Seudotumor inflamatorio subglótico en un niño de 3 años / Subglottis inflammatory pseudotumour in a 3-year-old child

INTRODUCCIÓN: El cierre quirúrgico de las perforaciones septales sintomáticas a menudo conduce a resultados no satisfactorios. El conocimiento de la irrigación vascular es de suma importancia para el éxito. OBJETIVO: El manejo de las perforaciones septales constituye un reto para el cirujano. Hay descritas una gran variedad de técnicas quirúrgicas, con distintas vías de abordaje. No existen pruebas científicas que avalen un abordaje en concreto. El objetivo de esta revisión es presentar una guía práctica sobre la técnica de elección para cada caso de perforación septal. DISCUSIÓN: La inspección de la mucosa nasal, el tamaño de la perforación, la localización y, sobre todo, el soporte osteocartilaginoso son los pilares para lograr el éxito de la cirugía. Para los colgajos de deslizamiento o rotación de la mucosa del tabique es fundamental haber estudiado previamente si es posible la elevación del mucopericondrio o mucoperiosteo del septum, de lo contrario, el uso de estos colgajos no estaría indicado. Los colgajos de la pared lateral o del suelo nasal son la alternativa. El colgajo pericraneal podría estar indicado en perforaciones totales o casi totales. CONCLUSIÓN: El remanente del septum nasal y el estado del soporte osteocartilaginoso son los factores determinantes en el manejo de las perforaciones septales. Cada caso debe valorarse individualmente y la elección del abordaje se realiza según el tamaño y la localización de la perforación, la calidad de la mucosa, los antecedentes personales, la cirugía previa y la experiencia del cirujano

OBJECTIVE: The management of septal perforations is a challenge for the surgeon. A wide variety of surgical techniques have been described, with different approaches. There is no scientific evidence to support a particular approach. The objective of this review is to present a practical guide on the technique of choice for each case of septal perforation. DISCUSSION: Inspection of the nasal mucosa, the size of the perforation, the location and especially the osteo-cartilaginous support, are the pillars of a successful surgery. For the sliding or rotating flaps of the mucosa of the septum it is essential to know in advance if the elevation of the mucopericondrio or mucoperiosteo of the septum is possible, otherwise the use of these flaps would not be indicated. The flaps of the lateral wall or nasal floor are the alternative. The pericranial flap may be indicated in total or near total perforations. CONCLUSION: The remnant of the nasal septum and status of osteo-cartilaginous support are the determining factors in the management of septal perforations. Each case should be evaluated individually and the approach chosen according to the size and location of the perforation, mucosal quality, personal history, previous surgery and the experience of the surgeon

Common cavity and custom-made electrodes: speech perception and audiological performance of children with common cavity implanted with a custom-made MED-EL electrode.

OBJECTIVE: Few studies exist on children with common cavity, fewer still on their long-term audiological development after having received a cochlear implant. Our goal was to observe and report the long-term audiological progress of children with common cavity who were implanted with a custom-made electrode. METHODS: In this longitudinal, multi-center study, 19 children were implanted with a MED-EL custom-made electrode via either single slit cochleostomy or double posterior labyrinthotomy. We observed their audiological development with a test battery consisting of Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and Ling 6-Sounds tests. We tested the children 1 month prior to the surgery; at first fitting; at 1, 3, 6, 12, and 18 months post first-fitting; at 2 years after first-fitting; and, whenever possible, at 3, 4, and 5 years after first-fitting. RESULTS: Children with common cavity tend to steadily and significantly improve their audiological skills over time. This development may, however, be highly individual; probably in part due to relatively high levels of additional needs. Parents should be counseled to establish realistic post-implantation expectations. Surgically, contrary to our expectations, we cannot confirm that double posterior labyrinthotomy reduces intracochlear electrode movement or that the MED-EL custom electrode leads to fewer incidences of intra- or post-implantation complications. CONCLUSIONS: Cochlear implantation is a safe and effective treatment option in children with common cavity. The majority of children with CC derive significant audiological benefit from implantation. Intra- and post-surgical complications, while serious, and be dealt with effectively in most cases.

