[Laryngeal radionecrosis as a complication of radiotherapy]. / Radionecrosis laríngea como complicación del tratamiento radioterápico.

The laryngeal cartilage radionecrosis is an infrequent treatment complication with radiotherapy of head and neck tumoral lesions and it can present since a few months to many years later its application. We present the different evolution of two patients with laryngeal carcinoma treated with radiotherapy who developed laryngeal radionecrosis. The differential diagnosis with the recidiva and the primitive tumoral lesion are very important, as well as the diagnosis difficulty and its treatment.

[Middle facial necrosis secondary to cocaine abuse]. / Necrosis mediofacial secundaria a abuso de cocaína.

The middle facial necrosis is a rare pathology that can be found related to multiple processes that can provoque it: traumatic, chemical, infections, inflammatory and tumorals. So for its diagnosis we require a wide differential diagnosis. We present a clinic case of a nose aspirated cocaine female patient who came to our department with a middle-facial necrosis not telling to us in the anamnesis the cocaine use. We were obliged to do multiple diagnostic tests searching other possible causes.

Radionecrosis laríngea como complicación del tratamiento radioterápico / Laringeal radionecrosis as a complication of the radiotherapic treatment

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Necrosis mediofacial secundaria a abuso de cocaína / Middle facial necrosis secundary to cocaine

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[Post-traumatic carotid cavernous fistula as a cause of objective tinnitus]. / Fístula carotidocavernosa postraumática: origen de acúfenos objectivos.

Reporting the case of a patient, seen in our Hospital Consulting Department, enduring heavy pulsatile tinnitus, following a craniocerebral traumatism. ENT examination was negative, but having the feeling of a carotid-cavernous fistula, angiographies confirmed this pathology. Embolisation of the fistula as treatment stopped the patient's symptomatology. We take the advantage of this case in order to review the etiology, the pathology, diagnostic measure and treatment of this condition.

[Long-term course of laryngeal verrucous carcinoma]. / Carcinoma verrucoso laríngeo de larga evolución.

Verrucous carcinoma is an odd kind from squamous or epidermoid carcinoma, amounting between 1 and 3.5% percent of the whole number of laryngeal growths. Its predominant sitting is glottic and are characterized through the pathological anatomy and its good prognosis. We report one case treated in our Department which evolved during 14 years and we point out its good prognosis and other particularities regarding its etiology, pathologic anatomy and diagnosis.

[Sarcoidosis in otorhinolaryngology]. / Sarcoidosis en O.R.L.

Sarcoidosis is a disease affecting the reticulo-histiocytary system and characterized by its several manifestations, always linked to the same lesion: the epithelioid granuloma without caseous necrosis. We make a review of this disease so scarce in our consulting rooms, and consider all patients diagnosed in our Hospital during one year-term, with their manifestations in ENT-area as well in other specialties and compare our inventory with other published series.

[Jugular-tympanic paraganglioma: our experience in 2 years]. / Paraganglioma yugulotimpánico: nuestra experiencia en dos años.

The paper is a review of the jugulotympanic paragangliomata seen in our Hospital in a 2 years term. The AA. discuss every case and achieve a checking of several therapeutics procedures accepted for these growths.

[Deep neck infections: complications of acute pharyngitis]. / Infección cervical profunda: complicación de faringitis aguda.

Deep neck infections develop as aftermath of spreading infections from an initial focus to the neighbourhood and soft tissues of the neck, through routes offering lesser resistance as fascial sheets. These cervical pictures are not numerous and generally after infective focus bad treated, linked with concomitant factors easing the rapid spread. The presence of complications as the involvement of great blood vessels, mediastin or jeopardizing the air-way may darken the prognosis, for which reason its precocious diagnosis and correct behaviour are very decisive. The paper deals with one case of neck infect, following an acute banal pharyngitis without predisposing circumstances. Follows a review of the published bibliography.

[Biopsy cannula as diagnostic alternative to puncture-aspiration biopsy with fine needle in head and neck tumors]. / La cánula de biopsia: alternativa diagnóstica de la punción-aspiración con aguja fina en tumores de cabeza y cuello.

Biopsy cannula is a diagnostic tool allowing anatomopathological examination of tissue samples, achieved through a percutaneous perforation. Unlike puncture-aspiration with fine needle method that only permits a cytologic study, this technique eases the removal of pieces big enough to provide the knowledge of the whole architecture of the lesion. At length in other specialities in our has been forgotten perhaps for the great efficiency of PAFN on neck masses or as complement of traditional surgery. We present one case in which the biopsy-cannula showed its diagnostic usefulness. We also discuss on the technique and made a bibliographic perusal about the published literature.

[Subcutaneous cervico-thoracic emphysema and pneumo-mediastinum following a tracheostomy]. / Enfisema subcutáneo cervico-torácico y neumomediastino tras traqueotomía.

