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Urbanelli A, Nitro L, Pipolo C, Maccari A, Albera A, Fadda GL, Felisati G, Albera R, Pecorari G, Fuccillo E, Saibene AM. Therapeutic approaches to sinonasal NUT carcinoma: a systematic review. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08489-0. [PMID: 38329527 DOI: 10.1007/s00405-024-08489-0] [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: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Sinonasal nuclear protein in testis carcinoma (SNUTC) is a rare, aggressive malignancy caused by genetic rearrangements in the NUTM1 gene. The prognosis of SNUTC ranks among the most unfavorable within the naso-sinusal district, with an overall survival of 9.7 months. This systematic review aimed to determine the best therapeutic strategy for SNUTC. METHODS We reviewed eligible articles for patient demographics, TNM and stage at presentation, best response after primary treatment, disease-free survival and overall survival (OS) times, other following therapy lines, and final outcomes. RESULTS Among 472 unique citations, 17 studies were considered eligible, with reported treatment data for 25 patients. Most studies (n = 12) were case reports. The most frequently administered treatment regimen was surgery as primary treatment and combined radiochemotherapy as second-line or adjuvant treatment. Four patients were alive at follow-up. CONCLUSION Basing on the existing literature, a standardized line in the treatment of SNUTC is not yet well delineated. A self-personalized strategy of therapy should be drawn on each patient affected by SNUTC.
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Affiliation(s)
- Anastasia Urbanelli
- Department of Surgical Sciences, Otorhinolaryngology Unit, University of Turin, Via G. Verdi, 8, 10124, Turin, Italy.
| | - Letizia Nitro
- Department of Health Sciences, Otorhinolaryngology Unit, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Carlotta Pipolo
- Department of Health Sciences, Otorhinolaryngology Unit, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Alberto Maccari
- Department of Health Sciences, Otorhinolaryngology Unit, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Andrea Albera
- Department of Surgical Sciences, Otorhinolaryngology Unit, University of Turin, Via G. Verdi, 8, 10124, Turin, Italy
| | - Gian Luca Fadda
- Otorhinolaryngology Unit, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Giovanni Felisati
- Department of Health Sciences, Otorhinolaryngology Unit, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Roberto Albera
- Department of Surgical Sciences, Otorhinolaryngology Unit, University of Turin, Via G. Verdi, 8, 10124, Turin, Italy
| | - Giancarlo Pecorari
- Department of Surgical Sciences, Otorhinolaryngology Unit, University of Turin, Via G. Verdi, 8, 10124, Turin, Italy
| | - Emanuela Fuccillo
- Department of Health Sciences, Otorhinolaryngology Unit, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Alberto Maria Saibene
- Department of Health Sciences, Otorhinolaryngology Unit, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
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De Donato G, Fuccillo E, Saibene AM, Ferrari E, Pipolo GC, Pisani A, Colletti L, Urbanelli A, De Donato L, Felisati G. Surgical management of tegmen defects of the temporal bone and meningoencephalic herniation: our experience. J Otol 2024; 19:30-34. [PMID: 38313759 PMCID: PMC10837531 DOI: 10.1016/j.joto.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/29/2023] [Accepted: 12/07/2023] [Indexed: 02/06/2024] Open
Affiliation(s)
- Giuseppe De Donato
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Emanuela Fuccillo
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Alberto Maria Saibene
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
- Department of Health Sciences, University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy
| | - Elena Ferrari
- Department of Health Sciences, University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy
| | - Giorgia Carlotta Pipolo
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
- Department of Health Sciences, University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy
| | - Antonia Pisani
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Liliana Colletti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy
| | - Anastasia Urbanelli
- ENT Unit, Department of Surgical Sciences, University of Turin, Via Verdi, 8, 10124, Turin, Italy
| | - Luigi De Donato
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Giovanni Felisati
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy
- Department of Health Sciences, University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy
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Vultaggio F, Martino B, Nitro L, Fuccillo E, Felisati G, De Pasquale L. A parathyroid cancer with soporous state, depression, and severe cognitive decline in acute renal failure. Clin Case Rep 2023; 11:e7627. [PMID: 37397577 PMCID: PMC10310898 DOI: 10.1002/ccr3.7627] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
Key Clinical Message Soporous state in acute renal failure represent an atypical presentation of parathyroid cancer. Complete prompt investigations and diagnosis have a fundamental role in the management of this disease. Abstract This report describes a case of parathyroid carcinoma (PC) with an uncommon first clinical presentation: soporous state, depression, and severe cognitive decline in association with acute renal failure. After discovering extremely high serum calcium and parathyroid hormone (PTH) levels, the diagnosis of primary hyperparathyroidism (pHPT) was made and a surgical en bloc resection was performed. After the surgical intervention, the histological examination revealed the presence of a malignant parathyroid disease, thus confirming our first preoperative suspicion.
