[Nasal T lymphoma]. / Linfoma T nasal.

Nasal T lymphoma constitute a type of lymphoproliferative very infrequent symdrome. One of the fondamental problems it presents to bring a high probability of survival obtain a precocious diagnose. It is due that it originates inespecific histologic lesions, and to its clinic. Only the close cooperation between the otorhinolaryngologist and the anatomopathologist can arrive to obtain a very speedy diagnose and in that way the possibility of a correct treatment, because newly treatments appear, to which this type of disease every day better respond. We present the cases of nasal T lymphomas diagnosticated in the ORL Service of the Toledo area during 15 years, their symptomotology, treatment, evolution and survival. Besides a up to date bibliographic revision on this controversial syndrome.

Linfoma T nasal / Nasal T lymphoma

Los linfomas T nasals constituyen un tipo de síndrome linfoproliferativo muy infrecuente. Uno de los problemas fundamentales que presenta para aportar una alta probabilidad de supervivencia a quien lo padece, es la dificultad que presenta para poder llevar a un precoz diagnóstico. Esto es debido a que origina unas lesiones histológicas inespecíficas, así como su clínica. Únicamente la estrecha cooperación entre el otorrinolaringólogo y el anatomopatologo, piuede llegar a obtener un diagnóstico con la mayor celeridad, y por tanto, poder tratarlo de forma correcta; ya que están apareciendo tratamientos novedosos a los que este tipo de enfermedad cada vez están respondiendo mejor. Se presentan los casos de linfomas T nasales diagnosticados en el Servicio de ORL del área sanitaria de Toledo, en un período de 15 años, su sintomatología, tratamiento, evolución y supervivencia. Además de una revisión bibliográfica actualizada sobre este controvertido síndrome

Nasal T lymphoma constitute a type of lymphoproliferative very infrequent symdrome. One of the fondamental problems it presents to bring a high probability of survival obtain a precocious diagnose. It is due that it originates inespecific histologic lesions, and to its clinic. Only the close cooperation between the otorhinolaryngologist and the anatomopathologist can arrive to obtain a very speedy diagnose and in that way the possibility of a correct treatment, because newly treatments appear, to which this type of disease every day better respond. We present the cases of nasal T lymphomas diagnosticated in the ORL Service of the Toledo area during 15 years, their symptomotology, treatment, evolution and survival. Besides a up to date bibliographic revision on this controversial syndrome

[Parotid tuberculosis simulating neoplasia. Presentation of a case and review of literature]. / Tuberculosis parotídea, simulando neoplasia. Presentación de un caso y revisión de la literatura.

A case ofparotid tuberculosis (PTB) that during its clinical presentation complementary proofs, exploration and realised treatment made suspect as first possibility a parotid tumor is presented. After an histologic study, it could be proved that the real problem of the patient was that she had suffered a parotid tuberculosis. An exposition of the case is made with the different technics that must be realised facing a patient of these caracteristics, before thinking in surgery, although secure, but with its mortal risks in these times where the incidence of tuberculosis is increasing in the first world.

[Laryngeal leishmaniasis]. / Leishmaniasis laríngea.

Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed.

Tuberculosis parotídea, simulando neoplasia. Presentación de un caso y revisión de la literatura / Parotid tuberculosis simulating neoplasia. Presentation of a cse review of literature

Se presenta un caso de tuberculosis parotídea (PTB), que durante su presentación clínica, pruebas complementarias exploratorias y tratamientos realizados; hizo sospechar como primera posibilidad, que presentaba un tumor en dicha glándula. Una vez estudiada histológicamente, se pudo comprobar como realmente el problema de la paciente era que había padecido una tuberculosis parotídea. Se hace una exposición del caso, así como las diferentes técnicas que se deben realizar ante un paciente de estas características, antes de llegar a someterle a una cirugía, que aunque segura, siempre entraña cierto riesgo de morbilidad. Sobre todo en estos tiempos en los que de nuevo la incidencia de tuberculosis está aumentando en el “primer mundo”

