[Examination of the patient with supraglottic carcinoma at the medical office. Contribution of the rigid optical devices and the fiberscope]. / La exploración en la consulta del paciente con carcinoma supraglótico. Aportación de la óptica rígida y de la fibroscopia.

Seventy one patients afflicted of supraglottic carcinoma were included in a prospective study whose purpose was to determine which of three optical tools available at the medical office--indirect mirror laryngoscopy, laryngotelescopy and fiberscopic examination--is the most suitable to examine the larynx of patients with this disease. No significant differences were found among these explorations in the easily observable regions, as the hypopharyngeal areas and the epilarynx. The examination of the pericommisural region--the most difficult area to see--was easier with the flexible fiberscope. The laryngotelescope provided better visualization than the mirror laryngoscopy. Exploration with the new optical devices did not correct the errors in the interpretation of images made with the mirror laryngoscopy. We conclude that flexible fiberoptic laryngoscopy provides better information than other diagnostic tools for the assessment of patients with supraglottic carcinoma at the medical office.

[Primary extramedullary plasmacytomas of the upper respiratory tract. A study of four cases with infrequent localization]. / Plasmocitomas primarios de vías aerodigestivas altas. A propósito de cuatro casos.

OBJECTIVE: Assessment of the incidence, diagnosis and treatment of three patients afflicted of extramedullary plasmacytoma located in the Waldeyer's ring, and one case afflicted of maxillary sinus disease. PATIENTS: The localization of the masses was the palatine amygdala in two cases, and the rhinopharynx and maxillary sinus in the remaining two patients. Major symptoms were dysphagia respiratory failure with closed rhinolalia, and headache. Diagnosis was made by histological study of biopsied tissue. In every case, general illness or other site of localization were ruled out. RESULTS: In our casuistic, the incidence of primary extramedullary plasmacytoma in Waldeyer's ring is 1.2%. The patient's age were 45, 50, 62, and 73 years respectively, and the male/female ratio was 1. In those cases located in the tonsils, a bilateral tonsillectomy was performed. In the case located at the maxillary sinus, a sinus trepanation was performed according the Caldwell-Luc's technique, followed by local radiotherapy at doses of 40 Gy. In the case located at the rhinopharynx, radiotherapy was the only choice. These three different therapeutical procedures led to the disappearance of the disease, and, after a 12 to 53 month-period, patients remain asymptomatic. A patient died due to other causes not related to the illness.