[Pleomorphic adenoma of deep lobe of the parotid gland]. / Adenoma pleomorfo gigante de lóbulo profundo de la parótida: a propósito de un caso.

Parapharyngeal space tumors are rare. Salivary neoplasms being the most frequent ones. The important volume they can reach, their silent character, and the complex anatomic relationships of this area makes their surgical resection difficult. This report describes a case of a pleomorphic adenoma in the deep lobe of the parotid gland presented like a parapharyngeal mass, and its diagnosis and treatment.

Adenoma pleomerofo gigante de lóbulo profundo de la parótida: a propósito de un caso / Pleomorphic adenoma of deep lobeo f the parotid gland

Los tumores del espacio parafaríngeo son una rareza. Las neoplasias de glándulas salivales son los tumores más frecuentes. Debido al importante volumen que pueden alcanzar en el momento de su diagnóstico, por su carácter silente durante largo tiempo, y la complejidad anatómica de esta región, su extirpación puede plantear dificultades. Presentamos un caso clínico de adenoma pleomorfo del lóbulo profundo de la parótida manifestado como una masa parafaríngea. El interés radica en los problemas de diagnóstico y tratamiento que plantea por su tamaño y localización

Parapharyngeal space tumors are rare. Salivary neoplasms being the most frequent ones. The important volume they can reach, their silent character, and the complex anatomic relationships of this area makes their surgical resection difficult. This report describes a case of a pleomorphic adenoma in the deep lobe of the parotid gland presented like a parapharyngeal mass, and its diagnosis and treatment

[Bilateral peripheral facial paralysis secondary to Lyme disease]. / Parálisis facial periférica bilateral secundaria a enfermedad de Lyme.

Simultaneous bilateral facial paralisis (SBFP) occurs in 0.3-2% of all facial paralisis. We report a case of SBFP in association with Lyme disease. A review of literature about SBFP is made, studing specially the one caused by Borrelia burgdorferi. We present a diagnostic guideline of SBFP. Suspect diagnosis of Lyme disease is based on clinical and epidemiological criteria. Culture isolation of this bacteria is difficult, therefore serologic testing is required. Neuroborreliosis treatment is intravenous Ceftriaxone or Cefotaxime. Oral Doxycycline is useful in the treatment of neuritis without central nervous system involvement.

Parálisis facial periférica bilateral secundaria a enfermedad de Lyme

La parálisis facial periférica bilateral simultánea (PFBS) representa entre el 0,3 y el 2 por ciento de todas las parálisis faciales periféricas. Presentamos un caso de PFBS secundaria a enfermedad de Lyme. Se hace una revisión de la literatura en torno a las posibles causas de PFPS haciendo especial hincapié en el estudio de la provocada por la Borrelia burgdorferi. Se expone un protocolo diagnóstico de la PFBS. El diagnóstico de sospecha de enfermedad de Lyme se basa en criterios clínicos y epidemiológicos. El aislamiento del germen mediante cultivo es difícil, por lo que se recurre a la serología. El tratamiento de la neuroborreliosis es la Ceftriaxona o la Cefotaxima por vía parenteral. La Doxiciclina vía oral se ha mostrado eficaz en el tratamiento de neuritis sin afectación del sistema nervioso central (AU)

[Our experience with extranodal lymphomas of the ORL region]. / Nuestra experiencia en linfomas extranodales del área ORL.

Head and neck extranodal lymphomas are rare. Waldeyer lymphatic ring is the most common localisation of these lymphomas, followed by oral cavity and parothoid glands. We have done a retrospective study of patients with extranodal lymphomas diagnosed in our hospital between 1991 and 1999. We have included in this study 23 patients, 15 males and 9 females. We have used the REAL classification. All of them have been non-Hodgkin lymphomas. The rhinopharynx has been the most affected region, followed by the palatine tonsils and oral cavity. Most of them were of medium degree and they were in the initial stages. The presentation symptoms varied depending on the localisation. The age, stage and histologic degree were important for the treatment election.

