[Blood viscosity profile in rapidly progressive sensorineural hearing loss with positive Western-blot]. / Perfil de la viscosidad sanguínea en la hipoacusia rápidamente progresiva con Western-blot positivo.

OBJECTIVE: To value a possible association between disorders in blood viscosity of patients with rapidly progressive sensorineural hearing loss (RPSHL) of autoimmune origin. PATIENTS AND METHODS: We studied the viscoelastic properties of blood in 43 subjects bearing of RPSHL and a positive Western-blot for anticochlear antibodies: whole blood viscosity (WBV) at different shear rates and erythrocyte filterability (EF). These results were related to hearing loss initially detected and recovery average one year later from steroid therapy. RESULTS: Just WBV at 230 sec(-1) shear rate was significatively higher in cases than in controls (p < 0.01). Hearing recovery degree correlated in an statistically way to increased values of EF (p < 0.01). There was no relation between initial hearing loss level and any rheology parameter. CONCLUSIONS: Autoimmune RPSHL does not show a pathophysiology mechanism associated to blood hyperviscosity. So, rheoactive therapies as plasmapheresis warrant no clinical improvement.

[Otologic determining factors on infra-red tympanic thermometry in children]. / Condicionantes otológicos en termometría timpánica con infrarrojos en niños.

OBJECTIVE: To evaluate the influence of different otoscopic findings on body thermometry in children using an infra-red tympanic thermometer. PATIENTS AND METHODS: Body temperature was measured on healthy right and left ear canals with Thermoscan systems. Moreover, it was determined on children with altered otoscopy, companng to normal contralateral ear. To assess its diagnostic fiability, accuracy ratios were calculated in different temperatures. RESULTS: Temperature measured bilaterally did not offer differences, and intra/interassay variation ratios were always less than 0.34%. Acute otitis externa increased tympanic thermometry a mean of 0.36 degrees C (p < 0.001), and cerumen and previously radical surgery decreased a mean of 0.62 and 0.53 degrees C, respectively (p < 0.001). CONCLUSIONS: The conditions mentioned before modify body thermometry if measured by infra-red tympanic thermometer. So, this system must be avoided in these circumstances. Otitis media, fluid in middle ear, tympanic perforation and ventilation tubes did not modify thermometric results.

[Atypical Cogan syndrome. Clinical and laboratory spectrum. Report of 2 cases]. / Síndrome atípico de Cogan. Espectro clínico y de laboratorio. Presentación de dos casos.

We show two atypical Cogan's syndrome cases in forty-seven and fifty-six years old individuals. Characteristical symptoms of the syndrome were detected in both (interstitial keratitis, sensorineural deafness and vestibular dysfunction), but they could be considered as unusual because of the association of systematic symptoms and an onset with hearing loss. In both cases there was an increase in erythrosedimentation rate and immunoglobulins levels, as well as high titles for rheumatoid factor and non-specific autoantibodies. By means of a Western-blot technique, several chochlear antibodies with distinct molecular weight were detected, but the 68 KD appeared in both. Metil-prednisolone treatment did not avoid ocular and auditive reactivation in ne of the patients.

[Non-interventional study on blood filterability changes in the clinical onset of sensorineural sudden deafness]. / Estudio no intervencionista de las alteraciones de la filtrabilidad sanguínea en el debut clínico de sorderas súbitas neurosensoriales.

An hemorheological study on whole blood filterability (WBF) was done in eleven patients bearing of sudden deafness, in a continuous way, even before clinical onset. This evaluation is making usually in animal models, but not in humans. Independently of clinical diagnosis of each patient (two cases of diabetes mellitus, one of ulcerative colitis, systemic lupus erythematosus, systemic hypertension, after blood transfusion, sepsis with disseminated intravascular coagulation, upper respiratory ways infection, after surgery, and two healthy individuals), all of them showed a decreased WBF when hearing loss appeared (from 19.97 +/- 1.15 microliters/sec to 16.87 +/- 1.21 microliters/sec). This value normalized at six or seven days from the onset in cases with some kind of hearing recovery (18.83 +/- 1.01 microliters/sec, n = 4), but did not in those with no improvement even at thirty days (17.39 +/- 0.77 microliters/sec, n = 7). There were differences in WBF values of patients with and without hearing recovery in determinations at seven and thirty days from onset. Decrease in WBF accompanies this hearing disorder and confirms the cochlear microcirculation susceptibility to the impairment of blood viscoelastic properties.

[True double dermoid cyst of the tongue]. / Doble quiste dermoide verdadero de lengua.

Dermoid cysts into ENT zone are specially infrequent--just the 7% of the organism--, and extremely rare if are located in the tongue. They are usually detected as midline acute swelling, and produce swallowing, speech and sleep disorders at neonatal period because of their congenital character. We present an eleven-year-old boy admitted at our Hospital bearing a submandibular and oral swelling, and dysphagia with odynophagia, finally diagnosed as an intralingual double dermoid cyst of the anterior two thirds. The history of frenulectomy due to a presumed ankyloglossia, the previous presence of a dorsal tumour in tongue with a difficult phonetic articulation, and the midline location of lesions made us to suspect on dermoid cysts of the tongue. Complete surgical excision were diagnostic and therapeutic, and the child recovered totally their mastication, swallowing and speech abilities. Pathophysiological aspects, treatment and the atypical course of the case are discussed.

[Inner ear autoimmune disorder. Cogan's syndrome]. / Un caso pediátrico de trastorno autoinmune del oído interno (síndrome de Cogan).

We present a case of Cogan's syndrome (interstitial keratitis, rapidly evolving sensorineural hearing loss and vestibular dysfunction) in a 12-year-old girl. Diagnosis was made by clinical and audiologic examination as well as by nonspecific laboratory findings (increased erythrosedimentation rate and positive IgA and IgM rheumatoid factor titers and antineutrophil cytoplasmic autoantibodies). Detection of specific autoantibodies against cochlear antigenic epitopes with a molecular weight of 68 kDa by Western-blot assay confirmed an organ-specific autoimmune mechanism. Therapy with deflazacort 1 mg/kg per day 3 three weeks decreasing progressively thereafter was successful and the patient remains symptom-free.

[Detection tonsillar pathology by superoxide dismutase levels. Comparative study of surgical indications for tonsillectomy]. / Detección de patología amigdalar mediante los niveles de superóxido dismutasa. Estudio comparativo por indicaciones quirúrgicas de amigdalectomía.

If oxygen-derived free radicals are considered the definitive cause of tonsillar damage after infection, it seems reasonable that scavenger antioxidants levels could be used as a detector of tissue impairment. So, superoxide dismutase (SOD) amounts were measured in palatine tonsils and peripheral blood on subjects bearing of hypertrophy without infection (H, n = 83), recurrent tonsillitis (RA, n = 75), and peritonsillar abscess (PA, n = 12). SOD levels in both tonsillar cultures supernatants and peripheral blood erythrocytes were detected progressively increased in groups with H, RA and PA, which were statistically significative (ANOVA-test; p < 0.001). A significative correlation between tissue and blood was observed for all the groups. We can conclude that SOD concentration in palatine tonsils and/or peripheral blood increases proportionally to infections incidence, which allows detecting patients with functional damage, and recommending objectively tonsillectomy or at least monitoring clinical response for a therapy. Practical use and results obtained from comparison to tonsil biopsies are discussed.