Carcinoma neuroendocrino de fosa nasal ¿una entidad independiente? / Neuroendocrine carcinoma of nasal fossa. An independant entity?

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Vértigo posicional paroxístico no benigno / No benign paroxystic positival vertigo

El vértigo posicional es una manifestación clínica frecuente de vértigo de causas muy variadas, siendo el vértigo posicional paroxístico benigno (VPPB) el tipo de vértigo posicional más frecuente, representando incluso la causa más frecuente de vértigo periférico en algunas series. Generalmente de etiología benigna, puede aparecer vértigo posicional en el contexto de entidades de gran gravedad y difícil diagnóstico. En estos casos, la persistencia de los síntomas a pesar de las maniobras de reposicionamiento, la asociación con otra sintomatología otológica o neurológica, así como el nistagmo de características atípicas provocado en la maniobra de Dix-Hallpike, deben hacer sospechar al otorrinolaringólogo de la posible existencia de una patología no benigna. Presentamos un caso de VPP causado por una tumoración intracraneal y revisamos los signos clínicos que nos ayudan a sospechar patologías no benignas que pueden simular un vértigo posicional (AU)

Positional vertigo is a frequent clinical manifestation of vertigo of very different etiologies, being the benign paroxystic positional vertigo (BPPV) the most frequent one of them, representing in some series even the most found etiology of peripheral vertigo. Usually of severe entities, positional vertigo may appear in the context of severe entities and of difficult diagnosis. In these cases, the bearing of the symptoms in spite of the repositioning manoeuvers, the association with otological or neurological symptoms, and the atypical nystagmus evoked by Dix-Hallpike manoeuver, must take the otolaryngologist to suspect of a feasible non benign pathology. We report a case of positional paroxysmal vertigo caused by an intracranial tumour and we review the clinical signs that shoved help us to suspect of non benign pathologies that can mimic a positional vertigo (AU)

[Non-benign paroxysmal positional vertigo]. / Vértigo posicional paroxístico no benigno.

Positional vertigo is a frequent clinical manifestation of vertigo of very different etiologies, being the benign paroxystic positional vertigo (BPPV) the most frequent one of them, representing in some series even the most found etiology of peripheral vertigo. Usually of severe entities, positional vertigo may appear in the context of severe entities and of difficult diagnosis. In these cases, the bearing of the symptoms in spite of the repositioning manoeuvers, the association with otological or neurological symptoms, and the atypical nystagmus evoked by Dix-Hallpike manoeuver, must take the otolaryngologist to suspect of a feasible non benign pathology. We report a case of positional paroxysmal vertigo caused by an intracranial tumour and we review the clinical signs that shoved help us to suspect of non benign pathologies that can mimic a positional vertigo.

[Neuroendocrine carcinoma of the nasal fossa. An independent entity?]. / Carcinoma neuroendocrino de fosa nasal. Una entidad independiente?

We present one case of a neuroendocrine carcinoma of nasal fossa and paranasal sinuses, of aggressive behavior, which has been controlled with chemo-radiotherapy after a double postsurgical recurrence. We do a literature revision emphasizing the anatomopathologic differentiation of these tumors with the olfactory neuroblastomas, and the therapeutic controversies in advanced stages.

[Stapedectomy: long term results]. / Resultados a largo plazo de las estapedectomías.

Stapedectomy, with its most innovatory variations, constitutes the treatment of choice for otoesclerosis. Short term results are spectacular, getting GAP closures of less than 5 dB approximatelly in 94% patients, variations depending on the authors. Long term follow up check results show a gradual auditory deterioration. The aim of this study is to audiometric evolution of patients operated of stapedectomy 7 to 10 years ago in our department and to correlate the results with those obtained by other authors, in an attempt to unify conclusions.

Resultados a largo plazo de las estapedectomías / Stapedectomies. Long term results

La estapedectomía, con sus más innovadoras variantes, constituye el tratamiento de elección de la otoesclerosis. Los resultados a corto plazo de esta intervención son espectaculares. El seguimiento a lo largo de los años de estos enfermos parece reflejar un deterioro auditivo paulatino. El objetivo de nuestro trabajo es saber si existe deterioro audiométrico valorable en los enfermos intervenidos de estapedectomía hace más de 7 años con buen resultado inicial. Material y métodos: Revisamos pacientes intervenidos de estapedectomía hace 7-10 años en nuestro servicio con buen resultado inicial valorado en el primer mes y volvimos a realizar una revisión audiológica. Resultados: Se produce un deterioro auditivo significativo valorado en 1,76 dB por año, pasando de una media auditiva previa de 56,2 dB a una postoperatoria inmediata de 27.07 dB, y por fin a una media postoperatoria tardía de 40,65 dB. Conclusión: Se produce una pérdida auditiva significativa tras la estapedectomía con el paso del tiempo, aunque se mantiene una audición significativamente mejor que la inicial (AU)

