[Results of applying a universal protocol for early detection of hypoacusia in newborn infants for 42 months]. / Resultados de aplicar durante 42 meses un protocolo universal de detección e intervención precoz de la hipoacusia en neonatos.

INTRODUCTION AND OBJECTIVES: We present the results from applying over a period of three and a half years a universal newborn hearing screening programme aimed at the early detection of hearing loss. Our goal has been to diagnose and treat all unilateral or bilateral permanent hearing losses > or =40 dB nHL. METHODS: The detection strategy consists of two screening phases with transient evoked otoacoustic emissions (TEOAE) and one diagnostic phase with auditory brainstem responses (ABR). ABR tests were performed on newborns "not passing" the TEOAE screening, as well as those with risk factors for hearing loss. RESULTS: Of 4568 live newborns (NB), we evaluated 97.6 %. Of these, 3.7 % presented risk factors for hearing loss. The first TEOAE was "passed" in both ears by 91.7 % of the newborns; after the second TEOAE, only 1.3 % of cases were referred to the diagnostic phase. We detected 2.7/1000 cases of severe/profound bilateral hearing loss. CONCLUSIONS: This programme was designed for early application of appropriate treatment. Although it is possible to reach the objectives of screening and diagnosis of newborn hearing loss, the intervention stage is much more complicated. This is because intervention depends on different disciplines that must act in co-ordination, as well as multiple environmental and family factors that are difficult to control. Therapeutic effectiveness still remains our challenge and a motive for discussion in fully justifying early congenital hearing loss screening programmes.

[Carcinoma on pleomorphic adenoma in cervical salivary heteropia. Handling of one case and literature review]. / Carcinoma sobre adenoma pleomorfo en heterotopia salival cervical. Manejo de un caso y revisión de la literatura.

The presence of salivary tissue outside of the salivary glands, a term called "salivary heterotopia," is not very common. The co-existence of carcinoma expleomorphic adenoma in a salivary heterotopia in the upper third of the neck can be considered unusual. We present an infrequent and clinically unsuspected case of carcinoma expleomorphic adenoma in the upper third of the neck and independent of the salivary glands. The tumour developed within heterotopic salivary tissue, with the histopathological study of the surgical extract being decisive for its diagnosis. The cervical salivary embryogenesis of heterotopias and their oncogenesis is analyzed. Their clinical signs are reviewed to indicate the difficulty in distinguishing the different types of diagnosis from other primary or metastatic tumours so as to assist in choosing the therapy to follow.

High frequency tympanometry (1000Hz) in young infants and its comparison with otoacoustic emissions, otomicroscopy and 226Hz tympanometry. / Timpanometría de alta frecuencia (1.000Hz) en lactantes y su comparación con otoemisiones acústicas, otomicroscopia y timpanometría de 226Hz.

INTRODUCTION AND OBJECTIVE: In the first 6 months of life, 226Hz tympanometry is considered an ineffective procedure for the diagnosis of otitis media with effusion. With the introduction of universal hearing screening, the use of high frequency 1000Hz (1kHz) tympanometry has been recommended. To optimise the diagnosis of neonatal hearing loss, we present this comparison, from the clinical point of view, of the results of 226Hz and 1kHz tympanometry in infants. MATERIALS AND METHODS: We designed a prospective study of 100 children under 9 months of age proceeding from our hearing screening program. We compare the result of tympanometry with binocular microscopy and transient evoked otoacoustic emissions. RESULTS: The application of transient otoacoustic emissions, otomicroscopy and 226Hz and 1kHz tympanometry has shown its usefulness in the management of otitis media with effusion of young infants, with a similar effectiveness between the 4 tests. CONCLUSION: The joint use of otomicroscopy, transient otoacoustic emissions and 226Hz and 1kHz tympanometry, has allowed us to diagnose otitis media with effusion in young infants more accurately than each test separately. We recommend initial use of 1kHz tympanometry, at least in children younger than 7 months, but in the presence of hearing loss or an unclear result, 226Hz tympanometry is a good diagnostic complement.

Laryngeal lipoma associated with Madelung's disease: a case report.

Multiple symmetric lipomatosis is an alteration in the neck, upper trunk and upper extremities fat deposits. It produces an aesthetic problem and sometimes upper airway obstruction when the larynx is infiltrated by the mass. We report the case of a male with Madelung's disease, which began with acute dyspnea caused by laryngeal fat deposits and obstructive lipoma.

[Hamartomatous polyp of the hypopharynx]. / Pólipo hamartomatoso de la hipofaringe.

We present the clinical case of a polyp in the hypopharynx discovered incidentally while performing an upper digestive endoscopy in a middle aged woman. Endoscopic resection was performed, and the histological result was a hamartomatous polyp. We review the diagnosis and treatment of this rare entity.

Nasogastric tube syndrome: a case report.

Nasogastric tube syndrome (NTS) is an uncommon complication of an indwelling nasogastric tube. Ulceration and infection in the posterior cricoid region causes dysfunction in the abduction of the vocal cords and may seriously compromise patients' airway. This pathology should be considered in patients with prolonged nasogastric intubation who start with moderate pharyngeal pain. We report a case of a 70 year-old woman, admitted to the Neurology department of our centre due to an ischaemic cerebral accident who presented acute dyspnoea requiring emergency tracheotomy following prolonged nasogastric intubation.