Nuestra experiencia en linfomas extranodales del área ORL / Our experience with extranodal lymphomas in ear, nose and throat practice

Los linfomas extranodales de cabeza y cuello son una entidad clínica poco común. El anillo linfático de Waldeyer es la localización más frecuente de estos linfomas, seguida de la cavidad oral y glándulas parótidas. Se ha realizado un estudio retrospectivo de pacientes diagnosticados de linfomas extranodales, entre los años 1991 al 1999 en nuestro Hospital. Se incluyeron en el estudio 23 pacientes, 15 hombres y 9 mujeres. Se empleó la clasificación REAL para su catalogación. Todos lo linfomas fueron linfomas de tipo no-Hodgkin. El cavum fue el lugar más afectado, seguido de amígdalas palatinas y cavidad oral. La mayor parte de los linfomas eran de grado intermedio y se encontraban en estados iniciales. Los síntomas de presentación variaban según la localización. La edad del paciente, estadio y grado histológico fueron importantes para la elección del tratamiento (AU)

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[Inverted papilloma of paranasal sinuses. Our experience of 15 cases. Review of literature]. / Papilomas invertidos de fosas y senos paranasales. Nuestra experiencia a partir de 15 casos. Revisión de la bibliografia.

Fifteen cases of nasosinusal inverted papilloma treated in our department from 1994 to 2000 are reported. The most frequent initial symptom was unilateral nasal obstruction. Some others symptoms were rhinorrea, facial pain and self limited epistaxis. The most frequent surgical procedure performed was the paralateral rhinotomy with medial maxillectomy. The median average for the follow up was 28 months, being diagnosed one recurrence. The paralateral rhinotomy with a medial maxillectomy, under functional endoscopic nasosinusal techniques are being more and more used, decreasing the indications of open techniques.

Papilomas invertidos de fosas y senos paranasales. Nuestra experiencia a partir de 15 casos. Revisión de la bibliografía / Inverted papillomas of nasal and paranasal sinus. Our experience in 15 cases. Revision of literature

Presentamos un estudio retrospectivo de 15 casos diagnosticados de papiloma invertido nasosinusal, tratados en nuestro servicio entre 1994 y 2000. La forma de inicio más frecuente fue la obstrucción nasal unilateral. Otra sintomatología asociada fue rinorrea, algias faciales y epitaxis autolimitadas. El tratamiento quirúrgico más frecuente realizado fue la rinotomía paralateronasal con maxilectomía media. En el control posoperatorio (de 28 meses de media) se observó una recidiva sólo en un paciente. La rinotomía paralateronasal con maxilectomía media con ayuda del microscopio óptico, es considerado el tratamiento de elección. No obstante, la incorporación de la endoscopia y la destreza en su manejo, van limitando las indicaciones de cirugía abierta (AU)

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[An exceptional form of cranio-facial fibrous dysplasia: fibrous dysplasia of middle turbinate]. / Una forma excepcional de displasia fibrosa craneofacial: displasia fibrosa de cornete medio.

Fibrous dysplasia is a rare bone disease that can be misdiagnosed because of the slowness of its symptoms. Although it is a benign disease its clinical behaviour can be severe, with possibility of local growth and malignant degeneration into osteosarcoma. An uncommon case of fibrous dysplasia is reported, affecting only the middle turbinate. Diagnostic and therapeutic problems are discussed.

Una forma excepcional de displasia fibrosa craneofacial: displasia fibrosa de cornete medio / An exceptional form of craneo-facial fibrous dysplasia: fibrous dysplasia of middle turbinate

La displasia fibrosa es una patología ósea poco frecuente y a menudo puede pasar desapercibida por su escasa sintomatología. A pesar de ser un proceso benigno, puede comportarse de forma agresiva por su crecimiento local, y en ocasiones degenerar a osteosarcoma. En este trabajo aportamos un caso de displasia fibrosa que es atípico por su localización exclusiva en el cornete medio.Se plantean los problemas diagnósticos y terapéuticos que ello conlleva. (AU)

Fibrous dysplasia is a rare bone disease that can be misdiagnosed because of the slowness of its symptoms. Although it is a benign disease its clinical behaviour can be severe, with possibility of local growth and malignant degeneration into osteosarcoma. An uncommon case of fibrous dysplasia is reported, affecting only the middle turbinate. Diagnostic and therapeutic problems are discussed (AU)

[Subtotal arytenoidectomy and posterior cordectomy with CO2 laser in the treatment of bilateral larynx immobility in adduction]. / La aritenoidectomía subtotal y cordectomía posterior con laser CO2 en el tratamiento de la inmovilidad laríngea bilateral en adducción.

This article deals with a retrospective study with 10 patients enduring laryngeal immobility in adduction and treated with CO2 laser. Presurgical assessment, surgical procedure, the causative etiology and end results are contemplated. Comparison with other procedures.

