Radionecrosis laríngea como complicación del tratamiento radioterápico / Laringeal radionecrosis as a complication of the radiotherapic treatment

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Necrosis mediofacial secundaria a abuso de cocaína / Middle facial necrosis secundary to cocaine

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[Post-traumatic carotid cavernous fistula as a cause of objective tinnitus]. / Fístula carotidocavernosa postraumática: origen de acúfenos objectivos.

Reporting the case of a patient, seen in our Hospital Consulting Department, enduring heavy pulsatile tinnitus, following a craniocerebral traumatism. ENT examination was negative, but having the feeling of a carotid-cavernous fistula, angiographies confirmed this pathology. Embolisation of the fistula as treatment stopped the patient's symptomatology. We take the advantage of this case in order to review the etiology, the pathology, diagnostic measure and treatment of this condition.

[Long-term course of laryngeal verrucous carcinoma]. / Carcinoma verrucoso laríngeo de larga evolución.

Verrucous carcinoma is an odd kind from squamous or epidermoid carcinoma, amounting between 1 and 3.5% percent of the whole number of laryngeal growths. Its predominant sitting is glottic and are characterized through the pathological anatomy and its good prognosis. We report one case treated in our Department which evolved during 14 years and we point out its good prognosis and other particularities regarding its etiology, pathologic anatomy and diagnosis.

[Sarcoidosis in otorhinolaryngology]. / Sarcoidosis en O.R.L.

Sarcoidosis is a disease affecting the reticulo-histiocytary system and characterized by its several manifestations, always linked to the same lesion: the epithelioid granuloma without caseous necrosis. We make a review of this disease so scarce in our consulting rooms, and consider all patients diagnosed in our Hospital during one year-term, with their manifestations in ENT-area as well in other specialties and compare our inventory with other published series.

[Jugular-tympanic paraganglioma: our experience in 2 years]. / Paraganglioma yugulotimpánico: nuestra experiencia en dos años.

The paper is a review of the jugulotympanic paragangliomata seen in our Hospital in a 2 years term. The AA. discuss every case and achieve a checking of several therapeutics procedures accepted for these growths.

[Deep neck infections: complications of acute pharyngitis]. / Infección cervical profunda: complicación de faringitis aguda.

Deep neck infections develop as aftermath of spreading infections from an initial focus to the neighbourhood and soft tissues of the neck, through routes offering lesser resistance as fascial sheets. These cervical pictures are not numerous and generally after infective focus bad treated, linked with concomitant factors easing the rapid spread. The presence of complications as the involvement of great blood vessels, mediastin or jeopardizing the air-way may darken the prognosis, for which reason its precocious diagnosis and correct behaviour are very decisive. The paper deals with one case of neck infect, following an acute banal pharyngitis without predisposing circumstances. Follows a review of the published bibliography.

[Biopsy cannula as diagnostic alternative to puncture-aspiration biopsy with fine needle in head and neck tumors]. / La cánula de biopsia: alternativa diagnóstica de la punción-aspiración con aguja fina en tumores de cabeza y cuello.

Biopsy cannula is a diagnostic tool allowing anatomopathological examination of tissue samples, achieved through a percutaneous perforation. Unlike puncture-aspiration with fine needle method that only permits a cytologic study, this technique eases the removal of pieces big enough to provide the knowledge of the whole architecture of the lesion. At length in other specialities in our has been forgotten perhaps for the great efficiency of PAFN on neck masses or as complement of traditional surgery. We present one case in which the biopsy-cannula showed its diagnostic usefulness. We also discuss on the technique and made a bibliographic perusal about the published literature.

[Subcutaneous cervico-thoracic emphysema and pneumo-mediastinum following a tracheostomy]. / Enfisema subcutáneo cervico-torácico y neumomediastino tras traqueotomía.

Reporting the case of a man, 70-year-old, suffering a chronic obstructive lung disease of moderate degree linked to important Reinke's oedema, who underwent a tracheotomy, being troubled the immediate postoperative period with subcutaneous emphysema and pneumomediastinitis, complications resolved favourably in a ten days term, and the patient could be decannulated.

[Cervical emphysema caused by Forestier's disease]. / Enfisema cervical por enfermedad de forestier.

