Recurrent Pediatric Extranasopharyngeal Angiofibroma of the Epiglottis: Case Report.

Angiofibroma is a non-encapsulated, highly vascular tumor that usually originates in the nasopharynx. Laryngeal cases of extranasopharyngeal angiofibroma (ENA) are a very rare pathology, especially in children. Only eight ENA laryngeal cases have been described in the literature, and only one of them is a pediatric case. In this report we present an 11-year-old child with epiglottic ENA resected with transoral endoscopic ultrasonic surgery (TOUSS) with review of the literature. Because of reccurrence after five months he underwent re-excision with CO2 laser. Recurrences in ENA are infrequent, but as demonstrated in our case, close endoscopic follow-up is mandatory in this location. Endoscopic hemostatic procedures like TOUSS and CO2 laser ensure bloodless surgery for the management of this type of vascular laryngeal tumors.

In-office cup biopsy and laryngeal cytology versus operating room biopsy for the diagnosis of pharyngolaryngeal tumors: Efficacy and cost-effectiveness.

BACKGROUND: In-office biopsy is an effective technique to diagnose the nature of pharyngolaryngeal lesions. METHODS: We selected patients with pharyngolaryngeal lesions suspicious for malignancy. For in-office biopsy procedures, laryngeal cytology and direct laryngoscopy biopsy were performed, and diagnostic parameters and costs were estimated. RESULTS: Eighty-eight patients were selected for this study. For laryngeal cytology, sensitivity was 70.3% (95% confidence interval [CI] = 59.9% to 80.7%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 50% (95% CI = 35.2% to 64.8%). In-office biopsy sensitivity was 81% (95% CI = 72.6% to 89.3%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 20% (95% CI = 2.5% to 37.5%). At our hospital, the use of in-office biopsies as a first approach for diagnosis saves $50,140.80 U.S. per annum. CONCLUSION: In-office biopsy is a more affordable technique that enables histologic diagnosis of pharyngolaryngeal lesions in a large percentage of patients.

[Otorhinolaryngology]. / Otorrinolaringología.

The terrorist attack on 11 March caused a high percentage of patients with ear injuries. Shock waves provoke alterations to the external ear as well as to the middle and inner ear. The most frequent lesion is tympanic membrane perforation. Initial evaluation with otoscopy, acoumetry, tonal audiometry and vestibular examination was performed and was repeated after 2 and 3 months. In most patients there was a correlation between the grade of middle ear lesion and auditory damage. In most patients with tympanic rupture, the perforation was total or subtotal. Spontaneous closure can occur in some patients but is usually related to the size of the initial lesion. Thus in tympanic perforations of more than 50%, spontaneous closure is unlikely.