Factors associated to functional recovery of left vocal fold motion impairment at two-years-old age in very preterm infants.

OBJECTIVE: To describe a cohort of neonates with left vocal fold motion impairment (LVFMI) and the factors associated to it in the neonatal period; procedures required during LVFMI treatment; and clinical outcomes at the age of 2-years. An additional objective was to study those factors which are likely to be most associated to functional recovery of LVFMI at this age. METHODS: A cohort of patients born in a tertiary care hospital with a diagnosis of left VFMI was included. Factors registered were: gender; clinical presentation at the time of examination; diagnosis of other laryngeal defects associated; data related to their neonatal period (gestational age, congenital heart defects corrective surgery required, neurologic disease, bronchopulmonary dysplasia, non-invasive ventilation required, invasive ventilation required, and tracheostomy required); treatment applied for LVFMI (tracheostomy and/or laryngeal surgery); need of language and hearing therapy; and outcomes considered by the pediatric otolaryngologist at the 2 years-old follow-up visit. RESULTS: A total of 56 patients with LVFMI diagnosis were included. Only 10 patients (17.9%) showed functional recovery from LVFMI at the age of 2 years. We found significant negative association between this recovery and language and hearing therapy (p = 0.03), which was also associated to psychomotor retardation (p < 0.001). Multivariate analysis produced similar results, being language and hearing therapy the only significant factor associated to a worse outcome (OR = 4.77 [CI95% 1.14; 20.08] p = 0.03). CONCLUSION: Psychomotor development retardation is negatively associated to functional recovery of full speech in a preterm infant's population with LVFMI diagnosis, regardless of other factors related to LVFMI etiology and severity.

Conservative surgical treatment of pharyngeal branchial cyst.

The parapharyngeal presentation of a branchial cleft cyst of the second arch is extremely uncommon. The treatment considered to be most effective is total extirpation via a transcervical approach, but this is not without its complications. A case is described here of a patient who requested conservative treatment. Thus, a transoral exeresis of the oropharyngeal wall of the cyst was carried out, the cyst was drained, and its borders were marsupialized to the pharyngeal wall. Postoperative evolution was towards obliteration of the tract, as should have occurred in the embryonal period.

[Solitary neurofibroma of the maxillary sinus]. / Neurofibroma solitario de seno maxilar.

Neurofibromas are benign tumours of peripheral nerve tissue, frequently associated with neurofibromatosis type I. Their isolated occurrence in the maxillary sinus is rare, with only 6 cases described in the literature. We present the case of a 70-year-old woman who consulted for left hemifacial paresthesias of 10 years' evolution. CT showed a heterogeneous lesion in the left maxillary sinus, eroding its lateral wall without signs of infiltration. Endoscopic surgery with nasalisation of the maxillary sinus was performed. The pathology was neurofibroma (positive for S-100 protein and vimentin). After 18 months, no tumour growth has been found.