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Elisabetta GENOVESE

Professore Ordinario
Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto

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2022 - Accogliere, orientare, inserire nel mondo del lavoro: i servizi di Unimore dedicati a studenti e laureati con disabilità [Capitolo/Saggio]
Guaraldi, Giacomo; Magnani, Cinzia; Genovese, Elisabetta

2022 - Bulging of the Oval Window in Common Cavity Deformity: A Possible Predictor of Meningitis [Articolo su rivista]
Manara, R.; Avato, I.; Uberti, A.; Trevisi, P.; Bovo, R.; Martini, A.; Brotto, D.; Berettini, S.; Canzi, P.; Ciorba, A.; Cristofari, E.; Cuda, D.; Della Volpe, A.; Frau, G. N.; Genovese, E.; Marsella, P.; Murri, A.; Sorrentino, F.; Vincenti, V.; Zanetti, D.

Objective:To investigate the prevalence-rate of oval window bulging in the common cavity and its association with bacterial meningitis.Patients:CT and clinical files of 29 children with preliminary diagnosis of common cavity deformity were collected from 13 Italian centers.Intervention:A retrospective case review study was conducted with a centralized evaluation of the temporal bone CT imaging was performed at Azienda Ospedale - Università Padova, Padova, Italy.Main Outcome Measure:Diagnosis of common cavity was reviewed; in addition, a fluid protrusion into the middle-ear cavity through the oval window at CT imaging was considered as oval window bulging. Its association with the history of bacterial meningitis was investigated.Results:Common cavity deformity was confirmed in 14/29 children (mean-age 11.4 ± 3.8; age-range 5-20; nine females) referred with this diagnosis. In 7/14 patients, the common cavity deformity was bilateral (i.e., 21 common cavities). Oval window bulging was found in 3/19 common cavities (concomitant middle-ear effusive otitis hampered the evaluation in two cases), while the internal acoustic meatus fundus was defective in 10/21 cases. History of bacterial meningitis was found in three children (21%) and two of them had oval window bulging at CT. In the case unrelated to oval window bulging, meningitis occurred late at the age of 12 during acute otitis contralateral to common cavity deformity (ipsilaterally to incomplete partition type 1).Conclusion:Patients harboring common cavity deformity have a high risk of meningitis in their first years of life. Oval window bulging seems to be associated with a higher risk of meningitis. This information might be important for appropriate surgical planning.

2022 - Monitoring of Communication Precursors in Extremely Low Birth Weight (ELBW) Newborns by Video Analysis Method: Preliminary Results [Articolo su rivista]
Sundas, L.; Palma, S.; Pugliese, M.; Roversi, M. F.; Apa, E.; Berardi, A.; Genovese, E.; Monzani, D.

Background: The survival of extremely low birth weight infants (ELBW) has increased worldwide. Even in the absence of major disabilities, ELBW infants show difficulty in simple language functions. It is relevant to assess early abilities, which are the base of early linguistic skills, in order to implement customized intervention programs in ELBW infants. Aims: To evaluate communication precursors of language development in ELBW infants at 12 and 24 months of correct age (C.A). To investigate the correlation of linguistic and communicative prerequisites with mental development outcome at 24 months CA. Method: 52 ELBW neonates (mean gestational age 26.6 weeks, mean birth weight was 775 g) who were admitted to the neonatal intensive care unit of the University Hospital of Modena, were enrolled. Data were collected from archived audio-video recordings of neurodevelopmental follow-up visits. Video analysis of communicative and linguistic developmental was performed at 12 and 24 months CA. Neurodevelopmental outcome was evaluated with Mental Developmental Scales (GMDS-R). Results: The video-analysis showed that infants at 12 months CA used predominantly eye contacts and gestural turns, while vocal turns were scant. At 24 months CA, a significant change in eye contacts, vocal turns, gestural turns, and utterances (p < 0.001) occurred. The total number of utterances (p = 0.036) and eye contacts (p = 0.045) were significantly correlated to the Development Quotient (DQ) of Hearing and Language scale. Moreover, a significant correlation was found with the Personal-Social scale vocal turns (p = 0.009) and the total number of utterances (p = 0,02). Finally, the Global Quotient of the GMDS-R was related to the Vocal Turns (p = 0.034) and the total number of Utterances (p = 0.013). Conclusions: ELBW infants at 12 months CA use predominantly eye contacts and gestural turns to communicate with adults. At 24 months CA, the child’s communicative intention evolves from gestural to verbal communication. The latter is characterized by an increase in both vocal turns and the number of utterances produced during interaction. The video analysis we implement appears to be a sensitive tool for early assessment of communication and language development and to refine early intervention.

2022 - Relationship between auditory processing disorders and attentional difficulties [Articolo su rivista]
Lotti, L.; Mazzoni, L.; Grigaliute, E.; Monzani, D.; Genovese, E.

Objectives: Attention deficit often emerges in individuals with auditory processing disorder and the relationship between them has not yet been completely understood. The aim of the present review is to investigate whether auditory attention deficit occurs in comorbidity or represents an expression of the same disorder and to compare different diagnostic and management criteria in the existing literature. Methods: A literature review was performed on the PubMed database that yielded 59 records, which were subsequently screened using PICO model. Out of 22 selected articles, four were excluded for non-adherence to the clinical question. Finally, 18 articles were included: one narrative review and 17 empirical research studies. Results: Twenty-two articles were analysed and compared in order to answer to the clinical question along with the assessment instruments of auditory processing and auditory attention. Conclusions: Our review pointed out a greater tendency to consider auditory processing disorder and deficit of attention as distinct entities often in comorbidity. Thus, it is important to evaluate the attentional performances in subjects with auditory processing disorder with particular regard to those who are suspected to suffer also from behavioural, language development or learning difficulties.

2022 - The Effect of the Use of Hearing Aids in Elders: Perspectives [Articolo su rivista]
Monzani, Daniele; Nocini, Riccardo; Presutti, Maria Teresa; Gherpelli, Chiara; Di Berardino, Federica; Ferrari, Silvia; Galeazzi, Gian Maria; Federici, Gaia; Genovese, Elisabetta; Palma, Silvia

: Older adults with hearing loss have difficulties during conversation with others because an elevated auditory threshold reduces speech intelligibility, especially in noisy environments. Listening and comprehension often become exhausting tasks for hearing-impaired elders, resulting in social isolation and depression. The aim of the present study was to investigate the advantages of hearing aid use in relation to relief from listening-related fatigue, which is still controversial. Participants included a sample of 49 hearing-impaired elders affected by presbycusis for whom hearing aids were prescribed. The Modified Fatigue Impact Scale was used to assess cognitive, physical and psychosocial fatigue. The vitality subscale of the Short Form Health Survey 36 and a single item of the multi-dimensional Speech, Spatial and Quality Hearing Scale ("Do you have to put a lot of effort to hear what is being said in conversation with others?") were also used. The Cognitive Failures Questionnaire was used to investigate daily errors related to lack of memory and reduced mindedness. Hearing aids rehabilitation resulted in improved speech intelligibility in competing noise, and a significant reduction in cognitive and psychosocial fatigue and listening effort in conversation. Vitality was also improved and a significant reduction in the Cognitive Failures Questionnaire scores was observed. Findings from the study indicate that the use of hearing aids in older impaired-listeners provide them not only with an increased auditory function but also with a reduction in listening-related fatigue and mindedness.

2022 - The music-related quality of life: Italian validation of MuRQoL into MUSQUAV questionnaire and preliminary data from a cohort of postlingually deafened cochlear implant users [Articolo su rivista]
Frosolini, A.; Parrino, D.; Mancuso, A.; Coppola, N.; Genovese, E.; de Filippis, C.

Purpose: Cochlear implant (CI) users do not receive much of the auditory information necessary for an accurate perception of music. This usually entails a dissatisfaction with the music they hear, so that their quality of life may potentially be affected. The main aim of this paper was to translate and validate into Italian an instrument to evaluate these aspects—The Music-Related Quality of Life Questionnaire (MuRQoL)—to help the work of clinicians and therapists. Methods: The translation of the MuRQoL into “Questionario Musica e Qualità della Vita” (MUSQUAV) was done according to the international guidelines. The translated questionnaire was administered to normal hearing (NH) and CI users adults. Exploratory factor analysis, confirmatory factor analysis and known group method were used to confirm construct validity and applicability of MUSQUAV. Results: We retrieved 225 results. The MUSQUAV questionnaire was acceptable according to the goodness-of-fit indices. The correlation between the items, evaluated using Cronbach’s α coefficient, indicates a good internal consistency (> 0.80). The non-parametric Mann–Whitney test showed significant differences in the distinct populations tested. Conclusions: The MUSQUAV questionnaire is a valid, low-cost and rapid instrument for professional workers in the audiological field, especially useful in the assessment of the patients' perception and musical engagement.

2021 - Auditory processing disorders: Diagnostic and therapeutic challenge [Articolo su rivista]
Cassandro, C.; Manassero, A.; Landi, V.; Aschero, G.; Lovallo, S.; Albera, A.; Genovese, E.; Canale, A.

BACKGROUND: The auditory processing disorders (APD) are characterized by normal peripheral hearing, but abnormal processing of auditory information within the central auditory nervous system and the neurobiological activity that underlies that processing and gives rise to the electrophysiological auditory potentials. Learning disorders (LD) are diagnosed when a subject's achievement on individually administered standardized tests in reading, mathematics or written expression is substantially below (defined as a discrepancy of more than two standard deviations from the mean) that expected for age, schooling and level of intelligence. Prevalence of APD in students diagnosed with LD is estimated to be as high but is still unclear the overlap between the APD and other developmental disorders. This lack of clarity is probably due to the use of multiple diagnostic criteria and different tests proposed that evaluate the same cognitive domains as memory, attention, speech production etc. METHODS: The aim of our study was to present a cluster analysis to determine the overall profile of students that are tested for dyslexia with the co-occurrence of poor performance on auditory skills. In absence of any audiometric hearing loss, they have been addressed for auditory processing assessment according to diagnostic criteria. We evaluated 70 patients (30 males and 40 females) aged between 17 and 55 years. The students were tested on cognitive, auditory, reading and language skills with an IQ assessment, dyslexia assessment, phonological awareness screening, instrumental evaluation for hearing threshold. Exclusion criteria: IQ below the norm (<70 points) and the presence of neurological and sensory deficits. RESULT S: Among 70 patients examined, 33% have poor SRT -PTA agreement because ITA Matrix test showed a SRT average of -3.8 dB SNR; of these 33%, 56% also showed a low score in repeating non-words with shielded mouth, 61% a speed less than 4th percentage in spelling and 39% less than the 5th percentage in the fusion test. Analyzing the profiles of the group with poor SRT-PTA agreement, we focused on four cases that are suspected for APD and we tested them. Only one subjects had a poor performance below two standard deviation on two tests according to diagnostic criteria, so we confirm an APD. CONCLUSIONS: The clinical presentation of APD has much in common especially with specific language impairment (SLI) and dyslexia and this occurrence suggests that may be a symptom of a more varied neurodevelopmental disorder. We conclude that all the patients with difficult on auditory skills with normal hearing threshold should be assess for an APD. The diagnosis of APD is still today a challenge that require a larger sample for further investigation.

2021 - Genetic and Non Genetic Hearing Loss and Associated Disabilities: An Epidemiological Survey in Emilia-Romagna Region [Articolo su rivista]
Genovese, Elisabetta; Palma, Silvia; Polizzi, Valeria; Bianchin, Giovanni; Cappai, Michela; Kaleci, Shaniko; Martini, Alessandro; Ciorba, Andrea; Stagi, Paolo

Hearing loss is one of the most common congenital sensory disorders. It can be associated with several comorbidities, in particular developmental disabilities (DD). In Emilia-Romagna (ER), a region in Northern Italy, Child and Adolescent Mental Health Services (CAMHS) provide the diagnostic framework and treatment for these conditions. The aim of the present study is to evaluate the prevalence of hearing loss, both isolated or in association with comorbidities, in the juvenile population. The study draws its data from the ER Childhood and Adolescent Neuropsychiatry Information System (SINPIAER), an Administrative Healthcare Database collecting the clinical data of all those who have attended CAMHS since 2010. The most frequent type of hearing loss was bilateral sensorineural hearing loss, which was present in 69-72% of the cases, while bilateral conductive hearing loss was the second most common type, ranging from 8 to 10%. Among DD, congenital malformations, mental retardation, visual impairment, and cerebral palsy were the most common. In particular, autism spectrum disorders show increasing incidence and prevalence among CAMHS users in ER region. In-depth knowledge of hearing loss epidemiology and related conditions, such as developmental disabilities, in the juvenile population is crucial for disease prevention, health planning, and resource allocation.

2021 - Hearing Loss in Children: Clinical-Epidemiological Data from Two Different Provinces of the Same Region [Articolo su rivista]
Palma, Silvia; Ciorba, Andrea; Nascimbeni, Laura; Pecovela, Mariachiara; Negossi, Laura; Pelucchi, Stefano; Stagi, Paolo; Genovese, Elisabetta

Background: In many countries, neonatal hearing screening programs (NHS) have been available for many years; however, because of the presence of hearing loss at late onset, early hearing detection programs (EHDP) have been implemented. The aim of this study was to evaluate all cases of infantile hearing loss under the care of two different provinces of a regional health service since the introduction of NHS. Methods: Clinical data (the presence of audiological risk factors, age at which children are placed under the care of health service, entity of hearing loss, treatment, and exposure to bilingualism) were retrospectively collected during the period from 1 January 2012 to 31 December 2018, starting from the IT management system used in all of the regional neuropsychiatric services. Results: In total, 124 children were included-116 cases failed the screening, 1 case had an untraceable result, and 7 cases (5.6%) had hearing screening that passed. Most of the children were placed under the care of a neuropsychiatric infantile and adolescence (NPIA) service within the first year of life. The main differences across the two provinces concerned the percentages of audiological risk factors and the number of unilateral hearing loss cases. Conclusion: In order to plan and manage hearing rehabilitation programs for children in the best way, it is very important to know the local clinical-epidemiological features of the population.

2021 - Newborn hearing screening programme based on an integrated hospital and community care system. Results of the first 4 years of activity [Articolo su rivista]
Palma, S.; Roversi, M. F.; Alberici, M. P.; Negri, M.; Chiossi, C.; Berardi, A.; Genovese, E.

Since January 2012, babies born in the province of Modena, Italy, have routinely undergone hearing testing as part of a two-stage screening programme. Newborn hearing screening (NHS) has been based on an integrated hospital and community care system and this study aims to assess screening coverage, referral rates, the prevalence, type and extent of hearing loss several years into the programme. Data were collected from January 1, 2012 to December 31, 2015. Coverage was over 99% in all five facilities of the province. The ratio of “fails of the screening” to the total number of infants tested varied over the period from 1.2% to 0.9% in the third level facility, and from 0.8% to 0.4% in the other four. Although hearing loss was mainly associated with dysmorphicsyndromic diseases or a family history of hearing loss, some 23% of cases were identified with no known risk factors. We highlight the importance of the NHSP and the need for strong support from healthcare administrators to ensure high coverage. This is especially true since although the prevalence of hearing loss was higher among infants with audiological risk factors, several cases of hearing loss were found in newborns with no known risk factors.

2021 - Physical Therapy for Benign Positional Vertigo of Posterior Canal: The Role of Alternated Epley and Semont Maneuvers [Abstract in Rivista]
Lovato, A.; Marioni, G.; Monzani, D.; Rossettini, G.; Genovese, E.; de Filippis, C.

Objective: To investigate if alternated Epley (EP) and Semont (ST) maneuvers could be more effective than repetition of the same in benign paroxysmal positional vertigo of posterior semicircular canal (pBPPV). Design: We retrospectively reviewed the outcome of pBPPV patients treated with a second maneuver for the persistence of positional nystagmus. Study Sample: Forty-seven patients underwent 2 STs, 64 with 2 EPs, and 71 EPs followed by ST. Videonystagmography and Dizziness Handicap Inventory (DHI) questionnaire were performed. Results: Absence of positional nystagmus was achieved after 2 maneuvers in 136 patients with pBPPV: 65.9% in the ST group, 70.3% in the EP group, and 84.5% in the EP-ST group. Alternated EP and ST were significantly more effective than repeated ST (P = .03), while we found no significant difference when compared with repeated EP (P = .07). At 1-month follow-up, 12 patients showed persistent positional nystagmus without difference between groups. After 1 month, the 46 patients with negative outcome had significantly higher DHI values (P = .01) than other 136 patients with pBPPV. Conclusions: Alternated EP and ST seemed more effective than repeating the same maneuver in treating pBPPV, and this should be confirmed in prospective clinical studies. Resolution of nystagmus after maneuvers was fundamental to reduce handicap deriving from dizziness as reported in DHI.

2021 - Production of third-person direct object clitics in children with cochlear implants speaking Italian [Articolo su rivista]
Giustolisi, B.; Guasti, M. T.; Nicastri, M.; Mancini, P.; Palma, S.; Genovese, E.; Arosio, F.

Previous research has shown that the production of third-person singular accusative object clitics (3DO clitics) might be taxing in Italian-speaking pre-school children with cochlear implants (CIs). We investigated this topic by assessing 3DO clitic production in 14 children with an average age of 8 years, who had received CI between age 1 and 4. The first goal of the study was to analyze whether school-aged children with CIs exhibit atypical behavior in 3DO clitic production. The second goal was to analyze whether children with CIs are prone to agreement errors in case of gender mismatch between the subject and the 3DO clitic, as has been shown for normal-hearing, typically developing children. To achieve this, we used two tasks in which subject and object clitic grammatical genders were manipulated so that they would or would not match. As for the first goal, the majority of children with CIs had good performance on the clitic tasks. However, some participants’ performance was poor. The pattern of deviant responses differed among the poor performers. We believe that children with CIs showing impairments in 3DO clitic production need careful individual analysis in order to plan effective speech therapy. As for the second goal, children with CIs were more prone to agreement errors in the mismatch condition compared to the match condition; this dimension needs to be considered when assessing and eventually rehabilitating clitic production.

