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Article ; Online: Unlocking tracheoesophageal speech from pharyngoesophageal spasm: preliminary results of a videofluoroscopic-guided botulinum toxin A injection technique.

Bandi, Francesco / Chu, Francesco / Zurlo, Valeria / Di Natale, Valentina / Zorzi, Stefano / Pietrobon, Giacomo / De Berardinis, Rita / Tagliabue, Marta / Ansarin, Mohssen

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

2024 Volume 281, Issue 4, Page(s) 1885–1893

Abstract: Purpose: The tracheoesophageal puncture for the voice prosthesis (VP) placement is the recognized gold standard in post-laryngectomy voice rehabilitation. Despite the development of specific intraoperative techniques, a subset of patients will suffer ... ...

Abstract	Purpose: The tracheoesophageal puncture for the voice prosthesis (VP) placement is the recognized gold standard in post-laryngectomy voice rehabilitation. Despite the development of specific intraoperative techniques, a subset of patients will suffer from poor functional outcomes due to pharyngoesophageal spasms (PES). This paper evaluates the functional outcomes after transcutaneous botulinum toxin type A (BTX-A) infiltration for PES with a videofluoroscopy-guided technique. Methods: Since 2022, eight consecutive patients with VP and affected by PES were treated with BTX-A injection by a standard videofluoroscopic guided technique at the European Institute of Oncology, IRCCS (IEO) in Milan. A lidocaine test was performed pre-operatively to evaluate the potential effect of chemical neurectomy. All patients with positive lidocaine tests were injected with 50 IU of BTX-A (Allergan, Irvine, CA) according to the sites marked during the videofluoroscopy. Reported symptoms (VHI, SECEL), perceptual (INFVo), aerodynamic (MPT) and manometric parameters were collected before and after treatment. Results: In all cases, BTX-A was performed as an outpatient procedure without complications. For seven patients, only one BTX-A injection was needed, while one patient required a re-injection. Subjective and perceptive improvement after BTX-A was significant for VHI, SECEL and INFVo. MPT showed significant improvement after a chemical neurectomy. After a mean follow-up of 6 months, all patients maintained a good TES quality. Conclusion: The videofluoroscopic guided BTX-A injection of the pharyngoesophageal tract showed to be a feasible and reproducible technique in all cases. The pharyngoesophageal videofluoroscopy allows defining of patients' anatomical landmarks that help the surgeon to perform a homogeneous injection, empowered by post-injection massage.
MeSH term(s)	Humans ; Botulinum Toxins, Type A ; Speech ; Laryngectomy/adverse effects ; Speech, Esophageal ; Spasm/etiology ; Lidocaine ; Treatment Outcome
Chemical Substances	Botulinum Toxins, Type A (EC 3.4.24.69) ; Lidocaine (98PI200987)
Language	English
Publishing date	2024-01-27
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/s00405-024-08448-9
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Article: The Role of New Morphological Parameters Provided by the BC 6800 Plus Analyzer in the Early Diagnosis of Sepsis.

Sacchetti, Sara / Vidali, Matteo / Esposito, Teresa / Zorzi, Stefano / Burgener, Alessia / Ciccarello, Lorenzo / Cammarota, Gianmaria / Zanotti, Valentina / Giacomini, Luca / Bellan, Mattia / Pirisi, Mario / Lopez, Ramon Simon / Dianzani, Umberto / Vaschetto, Rosanna / Rolla, Roberta

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 3

Abstract: Background: Late diagnosis of sepsis is associated with adverse consequences and high mortality rate. The aim of this study was to evaluate the diagnostic value of hematologic research parameters, that reflect the cell morphology of blood cells, ... ...

