[Otolaryngologist approuch of tumors of mid-line location. A case study]. / Actitud del otorrinolaringólogo frente a los tumores congénitos de la línea media. Presentación de un caso.

Congenital tumors of midline location are infrequent. Their highest incidence is before 3 years old. They can be localized on the surface of the skin or have a connection to the central nervous system. The diagnosis can be established by clinical examination, image study and biopsy. The present study describes the clinical case of a six year old boy with a fast growing swelling, located close to the inner orbit of the right eye and off the mid-nasal line. The diagnosis was established by TC (computerized axial tomography) as well as FNAB (fine needle aspiration biopsy), concluding it was a dermoid cyst. Literature was revised focusing our attention on the way of appearance, differential diagnosis and possibilities of treatment for these tumors.

[Achondroplasia, judgement about the upper airway approach]. / Acondroplasia, juicio crítico sobre el manejo de la vía aérea alta.

Achondroplasia is an hereditary disorder which belongs to the group of illnesses called condristrophic or anomalies in the ossification of the cartilages. Its main characteristic is a series of irregularities in the skeleton, but the most outstanding characteristic is the short height. The diagnosis of achondroplasia is achieved by means of a combination of clinical and radiological characteristics. The 99% of the cases is diagnosticated by the genetic study. Because of its multiple deformities not only in the skull and cervical but also thoracic, usually in adults, it means a challenge for the use of upper airway when it's requiered. To choose the fibreoptics or orotraqueal intubation or the tracheotomy are very complex processes in these cases. We do a revision about the ENT aspects to be considered in the patients of achondroplasia

[Glomic tumour and its diagnostic interest. A clinical case]. / Tumor glómico y su interés diagnóstico. Caso clínico.

Paragangliomas are tumours derived from cells in the neural crest that are normally benign, and have low incidence and slow growth rates. We report the clinical case of a 61 year-old female studied at the ENT's surgery suffering from a left side tinnitus with four years of evolution. Complementary explorations were carried out such as an audiogram, computerised axial tomography scans and angioresonance. In spite of the high diagnosis suspection, it is late confirmed, because it was not visible in the radiographic studies. We revised the literature referring this pathology.

[Upper dyspnea in nursing baby. Diagnostic and clinic treatment]. / Disnea alta en el lactante. Manejo diagnóstico y clínico.

We detail here the clinical case of a 22 month old child who was referred to our department because of recurring episodes of upper dyspnea and barking cough since he was 3 months old. The Pediatric Department suspected laryngeal stenosis or laryngomalacia and asked for confirmation of this. The ENT examination including nasofibrolaryngoscopy was normal. A computerised axial tomography (CAT) was carried out, as well as a magnetic resonance of the neck, both eliminating possible pathologies. Having tried several treatments, we prescribed empirical treatment with proton pump inhibitors, and to our surprise the improvement was spectacular. We have carried out a review of literature about gastroesophageal reflux, its manifestations, diagnosis and treatment.

[Revision of the immobile ciliary syndrome on the ENT speciality's point of view]. / Revisión y puesta a punto del síndrome de los cilios inmóviles, visto desde la otorrinolaringología.

Primary ciliary dyskinesia is a disorder characterized by the presence of recurrent infections of the superior and inferior respiratory tract. It is caused by a recessive autosomic genetic disorder. Its diagnosis is often given late, because other diagnostic possibilities are thought of first. It is common to find many previous visits to the ENT specialist in a medical record. The final diagnosis is given by electronic microscopy observing the ciliary defect, which is frequently due to the absence or anomalies of dineine in the arms and in the structures of the microtubule pairs responsible of movement. The mucus to study is usually obtained from the inferior nasal concha. In the rest of cases the mucus of the tracheobronchial apparatus is only studied if a fibrobronchoscopy is necesary in order to evaluate bronchial compromise or when the nasal sample is not sufficient. The ENT specialist must be alert in order to be able to think of this entity. The genetic advice is the best way to prevent it.

[Painful disorder and vertigo related to the ear. Frequent referral to the ENT specialist]. / Trastorno doloroso y vértigo referido al oido. Derivacion frecuente al ORL.

We revise the temporomandibular dysfunction or myofacial painful syndrome, a clinical entity that shows a high prevalence at the ear, nose and throat (ENT) specialist's surgery. They are polysymptomatic patients seen at the ENT , which are sent by the Internal Medicine and family doctors. As symptoms the patients present vertiginous feeling, tinnitus and/or deafness. We discuss the concept, the ethiopathogenia, diagnosis and the treatment of this syndrome. For the ENT specialist it is a challenge to choose the most appropriate type of treatment in order to obtain a satisfying result. In spite of the great amount of issues referring to this subject, there are still controversies regarding the orientation of the patients and the type of treatment to use.

[Revision of a complicated acute media otitis in a regional hospital. Our experience in 10 years]. / Revision de las otitis medias agudas complicadas en un hospital comarcal. Nuestra experiencia en 10 años.

Complications due to acute otitis media are still a cause of hospitalization on paediatric population. We have revised the cases that have been diagnosed in our hospital in a period of 10 years. There were 12 patients between 1 and 38 years of age. The most frequent complication was acute mastoiditis, with a total of 9 patients. The most frecuent symptom was fever and retroauricular edema. We analysed variables such as age, sex, main symptom, physical exploration, extrahospitalary treatment, laboratory and radiological findings, complications, hospital treatment, (medical and/or surgical and kind of operation) and mean hospitalary stay.

[Acute obstructive nasal syndrome as expression of infectious mononucleosis. A case report]. / Síndrome obstructivo nasal agudo como manifestación de una mononucleosis infecciosa. A propósito de un caso.

The infectious mononucleosis (IM) is a disease which mainly affects people between 15 and 24 years old. We present a case of a men, of 42 years, who has an infectious mononucleosis localized in the nasopharynx area, as its first and unique feature. This patient was admitted at hospital for an urgent treatment. We refer the clinical symptoms, diagnose, main complications and treatment of the condition.

[Sudden hearing loss. Clinical case]. / Hipoacusia súbita. Caso clínico.

In spite of the advance in the diagnose and treatment of sudden hearing loss and specially in the autoimmune sensorineural hearing loss, it is on the field of investigation to fix a specific mark for the latter allness. We refer the diagnostic and therapeutic use of sudden hearing loss and the autoimmune sensorial hearing loss.

[Elective mastoidectomy with reconstruction of the posterior wall or filling of mastoid cavity. Results]. / Mastoidectomía a demanda con reconstrucción de pared posterior o relleno de cavidad mastoidea. Sus resultados.

From the 80's and facing the different approaches available to asses which one offered more benefits between all of them, the surgery to the demand has its place. The objective of this work is to determine the audio-surgical results in the patients with aticomastoidectomy to demand with reconstruction of later wall or stuffing of the mastoid cavity, and to show the results three years later. A prospective and descriptive study in 22 patients who underwent a mastoidectomy to demand using outologous cartilage for the reconstruction of the later wall, and bone powder obtained from the surgical drilling to fill up the mastoid cavity.