[Cochlear implants using the Ultracision harmonic scalpel]. / Implantación coclear con bisturí armónico Ultracision.

We have evaluated the utility, indications and disadvantages of the Ultracision harmonic scalpel, in the cochlear implants, and his advantages compare to other electrocoagulation's systems. These aspects were evaluated in 50 cases of cochlear implants, made along the last years. We concluded that the Ultracision harmonic scalpel is indicated, mainly, in the otology field, in these situations in wich the cochlear implant is in the cochlea, and is mandatory the use of an electrocoagulation system. In this situation, the Ultracision harmonic scalpel was quick, safe and sure, and with many advantages, over the traditional scalpel and the bipolar diathermy.

[Study of bcl-2 oncogene in squamous-cell carcinoma of the larynx]. / Estudio del oncogén Bcl-2 en el carcinoma escamoso de laringe.

Apoptosis is a special type of programmed cell death that occurs in the embryonic period, in normal adult tissues, and in several pathological situations. The Bcl-2 gene (B-cell leukemia/lymphoma) is the first member of an oncogene family whose main function is to increase cell survival and inhibit apoptosis, thus participating in the carcinogenic process. This relationship motivated our study of antiapoptosis through the immunohistochemical expression of Bcl-2 oncogene in 72 patients with cancer of the larynx who underwent surgery in our department. The correlation between immunohistochemical expression and clinical factors was analyzed: age, sex, work, smoking and drinking history, marital status, etc., as well as other known biological and histopathological prognostic factors (tumoral stage, histological grade, neck metastases, and local invasion). Bcl-2 expression showed a statistically significant correlation with histological grade and regional lymph node involvement, but no correlation with the other parameters studied.

[Malignant melanoma of the middle ear, a rare site]. / Melanoma maligno de oído medio, una rara localización.

Melanomas of upper airway tract constitute around 1% of the total melanomas of head and neck. It's for this reason we cannot forget their location in middle ear, although it is truly rare, and we have only found three cases published in literature. We report a patient of 75 years old, who went to our hospital with otorrhea of two months of evolution, with subjective sensation of deafness. In the exploration ENT a bleeding neoformation was observed by otoscopy, which occupied all external auditory canal. The biopsy of this neoformation was informed as malignant neoplasm. These cells show a little cytoplasmic melanotic pigment and were positive to the tinction with Masson Fontana, as well as to the immunohistochemical antibodies S-100 and HMB-45. These antibodies are specific of malignant melanoma. We had a low opinion of surgical treatment because the affectation of the temporal bone and the size of melanoma. Because of badly prognosis, our patient died six months after the diagnosis.

[Olfactory esthesioneuroblastoma. Review of seven cases]. / Estesioneuroblastoma olfatorio. Revisión de siete casos.

Esthesioneuroblastomas are fairly rare malignant tumors: only 20 cases have been reported in Spanish records. It is locally aggressive and produces late recurrences. There is no such thing as a universally accepted treatment model. We describe our experience with 7 cases seen in our hospital from 1980 to 1996. A or B stages can be treated with irradiation, surgery or a combination of both. C stages with the most aggressive tendencies may require the combined use of preoperative irradiation, surgery and chemotherapy. We analyzed the forms of presentation, diagnosis, differential diagnosis, treatment, prognosis, and survival. The 5-year survival rate was 75, 60 and 41% for stages A, B and C, respectively.

[ENT outpatient surgery]. / Cirugía ambulatoria en ORL.

The number of patients who undergo outpatient surgery is constantly growing in Spain. Outpatient surgery is interesting not only because of its economy, but also the social benefits that derive from patients returning home sooner and the rapid reduction of the waiting list. We discuss our experience in the last year with 40 patients who underwent surgery. We made a comparative study of patients with the same pathology and anesthetic risk who were treated by outpatient surgery and those treated by inpatient surgery with a traditional technique who were admitted 24 hours before surgery. Our rate of complications (19%) was close to the traditional rate. However, 3, 927, 000 pesetas were saved and the patients were very satisfied, which encouraged us to continue. Indications and complications are discussed.

[Changes in the middle ear mucosa of the Wistar rat after experimental resection and obstruction of the eustachian tube]. / Modificaciones en la mucosa del oído medio de la rata Wistar tras sección y obstrucción experimental de la trompa de Eustaquio.

