[Cervical cysts of second branchial arch. Retrospective study of 14 cases]. / Quistes cervicales de segundo arco branquial: estudio retrospectivo de 14 casos.

Fourteen patients with lateral neck branchial cysts treated over an 18 year term were reviewed to analyze the authors' method of diagnosis and management. The possibility of an embryologic rest in the neck should therefore be kept in mind with all clinically evident neck masses. Histopathological examination revealed that cysts were lined with a stratified squamous epithelium. Computed tomography and fine-needle-aspiration currently are essential diagnostic methods in the study protocol of these lesions. Traditional surgical techniques for the management of branchial remnants rely on simple excision of the structures associated with the sinus tract, with dissection carried out in the plane between the branchial remnant and the normal anatomic structures of the neck. Initial surgery is crucial since the recurrence rate after incomplete surgery can be as high as 22%.

[Cervical necrotizing cellulitis caused by spider bite]. / Celulitis necrosante cervical por picadura de arácnido.

Foremost causes of originating shallow painful inflammations on the neck are: boils, carbuncle or infected dermoid cysts and atheroma. When remembering other possible inflammatory sources in this site we cont with insects bites through scarces in our environment. We report one case of spider's bite (Loxoceles rufecens) originating a necrotic neck cellulitis and remind also the several clinical symptoms of arachnid bites scarce in our environment.

[Granular cell tumor. A lingual case report]. / Tumor de células granulares. A propósito de un caso lingual.

Although the origin of granular cell tumor (GCT) is no totally clarified, a neurogenic source is generally accepted. Some think its forerunners are the Schwann cells. Despite the tongue's localisation is frequently seen, few are the papers dealing with this topic. We report the case of a patient suffering a granular cell tumor of the tongue and profit the opportunity to reconsider the followings items: clinical findings, examination, diagnosis, histology and management and course of these growths. Literature's review of the theme.

[Retroauricular approach to complete obliteration of the external ear canal caused by osteoid osteoma]. / Abordaje retroauricular en la obliteración completa del conducto auditivo externo por un osteoma osteoide.

Osteoid osteoma of the temporal bone is an infrequent benign bone tumor. The suspected diagnosis is based on clinical findings (occasionally pain, cosmetic deformities, repeated external otitis and conductive hearing loss), otoscopy, the radionuclide bone scan, and computerized tomography. Histopathology confirms the diagnosis of osteoma. Pain responds to acetylsalicyclic acid. Treatment is surgical excision by curettage and eburnation of the bone margins using an endaurul approach. We report a complete obliteration of the outer ear canal by an osteoid osteoma in a 32-year-old patient. A postauricular approach was required because of the large size of the tumor.

[Chronic cholesteatomatous otitis media: comparison of otoscopic, computed tomographic and surgical findings]. / Otitis media crónica colesteatomatosa: comparación de la otoscopia y TC frente a los hallazgos quirúrgicos.

A retrospective study was made of 43 patients diagnosed as chronic otitis media, with and without cholestatoma, who were treated with surgical tympanoplasty. Otoscopic and computed tomographic findings were analyzed and correlated with surgical findings in order to evaluate the diagnostic value of scans.

[Therapeutic approach to peritonsillar abscesses]. / Nuestra actitud terapéutica ante el absceso periamigdalino.

The treatment of peritonsillar abscesses is debated. A retrospective study was made of 19 patients diagnosed as peritonsillar abscess who were treated by incision, drainage, and intravenous antibiotics. The surgical, medical and diagnosis factors that affect the management of peritonsillar abscesses are discussed.

[Results of treating cervical metastases of an unknown primary tumor. A report of 29 cases]. / Resultados del tratamiento de las metástasis cervicales de primario no filiado. A propósito de 29 casos.

