Sensorineural hearing loss in patients reaching chronic renal failure in childhood.

The incidence of sensorineural hearing loss (SNHL) was investigated in 68 patients who reached chronic renal failure (CRF) in childhood with the aim of identifying possible risk factors. Tests were carried out by means of pure-tone and impedance audiometry. SNHL was found in 29% of patients on conservative treatment, 28% of patients on hemodialysis, and 47% after renal transplantation. Differences among groups were not significant. A significant correlation was found with the administration of ototoxic drugs (aminoglycosides and furosemide). We hypothesize that SNHL may be reduced in patients with CRF or on renal replacement therapy by strictly monitoring ototoxic therapy.

[A rare case of endotympanic hemangioma]. / Su di un raro caso di emangioma endotimpanico.

Hemangiomas affectioning the external ear canal or the tympanic membrane have rarely been described. Only a very few cases are reported in world literature conarn these vascular tumors involving the middle ear space. The Authors report a rare case of a right endotympanic hemangioma associated with ossicular dysmorphism, resulting in conductive unilateral hearing loss, in a 9 year-old girl with cutaneous hemangiomas of the face. The Authors review Literature and discuss the possible pathogenetic implications of the intraoperatory findings.

Paranasal giant cell fibroblastoma: case report and immunohistochemical findings.

Few published reports describe patients with giant cell fibroblastoma, a rare, benign soft-tissue tumor that recurs locally and predominantly arises in children. A 4-year-old boy underwent surgery for removal of a giant cell fibroblastoma in the paranasal region, an unusual site. Six months after excision the tumor recurred locally. Immunohistochemical examination of the primary tumor and recurrence revealed vimentin positive staining in the cytoplasm of all the cells. The multinucleated giant cells and the flat cells bordering the vessel-like spaces were negative for Factor VIII-related antigen, S-100 protein, actin and desmin. Some histiocytes stained positively for alpha-1-antitrypsin, alpha-1-antichymotrypsin, antimacrophage and lysozyme antibodies. These immunoreactions indicate that giant cell fibroblastomas have a fibrohistiocytic origin.

Acinic cell carcinoma of the parotid gland in childhood.

A 13-year-old girl underwent surgery at the Ear Nose and Throat Department of the Children's Hospital and Scientific Research Institute, Bambino Gesù, Rome, because of an acinic cell carcinoma of the parotid gland. Two years after total parotidectomy with preservation of the facial nerve, metastasis occurred in a lateral cervical lymph node. Acinic cell tumors are uncommon in childhood; in children under the age of 16 years only 35 cases have been reported. There are too few acinar cell carcinomas occurring in children to yield an idea of their natural course. The neoplasm is also referred to as 'acinar cell tumor', in contrast to acinar cell carcinoma, because the neoplasm may be benign or malignant. Unfortunately, there are no histological distinguishing features that permit the pathologist to determine which neoplasm will behave in an aggressive fashion.

[Bronchoalveolar lavage (BAL) in the diagnosis of pulmonary infections in immunocompromised children]. / Il lavaggio bronco-alveolare (BAL) nella diagnostica delle infezioni polmonari nei bambini immunocompromessi.

The authors report their personal case records of broncho-alveolar lavage in immuno-compromised children. 22 children were observed from 1991 to 1992 at the E.N.T. Department of the Bambino Gesù Hospital, National Research Institute, in Rome. Flexible bronchoscopy is used under both local and general anesthesia without muscle relaxants. The epithelial lining fluid collection is greater than that obtained when muscle relaxation is used. For each patient 3 specimens are collected: for virological, bacteriological, mycological and immunological analysis. In 90% of the cases a correct etiological diagnosis of the pulmonary disease was possible. In 14 cases the diagnosis was possible even after a week from the beginning of the antibiotic therapy.

Cervical chordoma in childhood: clinical statistical contribution.

Parapharyngeal neoplasias are rarely noticed in childhood, since they have their peak incidence between the 2nd and 4th decade of life. The authors report a case of a 4-year-old patient presenting with a retrostyloid mass, accompanied by nasal obstruction and some difficulty in swallowing at 12 months of age. CT scanning well ascertained the delimitation of the tumor, but it was of no help in the differential diagnosis. In fact, after surgical excision, the histological examination of the specimen revealed a chordoma. This result was unexpected because of the region concerned and the lack of a CT demonstration of the cervical boney involvement. A cervical vertebral localization of a chordoma is rare in all age groups and it is of particular clinical and statistical interest in infancy.

Peritonitis tuberculosa / Peritoneal tuberculosis

Se presentan 17 casos de peritonitis TBC comprobada, atendidos entre 1978 y 1986. Se analizan las formas clínicas de presentación, procedimientos diagnósticos y tratamientos. Se concluye que la visión directa del peritoneo, mediante laparoscopia o laparotomía, con toma de biopsia para estudio histopatológico, es de alto rendimiento en el diagnóstico de ésta enfermedad

The pathogenesis of chronic recurrent parotitis in infants: a study of 93 cases including an analysis of the vascular and glandular changes before and after parasympathectomy.

Ninety-three cases of infantile chronic recurrent parotitis are recorded. Fifty-three cases were treated with parasympathectomy which was carried out at 2 levels. Good results were achieved in 79.1% of patients. The paper describes the use of the Doppler examination to study the effects of operation on the physiology of the parotid.

Malignant hemangiopericytoma of the nasal cavity. Report of a case and review of the literature.

Haemangiopericytoma is only rarely localized in the nasal cavity. The authors' experience with one case has prompted them to review the literature critically, in order to understand better the most appropriate diagnostic procedures and therapeutic measures.