; 38:221-5. [PMID: 23219788 DOI: 10.1016/j.gaitpost.2012.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 10/04/2012] [Accepted: 11/13/2012] [Indexed: 02/02/2023]
Abstract
Impaired control of balance has been described in Williams syndrome (WS). The aim of this study was to investigate balance function by means of clinical and instrumental tests in order to measure postural sway in people with WS in an objective way. 23 WS patients (11 males, 12 females, mean age 17.52 ± 8.33 years) and 23 healthy subjects (11 males, 12 females, mean age 17.74 ± 8.93 years) performed static posturography with eyes open and closed, on a firm surface and on foam pads. The WS patients had higher mean length, velocity and surface values than controls under all of the test conditions, and their length and surface values were significantly higher in the eyes open test. The cognitive abilities of the WS patients were not related to their stabilometric performance. The greatest differences between the WS patients and the controls were found mainly in the older subjects. WS patients are more unstable than healthy subjects of the same age, particularly when they use visual information to maintain their balance: i.e. under conditions of normal everyday life. Possible explanations may be the ophthalmologic problems and the visuospatial difficulties attributed to a neural processing abnormality involving the dorsal stream impairment model. The balance function of WS patients is different from that of normal developing subjects, especially after adolescence when postural control is generally complete. This suggests an atypical developmental trajectory.
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Affiliation(s)
- Stefania Barozzi
- Audiology Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Pace 9, I-20122 Milano, Italy.
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Alpini D, Bavera PM, Di Berardino F, Barozzi S, Cesarani A. Bilateral sudden sensorineural hearing loss and chronic venous cerebrospinal insufficiency: a case report. Phlebology 2013; 28:231-3. [PMID: 22490722 DOI: 10.1258/phleb.2012.012009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We report a case of bilateral sudden sensorineural hearing loss (SSHL) in a patient suffering from chronic venous cerebrospinal insufficiency (CCSVI). METHODS Audiometric testing confirmed bilateral sensorineural hearing loss with hypoexcitability to caloric stimulation on the left side and echo-colour Doppler examination showed abnormal cerebral venous deficiency. RESULTS The patient's condition improved after 15 days following medical treatment. CONCLUSIONS CCSVI may explain the anatomical background which provides a predisposing factor for SSHL although further studies are needed to verify whether this observation is casual or coincidental.
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Affiliation(s)
- D Alpini
- Scientific Institute S. Maria Nascente, Don C. Gnocchi Foundation, Italy
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Abstract
INTRODUCTION In our clinical experience, some of the patients affected by benign paroxysmal positional vertigo (BPPV) reported the onset of tinnitus shortly before or in association with the positional vertigo. OBJECTIVES The aim of this study was to describe the prevalence and the clinical patterns of tinnitus episodes which occurred in association with BPPV and to suggest possible interpretative hypotheses. METHODS 171 normal hearing patients affected by BPPV (50 males and 122 females; age range: 25-77 years; mean age 60.3 years ± 14.9) underwent pure tone audiometry, immittance test and a clinical vestibular evaluation before and after repositioning manoeuvers. Those suffering from tinnitus were also assessed using visual analogue scales and tinnitus handicap inventory. RESULTS 19.3% of the patients reported the appearance of tinnitus concurrently with the onset of the positional vertigo. It was mostly unilateral, localized on the same ear as the BPPV, slight in intensity and intermittent. Tinnitus disappeared or decreased in all patients except two, either spontaneously, before performing the therapeutic manoeuvers, or shortly after. CONCLUSIONS A possible vestibular origin of tinnitus determined by the detachment of macular debris into the ductus reuniens and cochlear duct is discussed.
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Affiliation(s)
- Stefania Barozzi
- Department of Clinical Sciences and Community Health, Università degli Studi Milano.
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Abstract
We report a case of a patient complaining of severe high pitched tinnitus, dizziness, joint/muscle pain and gastrointestinal symptoms. A mild high-frequency sensorineural hearing loss of cochlear origin was diagnosed in the ear where tinnitus was present. The patient reported a considerable decrease in tinnitus and other symptoms with a gluten-free diet. Gluten sensitivity may have contributed to the pathogenesis of tinnitus in our patient; further research is needed to determine the exact role of gluten in this condition.