A case of parotid tuberculosis (PTB) that during its clinical presentation complementary proofs, exploration and realised treatment made suspect as first possibility a parotid tumor is presented. After and histologic study, it could be proved that the real problem of the patient was that she had suffered a parotid tuberculosis. An exposition of the case is made with the different technics that must be realised facing a patient of these characteristics, before thinking in surgery, although secure, but with its mortal risks in these times where the incidence of tuberculosis is increasing in the first world

Leishmaniasis laríngea / Laryngeal leishmaniasis

La leishmaniasis consiste en una infección zoonótica, es decir, que afecta a los animales. Debido a la picadura de la hembra de la mosca de arena del género Phlebotomus (en el Viejo Mundo) o Lutzomyia (en el Nuevo Mundo), el ser humano también la puede padecer. Las manifestaciones clínicas son muy variadas, dependiendo de factores relacionados con el huésped, el vector y el propio parásito. En el presente trabajo se exponen los tres únicos casos de leishmaniasis que afectan a la laringe, diagnosticados en el área sanitaria de Toledo. Debido a las características específicas que presentan cada caso, se han realizado diferentes tratamientos para cada uno de ellos, exponiéndose su resultado y seguimiento. Se presenta una revisión bibliográfica actualizada de la enfermedad, donde se hace referencia a los últimos conocimientos publicados sobre esta peculiar parasitosis

Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed

[Respiratory stridency by larynx paralysis. Anusual beginning of miastenia]. / Estridor respiratorio por parálisis laríngea. Debut inusual de miastenia gravis.

A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized.

Estridor respiratorio por parálisis laríngea. Debut inusual de miastenia gravis / Respiratory stridency by larynx paralysis. Anusual beginning of miastenia

Se presenta un caso de miastenia gravis que debuta con un cuadro de disnea secundaria a una parálisis laríngea bilateral en aducción. Durante el cuadro evolutivo de la miastenia gravis, no resulta infrecuente la afectación de la musculatura laríngea; pero sin embargo, después de haber realizada una revisión bibliográfica, se ha comprobado lo infrecuente que resulta el que esta enfermedad debute en un paciente mediante una parálisis laríngea bilateral en aducción. Se realiza una amplia exposición del caso clínico, métodos de exploración para llegar al diagnóstico de la miastenia gravis, y las diferentes opciones de tratamiento que actualmente existen para poder controlar esta enfermedad

A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized

[Laryngeal tuberculosis. Incidence between 1994 and 2004]. / Tuberculosis laríngea. Casos incidentes entre 1994-2004.

Tuberculosis is the chronic granulomatose most common infection of the larynx. It appears generally from pulmonary tuberculosis. It prevails in men. The most habitual symptomatology includes dysphony, odinophagy, referred otalgy and sometimes dispnea. The majority of patients use to have radiological pulmonary affectation to the diagnosis. The nodular exophitic or ulcerous lesions can be confused with carcinoma, therefore in these cases the anatomopathologic study is essential. The diagnosis is made with positive spit samples, specific characteristics of the thorax radiography and the positive biopsies of acid-alcohol resistant bacillus. We present the patients diagnosed with laryngeal tuberculosis in our hospital between 1994 and 2004. We describe the diagnostic procedures realised and the adopted therapeutic attitude in every case and results.

Tuberculosis laríngea. Casos incidentes entre 1994-2004 / Laryngeal tuberculosis. Incidentic cases between 1994 and 2004

La tuberculosis es la infección crónica granulomatosa más común de la laringe. Aparece, generalmente a partir de una tuberculosis pulmonar. Predomina en hombres. La sintomatología más habitual incluye disfonía, odinofagia, otalgia referida ya veces disnea. La mayoría de los pacientes suelen tener afectación pulmonar radiológica al diagnóstico. Las lesiones nodulares exofiticas o ulcerosas pueden confundirse con carcinoma, por lo que en estos casos es imprescindible el estudio anatomopatológico. El diagnóstico se hace mediante muestras de esputos positivos, características específicas de la radiografia de tórax y las biopsias positivas de bacilos ácido-alcohol resistentes. Se presentan los pacientes diagnosticados de tuberculosis laríngea en nuestro hospital entre 1994 y 2004. Se describen las pruebas diagnósticas realizadas así como la actitud terapéutica adoptada en cada uno de ellos y sus resultados

