Edema of the uvula: etiology, risk factors, diagnosis, and treatment.

Edema of the uvula (EU) is a rare occurrence sometimes associated with angioedema, urticaria, and anaphylaxis. We analyze the causes, predisposing factors, and characteristics of EU in a group of 58 patients with a mean (SD) age of 48.2 (15.2) years over the course of a year. Of the 58 patients studied, 49 (84.5%) were male and 44 (75.9%) presented isolated EU. Thirty-two patients (55.1%) with no clear etiology were classed as idiopathic. Snoring and a high body mass index were more prevalent in these patients. A variety of probable causes were identified in 26 patients (44.9%). In this group, EU was usually accompanied by urticaria, angioedema, and anaphylaxis and there was also a greater prevalence of atopy. We found that EU was idiopathic in just over half of the patients studied and that the predisposing factors were being overweight and having a tendency to snore. Patients with EU should be tested for allergies to drugs, airborne allergens, and food.

Bacterial community shifts in nonylphenol polyethoxylates-enriched activated sludge.

A molecular approach was used to evaluate the effect of nonylphenol ethoxylate surfactants on the bacterial diversity in lab-scale activated sludge reactors. Separate bench-scale units were fed synthetic wastewater with and without addition of branched nonylphenol ethoxylates (NPnEO). The performance of the reactors, in terms of carbonaceous removal was largely unaffected by the presence of NP10EO in the feeding solution. However, addition of NP10EO exerted a pronounced shift in bacterial community composition. In situ hybridization analyzing larger phylogenetic groups of bacteria with ribosomal RNA-targeted oligonucleotide probes revealed the dominance of clusters composed of Betaproteobacteria, accounting for up to one-third of 4',6-diamidino-2-phenylindol-dihydrochloride (DAPI)-stained cells in NP10EO amended reactors and only 5% of DAPI-stained cells in the controls. These shifts in populations of larger phylogenetic groups were confirmed by dot-blot analysis of rRNA. Members of gamma subclass of Proteobacteria were present in low numbers in all activated sludge samples examined, suggesting that only bacteria affiliated with the beta subclass of Proteobacteria may have a specific role in NP10EO degradation.

Bone SPECT in cholesteatoma assessment.

Bone SPECT in cholesteatoma assessment. Single photon emission computed tomography (SPECT) is a procedure in nuclear medicine which enables bone lesions to be better assessed. Twenty patients with cholesteatoma were studied to assess the efficiency of SPECT in bone lesions produced by cholesteatoma. Every patient also had a middle ear computed tomography (CT) and underwent surgery and anatomopathologic examination. Results obtained by SPECT are compared to CT results. SPECT was positive in 15 cases of which 2 of them with a negative CT for bone erosion. Five cases were false negative, but 2 of them had contralateral ear pathology and in one case bone erosion was not found. We conclude that in some patients SPECT can be a complementary diagnostic procedure in cholesteatomatous bone lesions.

[In-depth study of the causes of sudden deafness. Physiopathological mechanisms and their reversal]. / Profundizando en las causas de la hipoacusia súbita. Mecanismos fisiopatológicos y de reversión.

This article deals with an investigative work done by the AA. with the aim of determine the final cause of sudden sensorial deafness. Three causes are accepted as source of sudden deafness: viral infections, the tear away of labyrinthine membranes and the vascular theory. An increase in antibody titer suggest a viral origin. The labyrinthine membranes split has been observed at times when performing an exploratory tympanotomy. But circulatory troubles are hardly diagnosed, even with histopathological evidences of vascular upsets in temporal bones belonging to patients who suffered from an auditory stroke, because there are no diagnostic tests for "in vivo" control. Our intend is to investigate on the physiopathology of unforeseen deafness and also try to know the possible mechanisms of reversion of this calamitous pathology. We use, as investigative method of actual vascular changes in sudden deafness, the following; the speed analysis of the blood flow furnished by the A. labyrinthi through echography Doppler color transcranialis and angiography and magnetic resonance (Angio-MR). Both procedures are non invasive and harmless. We comment the findings of 13 patients. And find out, in 4 cases, an important trouble of the arterial vertebrobasilaris flow. The A. labyrinthi, a branch of the A. cerebelli inferior anterior (ACIA) and/or A. basilaris--rarely from the A. cerebelli inferior posterior (ACIP)--showed a heavy hypoplasy of these vessels, stenosis or complete blockage. In 2 of cases, 4 months later, a new exploration of the Doppler flow and angio-MR, was performed, and detected an improvement of the vertebrobasilar flow, in both instances. In those patients with an evident recovery of the hearing, it was attributed to these two compensatory mechanisms: 1) reversal of the flow at the level of cicle of Willis, at the expense of development of A. communicans posterior, and 2) cessation of the vertebral A. spasm and decrease of the vessel's tortuosity so improving the blood flow.

[Non-syndromic familial deafness. Review and genetic study]. / Sorderas familiares no sindrómicas. Revisión y estudio genético.