2021 - Unexpected hearing improvement after treatment with valganciclovir in a child with congenital cytomegalovirus infection [Articolo su rivista]
Palma, Silvia; Mazzoni, Laura; Roversi, Maria Federica; Botti, Cecilia; Monzani, Daniele; Berardi, Alberto; Genovese, Elisabetta

A 32-week preterm-born male with symptomatic congenital cytomegalovirus infection was treated with valganciclovir. He was also affected by congenital severe bilateral hearing loss and, unexpectedly, a normalization of the hearing threshold was reached at one year of age. The improvement of hearing level in relationship with both the late development of the auditory system and the administration of antiviral therapy is discussed. This case also highlights the importance of early diagnosis of congenital cytomegalovirus associated with close follow-up.

2021 - Vertigo and dizziness in children: An update [Abstract in Rivista]
Fancello, V.; Palma, S.; Monzani, D.; Pelucchi, S.; Genovese, E.; Ciorba, A.

Background: Vertigo and dizziness are relatively infrequent in paediatric patients, but specific data on the prevalence of these disorders are limited and influenced by various factors, including the age of the examined population. These conditions often have a significant impact on patients’ and parents’ quality of life. The aim of this paper is to investigate the prevalence of different aetiologies of vertigo in the paediatric population through a systematic review. Methods: According to PRISMA guidelines, a systematic review of the literature was performed. Medline and Embase were searched from January 2011 through to 10 September 2021. The search yielded 1094 manuscripts, which were reduced to 7 upon the application of inclusion criteria. Results: A total of 2470 paediatric patients were evaluated by the selected papers. Vestibular Migraine was the most frequently diagnosed condition, occurring alone or in association with other diseases. Overall, audio-vestibular disorders represented the second cause of vertigo, and the prevalence appears to increase according to age growth. Over the years, even though we assisted in the amelioration of diagnostic rates, partially related to an improvement in diagnostic tools, the aetiology of vertigo remains still unclear in a variable percentage of patients. Conclusion: Vertigo in children, despite being an uncommon symptom, requires a multidisciplinary approach, often involving Paediatricians, Neurologists and Otorhinolaryngologists. A comprehensive evaluation of children suffering from vertigo is crucial for establishing a successful therapy and reducing parental worries.

2021 - What happens when the newborn hearing screening program is integrated with congenital Cytomegalovirus infection screening? Preliminary results in a tertiary hospital [Articolo su rivista]
Palma, S.; Botti, C.; Roversi, M. F.; Bettini, M.; Pietrosemoli, P.; Berardi, A.; Genovese, E.

Objective: Early diagnosis of congenital Cytomegalovirus (cCMV) infection related hearing loss has increased since the spread of newborn hearing screening (NHS) programs worldwide. However, since most newborns affected are asymptomatic at birth but may develop hearing loss later, some of them may elude the NHS. The aim of this study was to compare the results in two cohorts of children, in one of which all newborns who failed the NHS were tested for cCMV. Methods: We retrospectively compared the results of early diagnosis of cCMV-related hearing loss between two groups of patients at a high-volume centre. Group 1 included the first 3 years of activity without a targeted cCMV screening and was composed of children born between 2012 and 2014. Group 2 included neonates born between 2015 and 2017: in this group, those who failed the NHS underwent urine CMV analysis within 14 days. Results: There were 17,229 live births during the study period, 20 were diagnosed with cCMV infection, with a global prevalence of 1.1:1000. 72 neonates (0.42%) with hearing loss were identified, 7% of which were diagnosed with cCMV infection, 3/34 (8.8%) in group 1 and 2/38 (5.3%) in group 2 (p =.66). One newborn in group 2 was identified through the protocol. The percentage of patients affected by cCMV-related hearing loss diagnosed during the NHS showed non-significant differences in the two groups. Conclusion: Our results suggest that the suspicion index of cCMV infection in a tertiary hospital is currently high and neonatologists are able to identify most symptomatic cases which have higher risk of developing hearing loss. Coupling the cCMV screening and the NHS program is worthwhile as it allows early recognition of asymptomatic cases with hearing loss and subsequent immediate administration of antiviral therapy.

2020 - A panel of jitter/shimmer may identify functional dysphonia at risk of failure after speech therapy [Articolo su rivista]
Lovato, A.; Bonora, C.; Genovese, E.; Amato, C.; Maiolino, L.; de Filippis, C.

Background: There are no reliable outcome predictors for functional dysphonia (FD) patients. Objectives: To investigate if any clinical or phoniatric characteristics could identify FD patients at risk of negative outcome after speech therapy. Methods: We retrospectively reviewed the results of 78 FD patients treated with the proprioceptive elastic method. Before and one-month after therapy, patients underwent endoscopy, acoustic analysis with Multi-Dimensional Voice Program, and Voice Handicap Index-10 questionnaire (VHI-10). Negative outcome was the persistence of VHI-10 ≥ 13. Results: 26 FD patients had negative outcome (i.e. VHI-10 ≥ 13) after speech therapy. At univariate analysis, clinical variables (i.e. sex, age, comorbidities, dysphonia duration, and professional voice use) were not associated with the outcome. Elevated Jitter% (Jitt; p = 0.03), Shimmer% (Shim; statistical trend, p = 0.06), and Noise to Harmonics Ratio (statistical trend, p = 0.06) were found in patients with poor results. At multivariate analysis, higher Jitt was an independent negative prognostic factor (p = 0.02), while a statically trend was identified for Shim (p = 0.06). A panel of Jitt >1.5 and Shim >5.1 showed an acceptable discriminatory power (AUC [ROC] = 0.76) according to Hosmer and Lemeshow scale. Conclusion: A panel of two acoustic analysis parameters could help in identifying FD patients at risk of speech therapy failure. Further studies in these patients are needed to evaluate the most efficient treatment protocol.

2020 - Correlations between bedside and instrumental endoscopic parameters in determining severity of dysphagia: An integrated clinical evaluation of safety and efficiency [Articolo su rivista]
Farneti, D.; Genovese, E.

Interaction between bedside and endoscopic parameters is of great interest in the management of patients with swallowing disorders. Our aim is to document if and how bedside parameters correlate with severity using endoscopic assessment. 556 consecutive patients (318 M/238 F, mean age 65.56 ± 10.36 years, range 18-91), were evaluated in our Swallowing Centre during 2008. All underwent bedside evaluation and fiberoptic endoscopic evaluation of swallowing (FEES), considering the pooling score (p-score) and the pooling sensation, collaboration and age score (p-SCA score) to express criteria of clinical severity of dysphagia. The correlation between the two tests (Spearman correlation coefficient) and their agreement to classify severity (Cohen’s kappa) was defined. After dichotomisation (cut-off: no risk/any kind of risk of aspiration), values of sensitivity and specificity were obtained after comparison with FEES results (gold standard). A close and significant correlation between the p-score and p-SCA score was found (rho = 0.88; p < 0.001). The agreement among scores in attributing the categories of risk is moderate (Cohen’s Kappa = 0.46; p < 0.001).The p-score had a sensitivity of 96% and specificity of 60%, while the p-SCA score has a sensitivity of 98% and specificity of 40%. Our results suggest that including even a few parameter from bedside evaluation to an endoscopic score, the level of severity expressed by the latter, decreases. The evaluation of patients with swallowing disorders should consider as many elements as possible, deriving from non-instrumental and instrumental evaluation (integrated clinical evaluation).

2020 - Different audiologic outcomes in twins with congenital cytomegalovirus infection [Articolo su rivista]
Botti, C.; Palma, S.; Roversi, M. F.; Monzani, D.; Berardi, A.; Genovese, E.

Congenital cytomegalovirus (cCMV) infection is a major cause of hearing loss in children. A few cases of cCMV twin pregnancies are reported in the literature. Twins can react differently to maternal infection, but hearing loss is rarely evaluated. Two couples of twins with cCMV infection and different audiologic outcomes are reported. The first couple of twins was composed by two male twins, both affected by cCMV infection. The first born had normal hearing function, and the second born had sensorineural hearing loss (SNHL). In the second couple, a male and a female twin, only the male twin was affected by cCMV infection, and both had normal hearing function. In this case series, an interesting finding was the association between the presence of viral DNA in liquor and hearing loss in one newborn. Further research is needed to better understand the pathophysiology of SNHL caused by cCMV infection.

2020 - L'esperienza della CNUDD a favore degli alunni con DSA [Capitolo/Saggio]
Genovese, Elisabetta; Guaraldi, Giacomo

2020 - OTOPLAN in Cochlear Implantation for Far-advanced Otosclerosis [Articolo su rivista]
Lovato, A.; Marioni, G.; Gamberini, L.; Bonora, C.; Genovese, E.; de Filippis, C.

AIM: To evaluate OTOPLAN software in the surgical planning of far-advanced otosclerosis (FAO) candidates to cochlear implant (CI) were considered. We aimed to preliminarily investigate if this software could influence the electrode length choice, or predict surgical difficulties. METHODS: We reviewed the outcome of five consecutive FAO patients that underwent unilateral CI. OTOPLAN was used to evaluate preoperative computed tomography imaging. A comparison was made with historical data (eight FAO patients). RESULTS: The mean cochlear duct length estimated by OTOPLAN was 32.4 mm. Evaluating OTOPLAN reconstructed images, we ruled out cochlear lumen fibrosis/ossification in three FAO patients and the longest electrodes according to cochlear dimensions were preferred. We disclosed fibrosis in the middle and apical turns of two patients. These findings allowed us to change surgical plans, choosing a shorter electrode (24 and 28 mm instead of 31 mm) to avoid incomplete insertion due to cochlear fibrosis. OTOPLAN reconstructed images identified preoperatively the two patients with round window niche ossification that required additional drilling during surgery. In the present series, we experienced no incomplete insertion. In two cases out of eight historical FAO patients, array insertion (24 mm) was incomplete. One years after unilateral CI, the mean speech reception threshold and disyllabic word recognition score of the five considered FAO patients were 36 dB and 94%, respectively (39 dB and 84% for the eight historical patients). There was no facial nerve stimulation or any other complication during the 1-year follow-up. CONCLUSION: According to our preliminary results, OTOPLAN was useful for the appropriate choice of array length.

2020 - Promuovere le potenzialità degli studenti con DSA. Scuola secondaria e Università a dieci anni dalla Legge 170. [Curatela]
Genovese, Elisabetta; Guaraldi, Giacomo

2019 - Hearing loss in children with congenital cytomegalovirus infection: An 11-year retrospective study based on laboratory database of a tertiary paediatric hospital [Articolo su rivista]
Palma, S.; Roversi, M. F.; Bettini, M.; Mazzoni, S.; Pietrosemoli, P.; Lucaccioni, L.; Berardi, A.; Genovese, E.

Congenital cytomegalovirus infection is considered the main cause of infantile non-genetic neurosensory hearing loss. Although this correlation was described more than 50 years ago, the natural history of internal ear involvement has not yet been fully defined. Hearing loss is the most frequent sequela and is seen in a variable percentage up to 30%; the hearing threshold is characterised by fluctuations or progressive deterioration. The purpose of this study was to evaluate the prevalence of hearing loss in cases of congenital CMV infection from Modena county, starting from the database of the microbiology and virology reference laboratory. All children undergoing urine testing for suspected CMV infection or viral DNA testing on Guthrie Card in the period between January 2004 and December 2014 were enrolled in the study. Family paediatricians were contacted and asked about clinical information on the possible presence at birth or subsequent occurrence of hearing loss, excluding cases where this was not possible. The results showed an annual prevalence of congenital cytomegalovirus infection among suspected cases that was stable over time despite the progressive increase in subjects tested. The prevalence of hearing loss was in line with the literature, whereas in long-term follow-up cases of moderate, medium-to-severe hearing loss with late onset were not detected. The introduction of newborn hearing screening in the county has allowed early diagnosis of hearing loss at birth as non-TEOAE-born births underwent a urine virus test. Moreover, despite all the limitations of the study, we can conclude that European epidemiological studies are needed to better define the relationship between congenital CMV infection and internal ear disease as the impact of environmental and genetic factors is still not entirely clarified.

2019 - The endoscopic evaluation of the oesophageal phase of swallowing (E-FEES): perspective in a audiological-phoniatric setting [Articolo su rivista]
Farneti, D.; Genovese, E.

During a fiberoptic endoscopic evaluation of swallowing (FEES) the study of the oesophagus, complete with tests with bolus (oesophageal FEES, E-FEES) is a procedure rarely used in a phoniatric setting, with patients complaining of swallowing and voice alterations. This extension of FEES toward the oesophagus by a transnasal approach is a procedure used for decades in the instrumental evaluation of patients with ENT complaints. E-FEES is used on out-patients without premedication or local anaesthesia. The patient is sitting upright and a 70 cm flexible endoscope, 3.5 cm diameter, is used. During the procedure the patients undergo tests with bolus. 20 patients (13M/7F, range 19–78 years, mean age 50, 51 years), taken from 437 consecutive outpatients seen in our Department from August to December 2011, underwent E-FEES (retrospective analysis). Patients were selected based on a reflux finding index (RFI) > 13, Reflux finding score (RFS) > 7 and FEES alterations (penetration/aspiration, spillage, residues). E-FEES findings were: 10 esophagitis, 1 gastroesophageal junction incontinence, 2 hiatal hernia, 4 motility alterations, 2 diverticula, 1 carcinoma. oesophageal alterations are not rare in patients with deglutition and voice disorders. E-FEES is a safe, reliable and cost-effective technique, worthy of being implemented in a phoniatric setting. The main steps and characteristic of the procedure are proposed.

2018 - Aspiration: Diagnostic contributions from bedside swallowing evaluation and endoscopy [Articolo su rivista]
Farneti, D.; Turroni, V.; Genovese, E.

The aim of this study was to identify which characteristics, collected by bedside swallowing evaluation (BSE) and fiberoptic endoscopic evaluation of swallowing (FEES), are a risk or a protective factor for aspiration. This retrospective study included data on 1577 consecutive patients, collected by BSE and FEES. Bivariate analysis was performed to verify the association of each variable with aspiration (Chi-Square test). The variables associated with aspiration were entered into a multivariate logistic model to quantify this association. Several variables were significantly associated (p < 0.05) with aspiration; cooperation, sensation, laryngeal elevation and direct therapy were found to be protective factors against aspiration. The regression model identified the most variables related with aspiration, among which tracheotomy, material pooling and spillage. Patients able to perform dry swallows were 77% less likely to aspirate (protective factor). Several variables are involved in protection of airways during swallowing. Their interaction, in patients with swallowing disorders, offers the clinician the best means of interpreting BSE and FEES.

2018 - DSA: dalla scuola secondaria all'università. Percorsi per il successo formativo [Curatela]
Guaraldi, G; Valenti, A; Genovese, E

Oggi sono sempre di più gli studenti con DSA che terminata la scuola secondaria di secondo grado, desiderano iscriversi all'Università e che cercano di inserirsi in contesti lavorativi in linea con i propri studi e le proprie aspirazioni. Questo è sicuramente un segnale positivo, soprattutto per la crescente attenzione da parte del mondo accademico, anche se rimane ancora molto da fare per approdare a una completa inclusione. I contributi presenti in questo volume, attraverso un'ottica multidisciplinare, indagano quali siano le misure dispensative e gli strumenti compensativi da utilizzare, le buone prassi da seguire, le possibili prospettive lavorative e le strategie più efficaci per favorire il successo formativo di ragazzi e giovani con DSA.

2018 - Introduzione [Breve Introduzione]
Valenti, A; Genovese, E; Guaraldi, G

2018 - Legge 170 ed Università [Articolo su rivista]
Genovese, Elisabetta; Guaraldi, Giacomo; Gubernale, Marco

A seguito dell’entrata in vigore della Legge 170/2010 gli alunni con disturbi specifici dell’apprendimento (DSA) di ogni ordine e grado scolastico, ivi comprese le Università, sono finalmente stati tutelati. Tale norma ha, infatti, il compito di garantire loro il diritto allo studio e pari opportunità di formazione. La normativa vigente prevede, inoltre, la possibilità di erogare loro misure compensative e strumenti dispensativi al fine di renderli, il più possibile, au- tonomi nello studio e garantendo loro una valutazione che tenga conto delle singole “caratteristiche”. Inoltre pur potendo usufruire di strumenti dispensativi durante le verifiche, essi sono perfettamente consapevoli di dover acquisire le medesime competenze dei propri compagni di classe. Importante è l’articolo 5 della normativa, secondo il quale i diversi ordini e gradi scolastici debbono garantire una particolare flessibilità didattica, trasformando, così, la didattica tradizionale in didattica “inclusiva”. Anche tra i compiti assegnati all’Università, infatti, vi è quello di prevedere che “gli studenti con diagnosi di DSA hanno il diritto di fruire di appositi strumenti dispensativi e compensativi che garantiscano la flessibilità didattica”. Presso l’Università di Studi di Modena e Reggio Emilia, infatti, è attivo dal 2007 un servizio di consulenza e di erogazione dei servizi per tutti gli studenti con disturbi specifici di apprendimento iscritti all’Ateneo. Tale sportello ha il compito di valutare, insieme agli studenti stessi, le modalità di intervento più consone al loro percorso universitario affinché anch’essi possano raggiungere i più elevati titoli di studio. L’Ateneo di Modena e Reggio Emilia, grazie ad un’importante opera di sensibilizzazione sulla cultura dei DSA, è riuscito a garantire a tali studenti diversi supporti individualizzati facendo emergere le loro potenzialità. Il numero degli studenti con DSA, in ambito accademico, infatti, è in crescita esponenziale come si deduce dai dati Censis presentati nel contributo .