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Singh AV, Rahman A, Sudhir Kumar N, Aditi A, Galluzzi M, Bovio S, Barozzi S, Montani E, Parazzoli D. Bio-inspired approaches to design smart fabrics. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.matdes.2011.01.061] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Barozzi S, Soi D, Comiotto E, Borghi A, Gavioli C, Spreafico E, Gagliardi C, Selicorni A, Forti S, Ambrosetti U, Cesarani A, Brambilla D. Audiological findings in Williams syndrome: A study of 69 patients. Am J Med Genet A 2012; 158A:759-71. [DOI: 10.1002/ajmg.a.35241] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 12/27/2011] [Indexed: 11/07/2022]
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Paglialonga A, Barozzi S, Brambilla D, Soi D, Cesarani A, Gagliardi C, Comiotto E, Spreafico E, Tognola G. Cochlear active mechanisms in young normal-hearing subjects affected by Williams syndrome: Time–frequency analysis of otoacoustic emissions. Hear Res 2011; 272:157-67. [DOI: 10.1016/j.heares.2010.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 09/16/2010] [Accepted: 10/13/2010] [Indexed: 12/15/2022]
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Abstract
It is well known that high intensity sounds modify balance by activating the saccule, which is sensitive to both vestibular and acoustic stimuli. Few studies have examined the effects of music on the postural responses in healthy subjects. The aim of this study was to evaluate the influence of different types of music (Mozart, Köhler, Köhler with a carrier of 12 KHz and subjects' favourite music) on twelve healthy subjects standing on a stabilometric platform. With each type of music, all subjects underwent static posturography with eyes opened and eyes closed, and with and without foam pads. We evaluated the length and the surface of body sway and the correlation between them, and we analyzed the visual, vestibular and somatosensory sub-components. Listening to different types of music did not significantly change the stabilometric variables, with the exception of listening to Mozart's Jupiter, which caused a significant reduction in the visual component with a consequent increase in both the vestibular and somatosensory inputs. Further studies are needed to determine the effect of Mozart's music in modifying the sensory strategy in the rehabilitation of patients with vestibular impairments.
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Affiliation(s)
- Stella Forti
- Audiology Unit, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
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Palamidessi A, Testa I, Frittoli E, Barozzi S, Garrè M, Mazza D, Di Fiore PP, Diaspro A, Scita G, Faretta M. Understanding biological dynamics: following cells and molecules to track functions and mechanisms. Eur Biophys J 2009; 39:947-57. [PMID: 19455321 DOI: 10.1007/s00249-009-0461-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 04/08/2009] [Accepted: 04/20/2009] [Indexed: 01/12/2023]
Abstract
The dissection of the molecular circuitries at the base of cell life and the identification of their abnormal transformation during carcinogenesis rely on the characterization of biological phenotypes generated by targeted overexpression or deletion of gene products through genetic manipulation. Fluorescence microscopy provides a wide variety of tools to monitor cell life with minimal perturbations. The observation of living cells requires the selection of a correct balance between temporal, spatial and "statistical" resolution according to the process to be analyzed. In the following paper ad hoc developed optical tools for dynamical tracking from cellular to molecular resolution will be presented. Particular emphasis will be devoted to discuss how to exploit light-matter interaction to selectively target specific molecular species, understanding the relationships between their intracellular compartmentalization and function.
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Affiliation(s)
- A Palamidessi
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
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Barozzi S, Di Berardino F, Atzeri F, Filipponi E, Cerutti M, Selicorni A, Cesarani A. Audiological and vestibular findings in the Kabuki syndrome. Am J Med Genet A 2009; 149A:171-6. [DOI: 10.1002/ajmg.a.32610] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Di Berardino F, Filipponi E, Barozzi S, Giordano G, Alpini D, Cesarani A, Giordano G, Gianpiero G, Alpini D, Dario A, Cesarani A, Antonio C. The use of rubber foam pads and "sensory ratios" to reduce variability in static posturography assessment. Gait Posture 2009; 29:158-60. [PMID: 18815042 DOI: 10.1016/j.gaitpost.2008.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Revised: 05/14/2008] [Accepted: 08/02/2008] [Indexed: 02/02/2023]
Abstract
UNLABELLED Despite the numerous works published, static posturography has still a limited clinical use due to its intrinsic inter-individual high variability. For this reason, foam pads have been introduced but their use is still not standardized. Aim of the study was to define the variability of static posturography parameters in standard and foam standing. METHODS 50 healthy subjects were studied with static posturography in four standing conditions: eyes open (EO) and eyes closed (EC), with and without foam pads. Unstable tests have been performed with two different types of rubber foam pads placed on the force platform. "Sensory ratios" have been calculated by the ratio of sway length among the four different conditions, adapted from dynamic posturography, in order to measure the relative contributions of vestibular, visual and somatosensory inputs. RESULTS Static posturography in standard conditions showed unacceptable coefficients of variation (>than 15%) for all the parameters. The use of foam pads reduced the high intrinsic variability, in particular for LFS (12.6-15.4%). The use of "sensory ratios" led to decrease the inter-subject coefficient of variation of this measurement to about 9.47-14.42% using the bilayer foam pads. CONCLUSIONS Further studies are needed to confirm these data by applying the ratio formulas in clinical practice.
