Publications by authors named "Chiarella Giuseppe"

Purpose: This study analysed the main artificial intelligence (AI) models for the diagnosis of cholesteatoma on computed tomography (CT), evaluating their performance and comparing them with each other. The increasing application of AI in radiology requires a systematic comparison of available methodologies.

Methods: A systematic literature review was conducted, selecting relevant articles from the main databases.

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  • The paper discusses the potential of analyzing perilymph to study inner ear diseases but notes that current sampling methods are risky and mostly limited to research contexts.
  • It reviews existing literature on perilymph sampling and microneedle technology, identifying eight studies that focus on perilymph features and outcomes related to inner ear drug injections.
  • The authors propose a new, safer method for collecting perilymph in clinical settings by combining traditional techniques and innovative tools like micro-endoscopes and microneedles.
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Objective: We systematically reviewed and meta-analyzed the efficacy of Tailor-Made Notched Music Training (TMNMT) for primary subjective tinnitus in adults. The main goal was to evaluate TMNMT's impact on tinnitus symptoms.

Methods: Following PRISMA guidelines, we included randomized and non-randomized trials.

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  • - The review aimed to assess how effective conservative treatments are for alleviating symptoms in patients with Menière's Disease (MD) and temporomandibular disorders (TMD).
  • - After reviewing 627 articles, only two met the criteria and both indicated that patients experienced significant improvements in various dizziness and vertigo assessments following occlusal splint therapy.
  • - Despite the positive findings, the limited number of studies means that more research is needed to make definitive conclusions about the effectiveness of these conservative approaches.
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Background: The term temporomandibular disorder (TMD) indicates a set of musculoskeletal conditions involving temporomandibular joint (TMJ), masticatory musculature, and related anatomical structures. Pain is the most common clinical manifestation of TMD, and the auditory system might be involved and affected, through tinnitus, dizziness, otalgia and ear fullness sensation.

Objectives: The aim of this systematic review of randomised controlled trails (RCTs) was to evaluate the efficacy of rehabilitative approaches on otologic symptoms in patients with TMD.

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Background: The most frequent form of vertigo in pediatric age is represented by vertigo linked to migraine, with a prevalence of 32.7%. This group of pathologies has received a redefinition of the diagnostic criteria to adapt them to the pediatric age with a new classification of the clinical pictures.

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Purpose: Meniere's disease (MD), a disorder of the inner ear, presents numerous therapeutic challenges, and intratympanic (IT) gentamicin has been proposed for intractable cases. However, controversy regarding dosage and method persists. The purpose of this study was to assess the efficacy and safety of low-dose IT gentamicin on vertigo attacks in MD using a clinical symptomatology-based method, wherein administration was repeated only if vertigo attacks recurred, with a 2-week interval between injections.

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Introduction: Meniere's disease (MD) is an idiopatic condition characterized by recurrent attacks of vertigo, hearing loss, tinnitus, and aural fullness, affecting quality of life. Intravenous glycerol has shown potential as a therapeutic option. This study evaluates its efficacy in a larger patient cohort.

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  • Adenoid cystic carcinoma is a rare and slow-growing salivary gland cancer with difficult treatment options and a poor prognosis.
  • This systematic review analyzed the effectiveness of post-operative radiotherapy compared to surgery alone, focusing on controlling local recurrences and improving survival rates.
  • Findings indicated that while post-operative radiation significantly enhanced local control at 5 years, there were no meaningful differences in overall survival at 5 and 10 years, highlighting the need for further high-quality studies.
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The purpose of this review was to evaluate the air-bone gap with vestibular aqueduct size in enlarged vestibular aqueduct syndrome. According to the PRISMA guidelines we conducted a systematic review of the literature. Published international articles in English from 2000 to 2022 were screened, checking for studies that evaluated the air-bone gap of patients affected by enlarged vestibular aqueduct syndrome and the size of vestibular aqueduct.

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  • The study aimed to evaluate rates of facial nerve palsy and tumor recurrence in patients with endolymphatic sac tumors after surgery, analyzing data from 34 relevant studies involving 202 patients.
  • Results showed that approximately 39.7% of patients experienced facial nerve palsy post-surgery, while 16.5% had residual tumors and 14% experienced tumor recurrence over an average follow-up period of nearly 50 months.
  • The findings indicate that preoperative facial nerve function is already impaired in about 30% of patients, and while surgical intervention can worsen this function, the occurrences of residual and recurring tumors suggest that rigorous follow-up is crucial.
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Vestibular Schwannoma is the most common tumour of Ponto Cerebellar Angle and is capable of strongly impacting the patient's quality of life. In recent decades, the proposals for the management of the disease have multiplied, just as the diagnostic capacity has improved. While in the past, the primary objective was the preservation of the facial function, and subsequently also of the auditory function, the attention to the vestibular symptomatology, which appears to be one of the main indicators of deterioration of quality of life, is still unsatisfactory.

