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Hung G, Faudoa R, Li X, Xeu Z, Brackmann DE, Hitselberg W, Saleh E, Lee F, Gutmann DH, Slattery W, Rhim JS, Lim D. Establishment of primary vestibular schwannoma cultures from neurofibromatosis type-2 patients. Int J Oncol 1999; 14:409-15. [PMID: 10024671 DOI: 10.3892/ijo.14.3.409] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary cultures were established from vestibular schwannomas of NF2 patients. The cultured tumor cells were selectively amplified by growth factor supplemented medium and characterized by immunocytochemistry. NF2 cDNA was amplified by RT-PCR and mutations were detected by both the non-isotopic RNase cleavage assay and direct DNA sequencing, no detectable wild-type NF2 transcript was found in cDNA from the cultured cells. Distinguishable morphology and growth rate differences have been observed in different passages of the primary cells. The data suggest that a pure schwannoma primary culture can be established and could be very useful in vitro model for further understanding the NF2 gene function in Schwann cells.
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Chapman HD, Saleh E. Effects of different concentrations of monensin and monensin withdrawal upon the control of coccidiosis in the turkey. Poult Sci 1999; 78:50-6. [PMID: 10023746 DOI: 10.1093/ps/78.1.50] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The efficacy of different concentrations of monensin in turkeys exposed to field isolates of Eimeria and the effect of the withdrawal of monensin from their diet were investigated. Results of a battery study indicated that 66 ppm monensin was effective against three species of Eimeria in the turkey. In floor pens in which poults were exposed to infection, use of 59.5, 79.4, and 99.2 ppm monensin resulted in reduced mortality and improved feed conversion at 3 wk of age compared with birds that had received no medication. Poults given 59.5 ppm monensin weighed more and had a better feed conversion at 3 wk than poults given 79.4 or 99.2 ppm monensin, but at 10 wk no differences in the body weight or feed conversion of poults given different concentrations of drug were apparent. At 14 wk (and from 10 to 14 wk), poults that had been given 99.2 ppm monensin had a lower feed intake and weighed less than birds that had been given 59.5 ppm of the drug but there were no significant differences in feed conversion. There was no significant difference in the weight gain or feed conversion of poults from 10 to 14 wk of age whether monensin was present in the feed or had been withdrawn. No evidence of compensatory growth was found in the present study.
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Sanna M, Mazzoni A, Saleh E, Taibah A, Mancini F. The system of the modified transcochlear approach: a lateral avenue to the central skull base. THE AMERICAN JOURNAL OF OTOLOGY 1998; 19:88-97; discussion 97-8. [PMID: 9455956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study aimed to update the authors' experience with the modified transcochlear approach for the management of lesions of the central skull base. The surgical technique, classification, indications, and results also are presented. STUDY DESIGN A retrospective review of the charts of 66 consecutive patients treated in our centers by the modified transcochlear approach was conducted. SETTING The study was performed in two tertiary referral centers. PATIENTS All patients treated by the modified transcochlear approach were included. Thirty-five patients had extradural lesions, whereas 31 lesions were intradural. INTERVENTION All patients were treated surgically using the modified transcochlear approach either in its basic form (type A) or with its extensions (types B, C, and D). MAIN OUTCOME MEASURES The outcome of surgery is evaluated with particular emphasis on the incidence of morbidity, mortality, and the degree of total tumor removal. RESULTS Total tumor removal was accomplished in 58 cases either in single or staged procedures. A second-stage procedure for total tumor removal is planned in five other patients. Subtotal tumor removal was performed in three patients. Mortality occurred in two cases. Ipsilateral hearing loss and immediate facial nerve palsy constituted the major drawbacks of this approach. However, 67.5% recovered to grade III facial function or better 1 year after surgery. CONCLUSIONS The modified transcochlear approach provides a relatively safe, wide, and versatile access to large lesions of the central skull base.