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Affiliation(s)
- Federica Di Berardino
- Audiology Unit, I.R.C.C.S. Policlinico, Mangiagalli e Regina Elena, Department of Otolaryngology, Chair of Audiology and Phoniatrics, University of Milan, via Pace 9, Milano, Italy.
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Tartaglia GM, Barozzi S, Marin F, Cesarani A, Ferrario VF. Electromyographic activity of sternocleidomastoid and masticatory muscles in patients with vestibular lesions. J Appl Oral Sci 2008; 16:391-6. [PMID: 19082397 PMCID: PMC4327709 DOI: 10.1590/s1678-77572008000600007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Accepted: 05/12/2008] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the electromyographic characteristics of masticatory and neck muscles in subjects with vestibular lesions. Surface electromyography of the masseter, temporalis and sternocleidomastoid muscles was performed in 19 patients with Ménière's disease, 12 patients with an acute peripheral vestibular lesion, and 19 control subjects matched for sex and age. During maximum voluntary clenching, patients with peripheral vestibular lesions had the highest co-contraction of the sternocleidomastoid muscle (analysis of covariance, p=0.02), the control subjects had the smallest values, and the patients with Ménière's disease had intermediate values. The control subjects had larger standardized muscle activities than the other patient groups (p=0.001). In conclusion, during maximum voluntary tooth clenching, patients with vestibular alterations have both more active neck muscles, and less active masticatory muscles than normal controls. Results underline the importance of a more inclusive craniocervical assessment of patients with vestibular lesions.
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Affiliation(s)
- Gianluca M Tartaglia
- Functional Anatomy Research Center (FARC), Department of Human Morphology, School of Medicine and Surgery, University of Milano, Milano, Italy
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Barozzi S, Di Berardino F, Arisi E, Cesarani A. A comparison between oculomotor rehabilitation and vestibular electrical stimulation in unilateral peripheral vestibular deficit. Int Tinnitus J 2006; 12:45-9. [PMID: 17147039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Rehabilitation therapy is proved to be effective in reducing disability in patients with persistent symptoms of disequilibrium after acute unilateral peripheral vestibular deficit. The aim of this study was to evaluate the effects of oculomotor rehabilitation (group 2) on static balance and a dizziness handicap and to compare those with the effects to vestibular electrical stimulation (group 1). Before and after therapy, we tested 28 patients, using static posturography and.the dizziness handicap inventory short form. After therapy, all subjects reported a reduction of symptoms (p = .00019). In group 1, the reductions seen in eyes-opened length of the oscillations and eyes-opened and eyes-closed surface of the body sway were statistically significant, respectively (p = .04; p = .02; p = .02). Group 2 patients revealed better stability on all parameters, and the reductions of eyes-opened length and of eyes-opened correlation function between length and surface were statistically significant (p = .01 and p = .01, respectively). Analysis of the equilibrium system subcomponents did not show any variation. Oculomotor exercises,employed in most rehabilitative protocols and including head movements to improve vestibular adaptation, have proved to reduce the perceived overall impairment and postural sway in patients with recent unilateral vestibular disorders, even though the disorders are not associated with head movements. Comparison of our two study groups did not show any significant difference, revealing that both forms of therapy are effective.
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Affiliation(s)
- Stefania Barozzi
- Department of Otorhinolaryngology and Ophthalmology, University of Milan, Italy.