Abstract	Background: Late diagnosis of sepsis is associated with adverse consequences and high mortality rate. The aim of this study was to evaluate the diagnostic value of hematologic research parameters, that reflect the cell morphology of blood cells, available on the BC 6800 plus automated analyzer (Mindray) for the early detection of sepsis. Materials and methods: A complete blood count (CBC) was performed by Mindray BC 6800 Plus Analyzer in 327 patients (223 with a confirmed diagnosis of sepsis following sepsis-3 criteria, 104 without sepsis), admitted at the Intensive Care Unit of the Novara's Hospital (Italy) and in 56 patients with localized infection. Results: In univariate logistic regression, age, Hb, RDW, MO#, NMR, NeuX, NeuY, NeuZ, LymX, MonX, MonY, MonZ were associated with sepsis ( Conclusions: In addition to already established biomarkers and basic CBC parameters, new morphological cell parameters can be a valuable aid in the early diagnosis of sepsis at no additional cost.
Language	English
Publishing date	2024-02-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14030340
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Article ; Online: Salvage transoral robotic surgery in recurrent oropharyngeal carcinoma: a single-center retrospective study.

Ansarin, Mohssen / Pietrobon, Giacomo / Tagliabue, Marta / Mossinelli, Chiara / Ruju, Francesca / Maffini, Fausto / Rocca, Maria Cossu / Alterio, Daniela / Simon, Christian / Zorzi, Stefano Filippo

2024

Abstract: Purpose: Salvage surgery is still the best therapeutic option for resectable recurrent oropharyngeal squamous cell carcinoma (rOPSCC). Transoral robotic surgery may potentially reduce the morbidity of standard open approaches. The aim of the study is to ...

Abstract	Purpose: Salvage surgery is still the best therapeutic option for resectable recurrent oropharyngeal squamous cell carcinoma (rOPSCC). Transoral robotic surgery may potentially reduce the morbidity of standard open approaches. The aim of the study is to present oncological and functional outcomes of a monocentric experience in salvage transoral robotic surgery. Methods: We performed a single-center retrospective analysis of patients submitted to transoral robotic salvage surgery with or without neck dissection for cT1-3 rOPSCC. We investigated complication rate, survival outcomes (Overall Survival, Disease Specific Survival, Loco-Regional Recurrence Free Survival) and functional outcomes (tracheal tube and/or gastrostomy dependence). Results: Sixty-one patients were included in the analysis. No major complications or perioperative deaths were recorded. The estimated 2-year OS was 76.7%, DSS 81.8% and LRRFS 50.5%. In multivariable analysis rpT, PNI (perineural infiltration) and HPV-positivity were significantly associated with LRRFS (Hazard Ratios: T3 vs T1 6.43, PNI yes vs no 4.19, HPV+ yes vs no 2.63). At last follow up, 97% of patients were tracheal tube-free, while 93% were gastrostomy-free. Conclusion: Transoral robotic salvage surgery is a successful treatment in selected patients affected by rOPSCC because it grants good oncologic and functional outcomes.
Language	English
Publishing date	2024-03-28
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/s00405-024-08590-4
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Book ; Online: Machine-learned 3D Building Vectorization from Satellite Imagery

Wang, Yi / Zorzi, Stefano / Bittner, Ksenia

2021

Abstract: We propose a machine learning based approach for automatic 3D building reconstruction and vectorization. Taking a single-channel photogrammetric digital surface model (DSM) and panchromatic (PAN) image as input, we first filter out non-building objects ... ...

Abstract	We propose a machine learning based approach for automatic 3D building reconstruction and vectorization. Taking a single-channel photogrammetric digital surface model (DSM) and panchromatic (PAN) image as input, we first filter out non-building objects and refine the building shapes of input DSM with a conditional generative adversarial network (cGAN). The refined DSM and the input PAN image are then used through a semantic segmentation network to detect edges and corners of building roofs. Later, a set of vectorization algorithms are proposed to build roof polygons. Finally, the height information from the refined DSM is added to the polygons to obtain a fully vectorized level of detail (LoD)-2 building model. We verify the effectiveness of our method on large-scale satellite images, where we obtain state-of-the-art performance. Comment: Accepted to CVPR workshop (EarthVision 2021)
Keywords	Computer Science - Computer Vision and Pattern Recognition ; Electrical Engineering and Systems Science - Image and Video Processing
Subject code	006
Publishing date	2021-04-13
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: PolyWorld