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Aristegui M, Canalis RF, Naguib M, Saleh E, Cokkeser Y, Mancini F, Sanna M. Retrolabyrinthine vestibular nerve section: a current appraisal. EAR, NOSE & THROAT JOURNAL 1997; 76:578-83. [PMID: 9282467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We report our experience (1987-1993) with Meniere's disease patients treated with a retrolabyrinthine vestibular neurectomy. The current literature was reviewed and our results have been compared with those of previous reports. The overall success rate for vertigo relief was 96.7%, with no serious or permanent complications resulting from the procedure. The technical elements of the operation, as they apply to our approach and those of others, have been analyzed, with special attention given to the anatomical features of the region and their influence on success or failure. We conclude that the retrolabyrinthine approach for vestibular nerve section remains a safe and highly successful technique which merits continued use.
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Mazzoni A, Sanna M, Saleh E, Achilli V. Lower cranial nerve schwannomas involving the jugular foramen. Ann Otol Rhinol Laryngol 1997; 106:370-9. [PMID: 9153100 DOI: 10.1177/000348949710600503] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Schwannomas involving the jugular foramen are rare lesions, and no consensus exists on their management. This paper reports on 20 such cases treated in our centers. Nineteen cases were operated on for removal of the tumors, and the remaining case is being managed by watchful expectancy. Fifteen cases were operated on by the petro-occipital trans-sigmoid approach with or without labyrinthectomy, 2 by the infratemporal fossa approach, 1 by the modified transcochlear approach, and 1 by the jugulo-petrosectomy approach. The petro-occipital trans-sigmoid approach allowed single-stage, total tumor removal with preservation of the facial nerve and of middle and inner ear functions. Lower cranial nerve paralysis was the major complication and seemed to be inherent to the disease rather than to the approach used. No cerebrospinal fluid leak or meningitis occurred in the present series. So far, no recurrence has been detected.
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Sanna M, Panizza B, Saleh E. Letter to the editor. Skull Base Surg 1997; 7:107. [PMID: 17170998 PMCID: PMC1656588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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Barsoum R, Nabil M, Saady G, Genin C, Saleh E, Francis M, el-Kalioubi A, Iskander I, el-Garem A. Immunoglobulin-A and the pathogenesis of schistosomal glomerulopathy. Kidney Int 1996; 50:920-8. [PMID: 8872967 DOI: 10.1038/ki.1996.392] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Several observations suggest that the evolution of schistosomal glomerulopathy into clinically overt and progressive disease may involve pathogenetic mechanisms other than simple glomerular deposition of parasitic antigens. In a previous study, IgA was suggested to be a mediator of late glomerular lesions in this disease. This issue is further addressed in this work. The study includes 32 patients with hepatosplenic schistosomiasis, of whom 16 had overt glomerular involvement, along with four control groups: (a) 15 healthy volunteers; (b) 15 patients with simple intestinal mansoniasis; (c) 17 patients with non-schistosomal chronic liver disease; and (d) 21 subjects with primary nephrotic syndrome not associated with schistosomiasis. Routine assessment was done for all subjects including confirmatory tests for schistosomal infection, liver and renal function tests, hepatitis viral markers and abdominal ultrasonography. The total serum concentrations of IgG, IgM, IgA were measured, as well as their respective circulating immune complexes, rheumatoid factors, anti-gliadin- and anti-DNA-antibodies. Liver and renal biopsies were obtained from the relevant groups and studied by light microscopy. Renal biopsies were also examined by immunofluorescence. Patients with simple intestinal schistosomiasis had a significant increase in IgM antigliadin antibodies. Those complicated with hepatosplenic involvement also had a significant increase in the mean IgG anti-gliadin antibodies, IgG rheumatoid factor and IgM anti-DNA activity. Cases further complicated by overt glomerular disease showed a distinct IgA predominance, mainly expressed in the serum anti-gliadin antibody pool and anti-DNA activity. This profile was essentially similar to that observed in control cirrhotics. There was a significant increase in the frequency of IgA glomerular deposits in renal biopsies obtained from patients with overt schistosomal glomerulopathy, in contrast to control nephrotics. The deposits were mainly mesangial, but were also encountered in subendothelial, subepithelial and peritubular locations. Their frequency was significantly higher with more advanced lesions as seen by light microscopy. The relevance of these data is discussed, leading to the following conclusions: (a) serum IgA-anti-gliadin and -anti-DNA antibodies, and glomerular IgA deposits are markers of significant renal involvement in patients with hepatosplenic schistosomiasis. (b) IgA may be involved in the pathogenesis of advanced glomerular pathology when superimposed on parasite-induced lesions. (c) There is a significant increase in serum auto-reactivity in hepatosplenic schistosomiasis, which may also have pathogentic implications. (d) Increased production by the inflammatory bowel lesions, impaired clearance by the fibrotic livers and probable switching of immunoglobulin synthesis are suggested to explain the observed IgA predominance in those who develop renal complications.
