Trend changes in the incidence of benign parotid tumours in the last 30 years in a Spanish population.

PURPOSE: To study the demographics and clinical characteristics of benign parotid tumours, focusing on the evolution of the incidence of Warthin tumour (WT) in recent years. METHODS: A retrospective observational study is designed of patients diagnosed with a benign parotid tumour in a single tertiary hospital centre, from 1994 to 2021. The evaluation of the relationship between the different variables, and the changes in tumour incidence, is carried out using an analysis of standardized residuals. RESULTS: The study evaluated 279 patients, and the total of benign parotid tumours was 291. The most frequent type of tumour was pleomorphic adenoma (PA) (52.7%), followed by WT (37.6%). WT was more frequent in men (79%), and PA in women (55.8%). Smoking history is significantly high in patients with WT (83%), as well as mid-age, compared to PA. CONCLUSIONS: It seems to be an increase in the proportion of WT compared to PA in recent years. These changes can be concerning tobacco use and older patients at diagnosis in our series.

Extended phenotype and clinical subgroups in unilateral Meniere disease: A cross-sectional study with cluster analysis.

OBJECTIVES: To define clinical subgroups by cluster analysis in patients with unilateral Meniere disease (MD) and to compare them with the clinical subgroups found in bilateral MD. DESIGN: A cross-sectional study with a two-step cluster analysis. SETTINGS: A tertiary referral multicenter study. PARTICIPANTS: Nine hundred and eighty-eight adult patients with unilateral MD. MAIN OUTCOME MEASURES: best predictors to define clinical subgroups with potential different aetiologies. RESULTS: We established five clusters in unilateral MD. Group 1 is the most frequently found, includes 53% of patients, and it is defined as the sporadic, classic MD without migraine and without autoimmune disorder (AD). Group 2 is found in 8% of patients, and it is defined by hearing loss, which antedates the vertigo episodes by months or years (delayed MD), without migraine or AD in most of cases. Group 3 involves 13% of patients, and it is considered familial MD, while group 4, which includes 15% of patients, is linked to the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by a comorbid AD. We found significant differences in the distribution of AD in clusters 3, 4 and 5 between patients with uni- and bilateral MD. CONCLUSIONS: Cluster analysis defines clinical subgroups in MD, and it extends the phenotype beyond audiovestibular symptoms. This classification will help to improve the phenotyping in MD and facilitate the selection of patients for randomised clinical trials.

[Intratympanic gentamicin in patients with Ménière's disease: analysis of our protocol]. / Gentamicina intratimpánica para la enfermedad de Ménière: análisis de la técnica.

OBJECTIVE: The aim of this paper is to analyze the peculiarities of a protocol for treatment with intratympanic gentamicin in patients with Ménière's disease. MATERIAL AND METHODS: 71 patients with unilateral disabling Ménière's disease were followed for a period longer than two years after concluding the treatment. AAO-HNS criteria for reporting treatment results was followed. Gentamicin was applied weekly until of symptoms or signs of vestibular hypofunction were noticed. RESULTS: Control of vertigo was obtained in 83% of the patients while in 24% a second course was needed beacuse of vertigo recurrence. 66% of the patients developed a typical syndrome of unilateral vestibular hypofunction in the ear treated. CONCLUSIONS: Ending weekly injections of gentamicin for the treatment of patients with Ménière's disease when signs of vestibular hypofunction appear warrants a control of vertigo similar to that obtained in other series.

[Analysis of the interaction between visual and vestibular influence in postural control]. / Análisis de la interacción visuo-vestibular y la influencia visual en el control postural.

INTRODUCTION: Postural control depends on a coordinate function of the visual, somatosensory and vestibular systems. A correct analysis of each of them is necessary, in order to obtain an adequate postural evaluation. METHODS: A normal and a pathological vestibular group of subjects are study. A dynamometric platform studied was performed for every subject in both groups. A scalogram, the centre of pressure variation velocity, and the area, were the parameters analyzed. RESULTS: In both groups, parameters showed higher values when propioceptive and visual system were altered. A pattern of visual dependence was identified in both groups. The scalogram in the normal group showed a minimal centre of pressure variation. In contrast, the pathological group showed a major variation, with differences depending on the compensation status. CONCLUSIONS: Our study protocol with posturography is an adequate instrument of postural evaluation, which discriminates the visual dependence and aids to evaluate the compensation.

