[Descriptive epidemiology of hospital interconsultations carried out at the ORL Service for a year in the San Millan-San Pedro Hospital Complex]. / Epidemiología descriptiva de las interconsultas hospitalarias realizadas al Servicio de ORL durante un año en el Complejo Hospitalario San Millán-San Pedro.

UNLABELLED: 391 requests of collaboration to our ENT Department during 1996 have been collected. Twelve variables were analysed: number of request, age, sex, date of emission, type (ordinary, with priority, urgent), time elapsed from emission until valuation of the patient, source, reason's request, pathology, complementary tests, treatment and destination (discharge, re-examination during admission or as an outpatient and admission to ENT-Service). RESULTS: 1,58 request were attended per working day, 80 percent were resolved during the first 48 hours, the Internal Medicine Department was the most frequent source, fever without focus or recalcitrant was the most frequent reason from Paediatric Department. We report the epidemiologic features of the most frequent variables.

Estudio evolutivo sobre 15 casos de tumores de la región temporal / Evolutionary study on 15 cases of tumors in th temporary region

Se ha realizado un estudio retrospectivo de 15 casos de tumores glómicos yúgulo-tímpanotemporales con un seguimiento de entre 5 y 23 años. Seis casos fueron tratados exclusivamente con cirugía. Cinco casos sólo con cobaltoterapia. Dos casos con cirugía (uno en dos ocasiones) y cobalto y dos casos no recibieron tratamiento. De los ocho casos tratados con cirugía con o sin cobalto complementario, se obtuvo la curación sin evidencia de recidiva en todos los casos. En los tratados con cobaltoterapia sólo, se han conseguido estabilizaciones o progresiones muy lentas de la enfermedad de hasta veinte años. Se hace énfasis en la conveniencia de establecer criterios individualizados para concretar el tratamiento idóneo en cada caso. (AU)

Variabilidad en el análisis digital de la voz según la vocal analizada, en pacientes normales y pacientes disfónicos / Variability in the digital analysis of the voice according to the vowel analyzed in normal and dysphonic patients

El objetivo de este trabajo es concluir cuál de las 5 vocales del español es la más adecuada en el análisis de la voz mediante el programa Dr. Speech 3. 0. Estudiamos 98 pacientes: 51 pacientes normales y 47 pacientes disfónicos (34 pólipos, 7 nódulos, 2 disfonías hiperfuncionales, 4 otras patologías) antes y después de seguir un tratamiento quirúrgico y/u ortofónico. El estudio consta de cuestionario protocolizado, exploración ORL, valoración auditivo-gestual de la voz y análisis acústico de las 5 vocales del idioma español. El jitter, shimmer y nivel de ruido en la señal eran diferentes según fuese la vocal analizada y según se tratase de pacientes normales o disfónicos. El nivel de ruido de las vocales [o] y [u] era más elevado que el de la vocal [a] (p < 0,001). El shimmer de las vocales [o] y [u] era inferior al shimmer de la vocal [a] en pacientes disfónicos (p < 0,05). El jitter de la vocal [a] era superior al jitter del resto de las vocales en pacientes normales. Todos los algoritmos mejoraron después del tratamiento quirúrgico y/u ortofónico, especialmente el nivel de ruido de las vocales [a] [e] y [o] (p < 0,001), el shimmer de las vocales [a] y [e] (p < 0, 001) y el jitter de la vocal [e] (p < 0, 01). Los pacientes disfónicos presentaron valores más patológicos que los pacientes normales, en especial el jitter de las vocales [a] [e] y [o] (p < 0, 001), el shimmer de las vocales [a] [e] [i] y [u] (p < 0,001) y el nivel de ruido de las vocales [a] [e] [o] y [u] (p < 0,001). Conclusión: el análisis de la vocal [e] presentó una r más alta que el análisis de la vocal [a] al relacionarlos con la valoración auditivo-gestual de la voz o con la calidad de voz que nos da el programa Dr. Speech 3.0. Asimismo, la vocal [e] expresa mejor la mejoría del jitter, shimmer y nivel de ruido de los pacientes disfónicos tras ser intervenidos quirúrgicamente o seguir un tratamiento ortofónico (AU)