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Affiliation(s)
- Federica Vultaggio
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
- Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Barbara Martino
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
- Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Letizia Nitro
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
- Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Emanuela Fuccillo
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Giovanni Felisati
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
- Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Loredana De Pasquale
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
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4
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Rosso C, Turati F, Saibene AM, Verduci E, Fuccillo E, Tavilla MC, Magnani M, Banderali G, Ferraroni M, De Corso E, Felisati G, Pipolo C. Nasal Cytology on 241 Children: From Birth to the First 3 Years of Life and Association with Common Airways Diseases. J Pers Med 2023; 13:jpm13040687. [PMID: 37109073 PMCID: PMC10146100 DOI: 10.3390/jpm13040687] [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: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Nasal cytology at birth and in the pediatric age is barely investigated regarding its association with the onset of common pediatric diseases. METHODS We enrolled 241 newborns within their first 24 h of life, studying their nasal cellular composition and repeating this at 1 and 3 years of life. We collected anamneses of perinatal factors and external factors (parental smoking, passive smoking, breastfeeding), and the prevalence of otitis, rhinosinusitis, bronchitis, asthma, and allergy at all timepoints. RESULTS 204 children completed the study. At birth, there was a prevalence of ciliated cells and rare neutrophils. At 1 and 3 years, ciliated cells started reducing in favor of muciparous cells and neutrophils. We found that caesarian delivery and nasogastric tube usage for choanal patency are significantly related to a certain cellular nasal composition. Additionally, development of upper respiratory tract infections, AOM (acute otitis media) and allergy correlates with specific cytological compositions which may predict those pathologies. CONCLUSIONS Our study is the first to show the normal nasal mucosa cellular composition and development in the first 3 years of life in a large cohort. Nasal cytology may be a tool for early risk assessment in the occurrence of upper airway disease.
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Affiliation(s)
- Cecilia Rosso
- Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, 20148 Milan, Italy
| | - Federica Turati
- Branch of Medical Statistics, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Alberto Maria Saibene
- Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, 20148 Milan, Italy
| | - Elvira Verduci
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Emanuela Fuccillo
- Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
| | - Maria Chiara Tavilla
- Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
| | - Mauro Magnani
- Department of Hand Surgery and Microsurgery, Gaetano Pini-CTO Orthopaedic Institute, University of Milan, 20122 Milan, Italy
| | - Giuseppe Banderali
- Pediatric Department, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
| | - Monica Ferraroni
- Branch of Medical Statistics, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
- Fondazione IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Eugenio De Corso
- Department of Otorhinolaryngology, La Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Felisati
- Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, 20148 Milan, Italy
| | - Carlotta Pipolo
- Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, 20148 Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, 20148 Milan, Italy
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5
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Nitro L, Martino B, Fuccillo E, Felisati G, Saibene AM. Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy. Clin Case Rep 2022; 10:e6412. [PMID: 36245466 PMCID: PMC9552548 DOI: 10.1002/ccr3.6412] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022] Open
Abstract
We present a case of sudden sensorineural hearing loss and rapidly progressive facial palsy in a female patient in her 40s with no, apparently, notable past medical or surgical history. Investigations revealed a positive serology for B. burgdoferi and the MRI allowed us to identify suggestive signs of Lyme meningitis with multiple cranial nerve involvement. After diagnosis, the patient was treated with intravenous ceftriaxone with a full recovery of sensorineural deafness and facial palsy. This case report highlights the importance of collecting a complete medical history in all cases of facial palsy and sudden hearing loss while presenting an infrequent clinical presentation of early disseminated Lyme disease with neuroborreliosis.