Diffuse idiopathic skeletal hyperostosis is a rare cause of dysphagia, preferentially affecting older men. This condition is also known as Forestier's malady, being characterized by a paravertebral ossification of 4 contiguous vertebrae at least. Seldom is the last etiology evoked for high dysphagia after other possible diagnosis exclusion. The diagnosis is confirmed by standard or contrast radiography. Introductory treatment is medical, being the surgery indicated for serious or resisting cases. One case is reported with dysphagia as primary sign of Forestier's malady, and review of possible diagnostic exams and treatments.

[Surgery of cancer of the larynx. Analysis of the results of our cases]. / Cirugía del cáncer de laringe. Análisis de resultados de nuestra casuística.

After 20 years of existence of this Department we decided to carry out a review of the characteristics of our series and also of the results of treatment, according to the protocol elaborated and followed in agreement with the Tumour Committee if the Hospital. 631 medical histories of patients diagnosed and operated for cancer of larynx between 1974 and 1990 were reviewed. 83 of which (13.154%) disappeared during the 5 year follow-up period. Epidemiological, clinical, location, extension and treatment fdata were considered as well as the survival results and a single descriptive statistical analysis performed. The mean age of our study was 59.02 years, showing a clear relation to exposure to tobacco (91.44% were smokers and 63.39% of more than 20 cigarettes per day). The predominant location of the growth was supraglottic (64.05% of cases) followed by glottic in 33.76%. The most frequently used surgical technique was the total laryngectomy and total and extended to either the pharynx or tongue basis in 76.28%, followed by supraglottic laryngectomy in 13m5%. The stages were rather advanced with predominance of stage III /40.60%) and stage IV (21.17%). Global survive rate of our series accounted for 68.61% while the adjusted survival rate was 71.4%.

[Otologic manifestations of Langerhans cell histiocytosis]. / Manifestaciones otológicas de la histiocitosis de células de Langerhans.

A case of temporal bone eosinophilic granuloma is reported. The patient had no symptoms other than aural discharge, conductive hearing loss and postauricular swelling. Otic features of Langerhans cell histiocytosis, diagnosis preferences and therapeutic choices are reviewed.

[Giant pleomorphic adenoma in accessory salivary gland]. / Adenoma pleomórfico gigante en glándula salival accesoria.

Giant pleomorphic adenoma is the most common neoplasm of salivary glands, specially of parotitis. Less frequently derives from minor salivary glands and, in the case, its size is small. We report one case of pleomorphic adenoma of great mass seated in a palatine salivary gland and avail the opportunity to review these sort of tumors.

Conocimiento del Síndrome de Apnea Obstructiva del Sueño (SAOS) por parte de los médicos generalistas / Generalist physician knowledge of the syndrome of sleep obstructive apnoea

El Síndrome de Apnea Obstructiva del Sueño (SAOS) ha adquirido una importancia creciente en los últimos años.En este estudio tratamos de evaluar el grado de conocimiento de los médicos de atención primaria sobre esta enfermedad. Para ello, seleccionamos una muestra de 130 médicos generalistas de la ciudad de Zaragoza. Remitimos por correo un cuestionario que constaba de 10 preguntas referentes a aspectos fisiológicos del sueño y su patología incluido el SAOS. 118 cuestionarios (90,7 por ciento) nos fueron devueltos. El 88,1 por ciento de la muestra contestó correctamente entre 4 y 8 preguntas. No hubo diferencias significativas en la puntuación total al agruparla por sexo o año de licenciatura. Es el grupo de menor edad el que contesta más acertadamente (p<0,05) y todos en general, responden mejor a las cuestiones relacionadas con el SAOS.Por todo ello concluimos que el conocimiento de los médicos generalistas sobre patología del sueño es alta (AU)

[ENT changes in Crouzon's syndrome]. / Alteraciones otorrinolaringológicas en el síndrome de Crouzon.

Crouzon's syndrome is a chapter of the craneosynostosis, congenital diseases characterized for the precocious closure of cranial sutures. It represents an autosomal dominant heredity. Recently has been find out that the mutation lies in the short arm of chromosome 10, which causes the alteration of type 2 receptor of growth factor of fibroblasts (FRFG2). Clinically together with the cranial deformities appear frequently malformations in ENT-sphere, but only in 3 percent of all cases has been observed otic changes. We present the case of a young girl of 16, bearing a Crouzon's syndrome, coming to our office because of bilateral hypacusis. Clinical examination and complementary tests showed bilateral atresia of both auditive meatus lack of mastoid pneumatization, anomalous facial route and heavy bilateral transmissive hearing impairment, together with septum nasi deflection and hypoplasy of paranasal sinuses.

