Ottavio Piccin

University of Bologna | UNIBO · Department of Experimental, Diagnostic and Specialty Medicine DIMES

To evaluate whether mandibular advancement device therapy is recommended in patients affected by obstructive sleep apnea. In order to predict oral appliances therapy response, drug induced sleep endoscopy with cardio-respiratory polygraphy and mandibular advancement device simulator was carried out. Patients in which upper airway obstruction was re...

Sternal wound complications following cardiac surgery, including sternal dehiscence, mediastinitis, and osteomyelitis, pose significant challenges in terms of management and patient outcomes. We present a case report highlighting the complex management of a patient who underwent open heart surgery for severe aortic valve stenosis, followed by stern...

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, d...

During childhood, the Obstructive Sleep Apnea Syndrome (OSAS) represent a very common disease with a prevalence that range from 1% to 4%. Laryngomalacia is considered an uncommon cause of OSAS even though it can play a significant role in younger children especially during the first year of life. Congenital laryngomalacia is a common cause of strid...

The role of lateral pharyngeal wall in the pathogenesis of obstructive sleep apnea has been demonstrated by DISE. The evolution regarding the techniques of pharyngoplasty has been focused on the concept of obtaining the expansion and stabilization of the pharyngeal airspace through the treatment of lateral pharyngeal wall collapse. The use of knotl...

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Objectives: Preoperative localization of pathological parathyroid glands with imaging is essential for focused unilateral neck exploration and minimally invasive techniques. Recently published studies suggested that contrast enhanced ultrasonography (CEUS) had high accuracy in the localization of hyperfunctioning parathyroid glands, with a general...

Chronic kidney disease Mineral and Bone Disorder may persist after successful kidney transplantation. Persistent hyperparathyroidism has been identified in up to 80% of patients throughout the first year after kidney transplantation. International Guidelines lack strict recommendations about the management of persistent hyperparathyroidism. However...

Purpose To evaluate the predictive factors for surgical success in sleep apnea surgical techniques addressing the lateral pharyngeal wall. Materials and methods This is a retrospective review of consecutive cases treated by functional expansion pharyngoplasty for OSA. Collected data included patients demographics, ENT physical examination and somn...

The presence of melanin pigment and melanocytic markers expression have been rarely reported in salivary gland tumors. Herein, two cases of carcinoma arising in pleomorphic adenoma of the parotid gland and showing diffuse expression of myoepithelial and melanocytic markers are described. The clinical-pathological clues useful in the differential di...

Closure of a tracheoesophageal puncture site performed during voice prosthesis implantation may sometimes be required. Besides local techniques, more elaborate procedures, such as closure by means of free microvascular flaps, have been advocated. In this report, we describe a case of local treatment of a hard-to-heal fistula with local application...

The definitive resource on the innovative use of DISE for obstructive sleep apnea Obstructive sleep apnea is the most prevalent sleep-related breathing disorder, impacting an estimated 1.36 billion people worldwide. In the past, OSA was almost exclusively treated with Continuous Positive Airway Pressure (CPAP), however, dynamic assessment of upper...

Purpose Preoperative imaging in patients with primary hyperparathyroidism provides important localization information, allowing the surgeon to perform a focused surgery. However there are no evidence-based guidelines suggesting which preoperative imaging should be used, resulting in a risk of excessive prescription of exams and waste of economic re...

In Italy, we have experienced Europe’s first and largest coronavirus outbreak. Based on our preliminary experience, we discuss the challenges in performing tracheotomy and tracheostoma care in the setting of a new pathogen.

Objectives/hypothesis: To investigate long-term complications of newer reconstructive palate surgery techniques. Study design: Retrospective case-series analysis. Methods: Retrospective six-country clinical study of OSA patients who had nose and palate surgery. Results: There were 217 patients, mean age = 43.9 ± 12.5 years, mean body mass in...

Background: Multicomponent defects of the head and neck involving the cervical skin pose a reconstructive challenge for microsurgeons and usually requires two flaps. However, many patients who undergo such surgical treatment had prior treatment with radiotherapy and the availability of recipient vessels for free flap reconstruction may be limited....

