Tumor nasal de músculo liso de comportamiento maligno incierto: informe de un caso / Nasal smooth muscle tumor of uncertain malignant potential: A case report

Los tumores de músculo liso que no pueden ser clasificados según su histología como leiomiomas o leiomiosarcomas se denominan tumores de músculo liso de comportamiento maligno incierto. La localización nasal de estos tumores es muy infrecuente y la extensión adecuada de la cirugía para tratar estas neoplasias no está bien definida. Se describe el caso clínico de una adolescente de 16 años, que consultó por padecer un tumor de aspecto vascular en la cavidad nasal derecha y que fue tratada con éxito mediante cirugía intranasal. El diagnóstico histológico fue tumor de músculo liso de comportamiento maligno incierto. Por la rareza de estas neoplasias, su infrecuente localización nasal y la falta de evidencia que soporte cuál debe ser la extensión de la cirugía, es relevante la descripción y discusión del caso clínico.

Smooth muscle tumors that cannot be histologically classified as leiomyomas or leiomyosarcomas are defined as smooth muscle tumors of uncertain malignant potential. The location of these tumors in the nose is very rare, and the appropriate surgical extent to manage these neoplasms has not been adequately defined. Here we describe the case of a 16-year-old female adolescent who consulted due to a vascular-like tumor in the right nasal cavity who was successfully treated with intranasal surgery. The histological diagnosis was smooth muscle tumor of uncertain malignant potential. Given that these neoplasms are rare, the uncommon location in the nose, and the lack of evidence indicating the extent of surgery, it is relevant to describe and discuss this clinical case.

Nasal smooth muscle tumor of uncertain malignant potential: A case report. / Tumor nasal de músculo liso de comportamiento maligno incierto: informe de un caso.

Smooth muscle tumors that cannot be histologically classified as leiomyomas or leiomyosarcomas are defined as smooth muscle tumors of uncertain malignant potential. The location of these tumors in the nose is very rare, and the appropriate surgical extent to manage these neoplasms has not been adequately defined. Here we describe the case of a 16-year-old female adolescent who consulted due to a vascular-like tumor in the right nasal cavity who was successfully treated with intranasal surgery. The histological diagnosis was smooth muscle tumor of uncertain malignant potential. Given that these neoplasms are rare, the uncommon location in the nose, and the lack of evidence indicating the extent of surgery, it is relevant to describe and discuss this clinical case.

Los tumores de músculo liso que no pueden ser clasificados según su histología como leiomiomas o leiomiosarcomas se denominan tumores de músculo liso de comportamiento maligno incierto. La localización nasal de estos tumores es muy infrecuente y la extensión adecuada de la cirugía para tratar estas neoplasias no está bien definida. Se describe el caso clínico de una adolescente de 16 años, que consultó por padecer un tumor de aspecto vascular en la cavidad nasal derecha y que fue tratada con éxito mediante cirugía intranasal. El diagnóstico histológico fue tumor de músculo liso de comportamiento maligno incierto. Por la rareza de estas neoplasias, su infrecuente localización nasal y la falta de evidencia que soporte cuál debe ser la extensión de la cirugía, es relevante la descripción y discusión del caso clínico.

Tratamiento quirúrgico del frenillo lingual corto en niños / Surgical treatment of short lingual frenulum in children

La anquiloglosia es una anomalía congénita que se caracteriza por un frenillo lingual anormalmente corto, que resulta en grados variables de dificultad de la movilidad lingual. Puede ser asintomática o manifestarse con dificultades en la lactancia, trastornos en el habla y en la dentición, y problemas sociales relacionados con la limitación funcional de la lengua. Si bien es una patología frecuente y conocida, persisten controversias y diversidad de opiniones relacionadas con la indicación, el momento y el método de la corrección quirúrgica. Describimos nuestra experiencia con 35 niños que presentaban esta afección, tratados quirúrgicamente de forma exitosa.