Reporting the case of a man, 70-year-old, suffering a chronic obstructive lung disease of moderate degree linked to important Reinke's oedema, who underwent a tracheotomy, being troubled the immediate postoperative period with subcutaneous emphysema and pneumomediastinitis, complications resolved favourably in a ten days term, and the patient could be decannulated.

[Giant pleomorphic adenoma in accessory salivary gland]. / Adenoma pleomórfico gigante en glándula salival accesoria.

Giant pleomorphic adenoma is the most common neoplasm of salivary glands, specially of parotitis. Less frequently derives from minor salivary glands and, in the case, its size is small. We report one case of pleomorphic adenoma of great mass seated in a palatine salivary gland and avail the opportunity to review these sort of tumors.

[Mucoepidermoid carcinoma of the larynx. A case report]. / Carcinoma mucoepidermoide de laringe. A propósito de un caso.

We report a case of laryngeal mucoepidermoid carcinoma that was diagnosed in the Hospital Miguel Servet of Zaragoza. The unusual tumor site and difficult diagnosis were notable and, above all the fatal outcome after local recurrence and metastasis in spite of good overall prognosis.

[An outpatient study in ENT (otorhinolaryngology) emergencies at a general hospital]. / Estudio de las urgencias externas otorrinolaringológicas en un hospital terciario.

ORL emergencies attended at in a general hospital for a year were studied from 1-7-1990 to 30-6-1991. 168,145 emergencies were received of which 3,101 (1.8%) were attended by an otorhinolaringologist. The age, sex, arrival time, aetiology, treatment, admissions and the admissions where AEP (Appropriateness Evaluation Protocol) criteria was applied were thoroughly examined. The most numerous pathologies presented were infectious inflammations (41%), hemorrhages (21%), and foreign bodies (18.5%). But the most frequent aetiologies were epistaxis (16.3%), otitis media (14.8%) and otitis externa (14.8%). Most patients arrived generally between 9-12 hrs. (21.3%), and 17-20 hrs. (25.4%). The average age was 38.8 years old, though there was a significant difference depending on the pathology presented. Infectious inflammations emergencies were usually the youngest age group (average age 32) and tumoral processes the eldest (average age 60), 5% of the cases were admitted. These admissions accounted for only 17.9% of total admissions. Because AEP criteria was employed 97.5% of admissions presented inclusion criteria.

[Kikuchi's necrotizing lymphadenitis. Clinical and pathological study of a new case]. / Linfadenitis necrotizante de Kikuchi. Estudio clínico-patológico de un nuevo caso.

Contribution to the topic with the case of a woman, 24, admitted in our ENT Department for exam and treatment of multiple right sided adenopathies of the neck. The histopathological study was consistent with diagnosis of Kikuchi's necrotizing lymphadenitis. This is a new clinicopathologic entity first described, 1972, by Kikuchi, of unknown etiology, an a picture characterized for painful cervical lymphadenitis presented in young women and healing spontaneously after 2-3 months course. We want to emphasize in this paper the scarcity of cases published and the difficulties arising when dealing with the differential diagnosis with lympho-proliferative malignancies as well.

[Cystic formations of the maxilla. Case report]. / Formaciones quísticas de los maxilares. A propósito de un caso.

The case of a man, 28, addressed to our ENT-Department complaining of pain and swelling of the left half of the face is presented. After X-Ray and tomographic study the diagnosis of an included tooth inside the maxillary sinus, accompanied by one cyst, is evidenced. In addition a canine tooth as well included on the floor of the nose and under the lower homonyme turbinate, is disclosed. Through sinusal approach, via Caldwell-Luc, are removed the lesions encountered. Then, the AA., attempt to classify the group of several cystic structures of maxillary sitting, aiming at unify the nomenclature of this pathology, and made a brief description of each type.

[Reported case of cystic cervical lymphangioma in an adult]. / Presentación de un caso de linfangioma quístico cervical en adulto.

Cystic lymphangiomas are abnormalities derived from lymphatic vessels that are characterized by the formation of cysts. The are located generally in head and neck and occur most frequently in children. They rarely appear in adults. We present a case of lymphangioma and review the disorder.

[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.

[Mastoid osteoma]. / Osteoma de mastoides.

Extra-canalicular osteomas of the temporal bones are rare benign tumours. We report a retroauricular osteoma in a 18 years old patient. Usually symptomless, they may present for cosmetic reasons. We briefly comment this type of tumours.

[Solitary extramedullary plasmocytoma of the nasal cavity]. / Plasmocitoma extramedular solitario de cávum.

A case of Extramedullary Plasmacytoma of nasopharynx is reported in a 41 years old man. The presenting symptom was bilateral nasal obstruction. Multiple Myeloma was excluded. The treatment was surgical excision and postsurgical radiotherapy. At present the patient is well.