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Article: A Clinical Infrared Video-Oculoscopy Suppression Head Impulse (IR-cSHIMP) Test.

Marcelli, Vincenzo / Giannoni, Beatrice

Audiology research

2024 Volume 14, Issue 1, Page(s) 151–165

Abstract: Background: We propose a Suppression Head IMPulse (SHIMP) test method that provides for equipment only through the use of InfraRed Video-OculoScopy (IR-VOS) and allows horizontal and vertical semicircular canal function evaluation in bedside mode. We ... ...

Abstract	Background: We propose a Suppression Head IMPulse (SHIMP) test method that provides for equipment only through the use of InfraRed Video-OculoScopy (IR-VOS) and allows horizontal and vertical semicircular canal function evaluation in bedside mode. We therefore named the test InfraRed clinical SHIMP (IR-cSHIMP). Methods: To check IR-cSHIMP diagnostic efficiency, we studied 22 normal subjects, 18 patients with unilateral, and 6 with bilateral deficient vestibulopathy. Each subject first underwent a vestibular examination and, only later, an IRc-SHIMP test. Results: When the IR-cSHIMP test was performed in the horizontal plane, all normal subjects showed anti-compensatory saccades. When the vertical semicircular canal function was evaluated, the same result was obtained in all normal subjects except three, which were considered false positives. In patients with vestibular deficits, the test performed in the horizontal and vertical planes were always pathological, with 100% agreement between clinical and instrumental tests. Conclusions: Our bedside method proved to be fast, simple, and effective in discriminating between healthy and pathological subjects. It required only the same skill as the better-known cHIT. For these reasons, we believe that the IR-cSHIMP should be part of daily clinical practice as a useful tool in the selection of patients to undergo more sophisticated investigations.
Language	English
Publishing date	2024-01-31
Publishing country	Switzerland
Document type	Journal Article
ISSN	2039-4330
ISSN	2039-4330
DOI	10.3390/audiolres14010013
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Article: Bone-Anchored Hearing Aid Effects on Vestibular Function: A Preliminary Report.

Pollastri, Federica / Giannoni, Beatrice / Marcelli, Vincenzo / Spadavecchia, Giulia / Pecci, Rudi

Audiology research

2024 Volume 14, Issue 2, Page(s) 386–400

Abstract: Objective: Cochlear receptors are sensitive to vibratory stimuli. Based on this sensibility, bone-anchored hearing aids have been introduced to correct unilateral or bilateral conductive or mixed hearing loss and unilateral deafness. The vestibular ... ...

Abstract	Objective: Cochlear receptors are sensitive to vibratory stimuli. Based on this sensibility, bone-anchored hearing aids have been introduced to correct unilateral or bilateral conductive or mixed hearing loss and unilateral deafness. The vestibular system is also sensitive to the vibratory stimulus and this type of response is used in clinics to test its functionality. Being aware of this double separated sensibility, we wondered whether bone vibration, which activates the acoustic receptors of patients with bone conduction aids, can also influence the functionality of the vestibular system. Methods: To this end, we recruited 12 patients with a bone-anchored hearing aid and evaluated their vestibular function with and without an activated vibratory acoustic device. Results: Our results show that the vibratory stimulus delivered by the bone conduction aid also reaches and stimulates the vestibular receptors; this stimulation is evidenced by the appearance or modification of some nystagmus findings during bedside vestibular testing. Despite this, none of these patients complained of dizziness or vertigo during prosthesis use. Nystagmus that appeared or changed during acoustic vibratory stimulation through the prosthesis was almost all predominantly horizontal, unidirectional with respect to gaze or body position, inhibited by fixation, and most often consistent with vestibular function tests indicating peripheral vestibular damage. Conclusions: The findings of sound-evoked nystagmus seem to indicate peripheral rather than central vestibular activation. The occurrence of some predominantly horizontal and high-frequency induced nystagmus seems to attribute the response mainly to the utricle and lateral semicircular canal.
Language	English
Publishing date	2024-04-20
Publishing country	Switzerland
Document type	Journal Article
ISSN	2039-4330
ISSN	2039-4330
DOI	10.3390/audiolres14020033
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Article: Treating benign paroxysmal positional vertigo of the lateral semicircular canal with a shortened forced position.

