[Antibiotic treatment in surgery for cholesteatoma]. / Tratamiento antibiótico en la cirugía del colesteatoma.

Cholesteatoma surgery is considered as a dirty one and consequently tributary of preoperative and postoperative antibiotic treatment. Thirty-seven patients diagnosed of cholesteatoma and surgically treated in 1994 are retrospectively analyzed in this article. All of them, whether or not presented with active preoperative otorrhea, received a protocolized antibiotic treatment with topical gentamicin and dexamethasone and oral clindamycin during seven postoperative days. The presence or absence of preoperative or postoperative infection, usually as suppuration is analyzed. Otopyorrhea occurred in 22 patients (62%) before surgery and only in 9 cases (25%) after surgery. Preoperative discharging ears showed greater disposition to continuing the suppuration. The surgical technique followed and the reconstructive middle ear procedure--with autologous bone or other synthetic materials (PORP, TORP)--have not proved, statistically, any predictably value regarding the appearance of any active postoperative infection. As a result of the study done, oral ciprofloxacin has been protocolized only in those adults showing a refractory suppuration to the antibiotic treatment employed. In patients with preoperative otorrhea, topical ciprofloxacin has been protocolized before surgery with the main aim to decrease the postoperative infections incidence of these cases.

[Considerations regarding the surgical techniques used in Laura model cochlear implantation]. / Consideraciones sobre la técnica quirúrgica utilizada en la implantación coclear con el modelo Laura.

Pitfalls in Laura cochlear implant surgery were studied and this implant was compared with other devices. We have experience with 14 cases of Laura cochlear implants. The absence of complications such as wound breakdown with exposure of the package and erosion of the external auditory canal skin are emphasized.

[Atypical ossifying hemangioma of the temporal bone]. / Hemangioma osificante de hueso temporal. Caso atípico.

Over the last decade, the hemangioma of the temporal bone has become clinically recognized as the benign tumor most commonly involving the facial nerve in its intratemporal portion. Its locally aggressive nature affects the VIIth cranial nerve at a very early stage, usually before the tumor reaches a 10 mm diameter. We present a case of ossifying hemangioma of the temporal bone which, in spite of being located in the region of the geniculate ganglion and of measuring over 20 mm, only caused hearing conductive loss. The atypical clinical course of this case contrasts with those described in the literature.

[The surgery technique of the implantation of the cochlear prosthesis LAURA]. / Técnica quirúrgica de implantación de la prótesis coclear LAURA.

The different steps to insert the elements which will be implanted of the LAURA cochlear prosthesis are exposed. The interpretation of the technique is made easier by numerous images.