The aim of this study is to decide which of Spanish's 5 vowels is the most suitable for the analysis of the voice by means of the program Dr. Speech 3.0. We assessed 98 patients: 51 normal subjects and 47 hoarse patients (34 polyps, 7 nodules, 2 hyperfunctional dysphonia, 4 other pathologies) before and after following a surgical and/or speech therapy. The methodology of the study included: protocolized questionnaire, ENT examination, perceptual evaluation of the hoarse voices and physical analysis of the 5 sustained vowels. Jitter, shimmer, NNE and HNR in the voice varied depending on the analyzed vowel and from normal subjects to hoarse patients. NNE and HNR for vowels [o] and [u] was higher than for [a], such differences were statistically significant (p < 0.001). Shimmer for vowels [o] and [u] was lower than shimmer for [a] in hoarse patients (p < 0.05). Jitter for [a] was higher than jitter for the other vowels in normal patients. All algorithms improveded with surgical and/or speech therapy. Especially levels of noise for vowels [a] [e] and [o] presented statiscally significant improvements (p < 0.001), shimmer for [a] and [e] (p < 0.001) and jitter for [e] (p < 0.01). The hoarse patients presented values more pathological than the normal subjects, especially jitter for vowels [a] [e] and [o] (p < 0.001), shimmer for [a] [e] [i] and [u] (p < 0.001) and level of noise for [a] [e] [o] and [u] (p < 0.001). CONCLUSION: The analysis of vowel [e] presented higher r than [a] when correlated with perceptual evaluation of voice or with voice quality that gave us Dr. Speech 3.0. Also, the [e] is the best vowel to express the improvements of jitter, shimmer and level of noise of hoarse patients after following surgical and/or speech therapy (AU)

[Variability in the digital voice analysis depending on the analyzed vocal, in normal patients and in patients with dysphonia]. / Variabilidad en el análisis digital de la voz según la vocal analizada, en pacientes normales y pacientes disfónicos.

UNLABELLED: The aim of this study is to decide which of Spanish's 5 vowels is the most suitable for the analysis of the voice by means of the program Dr. Speech 3.0. We assessed 98 patients: 51 normal subjects and 47 hoarse patients (34 polyps, 7 nodules, 2 hyperfunctional dysphonia, 4 other pathologies) before and after following a surgical and/or speech therapy. The methodology of the study included: protocolized questionnaire, ENT examination, perceptual evaluation of the hoarse voices and physical analysis of the 5 sustained vowels. Jitter, shimmer, NNE and HNR in the voice varied depending on the analyzed vowel and from normal subjects to hoarse patients. NNE and HNR for vowels [o] and [u] was higher than for [a], such differences were statistically significant (p < 0.001). Shimmer for vowels [o] and [u] was lower than shimmer for [a] in hoarse patients (p < 0.05). Jitter for [a] was higher than jitter for the other vowels in normal patients. All algorithms improveded with surgical and/or speech therapy. Especially levels of noise for vowels [a] [e] and [o] presented statiscally significant improvements (p < 0.001), shimmer for [a] and [e] (p < 0.001) and jitter for [e] (p < 0.01). The hoarse patients presented values more pathological than the normal subjects, especially jitter for vowels [a] [e] and [o] (p < 0.001), shimmer for [a] [e] [i] and [u] (p < 0.001) and level of noise for [a] [e] [o] and [u] (p < 0.001). CONCLUSION: The analysis of vowel [e] presented higher r than [a] when correlated with perceptual evaluation of voice or with voice quality that gave us Dr. Speech 3.0. Also, the [e] is the best vowel to express the improvements of jitter, shimmer and level of noise of hoarse patients after following surgical and/or speech therapy.

[Metastasis from hypernephroma to the parotid gland]. / Metástasis de un hipernefroma en la glándula Parótida.

Report of a carcinoma of renal clear cells, or hypernephroma, metastasized to parotid gland, in a 63 years old man. The occurrence of a mass progressively growing in link parotid was the early manifestation of the illness and the postsurgical anatomopathological study discovered the primary growth sitting in the kidney. Bibliographical survey of the subject and clinical, diagnostical and therapeutic features of this case as well.

[Lingual thyroid. A case report]. / Tiroides lingual. A propósito de un caso.

Account on a tongue thyroid case and bibliographic review of the subject. It is an anomaly due to the thyroid gland not come down. Symptomatic cases are scarce (around 400 reported in the literature). Diagnosis is basically scintigraphic. When there are symptoms management should begin with thyrotoxine. More severe instances require surgical exeresis.

[Tracheobronchial foreign body in the laryngectomized patient]. / Cuerpo extraño traqueobronquial en paciente laringectomizado.

We report a case of aspiration of a foreign body in the left tracheobronchial tree occurring in a laryngectomy, operated one year previously. The accident presented by fracture of the inner tracheostomy cannula. The literature is reviewed in order to explain possible causes of tracheostomy tube components breakage and to suggest methods for preventing such complications.

[Incidence of nasopharyngeal cancer in La Rioja (Spain). Epidemiological aspects]. / Incidencia del cáncer de nasofaringe en La Rioja. Aspectos epidemiológicos.

A retrospective study was made of patients with nasopharyngeal carcinoma diagnosed at the Hospital San Millán of La Rioja (Spain), between August 1989 and August 1995. Epidemiological and clinical factors, and their relation to findings from other regional studies, were examined. Most patients had stage III and IV (1986 UICC/AJCC staging system) disease, which indicates that the diagnosis tended to be late. Primary care physicians should consider this disease in cases of nasal obstruction, nosebleed, or seromucous otitis in adults.