Stapedectomy, with its most innovatory variations, constitutes the treatment of choice for otoesclerosis. Short term results are spectacular, getting GAP closures of less than 5 dB approximatelly in 94% patients, variations depending on the authors. Long term follow up check results show a gradual auditory deterioration. The aim of this study is to audiometric evolution of patients operated of stapedectomy 7 to 10 years ago in our department and to correlate the results with those obtained by other authors, in an attempt to unify conclusions (AU)

[Histologic changes in soft palate in patients with obstructive sleep apnea]. / Cambios histológicos en el paladar blando en pacientes con apnea obstructiva del sueño.

In patients suffering from obstructive sleep apnea syndrome (OSAS) the reiterate injuries against the soft structures of the pharyngeal wall causes macro- and microscopic damages, which differ basically from the alterations verified in subjects without OSAS. We present a comparative histological study of 45 patients with OSAS operated on uvulopalatopharyngoplasties to face up 10 palates coming from normal post-mortem human among which a comparative anatomopathological study of 8 parameters was realized and the differences between the two groups signaled.

[Kikuchi-Fujimoto's disease and the association with systemic lupus erythematosus]. / Enfermedad de Kikuchi-Fujimoto y su asociación a lupus eritematoso sistémico.

Kikuchi-Fujimoto's disease (KFD), Histiocytic Necrotizing lymphadenitis, is a rare self-limiting condition characterized by lymphadenopathy, fever and neutropenia. The aetiology of KFD is controversial, and its diagnosis is confirmed histologically. Although KFD has rarely been reported associated to Systemic lupus erythemotosus (SLE) should be ruled out given its different prognosis and management. We present the clinical, histological and evolution the two cases of patients with Kikuchi's disease; one case had evolution classic and the other case were associated with SLE.

Enfermedad de Kikuchi-Fujimoto y su asociación a lupus eritematoso sistémico / Kikuchi-Fujimoto's disease and its association with systemic lupus erytematosus

La enfermedad de Kikuchi-Fujimoto (EKF) o linfadenitis necrotizante histiocítica es una patología autolimitada que se caracteriza por linfadenopatías, fiebre y neutropenia entre otros síntomas. La etiología de la EKF es controvertida y será el estudio histológico el que proporcione el diagnóstico de confirmación. Aunque la EKF no es muy frecuente, se han publicado varios casos en los cuales se asocia a Lupus Eritematoso Sistémico (LES) lo cual se ha de tener presente, puesto que modifica tanto el pronostico como el manejo terapéutico de estos pacientes.Se presentan dos casos de enfermedad de Kikuchi: el primero de los casos presente una evolución clásica de la enfermedad, mientras que el segundo caso asoció un LES (AU)

[Lateral cervical tumor of neural etiology: cervical schwannoma]. / Tumoración laterocervical de etiología nerviosa: schwannoma cervical.

Schwannoma are benign tumors of the nerve sheath arising from Schwann cells of cranial and spinal nerves. The most frequent sites are the peripheral nerves of the head and neck and the flexor surfaces of the upper extremities. Cervical schwannoma are rare, which makes them interesting to ENT-specialists. A new case of cervical schwannoma is reported, the literature is reviewed and the pathogenic, criteria and therapy are discussed.

[Dilated vestibular aqueduct syndrome in children. Report of a case]. / Síndrome del acueducto vestibular dilatado en la infancia. A propósito de un caso.

Enlarged vestibular aqueduct syndrome is a clinical condition characterized for a progressive perceptive deafness linked to a broadening of vestibular aqueduct greater than 1.5 mm without other otic abnormal structures. We report the case of a 2-year-old child with such congenital malformation. We have reviewed the actual literature and point out its clinical and physiopathologic features as well treatment possibilities of these cases.

[Tonsillectomy in adults. Our experience]. / Amigdalectomía en adultos. Nuestra experiencia.

Tosillectomy or palatine tonsils removal was by far as the very middle of the twenty century the commonest surgery in childhood, but owing to the abstinence behavior in past decades this operation has dropped considerabily and in consequence numerous grown up presents frequently tonsillar pathology requiring its removal in middle adult life.

[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.

[Benign positional paroxysmal vertigo in the general ear, nose, and throat clinic]. / El vértigo posicional paroxístico benigno en la consulta de ORL general.

