9 results on '"Michelangelo Pierri"'
Search Results
2. Could the use of a new novel bipolar radiofrequency device (Aerin) improve nasal valve collapse? A systematic review and meta-analysis
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Manuele Casale, Antonio Moffa, Lucrezia Giorgi, Michelangelo Pierri, Rodolfo Lugo, Ofer Jacobowitz, and Peter Baptista
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Radiofrequency treatment ,Vivaer ,Office-based procedure ,Nasal valve collapse ,NOSE score ,Surgery ,RD1-811 - Abstract
Abstract Background Surgical treatment for nasal obstruction caused by nasal valve collapse requires a significant recovery period and risks of complications, while nasal dilators are uncomfortable. Recently, radiofrequency treatment of lateral walls has been used under local anesthesia as an office base surgery. This work aims to assess the efficacy of a new radiofrequency device, the Vivaer™ System (Aerin Medical, Sunnyvale, CA), to treat nasal obstruction through a systematic review and meta-analysis. Methods Two researchers independently reviewed the literature up to December 2021. Studies on patients seeking treatment for nasal obstruction due to nasal valve collapse were included in the analysis. Results Four studies (218 patients) met the inclusion criteria and treated the nasal valve regions bilaterally with the Aerin Medical Vivaer™ System. After the treatment, the NOSE score was reduced at three months postoperatively. Minor adverse events were reported in the included studies, and two showed no complications. None of the studies reported changes in the external appearance of the nose. Conclusion The radiofrequency treatment using the Vivaer device can be useful for treating nasal valve collapse, improving significantly subjective breathing symptom scores. Further studies on a large scale are needed to confirm these results.
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- 2023
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3. Odontogenic Sinusitis with Oroantral Communication and Fistula Management: Role of Regenerative Surgery
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Lorenzo Sabatino, Michele Antonio Lopez, Simone Di Giovanni, Michelangelo Pierri, Francesco Iafrati, Luigi De Benedetto, Antonio Moffa, and Manuele Casale
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odontogenic sinusitis ,oro-antral fistula ,oro-antral communication ,Medicine (General) ,R5-920 - Abstract
Objective: The aim of this study is to show our experience with the correct management of patients suffering from odontogenic sinusitis with oroantral communication and fistula. Methods: According to the inclusion criteria, 41 patients were enrolled in this retrospective study with a diagnosis of odontogenic sinusitis with oroantral communication and fistula; 1 patient with pre-implantological complication, 14 with implantological complications, and 26 with classical complications. Results: Two patients were treated with a fractioned combined approach, 13 patients were treated with an oral approach only, and 26 patients were treated with a combination. There was a complete resolution of the symptoms and closure of the fistula in all the patients enrolled. Conclusions: In our study, in all 41 patients, there was a surgical success. The best option is to use a multidisciplinary approach for patients suffering from odontogenic sinusitis.
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- 2023
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4. High-Definition 3D Exoscope-Assisted Barbed Pharyngoplasty for OSAS and Snoring: Better Than Live
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Manuele Casale, Antonio Moffa, Michelangelo Pierri, Peter Baptista, and Lucrezia Giorgi
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sleep apnea ,barbed pharyngoplasty ,3D exoscope ,high definition ,Medicine - Abstract
Recently, a high-definition 3D exoscope (VITOM), a new magnification system that provides a 3D image of the surgical field, has been introduced. This study aims to describe the first use of VITOM 3D technology in Barbed Pharyngoplasty (BP) for Obstructive Sleep Apnea (OSA). VITOM 3D technology is used to support visualization during BP in a male patient affected by severe OSA with a circular palatal collapse pattern at drug-induced sleep endoscopy. During the surgical procedure, this approach markedly improves the visualization of the surgical field through anatomic details of the oral cavity, facilitating surgical dissection and enhancing the teaching environment. It allows for a better involvement and more interactions during the surgery, as scrubbed and assistant nurses can see the surgical field and anticipate the surgeon’s choice of instrument. VITOM 3D technology, by combining a telescope with a standard endoscope, has been successfully used in various surgical disciplines and could be very useful, especially in teaching hospitals. VITOM 3D can guarantee “a real immersive” surgical experience for all participants in the operating room. Economic and efficacy studies would be conducted to support the use of a VITOM-3D exoscope in common clinical practice.