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Affiliation(s)
- Letizia Nitro
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo HospitalUniversità degli Studi di MilanoMilanItaly
| | - Barbara Martino
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo HospitalUniversità degli Studi di MilanoMilanItaly
| | - Emanuela Fuccillo
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo HospitalUniversità degli Studi di MilanoMilanItaly
| | - Giovanni Felisati
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo HospitalUniversità degli Studi di MilanoMilanItaly
| | - Alberto Maria Saibene
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo HospitalUniversità degli Studi di MilanoMilanItaly
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6
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Bulfamante AM, Lori E, Bellini MI, Bolis E, Lozza P, Castellani L, Saibene AM, Pipolo C, Fuccillo E, Rosso C, Felisati G, De Pasquale L. Advanced Differentiated Thyroid Cancer: A Complex Condition Needing a Tailored Approach. Front Oncol 2022; 12:954759. [PMID: 35875142 PMCID: PMC9300941 DOI: 10.3389/fonc.2022.954759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 12/28/2022] Open
Abstract
Differentiated thyroid cancers (DTCs) are slow-growing malignant tumours, including papillary and follicular carcinomas. Overall, prognosis is good, although it tends to worsen when local invasion occurs with bulky cervical nodes, or in the case of distant metastases. Surgery represents the main treatment for DTCs. However, radical excision is challenging and significant morbidity and functional loss can follow the treatment of the more advanced forms. Literature on advanced thyroid tumours, both differentiated and undifferentiated, does not provide clear and specific guidelines. This emerges the need for a tailored and multidisciplinary approach. In the present study, we report our single-centre experience of 111 advanced (local, regional, and distant) DTCs, investigating the rate of radical excision, peri-procedural and post-procedural complications, quality of life, persistence, recurrence rates, and survival rates. Results are critically appraised and compared to the existing published evidence review.
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Affiliation(s)
- Antonio Mario Bulfamante
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Eleonora Lori
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
- *Correspondence: Eleonora Lori,
| | | | | | - Paolo Lozza
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Luca Castellani
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Alberto Maria Saibene
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Carlotta Pipolo
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Emanuela Fuccillo
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Cecilia Rosso
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Loredana De Pasquale
- Thyroid and Parathyroid Surgery Service-Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
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7
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Pipolo C, Bottai D, Fuccillo E, Aronica E, Bruschi F, Bulfamante AM, Castellani L, Canevini MP, Chiumello D, Ferrari S, Martinelli C, Muttini S, Priori A, Saibene AM, Spoldi C, Tosi D, Zanusso G, Bulfamante GP, Felisati G. Evidence of SARS-CoV-2 in nasal brushings and olfactory mucosa biopsies of COVID-19 patients. PLoS One 2022; 17:e0266740. [PMID: 35413071 PMCID: PMC9004784 DOI: 10.1371/journal.pone.0266740] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 03/25/2022] [Indexed: 01/12/2023] Open
Abstract
The aim of the present study is to detect the presence of SARS-CoV-2 of patients affected by COVID-19 in olfactory mucosa (OM), sampled with nasal brushing (NB) and biopsy, and to assess whether a non-invasive procedure, such as NB, might be used as a large-scale procedure for demonstrating SARS-CoV-2 presence in olfactory neuroepithelium. Nasal brushings obtained from all the COVID-19 patients resulted positive to SARS-CoV-2 immunocytochemistry while controls were negative. Double immunofluorescence showed that SARS-CoV-2 positive cells included supporting cells as well as olfactory neurons and basal cells. OM biopsies showed an uneven distribution of SARS-CoV-2 positivity along the olfactory neuroepithelium, while OM from controls were negative. SARS-CoV-2 was distinctively found in sustentacular cells, olfactory neurons, and basal cells, supporting what was observed in NB. Ultrastructural analysis of OM biopsies showed SARS-CoV-2 viral particles in the cytoplasm of sustentacular cells. This study shows the presence of SARS-CoV-2 at the level of the olfactory neuroepithelium in patients affected by COVID-19. For the first time, we used NB as a rapid non-invasive tool for assessing a potential neuroinvasion by SARS-CoV-2 infection.