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Karmarkar S, Bhatia S, Khashaba A, Saleh E, Russo A, Sanna M. Congenital cholesteatomas of the middle ear: a different experience. THE AMERICAN JOURNAL OF OTOLOGY 1996; 17:288-92. [PMID: 8723963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A retrospective analysis is presented of 44 cases of congenital cholesteatoma of the middle ear. Twenty-one patients had cholesteatoma localized to the posterosuperior mesotympanum in complete contrast to the commonly reported anterosuperior location seen in only two cases. The remaining 21 patients had cholesteatoma involving either the entire mesotympanum or epitympanum or both. The posteriorly located congenital cholesteatomas might represent a completely different entity and originate from the trapped epithelial cell rests in the posterior mesotympanum during the development of temporal bone. All but one patient were treated by using a closed tympanoplasty. Eight patients underwent a single-stage surgery. A preplanned second-stage procedure was performed in 33 patients, and three are awaiting their second stage. Residual disease was seen in 19 (57%) patients undergoing second-stage surgery. No patient has had recurrent disease so far. Thirty-eight (85%) patients had a preoperative air-bone gap of > or = 30 dB. Of the 33 patients considered for hearing results, 16 (48%) had a postoperative gap within 10 db.
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Karmarkar S, Bhatia S, Saleh E, DeDonato G, Taibah A, Russo A, Sanna M. Cholesteatoma surgery: the individualized technique. Ann Otol Rhinol Laryngol 1995; 104:591-5. [PMID: 7639466 DOI: 10.1177/000348949510400801] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A retrospective analysis of 433 cholesteatoma cases, surgically treated at the Gruppo Otologico, Piacenza, Italy, over a 7-year period, is reported. The purpose of this study was to delineate actual indications for individualizing open and closed procedures and to compare their results as regards residual or recurrent disease and hearing. The total incidences of residual and recurrent cholesteatoma in the open cavity procedures were 10% and 2.38%, respectively, while the closed procedures showed higher incidences of residual and recurrent cholesteatoma: 31.22% and 11.16%, respectively. The problem of a persistently discharging cavity was encountered in only 1 case of an open procedure, while 2 patients had persistent otorrhea among the closed cavity cases. The hearing results, although slightly better in the closed procedures, were not significantly different from those in the open procedures.
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Falcioni M, Aristegui M, Landolfi M, Saleh E, Taibah AK, Russo A, Sanna M. [Meningoencephalic herniation into the middle ear]. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 1995; 15:305-11. [PMID: 8928663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Herniation of meningeal and/or encephalic tissue into the middle ear is a pathology which, even if rarely found by the otologist, can be life-threatening for the patient because of eventual infective intracranial complications. Four different etiological types are possible, infective, post-surgical, traumatic and spontaneous. From a pathogenic point of view, all types are characterized by a bony and dural defect localized in the tegmen through which meningeal and encephalic tissue can herniate. Symptomatology is often non-specific so that some cases are diagnosed during surgery. When there is strong suspicion of herniation neuroradiological assessment procedures must be carried out in order to make a correct pre-operative diagnosis, High Resolution Computed Tomography (HRCT) of the temporal bone in particular, can show the exact limits and location of the bone defect, while Magnetic Resonance Imaging (MRI) allows the nature of the tissue in the middle ear to be determined. Surgery is the only appropriate therapy. Different approaches have been described amongst which the transmastoid with or without temporal minicraniotomy and the middle cranial fossa (MCF) are the most frequently reported literature. From June 1982 to March 1994, 27 consecutive cases underwent surgery at the Gruppo Otologico, Piacenza. As a result of the occurrence of postoperative meningitis in one case, a new surgical technique through the MCF was standardized. The main step of this procedure consist in leaving the herniated tissue in situ so as to make a barrier between the middle ear and subdural space. The technique is indicated either in the case of large, multiple or very anteriorly located bony defects or when there is an infection in the middle ear.