Giannoni, Beatrice / Pecci, Rudi / Pollastri, Federica / Mininni, Sebastiano / Licci, Giuseppe / Santimone, Rossana / Di Giustino, Fabio / Mandalà, Marco

Frontiers in neurology

2023 Volume 14, Page(s) 1153491

Abstract: Benign paroxysmal positional vertigo (BPPV) is the peripheral vestibular disorder that is most frequently encountered in routine neuro-otological practice. Among the three semicircular canals, the lateral semicircular canal (LSC) is the second most ... ...

Abstract	Benign paroxysmal positional vertigo (BPPV) is the peripheral vestibular disorder that is most frequently encountered in routine neuro-otological practice. Among the three semicircular canals, the lateral semicircular canal (LSC) is the second most frequently interested in the pathological process. In most cases, LSC BPPV is attributable to a canalithiasis or cupulolithiasis mechanism. The clinical picture of LSC BPPV is that of positional nystagmus and vertigo evoked by turning the head from the supine to the side lateral position. With such a movement, a horizontal positional (and often also paroxysmal) direction-changing nystagmus is generated. Depending on whether the pathogenetic mechanism is that of canalithiasis or cupulolithiasis and depending on where the dense particles are located, LSC BPPV direction-changing positional nystagmus is geotropic or apogeotropic on both lateral sides. Due to its mechanical nature, BPPV is effectively treated by means of physical therapy. In the case of a LSC BPPV, one of the most effective therapies is the forced prolonged position (FPP), in which the patient is invited to lie for 12 h on the lateral side on which vertigo and nystagmus are less intense, to move the canaliths out from the canal (or to shift them inside of the canal from one tract to another) exploiting the force of gravity. Despite its efficacy, FPP is not always well tolerated by every patient, and it cannot be done during the diagnostic session because of its duration. The present study aimed to verify the efficacy of a different forced position, shortened forced position (SFP), with respect to the original FPP. SFP treatment would allow patients to more easily bear the forced position and physicians to control the outcome almost immediately, possibly enabling them to dismiss patients without vertigo. After 1 h of lying on the side where vertigo and nystagmus are the less intense, 38 out of 53 (71.7%) patients treated with SFP were either healed or improved. Although the outcomes are not as satisfying as those of the original FPP, SFP should be considered as a therapeutic prospect, especially by those physicians who work in collaboration with emergency departments or otherwise encounter acute patients to cure them of vertigo as soon as possible.
Language	English
Publishing date	2023-04-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1153491
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Article ; Online: Otoendoscopy in the era of narrow-band imaging: a pictorial review.

Pollastri, Federica / Locatello, Luca Giovanni / Bruno, Chiara / Maggiore, Giandomenico / Gallo, Oreste / Pecci, Rudi / Giannoni, Beatrice

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

2022 Volume 280, Issue 4, Page(s) 1683–1693

Abstract: Purpose: Otoendoscopy represents the initial non-invasive diagnostic cornerstone for external and middle ear disorders. Recently, new techniques of enhanced imaging such as narrow-band imaging (NBI) have been introduced but their role as a potential aid ...

Abstract	Purpose: Otoendoscopy represents the initial non-invasive diagnostic cornerstone for external and middle ear disorders. Recently, new techniques of enhanced imaging such as narrow-band imaging (NBI) have been introduced but their role as a potential aid in otological practice remains unproven. In this pictorial review, we want to present the potential application of this endoscopic method, highlight its limitations, and give some hints regarding its future implementation. Methods: Representative cases of external and/or middle ear pathologies were selected to illustrate the role of NBI in this regard. Results: NBI may represent a useful aid in the otological work-up, in the differential diagnosis of ear tumor-like masses, and, possibly, in the prognosis of tympanic perforations. For other ear disorders, instead, this technique does not seem to add anything to the standard clinical practice. Conclusions: NBI might prove useful in the assessment of selected external and middle ear disorders but its role must be prospectively validated.
MeSH term(s)	Humans ; Endoscopy/methods ; Ear, Middle/diagnostic imaging ; Narrow Band Imaging/methods ; Ear Diseases ; Tympanic Membrane Perforation
Language	English
Publishing date	2022-09-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1017359-6
ISSN	1434-4726 ; 0937-4477
ISSN (online)	1434-4726
ISSN	0937-4477
DOI	10.1007/s00405-022-07656-5
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Article: Congruous Torsional Down Beating Nystagmus in the Third Position of the Semont's Maneuver in Patients Treated for Canalithiasis of Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Its Significance and Prognostic Value.