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Affiliation(s)
- Carlotta Pipolo
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Daniele Bottai
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Fuccillo
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Eleonora Aronica
- Department of Neuropathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Fabio Bruschi
- Epilepsy Centre, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Antonio Mario Bulfamante
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Luca Castellani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Maria Paola Canevini
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Epilepsy Centre, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Davide Chiumello
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Sergio Ferrari
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Carla Martinelli
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Human Pathology and Medical Genetic, Cytogenetics and Molecular Pathology Unit, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Stefano Muttini
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Alberto Priori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- “Aldo Ravelli”, Center for Experimental Neurotherapeutics, Milan, Italy
| | - Alberto Maria Saibene
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Chiara Spoldi
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Delfina Tosi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Human Pathology and Medical Genetic, Cytogenetics and Molecular Pathology Unit, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Gianluigi Zanusso
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gaetano Pietro Bulfamante
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Human Pathology and Medical Genetic, Cytogenetics and Molecular Pathology Unit, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Giovanni Felisati
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Otorhinolaryngology Unit, Head and Neck Department, ASST Santi Paolo e Carlo Hospital, Milan, Italy
- * E-mail: ,
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Di Girolamo S, Martino F, Guerrieri M, Turco M, Flora B, Fuccillo E, Di Girolamo M. Odontogenic Maxillary Sinusopathies: a Radiological Classification. J Maxillofac Oral Surg 2022; 21:141-149. [PMID: 35400922 PMCID: PMC8934841 DOI: 10.1007/s12663-020-01329-8] [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: 02/04/2019] [Accepted: 01/04/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose Before implant surgery, a preoperative radiological evaluation is recommended for recognizing maxillary inflammatory conditions. In order to avoid a failure of the dental procedure and prevent medical-legal consequences, it is necessary to treat patients suffering of maxillary sinus pathologies. The classification proposed in our study aims to standardize the reference values for mucosal thickening and to verify their association with the odontogenic or disventilatory causes of sinus pathology. Methods The maximum mucosal thickness was measured at the level of the maxillary sinus floor: mucosal thickness was present when greater than 1 mm and was classified according to its extension within the sinus cavity. Results Imaging data of 270 adult patients were included, performed for dental diagnosis and treatment planning, and they were divided into four main classes: Class I (85 pt.), mucosal thickness lesser than 2 mm, not pathological. Class II A (52 pt.), mucosal thickness between 2 and 5 mm, localized to the maxillary sinus floor: it is still considered non-pathological, and a "wait-and-see" approach is recommended. Class II B (46 pt.), mucosal thickness greater than 5 mm but localized at sinus floor: pathological mucosa with odontogenic etiology, requiring dental treatment. Class III A (39 pt.), mucosa thicker than 5 mm and concentric, most likely due to sinus ventilation disfunction: it requires maxillary antrostomy. Class III B (30 pt.), sinonasal manifestations such as nasal polyposis, retention cysts, mucocele, dental foreign body: pathological mucosa to be treated with ESS. Class IV (12 pt.), oroantral fistula: nasal endoscopic or oral approach. Conclusions Our classification intends to suggest the better therapeutic option, in case of sinus pathology, according to the entity and pathogenesis of the mucosal thickening, in order to reduce complication and failure rate of dental surgery.