Benign positional paroxysmal vertigo is a common disease which may be caused by abnormal movement of utricular debris in the posterior semicircular canal. It is diagnosed by the Dix-Hallpike positional maneuver eliciting vertigo and nystagmus. Treatment generally consists of physical exercises with the Epley or Semont maneuvers. We review 43 consecutive patients diagnosed as BPPV in the last year and treated with physical therapy (Epley maneuvers). Results were very good, with a cure rate of 88.37% (53.5% after a single maneuver). Physical therapy is an effective treatment for BPPV.

[Hernia of the external ear canal of uncommon origin]. / Hernia de etiología infrecuente en el conducto auditivo externo.

The temporo-mandibular joint is directly related to the anterior wall of the external ear canal. Therefore, defects in this wall may lead to herniation of the soft tissues of the temporo-mandibular joint into the external ear canal. Such herniation usually is secondary to external injuries, iatrogenic trauma, neoplasms, and so on, but it may also be congenital. We report a well-documented case of temporo-mandibular joint herniation into the external ear canal of probable congenital origin.

[Diffuse deep cervical infection. Report of three cases]. / Infección cervical profunda difusa. A propósito de tres casos.

Deep cervical infections still appear despite antibiotic use. Necrotizing fasciitis of the head and neck is a rare but serious infection caused by mixed, predominantly anaerobic bacterial flora. The natural course of the disease is spreading necrosis of the soft tissues of the neck and septicemia. Three recent cases of cervical necrotizing soft-tissue infection are presented. The importance of early and aggressive surgical treatment complemented by parenteral antibiotics with an aerobic-anaerobic spectrum is emphasized.

Infección cervical profunda difusa. A propósito de tres casos / Diffuse deep cervical infection. Report of three cases

Las infecciones cervicales profundas continúan apareciendo en la actualidad, a pesar del uso de los antibióticos. Las fascitis necrotizantes de cabeza y cuello son infecciones raras pero graves, de etiología polimicrobiana con predominio de gérmenes anaerobios. El curso natural de la enfermedad supone la necrosis de los tejidos profundos del cuello y la septicemia. Presentamos tres casos recientes de infección cervical profunda haciendo énfasis en la importancia del tratamiento quirúrgico precoz y agresivo, complementado con el uso parenteral de antibióticos de espectro aero-anaerobio (AU)

Deep cervical infections still appear despite antibiotic use. Necrotizing fasciitis of the head and neck is a rare but serious infection caused by mixed, predominantly anaerobic bacterial flora. The natural course of the disease is spreading necrosis of the soft tissues of the neck and septicemia. Three recent cases of cervical necrotizing soft-tissue infection are presented. The importance of early and aggressive surgical treatment complemented by parenteral antibiotics with an aerobic-anaerobic spectrum is emphasized (AU)

[Sphenoidal mucocele. A case report]. / Mucocele esfenoidal. A propósito de un caso.

Mucocele of the sphenoidal sinus is a rare benign neoplasm. These tumors are probably under-diagnosed as they may be asymptomatic or cause non-specific symptoms. The findings of computed tomography and magnetic resonance imaging increase the precision of the pretherapeutic evaluation. Treatment is surgical. A case of sphenoidal sinus mucocele in a 41-year-old man is reported. Sudden dyplopia was the first symptom. The characteristics of sphenoidal mucocele are reviewed, with special attention to its clinical features and radiodiagnosis.

[The effect of tobacco consumption on acoustic voice analysis]. / Efecto del consumo de tabaco en el análisis acústico de la voz.

An observational study of acoustic voice parameters was made in non-dysphonic adult smokers and non-smokers. The sustained vocal /a/ of 79 smokers and 169 non-smokers was recorded with Mini-Disk equipment. Acoustic analysis was performed with the Dr. Speech Science 3.0 program. Some acoustic parameters differed between smokers and non-smokers: the fundamental frequency (FQ) was lower in smokers. Average jitter (PPQ) and shimmer (APQ) were higher in smokers (Ji:0.27%, Shi: 2.56%) than in non-smokers (Ji: 0.23%, Shi: 2.02%). HNR and NNE values did not differ significantly.

[Our experience in chondrosarcoma. Three case reports]. / Nuestra experiencia en condrosarcomas de laringe. A propósito de 3 casos.

Sarcoma of the larynx are extremely rare neoplasms that account for approximately 1% of all tumors of this organ. Less than 0.1% correspond to chondrosarcomas. Three cases of laryngeal chondromas are described. The patient's age ranged between 65 and 75 years, and all they were men. Two of the tumors arose in the cricoid cartilage, and the other one, in the left wing of the thyroid cartilage. Two of the cases corresponded to high-grade, indifferentiated chondrosarcoma. Two of the patients were alive and free of recurrence of metastases 5 years after surgery.