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Di Berardino F, Barozzi S, Cesarani A. Allergy and Meniere's disease: a review. Eur Ann Allergy Clin Immunol 2005; 37:299-300. [PMID: 17066646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- F Di Berardino
- ENT Department, Maggiore Hospital I.R.C.C.S. University of Milan, Milan, Italy
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Barozzi S, Giuliano DA, Giordano GP, Cesarani A. Dynamic stabilometric findings in equilibrium disorders of the elderly. Acta Otorhinolaryngol Ital 2005; 25:220-3. [PMID: 16482979 PMCID: PMC2639891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Equilibrium disorders are frequent symptoms of aging, both on account of the so-called "multisensorial decay" and age-related diseases. Aim of the study was to evaluate the functional integrity of static-dynamic postural control related subsystems (visual, somatosensorial, vestibular), the fundamental postural strategies effected and adaptation to destabilizing inputs, in elderly subjects with otoneurological disorders. From January to November 2003, 40 elderly patients (19 male, 21 female, mean age +/- SD: 69.5 +/- 4.3 years; range: 65-83), with balance disorders, consisting in dizziness or vertigo, have been observed. Otoneurologic and internal case history was collected in all patients, all of whom were submitted to otoscopy, otoneurologic examination, pure-tone audiometry, as well as a specific examination called Equi test. The sensorial analysis, as often occurs in elderly subjects without unbalance, revealed marked impairment of the somatosensorial (85%), compared to vestibular (60%) and visual (40%), subsystems. Longer latencies of motor responses to forward platform translations than to backward translations were observed, even if the symmetry of movements was more evident in the former. Postural adaptation was more frequently impaired during raising of the support (70%) than during lowering. Therefore, in elderly people, somatosensorial impairment, combined with flexor muscle dysfunction, exists. Indeed, extensor responses, although slower than flexor responses, are more correctly performed.
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Affiliation(s)
- S Barozzi
- Otorhinolaryngology Department, University of Milan, Italy
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Cesarani A, Meloni F, Alpini D, Barozzi S, Verderio L, Boscani PF. Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders. Adv Ther 1998; 15:291-304. [PMID: 10345150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
In an open, controlled study, 44 patients complaining of vertigo, dizziness, or both, caused by vascular vestibular disorders were randomly treated with extract of Ginkgo biloba (EGb 761) 80 mg twice daily or with betahistine dihydrochloride (BI) 16 mg twice daily for 3 months. A complete neuro-otologic and equilibrimetric examination was performed at baseline and after 3 months of treatment, with evaluation of clinical findings. In the first month of therapy, vertigo and dizziness improved in 64.7% of patients treated with BI and in 65% of those who received EGb 761. Compared to baseline, no statistically significant changes were observed in cranial scans for patients with a "central" cranial pattern. Likewise, no changes versus baseline were observed in both groups for the equilibrium score. The comprehensive test battery showed the following findings: EGb 761 induced a slight decrease of saccadic delay and considerably increased saccadic velocities; BI improved saccadic accuracy but did not modify delay; EGb 761 improved smooth pursuit gain at 0.4 Hz 40 degrees/s three times more than BI; both drugs asymmetrically reduced nystagmus maximum velocity at 40 degrees/s; both drugs asymmetrically improved the sinusoidal vestibulo-ocular reflex; BI considerably reduced--whereas EGb 761 considerably improved--visuovestibular ocular reflex. No side effects were recorded during the trial except for transient mild headache and gastric upset in 2 patients receiving EGb 761 and transient cyanosis of nails and lips in 1 patient given BI. These results suggest that EGb 761 and BI operate at different equilibrium receptor sites and show that EGb 761 can considerably improve oculomotor and visuovestibular function.
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Affiliation(s)
- A Cesarani
- Institute of Otolaryngology, University of Sassari, Italy
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Vallar G, Rusconi ML, Barozzi S, Bernardini B, Ovadia D, Papagno C, Cesarani A. Improvement of left visuo-spatial hemineglect by left-sided transcutaneous electrical stimulation. Neuropsychologia 1995; 33:73-82. [PMID: 7731542 DOI: 10.1016/0028-3932(94)00088-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The effects of transcutaneous electrical stimulation on left visuo-spatial hemineglect, assessed by a visuo-motor exploratory task (letter cancellation), were investigated in patients with right hemisphere lesions. In Experiment 1 left neck stimulation temporarily improved the deficit in 13 out of 14 patients (93%), while stimulation of the right neck had no positive effects, worsening exploratory performance in nine patients (64%). Experiment 2 showed that left neck stimulation temporarily improved neglect also when head movements were prevented by a chin-rest. In Experiment 3, stimulation of both the left hand and left neck had comparable positive effects on visuo-spatial hemineglect. These results are interpreted in terms of: (1) non-specific activation of the right hemisphere, contralateral to the stimulation side; (2) specific directional effects of left somatosensory stimulation on the egocentric co-ordinates of extra-personal space, which in neglect patients are distorted towards the side of the brain lesion.
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Affiliation(s)
- G Vallar
- Dipartimento di Psicologia, Università di Roma, La Sapienza, Italy
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