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Affiliation(s)
- Stefano Di Girolamo
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
| | - Federica Martino
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
| | - Mariapia Guerrieri
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
| | - Margherita Turco
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
| | - Barbara Flora
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
| | - Emanuela Fuccillo
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
| | - Michele Di Girolamo
- Department of Translational Medicine, Otolaryngology, University of Rome “Tor Vergata”, Via Montpellier,1, 00133 Rome, Italy
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Fuccillo E, Frezza E, Massa R, Di Girolamo S. RESPONSE TO LETTER TO THE EDITOR "AUDITORY DYSFUNCTION IN FACIOSCAPULOHUMERAL MUSCULAR DYSTROPHY TYPE 1: BEYOND THE INNER EAR INVOLVEMENT" BY GHELLER ET AL. Otol Neurotol 2022; 43:e392-e393. [PMID: 34772889 DOI: 10.1097/mao.0000000000003423] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Emanuela Fuccillo
- Department of Clinical Sciences and Translational Medicine
- Otorhinolaryngology Unit, Tor Vergata University of Rome
- Rome, Italy
- Santi Paolo e Carlo Hospital, Otorhinolaryngology Unit
- Head and Neck Department, Milan, Italy
| | - Erica Frezza
- Department of Systems Medicine
- Neuromuscular Diseases Unit
- Tor Vergata University of Rome
- Rome, Italy
| | - Roberto Massa
- Department of Systems Medicine
- Neuromuscular Diseases Unit
- Tor Vergata University of Rome
- Rome, Italy
| | - Stefano Di Girolamo
- Department of Clinical Sciences and Translational Medicine
- Otorhinolaryngology Unit
- Tor Vergata University of Rome
- Rome, Italy
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Rosso C, Bulfamante AM, Pipolo C, Fuccillo E, Maccari A, Lozza P, Scotti A, Pisani A, Castellani L, De Donato G, Tavilla MC, Portaleone SM, Felisati G, Saibene AM. Adenoidectomy for middle ear disease in cleft palate children: a systematic review. Eur Arch Otorhinolaryngol 2021; 279:1175-1180. [PMID: 34453572 PMCID: PMC8897369 DOI: 10.1007/s00405-021-07035-6] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/08/2021] [Indexed: 11/24/2022]
Abstract
Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07035-6.
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Affiliation(s)
- Cecilia Rosso
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Antonio Mario Bulfamante
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Carlotta Pipolo
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Emanuela Fuccillo
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Alberto Maccari
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Paolo Lozza
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Alberto Scotti
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Antonia Pisani
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Luca Castellani
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Giuseppe De Donato
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Maria Chiara Tavilla
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Sara Maria Portaleone
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Alberto Maria Saibene
- Otolaryngology Unit, Department of Health Sciences, Santi Paolo E Carlo Hospital, Università Degli Studi Di Milano, Via Antonio di Rudinì, 8, 20142, Milan, Italy.
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Saibene AM, Fuccillo E, Felisati G. Vagus nerve stimulator implantation for drug-resistant epilepsy, with video. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 2:69-70. [PMID: 34127409 DOI: 10.1016/j.anorl.2021.02.018] [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: 01/11/2021] [Revised: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 10/21/2022]
Affiliation(s)
- A M Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, via Antonio di Rudinì, 20142 Milan, Italy.
| | - E Fuccillo
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, via Antonio di Rudinì, 20142 Milan, Italy.
| | - G Felisati
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, via Antonio di Rudinì, 20142 Milan, Italy.
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12
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Fuccillo E, Saibene AM, Canevini MP, Felisati G. Olfactory disorders in coronavirus disease 2019 patients: a systematic literature review. J Laryngol Otol 2020; 134:1-10. [PMID: 32928323 PMCID: PMC7511837 DOI: 10.1017/s0022215120002005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Recent scientific literature has widely described a possible major role of smell dysfunction as a specific symptom of coronavirus disease 2019. This systematic review may provide a more holistic approach to current knowledge of the disease. METHODS A systematic review was completed using Embase, PubMed and Web of Science databases that considered original articles focused on olfactory evaluation in coronavirus disease 2019 patients, published between March and May 2020, in English language. RESULTS From the 483 research papers initially identified, 32 original studies were selected, comprising a total of 17 306 subjects with a laboratory confirmed diagnosis of coronavirus disease 2019. Individual study sample sizes ranged from 6 to 6452 patients. This comprehensive analysis confirmed that olfactory disorders represent an important clinical feature in coronavirus disease 2019, with a prevalence of 11-100 per cent in included patients, although there was heterogeneity in terms of assessment tools and population selection criteria. CONCLUSION The results indicate that an accurate clinical evaluation should be carried out using structured questionnaires and tests with olfactory substances.