Tuberculosis is the chronic granulomatose most common infection of the larynx. It appears generally from pulmonary tuberculosis. It prevails in men. The most habitual symptomatology includes dysphony, odinophagy, referred otalgy and sometimes dispnea. The majority of patients use to have radiological pulmonary affectation to the diagnosis. The nodular exophitic or ulcerous lesions can be confused with carcinoma, therefore in these cases the anatomopathologic study is essential. The diagnosis is made with positive spit samples, specific characteristics of the thorax radiography and the positive biopsies of acid-alcohol resistant bacillus. We present the patients diagnosed with laryngeal tuberculosis in our hospital between 1994 and 2004. We describe the diagnostic procedures realised and the adopted therapeutic attitude in every case and results

Amiloidosis laríngea. Revisión bibliográfica y actualización / Laryngeal amiloidosis. Bibliographic revision and actualisation

La amiloidosis es una extraña enfermedad producida por el depósito extracelular de un material proteínico, homogéneo, eosinofílico en forma de fibrillas llamado amiloide. Esto va a producir una alteración de la homeostasia del órgano afectado. Se presentan tres únicos casos diagnosticados en nuestra institución, de amiloidosis laríngea localizada en el periodo comprendido entre el año 1990-2004. El diagnóstico y el tratamiento fue realizado mediante microcirugía endolaríngea convencional. Por otro lado, se expone una revisión bibliográfica actualizada donde se expone las tendencias más actuales sobre este proceso

The amyloidosis is a uncommon and rare entity. It is a condition characterized by the extracellular deposition of homogeneous, eosinophilic proteinaceous material in the form of fibrils called «amyloid». This situation make a disfunction of the homeostasy in the affected place. In this letter we present three cases of localized laryngeal amyloidosis diagnosed between 1990 and 2004. Diagnosis and treatment were made in the three cases by direct laringoscopic and conventional microsurgery. Also we expose a actualised bibliographic review about studies more recent

[Juvenile nasopharyngeal angiofibroma]. / Angiofibroma nasofaringeo juvenil. Situación actual.

Juvenile Juvenile nasopharyngeal angiofibroma (JNA) is a benign and highly vascular tumor. In this article we present a case treated in our institution. We present form of presentation, exploration and intra-arterial pre-operative embolization by neuroradiology, and the treatment with the Le Fort technique. JNA has a complex anatomy, high recurrence and special histopathology, therefore the surgery is very complex and as an with high morbidity. The pre-operative embolization has decrease the hemorragic complications. We review the literature the of the JNA nowadays.

Angiofibroma nasofaringeo juvenil. Situación actual / Juvenile nasopharyngeal angiofibroma

El angiofibroma nasofaríngeo juvenil (AJN) es un infrecuente tumor benigno y altamente vascularizado. En esteartículo se presenta un caso tratado en nuestro servicio. Se describe la forma de presentación, pruebas diagnósticas, preparación previo al tratamiento mediante embolización de arterias nutricias por parte de los neurorradiólogos vasculares, y la vía de abordaje LeFort para el tratamiento.Debido a la complejidad del abordaje por su localización, alta recurrencia, e histopatología; la cirugía siempre ha tenido un cierto grado de morbilidad. La embolización preoperatoria ha contribuido a disminuirla.Se presenta una revisión bibliográfica de las últimastendencias sobre la situación actual sobre este tumor

Juvenile Juvenile nasopharyngeal angiofibroma (JNA) is a benign and highly vascular tumor. In this article we present a case treated in our institution. We present form of presentation, exploration and intra-arterial pre-operative embolization by neuroradiology, and the treatment with the Le Fort technique. JNA has a complex anatomy, high recurrence and special histopathology, therefore the surgery is very complex and as an with high morbidity. The pre-operative embolization has decrease the hemorragic complications. We review the literature the of the JNA nowadays

[Neck and thorax multifocal rhabdomyoma. A case report and review of the literature]. / Rabdomioma multifocal cervical y torácico. Descripción del caso y revisión de la literarura.

