[Surgical treatment of primary hyperparathyroidism. A descriptive analysis]. / Tratamiento quirúrgico del hiperparatiroidismo primario. Estudio descriptivo.

In the last decades the primary hyperparthyroidism has become a common disease, often diagnosed by biochemical chance. The Elche General Hospital Department of Otorhinolaryngology has performed 55 parathyroidectomies between November 1996 and March 2003. Thirty-six cases (65.4%) were diagnosed as primary hyperparathyroidism. This disease usually has few symptoms. Since February 2000, Elche Hospital has available a device for quick appraisal of parathormone rate, allowing us in a few minutes to determine it and with the patient still in the operating theatre. The surgery results were: 25 solitary adenomas, 6 double adenomas and 5 hyperplasic. All patients became normocalcemic, and there were no major complications in this series.

Tratamiento quirúrgico del hiperparatiroidismo primario. Estudio descriptivo / Surgical treatment of primary hyperparathyroidism. A descriptive analysis

En las últimas décadas el hiperparatiroidismo primario se ha convertido en una enfermedad común, a menudo diagnosticado al azar en una determinación bioquímica. El Servicio de Otorrinolaringología del Hospital General de Elche ha intervenido quirúrgicamente 55 paratiroidectomías entre noviembre de 1996 y marzo de 2003. Treinta y seis casos (65,4 por ciento) son diagnosticados de hiperparatiroidismo primario. Esta enfermedad generalmente presenta síntomas muy sutiles. Desde febrero de 2000 el Hospital de Elche posee un aparato de detección rápida de nivel de hormona paratiroidea, permitiéndonos en pocos minutos su determinación intraoperatoriamente. Los resultados quirúrgicos son: 25 adenomas solitarios, 6 dobles adenomas y 5 hiperplasias. Todos los pacientes permanecen normocalcémicos y no se han presentado complicaciones significativas en este estudio (AU)

In the last decades the primary hyperparthyroidism has become a common disease, often diagnosed by biochemical chance. The Elche General Hospital Department of Otorhinolaryngology has performed 55 parathyroidectomies between November 1996 and March 2003. Thirty-six cases (65.4%) were diagnosed as primary hyperparathyroidism. This disease usually has few symptoms. Since February 2000, Elche Hospital has available a device for quick appraisal of parathormone rate, allowing us in a few minutes to determine it and with the patient still in the operating theatre. The surgery results were: 25 solitary adenomas, 6 double adenomas and 5 hyperplasic. All patients became normocalcemic, and there were no major complications in this series (AU)

[Report of a case: large tonsillolith in palatine tonsil]. / A propósito de un caso: gran tonsilolito en amígdala palatina.

A 69-year-old woman presented with a one-year history of dysphagia and a hard overgrowth of the right palatine tonsil visible in oral examination. Computerized Tomography scan showed a big calcified lesion inside the tonsil not seen in a pharyngoscopy. Tonsillectomy was performed and a giant tonsillolith was found inside the resected piece. The calculus was 3 x 2 x 2.3 cm and with an irregular-pyramidal shape. Normal tonsillar tissue with many colonies of Actionomyces inside the tonsillar crypts was the definitive pathological feature.

A propósito de un caso: gran tonsilolito en amígdala palatina / Giant tonsillolith in palatine tonsil: report of one case

Presentamos el caso de una paciente de 69 años con clínica de disfagia de un año de evolución. En la exploración se apreció crecimiento de amígdala palatina derecha, con consistencia dura. La tomografía computerizada mostró una imagen de gran calcificación ocupando el centro de la amígdala, no evidenciable por faringoscopia. Realizada la extracción quirúrgica de la amígdala, en su interior se halló un tonsilolito gigante, con forma de pirámide irregular de 3x2x2,3 cm. El análisis histopatológico de la pieza de amigdalectomía se informó como tejido amigdalar dentro de los límites normales con presencia de numerosas colonias de actinomices en las criptas (AU)

A 69-year-old woman presented with a one-year history of dysphagia and a hard overgrowth of the right palatine tonsil visible in oral examination. Computerized Tomography scan showed a big calcified lesion inside the tonsil not seen in a pharyngoscopy. Tonsillectomy was performed and a giant tonsillolith was found inside the resected piece. The calculus was 3 x 2 x 2.3 cm and with an irregular-pyramidal shape. Normal tonsillar tissue with many colonies of Actionomyces inside the tonsillar crypts was the definitive pathological feature (AU)

[Rhinoscleroma. A case report]. / Rinoescleroma. A propósito de un caso.

Rhinoscleroma is a chronic, specific, inflammatory granulomatous condition of the nose and other structures of the upper respiratory tract. It is caused by the bacterium Klebsiella rhinoscleromatis. We report a case in a 29-year-old black male emigrant who consulted for a 2-year history of hoarseness, cough, and nasal discharge. The diagnosis was scleroma with nasal, laryngeal, tracheal, and bronchial involvement and ulcerating and necrotizing lesions that caused respiratory obstruction. Bacterial over-infection responded to treatment with third-generation cephalosporins and clindamycin. The sclerotic lesions responded well to treatment with ciprofloxacin. We review the clinical findings at different stages, diagnostic options, and several treatments.