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Affiliation(s)
- E Fuccillo
- Department of Clinical Sciences and Translational Medicine, ‘Tor Vergata’ University of Rome, Italy
| | - A M Saibene
- Department of Health Sciences, University of Milan, Italy
| | - M P Canevini
- Department of Health Sciences, University of Milan, Italy
| | - G Felisati
- Department of Health Sciences, University of Milan, Italy
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13
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Castellani L, Chiesa V, Maccari A, Fuccillo E, Canevini MP, Felisati G, Saibene AM. Pharyngolaryngeal spasm-induced dysphagia in an epileptic patient undergoing vagus nerve stimulation therapy. Clin Case Rep 2020; 8:858-861. [PMID: 32477534 PMCID: PMC7250986 DOI: 10.1002/ccr3.2761] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 11/08/2022] Open
Abstract
Vagus nerve stimulation for refractory epilepsy may induce laryngeal side effects such as dysphonia and dysphagia. Careful tuning of the stimulation parameters and collaboration between epileptologists and otolaryngologists can help significantly reduce side effects.
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Affiliation(s)
- Luca Castellani
- Otolaryngology UnitASST Santi Paolo e CarloDepartment of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Valentina Chiesa
- Regional Centre for EpilepsyASST Santi Paolo e CarloDepartment of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Alberto Maccari
- Otolaryngology UnitASST Santi Paolo e CarloDepartment of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Emanuela Fuccillo
- Institute of OtorhinolaryngologyDepartment of Clinical Sciences and Translation MedicineUniversità di Roma Tor VergataRomeItaly
| | - Maria Paola Canevini
- Regional Centre for EpilepsyASST Santi Paolo e CarloDepartment of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Giovanni Felisati
- Otolaryngology UnitASST Santi Paolo e CarloDepartment of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - Alberto Maria Saibene
- Otolaryngology UnitASST Santi Paolo e CarloDepartment of Health SciencesUniversità degli Studi di MilanoMilanItaly
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Giacomini PG, Boccieri A, Fuccillo E, Di Mauro R, Di Girolamo S. Lateral osteotomy plus hump resection vs hump re-modeling without lateral osteotomy: impact on frontal nasal view. ACTA ACUST UNITED AC 2019; 39:92-97. [PMID: 31097826 PMCID: PMC6522865 DOI: 10.14639/0392-100x-1897] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 07/08/2018] [Indexed: 11/23/2022]
Abstract
This article reviews the personal experience and evolution of osteotomy approach in the last years of practice to obtain a natural appearance of the nasal pyramid in the frontal view. The aim is to analyse the long-term results after rhinoplasty on nasal width in two different cohorts of patients subjected to lateral osteotomy plus hump resection vs. hump re-modeling without lateral osteotomy considering the impact on frontal nasal view and how this relates to changes observed over time in the nasal width and contour. The study was carried out between January 2010 and December 2013, considering 42 patients undergoing primary rhinoplasty. Comparisons were made between the change in the dorsal width of the nasal pyramid at the level of the medial canthi, at the level of the inferior margin of the orbital rim, of ventral width of the nasal pyramid at the level of the medial canthi and at the level of the inferior margin of the orbital rim. In the first group, we found significant postoperative mean widening of the intercanthal dorsal width and narrowing of the ventral, while in the second group there was significant postoperative mean narrowing of the dorsal width both at level of the medial canthi and the anterior junction of the nasal bones. Our analysis seems to point out that dorsal grafting is useful for re-shaping the nasal profile with a persistent and harmonious correction of the dorsal frontal dimension of the nose. Simple hump removal/repositioning may be considered in selected instances to avoid lateral osteotomies. It also seems of paramount importance to tailor osteotomies according to nasal bone anatomy: large, strong and curved bones deserve aggressive narrowing by lateral and medial continuous osteotomies without periosteal elevation, although this approach may be insufficient to narrow the upper dorsal aspect of the nose.