Gentamicina intratimpánica para la enfermedad de Ménière: análisis de la técnica / Intratympanic gentamicin in patients with Ménière's disease: analysis of our protocol

Objetivo: Estudiar las características y los resultados de un protocolo de tratamiento con gentamicina intratimpánica para la Enfermedad de Ménière. Material y métodos: Se estudiaron 71 con enfermedad de Ménière unilateral seguidos por un período superior a 2 años después de finalizado el tratamiento. Se utilizaron los criterios de la AAO-HNS para el diagnóstico y seguimiento de estos pacientes. La gentamicina se aplicó hasta la aparición de síntomas o signos de hipofunción vestibular unilateral. Resultados: Se obtuvo un control del vértigo en el 83 por ciento de los enfermos si bien en un 24 por ciento fue necesario repetir el tratamiento por recurrencia de los síntomas. El 66 por ciento de los pacientes presentaron un cuadro clínico, vestíbulo-espinal y oculomotor típico de la desaferentización periférica unilateral aguda. Conclusiones: El protocolo de tratamiento con gentamicina intratimpánica resulta eficaz en el control de los síntomas siendo comparable a otras series de tratamiento a dosis única o semanales también (AU)

OBJECTIVE: The aim of this paper is to analyze the peculiarities of a protocol for treatment with intratympanic gentamicin in patients with Ménière's disease. MATERIAL AND METHODS: 71 patients with unilateral disabling Ménière's disease were followed for a period longer than two years after concluding the treatment. AAO-HNS criteria for reporting treatment results was followed. Gentamicin was applied weekly until of symptoms or signs of vestibular hypofunction were noticed. RESULTS: Control of vertigo was obtained in 83% of the patients while in 24% a second course was needed beacuse of vertigo recurrence. 66% of the patients developed a typical syndrome of unilateral vestibular hypofunction in the ear treated. CONCLUSIONS: Ending weekly injections of gentamicin for the treatment of patients with Ménière's disease when signs of vestibular hypofunction appear warrants a control of vertigo similar to that obtained in other series (AU)

Análisis de la interacción visuo-vestibular y la influencia visual en el control postural / Analysis of the interaction between visual and vestibular influence in postural control

Introducción: El control postural depende de la función coordinada del sistema visual, somatosensorial y vestibular. Es necesario el estudio de cada uno de los tres sistemas para una correcta valoración del equilibrio. Material y métodos: Se estudia un grupo de sujetos normales y otro con patología vestibular. Cada sujeto fue objeto de un estudio mediante una plataforma dinamométrica. Se obtuvo el valor de la velocidad media, área media recorrida de la variación del centro de presiones y un escalograma. Resultados: En ambos grupos, los parámetros estudiados mostraron valores mayores cuando el sistema propioceptivo y visual era alterado. En ambos grupos se identificó el patrón de dependencia visual. El escalograma obtenido en el grupo normal, muestra una mínima variación del centro de presiones, mientras que en el patológico, existe una mayor intensidad de la variación del centro de presiones con diferencias según el grado de compensación. Conclusiones: Nuestro protocolo de estudio con posturografía es un instrumento adecuado para la valoración del equilibrio, que discrimina el patrón de dependencia visual y ayuda a valorar la compensación (AU)

INTRODUCTION: Postural control depends on a coordinate function of the visual, somatosensory and vestibular systems. A correct analysis of each of them is necessary, in order to obtain an adequate postural evaluation. METHODS: A normal and a pathological vestibular group of subjects are study. A dynamometric platform studied was performed for every subject in both groups. A scalogram, the centre of pressure variation velocity, and the area, were the parameters analyzed. RESULTS: In both groups, parameters showed higher values when propioceptive and visual system were altered. A pattern of visual dependence was identified in both groups. The scalogram in the normal group showed a minimal centre of pressure variation. In contrast, the pathological group showed a major variation, with differences depending on the compensation status. CONCLUSIONS: Our study protocol with posturography is an adequate instrument of postural evaluation, which discriminates the visual dependence and aids to evaluate the compensation (AU)