Guaraldi, G; Genovese, E; Zonno, M P; Scorza, M; Stella, G

Il Progetto TIDE (New Tools For Inclusion of Dyslexic Students) nasce dalla collaborazione tra l’Università degli Studi di Modena e Reggio Emilia (capofila del progetto), For Modena (Formazione Professionale per i territori modenesi), l’Università degli Studi di Atene, l’Università Goldsmith di Londra ed il Provveditorato agli studi di Vienna. Il progetto, finanziato ed approvato dall’Unione Europea nel 2016, avrà durata triennale. Obiettivo della ricerca è quello di ottenere un quadro realistico delle metodologie di accompagnamento degli studenti con disturbo specifico dell’apprendimento (DSA) in ambito scolastico sia per quanto concerne la scuola secondaria di secondo grado che l’Università favorendo lo scambio di buone prassi tra i vari ordini e gradi scolastici. Tramite tale ricerca i diversi Partner coinvolti intendono conoscere, innanzitutto, la percentuale di studenti con DSA iscritti nelle scuole secondarie di secondo grado e nelle Università e le misure dispensative e strumenti compensativi loro erogati compiendo così un confronto tra tali dati e la percentuale di normolettori ed individuando eventuali carenze emerse dall’analisi dei bisogni. S’intende, pertanto, dare rilievo alle metodologie didattiche utilizzate nei singoli Paesi per favorire il più possibile lo studio ad allievi con DSA ed una didattica inclusiva oltre che compiere un’opera di sensibilizzazione sulla cultura dei DSA. Tramite interviste rivolte a specialisti (corpo docente, psicologi, pedagogisti, dirigenti scolastici, ecc.) e a studenti con DSA (appartenenti sia alla scuola secondaria di secondo grado e all’Università) si cercherà di individuare i bisogni educativi degli studenti con DSA e le buone prassi adottate nei Paesi coinvolti. Il progetto TIDE ha, pertanto, l’ambizione di favorire l’accompagnamento di studenti con DSA negli istituti superiori, nell’Università e negli enti di formazione professionale divulgando sempre di più la conoscenza degli strumenti compensativi e delle misure dispensative più idonee. Al fine di monitorare l’andamento del progetto stesso, saranno realizzati eventi moltiplicatori in ciascun Paese partner ed ulteriori manifestazioni liberamente svolte. Il progetto ha anche lo scopo di sottolineare le sostanziali differenze relative ai servizi erogati agli studenti con DSA nei diversi Paesi europei e l’evolversi di buone prassi alle quali poter attingere al fine di garantire sempre più il diritto allo studio e pari opportunità di formazione senza correre il rischio di discriminare nessuno. L’impatto che si prevede per il progetto TIDE è quello di attivare linee guida condivisibili da tutti i Paesi partner al fine di gestire le attività di accompagnamento scolastico di soggetti con DSA dalla scuola secondaria di secondo grado all’Università, un passaggio spesso critico per molti giovani. Realizzando tale progetto ci si augura, pertanto, di poter creare uno strumento di supporto nel passaggio dalla scuola secondaria di secondo grado all’Università garantendo sempre più pari opportunità formative ai soggetti europei con diagnosi clinica di DSA.

2018 - Presentazione del database di Unimore [Capitolo/Saggio]
Guaraldi, G; Genovese, E

La presenza sempre maggiore di studenti con DSA presso gli Atenei italiani è ormai un fatto tangibile e riconosciuto da tutti. Ancor oggi, purtroppo, non tutti i Docenti sono formati sulla tematica dei DSA e non tutti sono particolarmente sensibili ad accogliere tali studenti presso i corsi di Laurea. Vista la grande variabilità de modo in cui possono manifestarsi i DSA è considerate le diverse caratteristiche di tali studenti, è opportuno valutare in modo personalizzato le misure compensative e gli strumenti dispensativi da erogare durante il loro percorso di studi. E' proprio per tale varietà di caratteristi che il Servizio Accoglienza Studenti disabile con DSA di UNIMORE ha realizzato un repository universitario con l'obiettivo di condividere efficacemente le informazioni relative a ciascuno studente con DSA.

2018 - The role of the audiologist–phoniatrician in performing the dynamic endoscopic study of swallowing. Position statement of the Italian study group on dysphagia (GISD)* [Articolo su rivista]
Farneti, D.; Schindler, A.; Fattori, B.; Ruoppolo, G.; Simonelli, M.; Coscarelli, S.; Travalca Cupillo, B.; Spadola Bisetti, M.; Nacci, A.; Genovese, E.; Barillari, U.; Schindler, O.

This paper expresses the views of a group of experts within the Italian Study Group on Dysphagia (GISD) concerning the role of the Audiologist–Phoniatrician in performing the dynamic endoscopic study of swallowing.

2018 - Vestibular findings in patients with schwannoma of the 8th cranial nerve: a survey of nine cases and review of the literature [Articolo su rivista]
Palma, S.; Boldrini, P.; Genovese, E.; Auletta, G.; Martini, A.; Cenacchi, G.

Introduction: Some aspects of the natural history of vestibular schwannoma (VS) remain unsettled. A better understanding of the pathophysiology of the disease would improve its diagnostic workup and therapeutic management, as VS often requires surgery, which carries the risk of severe complications. This paper discusses the significance of ultrastructural findings in the vestibular organs removed during surgery. Material and methods: This study examined specimens from vestibular organs removed from patients who underwent VS resection through the translabyrinthine approach. The sample includes 9 patients, seven women and two men, with a mean age of 55 years (range 39–71 years). Results: The sensory epithelium showed a loss of stereocilia, numerous lipofuscin granules and vacuoles in the cytoplasm. The subepithelial myelinated nerve fibres showed signs of demyelination and sheath rearrangement. Some axons had markedly degenerative modifications, with neurofilament aggregation, more numerous mitochondria and vacuolization. As it lost its specialized structures, the epithelial covering of the semicircular canal walls progressively flattened out in the area farthest away from the sensorial area. Conclusions: There were no specific correlations between schwannoma size and instrumental or ultrastructural findings in the vestibular epithelium organs. The morphological features of the non-sensory epithelium suggest that the potassium circulation system is preserved in patients with VS even when they present prominent cochlear and/or vestibular symptoms. VS formation appears to be multifactorial; the vestibular nerve conduction block caused by tumour compression would not necessarily cause irreversible damage to the vestibular receptors at the outset.

2017 - Endoscopic-assisted cochlear implant procedure in CHARGE syndrome: Preliminary report [Articolo su rivista]
Marchioni, Daniele; Carner, Marco; Soloperto, Davide; Sacchetto, Andrea; Genovese, Elisabetta; Presutti, Livio

The endoscopic approach demonstrated to be useful for cochlear implantations of children with CHARGE syndrome. It allows the surgeon to perform a direct 'safe' cochleostomy in difficult anatomical conditions. Three children with CHARGE syndrome underwent endoscopic-assisted cochlear implant surgery at the Tertiary University Referral Center of Modena and Verona between January 2014 and September 2015. A review of clinical data and videos from the operations was made. All procedures were re-analyzed and codified. Three children, all females (mean age 4.6 years; range: 3-7 years) underwent surgery. Two primary surgical procedures and one revision surgery, for secondary cholesteatoma, were performed. CT scans demonstrated complex malformations of middle and inner ear with anomalous course of the facial nerve. In all subjects, a transcanal endoscopic cochleostomy was performed; no immediate or late postoperative complications were observed. Discharge from hospital was the day post-surgery. The current mean follow-up is 12.5 months (range: 8-19 months).

2017 - Fenotipo lieve di sordità neurosensoriale e cheratoderma palmo-plantare causato da una nuova mutazione dominante di GJB2 [Articolo su rivista]
Stanghellini, I.; Genovese, E.; Palma, Silvana; Falcinelli, C.; Presutti, L.; Percesepe, Antonio

Dominant GJB2 mutations are known to cause a syndromic form of sensorineural hearing loss associated with palmo-plantar skin manifestations. We present the genotype/phenotype correlations of a new GJB2 mutation identified in three generations of an Italian family (proband, mother and grandfather) whose members are affected by sensorineural hearing impairment associated with adult-onset palmoplantar keratoderma. In all affected members we identified a new heterozygous GJB2 mutation (c.66G > T, p.Lys22Asn) whose segregation, population frequency and in silico prediction analysis have suggested a pathogenic role. The p.Lys22Asn GJB2 mutation causes a dominant form of hearing loss associated with variable expression of palmoplantar keratoderma, representing a model of full penetrance, with an age-dependent effect on the phenotype.

2017 - Il repository di UNIMORE per il monitoraggio delle carriere universitarIe di studenti con disturbi specifici dell'apprendimento [Capitolo/Saggio]
Guaraldi, G; Genovese, E.

La rilevazione sistematica e periodica di statistiche nell'ambito della Pedagogia Speciale è oramai, per tutti i Paesi, un compito ineludibile, che viene sollecitato anche da numerosi organismi a livello internazionale. In Italia, la mancanza di dati circa gli studenti con disabilità e con DSA è particolarmente significativa in ambito accademico e inadeguate risultano le informino attualmente prodotte dagli osservatori nazionali in merito. Il contributo riporta la buona prassi di un'Ateneo, quello di Modena e Reggio Emilia, che ha sviluppato uno strumento con cui è possibile monitorare facilmente e con rapidità la carriera di ciascuno studente con bisogni educativi speciali. Tale database, oltre a fornire preziose informazioni di tipo quantitativo, relative sia al profilo degli studenti sia ai servizi offerti, svolge la funzione di repository di informazioni e di suggerimenti didattici per i Docenti, contribuendo ad effettuare un'operazione di formazione e sensibilizzazione dell'Ateneo.

2016 - Endoscopic approach for cochlear implantation in advanced otosclerosis: A case report [Articolo su rivista]
Marchioni, D.; Soloperto, D.; Bianconi, L.; Guarnaccia, M. C.; Genovese, E.; Presutti, L.

Hypothesis: Ossification of the cochlea was once considered to be a contraindication for cochlear implantation. Advances in cochlear implant technology and coding strategies have led to developments in different surgical procedures to manage cochlear ossification. The endoscopic technique allows a direct approach to the round window and the cochlea, especially in remodeled labyrinth, allowing a better vision of scala tympani. Background: Tertiary referral ENT center. Methods: Between January 2011 and February 2015 three patients with far advanced otosclerosis with partial obliteration of the cochlea were selected and underwent endoscopic-assisted cochlear implantation. Results: In far advanced otosclerosis, endoscopy allowed a magnification of the anatomy of the round window, permitting the surrounding anatomical structures forming the anatomy of the niche to be identified, and avoiding a blind dissection. No postoperative complications were noted, in particular, no surgical site infection, no vertigo, and no facial nerve injuries. Implant activation was routinely performed 1 month after surgery. All monitoring till date has indicated that the external auditory ducts are well ventilated and there are no signs of extrusion. Conclusions: Ossification may occur as a consequence of the pathology of meningitis, chronic otitis media, severe otosclerosis, autoimmune inner ear diseases, temporal bone traumas, and other diseases. Advances in cochlear implant technology and coding strategies have led to developments in different surgical procedures to manage cochlear ossification. Supported by a number of years of experience in the field of otoendoscopic surgery, we propose a technique for cochlear implantation under unfavorable conditions using endoscopic-assisted surgery, especially in advanced otosclerosis. This technique permits us to extend the indication for cochlear implantation, and in our opinion will reduce the morbidity associated with this surgical procedure.

Guaraldi, G; Ghidoni, E; Genovese, E.

Il testo presenta il complesso rapporto tra genetica, basi neurobiologiche ed i fattori ambientali nei soggetti con DSA. All'interno della cornice del neuro-sviluppo, quindi partendo da solidi dati di ricerca clinica evidence based, ed attraverso la testimonianza diretta di persone con DSA, si affrontano i disturbi specifici dell'apprendimento rispetto alla scuola, l'Università ed il mondo del lavoro, che strutturano ancora i percorsi educativi e formativi sul deficit piuttosto che sulle potenzialità dei ragazzi. E' oramai chiaro, infatti, che i DSA hanno una componente genetica molto importante che però è fortemente condizionata dall'ambiente nel quale lo studente dei strofa d interagire. Occorre, pertanto, che il contesto sia "inclusivo" e non diventi un ostacolo per la crescita formativa e motivazionale. La scuola e l'Università, in primis, devono impedire la stigmatizzazione dei soggetti con DSA, favorendone l'autonomia ed accrescendone l'autostima, offrano le strategie migliori per potenziare il loro apprendimento, perché raggiungano competenze ed abilità adeguate per entrare a pieno titolo nel mondo del lavoro e nella società.

2016 - Is Ménière’s disease the ‘inner ear migraine’? A neurovascular region-based hypothesis supported by epidemiological appraisal and pathophysiological considerations [Articolo su rivista]
Alicandri Ciufelli, M.; Aggazzotti-Cavazza, E.; Cunsolo, E.; Marchioni, D.; Monzani, D.; Genovese, E.; Presutti, L.

Migraine (MG) and Ménière’s disease (MD) are idiopathic pathologies, but share several clinical, epidemiological, and genetic characteristics. Based on some considerations with regard to the pathophysiology and epidemiology of both MG and MD, the authors hypothesize that MG and MD could be interpreted as different neurovascular regional manifestations of the same pathology. An interpretation of MG and MD as the same phenomenon involving different brain regions could inspire and stimulate researchers studying aspects linking what has already been discovered in both fields, e.g. pathogenetic mechanisms or therapeutic development.

2016 - Mutation screening of the Otop1 gene in familial benign positional paroxysmal vertigo [Articolo su rivista]
Monzani, D.; Fancello, T.; Alicandri Ciufelli, M.; Genovese, E.; Tarugi, P.; Cavazza, E. A.; Percesepe, A.

Objectives: Benign paroxysmal positional vertigo (BPPV) is a sporadic disorder in the vast majority of cases, although a familial, benign, recurrent form, in which the disease segregates in an autosomal dominant fashion has been described. After the evidence for a role of a novel murine gene, Otop1, in knock-out tlt (tilted) and mlh (Mergulhador) mice, lacking the perception of gravity and linear motion and showing a vestibular disorder due to non-syndromic agenesis of both utricular and saccular otoconia, we aimed at verifying the role of the human analogue of the Otop1 gene in BPPV pathogenesis in familial cases of BPPV, collected in our tertiary university referral centre. Methods: Starting in 2007, families with at least two living members thought to have BPPV were considered for inclusion in the present study. The cases were both retrospectively and prospectively identified over the following two years. Results: Seven familial aggregations of BPPV were identified and Otop1 mutation screening showed the presence of a heterozygous mutation in one family, c.1013G> C p.Arg338Pro, which was considered possibly deleterious using the prediction software. It was absent in 100 control alleles, but was also found in two as yet unaffected relatives. Conclusions: The results of a mutation screening of the Otop1 gene in familial cases of BPPV do not support a major role of the gene in the pathogenesis of the disease.

2016 - Stapes malformations: the contribute of the endoscopy for diagnosis and surgery [Articolo su rivista]
Marchioni, Daniele; Soloperto, Davide; Villari, Domenico; Tatti, Maria Fatima; Colleselli, Elena; Genovese, Elisabetta; Presutti, Livio

The aim of this study is to investigate the contribute of the endoscopic exclusive transcanalar approach for the management of stapes malformations. A retrospective chart review was made at our tertiary referral centers. 17 patients with stapes malformations underwent surgery with endoscopic exclusive transcanal approach. A complete audiological and radiological assessment before and after surgery was performed. 12/17 (70 %) underwent a surgical endoscopic correction, In case of fixed platina underwent five endoscopic stapedotomy and one endoscopic stapedectomy were performed. In case of mobile platina five endoscopic ossiculoplasties with partial ossiculoplasty replacement prosthesis were performed, 3 with autologous remodeling incus and 2 with malleus head remodeling. In 1 case, only an endoscopic stapes mobilization was made. In 5/17 (30 %), due to difficult anatomical findings an endoscopic explorative tympanotomy was finally performed. The mean preoperative air conduction (AC), bone conduction (BC) and air-bone gap (ABG) were, respectively, 60.7, 26.3 and 34.4 dB. The mean postoperative AC, BC and ABG were, respectively, 33.8, 26.5 and 7.3 dB, with a mean improvement of the ABG of 27.1 dB. Discharge from hospital was on the first post-surgery day. No relevant postoperative complications were noted. The median follow-up was 3.6 years (range 1-6). The endoscopic approach results very adequate for the diagnosis and treatment of stapes malformations, checking variations of the ossicles conformation and functioning and performing safe surgery, under direct control of middle ear structures.

2016 - The production of direct object clitics in pre-school– and primary school–aged children with specific language impairments [Articolo su rivista]
Guasti, M. T.; Palma, S.; Genovese, E.; Stagi, P.; Saladini, G.; Arosio, F.

Third-person direct object (DO) clitic pronoun production is examined through an elicited production method in pre-school– and primary school–aged groups of Italian children with specific language impairment (SLI) to establish whether there is an improvement from age 5 years to age 7 years and whether there are qualitative differences in the two groups’ responses. It was found that 5- and 7-year-old Italian children with SLI produce fewer third-person DO clitics than same-age peers. The kind of responses they provide changes: at 5 years, children with SLI tend to omit clitics, while at 7 years, they use a full noun. Production of third-person DO clitics is a persistent challenge for children with SLI and is confirmed to be a good clinical marker both at 5 and 7 years of age.

Boni, C. D.; Guzzo, F; Guaraldi, G; Genovese, E.

Nella realtà italiana la diagnosi di DSA negli adulti incontra notevoli difficoltà, in quanto i servizi per l'età evolutiva valutano solitamente ragazzi fino a 18 anni neon esiste un servizio clinico per la diagnosi dell'adulto diffuso a livello nazionale, ad eccezione di alcune realtà. Nell'anno 2013 il Servizio Accoglienza Studenti Disabili e con DSA dell'Università degli Studi di Modena e Reggio Emilia, in collaborazione con il Servizio di diagnosi per studenti ed adulti con DSA dell'arcispedale Santa Maria Nuova di Reggio Emilia, ha condotto una ricerca al fine di individuare quali prove fossero più sensibili per la diagnosi di DSA nei soggetti adulti, attraverso la somministrazione di due diverse batterie neuropsicologiche.

2015 - Early diagnosis of branchio-oculo-facial syndrome in a patient with inner ear malformation and mild ocular involvement [Articolo su rivista]
Lugli, Licia; Just, Walter; Genovese, Elisabetta; Palma, Silvia; Ferrari, Fabrizio; Percesepe, Antonio

Case report

2015 - Endoscopic assisted cochlear implants in ear malformations [Articolo su rivista]
Marchioni, Daniele; Soloperto, Davide; Guarnaccia, MARIA CONSOLAZIONE; Genovese, Elisabetta; ALICANDRI CIUFELLI, Matteo; Presutti, Livio

The aim of present study is to describe the use of the endoscopic assisted cochlear implant approach in cases with severely malformed temporal bones and with anomalous anatomy of the inner ear and tympanic cavity. Eight patients with malformed middle and inner ear and bilateral profound hearing loss were operated using an endoscopic assisted cochlear implant procedure at our tertiary university referral center between January and September 2013. Five patients received a cochlear implant using a suprameatal endoscopic assisted approach. A chart review of clinical data and videos from the operations was performed. All procedures were re-analyzed and codified. In all patients, discharge from hospital was on the third day post-surgery. No immediate or late postoperative complications were noted. The current mean follow-up is 6 months, with range between 4 and 12 months. This approach proved to be successful in cochlear implant placement. It guaranteed a very good control on the facial nerve, even in cases with difficult anatomical conditions, mainly thanks to the endoscopic procedure. It also permitted an appropriate anatomical orientation of the abnormal middle ear with a direct safe cochleostomy, when the round window position would have been difficult to treat using a traditional approach.