Giannoni, Beatrice / Marcelli, Vincenzo / Verdolin, Ilaria / Checcucci, Curzio / Pollastri, Federica / Pecci, Rudi

Frontiers in neurology

2020 Volume 11, Page(s) 949

Abstract: Due to its mechanical pathogenesis, benign paroxysmal positional vertigo treatment is mainly physical: when posterior semicircular canal is involved, Semont's maneuver is reported as one of the most effective liberating procedures. In the case of a ... ...

Abstract	Due to its mechanical pathogenesis, benign paroxysmal positional vertigo treatment is mainly physical: when posterior semicircular canal is involved, Semont's maneuver is reported as one of the most effective liberating procedures. In the case of a canalolithiasis, the efficacy of the maneuver is corroborated by the appearance of some nystagmus findings during its performance. Liberating nystagmus, that can occur in the second position of Semont's maneuver and whose direction is congruous with the excitation of the affected posterior semicircular canal has proven to be a favorable prognostic sign. On the other hand, in clinical experience, we've frequently verified the appearance of another nystagmus during the execution of the maneuver: upon reaching the third position, when replacing the patient seated, a torsional down beating nystagmus, with the torsional component "congruous" with the stimulation of the vertical semicircular canals of the affected side, can often be appreciated. Such a sign can occur with or without having had the previous liberating nystagmus in the second position and is almost always associated with an intense vertigo and/or body pulsion. In this study, we describe the incidence and characteristics of the congruous torsional down beating nystagmus that can arise by assuming the third position of Semont's maneuver in a cohort of patients treated for posterior semicircular canal benign paroxysmal positional vertigo due to canalolithiasis. In the best of our knowledge, such a sign has never been described and explained before. On the basis of the pathophysiology and of the possible canal receptors stimulation during the different phases of Semont's maneuver, we formulated different hypothesis on how such a nystagmus can be generated. We observed that such a sign, when elicited, has a very good prognostic meaning for healing purposes, even better than that of liberating nystagmus. Therefore, congruous torsional down beating nystagmus should always be checked when performing Semont's maneuver because it could help in predicting success of physical treatment and in managing patients.
Language	English
Publishing date	2020-09-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2020.00949
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Article ; Online: Otoendoscopic characterisation of middle ear masses by the aid of narrow-band imaging: A preliminary report.

Bruno, Chiara / Pollastri, Federica / Locatello, Luca Giovanni / Maggiore, Giandomenico / Pecci, Rudi / Giannoni, Beatrice / Gallo, Oreste

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

2021 Volume 46, Issue 6, Page(s) 1315–1318

MeSH term(s)	Adult ; Aged ; Ear Diseases/diagnostic imaging ; Ear, Middle/blood supply ; Ear, Middle/diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Narrow Band Imaging ; Otoscopy
Language	English
Publishing date	2021-07-26
Publishing country	England
Document type	Letter
ZDB-ID	2205891-6
ISSN	1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
ISSN (online)	1749-4486
ISSN	1749-4478 ; 0307-7772 ; 1365-2273
DOI	10.1111/coa.13837
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Article ; Online: Vitamin D Insufficiency/Deficiency in Patients with Recurrent Benign Paroxysmal Positional Vertigo.

Pecci, Rudi / Mandalà, Marco / Marcari, Antonella / Bertolai, Roberto / Vannucchi, Paolo / Santimone, Rossana / Bentivegna, Lisa / Di Giustino, Fabio / Mengucci, Arianna / Vanni, Simone / Pollastri, Federica / Giannoni, Beatrice

The journal of international advanced otology

2022 Volume 18, Issue 2, Page(s) 158–166

Abstract: Background: The aim of this study is to verify if (1) there is a link between hypovitaminosis D and benign paroxysmal positional vertigo, (2) the number of benign paroxysmal positional vertigo relapses decreases after vitamin D supplementation; and (3) ... ...

