[Atypical thyrogloss cyst]. / Quiste tirogloso atípico.

UNLABELLED: The thyrogloss cysts present themselves usually as unique tumorations in the anterior cervical zone, more frequently in the second decade of life and affecting equally the two sexs. They move typically with the movements of deglution and can increase its volume with infections processes. In seldom occasions, the thyrogloss cysts can present symptoms as dysphonia, dysphagia or dyspnea facts that can suggest its laryngeal extension. METHODS: We present a case of a patient affected by dysphonia of long evolution, associated to the presence of a cervical mass. The CT showed a cervical cyst with extension to the left preepiglottic and paraglottic space with compression of the left thyroid wing. Although the clinic impression was a laryngeal neoplasia, the CT helped to realize the diagnosis ofthyrogloss cyst. During the surgery the thyrogloss cyst was removed with success, with the technique of Sistrunk and the patient recovered the voice. CONCLUSIONS: We present this case and realize a bibliographic revision on thyrogloss cysts, with atypical symptoms. We discuss also the role of CT in the diagnostic process in these types of processes.

Quiste tirogloso atípico / Atypical thyrogloss cyst

Los quistes tiroglosos se presentan habitualmente como tumoraciones únicas en la zona cervical anterior, más frecuentemente en la segunda década de la vida y afectando por igual a ambos sexos. Se desplazan típicamente con los movimientos deglutorios y pueden aumentar de tamaño con los procesos infecciosos. En raras ocasiones, los quistes tiroglosos cursan con síntomas tales como disfonía, disfagia o disnea hecho que debe sugerirnos la extensión laríngea del mismo. Métodos: Se presenta el caso de un paciente con una disfonía de de larga evolución asociada a la presencia de una masa cervical. La TAC mostró un quiste cervical con extensión hacia el espacio preepiglótico y paraglótico izquierdo con compresión del ala tiroidea izquierda. A pesar de que la impresión clínica era la de una neoplasia laríngea, la TAC ayudó a realizar el diagnóstico de quiste tirogloso. Durante la cirugía, el quiste tirogloso fueextraído con éxito mediante la técnica de Sistrunk y el paciente se recuperó de su disfonía. Conclusiones: Se presenta este caso y se realiza una revisión bibliográfica sobre quistes tiroglosos que cursan con síntomas atípicos. Asimismo se discute el papele de la TAC en el proceso diagnóstico de este tipo de procesos

The thyrogloss cysts present them selves usually as unique tumorations in the anterior cervical zone, more frequently in the second decade of life and affecting equally the two sexs. They move typically with the movements of deglution and can increase its volume with infections processes. In seldom occasions, the thyrogloss cysts can present symptoms as dysphonia, dysphagia or dyspnea facts that can suggest its laryngeal extension. Methods: We present a case of a patient affected by dysphonia of long evolution, associated to the presence of a cervical mass. The CT showed a cervical cyst with extension to the left preepiglottic and paraglottic space with compression of the left thyroidwing. Although the clinic impression was a laryngeal neoplasia, the CT helped to realize the diagnosis of thyrogloss cyst. During the surgery the thyrogloss cyst was removed with success, with the technique of Sistrunk and the patient recovered the voice. Conclusions: We present this case and realize a bibliographic revision on thyrogloss cysts, with atypical symptoms. We discuss algo the role of CT in the diagnostic process in these types of processe

[Treatment and complications of oesophagic foreign bodies]. / Manejo y complicaciones de cuerpos extraños esofágicos. Revisión de 77 casos.

OBJECTIVE: Revision of characteristics and diagnosis methods and treatment of foreign bodies (FB) embed in the oesophagus (OFB). METHOD: We have realized a retrospective study since 1994 to 2002, with 77 cases with suspicion of ingestion of the (OFB) treated in our ENT Service. RESULTS: We realized a total of 83 oesophagoscopies, flexible and rigid, that reaveled the oesophagic superior third, as the most common place of embedding, dysphagia as the most predominant symptom and coins and bones as the most common type of FB. Most of the cases did not present any kind of complications, but we present a case of death. CONCLUSIONS: The oesophagoscopies are a very useful method conditioned by the kind of FB and experience of the surgeon. We must not subestimate the complications of the embedding of the OFB, because they can be mortals, although they are.