Ankyloglossia is a congenital anomaly characterized by an abnormally short lingual frenulum resulting in varying degrees of difficulty of tongue mobility. It may be asymptomatic or it may present with breastfeeding difficulties, speech and dentition disorders, and social problems related to the functional limitation of the tongue. While it is a common and known pathology, controversies and diversity of opinions persist regarding the indication, timing and method of surgical correction. We describe our experience with 35 children presenting this condition; they underwent successful surgical treatment.

[Surgical treatment of short lingual frenulum in children]. / Tratamiento quirúrgico del frenillo lingual corto en niños.

Ankyloglossia is a congenital anomaly characterized by an abnormally short lingual frenulum resulting in varying degrees of difficulty of tongue mobility. It may be asymptomatic or it may present with breastfeeding difficulties, speech and dentition disorders, and social problems related to the functional limitation of the tongue. While it is a common and known pathology, controversies and diversity of opinions persist regarding the indication, timing and method of surgical correction. We describe our experience with 35 children presenting this condition; they underwent successful surgical treatment.

[Aspiration syndrome due to laryngeal cleft in an infant]. / Síndrome aspirativo por hendidura laríngea en un lactante.

Aspiration is the passage of food content and endogenous secretions into the airway. Anatomical, neuromuscular or functional anomalies are among the major causes. The laryngeal cleft is a rare congenital anomaly that should be considered in the differential diagnosis of aspiration syndrome in neonates and infants. The main symptoms are stridor, recurrent respiratory infections and cyanotic crisis, cough and choking during feeding. The diagnosis is confirmed by endoscopic examination. The therapeutic behaviour will depend on the extent of the cleft, among other factors. We describe the clinical manifestations, diagnostic methods and treatment of an infant with this disease, and we emphasize the need for recognition of swallowing disorders in children in order to establish an accurate diagnosis and appropriate treatment to prevent and avoid malnutrition as well as a severe and potentially irreversible lung compromise.

Síndrome aspirativo por hendidura laríngea en un lactante / Aspiration syndrome due to laryngeal cleft in an infant

La aspiración es el pasaje de contenido alimentario y de secreciones endógenas hacia la vía aérea. La causa puede ser anatómica, neuromuscular o funcional. La hendidura laríngea es una anomalía congénita poco frecuente que debe ser considerada en el diagnóstico diferencial de síndrome aspirativo en recién nacidos y lactantes. Los síntomas principales son el estridor, las infecciones respiratorias recurrentes, y las crisis de cianosis, tos y asfxia durante la alimentación. El diagnóstico se confrma mediante el examen endoscópico. La conducta terapéutica dependerá, entre otros factores, de la extensión de la hendidura que se presente. Se describen las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de un lactante con esta patología, y se enfatiza la necesidad de reconocer los trastornos de la deglución en los niños a fn de establecer el diagnóstico preciso y el tratamiento apropiado para prevenir y evitar la desnutrición, así como el compromiso pulmonar grave y potencialmente irreversible.

Aspiration is the passage of food content and endogenous secretions into the airway. Anatomical, neuromuscular or functional anomalies are among the major causes. The laryngeal cleft is a rare congenital anomaly that should be considered in the differential diagnosis of aspiration syndrome in neonates and infants. The main symptoms are stridor, recurrent respiratory infections and cyanotic crisis, cough and choking during feeding. The diagnosis is confrmed by endoscopic examination. The therapeutic behaviour will depend on the extent of the cleft, among other factors. We describe the clinical manifestations, diagnostic methods and treatment of an infant with this disease, and we emphasize the need for recognition of swallowing disorders in children in order to establish an accurate diagnosis and appropriate treatment to prevent and avoid malnutrition as well as a severe and potentially irreversible lung compromise.