Abstract	Background: The aim of this study is to verify if (1) there is a link between hypovitaminosis D and benign paroxysmal positional vertigo, (2) the number of benign paroxysmal positional vertigo relapses decreases after vitamin D supplementation; and (3) benign paroxysmal positional vertigo response to physical therapy improves after hypovitaminosis D correction. Methods: We enrolled 26 patients with benign paroxysmal positional vertigo and 24 subjects, who never suffered from vertigo, as a control group. All benign paroxysmal positional vertigo patients underwent physical therapy, once a week, until benign paroxysmal positional vertigo resolution. All participants were subjected to a dosage of serum 25(OH) vitamin D. In patients with hypovitaminosis D, we prescribed cholecalciferol. After 3 months of therapy, all patients were asked to undergo a second dosage of serum 25(OH) vitamin D. For each patient, we counted the number of maneuvers required to resolve each episode of benign paroxysmal positional vertigo before and after vitamin D supplementation. Results: Our results suggest that (1) there is a relationship between vitamin D deficiency and the onset of BPPV and (2) hypovitaminosis correction is able to reduce both the number of patients relapsing and the number of relapses per patient. Conclusions: We have not found a significant effect of vitamin D supplementation as regards the responsivity of benign paroxysmal positional vertigo to physical therapy.
MeSH term(s)	Benign Paroxysmal Positional Vertigo/therapy ; Humans ; Recurrence ; Vitamin D/therapeutic use ; Vitamin D Deficiency/complications ; Vitamins/therapeutic use
Chemical Substances	Vitamins ; Vitamin D (1406-16-2)
Language	English
Publishing date	2022-04-13
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2561231-1
ISSN	2148-3817 ; 1308-7649 ; 2148-3817
ISSN (online)	2148-3817
ISSN	1308-7649 ; 2148-3817
DOI	10.5152/iao.2022.21269
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Article ; Online: Posterior semicircular canal benign paroxysmal positional vertigo presenting with torsional downbeating nystagmus: an apogeotropic variant.

Vannucchi, Paolo / Pecci, Rudi / Giannoni, Beatrice

International journal of otolaryngology

2012 Volume 2012, Page(s) 413603

Abstract: The aim of this study is to verify the hypothesis that free-floating particles could sometimes localize into the distal portion of the non ampullary arm of the posterior semicircular canal (PSC) so that assuming the Dix-Hallpike's positions, the clot ... ...

Abstract	The aim of this study is to verify the hypothesis that free-floating particles could sometimes localize into the distal portion of the non ampullary arm of the posterior semicircular canal (PSC) so that assuming the Dix-Hallpike's positions, the clot could move towards the ampulla eliciting a inhibitory torsional-down beating paroxysmal positional nystagmus (PPNy), instead of typical excitatory torsional-up beating PPNy. Among 45 patients with vestibular signs suggesting anterior semicircular canal paroxysmal positional vertigo (PPV), collected from February 2003 to August 2006, we detected a group of 6 subjects whose clinical findings showed a singular behaviour during follow-up. At the first check-up, all patients were submitted to different types of physical manoeuvres for ASC canalolithiasis. Patients were controlled during the same session and after one week. When we found that nystagmus was qualitatively changed we adopted the appropriate physical therapies for that sign. At a next check-up, after having performed some physical therapies, all patients had a typical PSC PPNy of the opposite side, with respect to that of the ASC initially diagnosed. Basing on these observations we conclude that PSC PPV, similarly to lateral semicircular canal PPV, could manifests in a apogeotropic variant.
Language	English
Publishing date	2012-08-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2503281-1
ISSN	1687-921X ; 1687-9201
ISSN (online)	1687-921X
ISSN	1687-9201
DOI	10.1155/2012/413603
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Article ; Online: Papillary-cystic neoplasms of the middle ear are distinct from endolymphatic sac tumours.