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Saleh E, Achilli V, Naguib M, Taibah AK, Russo A, Sanna M, Mazzoni A. Facial nerve neuromas: diagnosis and management. THE AMERICAN JOURNAL OF OTOLOGY 1995; 16:521-6. [PMID: 8588654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Facial nerve neuromas are uncommon tumors that involve the facial nerve. There is no classic presentation of these tumors. This study presents a series of 22 patients with facial neuromas managed from 1977 to 1993. Facial nerve dysfunction was the most common complaint, present in 90.5% of cases. Hearing loss was the second most common complaint and was found in 76.2% of cases. High resolution computed tomography and magnetic resonance imaging with gadolinium proved to be the most accurate methods of preoperative assessment of these tumors and are complementary in selected cases. Different surgical approaches were performed according to tumor location and preoperative hearing level. In all cases long-term follow-up showed no tumor recurrence, and acceptable return of facial function was noted in 80% of cases.
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Mutlu C, Khashaba A, Saleh E, Karmarkar S, Bhatia S, DeDonato G, Russo A, Sanna M. Surgical treatment of cholesteatoma in children. Otolaryngol Head Neck Surg 1995; 113:56-60. [PMID: 7603723 DOI: 10.1016/s0194-5998(95)70145-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Treating cholesteatoma in children is still controversial. This article reviews 93 cases of pediatric cholesteatoma operated on from 1983 to 1991 in the Gruppo Otologico, Placenza, Italy, and details the results in 83 children who underwent the intact canal wall technique. During second-stage surgery, residual cholesteatoma was detected in 38% of patients. Recurrent cholesteatoma was detected in 10% of patients treated with the intact canal wall technique. Residual cholesteatoma was seen in the middle ear cleft in 63%, in the epitympanum in 26%, and in the mastoid in 11% of cases. Social hearing level (< 25 dB) was achieved in 85% of cases with suprastructure, whereas only 53% of patients without suprastructure had these levels. In the treatment of cholesteatoma in children by use of the intact canal wall technique, a preplanned second-look operation is mandatory to eradicate the disease.
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Celikkanat SM, Saleh E, Khashaba A, Taibah A, Russo A, Mazzoni A, Sanna M. Cerebrospinal fluid leak after translabyrinthine acoustic neuroma surgery. Otolaryngol Head Neck Surg 1995. [PMID: 7777347 DOI: 10.1016/s0194-5998(95)70171-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cerebrospinal fluid leakage is the most common complication of translabyrinthine acoustic neuroma surgery. This retrospective study reviews patients who had translabyrinthine acoustic neuroma surgery at the Gruppo Otologico, Piacenza, Italy, and ENT Department of Bergamo General Hospital, Bergamo, Italy, during the last 6 years. The incidence of postoperative cerebrospinal fluid leakage was 6.2%, and 75% of these patients underwent another surgery to control the cerebrospinal fluid leakage. A modification of translabyrinthine approach was used in patients with highly pneumatized temporal bones to prevent cerebrospinal fluid leakage in these high-risk patients.
