RESUMEN
Abstract Introduction: Deep neck infections are defined as suppurative infectious processes of deep visceral spaces of the neck. Objective: The aim of this study is to review different factors that may influence peritonsillar and deep neck infections and may play a role as bad prognosis predictors. Methods: We present a retrospective study of 330 patients with deep neck infections and peritonsillar infections who were admitted between January 2005 and December 2015 in a tertiary referral hospital. Statistical analysis of comorbidities, diagnostic and therapeutic aspects was performed with Excel and SPSS. Results: There has been an increase in incidence of peritonsilar and deep neck infections. Systemic comorbidities such as diabetes or hepatopathy are bad prognosis factors. The most common pathogen was S. viridans (32.1% of positive cultures). 100% of the patients received antibiotics and corticosteroids, 74.24% needed surgical treatment. The most common complications were mediastinitis (1.2%) and airway obstruction (0.9%). Conclusion: Systemic comorbidities are bad prognosis predictors. Nowadays mortality has decreased thanks to multidisciplinary attention and improvements in diagnosis and treatment.
Resumo Introdução: Infecções cervicais profundas são definidas como processos infecciosos supurativos dos espaços viscerais profundos do pescoço. Objetivo: Analisar diferentes fatores que podem influenciar as infecções peritonsilares e cervicais profundas que podem desempenhar um papel como preditores de mau prognóstico. Método: Apresentamos um estudo retrospectivo de 330 pacientes portadores de infecções cervicais profundas e de infecções peritonsilares admitidos entre janeiro de 2005 e dezembro de 2015 em um hospital terciário de referência. A análise estatística de comorbidades, aspectos diagnósticos e terapêuticos foi realizada utilizando-se os programas Excel e o SPSS. Resultados: Houve um aumento na incidência de infecções peritonsilares e infecções cervicais profundas. Comorbidades sistêmicas como diabetes ou doença hepática são fatores de mau prognóstico. O patógeno mais comum foi S. viridans (32,1% das culturas positivas). 100% dos pacientes receberam antibióticos e corticosteroides, e 74,24% necessitaram de tratamento cirúrgico. As complicações mais comuns foram mediastinite (1,2%) e obstrução das vias aéreas (0,9%). Conclusão: Comorbidades sistêmicas são preditores de mau prognóstico. Atualmente, a mortalidade diminuiu graças ao cuidado multidisciplinar e melhorias no diagnóstico e tratamento.
Asunto(s)
Humanos , Femenino , Embarazo , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano de 80 o más Años , Adulto Joven , Faringitis/diagnóstico , Faringitis/microbiología , Faringitis/tratamiento farmacológico , Absceso Peritonsilar/diagnóstico , Absceso Peritonsilar/microbiología , Absceso Peritonsilar/tratamiento farmacológico , Pronóstico , Estaciones del Año , Índice de Severidad de la Enfermedad , Comorbilidad , Estudios Retrospectivos , Factores de Riesgo , Absceso Retrofaríngeo/diagnóstico , Absceso Retrofaríngeo/microbiología , Absceso Retrofaríngeo/tratamiento farmacológicoRESUMEN
INTRODUCTION: Deep neck infections are defined as suppurative infectious processes of deep visceral spaces of the neck. OBJECTIVE: The aim of this study is to review different factors that may influence peritonsillar and deep neck infections and may play a role as bad prognosis predictors. METHODS: We present a retrospective study of 330 patients with deep neck infections and peritonsillar infections who were admitted between January 2005 and December 2015 in a tertiary referral hospital. Statistical analysis of comorbidities, diagnostic and therapeutic aspects was performed with Excel and SPSS. RESULTS: There has been an increase in incidence of peritonsilar and deep neck infections. Systemic comorbidities such as diabetes or hepatopathy are bad prognosis factors. The most common pathogen was S. viridans (32.1% of positive cultures). 100% of the patients received antibiotics and corticosteroids, 74.24% needed surgical treatment. The most common complications were mediastinitis (1.2%) and airway obstruction (0.9%). CONCLUSION: Systemic comorbidities are bad prognosis predictors. Nowadays mortality has decreased thanks to multidisciplinary attention and improvements in diagnosis and treatment.