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: Discussion is open about the relationship between diabetes (DM) and hearing loss (HL). There is a lot of evidence in the literature suggesting a causal link between these conditions, beyond being considered simple comorbidities. The difficulty in identifying populations free from confounding factors makes it difficult to reach definitive conclusions on the pathophysiological mechanisms at play.

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Background and Objectives: Several treatments are available for sudden sensorineural hearing loss (SSNHL), but no studies have compared the different treatments based on the delay from the onset of the disease. Our study aims to compare the effect of hyperbaric oxygen therapy (HBOT), oral steroids (OS) and combination of both therapies (HBOT + OS) for treating SSNHL. Materials and Methods: This randomized study analyzed 171 patients with SSNHL.

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Acute vestibular syndrome (AVS) represents a clinical picture that involves urgent management due to the important procession of symptoms accompanying the event, which can be positively or negatively influenced by therapeutic choices and intervention timing. This forces a differential diagnosis and therapeutic choices to be made in conditions that are not always favorable and often not in the specialist field. In this work, we will examine in detail the pharmacological therapeutic possibilities, correlating them to the differential and, as far as possible, to the etiological diagnosis.

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  • The study compares two myringoplasty (MPL) techniques—underlay and overlay—by analyzing the outcomes in 497 adult patients from 2010 to 2018.
  • Results showed that functional success was higher in the underlay technique (85%) compared to the overlay technique (68%), with overall anatomical failures at 13.4%.
  • The underlay method is recommended for better outcomes, particularly for small to medium perforations, while the overlay may be considered for larger perforations.
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Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences.

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  • The study aimed to compare the effectiveness and safety of various materials used for sealing the oval window during stapedotomy surgery, focusing on patients with otosclerosis or congenital stapes fixation.
  • A systematic review was performed, analyzing literature from 2000 to 2021, resulting in six studies that evaluated outcomes after using fat and gelfoam compared to other materials.
  • The findings showed no significant differences in the closure of the air-bone gap between materials, indicating that while multiple options are safe and effective, no specific material is superior at this time.
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Purpose: Most ELST data in the literature are case studies or limited to small cohorts (< 16 patients). We evaluated the main clinical signs observed at endolymphatic sac tumor (ELST) diagnosis in patients with or without Von Hippel-Lindau disease.

Methods: We conducted a comprehensive literature search in PubMed, Scopus, and Web of Science.

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The SARS-CoV-2 vaccination campaign is probably one of the most historic public hygiene measures in modern medicine. The drama of the pandemic has forced the scientific community to accelerate the development and commercialization of vaccines, thereby enhancing the phases of active surveillance. Among the adverse events following immunization (AEFI) reported, those of an audiovestibular interest, such as sudden sensorineural hearing loss (SSNHL), tinnitus, dizziness, and vertigo, constitute a very small percentage.

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Vertigo in children is a challenging topic. The lack of dedicated trials, guidelines and papers causes inhomogeneity in the treatment of vertigo in children. Meniere's disease, migraine equivalents, vestibular neuritis, paroxysmal positional benign vertigo (BPPV), persistent postural-perceptual dizziness (PPPD) and motion sickness may affect children with various degrees of incidence and clinical severity compared to adults.

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The purpose of this paper is to present the case of a patient undergoing kidney transplantation who developed limb tremor dizziness and vertical nystagmus (ny) during Tacrolimus (TAC) therapy and to investigate the pathophysiological mechanisms underlying the balance disorder. This case study regards a 51-year old kidney transplant male patient with hand tremors and lower limbs asthenia associated with dizziness and nausea. The symptoms started two months after the beginning of intravenous TAC for renal transplantation.

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Background: Sudden Sensorineural Hearing Loss (SSNHL) is a relatively rare symptom after immunisation from commonly used vaccines such as rabies, hepatitis B, measles and H1N1 and it could be an occasional symptom of COVID-19, even in mild manifestations of the disease.

Case Report: We describe the case of a 57-year-old patient that reported SSNHL and tinnitus in his right ear 2 days after the inoculation of the Oxford-AstraZeneca (VAXZEVRIA) Covid-19 vaccine. The patient almost fully recovered after therapy and was referred to a long term follow-up program.

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