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Celikkanat SM, Saleh E, Khashaba A, Taibah A, Russo A, Mazzoni A, Sanna M. Cerebrospinal Fluid Leak after Translabyrinthine Acoustic Neuroma Surgery. Otolaryngol Head Neck Surg 1995; 112:654-8. [PMID: 7777347 DOI: 10.1016/s0194-59989570171-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cerebrospinal fluid leakage is the most common complication of translabyrinthine acoustic neuroma surgery. This retrospective study reviews patients who had translabyrinthine acoustic neuroma surgery at the Gruppo Otologico, Piacenza, Italy, and ENT Department of Bergamo General Hospital, Bergamo, Italy, during the last 6 years. The incidence of postoperative cerebrospinal fluid leakage was 6.2%, and 75% of these patients underwent another surgery to control the cerebrospinal fluid leakage. A modification of translabyrinthine approach was used in patients with highly pneumatized temporal bones to prevent cerebrospinal fluid leakage in these high-risk patients.
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Arìstegui M, Falcioni M, Saleh E, Taibah A, Russo A, Landolfi M, Sanna M. Meningoencephalic herniation into the middle ear: a report of 27 cases. Laryngoscope 1995; 105:512-8. [PMID: 7760669 DOI: 10.1288/00005537-199505000-00013] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Meningoencephalic herniation into the middle ear is a rare and potentially life-threatening condition that may require prompt surgical intervention. Preoperative diagnosis is based on a high index of suspicion. Sometimes, however, meningoencephalic herniation is discovered during surgery. High-resolution computed tomography and magnetic resonance imaging should be performed to confirm the diagnosis and to evaluate the extension of the herniated tissue. This article discusses the diagnostic approach, management strategy, and surgical technique used in 27 patients with meningoencephalic herniation. In an attempt to avoid infective complications, the authors used the middle cranial approach in patients with large herniations.
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De Donato G, Russo A, Taibah A, Saleh E, Sanna M. [Incidence of normal hearing in acoustic neuroma]. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 1995; 15:73-9. [PMID: 8928653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Unilateral or asymetrical sensorineural hearing loss, tinnitus and instability classically represent the main symptoms for the suspected diagnosis of acoustic neurinoma. In literature there are very few studies which refer about acoustic neurinoma in patients with normal hearing. In this article we report the results of a retrospective analysis of 155 acoustic neurinoma cases with normal hearing managed in our center in the last 7 years. These patients are classified in two groups: 1) with normal hearing at the time of diagnosis and 2) with at least a mild sensorineural hearing loss. Of this 155 cases, 21 (13.5%) had normal pure tone audiogram. An important characteristic of these patients, in comparison with the group with normal hearing, is the younger age. Tinnitus, instability, sudden hearing loss with complete recovery and vertigo are the most common symptoms. The mean pure tone threshold is 14.7 dB, speech audiometry is positive in very few cases, while a large number of cases show false negative. ABR are positive in 90.5% of cases, and demonstrate its high sensitivity for retrococlear pathology. The mean tumor size shows significant differences between the group with normal hearing and this with hearing loss. We believe that the presence of this symptoms in a young patient should necessitate complete neurotologic examination and in the patients with normal hearing a high level of suspicion represents the first step for early diagnosis of small tumors; the next step is the through evaluation of patient with pure tone audiogram, ABR, and imaging studies, preferably MRI with gadolinium, as this permits the diagnosis of small intracanalicular tumor. Thus, in cases of small tumors with good hearing we feel that will be possible to adopt hearing conservation surgical approach like FCM and retrosigmoid approach in more cases.
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Saleh E, Naguib M, Aristegui M, Cokkeser Y, Sanna M. Lower skull base: anatomic study with surgical implications. Ann Otol Rhinol Laryngol 1995; 104:57-61. [PMID: 7832543 DOI: 10.1177/000348949510400109] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
With advances in the lateral approaches to the skull base and the increasing success of the management of jugular foramen lesions, a thorough knowledge of the anatomy of this region is needed. The purpose of the present work is to study the detailed microsurgical anatomy of the lower skull base and the jugular foramen area as seen through the lateral approaches. Forty preserved skull base specimens and 5 fresh cadavers were dissected. The shape of the jugular bulb and its relationship to nearby structures were recorded. The different venous connections of the bulb were noted. The hypoglossal canal was identified and its contents were observed. The lower cranial nerves were studied at the level of the upper neck, at their exit from the inferior skull base, and in the jugular foramen. The results of the present study showed the complex and variable anatomy of this area. The classic compartments of the jugular foramen were not always present. Cranial nerves IX through XI followed different patterns while passing through the jugular foramen, being separated from the jugular bulb by bone, thick fibrous tissue, or thin connective tissue.