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Affiliation(s)
- P G Giacomini
- Department of Clinical Sciences and Translation Medicine, Institute of Otorhinolaryngology University of Rome "Tor Vergata", Italy
| | - A Boccieri
- Private Practice, CdC Mercede Hospital, Rome, Italy
| | - E Fuccillo
- Department of Clinical Sciences and Translation Medicine, Institute of Otorhinolaryngology University of Rome "Tor Vergata", Italy
| | - R Di Mauro
- Department of Clinical Sciences and Translation Medicine, Institute of Otorhinolaryngology University of Rome "Tor Vergata", Italy
| | - S Di Girolamo
- Department of Clinical Sciences and Translation Medicine, Institute of Otorhinolaryngology University of Rome "Tor Vergata", Italy
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Chiaravalloti A, Fuccillo E, Martorana A, Ricci M, Giacomini PG, Schillaci O, Di Girolamo S. Hearing and cognitive impairment: a functional evaluation of associative brain areas in patients affected by Alzheimer's disease. Funct Neurol 2019; 34:15-20. [PMID: 31172935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Auditory dysfunction observed in patients with cognitive diseases is probably due to the alteration of some brain areas involved in sound stimulus processing. The present study aimed to investigate differences in such processing and in connectivity of the primary auditory cortex in patients affected by Alzheimer's disease (AD) and in normal subjects. We examined 131 diagnosed AD patients and a control group (CG) of 36 normal subjects. After a complete clinical investigation, focused on hearing function, all subjects underwent a brain FDG PET/CT. AD subjects vs CG showed reduced glucose consumption in BA 6,7,8,39, whereas we did not find differences in the primary auditory cortex. In AD, connectivity analyses showed a positive correlation of the primary auditory cortex with BA 6,8,21,31,39,40,42 and a negative correlation with BA 19, cerebellum and basal ganglia. Our findings suggest that neurological evaluation of patients with hearing loss might allow earlier (preclinical) identification of those affected by cognitive impairment.
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Pipolo C, Bianchini S, Barberi S, Landi M, D'Auria E, Fuccillo E, Gaffuri M, Marchisio P, Rosazza C, Saibene AM, Gelardi M, Torretta S. Nasal cytology in children: scraping or swabbing? Rhinology 2017; 55:242-250. [PMID: 28492610 DOI: 10.4193/rhin16.287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nasal cytology has become a valuable tool in the assessment of a multitude of nasal pathologies in children. Collection methods differ significantly and even though the use of the nasal curette is regarded as the most reliable in adults, most practitioners use the nasal swab in children. However, no studies have validated the reliability and supposed better tolerability of the latter. We have compared these two sampling methods regarding their tolerability and analysed the diagnostic accuracy of the cotton nasal swab (NSW) to identify nasal cytotypes and rhinitis phenotypes, using nasal scraping (NSC) for comparison. In a multicentric prospective study we recruited 208 children and performed nasal cytology by means of NSW and NSC. Microscopic evaluating of the nasal cytotypes was performed and tolerability of NSW and NSC was tested. Our data revealed a significantly inferior diagnostic accuracy of NSW compared to NSC regarding reliability and cell counts. Our study is the first to shed light on the role of the sampling tools for pediatric nasal cytology. We documented a poor diagnostic accuracy of NSW, thus suggesting using only the nasal curette in clinical practice. Furthermore, tolerability did not differ between the two, refuting the common thesis that swabs are to be preferred when doing nasal cytology in children.
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Affiliation(s)
- C Pipolo
- Otolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Universita degli Studi di Milano, Milan, Italy
| | - S Bianchini
- Pediatric Highly Intensive Care Unit, Department of Maternal and Pediatric Sciences, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan, Italy
| | - S Barberi
- Department of Pediatrics, ASST Fatebenefratelli, Sacco, Milan, Italy
| | - M Landi
- Gruppo pediatrico di cure primarie Asl To1, Turin, Italy
| | - E D'Auria
- Department of Pediatrics, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Universita degli Studi di Milano, Milan, Italy
| | - E Fuccillo
- Otolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Universita degli Studi di Milano, Milan, Italy
| | - M Gaffuri
- Otolaryngology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan
| | - P Marchisio
- Pediatric Highly Intensive Care Unit, Department of Maternal and Pediatric Sciences, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan, Italy
| | - C Rosazza
- Pediatric Highly Intensive Care Unit, Department of Maternal and Pediatric Sciences, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan, Italy
| | - A M Saibene
- Otolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Universita degli Studi di Milano, Milan, Italy
| | - M Gelardi
- Otolaryngology Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - S Torretta
- Otolaryngology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan
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Mauro RD, Lazzaro GD, Schirinzi T, Martino F, Mercuri NB, Fuccillo E, Pisani A, Girolamo SD. Assessment of Hearing Impairment in Parkinson's Disease: Implications for Differential Diagnosis and Disease Progression. ACTA ACUST UNITED AC 2017. [DOI: 10.4172/2161-0460.1000396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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