Zorzi, Stefano / Bazrafkan, Shabab / Habenschuss, Stefan / Fraundorfer, Friedrich

Polygonal Building Extraction with Graph Neural Networks in Satellite Images

2021

Abstract: While most state-of-the-art instance segmentation methods produce binary segmentation masks, geographic and cartographic applications typically require precise vector polygons of extracted objects instead of rasterized output. This paper introduces ... ...

Abstract	While most state-of-the-art instance segmentation methods produce binary segmentation masks, geographic and cartographic applications typically require precise vector polygons of extracted objects instead of rasterized output. This paper introduces PolyWorld, a neural network that directly extracts building vertices from an image and connects them correctly to create precise polygons. The model predicts the connection strength between each pair of vertices using a graph neural network and estimates the assignments by solving a differentiable optimal transport problem. Moreover, the vertex positions are optimized by minimizing a combined segmentation and polygonal angle difference loss. PolyWorld significantly outperforms the state of the art in building polygonization and achieves not only notable quantitative results, but also produces visually pleasing building polygons. Code and trained weights are publicly available at https://github.com/zorzi-s/PolyWorldPretrainedNetwork.
Keywords	Computer Science - Computer Vision and Pattern Recognition
Subject code	006
Publishing date	2021-11-30
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Map-Repair

Zorzi, Stefano / Bittner, Ksenia / Fraundorfer, Friedrich

Deep Cadastre Maps Alignment and Temporal Inconsistencies Fix in Satellite Images

2020

Abstract: In the fast developing countries it is hard to trace new buildings construction or old structures destruction and, as a result, to keep the up-to-date cadastre maps. Moreover, due to the complexity of urban regions or inconsistency of data used for ... ...

Abstract	In the fast developing countries it is hard to trace new buildings construction or old structures destruction and, as a result, to keep the up-to-date cadastre maps. Moreover, due to the complexity of urban regions or inconsistency of data used for cadastre maps extraction, the errors in form of misalignment is a common problem. In this work, we propose an end-to-end deep learning approach which is able to solve inconsistencies between the input intensity image and the available building footprints by correcting label noises and, at the same time, misalignments if needed. The obtained results demonstrate the robustness of the proposed method to even severely misaligned examples that makes it potentially suitable for real applications, like OpenStreetMap correction.
Keywords	Computer Science - Computer Vision and Pattern Recognition
Publishing date	2020-07-24
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Machine-learned Regularization and Polygonization of Building Segmentation Masks

Zorzi, Stefano / Bittner, Ksenia / Fraundorfer, Friedrich

2020

Abstract: We propose a machine learning based approach for automatic regularization and polygonization of building segmentation masks. Taking an image as input, we first predict building segmentation maps exploiting generic fully convolutional network (FCN). A ... ...

Abstract	We propose a machine learning based approach for automatic regularization and polygonization of building segmentation masks. Taking an image as input, we first predict building segmentation maps exploiting generic fully convolutional network (FCN). A generative adversarial network (GAN) is then involved to perform a regularization of building boundaries to make them more realistic, i.e., having more rectilinear outlines which construct right angles if required. This is achieved through the interplay between the discriminator which gives a probability of input image being true and generator that learns from discriminator's response to create more realistic images. Finally, we train the backbone convolutional neural network (CNN) which is adapted to predict sparse outcomes corresponding to building corners out of regularized building segmentation results. Experiments on three building segmentation datasets demonstrate that the proposed method is not only capable of obtaining accurate results, but also of producing visually pleasing building outlines parameterized as polygons.
Keywords	Computer Science - Computer Vision and Pattern Recognition
Subject code	006
Publishing date	2020-07-24
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: A glimpse into multimodal neuromonitoring in acute liver failure: a case report.