2015 - Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: Our experience [Articolo su rivista]
Marchioni, Daniele; Soloperto, Davide; Rubini, Alessia; Villari, Domenico; Genovese, Elisabetta; Artioli, Franca; Presutti, Livio

The aim of the present study is to describe our experience in the management of tympanic cavity cholesteatoma in pediatric patients, treated with endoscopic exclusive transcanal approach.

Ghidoni, E; Guaraldi, G; Genovese, E.

Nonostante gli ostacoli che gli studenti dislessici incontrano durante il proprio percorso scolastico, ostacoli tanto maggiori quanto più tardiva è la diagnosi, la loro presenza nelle università è in continuo aumento. Ciò costituisce senz'altro un segnale positivo, perché è un ulteriore passo in avanti verso la piena realizzazione dei talenti di questi ragazzi, ma c'è ancora molta strada da fare. In questa prospettiva, Giovani adulti con DSA approfondisce alcune aree tematiche particolarmente rilevanti, illustrando le principali indicazioni normative ministeriali e regionali e l'iter diagnostico nei giovani adulti, descrivendo gli aspetti psicologici coinvolti e gli strumenti didattici più idonei ed efficaci per i DSA. Adottando una visione multidimensionale delle problematiche coinvolte, l'opera fornisce una base di conoscenze e di riferimenti pratici per gli operatori del settore - psicologi, medici, insegnanti, pedagogisti, educatori - e per le persone adulte con DSA, i loro familiari ed amici.

2015 - Nimodipine in otolaryngology: from past evidence to clinical perspectives [Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; Pini, Luigi Alberto; DI Berardino, F; Alicandri Ciufelli, Matteo; Galeazzi, Gian Maria; Presutti, Livio

As L-type voltage-gated calcium channels (VGCCs) control Ca(2+) influx and depolarisation of cardiac and vascular smooth muscle, they represent a specific therapeutic target for calcium channel blockers (CCBs), which are approved and widely used to treat hypertension, myocardial ischaemia and arrhythmias. L-type currents also play a role in calcium entry in the sensory cells of the inner ear. In hair cells of both cochlea and labyrinth, calcium cytoplasmic influx is the first physiological process that activates complex intracellular enzymatic reactions resulting in neurotransmitter release. Excessive calcium ion entry into sensory cells, as a consequence of L-VGCCs malfunction is responsible for over-activation of phospholipase A2 and C, protein kinase II and C, nitric oxide synthase and both endonucleases and depolymerases, which can cause membrane damage and cellular death if the cytoplasmic buffering capacity is overcome. Nimodipine, a highly lipophilic 1-4 dihydropyridine that easily crosses the brain-blood barrier, is generally used to reduce the severity of neurological deficits resulting from vasospasm in patients with subarachnoid haemorrhage. Moreover, due to its selective blocking activity on L-channel calcium currents, nimodipine is also suggested to be an effective countermeasure for cochlear and vestibular dysfunctions known as channelopathies. Indeed, experimental data in amphibians and mammalians indicate that nimodipine has a stronger efficacy than other CCBs (aminopyridine, nifedipine) on voltage-dependent whole-cell currents within hair cells at rest and it is the only agent that is also effective during their mechanically induced depolarisation. In humans, the efficacy of nimodipine is documented in the medical management of peripheral vestibular vertigo, sensorineural hearing loss and tinnitus, even in a pathology as complex as Ménière's disease. Nimodipine is also considered useful in the prophylaxis of damage to the facial and cochlear nerves caused by ablative surgery of cerebellopontine tumours; it has been recently hypothesised to accelerate functional recovery of recurrent nerve lesions during thyroid cancer surgery. Further trials with adequate study design are needed to test the efficacy of nimodipine in the treatment of vertigo due to cerebrovascular disease and vestibular migraine.

2015 - The impact of the Italian guidelines on antibiotic prescription practices for acute otitis media in a paediatric emergency setting [Articolo su rivista]
Palma, Silvia; Rosafio, Cristiano; DEL GIOVANE, Cinzia; Patianna, VIVIANA DORA; Lucaccioni, Laura; Genovese, Elisabetta; Bertolani, Paolo; Iughetti, Lorenzo

Acute otitis media (AOM) is one of the most common childhood infectious diseases. The recent Italian Pediatric Guidelines for the treatment of AOM constitutes a step forward in the management of children with uncomplicated AOM. The aim of this study was to evaluate antibiotic prescription patterns for AOM in a Pediatric Emergency Department (PED) after those guidelines were introduced and to assess the relationship between implementation of the "watchful waiting" strategy and the incidence of acute mastoiditis in the PED.

Cardinaletti, A; Santulli, F; Genovese, E; Guaraldi, G; Ghidoni, E.

I disturbi specifici dell'apprendimento sono da tempo oggetto di studio in ambito sia clinico che di ricerca; tuttavia, nonostante abbiano trovato una preciso collocazione negli schemi di classificazione ICF, permane una forte disomogeneità, nei vari contesti nazionale, circa l'approccio specifico all'analisi, alla diagnosi ed al trattamento. Il volume intende a questo scopo promuovere un dialogo interdisciplinare, che accanto ai contributi della neuropsichiatria, della neuropsicologia, della psicologia e della logopedia tenga conto anche dell'apporto, fondamentale delle scienze del linguaggio. Dalla definizione del quadro normativo ai rapporti tra lingua orale e lingua scritta, dalle difficoltà di diagnosi nei contesti bilingui a variegate proposte operative e didattiche da attuare in classe per potenziare l'apprendimento delle lingue e le abilità di lettura, "dislessia ed apprendimento delle lingue" offre a insegnanti, alunni e genitori spunti e strumenti per comprendere meglio la dislessia, ai fini della diagnosi e degli interventi educativi che i DSA richiedono.

2014 - Endoscopic cochlear implant procedure [Articolo su rivista]
Marchioni, Daniele; Grammatica, Alberto; ALICANDRI CIUFELLI, Matteo; Genovese, Elisabetta; Presutti, Livio

The objective was to asses the feasibility of the endoscopic technique for cochlear implant (CI) positioning avoiding mastoidectomy and to discuss the benefits and drawbacks of the technique. The study design is a surgical procedure description and prospective case series report. From December 2011 to October 2012, six patients underwent endoscopic CI. All cases were selected based on CT and MRI studies. All surgical steps were analyzed; intra-and post-operative complications were noted. The length of time for each surgical procedure was recorded. The surgical procedure was described step by step focusing on the anatomy of the round window (RW) niche, analyzing the critical point during the dissection. The timing of the surgical procedures was 120 ± 21 (mean ± SD) min. In 1/6 patients, intra-operative injury of the chorda tympani occurred. In all cases, an endoscopic identification was performed and the anatomical details of the RW niche were noted. In 6/6 cases, a RW niche magnification was performed endoscopically. 5/6 cases showed a normal conformation of the RW. In 1/6 patients, obliteration of the RW niche was found. In 4/6 patients, an endoscopic cochleostomy through the RW was performed. In 1/6 patients, a difficult insertion of the array was observed. The current follow-up is 7.3 months (SD ± 3.7). No post-operative short- or long-term complications were noted in this series. Endoscopic CI is a safe and viable technique with a low rate of complications and with good outcomes.

2014 - Facial nerve hemangioma of the geniculate ganglion: an endoscopic surgical approach [Articolo su rivista]
Marchioni, Daniele; Soloperto, Davide; Genovese, Elisabetta; Rubini, Alessia; Presutti, Livio

Facial nerve hemangiomas are rare benign tumors arising from the venous plexus surrounding the facial nerve. Surgical management of these tumors is controversial. The goal of surgery is complete tumor removal with restoration of facial nerve function and preservation of hearing, wherever possible. The approaches most used are the translabyrinthine and middle cranial fossa approaches. In this report, we describe the first facial hemangioma treated with an endoscopic transcanal approach, combined with a retroauricular transmastoid minicraniotomy for closure of the dural defect. A great auricular nerve graft was used to reconnect interrupted nerve segments. Histopathological examination confirmed the diagnosis of a hemangioma of the first genu of the facial nerve. With magnification of the structures, the transcanal endoscopic approach allowed a radical excision of the neoplasm permitting hearing function preservation, with the possibility to work with a minimally invasive approach with respect to the labyrinthine block and cochlea. Compared to a middle cranial fossa approach, the transcanal endoscopic approach avoided labyrinthine block removal and brain retraction.

Guaraldi, G; Guzzo, F.; Genovese, E.

Con la pubblicazione nella "gazzetta ufficiale" della Legge n. 170 del'8 Ottobre 2010, nuove norme in materia di disturbi specifici di apprendimento in ambito scolastico, la difficoltà di apprendimento ha ottenuto un suo riconoscimento anche a livello normativo. La Legge 170 e le successive Linee Guida allegate chiariscono, prendendo in considerazione specificatamente ogni ordine e grado scolastico, quali siano le misure dispensative e gli strumenti compensativi a disposizione dei soggetti con DSA. L'articolo descrive in maniera concisa la moltitudine di misure e di strumenti previsti ed ad oggi utilizzati in ambito sia scolastiche che clinico-riabilitativo al fine di favorire una sempre più efficiente acquisizione di conoscenze individuali. Il fine ultimo di questo articolo è quello di conoscere e quindi riconoscere all'interno delle indicazioni cliniche formulate per ogni soggetto con DSA i servizi che potrebbero essergli erogati in ambito accademico.

Guaraldi, G; Genovese, E.

Ne presente contributo si intende sottolineare il nuovo scenario scolastico in cui si trovano a dover svolgere la propria professione gli insegnanti di scuola secondaria di secondo grado e di Docenti universitari. I primi, infatti, come i colleghi dei vari ordini e gradi scolastici precedenti, sono invitati, nei primi mesi dell'anno a redigere un profilo dello studente e le indicazioni da seguire al fine di favorirne l'apprendimento ed il raggiungimento degli obiettivi (piano didattico personalizzato) mentre i secondi devono garantire, in ambito accademico ed i occasione degli esami curricolari il diritto allo studio e pari opportunità formative tramite l'erogazione di misure dispensative e l'utilizzo di strumenti compensativi.

2014 - Il Pooling-score (P-score): Variabilità inter- e intra-individuale nella valutazione endoscopica della gravità della disfagia [Articolo su rivista]
Farneti, Daniele; Fattori, B.; Nacci, A.; Mancini, V.; Simonelli, M.; Ruoppolo, G.; Genovese, Elisabetta

This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swal- lowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or re ex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short lms of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The lms were randomly distributed on two CDs, which differed in terms of the sequence of the lms, and were given to judges (after an explanatory ses- sion) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coef cient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the lms was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be in uenced by the different consistencies of the boluses, was not signi cant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team.

2014 - New and Rare GJB2 Alleles in Patients with Nonsyndromic Sensorineural Hearing Impairment: A Genotype/Auditory Phenotype Correlation [Articolo su rivista]
Stanghellini, Ilaria; Genovese, Elisabetta; Palma, Silvia; Ravani, Anna; Falcinelli, Cristina; Guarnaccia, Maria Consolatrice; Percesepe, Antonio

The aim of the study is to report the new and rare GJB2 variants identified in individuals with nonsyndromic sensorineural hearing impairment (HI) in a retrospective study based on 498 patients referred to the Otolaryngology and Medical Genetics Units of the Modena University Hospital, Italy, with the purpose of building new genotype/auditory phenotype correlations for the GJB2 gene.

2014 - Vertigo "In the Pink": The Impact of Female Gender on Psychiatric-Psychosomatic Comorbidity in Benign Paroxysmal Positional Vertigo Patients [Articolo su rivista]
Ferrari, Silvia; Monzani, Daniele; Baraldi, S; Simoni, E; Prati, G; Forghieri, M; Rigatelli, Marco; Genovese, Elisabetta; Pingani, Luca

BACKGROUND: Comorbidity between vestibular and psychiatric disorders in predisposed individuals is underestimated, untreated, and may result in chronicization and poor quality of life. There are few studies concerning the type and the prevalence of psychiatric-psychosomatic distress in patients with benign paroxysmal positional vertigo (BPPV). OBJECTIVE: The aim of this study was to evaluate psychiatric-psychosomatic comorbidities, in particular anxiety, depression, somatization symptoms, and alexithymia, in a group of BPPV patients compared with healthy subjects, and according to gender. METHODS: Case-control study comparing 92 BPPV patients recruited at the ENT Unit of Modena General Hospital between November 2007 and December 2010, and 141 healthy controls. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Diagnostic Criteria for Psychosomatic Research (DCPR), Brief Symptom Inventory (BSI), and Toronto Alexithymia Scale (TAS-20) were used to perform psychometric assessment. RESULTS: BPPV patients scored higher than controls, with statistical significance, at BDI, BSI somatization, anxiety, and phobic anxiety subscales, and STAI state anxiety; a larger proportion of BPPV patients suffered from clinically significant BDI depressive symptomatology; DCPR disease phobia, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were more common among BPPV subjects. High levels of symptomatology were still found among BPPV female patients, but not among males, even after controlling for symptom severity. CONCLUSIONS: Affective symptomatology, such as depression, demoralization, phobia and anxiety, and somatization, were significantly prevalent in BPPV patients, and female gender may be a predisposing factor.

2013 - A preliminary study on the relationship between central auditory processing and childhood primary headaches in the intercritical phase [Articolo su rivista]
Ciriaco, Antonella; Russo, Angelo; Monzani, Daniele; Genovese, Elisabetta; Benincasa, Paola; Caffo, Ernesto; Pini, Luigi Alberto

Recently, an increasing number of articles have appeared on central auditory processing disorders, but in the literature there is only one study that evaluated the possible correlation between migraine in the critical phase and central auditory processing. The aim of our study was to assess the correlation between auditory processing information and childhood primary headaches in the intercritical phase.

2013 - A step backward: the “Rough” facial nerve grading system [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Piccinini, Alessia; Grammatica, Alberto; Salafia, Francesca; Ciancimino, Cristel; Cunsolo, Eliomaria; Pingani, Luca; Rigatelli, Marco; Genovese, Elisabetta; Monzani, Daniele; Gioacchini, FEDERICO MARIA; Marchioni, Daniele; Presutti, Livio

Several modalities currently exist to rate the degree of facial function clinically but even though it has significant limitations, the most widely used scale is the House-Brackmann grading system (HBGS). A simplified scale is introduced here, the 'Rough' Grading System (RGS - Grade I: normal movement; Grade II: slight paralysis; Grade III: frank paralysis with eye closure; Grade IV: frank paralysis without eye closure; Grade V: almost complete paralysis with only slight movements; Grade VI: total paralysis). The aim of the present study was to verify the interrater reliability and the interscale validity of this simplified grading system. STUDY DESIGN: Scale validation study based on a prospective cohort. METHODS: Fifty patients with facial palsy, consecutively referred to our department were filmed while performing some codified facial movements. Then two independent groups (one rating using the HBGS, the other rating using the RGS) assigned a grade after reviewing the videos. The time required for the rating was also noted. RESULTS: The HBGS showed a mean value of interrater agreement of 0.46 while the RGS showed a mean value of 0.59. The concurrent validity between HBGS and RGS ranged from 0.86 to 0.90 (p < 0.001 for every comparison). There was no statistically significant difference between HBGS and RGS in the mean time taken for rating (p = 0.15). CONCLUSIONS: The RGS reached an adequate level of interrater reliability, higher than the HBGS. The correlation between the two scales is high and the times required for rating are similar. The present results may justify the use of the RGS in routine clinical practice. LEVEL OF EVIDENCE: N/A

Genovese, E; Ghidoni, E; Guaraldi, G

Indagini recenti indicano come oggi in Italia sia crescente il numero degli studenti di ogni ordine e grado scolastico che incontrano problemi dell'apprendimento del sistema dei numeri, manifestando difficoltà relative a: riconoscimento e denominazione dei simboli numerici, scrittura dei numeri, associazione del simbolo numerico alla quantità corrispondente, numerazione in ordine crescente e decrescente , risoluzione di situazioni problematiche, sintomatiche della discalculia.Il volume raccoglie i contributi dei maggiori esperti in tale ambito, partendo da una precisa definizione del disturbo per poi soffermarsi in particolare sulla sua ricaduta nei soggetti adulti. lo scopo del libro è infatti aiutare gli insegnanti , gli educatori, i professionisti e i familiari ad acquisire una migliore conoscenza della discalculia, offrendo una serie di suggerimenti e indicazioni che consentano a chi ne è affetto di migliorare la propria performance. Attraverso una didattica attenta ai bisogni educativi degli alunni discalculici è, infatti, possibile compiere progressi e raggiungere livelli soddisfacenti di competenza numerica e di calcolo sino ai più elevati gradi di istruzione.

Guaraldi, G; Guzzo, F.; Genovese, E.

Il presente capitolo tende ad elencare gli strumenti dispensativi di cui lo studente con DSA può fruire anche in ambito accademico. La normativa vigente non si limita infatti, a richiedere che le misure dispensative e gli strumenti compensativi vengano posti in essere, ma impone alla scuola di ogni ordine e grado di rendere espliciti, entro il primo trimestre, gli interventi individualizzati e personalizzati per il singolo alunno con DSA, nonché le misure compensative e dispensative. Questi accorgimenti vengono individuati dal personale specialistico (clinico e sanitario) in sede di diagnosi neuropsicologica e prescritti all'interno di un assetto diagnostico e del rispettivo trattamento.