Hemangioma de la fosa nasal en la infancia / Hemangioma of the nasal fossa in infants

Los hemangiomas en la infancia son los tumores benignos más frecuentes de cabeza y cuello en los niños. La localización intranasal es muy rara. Al obstruir toda la fosa nasal, produce un cuadro de dificultad respiratoria en el período neonatal que obliga a tomar medidas terapéuticas en los primeros meses de vida. Se presenta un paciente que nació con un hemangioma intranasal, se analizan las diferentes opciones terapéuticas y se expone la resolución final del caso, mediante vaporización con láser CO2 (AU)

Hemangiomas in infancy are the most frequent benign tumors of the head and neck in children. However, intranasal location is very rare. By obstructing the entire nasal fossa, it produces a problem of breathing difficulty in the neonatal period, which leads to therapeutic measures being taken in the first months of life. We present a patient who was born with intranasal hemangioma, we study the various therapeutic options and we expose the final resolution of the case, which was vaporization using CO2 laser (AU)

[Hemangioma of the nasal fossa in infants]. / Hemangioma de la fosa nasal en la infancia.

Hemangiomas in infancy are the most frequent benign tumors of the head and neck in children. However, intranasal location is very rare. By obstructing the entire nasal fossa, it produces a problem of breathing difficulty in the neonatal period, which leads to therapeutic measures being taken in the first months of life. We present a patient who was born with intranasal hemangioma, we study the various therapeutic options and we expose the final resolution of the case, which was vaporization using CO(2) laser.

[Post-traumatic haematoma and abscess in the nasal septa of children]. / Hematoma y absceso de tabique nasal postraumático en niño.

Septal haematoma following nasal trauma is a complication that, if not diagnosed and treated early, may evolve into a nasal septal abscess. We present the case of a 10-year-old male who suffered nasal trauma with fracture and an undiagnosed septal haematoma that evolved into a septal abscess. During drainage of the abscess, necrosis of the quadrangular cartilage was noted. The patient later presented collapse of the nasal dorsum and deviation of the nasal septum. This sequela was corrected by means of an osteochondral costal graft. In the presence of any nasal trauma, it is important to explore the nasal septum correctly to discard the presence of a haematoma which, if not drained early, may evolve into an abscess due to compression of the quadrangular cartilage, leading to its necrosis in a few days and later collapse of the nasal dorsum as the child grows.

Hematoma y absceso de tabique nasal postraumático en niño / Post-traumatic haematoma and abscess in the nasal septa of children

El hematoma septal tras traumatismo nasal es una complicación que de no ser diagnosticada y tratada precozmente puede evolucionar a un absceso septal. Presentamos el caso de un varón de 10 años que sufrió traumatismo nasal con fractura de huesos propios y un hematoma septal que no fue diagnosticado, y cuya evolución fue un absceso septal. Durante el drenaje de este absceso se evidenció una necrosis del cartílago cuadrangular. Posteriormente el paciente presentó un hundimiento del dorso nasal y una desviación del tabique nasal. Esta secuela se corrigió mediante la utilización de un injerto osteocondral costal. Ante cualquier traumatismo nasal es importante explorar correctamente el tabique nasal para descartar un hematoma, que si no se drena de forma precoz, puede evolucionar a un absceso por compresión del cartílago cuadrangular, cuyas consecuencias son su necrosis en pocos días y posterior hundimiento del dorso nasal en el curso del desarrollo del niño

Septal haematoma following nasal trauma is a complication that, if not diagnosed and treated early, may evolve into a nasal septal abscess. We present the case of a 10-year-old male who suffered nasal trauma with fracture and an undiagnosed septal haematoma that evolved into a septal abscess. During drainage of the abscess, necrosis of the quadrangular cartilage was noted. The patient later presented collapse of the nasal dorsum and deviation of the nasal septum. This sequela was corrected by means of an osteochondral costal graft. In the presence of any nasal trauma, it is important to explore the nasal septum correctly to discard the presence of a haematoma which, if not drained early, may evolve into an abscess due to compression of the quadrangular cartilage, leading to its necrosis in a few days and later collapse of the nasal dorsum as the child grows