A retrospective study was made of 29 patients with cervical metastasis of an unknown primary tumor. Sixteen patients received local treatment with surgery and radiotherapy (group A) and 13 patients were treated with induction chemotherapy, surgery and radiotherapy (group B). All patients responded. Local recurrence occurred in 21.4% of group A and 20% of group B. The frequency of distant metastases was similar (18.8% vs 15.4%). The mean survival time of 68 months in group A was longer than the 40 months of group B, and the a 2-year survival rate was 81% in group A and 67% in group B. The 5-year survival was better in group B (56% vs 40%). The primary tumor was identified twice as often in the patients who received only local treatment (group A 37.5% and group B 15.4%). Detection of the primary tumor was the only factor that significantly influenced patient survival.

[Postoperative complication in stapedectomy: excessive introduction of the prothesis in the oval window]. / Complicación postoperatoria en la estapedectomía: excesiva introducción de la prótesis en la ventana oval.

Postoperative failures and complications detected in patients who undergo surgery for otosclerotic disease are not uncommon in stapes surgery. Prosthesis displacement and incus necrosis are the most common findings in review stapedectomy. We report the case of a patient who had tinnitus, vertigo, and non-recovery of air conduction thresholds without neurosensorial lesions after stapes surgery. The suspected diagnosis of excessive introduction of the prosthesis in the oval window was confirmed by computed tomography, which showed the radio-opaque image of the McGee metal prosthesis. The prosthesis replacement and literature review are discussed.

[Evaluation of informed consent in ear, nose, and throat practice]. / Valoración del consentimiento informado en ORL.

The patient has a right to information about his or her disease and therapeutic options. A retrospective study was made of the opinion that 40 patients who underwent ear, nose and throat surgery had of this information. After receiving verbal and written information, they completed a questionnaire. Only 1 patient (2.9%) wanted no information, 100% wanted information about the evolution of the disease without treatment, 20.6% were more alarmed after receiving information, and 41.1% thought that written information was essential.

[Study of Cyfra 21-1 as a new tumor marker for the diagnosis of epidermoid carcinoma of the head and neck]. / Estudio del Cyfra 21-1 como un nuevo marcador tumoral en el diagnóstico del carcinoma epidermoide de cabeza y cuello.

Serum concentrations of Cyfra 21-1, a soluble cytokeratin fragment, were evaluated in 157 healthy patients, 66 patients with benign ear, nose or throat disease, and 102 patients with untreated epidermoid carcinoma of the head and neck. The technique had a sensitivity of 53.9% and specificity of 98.4% for a cutoff value of 1.5 ng/ml. Cyfra 21-1 levels differed significantly with tumor location (p < 0. 005) and tumor stage (p < 0.005), but not with the degree of histological differentiation.

[Bilateral recurrent nerve paralysis secondary to Ludwig's angina]. / Parálisis recurrencial bilateral secundaria a angina de Ludwig.

Although the incidence of Ludwig's angina has diminished, it still occurs. This disease can have life-threatening complications, including deep neck infection and mediastinitis. We report a case of Ludwig's angina with bilateral vocal cord paralysis secondary to cervical spread of infection.

[Care for elderly patients at an ENT clinic. Descriptive study]. / Asistencia a ancianos en una consulta de ORL. Estudio descriptivo.

We report the results of a descriptive one-year study of the disorders encountered in patients over 65 in an ENT clinic. Out of a total of 1,516 patients, 439 were over 65: 57.86% (n = 254) women and 42.14% (n = 185) men. Patients consulted mainly for ear disorders (n = 284, 61.21%). Cerumen obstruction accounted for 29.84% of all new patients. Chronic pharyngitis (n = 58) was the second most frequent complaint and affected 82.8% of women. Malignant tumors were present in 2.2% of new patients.

[Radiotherapy alone versus neo-adjuvant chemotherapy and irradiation in the treatment of carcinoma of the cavum]. / Radioterapia exclusiva frente a quimioterapia neoadyuvante más radioterapia en el tratamiento de los carcinomas de cávum.