2013 - DSA: strumenti compensativi e misure dispensative [Capitolo/Saggio]
Genovese, E; Guaraldi, G

Spesso le parole "difficoltà" e "disturbo" vengono utilizzate indifferentemente, eppure, ognuna di esse si riferisce a situazioni assai diverse tra loro: quando, infatti, si parla di "difficoltà di apprendimento" ci si riferisce a qualsiasi difficoltà che uno studente rincontra durante il suo percorso di studi. La normativa italiana non si limita a richiedere che le misure dispensative e gli strumenti compensativi vengano posti in essere, ma impone alla scuola di ogni ordine e grado di rendere espliciti gli interventi individualizzati e personalizzati per il singolo alunno con DSA, nonché le miste compensative e dispensative.

Guzzo, F; Guaraldi, G; Genovese, E

Indagini recenti indicano come oggi in Italia sia crescente il numero degli studenti di ogni ordine e grado scolastico che incontrano problemi nell'apprendimento del sistema dei numeri, manifestando difficoltà relative a: riconoscimento e denominazione dei singoli numerici, scrittura dei numeri, associazione del simbolo numerico alla quantità corrispondente, numerazione in ordine crescente e decrescente, risoluzione di situazioni problematiche, sintomatiche della discalculia. Il contributo rende noti i serviz erogati agli studenti con DSA presso l'Università degli Studi di Modena e Reggio Emilia.

2012 - A clockwork ear [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Soloperto, Davide; Palma, Silvia; Marrara, Antonino; Genovese, Elisabetta

Objective tinnitus refers to a tinnitus that can also be heard by the examiner. It is a relatively rare condition, and can be misdiagnosed or neglected. Some causes of objective tinnitus are head and neck vascular malformations, or muscular myoclonus of the tensor tympani, stapedial, or palatal muscles. The case of an 11-year-old girl with an objective tinnitus lasting from 1 year is herein presented, and the diagnostic workup performed in this unusual case is described.

Ghidoni, E; Guaraldi, G; Genovese, E; Stella, G.

Dopo i volumi "Dislessia e Università" (2010) ed "Dislessia nei giovani adulti" (2011), lo stesso gruppo di autori cura questa nuova raccolta di interventi e ricerche, la cui uscita a così breve distanza di tempo testimonia l'interesse e la vivace attività che si sono sviluppati rapidamente su questo tema. Si tratta di un settore in cui la ricerca accademica strettamente correlata alla pratica clinica ed è stimolata da esogene sociali emergenti di grande impatto, conseguenti all'approvazione della Legge 170/2010 "Nuove norme in materia di disturbi specifici di apprendimento in ambiti scolastico", che prevede la tutela ed il supporto all'apprendimento delle persone con DSA anche in età adulta dirupante il percorsi universitario. L'opera sci articola in 4 sezioni:università e nuove norme, esperienze di vita, ricerche su studenti universitarie e giovani adulti, il supporto con e tecnologie informatiche. In appendice raccoglie tutti i documenti di riferimento sul tema, sia quello normativi sia quelli di società od enti scientifici, che possono essere un utile strumento di lavoro per chi è implicato direttamente nelle attività cliniche e di ricerca.

2012 - Effect of a fixed combination of nimodipine and betahistine versus betahistine as monotherapy in the long-term treatment of Ménière's disease: a 10-year experience [Articolo su rivista]
Monzani, Daniele; Barillari, M. R; ALICANDRI CIUFELLI, Matteo; Aggazzotti Cavazza, E; Neri, Vincenzo; Presutti, Livio; Genovese, Elisabetta

Despite an abundance of long-term pharmacological treatments for recurrent vertigo attacks due to Ménière's disease, there is no general agreement on the their efficacy. We present the results of a retrospective study based on a 10-year experience with two long-term medical protocols prescribed to patients affected by Ménière's disease (diagnosed according to the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium guidelines) who completed treatments in the period 1999-2009. A total of 113 medical records were analysed; 53 patients received betahistine-dihydrochloride at on-label dosage (32 mg die) for six months, and 60 patients were treated with the same regimen and nimodipine (40 mg die) as an add-therapy during the same period. Nimodipine, a 1,4-dihydropyridine that selectively blocks L-type voltage-sensitive calcium channels, has previously been tested as a monotherapy for recurrent vertigo of labyrinthine origin in a multinational, double-blind study with positive results. A moderate reduction of the impact of vertigo on quality of life (as assessed by the Dizziness Handicap Inventory) was obtained in patients after therapy with betahistine (p < 0.05), but a more significant effect was achieved in patients treated by combined therapy (p < 0.005). In the latter group, better control of vertigo was seen with a greater reduction of frequency of attacks (p < 0.005). Both protocols resulted in a significant improvement of static postural control, although a larger effect on body sway area in all tests was obtained by the fixed combination of drugs. In contrast, no beneficial effect on either tinnitus annoyance (as assessed by the Tinnitus Handicap Inventory) and hearing loss (pure-tone average at 0.5, 1, 2, 3 kHz frequencies of the affected ear) was recorded in patients treated with betahistine as monotherapy (p > 0.05), whereas the fixed combination of betahistine and nimodipine was associated with a significant reduction of tinnitus annoyance and improvement of hearing loss (p < 0.005). It was concluded that nimodipine represents not only a valid add-therapy for Ménière's disease, and that it may also exert a specific effect on inner ear disorders. Further studies to investigate this possibility are needed.

2012 - Etiological,clinical and neuroradiological investigation of deaf children with additional neuropsychiatric disabilities [Articolo su rivista]
Chilosi, A. M.; Scusa, M. F.; A., Comparini; Genovese, Elisabetta; F., Forli; S., Berrettini; P., Cipriani

La sordità neurosensoriale nel bambino è complicata in circa il 30-40% dei casi dalla presenza di disabilità associate, ma i dati epidemiologici sulla natura di questi disturbi non sono ancora chiaramente definiti. Lo studio si propone di valutare l’incidenza, la tipologia e la gravità delle patologie neuropsichiatriche associate alla sordità in un campione di bambini sordi e di analizzare le eventuali correlazioni tra disabilità ed eziologia della sordità.

2012 - Evaluating Benefits of Cochlear Implantation in Deaf Children with Additional Disabilities. [Articolo su rivista]
M., Palmieri; S., Berrettini; F., Forli; P., Trevisi; Genovese, Elisabetta; Chilosi, A. M.; E., Arslan; A., Martini

Cochlear-implanted deaf children having additional disabilities may develop speech perception and language skills at a slower pace than their implanted peers without such disorders. Nevertheless, it has been shown that, even for these special cases, cochlear implantation (CI) provides benefits for a larger range of neuropsychological functions including social and relational skills. These benefits are frequently mentioned by parents, but rarely objectively measured by tests. This article presents a new evaluation tool aimed at assessing the global benefits offered by CI in these special cases.

2012 - Herpes zoster oticus: a clinical model for a transynaptic, reflex pathways, viral transmission hypotheses [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Genovese, Elisabetta; Monzani, Daniele; Presutti, Livio; Aggazzotti Cavazza, Elisa

Reactivation of the varicella-zoster virus (VZV) along the sensory nerves innervating the ear, including the geniculate ganglion, is responsible for herpes zoster oticus (HZO). In some cases, HZO is associated with polyneuropathy of the cranial nerves, although the mechanism of this involvement is not known. To explain this phenomenon and based on some clinical considerations, the present authors hypothesize an intersynaptic spread of VZV along the reflex pathways of the brainstem

2012 - LIM e strumenti compensativi a supporto degli alunni universitari. [Monografia/Trattato scientifico]
Genovese, Elisabetta; Guaraldi, G.; Malagoli, G. M.


2012 - La Lavagna interattiva multimediale a supporto degli studenti disabili e con DSA all'Università degli Studi di Modena e Reggio Emilia [Articolo su rivista]
Guaraldi, G; Genovese, E

Negli ultimi anni l'introduzione delle moderne tecnologie ha consentito agli studenti con disabilità di raggiungere un maggior grado di autonomia ed ha favorito un mutamento nella didattica che è diventata sempre più una "didattica inclusiva", incentrata sui bisogni educativi speciali di tali soggetti e soprattutto sulle potenzialità nascoste in essi. I software per l'apprendimento, le sintesi vocali, le lavagne interattive multimediali (LIM), i notebook, i tablet, gli Ipad creano una "rete integrata" che permette, grazie a linguaggi diversi e multimodali, di accrescere l'autostima dei soggetti con disabilità e favorire la loro autonomia. La lavagna è uno strumento che stimola l'apprendimento, in quanto utilizza un linguaggi ìo più vicino alla modalità comunicativa delle nuove generazioni riducendo così la distanza tra Dcoente e discente. Questo è tanto più importante nel caso di studenti con disabilità o con disturbo specifico dell'apprendimento: il disabile sensoriale può utilizzare la modalità comunicativa residua, il disabile motorio può "sfogliare" un testo, farselo leggere, prendere appunti, il ragazzo con DSA può usufruire della sintesi vocale per la lettura e/o per la scrittura.

2012 - Legge 170 e università. [Monografia/Trattato scientifico]
Genovese, Elisabetta; Guaraldi, G.; Guzzo, F.

Legge 170 e università.

2012 - Mastoid: a vestigial function in humans? [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Gioacchini, FEDERICO MARIA; Marchioni, Daniele; Genovese, Elisabetta; Monzani, Daniele; Presutti, Livio

At the present time, the function of the mastoid remains unknown. One of the main hypotheses accredited in the literature interprets the mastoid as a pressure buffer. Other theories underline the role of the mastoid mucosa in pressure regulation by transmucosal gas exchanges. The question is what advantage does air reabsorption and the creation of a certain degree of negative pressure that mastoid seems to produce, bring to the middle ear and hearing? In the authors' opinion, it is possible that the mastoid, or, in general, every kind of mucosa contained in the middle ear of mammals, would act to create a quite constant, although slight, negative pressure to obtain favorable compliance and impedance conditions in the middle ear to hear and transmit high frequency sounds and ultrasounds. The Eustachian tube, in this perspective, would compensate excessive values of negative pressure. Clearly, that function of mastoid pneumatization in humans would have lost its role, due to the absence of a sensorineural system to analyse ultrasounds.

2012 - Principi di intervento logopedico. [Capitolo/Saggio]
E., Tomaiuolo; D., Farneti; Genovese, Elisabetta

Principi di intervento logopedico

2012 - Role of osteocyte apoptosis in peculiar ossicles of the hearing sense organ: preliminary observations on hearing loss and osteoporosis [Abstract in Rivista]
Palumbo, Carla; Presutti, Livio; Genovese, Elisabetta; Cavani, Francesco; Sena, Paola; Benincasa, Marta; Ferretti, Marzia

Starting point of the present study is the osteocyte role in bone remodelling that allows bone adaptation to mechanical load [1-3]. Bone remodelling has been investigated in relation to the occurrence of apoptosis [4] to understand if and how the process of programmed cell death interferes with bone turnover. In 1998, in a study on human middle ear, Marotti et al. [5] demonstrated that: 1) over 40% of osteo-cytes are dead within the 2nd year of age (but the authors were not able to demonstrate if osteocyte death occurred by degeneration or apoptosis); 2) bone remodelling occurs only occasionally. Recently [6], we showed that: 1) osteocytes of human auditory ossicles die by apoptosis; 2) also osteocytes located inside scleral ossicles of lower vertebrate eye (reptiles and birds) phylogenetically so far from human auditory ossicles are widely affected by apoptosis (about 60%); 3) in scleral ossicles bone turnover never occur. It is to be noted that both auditory ossicles of human ear and scleral ossicles of vertebrate eye are peculiar bony segments continuously submitted to stereotyped stresses and strains, with specialized func-tions: the first are involved in sound wave transmission and the latter protect the eyeball against deformation during the movement and have a role in visual accomodation, providing attachment for the ciliary muscles. In both cases, bone remodelling might severely impair, by resorption, the mechanical resistance of these extremely small specialized bony segments. Thus, we suggested that in auditory and scleral ossicles, submitted to stereotyped loading for all life, bone mechanical adaptation is not needed and osteocyte programmed death could represent the mechanism to avoid bone remodelling and to make stable, when necessary, bone structure and mechanical resistance. More recently, to confirm this hypothesis, clinical data were collected from a cohort of patients aged 55-85 years affected by hearing loss. The main target of the present study is to exclude any correlation between hearing loss and osteoporosis. During osteoporosis, unbalanced bone turnover causes the bone depletion in skeletal segments; such condition, in the peculiar ossicles of human middle ear, should imply hearing impairment. Our preliminary observations indicate, instead, that osteoporotic patients do not show higher percentage of hearing loss with respect to non osteoporotic ones. This evidence is ascribable to osteocyte apoptosis of auditory ossicles that avoid bone remodelling, thus assuring the integrity of such bony segments also in osteoporotic conditions. References [1] Turner (1991) Omeostatic control of bone structure: an application of feed-bach theory. Bone 12: 203-217. [2] Turner and Forwood (1995) What role does the osteocyte network play in bone adaptation? Bone 16: 283-285. [3] Marotti (1996) The structure of bone tissue and the cellular control oftheir deposition. IJAE 101(4): 26-79. [4] Noble et al. (1997) Identification of apoptotic changes in osteocytes in normal and pathological human bone. Bone 20: 273-282. [5] Marotti et al. (1998) Morphometric investigation on osteocytes in human auditory ossicles. Ann Anat 180: 449-453. [6] Palumbo et al. (2012) Osteocyte apoptosis in human auditory ossicles and scleral ossicles of lower ver-tebrates: a mere coincidence or linked processes? Calcif. Tissue Int. 90: 211-218.

2012 - The CATS project [Relazione in Atti di Convegno]
Sbattella, L.; Tedesco, R.; Li, A. Q.; Genovese, E.; Corradini, M.; Guaraldi, G.; Garbo, R.; Mangiatordi, A.; Negri, S.

University students with learning or sensorial disability often face huge difficulties in accessing campus facilities and, specifically, lectures. Many universities offer a wide range of support services to overcome such issues, but this is not always enough. This paper presents CATS, an ongoing research project involving three Italian universities, aiming to design and test technological solutions directed towards a better support to accessible lectures. By providing students with a set of experimental, advanced tools, the aim of the project is also to foster inclusive practices. The solutions described here share the principle of being adaptable to the real needs of the students, which are measured using ICF*, an adapted version of the WHO ICF model.

2012 - Trattamento logopedico del bambino con ritardo mentale. [Capitolo/Saggio]
D., Farneti; Genovese, Elisabetta

Trattamento logopedico del bambino con ritardo mentale

2011 - Advanced learning and ICT: new teaching experiences in university setting [Articolo su rivista]
Fabio, Bertarelli; Corradini, Matteo; Guaraldi, Giacomo; Fonda, Sergio; Genovese, Elisabetta

The digital board is thought of as a tool that has limited use, primary or secondary school or in a situation of learning for the handicapped. This case study aims to show how these new tools can be used in for higher learning, in scientific and technical universities. The current software available on the market and its use with these tools foresees originality in the approach to teaching in the future. The article explores the use of advanced innovative technology in the lecture hall for effective teaching and learning. The digital whiteboard tool is a flexible and powerful didactic instrument that can greatly enrich the experience of both the learner and the lecturer. This article will explore a completed case study, a case study still in progress and future possibilities.

2011 - Alternative learning technologies for students with special educational needs [Relazione in Atti di Convegno]
Giliberti, E.; Corradini, M.; Guaraldi, G.; Bertarelli, F.; Genovese, E.

In recent years, the introduction of modern technologies has allowed students with disabilities to achieve a greater degree of autonomy and independence, and favored a change in teaching that has become an increasingly inclusive education, focusing on special educational needs and, above all, on their hidden potential. The increasing number of students with special education needs at the university level requires strategies to guarantee same rights to every student. Today, the learning processes make substantial use of digital environment and students with disabilities can successfully use specific technologies. We present a system developed at the University of Modena and Reggio Emilia based on digital white boards, tablets, and a repository for the audio-video recording, and other learning resources that specially target students with special educational needs. © 2011 IEEE.

2011 - Alternative learning techonogies for students with Special Educational Needs [Relazione in Atti di Convegno]
Giliberti, Enrico; Corradini, Matteo; Guaraldi, Giacomo; F., Bertarelli; Genovese, Elisabetta

In recent years the introduction of modern technologies has allowed students with disabilities to achieve a greater degree of autonomy and independence and favored a change in teaching that has become an increasingly "inclusive education", focusing on special educational needs and above all on their “hidden potential”. The increasing number of students with special education needs at the university level requires strategies to guarantee to every student the same rights. Today the learning processes make a large use of digital environment and the students with disabilities can successfully make use of specific technologies. We present a system developed at the University of Modena and Reggio Emilia based on digital white boards, tablets, and a repository for the audio-video recording of the lecture and of the learning resources specially addressed to students with special educational needs.

2011 - Analogic and Symbolic Comparison of Numerosity in Preschool Children with Cochlear Implants [Articolo su rivista]
Barbara, Arfé; Daniela, Lucangeli; Genovese, Elisabetta; Monzani, Daniele; Marco, Gubernale; Patrizia, Trevisi; Rosamaria, Santarelli

This study explores how preschoolers with cochlear implants process numericalcomparisons from two different inputs: a) nonverbal (analogical) and b)verbal (symbolic). Preschool cochlear-implanted children (CI) ranging in agefrom 4;3 to 6;1 were compared with 99 age-matched hearing children (HC)in three numerical tasks: verbal counting, a digit comparison and a dot comparison.Results show that CI children may outperform HC in numerical tasksthat require visuo-spatial analysis (e.g. analogical comparison). More importantly,they perform as well as HC in numerical tasks that require symbolic processes(digit comparison) and in verbal counting. However, when theinfluence of children's verbal counting skills on digit comparison is examineddifferences between the two groups emerge. HC's capacity to compare digitswas influenced by their knowledge of the verbal counting system, but thisknowledge was not influential when CI children's performance in the sametask was considered. These findings suggest that different strategies may characterize the way the two groups tackle symbolic numerical comparisons.The educational and instructional implications of these findings are discussed.

2011 - Communication skills in a group of bilingual deaf children. [Relazione in Atti di Convegno]
Guarnaccia, M. C.; Artioli, F. L.; P., Benincasa; D., Soloperto; Genovese, Elisabetta; R., Santarelli

Evaluation of oral language acquisition in a group of prelingually deaf bilingual children with hearing aids or cochlear implant

Genovese, E; Ghidoni, E; Guaraldi, G; Stella, G.