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el-Ghazzawi E, Drew L, Hamdy L, El-Sherbini E, Sadek SED, Saleh E. Intravenous drug addicts: a high risk group for infection with human immunodeficiency virus, hepatitis viruses, cytomegalo virus and bacterial infections in Alexandria Egypt. J Egypt Public Health Assoc 1995; 70:127-50. [PMID: 17214204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
In this work the seroprevalence of HIV, HBV, HCV and CMV were studied among two groups of population; IVDA (intravenous drug addicts) (100) and control group (40). Syphilis and other bacterial infections which may be encountered among IVDA were also investigated. It was found that all serum samples (of both groups) were negative for anti-HIV. Regarding HBV markers, the prevalence of HBc antibodies was significantly higher among IVDA (62%) than the control group (27.5%). Also HBsAg was detected in 16% of IVDA while it was 75% among the control group. Prevalence of anti-HCV was significantly higher among IVDA (63%) than the control group (27.5%). The prevalence of co-infection with HBV and HCV was significantly higher in IVDA (40%) than the control group (15%). Sharing of needles and duration of drug use were positively associated with the presence of both HBV markers and anti-HCV. CMV seroprevalence was high in both groups. Antibodies to Syphilis were found in sera of 3 IVDA and one control using MHA-TP test. Although HIV infection has not yet been sufficiently introduced among IVDA in Alexandria but potentials for its spread among addicts are high as supported by observation that other infections with similar mode of transmission are common among addicts.
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Naguib MB, Aristegui M, Saleh E, Cokkeser Y, Russo A, Sanna M. Surgical management of epitympanic cholesteatoma with intact ossicular chain: the modified Bondy technique. Otolaryngol Head Neck Surg 1994; 111:545-9. [PMID: 7970789 DOI: 10.1177/019459989411100501] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The results of 37 cases surgically treated with the modified Bondy technique during a 6-year period at the Gruppo Otologico-Piacenza, Italy, are reported. This technique, indicated in epitympanic cholesteatoma with good hearing and intact ossicular chain and pars tensa, provides a one-stage mastoid cavity exteriorization with radical removal of cholesteatoma while preserving the preoperative hearing levels. The technique, indications, results, and comparison with other current techniques are discussed in this article.
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Cokkeser Y, Naguib M, Aristegui M, Saleh E, Landolfi M, Russo A, Sanna M. Revision stapes surgery: a critical evaluation. Otolaryngol Head Neck Surg 1994; 111:473-7. [PMID: 7936681 DOI: 10.1177/019459989411100414] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fifty-six revision stapes surgeries performed during the last 9 years were evaluated retrospectively for their preoperative symptoms, intraoperative findings, and postoperative results according to the causes of failure, at the Gruppo Otologico, Piacenza, Italy. The most frequent causes of failure were found to be prosthetic misalignments, a reaction to the surgical trauma in the form of excess fibrous tissue reaction or new bony regrowth at the oval window, and ossicular chain problems. The location of the pathology was found to be an important factor in the outcome. Sixty percent of cases resulted in 0- to 20-dB air-bone gap. The causes of these failures, management, and their prevention during primary surgeries are also discussed.
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Naguib MB, Aristegui M, Saleh E, Cokkeser Y, Landolfi M, Taibah A, Russo A, Sanna M. Surgical anatomy of the petrous apex as it relates to the enlarged middle cranial fossa approaches. Otolaryngol Head Neck Surg 1994; 111:488-93. [PMID: 7936684 DOI: 10.1177/019459989411100417] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This work was designed to study the surgical anatomy of the petrous apex as it relates to the enlarged middle cranial fossa approaches, on 25 temporal bones. In this study we suggest dividing the petrous apex into two topographic areas: an anterior triangular and a posterior quadrangular area with respect to the posterior border of the Gasserian ganglion. Anatomic descriptions endorsed by relevant measurements of these areas are provided in this study.