Asunto(s)
Absceso Peritonsilar , Faringitis , Absceso Retrofaríngeo , Adolescente , Adulto , Anciano de 80 o más Años , Niño , Preescolar , Comorbilidad , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Absceso Peritonsilar/diagnóstico , Absceso Peritonsilar/tratamiento farmacológico , Absceso Peritonsilar/microbiología , Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Faringitis/microbiología , Embarazo , Pronóstico , Absceso Retrofaríngeo/diagnóstico , Absceso Retrofaríngeo/tratamiento farmacológico , Absceso Retrofaríngeo/microbiología , Estudios Retrospectivos , Factores de Riesgo , Estaciones del Año , Índice de Severidad de la Enfermedad , Adulto JovenAsunto(s)
Humanos , Masculino , Anciano , Parotiditis/etiología , Vacuna BCG/efectos adversos , Adyuvantes Inmunológicos/efectos adversos , Parotiditis/diagnóstico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Administración Intravesical , Vacuna BCG/administración & dosificación , Adyuvantes Inmunológicos/administración & dosificación , Recurrencia Local de NeoplasiaRESUMEN
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Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Adenoma Pleomórfico/patología , Adenoma Pleomórfico , Paraganglioma/patología , Paraganglioma , Parálisis Facial/patología , Parálisis Facial/fisiopatología , Adenoma Pleomórfico/fisiopatología , Adenoma Pleomórfico/cirugía , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética/métodos , Cuidados Posoperatorios/métodos , Periodo Posoperatorio , Paraganglioma/cirugía , Manejo del Dolor/métodosRESUMEN
Cricoarytenoid joint subluxation is rare condition. There are <200 cases reported in the English literature. The most frequent cause of this condition is a traumatic tracheal intubation which account for approximately 80 % of all cases. The most common symptoms are dysphonia and pain of the anterior region of the neck which appear after upper airway manipulation or cervical trauma. In this report we present a well-documented case of a 31 year old male that was referred to the outpatient clinic because of acute dysphonia and pain that appeared immediately after receiving a blow of a soccer ball. Diagnosis was suspected after patient reported the acute onset of symptoms after the traumatic event along with findings in flexible fiberoptic laryngoscopy and videostroboscopy. A CT scan of the larynx was done where the injury of the left cricoarytenoid joint was seen. The patient was informed of the condition and was given the option of surgical reduction or speech therapy. Speech therapy was done for 3 month and the patient was satisfied with the result, although the anatomical abnormality persisted. We reviewed the literature and we discuss the diagnosis process and possible treatment options.
Asunto(s)
Adyuvantes Inmunológicos/efectos adversos , Vacuna BCG/efectos adversos , Parotiditis/etiología , Adyuvantes Inmunológicos/administración & dosificación , Administración Intravesical , Anciano , Vacuna BCG/administración & dosificación , Humanos , Masculino , Recurrencia Local de Neoplasia , Parotiditis/diagnóstico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológicoRESUMEN
INTRODUCTION AND OBJECTIVES: Periprosthetic leakage of liquids is a common complication in patients rehabilitated with voice prostheses. Our objective was to describe and review the results of procedures for treating periprosthetic leakage. MATERIALS AND METHODS: This was a retrospective analysis of 41 patients rehabilitated with Provox® 2 voice prostheses between 1997 and 2015. We describe 3 techniques: periprosthetic silicon collar placement, injection of hyaluronic acid into the tracheoesophageal wall and the combination of the 2 techniques. We present a method to reduce the diameter of the tracheoesophageal fistula by removing the voice prosthesis and placing a nasogastric tube through the fistula. RESULTS: In the 3 groups treated with silicone collar (n=5, 13 procedures), hyaluronic acid injection (n=5, 9 procedures) and the combination of both techniques (n=3, 5 procedures), we observed an increase in prosthesis lifespan of an average of 56 days (range 7-118 days), 32 days (range 3-55 days) and 63 days (range 28-136 days), respectively. The tracheoesophageal fistula diameter reduction was performed in 100% (n=6) of patients. CONCLUSIONS: The use of silicone collars, injection of hyaluronic acid into the tracheoesophageal wall and the combination of both techniques for the treatment of periprosthesis leakage increase the lifespan of the prosthesis. Temporary prosthesis removal and placement of nasogastric tube has also been shown effective in our experience. These techniques are simple, inexpensive and reproducible, thereby reducing healthcare costs.
Asunto(s)
Laringectomía/rehabilitación , Laringe Artificial , Complicaciones Posoperatorias/terapia , Adulto , Anciano , Femenino , Humanos , Laringectomía/métodos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Estudios RetrospectivosRESUMEN
BACKGROUND: The purpose of this study was to reflect our experience in the management of multicentric head and neck paragangliomas, including genetic study and counseling, diagnostic tools, types of treatment, and the need for monitoring. METHODS: A retrospective review of 24 patients with multicentric paraganglioma, including a total of 60 paragangliomas: 37 carotid body tumors, 13 jugulotympanic paragangliomas, and 10 vagal paragangliomas. RESULTS: A total of 26 surgical procedures were performed, including the resection of 36 paragangliomas. Four tumors were pending surgery at the time of this review. Radiotherapy was administered in 7 patients with 9 tumors. A "wait-and-scan" policy with periodic MRI imaging tests was instituted for 9 patients with 12 paragangliomas. CONCLUSION: The knowledge of the different modalities of management is especially relevant in patients with multicentric paragangliomas. In every case, benefits and potential risks of all treatment options may be taken into consideration for every individual patient.