Purpose To evaluate the reliability of intermittent intraoperative neuromonitoring (I-IONM) through recurrent laryngeal nerve (RLN) stimulation and laryngeal palpation in predicting postoperative vocal cord palsy and to examine the reliability of this technique in providing useful information in the decision to perform a staged surgery in initially...

Background: The first edition of the European position paper (EPP) on drug-induced sleep endoscopy (DISE) was published in 2014 with the aim to standardise the procedure, to provide an in-depth insight into the main aspects of this technique and to have a basis for future research. Since 2014, new studies have been published concerning new sedativ...

The recent evolution regarding the techniques of pharyngoplasty has been focused on the concept of obtaining the expansion and stabilization of the pharyngeal airspace through the treatment of soft palate collapse rather than through ablation of the redundant pharyngeal soft tissue. This was obtained by means of a less aggressive and more “physiolo...

The mechanism of OSA is usually multifactorial and the obstruction in the upper airway is very likely to be multilevel, especially in moderate to severe OSA patients. Therefore, the success of surgery for treatment of OSA depends on the accurate diagnosis of the sites of obstruction and the appropriate selection of procedures to address these sites...

correction of nasal deformity remains a challenge because of the complexity of the operation and because of its effect on facial growth. Asymmetry and relapse are common, and one of the main aspects is that residual or recurrent deformity can be accentuated with further time and growth, especially when endonasal anomalies are not properly corrected...

Objectives A relatively neglected aspect of cleft lip nasal deformity is the effect of septal deviation and inferior turbinate hypertrophy (ITH) on the functional airway. In particular, ITH in the noncleft side can be especially problematic, because it reduces the healthy nasal area, creating bilateral nasal obstruction that might affect the growt...

Introduction: Solitary fibrous tumor is an uncommon mesenchymal neoplasm that may be found in any location. To date, only a few cases of solitary fibrous tumor involving the tongue have been reported. Case summary: We present the case of a 31-year-old man with a history of progressively worsening snoring and daytime sleepiness. Polysomnography r...

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. Its clinical course is typically indolent; however, based on a series of pathobiological, clinical, genetic, and phenotypic parameters, patient survival varies from less than 5 to more than 20 years. In this paper, we show for the first time that the expression of the interfe...

Objective Silent sinus syndrome (SSS) and chronic maxillary atelectasis (CMA) are unusual conditions having subtle symptoms with a possible progressive evolution. They are particularly infrequent in the pediatric population. Our objective was to review our experience with pediatric patients having SSS or CMA, and to review all cases involving patie...

Objective: Pediatric periorbital cellulitis represents a common disease complicating a nasal infection. Methods: A ten–year retrospective review of fifty-seven children admitted to our institution with the diagnosis of periorbital cellulitis as a complication of sinus infections was carried out. Results: The age varied from one month to eleven year...

Importance: Drug-induced sleep endoscopy is a diagnostic technique that allows dynamic evaluation of the upper airway during artificial sleep. The lack of a standardized procedure and the difficulties associated with direct visual detection of obstructive events result in poor intraobserver and interobserver reliability, especially when otolaryngo...

Background: Madelung's disease is a rare disorder characterised by the presence of multiple, symmetric, non-capsulated fat masses in the face, neck and other areas of upper extremities. In some cases, severe clinical complications such as upper airway compression can occur. Case report: A 56-year-old man affected by Madelung's disease complained...

Purpose The endoscopic bidimensional vision offered by the endoscope during endoscopic sinus surgery involves difficulty in visualizing surgical field depth which makes it difficult to learn this surgical technique and makes it necessary for the endoscopic surgeon to mentally create a three-dimensional (3D) picture of the paranasal sinuses anatomy....

To evaluate the success rates of combined Expansion Sphincter Pharyngoplasty and the Anterior Palatoplasty in the treatment of OSA. A two center prospective series of 73 patients with OSA. All patients were >18 years old, retro-palatal obstruction, concentric velo-pharyngeal collapse, BMI < 33, Friedman clinical stage II, with all grades of AHI. Th...