Il volume raccoglie numerosi contributi sul tema della dislessia e dei disturbi specifici dell'apprendimento in età adulta e si basa sul pluriennale lavoro di ricerca e di pratica clinica da parte di esperti che a vario titolo operano in Italia. Una vasta ricognizione sulla ricerca internazionale offre una visione di insieme articolata ed esamina le nuove frontiere sugli aspetti eziologici della dislessia. Vengono quindi affrontati alcuni temi cruciali, quali la necessità di adattare la valutazione diagnostica nel passaggio alla scuola secondaria di secondo grado e gli strumenti e le strategia di compensazione. Vengono infine descritte esperienze di studenti dislessici all'Università o nel mondo del lavoro e forniti suggerimenti ed esempi di percorsi ed attività, con l'obiettivo di offrire loro pari opportunità di successo.

2011 - Il problema dell’accessibilità dei centri urbani: l’esempio di Modena.Atti Convegno internazionale Il wonderland nel mosaico paesistico-culturale: idea, immagine, illusione [Articolo su rivista]
Bertacchini, Milena; Genovese, Elisabetta; Guaraldi, Giacomo

Il progetto “Modena accessibile” rappresenta un esempio di come Enti, Istituzioni ed Associazioni che operano in ambito locale nel campo dell’educazione, del turismo e delle disabilità, possano collaborare per contribuire ad una maggiore conoscenza e ad una migliore fruibilità delle realtà territoriali locali. Tra gli obiettivi del progetto vi è stato quello di tracciare, in modo accurato, un percorso pedonabile di accesso al centro storico di Modena, fruibile da tutta la popolazione.

2011 - Indagine conoscitiva di studenti dislessici in ambito universitario [Capitolo/Saggio]
Genovese, Elisabetta; Montanaro, Alice; Angelini, Damiano; Scorza, Maristella; Cacciari, Cristina; Vallarino, MARIA VITTORIA


2011 - Low cost wireless technology and digital board for education in rural Kenya [Relazione in Atti di Convegno]
Bertarelli, F.; Padoa, S.; Guaraldi, G.; Genovese, E.; Corradini, M.; Mayeku, B.; Kilwake, J.

The application of wireless technologies in education is having a big development, but contrary to what we think the tools are not overly expensive. Thanks to the spread of wireless coverage, it's possible to reach the most remote corners and rural areas with simple mobile phone connected to a central system of information dissemination. This paper explores the use of wireless technology in combination with low-cost tools that have enabled access to education in rural areas of Kenya: this is a work in progress that will surely give you amazing results in the coming years. © 2011 Springer-Verlag.

2011 - MR evaluation of PDMS injections in head and neck tissues: a pilot study [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Ligabue, Guido; Grammatica, Alberto; Bergamini, Giuseppe; Marchioni, Daniele; Ghidini, Angelo; Genovese, Elisabetta; Presutti, Livio

To describe the magnetic resonance (MR) appearance of polydimethylsiloxane (PDMS) injections in the head and neck region.Retrospective review of MR images from a case series.MR images of 10 patients, who underwent PDMS injections at our department, were reviewed. Data from imaging were collected and analyzed.After injection, PDMS can be identified in MR images, particularly in T2-weighted images in the early stages. Its MR characteristics are similar to silicone in other regions, but with time, its appearance can change.The integration of PDMS with tissues may also be reflected in changes in MR appearance, as a result of an increased amount of fibrous tissue in the region injected. Radiologists and ENT specialists may benefit from knowledge of the MR characteristics and variability in appearance of PDMS in human tissues for improving image interpretation.

2011 - Psycological, audiological and vestibular assesment in primary paediatric headache [Abstract in Rivista]
Ciriaco, Antonella; Caffo, Ernesto; Genovese, Elisabetta; Monzani, Daniele; Benincasa, P.; Pini, Luigi Alberto


2011 - Surgical Anatomy of Transcanal Endoscopic Approach to the Tympanic Facial Nerve [Articolo su rivista]
Marchioni, Daniele; ALICANDRI CIUFELLI, Matteo; Piccinini, Alessia; Genovese, Elisabetta; Monzani, Daniele; Tarabichi, Muaaz; Presutti, Livio

Objectives/Hypothesis: Until recently, tympanic facial nerve surgery had been performed using microscopic approaches, but in recent years, exclusive endoscopic approaches to the middle ear have increasingly been used, particularly in cholesteatoma surgery. The aim of this report was to illustrate the surgical anatomy of the facial nerve during an exclusive endoscopic transcanal approach. Study Design: Retrospective video review of cadaveric dissections and operations on living patients in a tertiary university referral center. Methods: Between November 2008 and July 2010, a total of 12 endoscopic cadaveric dissections were performed by an exclusive endoscopic transcanal approach. All dissections were recorded and stored in a database. In July 2010, video recordings from those dissections were reviewed, and the anatomic variations and accessibility of the tympanic facial nerve were studied and noted. Two further video recordings from living patients affected by middle ear chronic disease were also included in our study. Results: In all 14 subjects, the transcanal endoscopic approach guaranteed direct access to the entire tympanic segment of the facial nerve after ossicular chain removal, allowing decompression of the nerve from the geniculate ganglion and the greater petrosal nerve to the second genu of the facial nerve. As in microscopic techniques, the cochleariform process and transverse crest (cog) may represent useful landmarks. Conclusions: The tympanic facial nerve can be thoroughly visualized by an exclusive endoscopic transcanal approach, even in poorly accessible regions such as the second genu and geniculate ganglion. Further clinically based reports may strengthen our preliminary results.

2011 - The contribution of selective dysventilation to attical middle ear pathology [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Genovese, Elisabetta; Presutti, Livio; Marchioni, Daniele; Grammatica, Alberto; Aggazzotti Cavazza, Elisa

Epitympanic primary cholesteatoma represents a challenge for ENT surgeons. Its exact pathogenesis is still unknown because of the very complex anatomy of this region. Until now, only a few authors have described this region and tried to hypothesize the causes that could lead to cholesteatoma genesis. We hypothesize the existence of a selective dysventilation of the epitympanic region based on the presence of various mucosal folds occluding air ventilation from the middle ear to the epitympanum, through the epitympanic isthmus, causing a negative epitympanic pressure and consequently cholesteatoma formation. All the anatomic findings were obtained with the aid of 0 and 45 angled surgical endoscopes. From our findings, patients affected by an epitympanic cholesteatoma often have a total isthmus blockage that completely isolates the whole epitympanum from the middle ear, causing a deficit of oxygenation of the mucosa that normally should be guaranteed by the Eustachian tube and which always works physiologically in these patients. This is confirmed by the tympanogram test where we observed how the pressure at the level of the tympanic cavity was normal, whereas the epitympanic pressure was selectively negative. In conclusion, selective epitympanic dysventilation syndrome consists of the concomitant presence of a series of complete or incomplete epitympanic diaphragms and ME isthmus blockage causing negative epitympanic pressure, and leading to the formation of a retraction pocket or cholesteatoma associated with normal Eustachian tube function

2011 - Validation Of Current International Legislation On Organ Allocation With Actual Practice In Persons With Disability. [Abstract in Rivista]
Nizzi, Mc; Ravera, F; Bonucchi, D; Genovese, Elisabetta; Griffo, G; Guaraldi, Giovanni; Guaraldi, Giacomo

There is increasing concern that persons with disability are being marginalized and discriminated against for their disability status in the organ allocation process despite legislation which guarantees transparency and equity. This is due to perceived infeasibility of organ allocation in this subset of patients with end-stage organ failure.

2010 - "Hide and seek" with antineutrophil cytoplasmic antibodies [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Molteni, Gabriele; Mascia, Maria Teresa; Genovese, Elisabetta; Presutti, Livio

Wegener Granulomatosis (WG) is a rare disease that can manifest initially with recurrent facial palse in the absence of any other symptom and in this case diagnosis could be missed for a long time. WG should be considered in all cases of multipe cranial palsy with unknown origin. This is a case report interesting for many specialist physicians ( ENT, ophthalmologists, rheumatologists, pneumologists)

2010 - AAC in communication disorders [Articolo su rivista]
Genovese, E.; Vallarino, M.; Farneti, D.

Any condition that alters the acquisition of a morpho-syntactic organization of thought will compromise communicative interaction. Verbal disability relates to diversified morbid conditions; these could be congenital or acquired, permanent or temporary and could arise over the entire lifespan. The degree of verbal disability presents a different range of severity and not only involves speech but cognitive and emotional aspects. In all these conditions a possibility of communication can be facilitated or substituted through ecological or mediate interventions, using technological devices of differing complexity. AAC (Augmentative Alternative Communication) refers to any communication method used to increase natural communication or to replace it if entirely absent. The presuppositions and the general principles of AAC are described. © 2010 Informa Healthcare.

Giliberti, E; Corradini, M; Guaraldi, G; Bertarelli, F; Genovese, E

n recent years the introduction of modern technologies has allowed students with disabilities to achieve a greater degree of autonomy and independence and favored a change in teaching that has become an increasingly "inclusive education", focusing on special educational needs and above all on their “hidden potential”. The increasing number of students with special education needs at the university level requires strategies to guarantee to every student the same rights. Today the learning processes make a large use of digital environment and the students with disabilities can successfully make use of specific technologies. We present a system developed at the University of Modena and Reggio Emilia based on digital white boards, tablets, and a repository for the audio-video recording of the lecture and of the learning resources specially addressed to students with special educational needs.

Genovese, E; Ghidoni, E; Guaraldi, G; Stella, G.

La presenza di studenti dislessici nelle Università è in rapido aumento e richiede provvedimenti specifici per assicurare loro pari opportunità di apprendimento e successo formativo. La dislessia è un disturbo "invisibile" che può condizionare pesantemente lo studio, ma non esclude la possibilità di laurearsi ed avere una vita professionale soddisfacente, purché si predispongano aiuti e strumenti che facilitino le attività accademiche. Dislessia ed Università riunisce, per la prima volta, i contributi dei gruppi di ricerca che si occupano della diagnosi e dell'intervento a favore dei dislessici adulti, In Italia, nonostante la situazione si presenti problematica fin dalla diagnosi per la mancanza di strumenti specifici si registra un vivace interesse dei Servizi per gli studenti disabili di alcune Università. Il volume affronta diversi aspetti del problema: dalla valutazione diagnostica a l'individuazione di strumenti e strategie per favorire il lavoro accademico, fino alle opportunità ed alle risorse delle nuove tecnologie. Il confronto con la situazione inglese fornice inoltre stimoli interessanti per la gestione della dislessia, non solo a livello universitario, ma anche per l'inserimento nel mondo del lavoro.

2010 - Endoscopic tympanoplasty in patients with attic retraction pockets [Articolo su rivista]
Marchioni, Daniele; ALICANDRI CIUFELLI, Matteo; Molteni, Gabriele; Genovese, Elisabetta; Presutti, Livio

OBJECTIVES:Patients undergoing endoscopic middle ear surgery require reconstruction procedures that are able to give adequate functional results, with particular attention to ventilation of middle ear routes and mastoid tissue preservation.STUDY DESIGN:Outcome research on a prospective case series in a tertiary university referral center.METHODS:A case series of 27 patients with attic retraction pockets underwent endoscopic middle ear surgical procedures. Three kinds of tympanoplasty were selected and performed.RESULTS:In all 27 subjects, it was possible to preserve the mastoid bone and the epitympanic-mastoid mucosa by performing a transcanal endoscopic approach. In total, 21 of 27 (77.7%) subjects presented no recurrence of the disease at 20.1 months mean follow-up.CONCLUSIONS:Three main types of endoscopic tympanoplasty can be performed for surgical treatment of attic retraction pockets, preserving as much as possible the ventilation routes, physiology, and anatomy of the middle ear

2010 - Inferior retrotympanum revisited: an endoscopic anatomic study [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Genovese, Elisabetta; Presutti, Livio; Marchioni, Daniele; Piccinini, Alessia

AbstractObjectives/Hypothesis:To describe the inferior retrotympanic anatomy from an endoscopic perspective.Study Design:This was an anatomic study on a retrospective case series.Methods:During November 2009 and December 2009, videos from endoscopic middle ear procedures carried out between June 2007 and November 2009 and stored in our database were retrospectively reviewed. Surgeries in which the inferior retrotympanic region was visualized were included in the study. Accurate descriptions of the anatomic findings were made for each ear included in the study group.Results:The final study group consisted of 25 videos from 25 ear procedures. In 14/25 subjects, a bony ridge connecting the inferior portion of the styloid prominence to the anterior and inferior lip of the round window niche (Proctor's sustentaculum promontory) was identified and renamed the finiculus (from the Latin finis, -is: borderline), representing the ideal limit between the inferior retrotympanum and hypotympanum. In 14/25 patients, a complete sinus subtympanicus could be identified, lying between the subiculum and finiculus.Conclusions:Endoscopic exploration of the middle ear might guarantee a very good exposure of the inferior retrotympanum, allowing detailed anatomic descriptions of this hidden area. Improvement in our knowledge of its anatomy might decrease the possibility of residual disease during cholesteatoma surgery.

2010 - Intermittent self-limiting epistaxis: not always a triviality [Articolo su rivista]
Molteni, Gabriele; ALICANDRI CIUFELLI, Matteo; Romualdi, Pietro; Genovese, Elisabetta; Presutti, Livio

Intermittent self-limiting epistaxis: not always a triviality

2010 - Lateral endoscopic approach to epitympanic diaphragm and Prussak's space: a dissection study [Articolo su rivista]
Marchioni, D.; Alicandri Ciufelli, Matteo; Grammatica, A.; Mattioli, F.; Genovese, Elisabetta; Presutti, Livio

Introduction Until now, anatomic descriptions of the epitympanic diaphragm and Prussak’s space have been performed using a microscope. The aim of this study is to thoroughly describe and review the epitympanic diaphragm and the anatomy of Prussak’s space from an endoscopic point of view. Study design Cadaver dissection study. Setting Tertiary referral university center. Materials and methods The anatomy of four temporal bones dissected using an endoscope was studied. The most important findings were noted and described. Results Endoscopic cadaveric dissection of the middle ear allows a very good visualization of the epitympanic diaphragm, Prussak’s space and middle ear anatomy in general. Conclusion Endoscopic exploration and thorough knowledge of the complex fold anatomy may improve ‘functional’ interventions in middle ear inflammatory pathology during middle ear surgery, particularly in the case of selective dysventilation

2010 - Numerical Intelligence, Verbal Competence and Intelligence in preschool children with cochlear implants: our findings in a clinical sample [Articolo su rivista]
Palma, S; Gubernale, M; Guarnaccia, M. C.; Genovese, Elisabetta

This study synthesizes some preliminary observations made by the clinicians of the Audiology and Phoniatrics Department of Padua-Treviso University on the development of numerical intelligence in deaf children who received cochlear implantation at an early age. This study collected data from clinical observation and standardized instruments, such as Leiter-R and PRCR-Numeri, on a group of 11 preschool deaf children.These data were then compared with those obtained from language performances and audiometric examinations. It is generally recognized that a normal cognitive profile corresponds to scaled scores between 85 and 122. Specifically, the Numerical Intelligence competence is lower in deaf children than in normally hearing children. In particular, the most obvious difference is in the ‘‘number comparison’’ performance, which involves mental operations. In our study, we observed a meaningful connectionbetween Intelligence Quotient (IQ) and the Fluid Reasoning (Fr)score, that is, the ability to solve non-verbal problems independent of previous learning. These results appear to demonstrate a pronounced connectivity of the subcomponents which, taken together, produce visualspatial functionality.

2010 - Protocollo per la valutazione di disfagia nel bambino con patologia neurologica grave presso l’UO di Pediatria dell’Azienda Ospedaliero-Universitaria Policlinico di Modena [Abstract in Rivista]
Frassoldati, Rossella; D., Soloperto; M. P., Luppi; G., Bergamini; C., Rossi; G., Vivi; C., Molinari; S., Cipolli; S., Leoni; A., Guerra; Genovese, Elisabetta; Presutti, Livio; Iughetti, Lorenzo; Paolucci, Paolo

Secondo uno studio di Reilly (1996) il riscontro di disfunzioni motorie orali nei soggetti con PCI arriva fino al 90%, e la prevalenza di compromissione della fase orale e faringea è del 38%

Ruggerini, C; Guaraldi, G; Genovese, E; MORETTI FANTERA, M; Bertolani, F; Mingione, A

In Italia le disposizioni legislative a favore degli studenti con DSA nel 2010 erano ancora molto carenti. Si parlava, infatti, di integrazione di alunni con disabilità. L'alunno con DSA, la contrario, non era tutelato prima della Legge 170/2010 nonostante la Conferenza Nazionale dei delegati Universitari alla Disabilità (CNUDD) in collaborazione con l'Associazione Italiana Dislessia (AID) già prima della Legge cercasse di favorire l'integrazione scolastica ed universitaria anche degli alunni con DSA garantendo loro il diritto allo studio e pari opportunità di formazione tramite la fruizione di ausili compensativi e misure dispensative.

2010 - Selective epitympanic dysventilation syndrome [Articolo su rivista]
Marchioni, Daniele; ALICANDRI CIUFELLI, Matteo; Molteni, Gabriele; Artioli, FRANCA LAURA; Genovese, Elisabetta; Presutti, Livio

OBJECTIVES/HYPOTHESIS:Although middle ear aeration is certainly related to eustachian tube (ET) function, other anatomic factors may play an important role in ventilation of these spaces, particularly the epitympanum.STUDY DESIGN:A prospective case series study group with retrospective case series comparison.METHODS:Eight patients affected by non-self-cleaning attic retraction pockets or attic cholesteatoma of the middle ear and normal tubal function (verified by type A tympanogram or Williams' test) underwent endoscopic surgery. Anatomic findings were noted and collected, with particular attention paid to middle ear folds. A control group was used for comparison. The prevalence of an isthmus blockage with a complete tensor fold in pathologic ears was compared between the study group and control group.RESULTS:The higher prevalence of an isthmus blockage associated with a complete tensor fold in the study group was found to be statistically significant (P = .001).CONCLUSIONS:A selective epitympanic dysventilation syndrome is hypothesized; normal ET function seems to be insufficient for complete ventilation of the middle ear, and an open tympanic isthmus or an incomplete tensor fold may be necessary for epitympanic recess ventilation. The selective epitympanic dysventilation syndrome would consist of the contemporary presence of the following four conditions: attic retraction pocket or cholesteatoma, normal tubal function tests, complete epitympanic diaphragm, and isthmus blockage.

