Radiotherapy versus laser microsurgery in the treatment of early glottic cancer.

BACKGROUND: Glottic squamous cell carcinoma (SCC) in stages I or II can be treated by transoral CO2 laser microsurgery (TLM) or exclusive radiotherapy (RT). OBJECTIVES: To compare the oncological results of patients treated with TLM, to those treated with RT, in a tertiary hospital. MATERIAL AND METHODS: Data from patients diagnosed with glottic SCC in stages I and II between 2004 and 2018 were analyzed. Response to treatment was studied in terms of recurrence, local control and laryngeal preservation. RESULTS: Of 164 patients, 63.41% received treatment with TLM and 36.58% with RT. 26.21% presented a recurrence or progression of the tumor. Both treatments obtained good local control rates (84.15% in the case of TLM and 89.6% in the case of RT) and no significant association was found between tumor recurrence and type of treatment, nor with the involvement of the anterior commissure. However, treatment with RT obtained worse laryngeal preservation rate compared to TLM (81.6% and 100% respectively) (p < .001LR). Conclusions and significance: Both treatments obtained good oncological results. There were no significant differences regarding local control. However, TLM obtained a better laryngeal preservation rate. The involvement of the anterior commissure was not a poor prognosis factor for tumor recurrence.

Tonsillectomy in adults: Analysis of indications and complications.

OBJECTIVE: Tonsillectomy is one of the surgical techniques most practiced by otolaryngologists, and despite being a relatively simple technique; it presents a considerable percentage of complications, such as postoperative bleeding. The aim of this study is to describe the surgical indications and most frequent complications, analyze whether surgical suture of the tonsillar pillars has an influence on bleeding, and study the data of hospital stay and its importance for the control of complications. METHODS: A retrospective study of 326 patients who underwent a tonsillectomy in our Department of Otolaryngology from 2006 to 2014 was conducted. The obtained data were statistically analyzed using the Excel and SPSS 21.0 programs. RESULTS: The most frequent indication was recurrent tonsillitis, with a 74.85% (244) occurrence, and the most recurrent complication was bleeding, in 5.21% (17) of the tonsillectomies, requiring surgical revision 13 of the 17 patients. No statistically significant differences in the risk of bleeding were observed in patients in whom tonsil pillars were sutured comparing to those that were not. No statistically significant differences were detected associating surgical indication and oropharyngeal post-tonsillectomy hemorrhage. All operated patients were admitted, with a postoperative average hospital stay of 2.17 days, gaining a quick and effective control of the immediate complications. CONCLUSION: Bleeding is the most common and important complication. No statistically significant association between bleeding and tonsil pillar suture or surgical indication was found. Tonsillectomy was not set as outpatient surgery at the time.

CO2 laser surgery of supraglottic carcinoma: our experience over 6 years.

INTRODUCTION AND OBJECTIVES: The study goal was to analyze the oncologic and functional outcomes of transoral laser microsurgery in the treatment of carcinoma of the supraglottic larynx. MATERIAL AND METHODS: A total of 53 patients were included in this retrospective review between 2000 and 2006. The follow-up period was more than 2 years and the mean follow-up for all patients was 49 months. RESULTS: Tumour extension was as follows: T1 in 12 (22.6%), T2 in 37 (69.8%) and T3 in 4 (7.5%). Forty-seven patients (88.7%) had neck dissections. Nineteen patients (35.8%) received adjuvant radiotherapy. Kaplan-Meier estimates for disease-specific survival were 80%, 74.11% and 65%, at 2, 3 and 5 years, respectively. The overall functional laryngeal preservation rate was 90.56%. (48 of 53), and local control 81.13%. During follow up, 13.2% of patients developed local recurrence, 11.3% regional recurrence and 5.7% loco-regional recurrence. Patients started swallowing early after surgery, with a mean time of 5.83 days, and the mean hospital stay was 14.69 days. Complications included 20.75% who suffered pneumonia and 11.32% with bleeding. Only one patient (1.88%) received total laryngectomy due to the impossibility of swallowing. CONCLUSIONS: With careful selection of patients, laser supraglottic laryngectomy is a safe and effective treatment for cancer of the supraglottic larynx.

[Abscess of cavum and ophthalmoplegia secondary to malignant external otitis]. / Absceso de cavum y oftalmoplejía secundarios a otitis externa maligna.

We present a rare case of ophthalmoplegia, labyrinthitis and abscess of cavum secondary to skull base osteomyelitis by malignant external otitis. Since symptoms persisted in spite of antibiotic therapy, surgical drainage using a transnasal endoscopic approach was performed.

[Subacute necrotizing histiocytic lymphadenitis. An almost unknown condition]. / Linfadenitis histiocitaria necrotizante subaguda. Una entidad poco conocida.

The etiology of neck masses is multifactorial, including genetical troubles, infections or tumoral lesions. A detailed medical history and a thorough physical check-up with the aid of analyses and imaging pictures properly selected, provide the doctor with the needle information in order to establish a correct diagnosis (table 1). We present the case of a young woman with lateral neck and supraclavicular adenopathies which diagnosis although sporadic must be keep in mind in daily clinic owing its growing incidence in last years.