We present one rare case of multifocal rabdomyoma in the cervical region and chest. We describe the presentation, clinical, special tests done for the diagnosis and localization. Therefore we present the type of the treatment and evolution post therapy. We review the literature.

Rabdomioma multifocal cervical y torácico. Descripción del caso y revisión de la literatura / Cervical and thoracic multifocal rabdomyoma. A case report

Se presenta un caso infrecuente de rabdomioma multifocal con una localización cervical y otra torácica no aparecida anteriormente en la literatura.Se describe la forma de presentación, las técnicas exploratorias realizadas para llegar a su diagnóstico y localización; el tratamiento utilizado así como la evolución inmediata posoperatoria y seguimiento.Por otro lado, se expone una revisión bibliográfica de lo existente hasta ahora en relación a este tipo de tumor, con esta peculiar y poco frecuente forma multifocal de presentación, y las diferentes localizaciones descritas por otros

We present one rare case of multifocal rabdomyoma in the cervical region and chest. We describe the presentation, clinical, special tests done for the diagnosis and localization. Therefore we present the type of the treatment and evolution post therapy.We review the literature

[Laryngeal amyloidosis. Bibliographic revision and actualisation]. / Amiloidosis laríngea. Revisión bibliográfica y actualización.

The amyloidosis is a uncommon and rare entity. It is a condition characterized by the extracellular deposition of homogeneous, eosinophilic proteinaceous material in the form of fibrils called "amyloid". This situation make a disfunction of the homeostasy in the affected place. In this letter we present three cases of localized laryngeal amyloidosis diagnosed between 1990 and 2004. Diagnosis and treatment were made in the three cases by direct laringoscopic and conventional microsurgery. Also we expose a actualised bibliographic review about studies more recent.

[Ten years of ENT surgery in the Toledo's outpatient surgery unit]. / Diez años de cirugía otorrinolaringológica en la unidad de cirugía mayor ambulatoria de Toledo.

One of the Spain's pioneer out patient surgery units is the Toledo's one. We have realized a retrospective study of the 10th first years of its functioning. During this period, 4733 patients were operated, on tonsills and adenoids, laryngeal microsurgeries, septoplasties, miringotomies, and miringoplasties. We obtained a 91.8% of discharge from hospital in the same day and few complications (5.5% without hospitalization and 0.7% with). Thanks to a questionary we know that the degree of satisfaction of the patients is high, and so, added to our good statistic results, stimulate us to follow in this working line.

Diez años de cirugía otorrinolaringológica en la unidad de cirugía mayor ambulatoria de Toledo / Ten years of ent surgery in the Toledo's out patient surgery unit

Una de las unidades de cirugía mayor ambulatoria pioneras de Espala, es la de Toledo. Hemos realizado un estudio retrospectivo de los 10 primeros años de su funcionamiento. En este lapso, se han intervenido 4733 pacientes, realizándose cirugías de amígdalas y adenoides, microcirugías laringeas, septoplastias, miringotomías y miringoplastias. Hemos obtenido un 91,8 por ciento de altas en el día y escasas complicaciones (5,5 por ciento sin hospitalización, 0,7 por ciento con ingreso). Gracias a una encuesta, sabemos que el grado de satisfacción del usuario es alto, lo que, sumado a nuestros buenos resultados estadísticos, nos estimulan a seguir en esta línea de trabajo (AU)

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[Actinomycosis sub-masseter abscess, simulating a parotiditis. Review of case and revision of literature]. / Absceso submaseterino por actinomicosis, simulando parotiditis. Descripción del caso y revisión de la literatura.

We present one case of a pluripathologic female patient who has developed an submaseterin abscess secondary to an actinomyces mandibular osteomielitis. The initial presentation seems an acute supurative parothiditis. We describe its presentation, evolution, special tests done for its diagnostic, as also the discussion of the type and duration of the treatment. And we include also a differential diagnosis between the two diseases, with a similar form. We do also a bibliographic revision of the few similar cases published.

Absceso submaseterino por actinomicosis, simulando parotiditis descripción del caso y revisión de la literatura / Actinomycosis submaseterin absces, simulating a parothiditis, description of the case and revision of the literatur

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