2010 - Stimulation of the cholinergic neurotransmissions enhances the efficacy of vestibular rehabilitation [Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; A., Marrara; Presutti, Livio; C., Gherpelli; P., Panzetti; M., Forghieri

The primary aim of this study was to investigate the efficacy of vestibular rehabilitation in a cohort of elderly labyrinthine-defective patients also affected by a moderate cognitive impairment of vascular origin. A secondary aim was to establish whether additional treatment with a cholinergic precursor (choline alphascerate) might enhance the results of the physical therapy in these patients. A retrospective clinical design was employed and data were collected from the vestibular rehabilitation treatment charts of 42 selected elderly patients who attended the tertiary referral centre of the Audiology and Vestibology of the university hospital of Modena, Italy, in the period 1998-2008. Two groups of patients, well-matched for sex, age, and as close as possible for the vestibular examination upon admittance, were selected; group A included 20 patients who had undergone vestibular rehabilitation training for one month and group B included 22 patients who had attended the same physical therapy sessions as the former and had also received daily medication with 1200 mg of choline alphascerate per os. The outcome measures of the two forms of treatments were obtained from comparisons between posturographic and electronystagmographic examinations at baseline and 3 weeks after the end of treatment. instrumental findings were completed by recording scores of the Dynamic gait index, the Dizziness handicap inventory and the hospital Anxiety and Depression Scale before and after treatment. A statistically significant improvement in postural control (p < 0.05) and gait and balance performances (p < 0.005) was recorded in both groups; a relevant and statistically significant reduction of the asymmetry of the vestibular-ocular reflexes was also observed (p < 0.005). The self-rated dizziness handicap and psychological distress were significantly reduced (p < 0.005). Comparisons between the two groups revealed that patients who had also received medication, had achieved significantly better results than the other patients with respect to postural control in response to optokinetic stimulations (p < 0.05) and to Dynamic gait index (p < 0.05), thus suggesting, a reinforcement of cholinergic stimulation on vestibular compensation when tested in clinical conditions that require complex perceptual-motor skills and make a significant demand upon cognitive spatial processing resources. Further applications of stimulation of the cholinergic neurotransmission are discussed with particular regard to vestibular compensation in patients with no cognitive impairment or recurrent vertigo attacks of labyrinthine origin.

2010 - Studenti dislessici all'Università di Modena e Reggio Emilia: primi dati e riflessioni di un gruppo di lavoro. [Capitolo/Saggio]
Genovese, E; Guaraldi, G

Studenti dislessici all'Università di Modena e Reggio Emilia: primi dati e riflessioni di un gruppo di lavoro.

2010 - The digital board in a university setting: Two real cases in Europe and East Africa [Relazione in Atti di Convegno]
Bertarelli, F.; Corradini, M.; Guaraldi, G.; Genovese, E.; Kilwake, J.; Mutua, S.

Usually the digital board is thought of as a tool that can only be used beneficially in the context of primary school, secondary school or in a situation of learning handicap. In this case study we want to highlight how the new tools can be used in more broad settings such as teaching in scientific and technical universities. The easy adoption of all useful software on the market to the use of these tools makes them an innovative element in the teaching techniques of the future. © 2010 Springer-Verlag Berlin Heidelberg.

2010 - Therapy of unilateral vocal fold paralysis with polydimethylsiloxane injection laryngoplasty: our experience [Articolo su rivista]
Bergamini, G; ALICANDRI CIUFELLI, Matteo; Molteni, Gabriele; Villari, D; Luppi, Mp; Genovese, Elisabetta; Presutti, Livio

The objective of this study was to document functional results and to compare objective and subjective voice measures after endoscopic laryngoplasty with injection of polydimethylsiloxane (PDMS) for the treatment of unilateral vocal fold paralysis, and to verify PDMS biocompatibility in vocal fold. The design used was a longitudinal prospective study. Fifteen patients with unilateral vocal fold paralysis underwent endoscopic injection of PDMS in general anesthesia. Accurate voice evaluation protocol (acoustic and aerodynamics analyses, GIRBAS [Grade, Instability, Roughness, Breathiness, Asthenia, and Strain] scale, videostrobolaryngoscopy, and Voice Handicap Index test) before, after surgery, and at follow-up time was performed. The median follow-up was 21.7 months (range, 6-35). Data obtained were statistically significant. All acoustic, aerodynamics, perceptive, and subjective evaluations showed a significant improvement. No complications due to PDMS were reported. Functional results were found comparable to framework surgery. Endoscopic injection laryngoplasty with PDMS is a safe and long-term option for treatment of unilateral vocal fold paralysis.

2009 - Comparison of speech perception performance between Sprint/Esprit 3G and freedom processors in children implanted with nucleus cochlear implants [Articolo su rivista]
Rosamaria, Santarelli; Vincenzo, Magnavita; Roberta De, Filippi; Laura, Ventura; Genovese, Elisabetta; Edoardo, Arslan

OBJECTIVE:: To compare speech perception performance in children fitted with previous generation Nucleus sound processor, Sprint or Esprit 3G, and the Freedom, the most recently released system from the Cochlear Corporation that features a larger input dynamic range. STUDY DESIGN:: Prospective intrasubject comparative study. SETTING:: University Medical Center. SUBJECTS:: Seventeen prelingually deafened children who had received the Nucleus 24 cochlear implant and used the Sprint or Esprit 3G sound processor. INTERVENTION:: Cochlear implantation with Cochlear device. MAIN OUTCOME MEASURES:: Speech perception was evaluated at baseline (Sprint, n = 11; Esprit 3G, n = 6) and after 1 month's experience with the Freedom sound processor. Identification and recognition of disyllabic words and identification of vowels were performed via recorded voice in quiet (70 dB [A]), in the presence of background noise at various levels of signal-to-noise ratio (+10, +5, 0, -5) and at a soft presentation level (60 dB [A]). Consonant identification and recognition of disyllabic words, trisyllabic words, and sentences were evaluated in live voice. Frequency discrimination was measured in a subset of subjects (n = 5) by using an adaptive, 3-interval, 3-alternative, forced-choice procedure. RESULTS:: Identification of disyllabic words administered at a soft presentation level showed a significant increase when switching to the Freedom compared with the previously worn processor in children using the Sprint or Esprit 3G. Identification and recognition of disyllabic words in the presence of background noise as well as consonant identification and sentence recognition increased significantly for the Freedom compared with the previously worn device only in children fitted with the Sprint. Frequency discrimination was significantly better when switching to the Freedom compared with the previously worn processor. CONCLUSION:: Serial comparisons revealed that that speech perception performance evaluated in children aged 5 to 15 years was superior with the Freedom than previous generations of Nucleus sound processors. These differences are deemed to ensue from an increased input dynamic range, a feature that offers potentially enhanced phonemic discrimination.

2009 - Guidelines on acute otitis media [Articolo su rivista]
Marchisio, P.; Principi, N.; Bellussi, L.; Di Mauro, G.; Felisati, G.; Conforti, G.; Cunsolo, E.; Doria, M.; Longhi, R.; Navone, C.; Renna, S.; Pignataro, L.; Piemonte, M.; Mariniello, L.; Nicoletti, G.; Speciale, A.; De Vincentiis, G.; Genovese, E.; Mansi, N.; Mele, G.; Del Giudice, M. M.; Novelli, A.; Diana, M. C.; Paravati, F.; Scaglione, F.; Vitali-Rosati, G.

2009 - Hearing loss features in GJB2 biallelic mutations and GJB2/GJB6 digenic inheritance in a large Italian cohort [Articolo su rivista]
Elona, Cama; Salvatore, Melchionda; Teresa, Palladino; Massimo, Carella; Rosamaria, Santarelli; Genovese, Elisabetta; Filippo, Benettazzo; Leopoldo, Zelante; Edoardo, Arslan

The aim of this study was to describe the clinical features of hearing loss due to mutations on connexin 26/30 coding genes (GJB2/GJB6). Mutations in the GJB2 gene are found to account for approximately 50\% of cases of autosomal recessive non-syndromic deafness. Several European studies have estimated that the GJB2 healthy carrier condition involves about 2-4\% of the population, with the 35delG mutations being the most common. A 342-kb deletion truncating the GJB6 gene (encoding connexin-30) has been associated with autosomal recessive non-syndromic deafness, mostly as digenic inheritance of the Cx30 deletion/Cx26 mutation. The following retrospective study describes audiological features and genotypes of a large cohort of 376 Italian hearing-impaired patients who underwent genetic screening for the GJB2/GJB6 genes and received follow-up care at our centre between January 2002 and October 2006. Sixteen different genotypes causing deafness in more than 27\% of patients with either biallelic mutations or digenic inheritance GJB2/GJB6 were identified. The most frequent mutations were 35delG, M34T, L90P, and R184P.

2008 - Audiological and electrocochleography findings in hearing-impaired children with connexin 26 mutations and otoacoustic emissions. [Articolo su rivista]
Rosamaria, Santarelli; Elona, Cama; Pietro, Scimemi; Erica Dal, Monte; Genovese, Elisabetta; Edoardo, Arslan

We recorded cochlear potentials by transtympanic electrocochleography (ECochG) in three hearing-impaired children with GJB2 mutation who showed otoacoustic emissions. Pure tone thresholds, distortion product otoacoustic emissions (DPOAEs) and, auditory brainstem responses (ABRs) were also obtained. Subjects 1 (35delG/35delG) and 3 (M34T/wt) had profound hearing loss and showed the picture of auditory neuropathy (AN) as DPOAEs were detected with absent ABRs in both ears. The hearing impairment found in subject 2 (35delG/35delG) was profound in the right ear and moderate in the left ear. Both DPOAEs and ABRs with normal latencies and morphology were recorded only from the left ear. On the ECochG recording the cochlear microphonic was obtained from all children. No compound action potential (CAP) was detected in subject 1. A neural response was recorded only from the left ear in subject 2 with a threshold corresponding to the audiometric threshold while no CAP was detected on the right side. The ECochG obtained from subject 3 showed a low-amplitude broad negative deflection which was identifiable down to low stimulus levels. This response decreased in amplitude and duration when utilizing a high-rate stimulation paradigm. The amount of amplitude reduction was close to that calculated for normal ears, thus revealing the presence of an adapting neural component. These findings indicate that patients with GJB2 mutations and preserved outer hair cells function could present with the picture of AN. The hearing impairment is underlain by a selective inner hair cell loss or a lesion involving the synapses and/or the auditory nerve terminals. We suggest that neonatal hyperbilirubinemia may play a role in protecting outer hair cells against the damage induced by GJB2 mutations.

2008 - Cochlear implantation in deaf children with associated disabilities: Challenges and outcomes [Articolo su rivista]
Stefano, Berrettini; Francesca, Forli; Genovese, Elisabetta; Rosamaria, Santarelli; Edoardo, Arslan; Anna Maria, Chilosi; Paola, Cipriani

The issue of cochlear implantation in deaf children with associated disabilities is an emerging subject. Currently, there is no consensus on whether to implant children with multiple impairments; moreover, it may be difficult to evaluate these children with standard tests pre- or post-implantation. In addition, these children often have poor speech perception and language skills, making assessment more difficult. Despite these factors, these children often receive important benefits in daily life, with an overall improvement in quality of life. In the present study, post-implant outcomes of 23 profoundly deaf children with neuropsychiatric disorders were analysed, using objective measures of speech perception, and a questionnaire administered to the parents, aimed at evaluating the benefits in daily life after implantation. The results were quite variable, but overall positive, in terms of speech perception, communication abilities, and improvement in quality of life. The findings add an additional piece of evidence to support the effectiveness of cochlear implantation in these special cases.

2008 - Cochlear implantation outcome in prelingually deafened young adults: A speech perception study [Articolo su rivista]
Rosamaria, Santarelli; Roberta De, Filippi; Genovese, Elisabetta; Edoardo, Arslan

The outcome of cochlear implantation in patients with deafness of prelingual onset is largely unpredictable due to high individual variability. This study evaluated speech perception performances in a group of 18 prelingually deafened subjects (aged 13-30 years) which was homogeneous with respect to duration of deafness, hearing aid use before cochlear implantation, mode of communication and administration of auditory-oral speech therapy. Word discrimination length, word and sentence identification, phoneme identification and word and sentence recognition were tested before cochlear implantation and at 6 months, 1, 2 and 3 years of cochlear implant use. Scores on all tests significantly improved after cochlear implantation, although mean values were lower compared to those achieved by postlingually deafened patients. Speech performances on both word and sentence recognition continued to increase over time also beyond 1 year after cochlear implantation. Moreover, scores on sentence recognition tests were significantly higher compared to disyllabic words at 3 years of cochlear implant use. The presence of an auditory input delivered by hearing aids before cochlear implantation associated with auditory-oral therapy and a good level of education may positively influence the cochlear implant outcome in prelingually deafened adults.

2008 - Psychological profile and social behaviour of working adults with mild or moderate hearing loss. [Articolo su rivista]
Monzani, Daniele; Galeazzi, Gian Maria; Genovese, Elisabetta; A., Marrara; A., Martini

In this study, an assessment was made of the global assumption that working adults with a mild to moderate sensorineural hearing loss experience more negative emotional reactions and socio-situational limitations than subjects with no hearing problems and that a deterioration of health-related quality of life on these specific domains would occur. Comparisons between 73 hearing-impaired subjects and 96 controls, well-matched for socio-demographic variables, were performed using the HHIA, MOS 36-Item Short Form Health Survey (SF-36) and SFQ questionnaires scores and revealed that the former experience a higher level of perceived hearing handicap and a deterioration of health-related quality of life while investigating emotional and socio-situational domains than the latter (p < 0.005). While investigating the psychological distress dimension of the hearing-impaired subjects by means of the Symptom Check List (SCL-90-R), it emerged that they are more prone to depression, anxiety, interpersonal sensitivity, and hostility than subjects with no hearing problems (p < 0.05). It is argued that the sensory impairment, with its associated disability, may discourage hearing-impaired individuals from exposing themselves to socially challenging situations, producing isolation that leads to depression, irritability, feelings of inferiority. The same psychological symptoms, on the other hand, can compound and worsen the picture by influencing social behaviour of the affected persons. Further prospective studies are needed to address this issue. Nevertheless, it is concluded that Audiology Services, despite the time and costs involved, should improve their diagnostic ability by exploring more areas of hearing-impaired subjects concerns in order not to overlook their potentially reduced psychosocial well-being.

2008 - Validity of the Italian adaptation of the Tinnitus Handicap Inventory; focus on quality of life and psychological distress in tinnitus-sufferers [Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; Marrara, A.; Gherpelli, Chiara; Pingani, Luca; Forghieri, M.; Rigatelli, Marco; Guadagnin, T.; Arslan, E.

The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach's alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach's alpha = 0.93) and its Danish (Cronbach's alpha = 0.93) and Portuguese (Cronbach's alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach's alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale scores indicating a good construct validity. Moreover, these statistically significant correlations (p < 0.005) confirmed that the self-report tinnitus handicap is largely related to psychological distress and a deterioration in the quality of life. On the other hand, it was confirmed that the tinnitus perceived handicap is totally independent (p > 0.05) from its audiometrically-derived measures of loudness and pitch thus supporting previous studies that focused on the importance of non-auditory factors, namely somatic attention, psychological distress and coping strategies, in the generation of tinnitus annoyance. Finally the results of the present study suggest that the THI-I maintains its original validity and should be incorporated, together with other adequate psychometric questionnaires, in the audiological examination of patients suffering from tinnitus and that psychiatric counselling should be recommended for the suspected co-morbidity between tinnitus annoyance and psychological distress.

2007 - Genetics of communication disorders [Capitolo/Saggio]
Genovese, E.; Galizia, R.; Santarelli, R.; Arslan, E.

Dyslexia, also a language problem, is known to be inherited (8,9). Phonological language disorders, also, have been shown to be more common among children whose parents had such disorders than among controls (10).

2007 - Hearing, Language and Communication [Capitolo/Saggio]
Cipriani, P.; Genovese, Elisabetta; Chilosi, A. M.

After a brief description of the neurophysiological basis of development in the first years, the book provides a comprehensive review of the various methods used for the neurological assessment in young infants describing how a combined approach of clinical and instrumental investigations can provide important diagnostic and prognostic information. The first part of the book describes the most used clinical neurological examinations and their applications in infants with neurological abnormalities, followed by a description of the value of neuroimaging and neurophysiological techniques in normal preterm and full term infants in the first two years and the main types of abnormal MR findings of neurophysiological findings (EEG and evoked potentials) in relation to brain lesions.Other sections include chapters describing techniques assessing specific aspects of cognitive, perceptual and sensory abilities.Special attention is given to hearing, language and communication and to development of vision and visual attention both in normal infants and in those with neonatal brain lesions.

2007 - Measuring the psychosocial consequences of hearing loss in a working adult population: focus on validity and reliability of the Italian translation of the hearing handicap inventory. [Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; S., Palma; V., Rovatti; M., Borgonzoni; A., Martini

Despite increasing demand for questionnaires for assessing hearing handicap and the effectiveness of some tools across different languages, empirical studies to evaluate the reliability and the validity of translations of original English questionnaires into an Italian version have not been reported in the literature, thus making comparisons of Italian experimental and clinical data across cultures and countries impossible. This study tested the global assumption that the Hearing Handicap Inventory for Adults (HHIA), that is one of the most widely used instruments in English-speaking countries, can be adapted to the Italian language maintaining the reliability and clinical validity of the original version. The English version of this 25-item, self-assessment questionnaire was developed by Newman et al. in 1990 and special emphasis was placed on emotional reaction and social limitations perceived by hearing-impaired subjects and scored separately. This tool was translated into the Italian language by a forward and backward technique, as established by the IQOLA (International Quality of Life Assessment) project. Overall, 94 subjects, aged 18-65 years, with acquired hearing impairment and 104 individuals with no hearing problems, well-matched for socio-demographic variables, were enrolled in the study in a case-control design. Reliability of the Italian version of HHIA was tested by measuring internal consistency and test-retest reproducibility. Validity was assessed by using construct, convergent and discriminant methods. A Cronbach's alpha coefficient near 0.90 confirmed a more than acceptable internal consistency and a highly statistically significant Spearman's correlation coefficient (< 0.005) between scores of the two administrations at an interval of one month documented an excellent stability of the questionnaire over time. Construct validity was demonstrated by a correlation between the severity of hearing loss and the score of questionnaire (< 0.005) and convergent validity was supported by a significant correlation between the scores of the emotional and socio/situational subscales of the HHIA to the analogous subscales of a health-related quality of life questionnaire (MOS 36-Item Short Form Health Survey) (< 0.005). Finally, since hearing-impaired subjects scored significantly higher than controls on HHIA (< 0.005), it clearly emerged that also the Italian version of HHIA differentiates the two populations (those with and those without hearing problems) demonstrating a robust discriminant validity. Given the lack of appropriate measures to assess hearing handicap in Italy, the results achieved in this study, confirm that the HHIA, Italian version, is suitable for both experimental and clinical use.

