[Cup-to-disk ratio asymmetry: diagnostic value in glaucoma]. / Asimetría papilar: valor diagnóstico en el glaucoma.

PURPOSE: To assess visual field abnormalities in suspected glaucoma patients showing evident asymmetry in cup-to-disk ratio. MATERIAL AND METHOD: Twenty two hypertensive eyes in 11 subjects evidencing lateral differences in cup-to-disk ratio of more than 2/10 were included in the study. Conventional and short wavelength automated perimetry (SWAP) was performed with a Humphrey field analyser. A retinal nerve fiber layer (RNFL) study was also performed. RESULTS: Differences in IOP were 1.23 mmHg (p<0.05). No differences were evidenced in conventional automated perimetry between both eyes. Average sensitivity (SWAP) showed significantly lower (p<0.05) in those ayes with greater cup-to-disk ratio. RNFL showed a higher rate of defects in eyes with a higher cup-to-disk ratio. CONCLUSION: Lateral differences in cup-to-disk ratio indicate structural glaucomatous damage which is related to IOP levels. Associated functional loss was evidenced with SWAP (Arch Soc Esp Oftalmol 2002; 77: 17-22).

[Immunohistochemical markers of cell proliferation in laryngeal carcinoma]. / Marcadores inmunohistoquímicos de proliferación celular en el carcinoma de laringe.

Although several clinicopathological factors may contribute to the prognosis of laryngeal carcinoma, these factors are still uncertain because the carcinogenesis process and malignant behavior are not well known. Immunohistochemical methods using two important markers, PCNA and Ki67 antigen, were used to assess proliferative activity in malignant laryngeal lesions. We studied the correlation between expression of these markers and clinical factors in 72 patients with carcinoma of the larynx: age, sex, occupation, smoking, alcohol consumption, marital status, etc. We also analyzed other known biological and histopathological prognostic factors (tumor stage, histological grade, lymph node metastases, and local invasion). PCNA and Ki-67 expression differed significantly in relation to histological grade and lymph node involvement. No associations were seen between the expression of PCNA and Ki-67 antigens and other study parameters.

[Malignant melanoma of the middle ear, a rare site]. / Melanoma maligno de oído medio, una rara localización.

Melanomas of upper airway tract constitute around 1% of the total melanomas of head and neck. It's for this reason we cannot forget their location in middle ear, although it is truly rare, and we have only found three cases published in literature. We report a patient of 75 years old, who went to our hospital with otorrhea of two months of evolution, with subjective sensation of deafness. In the exploration ENT a bleeding neoformation was observed by otoscopy, which occupied all external auditory canal. The biopsy of this neoformation was informed as malignant neoplasm. These cells show a little cytoplasmic melanotic pigment and were positive to the tinction with Masson Fontana, as well as to the immunohistochemical antibodies S-100 and HMB-45. These antibodies are specific of malignant melanoma. We had a low opinion of surgical treatment because the affectation of the temporal bone and the size of melanoma. Because of badly prognosis, our patient died six months after the diagnosis.

[Effectiveness of tonsillectomy, evaluated by acoustic rhinometry]. / Eficacia de la adenoidectomía evaluada mediante rinometría acústica.

Hypertrophy adenoid commonest cause of nasal obstruction in paediatrics. The morbility can be try alteration in the respiratory physiology, as well as in the face development and function of the middle ear. We used the acoustic rhinometry to evaluate the surgical results of the adenoidectomy in children with hypertrophy adenoid, compiling the data on their clinic, and correlating them as well with the rhinometric results. The acoustic rhinometry is a relatively new method of exploration of the nasal cavity. We obtain space measures that are going to allow to us to prove it. These measures are the cross-sectional areas and volumes registered in the nasal cavity when this cavity is divided longitudinally in two zones, the previous one until 32 mm measured from the narina, and the later one to 64 mm from the same point. For this study we have taken 45 patients with hypertrophied adenoids. We have made measurements pre and post surgery. Our results show a clear gain in areas as in volumes after surgery and also show the utility of the acoustic rhinometry like method of exploration at the time of quantifying the morphometric alterations of the nasal cavity.