Eustachian tube (ET) disfunction, alone or combined with other factors, is the main source of middle ear pathogenesis and can lead to other physiopathological events that originate disease (serous otitis media, adhesive otitis, cholesteatoma). In seven Wistar rats (study group), experimental mechanical obstruction of the left Eustachian tube was performed. Using an anterior cervical incision, the osteocartilaginous junction of the ET was severed and obliterated with a bit of muscle in order to prevent rechanneling. After a period of six months, the middle ear mucosa was removed for histological study. Comparisons were made of the experimental ear and the opposite ear, as well as the ears of three rats in the control group. We compared our findings with those of other authors and reviewed experimental animal models of serous otitis media and cholesteatoma that have been used to study the influence of ET in middle ear disease.

[Wegener's disease: localized and generalized forms]. / Enfermedad de Wegener: formas localizadas y generalizadas.

Two new cases of Wegener's granulomatosis are reported. One of them with the classic sinusal, pulmonary and renal involvement, and the other one as a limited form of the disease, only with respiratory affection, sparing the characteristic renal entailment, although its prolonged survival. The AA, comment literature controversial about if the forms limited to the ENT-area represents a unique and separate entity or an early and modified state of the disease.

[The influence of hypercholesterolemia and noise on human auditory function]. / Influencia de la hipercolesterolemia y el ruido en la audición humana.

A cross-sectional study on occupational noise exposure and hypercholesterolemia was conducted in a group of 1.209 workers exposed to industrial noise. Clinical examinations and audiograms were compared in exposed and not exposed subjects to noise. There was a strong relationship between severe noise induced hearing loss and hypercholesterolemia in all de workers. But the relationship was not convincing when the workers were considered stratified in groups of age, because the number of hard of hearing labourers with high levels of cholesterol, increases as they get older. The AA, support the point of view that the age is an important confounding factor, and in their study there is no relation between noise induced hearing loss and hypercholesterolemia.

[Interaction of arterial blood pressure and industrial noise on human hearing]. / Interacción de la tensión arterial y el ruido industrial sobre la audición humana.

A cross-sectional study of occupational noise exposure and high blood pressure was conducted in a group of 1584 workers. Clinical examination, audiograms, and body mass index were compared in exposed and not to noise finding a strong relationship between severe noise induced hearing loss and high blood pressure in all the staff, as it has been marked by different authors. But when we stratify the population in groups of age, we can't find any influence between noise exposure and hypertension, or between the appearing of high blood pressure and noise induced hearing loss.

[Results of tracheal reconstructive surgery using homografts preserved in formaldehyde]. / Resultados de la cirugía reconstructiva traqueal mediante homotransplantes conservados en formaldehido.

The present study was designed to investigate the results of homograft of cervical trachea preserved in formaldehyde. Surgical approach consists in end-to-end anastomosis. In all our cases the graft was rejected, and the animals could only live 13 days as a maximum. We find tracheal mucosa is responsible for graft antigens. The results both clinical and histopathological are compared with a control group and with those obtained by other authors using different conservation methods.

[Homotransplants in cervical trachea: clinical and histopathologic results]. / Homotrasplantes en tráquea cervical: resultados clínicos e histopatológicos.

An experimental study about homotransplant of cervical trachea in Wistar rats is presented. Surgical approachment consists in excision of 7 or 9 tracheal rings and their posterior end-to-end anastomosis. The animals are divided in two groups. In the first one an homotransplant of cervical trachea is practised and compared with the second one as control group. Clinical and histopathological results are similar in both groups. Our findings are also discussed, comparing with other authors.

[Interaction between hypertriglyceridemia and noise in human hearing]. / Interacción de la hipertrigliceridemia y el ruido en la audición humana.

We carry out a cross-sectional study on 1205 workers exposed to industrial noise. After the clinical, analytical and audiological examination, we can't demonstrate any influence of hypertriglyceridemia on noise induced hearing loss. We get a statistically significant relationship between noise and hearing loss only in the group of workers with normotriglyceridemia.

[Diagnostic role of the biopsy in angiofibroma of the cavum]. / Papel diagnóstico de la biopsia en el angiofibroma de cavum.

The AA. inform about the case of a child, 13, with an antro-choanal Polyp of angiofibromatous structure, diagnosed as Angiofibroma. Though in the greater number of instances the arteriography is enough to support the suspicion, the confirmation through histopathology is compulsory.