The tongue is a complex organ composed of different groups of muscles, connective tissue, and fat deposits; it plays a central role in speech, deglutition, respiration and the pathophysiology of obstructive sleep apnea (OSA) because of its direct involvement in the collapse of upper airway. The tongue can be described in biomechanical terminology a...

Introduction Eyelid malignant melanoma represents less than 1 % of all skin melanomas and approximately 1 % of all malignant neoplasms of the eyelid skin. Because of its relative rarity, there is a paucity of descriptive papers reporting only small series of reconstructed patients. The repair of eyelid defects represents a reconstructive challenge....

This is an update to the recent meta-analysis on expansion sphincter pharyngoplasty.

Sleep apnea has been shown to be more prevalent in patients who underwent radiotherapy and or surgery for head and neck cancer. Here we describe two cases of severe OSAS induced by surgery and radiotherapy, treated by Mandibular Advancing Devices as an alternative option to continuous positive airway pressure

The recent evolution regarding the techniques of pharyngoplasty has been focused on the concept of obtaining the expansion and stabilization of the pharyngeal airspace through the treatment of lateral pharyngeal wall (LPW) collapse rather than through ablation of the redundant pharyngeal soft tissue. The role of LPW in the pathogenesis of obstructi...

The interferon-inducible DNA sensor IFI16 is involved in the modulation of cellular survival, proliferation, and differentiation. In the hematopoietic system, IFI16 is consistently expressed in the CD34+ stem cells and in peripheral blood lymphocytes; however, little is known regarding its regulation during maturation of B- and T-cells. We explored...

Table S1: Genes differentially expressed upon CD40 triggering.

Background: Although drug-induced sedation endoscopy (DISE) represents the most widespread diagnostic tool for upper airway endoscopic evaluation of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS), many controversies exist about how to perform the sedation, the indications for DISE, and how to report DISE findings. The present positi...

Several are the causes of cervical masses and among them a spontaneous hemorrhage presents a rare and life-threatening condition. Sometimes hemorrhage develops from a previous silent neck lesion as in the case of an anaplastic thyroid carcinoma associated with bleeding. We present two cases: a 70-year-old woman suffering from enlarging cervical ma...

Objective Using the Hörmann technique of hyoid suspension in sleep apnea surgery, a steel wire is placed through the thyroid cartilage and slung around the hyoid bone. However, we experienced thyroid cartilage fracture by steel wire traction. A modification is presented to avoid thyroid cartilage fracture.Study DesignCase series with chart review.S...

Objective. To correlate the presence of BRAF V600E mutation with clinicopathological parameters. Study Design. Case-control study. Setting. BRAF mutation represents the most common oncogenic event in sporadic papillary thyroid cancer (PTC). There are, however, significant discrepancies regarding the overall frequency and its relationship with clini...

Objective To correlate the presence of BRAF V600E mutation with clinicopathological parameters.Study DesignCase-control study.SettingBRAF mutation represents the most common oncogenic event in sporadic papillary thyroid cancer (PTC). There are, however, significant discrepancies regarding the overall frequency and its relationship with clinicopatho...

Background. The aim of this study was to assess a prospective, randomized clinical trial (RCT) comparing neurostimulation with laryngeal palpation (NSLP) of recurrent laringeal nerve (RLN) alone with NSLP associated with laryngeal neuromonitoring (LNM) to evaluate the ability of LNM in reducing the rates of RLN palsy. Methods. In all, 250 consecuti...

Background: Microsurgical reconstruction has become the worldwide gold standard for repairing surgical defects in head and neck cancer. The aim of this article is to describe a standardized reconstructive approach to the oral cavity and oropharynx soft tissue defects. Patients and methods: Since 1992, the authors have treated 163 patients affect...

Retropalatal airway segment is the main contributor to airway obstruction in sleep apnea. Direct visualization of the pharynx during drug-induced sleep and pathophysiological studies emphasized the role of the lateral pharyngeal wall collapse in the origin of obstructive events. Based on these findings, new surgical techniques which create adequate...

Objective: Neurostimulation with laryngeal palpation (NSLP) is an intermittent monitoring technique that facilitates nerve identification and permits an assessment of the recurrent laryngeal nerve (RLN) function during thyroid surgery. In this study we report our experience with NSLP, evaluating the predictive value of this technique for postoperat...