Síndrome aspirativo por hendidura laríngea en un lactante / Aspiration syndrome due to laryngeal cleft in an infant

La aspiración es el pasaje de contenido alimentario y de secreciones endógenas hacia la vía aérea. La causa puede ser anatómica, neuromuscular o funcional. La hendidura laríngea es una anomalía congénita poco frecuente que debe ser considerada en el diagnóstico diferencial de síndrome aspirativo en recién nacidos y lactantes. Los síntomas principales son el estridor, las infecciones respiratorias recurrentes, y las crisis de cianosis, tos y asfxia durante la alimentación. El diagnóstico se confrma mediante el examen endoscópico. La conducta terapéutica dependerá, entre otros factores, de la extensión de la hendidura que se presente. Se describen las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de un lactante con esta patología, y se enfatiza la necesidad de reconocer los trastornos de la deglución en los niños a fn de establecer el diagnóstico preciso y el tratamiento apropiado para prevenir y evitar la desnutrición, así como el compromiso pulmonar grave y potencialmente irreversible.(AU)

Aspiration is the passage of food content and endogenous secretions into the airway. Anatomical, neuromuscular or functional anomalies are among the major causes. The laryngeal cleft is a rare congenital anomaly that should be considered in the differential diagnosis of aspiration syndrome in neonates and infants. The main symptoms are stridor, recurrent respiratory infections and cyanotic crisis, cough and choking during feeding. The diagnosis is confrmed by endoscopic examination. The therapeutic behaviour will depend on the extent of the cleft, among other factors. We describe the clinical manifestations, diagnostic methods and treatment of an infant with this disease, and we emphasize the need for recognition of swallowing disorders in children in order to establish an accurate diagnosis and appropriate treatment to prevent and avoid malnutrition as well as a severe and potentially irreversible lung compromise.(AU)

Síndrome aspirativo por hendidura laríngea en un lactante. / [Aspiration syndrome due to laryngeal cleft in an infant].

Aspiration is the passage of food content and endogenous secretions into the airway. Anatomical, neuromuscular or functional anomalies are among the major causes. The laryngeal cleft is a rare congenital anomaly that should be considered in the differential diagnosis of aspiration syndrome in neonates and infants. The main symptoms are stridor, recurrent respiratory infections and cyanotic crisis, cough and choking during feeding. The diagnosis is confirmed by endoscopic examination. The therapeutic behaviour will depend on the extent of the cleft, among other factors. We describe the clinical manifestations, diagnostic methods and treatment of an infant with this disease, and we emphasize the need for recognition of swallowing disorders in children in order to establish an accurate diagnosis and appropriate treatment to prevent and avoid malnutrition as well as a severe and potentially irreversible lung compromise.

Tratamiento quirúrgico del frenillo lingual corto en niños. / [Surgical treatment of short lingual frenulum in children].

Ankyloglossia is a congenital anomaly characterized by an abnormally short lingual frenulum resulting in varying degrees of difficulty of tongue mobility. It may be asymptomatic or it may present with breastfeeding difficulties, speech and dentition disorders, and social problems related to the functional limitation of the tongue. While it is a common and known pathology, controversies and diversity of opinions persist regarding the indication, timing and method of surgical correction. We describe our experience with 35 children presenting this condition; they underwent successful surgical treatment.

Tratamiento de las estenosis laríngeas adquiridas en pediatría: Serie de casos / Treatment of acquired laryngeal stenosis in pediatrics: Case series

La estenosis subglótica es una de las causas más frecuentes de obstrucción de la vía aérea superior en los niños. Si bien puede tener un origen congénito, la mayoría de las estenosis son adquiridas. Debe pensarse en esta patología en todo niño con antecedentes de intubación, instrumentación o trauma de la vía aérea que presenta difcultad respiratoria. El diagnóstico se sospecha por la clínica, los antecedentes y la radiografía cervical, y se confrma mediante el examen endoscópico. La conducta terapéutica dependerá, entre otros factores, del grado de estenosis que se presente. Describimos nuestra experiencia con 6 pacientes que presentaban estenosis subglótica posintubación, tratados quirúrgicamente con técnica de expansión.

Subglottic stenosis is one of the most common causes of upper airway obstruction in children. Even though it may have a congenital origin, most of them are acquired stenosis. This condition should be suspected in any child with a history of intubation, instrumentation or trauma of the airway that is having diffculty breathing. The diagnosis is suspected by clinical, history and cervical radiograph, and is confrmed by endoscopic examination. Among others factors the treatment depends on the stenosis degree. We describe our experience with 6 patients with post-intubation subglottic stenosis treated surgically with expansion technique.