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- 2023
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5. Odontogenic Sinusitis from Classical Complications and Its Treatment: Our Experience
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Lorenzo Sabatino, Michelangelo Pierri, Francesco Iafrati, Simone Di Giovanni, Antonio Moffa, Luigi De Benedetto, Pier Carmine Passarelli, and Manuele Casale
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odontogenic sinusitis ,classic complications ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Odontogenic sinusitis (ODS) refers to the maxillary sinus infection, which is secondary to either adjacent infectious dental pathologies or procedures. The aim of this retrospective study is to report the experiences of the department of integrated therapies in otolaryngology (Campus Bio-Medico Foundation, Rome, Italy) in classifying and treating patients that are affected by odontogenic sinusitis derived from “classic complications”. A total of 68 patients responding to the criteria and to the definition as a classical odontogenic complication were included. The surgical therapy consisted of a combined oral and nasal simultaneous approach for 28 patients (43%), a combined non-simultaneous approach for 4 patients (6%), a nasal only approach for 14 patients (21%), and an oral only approach for 20 patients (30%). All the patients presented a complete resolution of the symptoms. The choice of performing a nasal, oral, or combined approach is based on the presence of anatomical elements that facilitate sinusitis and reinfection occurrence, such as deviated nasal septum, concha bullosa, or obstructed osteo-meatal complex. The correct use of validated classification, the pre-operative CT scan, a multidisciplinary approach, and an appropriate presurgical examination are the necessary elements to obtain a good success rate.
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- 2023
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6. No-cutting remodelling intra-pharyngeal surgery can avoid CPAP in selected OSA patients: myth or reality?
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Manuele Casale, Antonio Moffa, Lucrezia Giorgi, Lorenzo Sabatino, Michelangelo Pierri, Rodolfo Lugo, Peter Baptista, and Vittorio Rinaldi
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Adult ,Sleep Apnea, Obstructive ,Treatment Outcome ,Continuous Positive Airway Pressure ,Otorhinolaryngology ,Snoring ,Humans ,Pharynx ,General Medicine ,Middle Aged - Abstract
Oropharyngeal surgery for Obstructive Sleep Apnea (OSA) has evolved from a radical excision of "redundant" soft tissue for the enlargment of the airway to a minimally invasive reconstruction to fulfill both preservation of pharyngeal function and improvement of sleep apnea. Recently, Alianza surgical technique has been successfully introduced as a new, non-resective procedure aimed to treat concentric pharyngeal collapse at the velum using Barbed Sutures. The aim of this study was to show the effectiveness and safety of Alianza technique as standalone surgical treatment in selected patients with moderate-severe OSA and concentric pharyngeal collapse that refused or did not tolerate Continuous Positive Airway Pressure therapy.Effectiveness of the surgical procedure was assessed by means of the Epworth Sleepiness Scale (ESS), Home Sleep Test, and a 0-10 snoring VAS.At the end of our selection process, 26 patients were enrolled, with a mean age of 52.7 ± 9.2 years, that undergone Alianza tecnique. There was a statistically significant reduction in mean post-operative apnea-hypopnea indexes (34.1 ± 11.5-16.3 ± 10.3; p 0.01), mean oxygen desaturation index (29.0 ± 14.5-13.1 ± 9.2; p 0.01), and mean ESS scores (12.1 ± 5.8 and 5.8 ± 4.4; p 0.01).There was also a significant decrease in mean post-operative snoring VAS scores (7.85 ± 1.23 vs 3.2 ± 1.7, p 0.01). There were no major complications.Our preliminary results suggest that Alianza technique is a safe and repeatable surgery. Further studies on a larger scale are needed to confirm these encouraging data supporting the role of Alianza alone or in OSA multilevel surgery in selected OSA patients.
