[Mitochondrial and microcirculatory distress syndrome in the critical patient. Therapeutic implications]. / Síndrome de distrés mitocondrial y de la microcirculación en el paciente crítico. Implicaciones terapéuticas.

Mitochondrial and microcirculatory distress syndrome (MMDS) can occur during systemic inflammatory response syndrome (SIRS), and is characterized by cytopathic tissue hypoxia uncorrected by oxygen transport optimization, and associated with an acquired defect in the use of oxygen and energy production in mitochondria, leading to multiple organ dysfunction (MOD). We examine the pathogenesis of MMDS, new diagnostic methods, and recent therapeutic approaches adapted to each of the three phases in the evolution of the syndrome. In the initial phase, the aim is prevention and early reversal of mitochondrial dysfunction. Once the latter is established, the aim is to restore flow of the electron chain, mitochondrial respiration, and to avoid cellular energy collapse. Finally, in the third (resolution) stage, treatment should focus on stimulating mitochondrial biogenesis and the repair or replacement of damaged mitochondria.

Anatomical relationship between the position of the sigmoid sinus, tympanic membrane and digastric ridge with the mastoid segment of the facial nerve.

Our study was carried out to examine the relationships of the sigmoid sinus, tympanic membrane and digastric ridge with the mastoid segment of the facial nerve. We studied 33 adult temporal bones. The distances among these structures were evaluated according specific landmarks that can be repeated in a simple manner. We found a good relation, in a proportional and lineal order, between these three structures and the facial nerve. This study indicated a correlation between the position of these three structures and the mastoid segment of the facial nerve through a simple morphometric method.

[A case of bilateral otohematoma]. / Otohematoma bilateral: a propósito de un caso.

We denominate otohematoma to the blood stock in the pinna. It occurs by the broke of pinna drilling vessels. Its origin is traumatic. It is usual after soft but continuous hits, less often after hard and unique ones, and more less often bilateral forms like the case we present.

[Morphological changes in adenotonsillar tissue as early manifestation of asymptomatic HIV patient]. / Cambios morfológicos en el tejido adenoamigdalar como manifestación inicial de HIV en pacientes asintomáticos.

The HIV virus induces in the host several changes in your immunological system, which heads to the AIDS. We report two cases diagnosed by pathological studies after adenotonsilectomy for adenotonsilar hypertrophy. The diagnosis of HIV patients is suspected by epidemiologic (risk groups) or clinical features (opportunist diseases). But, it exists a early diagnosis, the histological findings in the extranodal lymphoid tissues, unusual on the literature. These phenomenons re-enforce the contamination way by means of the superior aerodigestive tract mucosis.

[Recurrent Bell's facial palsy: our experience]. / Parálisis facial de Bell recurrente: nuestra experiencia.

Recurrent facial palsy is noted infrequently in the literature. We present a comparative study of recurrent Bell's palsy (RBP) with regard to non-recurrent Bell's palsy (NRBP). Afterwards we compare among RBP cases those of ipsilateral recurrence (RRBP) to those of contralateral one (ARBP). We constate that non-recurrent Bell'palsy formes behave similarly to the contralateral recurrent forms.

[Stapedectomy versus stapedotomy. Our experience]. / Estapedectomía versus estapedotomía. Nuestra experiencia.

Otosclerosis surgery has seen three well-differentiated stages of development: a) SHC fenestration; b) stapes mobilization, and c) platinectomy, a procedure introduced in 1960 by Shea. Since then, only one variation has been proposed: platinotomy. After a comparative study of platinectomy versus platinotomy, we, like other authors, concluded that platinotomy was a better technique because of the ease of execution and good functional results.

[Treatment of idiopathic facial paralysis: corticoids versus acyclovir versus empirical treatment]. / Tratamiento de la parálisis facial idiopática: corticoides versus aciclovir versus empírico.

Bell's palsy has no specific treatment because its cause is still debated. The most widely accepted theory postulates an immunovirological origin consisting of the reactivation of a silent herpesvirus on the geniculate ganglion. We studied three groups of patients with Bell's palsy who received different treatments in an attempt to discern differences in evolution between treatment groups.

[The ear of a boxer from Canary islands]. / La oreja del luchador Canario.

The canary fight is a sport with traditional character deeply-rooted in Spain. The pinna rubbing by bodies contact in hand-to-hand combat produce a typical deformity. We present this pathology not only due to its specific pathogenesis but also as part of the cultural patrimony of Canary Islands (Fortunate Islands).

[Anomalies of the facial nerve]. / Anomalía del nervio facial.

An anomaly of the tympanic segment of the facial nerve in an adult cadaver specimen is reported. The second portion of the facial nerve crossed between the stapedal pillars. The rarity of this anomaly, particularly in a well constituted temporal bone, is discussed.

[Idiopathic facial hemispasm: a case report]. / Hemiespasmo facial idiopático: a propósito de un caso.

A case of prolonged, slowly progressive, idiopathic hemifacial spasm in a 68-year-old man is presented. A suspected cerebellopontine angle lesion was confirmed by MRI and digital angiography. Cerebellopontine angle lesions have to be differentiated from idiopathic hemifacial spasm.

[Bell's facial paralysis. Study with magnetic resonance and gadolinium]. / Parálisis facial de Bell. Estudio con resonancia magnética y gadolinio.

The facial never was investigated by gadolinium-enhanced MR in 7 patients diagnosed as Bell's Palsy. All cases showed complete facial paralysis, and were studied on the acute phase of the disease. Most Bell's palsy patients demonstrate facial nerve enhancement, usually in the tympanic and labyrinthine segments. No gadolinium enhancement on the opposite facial never was seen in this serie. Because Gad-MR does not appear to influence the therapeutic decision, it may not be necessary in the management of Bell's Palsy.

Acute epiglottitis in the adult.

Acute epiglottitis in the adult is a rare disease, which has shown an appreciable increase since the sixties and in our locality since 1984. We present a review of the cases registered in our hospital, analyzing their aetiology, evolution and treatment. The disease is most likely to be suspected in the presence of any patient having a sudden dysphagia, especially if he shows symptoms of an acute infection and a lack of oropharyngeal pathology.

Extramedullary nasal plasmacytoma.

The literature on this rare tumour has been reviewed and three cases of nasal plasmacytoma are described. Immunohistochemistry demonstrated cytoplasmic IgA and Kappa determinants in all cases. Two patients are disease-free at the present time, the third developed an IgG-k multiple myeloma, previously not described in the literature.

Eosinophilic granuloma of the temporal bone.

Involvement of the temporal bone by eosinophilic granuloma is rare. Two cases are presented and their clinical manifestations, histopathological findings and treatment procedures discussed.

Nasal myiasis due to Oestrus ovis larvae.

Herein we report our experiences in managing nasal infestation due to fly larvae in an urban population. The nasosinus location is infrequently seen in cases with human infection. The life cycle of the fly (Oestrus ovis) is discussed in view of the clinical features of our case.