Tratamiento de las estenosis laríngeas adquiridas en pediatría: Serie de casos / Treatment of acquired laryngeal stenosis in pediatrics: Case series

La estenosis subglótica es una de las causas más frecuentes de obstrucción de la vía aérea superior en los niños. Si bien puede tener un origen congénito, la mayoría de las estenosis son adquiridas. Debe pensarse en esta patología en todo niño con antecedentes de intubación, instrumentación o trauma de la vía aérea que presenta difcultad respiratoria. El diagnóstico se sospecha por la clínica, los antecedentes y la radiografía cervical, y se confrma mediante el examen endoscópico. La conducta terapéutica dependerá, entre otros factores, del grado de estenosis que se presente. Describimos nuestra experiencia con 6 pacientes que presentaban estenosis subglótica posintubación, tratados quirúrgicamente con técnica de expansión.(AU)

Subglottic stenosis is one of the most common causes of upper airway obstruction in children. Even though it may have a congenital origin, most of them are acquired stenosis. This condition should be suspected in any child with a history of intubation, instrumentation or trauma of the airway that is having diffculty breathing. The diagnosis is suspected by clinical, history and cervical radiograph, and is confrmed by endoscopic examination. Among others factors the treatment depends on the stenosis degree. We describe our experience with 6 patients with post-intubation subglottic stenosis treated surgically with expansion technique.(AU)

[Treatment of acquired laryngeal stenosis in pediatrics: case series]. / Tratamiento de las estenosis laríngeas adquiridas en pediatría: Serie de casos.

Subglottic stenosis is one of the most common causes of upper airway obstruction in children. Even though it may have a congenital origin, most of them are acquired stenosis. This condition should be suspected in any child with a history of intubation, instrumentation or trauma of the airway that is having difficulty breathing. The diagnosis is suspected by clinical, history and cervical radiograph, and is confirmed by endoscopic examination. Among others factors the treatment depends on the stenosis degree. We describe our experience with 6 patients with post-intubation subglottic stenosis treated surgically with expansion technique.

Tratamiento de las estenosis laríngeas adquiridas en pediatría: Serie de casos. / [Treatment of acquired laryngeal stenosis in pediatrics: case series].

Subglottic stenosis is one of the most common causes of upper airway obstruction in children. Even though it may have a congenital origin, most of them are acquired stenosis. This condition should be suspected in any child with a history of intubation, instrumentation or trauma of the airway that is having difficulty breathing. The diagnosis is suspected by clinical, history and cervical radiograph, and is confirmed by endoscopic examination. Among others factors the treatment depends on the stenosis degree. We describe our experience with 6 patients with post-intubation subglottic stenosis treated surgically with expansion technique.

Subcranial approach in pediatric craniofacial surgery.

We report our experience with the subcranial approach, developed at the Plastic Surgery Unit of Hospital "Ricardo Gutiérrez," for the treatment of injuries in the frontoethmoidal orbital region in pediatric patients. The subcranial approach was described by Raveh et al for the treatment of fractures in the frontoethmoidal area. The subcranial approach was used later for surgery of tumors and deformities of the frontoethmoidal region. We have used this approach in nine cases of nontraumatic injuries (one meningioma, one orbital bone fibrous dysplasia, one vascular malformation, five nasal dermoid cysts, and one fronto-orbital mucocele). One patient with vascular malformation died of a stroke 10 days after surgery. The patient with the meningioma had a recurrence. Another patient developed an infection that needed surgical resolution and hardware removal. A third patient suffered a mild infection that receded with medication. No other complications were registered. The surgical exposure obtained through this approach was always excellent and left no cosmetic defects. There was no evidence of facial growth disturbance in this group of patients, except in one patient who received radiotherapy after surgery. Operative time and hospitalization were lower in this group than in patients with conventional frontal craniotomy.