[Cervical hematoma after discectomy for spondylosis. An indication of urgent tracheotomy]. / Hematoma cervical tras disquectomía por espondilosis. Indicación de Traqueotomía Urgente.

We report the clinical case of a hematoma after surgery of cervical spondylosis which required an urgent tracheotomy due to failure in the orotracheal intubation. This illness in advanced degree, so called cervical spondylotic myelopathy, is the most serious consequence of cervical intervertebral disc degeneration.

Hematoma cervical tras disquectomía por espondilosis. Indicación de Traqueotomía urgente / Cervical Hematoma after disectomy for spondylosis. An idication of urgent tracheotomy

Se presenta un caso clínico de hematoma cervical tras cirugía de espondilosis cervical que precisó traqueotomía urgente por imposibilidad de intubación orotraqueal. Esta enfermedad en grado avanzado, denominada también mielopatía cervical espondilótica, es la consecuencia más seria de la degeneración del disco cervical intervertebral

We report the clinical case of a hematoma after surgery of cervical spondylosis which required an urgent tracheotomy due to failure in the orotracheal intubation. This illness in advanced degree, so called cervical spondylotic myelopahty, is themost serious consequence of cervical intervertebral disc degeneration

[Nasal osteocartilaginous necrosis caused by cocaine. Our experience with two patients]. / Necrosis osteocartilaginosa nasal por cocaína. Nuestra experiencia en dos pacientes.

Sinonasal osteocartilaginous necrosis induced by the abuse of inhaled cocaine must be considered in the differential diagnosis of those pathologies that produce facial midline destructions. We report two cases corresponding to women admitted in our Hospital because of such entity. There were analysed their respective clinical histories, exploration data, complementary tests, medical-surgical treatment and evolution. Cocaine is one of the drugs that has increased in last 10 years producing an elevated number of complications, as we could proved on the bibliographic review performed.

Necrosis osteocartilaginosa nasal por cocaína. Nuestra experiencia en dos pacientes / Nasal osteocartilaginous necrosis by cocaine. Our experience in two patients

Las necrosis osteocartilaginosas nasosinusales debidas al abuso de cocaína por vía inhalatoria deben considerarse en el diagnóstico diferencial de las patologías que ocasionan destrucción de la línea media facial. Presentamos los casos clínicos de dos mujeres que fueron ingresadas en nuestro Hospital por este motivo. Analizamos sus historias clínicas respectivas, datos de la exploración, pruebas complementarias, tratamiento médico-quirúrgico y evolución. La cocaína es una de las drogas que ha experimentado un mayor incremento consumista en los últimos 10 años lo que ha dado lugar a un mayor número de complicaciones, como se pone de manifiesto en la revisión bibliográfica realizada

Sinonasal osteocartilaginous necrosis induced by the abuse of inhaled cocaine must be considered in the differential diagnosis of those pathologies that produce facial midline destructions. We report two cases corresponding to women admitted in our Hospital because of such entity. There were analysed their respective clinical histories, exploration data, complementary tests, medical-surgical treatment and evolution. Cocaine is one of the drugs that has increased in last 10 years producing an elevated number of complications, as we could proved on the bibliographic review performed

[Unilateral versus bilateral neck exploration in the surgery of primary hyperparathyroidism]. / Exploración cervical unilateral versus bilateral en la cirugía del hiperparatiroidismo primario.

The aim of this study is to know the indications, advantages and disadvantages of a unilateral neck exploration versus bilateral in the primary hyperparathyroidism (HPT) surgery. Since april 1990 to april 2002 we have operated 80 patients diagnosed of HPT. They where divided in different groups in function of the results of the clinic exploration intact paratohormone results (PTHi turbo). In 48 patients (60%) we have done an unilateral cervical surgical exploration (in 9 cases we have determined the PTHi turbo) with good postoperative results. In 32 patients we have realised a bilateral exploration with exposition of both recurrent nerves, based on the discordance between the image exploration and because we were not able to have the intro-operative dose of turbo of PTHi, which use parameter we defend because of its contrasted efficiency, with less surgical time and less iatrogenic possibilities.