Manejo y complicaciones de cuerpos extraños esofágicos. Revisión de 77 casos / Treatment and complications of oesophagic foreign bodies

Objetivo: Revisar características y métodos diagnósticos y de tratamiento de cuerpos extraños (CE) enclavados en el esófago (CEE). Métodos: Hemos realizado un estudio retrospectivo desde 1994 a 2002 que comprende 77 casos con sospecha de ingesta de CEE que fueron tratados en nuestro Servicio de ORL. Resultados: Se realizaron un total de 83 esofagoscopias, entre flexibles y rígidas, que revelaron el tercio superior esofágico como lugar más frecuente de enclavamiento, el síntoma predominante la disfagia y las monedas y los huesos como tipo de CE más común. La mayoría de casos no presentaron complicaciones pero presentamos un caso que fue éxitus. Conclusiones: las esofagoscopias se muestran como un método muy útil condicionado por el tipo de CE y experiencia del personal que las realiza, entre otros. No debemos infravalorar las complicaciones derivadas del enclavamiento de CEE puesto que, aunque infrecuentes, pueden llegar a ser mortales (AU)

[Laryngeal sarcoidosis: a case report]. / Sarcoidosis laríngea aislada. A propósito de un caso.

Sarcoidosis is a chronic multisystemic granulomatosis of unknown etiology that affects mainly young adults. It characterized by bilateral hiliar adenopathies interstitial pulmonary infiltrate, and cutaneous and ocular lesions. Localization in upper respiratory tract is infrequent. In the present report we describe a 26-year-old male with a three-month history of a globus sensation, hoarse voice, loud snoring and obstructive sleep apnoea, because of a laryngeal noncaseating granulomatous infiltration. The diagnosis is made through the history, the radiology and the pathological examination. Treatment is symptomatic, due to its tendency to a spontaneous regression. The treatment is based on corticosteroids by systemic or aerosol routes. Micro surgical excision and tracheotomy may be useful in selected patients.

Sarcoidosis laríngea aislada. A propósito de un caso / Laryngeal sarcoidosis: a case report

La sarcoidosis es una enfermedad granulomatosa crónica multisistémica de etiología desconocida que afecta principalmente a adultos jóvenes. Se caracteriza por adenopatías hiliares bilaterales, infiltrado pulmonar intersticial, lesiones cutáneas y oculares. La afectación de la vía respiratoria superior es rara. Presentamos un caso clínico de un varón de 26 años que refiere sensación de cuerpo extraño en hipofaringe, disfonía y apneas obstructivas del sueño de tres meses de evolución debido a la infiltración de las estructuras supraglóticas por tejido sarcoideo. El diagnóstico se establece a partir de la clínica, los estudios radiológicos, las pruebas de laboratorio y el estudio histológico. El tratamiento de base son medidas de soporte, debido a la remisión espontánea de la clínica. Los corticoides sistémicos y locales presentan buenos resultados. En ocasiones son necesarias técnicas microquirúrgicas y la traqueotomía (AU)

Sarcoidosis is a chronic multisystemic granulomatosis of unknown etiology that affects mainly young adults. It characterized by bilateral hiliar adenopathies interstitial pulmonary infiltrate, and cutaneous and ocular lesions. Localization in upper respiratory tract is infrequent. In the present report we describe a 26-year-old male with a three-month history of a globus sensation, hoarse voice, loud snoring and obstructive sleep apnoea, because of a laryngeal noncaseating granulomatous infiltration. The diagnosis is made through the history, the radiology and the pathological examination. Treatment is symptomatic, due to its tendency to a spontaneous regression. The treatment is based on corticosteroids by systemic or aerosol routes. Micro surgical excision and tracheotomy may be useful in selected patients (AU)

Revisión clínica del neurinoma del acústico / A clinical review of the acoustic neurinoma

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