[Cordectomy in the surgical treatment of tumors T1 of the vocal cords. Review of our cases (1974-1990)]. / La cordectomía en el tratamiento quirúrgico de los tumores T1 de cuerda vocal. Revisión de nuestra casuística (1974-1990).

We decided to review the results of cordectomy in our surroundings over the 22 years of existence of our Service. 631 clinic histories of patients undergoing surgery for laryngeal cancer in our Department, between 1974 and 1990, were reexamined, and from those selected 56 pertaining to T1 tumors treated with cordectomy. In this reduced group were studied epidemiology, clinical and pathologic data, complications, survival and death causes as well. The 58 considered were of male sex, middle aged (58-86) excepting 9 patients under 50. Their relation with tobacco eas clear, although less than in our general series (87.93% smokers). Of the 58 patients group 4 of then disappear during the 5 years follow-up term (8.62%). Three died: one from ganglion disease, other from local recurrence and the last one from other condition. In brief, global survival are accounted for 94.34% and the adjusted survival was 96.1%.

[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%.

[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)

[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.

[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.

[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.

[The influence of age and previous thresholds on stapedectomy results]. / Influencia de la edad y los umbrales óseos previos en el resultado de las estapedectomías.

This is a retrospective study dealing with 719 primary stapedectomies and 48 reoperations done between 1975 and 1993 by the AA. of the paper. They consider the audiometric tracings before and after surgery (6 and 12 months). Frequencies analyzed were 250 Hz, 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz; the air-bone gap; and modifications of bone thresholds. The patients were ranged in groups according the ages and previous bone thresholds. Thereafter an analysis aiming to a comparison of surgery results en each group was contemplated. The age resulted without influence on the postoperative gap neither in modifications of bone conduction. The previous bone thresholds nor influencing the final gap. Conversely there are significative differences (P > 0.01) regarding the modifications of bone conduction.

[Cerebral abscess as a complication of the chronic otitis]. / Absceso cerebral como complicación de la otitis crónica.

Otogenic intracranial complications are now rare. Meningitis is the most frequent, followed by cerebral abscess. In spite of diagnostic and therapeutic advances, cerebral abscess has a high mortality. We report four cases seen in our service over the last five years and their treatment. The subject is reviewed.

[Pleomorphic adenoma of the nasal wall. Revision]. / Adenoma pleomorfo de tabique nasal. Revisión.

The pleomorphic adenoma is the most common neoplasm of the salivary glands, especially the parotid. It can also be originated from minor salivary glands and may appear in nasal cavities and paranasal cavities. We showed a case of pleomorphic adenoma of nasal septum and, at the same time, we reviewed all related bibliography.

[Inflammatory pseudotumor of the paranasal sinuses]. / Pseudotumor inflamatorio de senos paranasales.

The inflammatory pseudotumor of the head and of the neck is a lesion of unknown etiology which affects the orbita more frequently but cases have also been described in the paranasal sinuses, larynx, mouth, cervical column and by direct extension from the orbita in the Central Nervous System. In the majority of cases, it behaves as a limited benignant inflammation within the osseous walls of the area where it is to be found; other times it destroys the osseous limits and invades the surrounding areas, behaving as a neoplasia. It must be distinguished from sinusitis, granulomatous inflammations, vasculitis, diseases of the collagen, sarcoidosis, neoplasias and benignant tumours. We present a case of inflammatory pseudotumour, occupying the right maxillary sinus, nasal fossa and rhinopharynx. Surgical extirpation has been the treatment used.