Background The aim of this study was to assess a prospective, randomized clinical trial (RCT) comparing neurostimulation with laryngeal palpation (NSLP) of recurrent laringeal nerve (RLN) alone with NSLP associated with laryngeal neuromonitoring (LNM) to evaluate the ability of LNM in reducing the rates of RLN palsy.Methods In all, 250 consecutive...

Objective: Using the Hormann technique of hyoid suspension in sleep apnea surgery, a steel wire is placed through the thyroid cartilage and slung around the hyoid bone. However, we experienced thyroid cartilage fracture by steel wire traction. A modification is presented to avoid thyroid cartilage fracture. Method: Twenty-two patients affected by O...

Hyoid bone fractures are rare (0.002% of all fractures) and most result from strangulation or hanging. Other causes are direct trauma, mostly traffic accidents, and sports injuries, and gunshots, and induced vomiting. The diagnosis is often difficult, especially when associated with other soft tissue injuries or fractures, which may seem more worth...

Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reco...

To determine the accuracy of neurostimulation with laryngeal palpation (NSLP) and intraoperative neuromonitoring (IONM) to predict the postoperative function of recurrent laryngeal nerve (RLN) in thyroid surgery. Historical cohort study. A retrospective case control study with 993 patients. The control group (799 patients with 1450 nerves at risk)...

Background The recognition of the role of craniofacial abnormalities in the development of obstructive sleep apnea (OSAS) has led to several treatment strategies to correct or improve craniofacial structures. We report a case of severe OSAS [Apnea Hypopnea Index (AHI) = 80] in which an increase in the transverse dimensions by surgically assisted ra...

BackgroundThe recognition of the role of craniofacial abnormalities in the development of obstructive sleep apnea (OSAS) has led to several treatment strategies to correct or improve craniofacial structures. We report a case of severe OSAS [Apnea Hypopnea Index (AHI) = 80] in which an increase in the transverse dimensions by surgically assisted rap...

Introduction Neoplasms arising within the parapharyngeal space are rare and represent approximately 0.5% of all head and neck tumors. The majority of these lesions consist of minor salivary gland tumors, tumors of the deep lobe of the parotid gland, and tumors of neurogenic origin (paragangliomi and schwannomi), while branchial cysts are extremely...

To evaluate the accuracy of the intraoperative parathyroid hormone (ioPTH) and 6-hour PTH (6hPTH) assay in predicting transient hypoparathyroidism after thyroidectomy. A nonrandomized prospective study was conducted on patients undergoing thyroid surgery. Of 138 patients undergoing thyroid surgery, intraoperative PTH was measured 10 minutes after g...

More than 20 years have passed since the introduction of surgical techniques based on distal myocutaneous flaps or microvascular flaps in the reconstruction after head and neck cancer resections. The experience gained from the beginning of these techniques until today, has improved the possibility to better predict functional impairment of swallowi...

Cervico facial lipomas are relatively rare and only a few of them affect retropharyngeal space. Because of their slow growth rate, they can reach large size before causing respiratory disturbances and surgery is the treatment of choice. We present a case of 73-year-old female patient with severe obstructive sleep apnea [Apnea Hypopnea Index (AHI) =...

The purpose of this study was to identify the risk factors for postoperative transient hypoparathyroidism in a group of patients undergoing thyroid surgery. A prospective study was conducted on 604 patients undergoing thyroid surgery. Gender, final diagnosis, extent of resection, biology of pathology, intrathoracic involvement, surgery for recurren...

To describe the results of a 1 phase surgical procedure for the treatment of severe obstructive sleep apnea (OSA) attributable to tongue base obstruction. A retrospective nonrandomized study at S Orsola Malpighi University Hospital of Bologna, Italy. Ten male patients affected by severe OSA (mean apnea/hypopnea index [AHI] of 54.7), underwent uvulo...

Minimal-access thyroid surgery, using various techniques, is increasingly being reported. The present study reviews our experience with thyroid surgery using a minimally invasive approach (MIT). Between October 2002 and December 2004, a prospective nonrandomized study of patients undergoing thyroid surgery was performed to evaluate the variables th...