[Prevalence of oral lichen planus and oral leukoplakia in 112 patients with oral squamous cell carcinoma]. / Prevalencia de liquen plano oral y leucoplasia oral en 112 pacientes con carcinoma oral de células escamosas.

OBJECTIVE: To study the association existing between precancerous conditions, like oral lichen planus and oral leukoplakia into 112 patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: We applied a protocol to 112 patients with OSCC in the "Servicio de Estomatología del Hospital General Universitario de Valencia". We made two groups: 1. patients with precancerous lesions and oral carcinoma, 2. patients with OSCC and no precancerous lesions. RESULTS: The average age was 61.4 years, 85 of them being men and 27 women. The tongue and floor of the mouth were the most common locations. 33.6% of the tumours presented stage TNM I, most of them being histologically well differentiated and the 55.8% were ulcerated. We found differences between two groups of the patients regarding alcohol and tobacco habits, location, size and clinical stage and histological differentiation of the malignant lesions.

[Benign sinusal mucor colonization in association with septal deviation]. / Colonización benigna sinusal por mucor asociada a desviación septal.

Mucormycosis is a well recognised opportunistic infection caused by saprophytic fungi of the Mucoraceae family. Usually, the upper aerodigestive tract is the portal of entry. Patients who are debilitated or inmunosuppressed might present with these infections, although sometimes can happen in patients with good health. We present a case of benign mucor colonitation at the sinus maxillary associated a deviated nasal septum.

[Topical treatment of rhinitis: current status. Physiopathologic and pharmacologic bases]. / Tratamiento tópico de la rinitis: situación actual. Bases fisiopatológicas y farmacológicas.

Rhinitis is defined as inflammation of the lining of the nose, characterized by one or more of the following symptoms: nasal congestion, rhinorrhea, sneezing and itching. Modifications of nose secretion and of the blood supply of the nasal mucosa are responsible for development of rhinitis. Cholinergic and adrenergic agents as well as histamine, 5-hydroxytriptamine, kallidin and substance P are mediators of inflammation in rhinitis. The topical pharmacological principles we have today for management of rhinitis include: antihistamines, corticosteroids, anticholinergic agents, decongestants, sodium cromoglycate, nasal douching and aromatic inhalations.

Prevalencia de liquen plano oral y leucoplasia oral en 112 pacientes con carcinoma oral de células escamosas / Prevalence of oral lichen planus and oral leukoplakia in 112 patients with oral squamous cell carcinoma

Objetivo: Estudiar la asociación de las lesiones premalignas; liquen plano y leucoplasia en 112 pacientes con carcinoma oral de células escamosas (COCE). Material y método: Se aplicó un protocolo a 112 pacientes diagnosticados de COCE en el Servicio de Estomatología del Hospital General Universiario de Valencia. Se distinguieron dos grupos: 1º pacientes con lesiones precancerosas y cáncer oral, y 2º pacientes con COCE sin lesiones precancerosas. Resultados: La edad media, fue de 61,4 años, 85 eran hombres y 27 mujeres. La lengua y el suelo de boca eran las localizaciones más habituales. El 33,6 por ciento de los tumores se encontraban dentro del TNM estadio I siendo la mayoría de ellos histológicamente bien diferenciados y el 55,8 por ciento tenían forma ulcerada. Existían diferencias significativas entre ambos grupos de pacientes con respecto al consumo de alcohol y tabaco, la localización, el tamaño, el estadio clínico y la diferenciación histológica de las lesiones tumorales. Conclusiones: De los 112 pacientes estudiados 27 (24,10 por ciento) tenían lesiones precancerosas asociadas al cáncer oral. Estos últimos presentaban cierta predilección por el sexo femenino, tenían menor hábito tabáquico y alcohólico y la clínica e histología del tumor era menos agresiva (AU)

OBJECTIVE: To study the association existing between precancerous conditions, like oral lichen planus and oral leukoplakia into 112 patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: We applied a protocol to 112 patients with OSCC in the "Servicio de Estomatología del Hospital General Universitario de Valencia". We made two groups: 1. patients with precancerous lesions and oral carcinoma, 2. patients with OSCC and no precancerous lesions. RESULTS: The average age was 61.4 years, 85 of them being men and 27 women. The tongue and floor of the mouth were the most common locations. 33.6% of the tumours presented stage TNM I, most of them being histologically well differentiated and the 55.8% were ulcerated. We found differences between two groups of the patients regarding alcohol and tobacco habits, location, size and clinical stage and histological differentiation of the malignant lesions (AU)