Taverna, Cecilia / Pollastri, Federica / Pecci, Rudi / Giannoni, Beatrice / Fattorini, Caterina / Santucci, Marco / Mueller, Sarina K / Stoehr, Robert / Franchi, Alessandro / Agaimy, Abbas

Histopathology

2020 Volume 79, Issue 3, Page(s) 306–314

Abstract: Aims: Papillary neoplasms of the middle and inner ear are rare and poorly characterised. The current World Health Organization classification divides them into two major subtypes: aggressive papillary tumours (APTs) and endolymphatic sac tumours (ELSTs). ...

Abstract	Aims: Papillary neoplasms of the middle and inner ear are rare and poorly characterised. The current World Health Organization classification divides them into two major subtypes: aggressive papillary tumours (APTs) and endolymphatic sac tumours (ELSTs). The aim of this article is to present two papillary neoplasms of the middle ear that do not fit into either the classic APT category or the classic ELST category, and compare them with three ELSTs. Methods and results: The patients were a 48-year-old female and a 59-year-old male without a history of other neoplasms. Histology showed papillary-cystic growth of predominantly oncocytic (Case 1) or mucinous (Case 2) cells surrounded by a p63-positive basal layer. The overall histology was reminiscent of oncocytic sinonasal papilloma (Case 1) and pancreatobiliary or salivary intraductal papillary mucinous neoplasms (Case 2). Ovarian-type stroma, invasion and malignant features were absent. Immunohistochemistry revealed expression of cytokeratin (CK) 7, but not carbonic anhydrase IX (CAIX) or paired box gene 8 (PAX8) (except for very focal PAX8 expression in Case 1). The TST15 gene panel and HRAS sequencing revealed no pathogenic mutations in BRAF, KRAS, EGFR, AKT1, or HRAS. The TruSight RNA fusion panel revealed an MKRN1-BRAF fusion in Case 1. No fusion was detected in Case 2. The three ELSTs showed classic features of the entity, expressed CK7, epithelial membrane antigen, PAX8, and CAIX, and lacked a basal cell layer. Conclusion: These novel cases suggest that papillary tumours of the ear represent a heterogeneous spectrum of distinct neoplasms unified by a prominent papillary-cystic pattern rather than a single entity. Future studies should clarify whether the MKRN1-BRAF fusion is a defining recurrent driver event, especially in those cases reported as sinonasal-type middle ear papillomas.
MeSH term(s)	Adenocarcinoma, Papillary/diagnosis ; Adenocarcinoma, Papillary/pathology ; Biomarkers, Tumor/analysis ; Biomarkers, Tumor/metabolism ; Diagnosis, Differential ; Ear Neoplasms/diagnosis ; Ear Neoplasms/pathology ; Ear, Middle/pathology ; Endolymphatic Sac/pathology ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pancreatic Intraductal Neoplasms/pathology ; Proto-Oncogene Proteins B-raf/analysis ; Proto-Oncogene Proteins B-raf/metabolism
Chemical Substances	Biomarkers, Tumor ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1)
Language	English
Publishing date	2020-11-09
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	131914-0
ISSN	1365-2559 ; 0309-0167
ISSN (online)	1365-2559
ISSN	0309-0167
DOI	10.1111/his.14250
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Zs.A 1328: Show issues

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Article: Apogeotropic Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Some Clinical and Therapeutic Considerations.

Vannucchi, Paolo / Pecci, Rudi / Giannoni, Beatrice / Di Giustino, Fabio / Santimone, Rossana / Mengucci, Arianna

Audiology research

2015 Volume 5, Issue 1, Page(s) 130

Abstract: We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior ... ...

Abstract	We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior semicircular canal (PSC). We considered this particular pathological picture the apogeotropic variant of PSC benign paroxysmal positional vertigo (BPPV). Since the description of the pilot cases we observed more than 150 patients showing the same clinical sign and course of symptoms. In this paper we describe, in detail, both nystagmus of apogeotropic PSC BPPV (A-PSC BPPV) and symptoms reported by patients trying to give a reasonable explanation for these clinical features. Moreover we developed two specific physical therapies directed to cure A-PSC BPPV. Preliminary results of these techniques are related.
Language	English
Publishing date	2015-03-31
Publishing country	Italy
Document type	Journal Article
ISSN	2039-4330
ISSN	2039-4330
DOI	10.4081/audiores.2015.130
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