2007 - The development of numerical intelligence in preschool children with cochlear implants: a hypothesis on mathematical, verbal and non verbal cognitive competence. [Capitolo/Saggio]
D., Lucangeli; Genovese, Elisabetta; M., Gubernale; S., Cabrele; Monzani, Daniele

This study synthesizes some preliminary observations made by the clinicians of the Audiology and Phoniatrics Department of Padua Treviso University on the development of numerical intelligence in deaf children who received cochlear implantation at an early age. This study collected data from clinical observation and standardized instruments, such as Leiter-R and PRCR-Numeri, on a group of 11 preschool deaf children. These data were then compared with those obtained from languageperformances and audiometric examinations. It is generally recognized that a normal cognitive profile corresponds to scaled scores between 85 and 122. Specifically, the Numerical Intelligence competence is lower in deaf children than in normally hearing children. In particular, the most obvious difference is in the ‘‘number comparison’’ performance, which involves mental operations. In our study, we observed a meaningful connection between Intelligence Quotient (IQ) and the Fluid Reasoning (Fr) score, that is, the ability to solve non-verbal problems independent of previous learning. These results appear to demonstrate a pronounced connectivity of the subcomponents which, taken together, produce visual spatial functionality.

2006 - Auditory neuropathy in systemic sclerosis: a speech perception and evoked potential study before and after cochlear implantation [Articolo su rivista]
R., Santarelli; P., Scimemi; E., Dal Monte; Genovese, Elisabetta; E., Arslan

We report the results of speech perception and electrophysiological evaluation of the auditory periphery performed before and after cochlear implantation in a 18-year-old girl with systemic sclerosis (SS) who presented the clinical picture of auditory neuropathy. Transtympanic electrocochleography (ECochG) in response to 0.1 ms clicks was recorded 1 month before cochlear implantation on both sides while the electrically evoked neural response was obtained intraoperatively in the right ear through cochlear implant stimulation. The ECochG recordings revealed the presence of the cochlear microphonic with normal amplitude and threshold on both sides. A compound action potential was only detected in the left ear at high stimulation intensity, while the electrically evoked neural response was clearly identifiable at all the recording sites during neural response telemetry. Standardized speech perception tests were performed 1 month before cochlear implantation and several times after cochlear implant connection. Speech perception scores were close to chance before cochlear implantation while they showed a remarkable improvement thereafter. The results of this study show that subjects affected by SS could present the clinical picture of auditory neuropathy which is possibly underlain by lesions involving the distal portion of auditory nerve fibers and/or synapses with inner hair cells. The restoration of synchronous neural discharge could be achieved by electrical stimulation through cochlear implant.

2006 - Life events and benign paroxysmal positional vertigo: A case-controlled study [Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; Virginia, Rovatti; Maria Ludovica, Malagoli; Rigatelli, Marco; Giorgio, Guidetti

CONCLUSIONS: Within the poorly understood mechanisms implicated in the aetiology of benign paroxysmal positional vertigo (BPPV), the results of this trial provide clinical evidence of a potential role of emotional stress connected to adverse life events as a trigger of otoconial dysfunction. High levels of anxiety, depression and somatization were recorded and considered psychogenic precursors of BPPV, thus emphasizing the role of psychological distress in precipitating peripheral vestibular disorders. Therefore, appraisal of life stress and psychological attitudes may have potential implications in the clinical assessment of this labyrinthine vertigo and its frequent relapses. OBJECTIVES: BPPV is one of the most common peripheral vestibular disorders, and although it has been the subject of several studies and debates, its aetiology still remains unknown in most cases. Because it has been shown that emotional stress is related to the onset or worsening of other inner ear dysfunctions such as Ménière's disease and sudden hearing loss, this study investigated the hypothesis that life events, mood and psychological attitudes may have a causal relationship with BPPV. PATIENTS AND METHODS: Fifty patients (40 females and 10 men; mean age 43.5+/-10.1 years, range 30-65 years) were recruited and compared with 50 healthy volunteers matched for sex, age and socio-demographic variables. Patients were selected among dizzy patients who were referred to the ENT Clinic of the University of Modena and Reggio Emilia from the emergency unit with a primary diagnosis of 'positional vertigo' and enrolled in the study only if they had a paroxysmal positional nystagmus as diagnosed by Dix-Hallpike and Semont's manoeuvres. Patients with a history of recurrent vertigo and additional otoneurological diseases were excluded. The Paykel Life Events Scale, Spielberger State-Trait Anxiety Inventory, Symptom Check List-90 Revisited and Hamilton Depression Scale were the psychometric questionnaires used to complete the audiological and vestibular examinations. RESULTS: Patients with BPPV reported significantly more life events than control subjects in the year preceding the onset of vertigo (p<0.005). Negative life events, objective negative impact and a poor degree of control were also significantly more frequent in patients compared with controls (p<0.005). There were no significant differences between groups concerning positive life events (p>0.05). Psychometric questionnaires recorded significantly higher levels of anxiety, depression and somatization in the pathological sample (p<0.005), as well as an increased obsessive-compulsive attitude (p<0.05).

2005 - Mathematical vs. reading and writing disabilities in deaf children, a pilot study on the development of numerical knowledge. [Capitolo/Saggio]
Genovese, Elisabetta; Galizia, R. GUBERNALE M.; Lucangeli, D.

In the literature there is limited research on the interaction of language and arithmetic performance of deaf students, although previous studies have demonstrated that many of these students are delayed in both their language acquisition and arithmetic performance. The focus of the first part of this work is a brief review of the literature on acquisition of learning abilities in prelingually deaf children with hearing aids and cochlear implants. Children who experience severe to profound deafness early in their life have a better prognosis for normal literacy development than ever before. In fact, the restoration of the auditory threshold allows children to achieve language and learning abilities like normally hearing children. In the second part we describe our initial experiences in the field. We discuss some preliminary results of an investigation of the longitudinal development of cognitive abilities related to numerical cognition in hearing-impaired children who have had a hearing aid or a cochlear implant at a young age. Specifically, we analyse the development of numerical abilities related to verbal abilities (such as those implied in counting tasks), reading and writing numbers, and analogical numerical abilities (such as those based on quantity recognition as in number comparison and number seriation).

2005 - Repeated visually-guided saccades improves postural control in patients with vestibular disorders [Articolo su rivista]
Monzani, Daniele; Setti, G; Marchioni, D; Genovese, Elisabetta; Gherpelli, Chiara; Presutti, Livio

One of the most recent and promising theoreticalhypotheses for compensation of persistent asymmetry ofdynamic vestibulo-ocular gain is sensory substitution. Asa switch between oculomotor and vestibulo-ocular systems,saccadic eye movements are engaged in humans to compensatethe angular displacement of the head towards thelabyrinthine defective side thus preserving the foveal fixationof the target. This study focused on the possibility thatsaccadic eye movements might also compensate for theimpaired vestibulo-spinal reflexes and force the posturalsystem to a more effective control on upright stance andverified whether this sway-stabilizing effect could beapplied to patients with vestibular disorders and balancedysfunction. In the first experiment, 27 patients with unilaterallabyrinthine hypofunction, 24 patients with centralvestibular disorders and 24 healthy volunteers were evaluatedby static posturography in 3 different visual conditions:a) eye open with fixation of a steady target, b) eyeclosed, and c) while performing horizontal visually-guidedsaccades. The percentage of individuals with a decreasedbody sway area during the oculomotor task was found tobe higher in labyrinthine-defective patients as compared tothose with central vestibular disorders and controls. In thesecond experiment, 46 patients with vestibular disordersboth of central and peripheral origin, whose postural controlimproved by eye-tracking, as assessed by posturography,were later submitted to 12 consecutive training sessionsbased on repeated visually-guided saccades. Both thesaccadic performances and postural control improved in allpatients but a more pronounced effect was observed in thosewith peripheral vestibular disorders. Outcome of this rehabilitationtechnique was also corroborated by a generalreduction of the perceived overall impairment from balancedisorders as tested by a specific questionnaire.

2003 - Development of communication and speech skills after cochlear implant in a sign language child [Articolo su rivista]
Cassandro, E.; Nicastri, M.; Chiarella, G.; Genovese, E.; Gallo, L. V.; Catalano, M.

In selecting patients to undergo cochlear implant, a pre-existing use of sign language gives rise to two problems that have been widely debated in the literature. First, the caution shown toward the candidacy of patients using this mode of communication, since it is considered a possible element of interference in the acquisition of speech. Secondly, refusal of the cochlear implant procedure, on the part of the deaf community, on the grounds both of cultural identity and of it being more "natural" for a deaf person to use an unimpaired visual channel rather than an impaired hearing channel. In order to establish whether knowledge of sign language does, indeed, affect speech production negatively and evaluate which mode of communication, oral or gestual, is preferred, the present investigation was carried out on a preverbal deaf child who had undergone cochlear implant at about 7 years of age and has always used both languages. His verbal skills were evaluated in the precochlear implant stage, then at 6 and 12 months after, together with the changes in his use of sign language and in the relationship between the two modes. Results, besides observing the presence of linguistic evolution at each level examined and already evident at 6 months, also documented a progressive reduction in the spontaneous use of sign language. In conclusion, the present experience revealed no temporal or qualitative differences in post-cochlear implant evolution of speech skills, in comparison with that observed in patients with an exclusively aural-oral approach. Furthermore, the increased use of the hearing pathway, made possible by cochlear implant, determined a spontaneous choice of verbal language as the most natural and economic mode of communication.

1997 - Cochlear implantation in a bilateral Mondini dysplasia [Articolo su rivista]
Turrini, M.; Orzan, E.; Gabana, M.; Genovese, E.; Arslan, E.; Fisch, U.

We report the speech perception progress and programming procedures of a case of congenital profound deafness and bilateral Mondini dysplasia implanted with a Nucleus 20 + 2 cochlear implant at the age of six. Unclear relations between electrodes array and cochlear partition made implant programming difficult and nun-standard procedures were set. Cochlear implantation may give excellent rehabilitative results also in cochleae with malformation.

1997 - Hearing threshold assessment with auditory brainstem response (ABR) and Electrocochleography (ECochG) in uncooperative children [Articolo su rivista]
Arslan, E.; Turrini, M.; Lupi, G.; Genovese, E.; Orzan, E.

Two-hundred-and-sixty uncooperative children (442 ears) performed auditory brainstem response (ABR) and Electrocochleography (ECochG) in the same diagnostic session under general anaesthesia, and the results obtained with the two different methods were compared. A difference ≤ 20 dB between the two methods was found in 134 ears (30.3%). The presence of middle ear effusion and symptoms of a possible central nervous system pathology were considered in order to verify the evidence of a correlation between the difference in ABR-ECochG results and these clinical parameters. The presence of middle ear effusion was not significantly correlated with differences ≤ 20 dB (p = 0.1347). On the contrary, the presence of symptoms indicative of a possible central nervous system (CNS) involvement was significantly correlated with differences ≤ 20 dB (p = 0.0000). ABR has to be considered the first choice in hearing assessment strategy, either for screening or diagnosis. However, the diagnosis of hearing loss only on the basis of the presence or absence of wave V requires some care in case of suspected central auditory pathway lesions. In these cases, ECochG may be the only reliable diagnostic tool for hearing assessment in uncooperative subjects.

1997 - Persistent high MR signal of the posterior pituitary gland in central diabetes insipidus [Articolo su rivista]
Maghnie, M; Genovese, Elisabetta; Bernasconi, S; Binda, S; Arico, M.

We describe three cases of central diabetes insipidus, each with a different pathogenesis, in which unexpected hyperintensity of the posterior pituitary gland was seen on T1-weighted MR images obtained at the time of presentation, In the first case (idiopathic), the posterior pituitary signal persisted more than 10 years; in the second case (Langerhans cell histiocytosis), the signal disappeared within 3 months, despite early specific chemotherapy with etoposide; and in the third case (transient), the posterior signal disappeared within 1 year, but it was documented at the time of spontaneous reversal of polyuria and polydipsia.

1996 - Comparison between auditory brainstem response (ABR) and electrocochleography (ECochG) in infant hearing threshold assessment [Articolo su rivista]
Arsan, E.; Lupi, G.; Turrini, M.; Genovese, E.

1996 - Hearing aid systems in undeveloped, developed and industrialized countries [Articolo su rivista]
Arslan, E.; Genovese, E.

The problems related with the hearing loss prevalence and deafness rehabilitation in Developing (D) countries are so complex that only basic needs and some suggestions are discussed in this paper. In fact for D countries the main demographic and social indi reveal the enormous gravity of the health situation and so the availability of a hearing aid delivery system is often considered less urgent and secondary to the basic unmet needs of the population. Nevertheless we think this concept may be applied to the adult, but for the child with a preverbal deafness it must deserve immediate attention in order to prevent a very serious handicap limiting all his life. Schematically the three types of handicaps developed by a child with a preverbal hearing loss are presented and discussed. The essential assumption, however, for any hearing aid program in D countries is the creation in loco of competent personnel for the prescription, for fitting and checking the aids. If D countries are to achieve this objective, industrialized countries must begin to transfer technology and training to develop pilote centers.

1995 - Speech perception test in Italian language for profoundly deaf children. [Articolo su rivista]
Genovese, Elisabetta; E., Orzan; M., Turrini; G., Babighian; E., Arslan

Speech perception tests are an important part of procedures for diagnosing pre-verbal hearing loss. Merely establishing a child's hearing threshold with and without a hearing aid is not sufficient to ensure an adequate evaluation with a view to selecting cases suitable for cochlear implants because it fails to indicate the real benefit obtained from using a conventional hearing aid reliably. Speech perception tests have proved useful not only for patient selection, but also for subsequent evaluation of the efficacy of new hearing aids, such as tactile devices and cochlear implants. In clinical practice, the tests most commonly adopted with small children are: The Auditory Comprehension Test (ACT), Discrimination after Training (DAT), Monosyllable, Trochee, Spondee tests (MTS), Glendonald Auditory Screening Priocedure (GASP), Early Speech Perception Test (ESP), Rather than considering specific results achieved in individual cases, reference is generally made to the four speech perception classes proposed by Moog and Geers of the CID of St. Louis. The purpose of this classification, made on the results obtained with suitably differentiated tests according to the child's age and language ability, is to detect differences in perception of a spoken message in ideal listening conditions. To date, no italian language speech perception test has been designed to establish the assessment of speech perception level in children with profound hearing impairment. We attempted, therefore, to adapt the existing English tests to the Italian language taking into consideration the differences between the two languages. Our attention focused on the ESP test since it can be applied to even very small children (2 years old). The ESP is proposed in a standard version for hearing-impaired children over the age of 6 years and in a simplified version for younger children. The rationale we used for selecting Italian words reflect the rationale established for the original version, but the choice of single words follows different criteria from the original version. In fact, the two languages differ in important linguistic features so that the test can not be not adapted to the Italian language by simply translating the words involved. As currently there is no children's language dictionary in Italian arranged according to age bracket, we chose words used in children and in pre-school reading material.

1992 - Phoniatric aspects of reconstructive laryngectomy [Articolo su rivista]
Genovese, E.; Calearo, C.; Bignardi, I.

1992 - Primary prevention of infantile sensorineural deafness|PREVENZIONE PRIMARIA DELLE IPOACUSIE NEUROSENSORIALI INFANTILI [Articolo su rivista]
Arslan, E.; Genovese, E.

1991 - Hearing Loss Etiolgy in a group of 996 Children [Articolo su rivista]
Arslan, E.; Trevisi, P.; Genovese, E.; Lupi, G.; Prosser, S.

1984 - Hearing aid fitting evaluation in a group of deaf children [Articolo su rivista]
Tartari, M. C.; Genovese, E.; Prosser, S.; Arslan, E.

One hunderd deaf children underwent a clinical evaluation 6 months-2 years after they had been examined by means of electrocochleography. The purpose of this study was to evaluate the long-term effects of the hearing aids on child speech development. Data concerning the use of the hearing aid (age of fitting, daily use, ear mold, gain setting) were collected through a questionnaire which also included information about family, school, rehabilitative program and associated pathologies. The questionnaires were compiled by the authors in cooperation with the child's relatives. Two multiple level scales were designed to assess speech development and comprehension as a result of the phoniatric evaluation. In spite of large differences in the methods and times in which rehabilitation was initiated, the main result of this study is an evident relationship between speech and appropriate amplification. However, the advantage of amplification is frequently reduced by an inappropriate ear mold, or by a concomitant long-lasting middle ear pathology. These results demonstrate the need for a follow-up procedure which can allow the deaf child to take the maximum advantage of the hearing aid.

1984 - Long-term evaluation of language development in profoundly deaf children [Articolo su rivista]
Genovese, E.; Tartari, M. C.; Prosser, S.; Arslan, E.

A group of 100 profoundly deaf children were examined in order to evaluate the influence of the hearing loss on their speech development. Data concerning the speech therapy, as well as peculiar aspects of linguistic performance, were collected through a questionnaire compiled by the authors in cooperation with the children's relatives. The following arguments were considered: gestual vs oral communication, language development, overall comprehension, reading. The oral method had been used in most cases with programs performed by speech therapists. Based on the frequency of the rehabilitative sessions the children could be subdivided into two main groups: those with two or less sessions/week, and those with three or more sessions/week. The second group obtained the highest scores in comprehension and linguistic production. This study proves that a prolonged and close relationship between child and therapist may lead to the best results of any rehabilitative program.