Colonización benigna sinusal por mucor asociada a desviación septal / Benign sinusal mucor colonisation in association to septal deviation

La mucormicosis es una reconocida infección oportunista causada por hongos saprofitos de la familia Mucoraceae. Generalmente, la vía aero-digestiva superior es la puerta de entrada. Pacientes que están debilitados o inmunosuprimidos pueden presentar estas infecciones, aunque en ocasiones puede aparecer en pacientes con buena salud. Presentamos un caso de colonización por mucor del seno maxilar asociado a una desviación de tabique (AU)

Mucormycosis is a well recognised opportunistic infection caused by saprophytic fungi of the Mucoraceae family. Usually, the upper aerodigestive tract is the portal of entry. Patients who are debilitated or inmunosuppressed might present with these infections, although sometimes can happen in patients with good health. We present a case of benign mucor colonitation at the sinus maxillary associated a deviated nasal septum (AU)

[Tuberculous chronic otitis media. A clinical case]. / Otitis media crónica tuberculosa. Un caso clínico.

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. Patients typically have chronic tympanic membrane perforation and ear discharge associated with progressive, profound hearing loss, and resistance to antibiotic treatment. Diagnosis is often delayed by a low clinical suspicion, thus leading to complications such as irreversible hearing loss and facial nerve paralysis. Histological examination of a biopsy specimen reveals tuberculous changes. The disease is treated with antituberculosis agents.

Otitis media crónica tuberculosa. Un caso clínico / Tuberculous chronic otitis media. A clinical case

La tuberculosis de oído medio es una causa rara de infección supurativa de oído medio y mastoides. Los pacientes, típicamente, tienen una perforación timpánica crónica, supuración ótica asociada a una progresiva hipoacusia con resistencia a los tratamientos antibióticos. Hay frecuentemente un considerable retraso en el diagnóstico porque el grado de sospecha es bajo, con el resultado frecuente de complicaciones como hipoacusia y parálisis facial. Examen histológico de pieza de biopsia revela cambios tuberculosos. Tratamiento con agentes antituberculosos (AU)

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. Patients typically have chronic tympanic membrane perforation and ear discharge associated with progressive, profound hearing loss, and resistance to antibiotic treatment. Diagnosis is often delayed by a low clinical suspicion, thus leading to complications such as irreversible hearing loss and facial nerve paralysis. Histological examination of a biopsy specimen reveals tuberculous changes. The disease is treated with antituberculosis agents (AU)

[Oral lichen planus plaques and homogeneous leukoplasia: comparative results of treatment with CO2 laser]. / Liquen plano oral en placas y leucoplasia oral homogénea: resultados comparativos tras el tratamiento de estas lesiones con láser CO2.

OBJECTIVE: To determine the efficacy of CO2 laser therapy in plaque-like oral lichen planus and homogeneous oral leukoplakia. MATERIAL AND METHODS: We studied two groups of patients; one comprised 29 cases of plaque-like oral lichen planus (group 1) and the other one included 34 cases of homogeneous oral leukoplasia (group 2). After histological study, all the lesions were treated by CO2 laser evaporation at 10 W. We analyzed the results following one month, three months and one year after the treatment. RESULTS: In group 1, 19 lesions (65.5%) were revoluted enterally in one month. Patients reported a slight to moderate pain in 16 cases (55.2%), while 4 (13.8%) showed recurrences after three months and 12 (41.4%) at the end of the following time (one year). In group 2 we found a complete healing after one month in 28 cases (82.4%), with a slight to moderate pain in 22 cases (64.7%). Three months after the treatment we found 7 recurrences (20.6%) and 8 (25.8%) one year after. CONCLUSIONS: We found lower rate of recurrences in homogeneous oral leukoplakias than in plaque-like oral lichen planus after treatment with carbon dioxide laser therapy.

[Postoperative clinical and ct-xray evaluation of the septic inflammatory sinus pathology]. / Evaluación posoperatoria clínica y por TAC en la patología sinusal séptico-inflamatoria.

It is classically been though that radical sinus surgery implies a difficulty for ulterior image diagnosis. The reason is postoperative fibrosis of soft tissue may be shown at TC scan as an occupation of paranasal sinuses. We realized that it does not usually happen. The aim of our study is to find out the appearance of sinuses after radical surgery performed to treat chronic sinusitis, mucocele and sinusal cysts. For so doing we have reviewed symptoms and radiological signs before and after surgery.