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Naguib MB, Saleh E, Cokkeser Y, Aristegui M, Landolfi M, Taibah AK, Mazzoni A, Sanna M. The enlarged translabyrinthine approach for removal of large vestibular schwannomas. J Laryngol Otol 1994; 108:545-50. [PMID: 7930886 DOI: 10.1017/s0022215100127392] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study was carried out to validate the enlarged translabyrinthine approach for the surgical management of large vestibular schwannomas. A retrospective review of the charts of 53 patients with large tumours removed via the enlarged translabyrinthine approach at the Gruppo Otologico, Piacenza, Italy, during the last five years was carried out. The ability to control large tumours and the achievement of total removal with low morbidity and very few complications, demonstrate that tumour size does not influence the use of the enlarged translabyrinthine approach for managing large tumours.
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Landolfi M, Arsistegui M, Taibah A, Russo A, Saleh E, Sanna M. [The extended middle cranial fossa approach: a morphometric analysis]. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 1994; 14:127-34. [PMID: 7976322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The extended middle cranial fossa (EMCF) approach calls for removal of the petrous bone from its subtemporal surface in order to well expose the internal auditory canal (IAC) and the posterior fossa dura (PDF) around its meatus, safeguarding, at the same time, all the important, closely related, anatomical structures (the Gasserian ganglion (GG) and its third trigeminal division, the internal carotid artery (ICA), the cochlea, the posterior labyrinth, the superior petrosal sinus (SPS), the inferior petrosal sinus (IPS) and the jugular bulb (JB). The middle meningeal artery, on the other hand, could be divided when necessary. We dissected 25 temporal bones preserved in formaldehyde and those of five cadavers in order to define the limits of this approach. Measurements were taken so as to establish the limits of the approach as well as to determine the most appropriate angles and distances in working in this area. As previously suggested by the Senior Author (MS), we found it safer to start working medially in order to identify the IAC and then to extend the dissection laterally. The most constant angle proved to be that between the IAC and the SPS. The distances and areas found appear to be highly variable and difficult to rely upon. A thorough knowledge of this anatomy is of most importance for the surgeon who intends to use this approach.
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Saleh E, Naguib M, Russo A, Taibah AK, Sanna M. Vascular malformation of the internal auditory canal. J Laryngol Otol 1993; 107:1039-42. [PMID: 8288977 DOI: 10.1017/s0022215100125216] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A report of a case with a vascular malformation of the internal auditory canal (IAC) is presented. A review of the literature of this rather rare lesion is also made in an attempt to outline its clinical features, radiological diagnosis and management. The differential diagnosis and distinction between vascular malformations and other internal auditory canal tumours are discussed.
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Drew WL, Miner R, Saleh E. Antiviral susceptibility testing of cytomegalovirus: criteria for detecting resistance to antivirals. ACTA ACUST UNITED AC 1993; 1:179-85. [PMID: 15566731 DOI: 10.1016/0928-0197(93)90012-t] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/1992] [Revised: 04/15/1993] [Accepted: 04/19/1993] [Indexed: 10/27/2022]
Abstract
Testing cytomegaloviruses for antiviral susceptibility is increasing especially since the reports of 'resistance' to ganciclovir and foscarnet (Erice et al., 1989; Knox et al., 1991). There is however no standardized method for susceptibility testing nor are there criteria for designating an isolate as sensitive or resistant. In a previous paper we utilized a plaque reduction assay and suggested that a resistant strain be defined as one requiring > 12 microM ganciclovir for inhibition of 50% of viral plaques. (Drew et al., 1991) This concentration was chosen because it was at least four-fold greater than the mean concentration required to inhibit pretherapy isolates. In this paper we present the results of testing a large number of isolates prior to and during therapy with either ganciclovir or foscarnet. By analyzing the results of these assays we propose revised criteria for susceptibility of cytomegalovirus </= 5 microM for ganciclovir and <400 microM for foscarnet.
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