[PTHi value in the surgical treatment of hyperparathyroidism]. / Valoración de la PTHi en el tratamiento quirúrgico del hiperparatiroidismo.

The prevalence of hyperparathyroidism as increased in the last 20 years due to a longer number of biochemical determinations, in which we observe in many cases hipercalcemia by casualty. The simptomatology of the primary hyperparathyroidism is very subtile and sometimes none in an 80% of the patients. Between november 1996 and march 2003 we have operated 55 parathyroidectomies. 36 patients (65,4%) had primary hyperparathyroidism, 16 (29,1%) secondary hyperparathyroidism and the rest (5,4%) tertiary hyperparathyroidism. Our hospital has a device of rapid detection of the parathyroid hormone level since february 2000, allowing us its satisfactory intraoperative determination in few minutes, evaluating the decrease to values inferior to the half of its basal level.

[Parapharyngeal abscess secondary to peritonsillar abscess in childhood]. / Absceso parafaríngeo secundario a un absceso periamigdalino en la infancia.

We report a case of parapharyngeal abscess in a five-years-old girl, secondary to a local extension of a peritonsillar abscess. The typical signs of peritonsillar abscess, medially displaced tonsil and displacement of the uvula toward the opposite side, were either less pronounced than usual. In this case, with parapharyngeal involvement, the treatment was abscess tonsillectomy under intravenous anti-.

[A prolonged case of intractable sneezing. Pathophysiological hypothesis]. / Un prolongado caso de estornudo incoercible. Hipótesis fisiopatológica.

A 13-year-old boy sneezed paroxysmally and continuously, day and night, for 18 days. Sneezing limited his daily activities and motivated hospital admission. Pediatric clinical examination and all other immunologic, otorhinolaryngologic, pneumologic, neurologic, radiologic, and psychiatric studies were normal. There was no response to treatment with antihistamines, corticoids, or anti-convulsants, which obscured the diagnosis. Definitively effective treatment and its implications in the pathophysiology of sneezing are discussed.

[Diphtheria and Renaissance Spanish physicians]. / La difteria y los médicos españoles del renacimiento.

Along the history of medicine, diphtheria has been the cause of many deadly epidemics. Up to the incorporation of microbiology in medicine and the definition of diphtheria provided by Bretonneau in 1826, this disease was studied with all types of sore throut into the galenic system. Spanish physicians in Renaissance started the way to its systematisation, taking it off the rest of sore throat types, with other laryngeal diseases, as it was known later as "croup", giving it the name of "garrotillo". They were the first to describe some important questions about this disease, as the specificity of the diphtheric pseudomembranes, the ineffective potential of salivary drops and the palsy of the soft palate.

[Clinical study on the ototoxicity of cisplatin with distortion products]. / Estudio clínico de la ototoxicidad del cisplatino con productos de distorsión.

Distortion products are an objective method of hearing assessment that provides a rapid way to evaluate the functional status of the cochlea, so they are interesting for monitoring drug ototoxicity. We studied 50 ears from patients who received an ototoxic drug, cisplatin. Two consecutive measurements were made using distortion products 2f1-f2, before and after taking the ototoxic agent. We observed a significant reduction in the amplitudes of the DP-grams. At the same time, we evaluated the influence of previous sensorineural hearing loss on DP-grams, dividing the patients into two groups: normal hearing and sensorineural hearing loss. All these patients were evaluated at the same time by conventional audiometry in order to compare the effect of cisplatin on both tests. We conclude that cisplatin produced little effect on audiometric thresholds and an evident effect on the amplitude of distortion products.

[Monitoring drug ototoxicity with distortion products]. / Monitorización de la ototoxicidad por fármacos con productos de distorsión.

Distortion products are currently considered an objective method for rapidly evaluating the functional status of the cochlea, which is interesting for the monitoring of drug ototoxicity. We studied 40 ears from patients who had received an ototoxic drug, tobramycin. Two consecutive measurements were made using distortion products 2f1-f2, before and after taking the ototoxic agent. A significant reduction was observed in the amplitudes of the DP-grams. At the same time, we evaluated the influence of previous hearing loss on the DP-grams and divided the patients into two groups: normal hearing and sensorineural hearing loss. Patients were evaluated at the same time by conventional audiometry to compare the effect of tobramycin on both tests. To conclude, tobramycin had little effect on audiometric thresholds, but produced an evident change in the amplitude of the distortion products.

[Angiosarcoma of the outer ear. A case report]. / Angiosarcoma de pabellón auricular. A propósito de un caso.

Angiosarcoma (AS) is one of the rarest forms of soft tissue neoplasm. They are considered highly aggressive tumors with a poor prognosis. They range from highly differentiated tumors resembling hemangiomas to anaplastic tumors that are difficult to distinguish from carcinomas. Clinically, the appearance of these lesions varies, so confusion may arise from an initially benign appearance. AS comprise less than 1% of all sarcomas. In these patients, tumor size is an important predictor of survival. In our case, the tumor was located in the outer ear and the patient was treated with surgery, radiotherapy (65 Gy), and chemotherapy (adriamycin). A recurrence one year later was treated with salvage surgery and external carotid artery ligature to control abundant hemorrhage.

[Surgical treatment of primary hyperparathyroidism. A descriptive analysis]. / Tratamiento quirúrgico del hiperparatiroidismo primario. Estudio descriptivo.

In the last decades the primary hyperparthyroidism has become a common disease, often diagnosed by biochemical chance. The Elche General Hospital Department of Otorhinolaryngology has performed 55 parathyroidectomies between November 1996 and March 2003. Thirty-six cases (65.4%) were diagnosed as primary hyperparathyroidism. This disease usually has few symptoms. Since February 2000, Elche Hospital has available a device for quick appraisal of parathormone rate, allowing us in a few minutes to determine it and with the patient still in the operating theatre. The surgery results were: 25 solitary adenomas, 6 double adenomas and 5 hyperplasic. All patients became normocalcemic, and there were no major complications in this series.

[Rendu-Osler disease. Follow-up of 6 patients treated by embolization. Nasal telecobaltotherapy in a refractory case]. / Enfermedad de Rendu-Osler. Seguimiento de seis casos tratados mediante embolización. Telecobaltoterapia nasal en un caso refractario.

Patients with Rendu-Osler-Weber disease can present severe nose bleeding. The treatment of 6 patients with this condition is reported. Supraselective embolization was the treatment of choice. One patient showed no improvement with embolization and suffered massive nosebleed requiring blood transfusion. After a review of the literature, the nasal cavity was irradiated.s.