Critical analysis of robotic surgery for laryngeal tumours.

In recent years, transoral robotic surgery (TORS) with the Da Vinci robot has been used for the removal of laryngeal cancers with the objective to improve functional and aesthetic outcomes without worsening survival. The advantages of TORS are described in this article. However, its disadvantages, mainly high cost amongst others, do not make robotic surgery the current treatment of choice for laryngeal tumours; transoral laser surgery is superior in most cases. Major technical improvements are expected. Smaller, more ergonomic, new-generation robots better adapted to the head and neck will probably be available in the near future.

Acute-phase inflammatory response in idiopathic sudden deafness: pathogenic implications.

The acute-phase inflammatory response in the peripheral bloodstream can be an expression of transient cerebral ischaemia in idiopathic sudden deafness. For this, a neurological and otorhinolaryngological examination of each patient, performing tests on audiometry, and tympanometry, haemogram, and cranial magnetic resonance were performed. The acute-phase inflammatory response manifests as an increased neutrophil/lymphocyte ratio that is detected 48-72 hours after the appearance of sudden deafness. This study shows that there is an acute-phase response in the peripheral bloodstream with an increased neutrophil/lymphocyte ratio as an expression of an inflammatory process that can be caused by transient cerebral ischaemia in sudden deafness. In addition, the increased neutrophil/lymphocyte ratio can rule out a viral origin of sudden deafness, since a viral infection lowers the neutrophil count and increases the lymphocyte count, thus reducing the neutrophil/lymphocyte ratio. These findings aid in understanding the pathogenic mechanisms involved in sudden deafness and offer better treatment to the patient.

[Tinnitus measurement with conventional audiometer versus high-frequency audiometer]. / Medición de acúfenos con audiómetro convencional versus audiómetro de alta frecuencia.

INTRODUCTION AND OBJECTIVES: Determinations of the psychoacoustic characteristics of tinnitus (frequency and intensity) are valid for diagnosis, treatment, monitoring and research purposes. The aim of this work is to compare the frequency of the tinnitus measured with a standard audiometer and a high frequency audiometer. METHODS: We used a conventional audiometer (frequency range: 125-12,000 Hz) and a high-frequency audiometer (frequency range: 125-18,000 Hz) to measure the frequency and intensity of tinnitus in 47 patients with tinnitus as a continuous ringing. RESULTS: We found statistically-significant differences between the determination of the frequency of tinnitus made with conventional and high-frequency audiometers, as well as a correlation between high-frequency tinnitus and distress expressed by patients. CONCLUSIONS: 1) The frequency of tinnitus determined by high-frequency audiometer is greater than the frequency determined by conventional audiometer; 2) the higher the frequency of tinnitus, the more discomfort the patient manifests; and 3) there is no relationship between the intensity and discomfort caused by tinnitus.

[Sound therapy in sudden deafness]. / Terapia sonora en sordera súbita.

INTRODUCTION AND GOALS: Idiopathic sudden sensorineural hearing loss is a hearing disorder of unknown cause. The spontaneous recovery rate ranges from 50 to 75% of the patients. Scientific experiments on animals support the present study in patients with sudden deafness treated with sounds. PATIENTS AND METHODS: During the period 2003-2009, patients with idiopathic sudden sensorineural hearing loss were administered steroids, piracetam and antioxidants, together with the addition of sounds by means of music and words. RESULTS: Comparing the results of patients treated with medication (n=65) and those treated with medication and sounds (n=67), it was observed that patients treated with medication and sounds had higher recovery. Within the group of patients treated with medication and sounds, 25 (37%) experienced complete recovery, 28 (42%) good recovery, 11 (16%) slight recovery and 3 (5%) poor or no recovery. CONCLUSION: The patients who recovered more than half of their audition accounted for 54% in the group treated with medication and for 79% in the group of patients receiving medication and sounds. Auditory recuperation showed no alterations, at least up to 12 months after therapy.

Calpain 10 gene and laryngeal cancer: a survival analysis.

BACKGROUND: Laryngeal carcinoma is a common upper respiratory tract cancer with different environmental and genetic factors involved in its development. Calpains are Ca2+-dependent cysteine proteases that modulate cellular function. A novel association between calpain 10 (CAPN10) haplotypes and laryngeal cancer has been found recently. Therefore, the goal of this study was to analyze the contribution of CAPN10 alleles to laryngeal cancer survival. METHODS: Patients were recruited from southern Spain. Genotypes were determined using pyrosequencing technology. We analyzed CAPN10 UCSNP-44, UCSNP-43, UCSNP-19, and UCSNP-63 allelic distributions in 199 patients with unrelated laryngeal cancer. Survival curves were calculated from the date of the intervention to the date of death. Multivariate analyses were done using the Cox proportional risk model. RESULTS: UCSNP-19, UCSNP-43, and UCSNP-44 were unrelated to survival in both univariate and multivariate analyses. However, for UCSNP-63 genotype 12 a significant relationship was observed in multivariate analysis (hazard ratio [HR] = 2.73; 95% confidence interval [CI], 1.21-6.20). CONCLUSION: CAPN10 UCSNP-63 genotype 12 seems to be related with a worse prognosis in laryngeal cancer.