Many cases of hearing impairment are of genetic origin. Non-syndromic recessive transmission is the most frequent form. A genetic study was made of cases of non-syndromic familial hearing impairment seen in our service. The pattern of Mendelian inheritance was studied in the disorders associated with deafness. Four families had non-syndromic deafness and autosomal inheritance (3 dominant and one recessive) and one had a probable sex-linked inheritance. Genetic counseling was given and guidelines were created after reviewing the literature.

[Treatment and outcome of infantile cholesteatoma surgery]. / Tratamiento y resultados en la cirugia del colesteatoma infantil.

Infantile Cholesteatoma has been lately the aim of a large number of papers dealing with its natural history and optimal treatment. The outcome of 26 cases of ear surgery, done between 1990 and 1991, are reviewed. The etiology of Cholesteatoma was congenital in 2 cases, iatrogenic in an other one and unknown for the remainder (88%). Fifteen (15) closed surgical procedures and 11 open were carry out, achieving global removal of lesions in 76 percent of cases. Ninety-one (91%) of open tympanoplasties and 66 percent of closed procedures. Six cases evolved to recidivation (and later reoperatively reconverted in open cases) owing either to the erosion of the ossicular chain or encroachment of the recessus. Reconstructions of the ossicular chain was undertaken in 61.5 percent of cases and the hearing preserved in all instances and improved in 35 percent of reconstructions.

Adenoid cystic carcinoma initially diagnosed and treated as hemangioma.

Adenoid cystic carcinoma initially diagnosed and treated as hemangioma. A case diagnosed as having a hemangioma of the soft palate according to clinical and arteriographic findings is discussed. Recurrence appeared one year after embolization. Arteriography showed no vascular lesion and histopathologic study revealed an adenoid cystic carcinoma. It is stated that imaging studies may be insufficient.

[Mikulicz disease as the beginning of AIDS]. / Enfermedad de Mikulicz como debut en un caso de SIDA.

Major salivary lymphoepithelial lesions accounted for less than 3 percent of all benign parotid tumors, prior to AIDS acquaintance. Defined as the presence of enlargement of one or more salivary glands and, in some cases, with diminished salivary function. The paper present the case of an acquired immunodeficiency syndrome starting as a Mikulicz's disease. Reviewed the medical literature and treatment options.

[Benign nasal melanosis transformed into malignant mucosal melanoma: a documented case]. / Melanosis benigna nasal hacia melanoma maligno mucoso: una transformación documentada.

We report a case of nasal mucosal melanosis transformed into malignant mucosal melanoma. We review the feature of these disorders, their association, and preventive treatment.

[Acoustic emissions from the ear]. / Otoemisiones acústicas.

In this paper we study the phenomenon of the acoustic emissions. This study presents two cases with different auditif pathology and their clinics applications.

[Unusual manifestations of squamous carcinoma of the lip]. / Manifestaciones inusuales del carcinoma escamoso de labio.

We present a case of squamous cell carcinoma of the lip with metástasis to the mandible and meningeal involvement causing multiple cranial nerve palsies. Biopsy proven metástasis to the mandible was demonstrated. Studies of CT scan of the head were negative. Extension through perineural space have been speculated.

[Nasosinusal inverted papilloma]. / Papilomas invertidos nasosinusales.

Inverted papilloma is a papillar lesion of the nasal cavity and paranasal sinuses that arise from the Schneiderian membrane. This tumor has a high rate of local recurrence. We present a review of 10 cases of inverted papilloma of the nose and paranasal sinuses. A review of the literature is done.

[Verrucous carcinoma of the larynx]. / Carcinoma verrucoso de laringe.

From 1981-1984, we have diagnosed and treated 5 cases verrucous carcinoma of the larynx. The clinical findings, histopathology, and management of verrucous carcinoma of the larynx are discussed.

[Cranioencephalic traumatism. Audiovestibular sequelae]. / Traumatismos craneoencefálicos. Secuelas audiovestibulares.

A group of 80 patients with blunt head injury were examined. Long-term clinical neurologic and otologic sequelae of traumatic head injury are well recognized. The authors studied the vestibular disorders using ENG, EEG and high resolution CT.

[Primary malignant melanoma of the nasal cavity]. / Melanoma maligno primario de cavidad nasal.

This refers to a case of a malign melanoma in the nasal cavity. Melanomas of the mucosal origin differed from the melanomas cutaneous in that size of the primary lesion did not influence prognosis. Regional lymph node metastases are rare and did not influence prognosis. Local recurrence at the primary site is frequent. Surgical treatment offers long-term cure to only a limited number of patients.

[Review of 156 myringoplasties]. / Revisión de 156 miringoplastias.

We report the anatomical and functional results of 156 myringoplasty; 134 with onlay surgical technique and 22 with underlay technique. We comment the climatologic of our area and its relation with the surgical failures.

[Aberrant internal carotid artery in the middle ear]. / Carótida interna aberrante en oído medio.

An aberrant internal carotid artery in the middle ear is rare. We present a new case with a red mass behind the eardrum. The diagnosis must be established by radiology and angiography. The consequences of injury and surgical intervention are serious. The purpose of this paper is to review the literature on the subject of vascular anomalies of the middle ear and to discuss the diagnosis and management of this lesion.