Exploración cervical unilateral versus bilateral en la cirugía del hiperparatiroidismo primario / Unilateral neck exploration versus bilateral one in the surgery of primary hyperparathyroidism

El objetivo de este estudio es conocer las indicaciones, ventajas e inconvenientes de una exploración cervical unilateral versus bilateral en la cirugía del hiperparatiroidismo primario (HPT). Para ello, desde abril de 1990 y hasta abril de 2002, hemos intervenido 80 pacientes diagnosticados de HTP. Primero fueron divididos en varios grupos en función de los resultados de la exploración clínica, pruebas de paratohorma intacta (PTHi turbo). En 48 de los 80 pacientes (60 por ciento) se realizó una exploración quirúrgica cervical unilateral (en 9 casos se determinó la PTHi turbo) con buenos resultados posoperatorios. Sobre 32 pacientes se realizó una exploración bilateral con exposición bilateral con exposición de ambos recurrentes, por discordancia entre las pruebas de imagen por no disponer entonces de la dosificación turbo intraoperatoria de PTHi, parámetro cuya utilización defendemos por su eficacia contrastada, menor tiempo quirúrgico y menor posibilidad de yatrogenia (AU)

No disponible

No disponible

Determinación de PTH I en la cirugía del hiperparatiroidismo. Nuestra experiencia / PTH I assay in surgery of hyperparathyroidism. Our experience

Nuestro Servicio de ORL lleva realizadas un total de 90 paratiroidectomías desde abril de 1990 hasta el 2000 sobre 92 pacientes remitidos con diagnóstico de hiperparatiroidismo. De ellos, 67 pacientes fueron diagnosticados de hiperparatiroidismo primario; 22, secundario y 3 casos correspondían a hiperparatiroidismos terciarios. Analizamos una serie de variables preoperatorias y postoperatorias, entre las que destacamos la reciente determinación de los niveles de la PTH i rápida. El tipo de cirugía que realizamos fue la resección de adenoma en 63 casos; 23 pacientes fueron sometidos a una paratiroidectomía subtotal y 4 a paratiroidectomía total. En 2 pacientes intervenidos se realizó cirugía exploradora cervical sin hallar patología paratiroidea. Comparamos los resultados obtenidos con otras series publicadas y creemos útil la determinación de los niveles de paratohormona rápida (PTH i) pre y postoperatoria (actualmente sólo 3 casos) para predecir la respuesta clínica de los pacientes con diagnóstico de hiperparatiroidismo (AU)

Our Service of Otolaryngology has performed 90 parathyroidectomies at all since april 1990 to 2000 on 92 patients sent to us with diagnosis of hyperparathyroidism. 67 patients were diagnosed as primary hyperparathyroidism; 22 as secondary and 3 cases corresponded to tertiary hyperparathyroidism. We analysed a string of variables before and after the surgery standing out the recent estimate of rapid PTH i levels. The kind of surgery we performed was the removal of adenoma in 63 cases; 23 patients were put to subtotal parathyroidectomy and 4 to a total one. An exploratory neck surgery was performed in two patients without finding a parathyroid pathology. We compare the obtained results with other published series and we think it can be useful to determinate the rapid paratohormone levels (PTH i) pre and postsurgery (only used in 3 cases by now) in order to predict the clinic response of the patients with hyperparathyroidism (AU)

[Determination of PTH I in hyperparathyroidism surgery. Our experience]. / Determinación de PTH I en la cirugía del hiperparatiroidismo. Nuestra experiencia.

Our Service of Otolaryngology has performed 90 parathyroidectomies at all since april 1990 to 2000 on 92 patients sent to us with diagnosis of hyperparathyroidism. 67 patients were diagnosed as primary hyperparathyroidism; 22 as secondary and 3 cases corresponded to tertiary hyperparathyroidism. We analysed a string of variables before and after the surgery standing out the recent estimate of rapid PTH i levels. The kind of surgery we performed was the removal of adenoma in 63 cases; 23 patients were put to subtotal parathyroidectomy and 4 to a total one. An exploratory neck surgery was performed in two patients without finding a parathyroid pathology. We compare the obtained results with other published series and we think it can be useful to determinate the rapid paratohormone levels (PTH i) pre and postsurgery (only used in 3 cases by now) in order to predict the clinic response of the patients with hyperparathyroidism.