Zorzi, Stefano / Ayako Minemura Ordinola, Amanda / Cunha De Souza Lima, Eduardo / Martins Teixeira, Gabriela / Salvagno, Michele / Sterchele, Elda Diletta / Taccone, Fabio Silvio

Annals of medicine and surgery (2012)

2023 Volume 86, Issue 1, Page(s) 539–544

Abstract: Introduction: Acute liver failure (ALF) is a rapidly progressing, life-threatening syndrome characterized by liver-related coagulopathy and hepatic encephalopathy (HE). Given that higher HE grades correlate with poorer outcomes, clinical management of ... ...

Abstract	Introduction: Acute liver failure (ALF) is a rapidly progressing, life-threatening syndrome characterized by liver-related coagulopathy and hepatic encephalopathy (HE). Given that higher HE grades correlate with poorer outcomes, clinical management of ALF necessitates close neurological monitoring. The primary objective of this case report is to highlight the diagnostic value of utilizing multimodal neuromonitoring (MNM) in a patient suffering from ALF. Case report: A 56-year-old male patient with a history of chronic alcoholism, without prior chronic liver disease, and recent acetaminophen use was admitted to the hospital due to fatigue and presenting with a mild flapping tremor. The primary hypothesis was an acute hepatic injury caused by acetaminophen intoxication. In the following hours, the patient's condition deteriorated, accompanied by neurological decline and rising ammonia levels. The patient's neurological status was closely monitored using MNM. Bilaterally altered pupillary light reflex assessed by decreasing in the Neurological Pupil Index values, using automated pupillometry, initially suggested severe brain oedema. However, ultrasound measurements of the optic nerve sheath diameter showed normal values in both eyes, P2/P1 noninvasive intracranial pressure waveform assessment was within normal ranges and the cerebral computed tomography-scan revealed no signs of cerebral swelling. Increased middle cerebral artery velocities measured by Transcranial Doppler and the initiation of electroencephalography monitoring yielded the presence of status epilepticus. Discussion: The utilization of MNM facilitated a more comprehensive understanding of the mechanisms underlying the patient's clinical deterioration in the setting of HE. Nonetheless, future studies are needed to show feasibility and to yield valuable insights that can enhance the outcomes for patients with HE using such an approach. Given the absence of specific guidelines in this particular context, it is advisable for physicians to give further consideration to the incorporation of MNM in the management of unconscious patients with ALF.
Language	English
Publishing date	2023-11-16
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000001519
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Article ; Online: Outcomes of mini-invasive transoral surgery without neck dissection in supraglottic laryngeal cancer: Real world data from a tertiary cancer center.

Zorzi, Stefano / Pietrobon, Giacomo / Mossinelli, Chiara / Bandi, Francesco / Chu, Francesco / Tagliabue, Marta / De Berardinis, Rita / Zocchi, Jacopo / Alterio, Daniela / Rocca, Maria Cossu / Ruju, Francesca / Ansarin, Mohssen

American journal of otolaryngology

2023 Volume 45, Issue 1, Page(s) 104113

Abstract: Purpose: The neck management in early-stage cN0 supraglottic cancer represents an argument of debate. The aim of our study is to evaluate the oncological and functional outcomes in patients with early-stage cN0 supraglottic carcinoma treated with a wait- ...