Radiation therapy is the usual treatment for nasopharyngeal carcinoma. However, in recent years the use of neoadyuvant chemotherapy in the treatment of local and regionally advanced carcinoma has been investigated. We report the results of a retrospective study of two treatments used in our center. The study included 68 patients: 34 (group A) who received radiotherapy alone and 34 (group B) who received neoadyuvant chemotherapy before radiotherapy. In group A, 70.6% achieved a complete clinical response: 23.5% relapsed: 5 patients presented distant metastases. Survival rates at 5 and 10 years were 53% and 27% respectively; the disease-free survival was 71.4% at 5 years and 54% at 10 years. In group B, the complete clinical response rate to neoadyuvant chemotherapy was 35.3%, which increased to 73.5% when the treatment was complemented with radiotherapy. The relapse rate was 14.7%; the survival rates at 5 and 10 years were 49.5% and 49%, respectively; and the disease-free survival was 77.2% at 5 and 10 years.

[Benign paroxysmal vertigo in childhood]. / Vértigo benigno paroxístico de la infancia.

Benign paroxysmal vertigo of childhood is a clinical disorder that usually begins at age 4. The child's otoneurological examination is normal in the intercrisis and the brief episodes of true vertigo are typical. In this paper we describe six new cases that had a follow-up of at least one year after diagnosis. Only a few of the patients had demonstrated vasomotor migraine, but all the children had a family history of migraine, which supports the hypothesis that this disorder is a migraine equivalent. The pathogenesis may be related with a transitory vascular disturbance that produces ischemia of the vestibular nuclei and pathways, as occurs in other vascular territories during typical migraine. One longer-than-usual episode is reported. Otherwise, the evolution of this condition is favorable.

[Primary health care in otorhinolaryngology. Descriptive study]. / Asistencia primaria en otorrinolaringología. Estudio descriptivo.

We present a one-year study describing the ENT pathology seen in a rural ENT clinic. The study included 1,516 patients whose characteristics are described (age, sex, diagnosis, and others).

[Subcutaneous cervical emphysema secondary to tooth extraction]. / Enfisema cervical subcutáneo secundario a extracción dental.

Cervical emphysema is rare and its diagnosis involves the ENT specialist. A case of cervical subcutaneous emphysema secondary to lower molar extraction is reported. The patient had no signs or symptoms other than cervical emphysema. Simple radiography and CT are recommended for early diagnosis. The etiopathogenic mechanisms of subcutaneous cervical emphysema are reviewed. Recent literature contains few cases of dental origin.

[Dilatation of esophageal strictures with balloon catheter. Safety and effectiveness of balloon dilatation]. / Dilatación de estenosis esofágicas con catéter balón. Seguridad y efectividad de las dilataciones neumáticas.

Radioscopically-guided balloon dilation of esophageal stenosis is an effective and easily performed palliative procedure. Our experience with balloon dilation of esophageal stenosis in 12 patients was reviewed. Every patient underwent 2-5 sessions. Dysphagia disappeared completely in 2 patients. Ten patients had significant improvement. No case of esophageal perforation occurred during balloon dilation.

[Recurrent bilateral paralysis: our 15-year experience]. / Parálisis recurrencial bilateral: nuestra experiencia en quince años.

We report our experience with the treatment of patients with bilateral vocal cord paralysis. The sample was small because the disease is rare. The therapeutic techniques first used were arytenoidopexy using King's technique and Graff-Woodman's arytenoidectomy with cordopexy. Cordectomy was used when other techniques failed. Nine of 11 patients were decannulated successfully. Tracheotomy was maintained in the other 2 for reasons unrelated with the initial picture. Breathing and voice quality were acceptable in all patients. Complications were limited to aspiration pneumonia. Cordectomy was necessary in 3 cases because conservative treatment was insufficient. Although the development of new techniques for treating this problem should continue, classic techniques remain valid. A case of paralysis caused by nitrocuanitin intoxication is reported.