[Endocranial invasion of inverted papilloma]. / Invasión endocraneal por papiloma invertido.

Inverted papilloma (PI) is a benign neoplasm of nose and paranasal sinuses. IP's pathophysiology is characterized by its capacity to be locally destructive, its ability to grow rapidly and its tendency to recur. IP's association with carcinoma is about 13 percent of cases. The surgical treatment of IP has evolved over the years, with a progression toward more radical en bloc extirpation. The paper reports an inverted papilloma case of nasal cavities, with destruction of frontal sinus roof and intracranial extension aside frontal lobe displacement.

[Mortality in laryngeal cancer surgery]. / Mortalidad en la cirugía del cáncer de laringe.

UNLABELLED: The causes of death were studied in a series of 171 patients who died in a 5-year follow-up period, out of a total of 631 patients who underwent different surgical techniques for cancer of the larynx. MATERIAL AND METHODS: The case histories of 631 patients who had undergone surgery between 1974 and 1990 were reviewed; 83 did not have a 5-year follow-up and were excluded from the study. A descriptive and inferential statistical study was made of the remaining cases to determine the relation between cause of death and tumoral extension, primary location, degree of tumoral differentiation, surgical technique and other data. RESULTS: Ninety-one patients died from local or regional recurrence, 50 from distant metastases, 20 from diseases other than the tumor, and 10 from postoperative complications. These findings were studied with regard to factors such as tumor extension, location, surgical technique, etc. CONCLUSIONS: The main cause of death in surgery for cancer of the larynx was recurrence, either local, on the tumor bed (62 patients) or regional (29 patients). The mortality rate was higher in older patients, patients with lymph-node involvement in the postoperative histological study, and patients with less differentiated histological forms.

[Vernet's syndrome as an early manifestation of systemic erythematous lupus]. / Síndrome de Vernet como manifestación precoz de un lupus eritematoso sistemico.

Report of one case of Vernet's syndrome (involving the IX, X and XIth cranial nerves) in a young woman, as early sing of SEL. The patient presented the 4 criteria suggested by the American Society in order to diagnose SEL: arthritis, serositis, positive anti-nuclear antibodies and anemia. The AA. carry out a study in search of other cases sitting in the larynx and a perusal about etiopathogenical theories as well. Hinting, for the clinical picture, of being it due to a localised vasculitis of vasa nervorum, a treatment with corticoids and pentoxifylline was ordered, being the outcome, after 3 weeks, the eradication of ENT syndrome.

[Results of 769 stapedectomies performed between 1975 and 1993]. / Resultados de 769 estapedectomías realizadas entre 1975 y 1993.

A retrospective review was made of 719 primary stapedectomies and 48 re-operations carried out between 1975 and 1993. Preoperative and postoperative audiograms (6-12 months) were studied, analyzing 250, 500, 1000, 2000 and 4000 Hz, auditory gain and closure of the air-bone gap < or = 10 dB. Ninety percent had an auditory gain of > or = 10 dB at conversational frequencies. Age, the surgeon, and average preoperative pure tone did not influence the final result. Polyethylene prostheses (70.9%) and steel and teflon pistons (21.1%) were the prostheses used most often. Neurosensorial hearing loss (> 10 dB) occurred in 24 cases (3.3%). In revision stapedectomy, 66.6% of patients had air-bone gap closure of < or = 20 dB and 71% had a hearing gain of < or = 10 dB. Prosthesis displacement (43.7%) and incus necrosis (18.7%) were the most common findings in revision stapedectomy.

[Primary mucous melanoma of the nasal cavity: a case report]. / Melanoma mucoso primario de fosas nasales. A propósito de un caso.

Mucous melanoma in the nasal cavity are unusual tumours that develop from common melanocytes pre-existent in the respiratory epithelium. They manifest a high diagnostic and therapeutic difficulties as well as an obscure prognosis. A case of this rare tumour is exposed and a bibliographic review in which clinical, diagnostic, histological, therapeutic and prognostic features are contemplated.