Mucocutaneous leishmaniasis must be included in the differential diagnosis of midline destructive disease: two case reports.

Midline destructive lesions have multiple possible etiologies, which can be grouped into neoplastic, infectious, or vasculitis-associated. The purpose of these case reports and literature review was to highlight the need to include mucocutaneous leishmaniasis in the diagnosis of midfacial lesions in any patient who has lived in Leishmania-endemic areas because this entity meets all of the clinical criteria to be considered a form of midline destructive lesion. We present two cases of mucocutaneous leishmaniasis that occurred in a Bolivian male immigrant and a European male traveler to Panama, in whom lesions were misdiagnosed as different midline destructive lesions with different causes (Wegener, vasculitis, and natural killer or T-cell lymphoma [NKTL]). The conclusion of our work is that all patients with midline destructive lesions should undergo histologic and molecular studies to be evaluated for mucosal leishmaniasis, particularly patients whose clinical history suggests this possibility. In cases of uvular involvement, biopsy of this region might be a possible alternative to nasal biopsy.

[Superior semicircular canal dehiscence syndrome. Embryological and surgical consideration]. / Síndrome de dehiscencia del canal semicircular superior. Aspectos embriológicos y quirúrgicos.

OBJECTIVE: Presenting the first case of superior semicircular canal dehiscence syndrome in the Spanish literature and to establish, using embryological studies, the period in wich superior semicircular canal dehiscence originates. MATERIAL AND METHODS: 52 embryos and foetuses, from 6 mm to foetal maturity, were studied. The case of a patient suffering from superior semicircular canal dehiscence syndrome is presented. RESULTS: The superior semicircular canal and the intracranial space are communicated through bony lacunae, in the period between the 24th and 28th week of foetal development, but this communication is discontinued in the 30th week. Permeability of these lacunae, later in life, could result in the development of superior semicircular canal dehiscence syndrome. The clinical results of the surgical repair of this abnormal communication, in this particular case, using a middle fossa approach and a transmastoid approach is presented. CONCLUSIONS: Superior Semicircular Canal Dehiscence Syndrome could be due to an abnormality in foetal development and its genesis, therefore, could be prenatal. Surgical repair via transmastoid approach is a reasonable alternative treatment to the middle fossa approach.

[Diagnostic criteria and therapy of malignant external otitis]. / Estado de los criterios diagnósticos y de la terapéutica de la otitis externa maligna.

The development of quinolone derivatives has completely changed the treatment and prognosis of malignant external otitis. Two cases are reported and the current diagnostic criteria are reviewed.

[Tuberculous otitis media: a case report]. / Otitis media tuberculosa. A propósito de un caso.

Tuberculosis is endemic in Spain and the primary site is pulmonary in 70% of cases. Extrapulmonary foci have increased in frequency and the incidence of tuberculous middle otitis, which often is difficult to diagnose, is about 0.04%. A case of chronic tuberculous middle otitis is reported.

[Deep cervical infection]. / Infección cervical profunda.

The authors present the evolutive course of three cases of deep cervical infection. A discussion about the influence of the surgical and antibiotical treatment is done.

[Idiopathic facial paralysis. A protocol with trunco encephalic auditory evoked potentials and viral serology]. / Parálisis facial idiopática. Protocolo con PEATE y serologías víricas.

The idiopathic facial is a interesting pathology of unknown etiology, with disputable treatment. The authors propose a diagnostic protocol, in search of a possible relation between this palsy and viral diseases or alteration of eight-cranial nerve conduction.

[Image diagnosis and pleomorphic adenoma]. / Diagnóstico por imagen y adenoma pleomorfo.

We examined the imaging technical findings of 11 benign pleomorphic adenomas of major salivary glands. The imaging technical included sialography, echography, computed tomography and gammagraphy. We compared the diagnostic usefulness of each of these imaging technical. The purpose of this paper is to identify the actual advantages, disadvantages and uses of these diagnostic methods.

[Complications of tonsillectomy. Our experience. Comparison of the dissection and Sluder-Ballenger technics]. / Complicaciones de la amigdalectomía. Nuestra experiencia. Comporación de las técnicas de disección y de Sluder-Ballenger.

One hundred and eighty six operations of tonsillectomy are revised, finding to the haemorrhage like the complication more important and we compare the incidence of this, according to the surgical technic.