Abstract	Purpose: The neck management in early-stage cN0 supraglottic cancer represents an argument of debate. The aim of our study is to evaluate the oncological and functional outcomes in patients with early-stage cN0 supraglottic carcinoma treated with a wait-and-see policy for the neck. Materials and methods: Retrospective monocentric cohort study in a referral cancer care center. We collected a consecutive sample of patients from 2000 to 2020 with Squamous Cell Carcinoma of the supraglottis without clinical evidence of nodal metastases (cN0), surgically treated with Transoral Surgery (Laser or Robotic) without neck dissection. From 316 supraglottic cancer we finally selected 66 eligible participants that met all inclusion criteria. Results: Sixty-six patients (M 75.8 % vs F 24.2 %), median age 65.8 years (IQR 60.9, 70.5). The most common subsite was the epiglottis (62.1 %). Tumor stage distribution was as follows: 35 % cT1, 53 % cT2, 15.2 % cT3. Neither deaths nor major treatment-related complications were reported after surgery. The median follow-up was 62 months. For oncological outcomes, we evaluated 56 patients (10 excluded for adjuvant radiotherapy): 5-year overall survival rate 87 % (CI 95 %: 73.1-94), disease- specific survival rate 95.3 % (CI 95 %: 82-98.8) and neck recurrence-free survival rate 87 % (CI 95 %: 73.1-94). Six patients developed neck recurrence, with a median time of 13 months. Conclusions: Supraglottic carcinoma has been historically associated to a considerable risk of occult metastasis. However, in early-stage cases data are still inconclusive. Our results suggest that in such patients a wait-and-see policy does not impact negatively on survival outcomes, while granting the reduced morbidity associated to a minimally invasive surgical approach.
MeSH term(s)	Humans ; Aged ; Laryngeal Neoplasms/pathology ; Neck Dissection/methods ; Retrospective Studies ; Cohort Studies ; Neoplasm Staging ; Carcinoma, Squamous Cell/pathology
Language	English
Publishing date	2023-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	604541-8
ISSN	1532-818X ; 0196-0709
ISSN (online)	1532-818X
ISSN	0196-0709
DOI	10.1016/j.amjoto.2023.104113
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Zs.A 1637: Show issues

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Article ; Online: The Role of Transoral Robotic Surgery for Parapharyngeal Space: Experience of a Tertiary Center.

Chu, Francesco / De Berardinis, Rita / Tagliabue, Marta / Zorzi, Stefano / Bandi, Francesco / Ansarin, Mohssen

The Journal of craniofacial surgery

2019 Volume 31, Issue 1, Page(s) 117–120

Abstract: The parapharyngeal space (PPS) is an anatomically and functionally complex region of the craniofacial district. Tumors that originate from this region are rare, and surgery is currently the best practice in the vast majority of cases with different ... ...

Abstract	The parapharyngeal space (PPS) is an anatomically and functionally complex region of the craniofacial district. Tumors that originate from this region are rare, and surgery is currently the best practice in the vast majority of cases with different surgical approaches being reported in the literature. Recently, mini-invasive robotic/endoscopic techniques have begun to emerge as effective alternatives in selected cases. In this work, we retrospectively analyzed 17 patients affected by PPS tumors, and managed by transoral robotic surgery (TORS) as a therapeutic or diagnostic procedure. TORS was used alone or combined with a transcervical approach for huge lesions of the PPS, at risk of fragmentation (curative intent). TORS also permitted biopsies of unknown lesions of the PPS to be conducted (diagnostic intent) otherwise unreachable without performing a mandibulotomy. All patients treated with curative intent benefited from radical surgery. No major complications were observed, and tumor fragmentation occurred only in 2 of 17 patients (11.8%). All patients receiving TORS with diagnostic intent were successfully referred to nonsurgical treatments based on the final histhopathological findings. This work also demonstrated TORS to be effective and safe on a larger group of patients compared to our preliminary study in 2016. TORS provides good oncological and functional outcomes when used with curative intent and is an effective diagnostic tool in cases of suspicious lesions of the PPS.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Female ; Humans ; Male ; Mandibular Osteotomy ; Middle Aged ; Parapharyngeal Space/surgery ; Retrospective Studies ; Robotic Surgical Procedures ; Young Adult
Language	English
Publishing date	2019-09-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000005912
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