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- 2022
7. Endolymphatic duct and sac decompression: A new technique for Ménière's disease treatment
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Fabrizio Salvinelli, Francesca Bonifacio, Fabio Greco, Giulio Cavicchioni, Valeria Frari, Michelangelo Pierri, Maurizio Trivelli, and Maurizio Iacoangeli
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Surgery ,Neurology (clinical) - Abstract
Background: The present article aims to introduce the endolymphatic duct and sac decompression technique (DASD) and to give a spotlight on its benefits in Ménière’s disease (MD) treatment. Methods: Eighty-two patients with intractable MD which met the inclusion criteria were recruited and underwent DASD. This technique allows a meningeal decompression of the duct and the sac from the posterior cranial fossa to the labyrinthine block. The authors considered as main outcomes, the change of the dizziness handicap inventory (DHI) results, with the evaluations of the three sub-scales (Functional scale, Physical scale, and Emotional scale); ear fullness and tinnitus change on the perceptions of the patient; and hearing stage with four-Pure Tone Average (500 hz-1000 hz-2000 hz-4000 hz). The differences between the preoperative and the postoperative score were evaluated. A comparison with the literature was conducted. Results: After a 14-month follow-up, patients that underwent DASD reported a remarkable improvement of the symptoms in all three functional scales, confirmed by the total DHI. The difference between preoperative and postoperative scores is statistically significant. The data describe an ear fullness and tinnitus improvement. The multi-frequency tonal average before and after the surgery does not suggest a worsening of the value for any of 82 patients. Conclusion: The modification of sac surgery includes the endolymphatic duct in the decompression area allowing inner ear functional improvement, vertigo control, ear fullness improvement with minimal risk of facial nerve paralysis, and hearing loss. DASD is an improved old surgical technique.
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- 2022
8. Different barbed pharyngoplasty techniques for retropalatal collapse in obstructive sleep apnea patients: a systematic review
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Michelangelo Pierri, Manuele Casale, Lorenzo Pignataro, Vittorio Rinaldi, Michele Cassano, Andrea Costantino, Valeria Fiore, Mario Mantovani, Antonio Moffa, and Peter Baptista
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medicine.medical_specialty ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Collapse (medical) ,Sleep Apnea, Obstructive ,Soft palate ,business.industry ,Epworth Sleepiness Scale ,Suture Techniques ,medicine.disease ,Otorhinolaryngologic Surgical Procedures ,Surgery ,Obstructive sleep apnea ,medicine.anatomical_structure ,030228 respiratory system ,Otorhinolaryngology ,Barbed suture ,Pharynx ,Sphincter ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
The use of barbed sutures (BS) for the treatment of retropalatal collapse and vibration in patients suffering from snoring and obstructive sleep apnea (OSA) has significantly increased in the last few years. Many surgeons have discovered the advantages and unique properties of the BS and allowed the popular surgical pharyngoplasty techniques to be updated and improved. A systematic review was performed to identify all the clinical studies concerning the different barbed pharyngoplasty (BP) techniques used for the treatment of palatal collapse in snoring and OSA patients. A qualitative analysis of data extracted was conducted. We included 12 studies of which 10 are prospective and 2 retrospective: 9 single-arm studies on the efficacy of a specific BP technique, 1 randomized clinical trial on the comparison between BP and control groups, and 2 studies on the correlation between two different BP techniques. To date, in the literature, 5 different types of BP techniques have been described: barbed snore surgery, barbed reposition pharyngoplasty, barbed expansion sphincter pharyngoplasty, barbed suture suspension, and barbed soft palate posterior webbing flap pharyngoplasty. All the studies showed an overall improvement in the primary efficacy parameters investigated (apnea-hypopnea index, oxygen desaturation index, and Epworth sleepiness scale) in each of the surgical techniques performed without any major complications. Given the extreme heterogeneity of the studies analyzed, it is necessary to perform more randomized and control studies on large samples aimed to define the best BP technique based on its effectiveness, surgical success rate, patient’s compliance, and complications.
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- 2020
9. Epidural Steroid Injections for Low Back Pain: A Narrative Review
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Massimiliano Carassiti, Giuseppe Pascarella, Alessandro Strumia, Fabrizio Russo, Giuseppe Francesco Papalia, Rita Cataldo, Francesca Gargano, Fabio Costa, Michelangelo Pierri, Francesca De Tommasi, Carlo Massaroni, Emiliano Schena, and Felice Eugenio Agrò
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Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Injections, Epidural ,Review ,disk herniation ,lumbosacral radicular pain ,Back Pain ,epidural steroid injections ,Quality of Life ,Medicine ,Humans ,Steroids ,Low Back Pain ,canal stenosis - Abstract
Low back pain represents a significant socioeconomic burden. Several nonsurgical medical treatments have been proposed for the treatment of this disabling condition. Epidural steroid injections (ESIs) are commonly used to treat lumbosacral radicular pain and to avoid surgery. Even though it is still not clear which type of conservative intervention is superior, several studies have proved that ESIs are able to increase patients’ quality of life, relieve lumbosacral radicular pain and finally, reduce or delay more invasive interventions, such as spinal surgery. The aim of this narrative review is to analyze the mechanism of action of ESIs in patients affected by low back pain and investigate their current application in treating this widespread pathology.
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- 2021
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