[Otic myiasis. Case report]. / Miasis ótica. A propósito de un caso.

Otic myiasis is rare in developed countries and is related to environmental conditions and poor hygiene. We present the case of a 65-year-old woman with pain and tinnitus in the left ear lasting for one week. Physical examination in the emergency room showed numerous dipteran larvae totally occupying the external auditory canal. After the diagnosis of otic myiasis, the larvae were removed and the patient was discharged after 24 hours of medical observation. The diagnosis of otic myiasis is by means of direct visualization of the larvae in the ear cavities and treatment includes the removal of larvae from the ear. Prognosis is generally good.

Miasis ótica. A propósito de un caso / Otic miasis. Case report

La miasis ótica es una enfermedad que se relaciona con condiciones ambientales e higiénicas deficientes y es muy poco frecuente en los países desarrollados. Presentamos el caso de una mujer de 65 años de edad que acude al servicio de urgencias del hospital por presentar otalgia y acufenos en el oído izquierdo de una semana de evolución. La exploración mostró ocupación total del conducto auditivo externo por larvas de dípteros. Tras el diagnóstico de miasis ótica, se procedió a la extracción de las larvas y se sometió a observación durante 24 h antes del alta definitiva. El diagnóstico de la miasis ótica consiste en la visualización directa de las larvas en las cavidades óticas, y su tratamiento incluye la extirpación de las larvas de las cavidades del oído; generalmente el pronóstico es favorable (AU)

Otic myiasis is rare in developed countries and is related to environmental conditions and poor hygiene. We present the case of a 65-year-old woman with pain and tinnitus in the left ear lasting for one week. Physical examination in the emergency room showed numerous dipteran larvae totally occupying the external auditory canal. After the diagnosis of otic myiasis, the larvae were removed and the patient was discharged after 24 hours of medical observation. The diagnosis of otic myiasis is by means of direct visualization of the larvae in the ear cavities and treatment includes the removal of larvae from the ear. Prognosis is generally good (AU)

Paraganglioma of the thyroid gland: a rare entity.

Paragangliomas are neuroendocrine tumors. The thyroid gland is one of the anatomic sites in which paraganglia are not normally located and are exceptionally rare. We report a case of a 36-year-old Hispanic woman with a soft mass measuring about 30 mm in the right thyroid lobe. Patient was operated on and the neoplasm showed microscopically a typical nesting organoid pattern (zellballen). The inmunohistochemical analysis revealed that the tumor showed strongly and diffuse stain for NSE, Synaptophysin, Chromogranin A, and S-100 protein in the sustentacular cells, whereas no inmunoreactivity was detected with antibodies against thyroglobulin, calcitonin, TTF-1, CEA, and AE1-AE3. The MIB-1 labeling showed 7% of neoplastic cells. Head and neck paragangliomas usually develop slowly, and this tumor exhibited a low proliferative activity. In view of the uncertain malignant potential of paragangliomas, we recommended a careful long-term follow-up.

[Surgical costs in an otorhinolaryngology department]. / Costes quirúrgicos en un servicio de otorrinolaringología.

OBJECTIVE: To describe the costs of the surgical procedures most frequently performed in an Otorhinolaryngology Department. MATERIALS AND METHOD: A descriptive economic analysis of the 5 most frequent surgical procedures performed during 2006, based on the following variables: human resources, non-structural equipment, medication, diagnostic tests and hospitalization during pre-operative, intra-operative, and post-operative phases. RESULTS: Of the 1108 procedures, the most common was tonsillectomy/adenoidectomy with 25.45 % (282), followed by thyroidectomy/hemithyroidectomy with 8.39 % (93), septoplasty with 8.3 % (92), endoscopic CO2 laser with 8.21 % (91) and tympanoplasty with 7.85 % (87). The total cost for each surgical procedure was 301.02 euro, 1422.09 euro, 315.57 euro, 1245.29 euro, and 1454.04 euro, respectively. CONCLUSIONS: The analysis of costs shows a direct relationship between the complexity of the procedure and its cost, in terms of human resources, equipment and hospitalization. The use of ambulatory surgery units positively influenced by reducing costs.

Costes quirúrgicos en un servicio de otorrinolaringología / Surgical costs in an otorhinolaryngology department

Objetivo: Describir los costes de las intervenciones más frecuentemente realizadas en un servicio de otorrinolaringología. Material y método: Analizamos los costes de las 5 intervenciones quirúrgicas más frecuentes realizadas en nuestro servicio durante el año 2006. Distribuimos y cuantificamos los costes según las siguientes variables: personal, equipamiento no estructural, medicación, pruebas diagnósticas y hospitalización en las fases de preoperatorio, intraoperatorio y postoperatorio. Resultados: De las 1.108 intervenciones realizadas, la más frecuente fue la amigdalectomía/adenoidectomía con el25,45 % (282), seguida de tiroidectomía/hemitiroidectomía con el 8,39 % (93), la septoplastia con el 8,3 % (92), el láser de laringe con el 8,21 % (91) y la timpanoplastia con el 7,85 % (87). Los costes totales fueron 301, 1.422, 315,5, 1.245,2 y 1.454 euros respectivamente. Conclusiones: El análisis de costes muestra una relación directa entre la complejidad de la intervención quirúrgica y su coste, a expensas de personal, equipamiento y hospitalización. El empleo de unidades de cirugía sin ingreso influye de manera positiva en la reducción de costes (AU)

Objective: To describe the costs of the surgical procedures most frequently performed in an Otorhinolaryngology Department. Materials and method: A descriptive economic analysis of the 5 most frequent surgical procedures performed during 2006, based on the following variables: human resources, non-structural equipment, medication, diagnostic tests and hospitalization during pre-operative, intra-operative, and post-operative phases. Results: Of the 1108 procedures, the most common was tonsillectomy/adenoidectomy with 25.45 % (282), followed by thyroidectomy/hemithyroidectomy with 8.39 % (93), septoplasty with 8.3 % (92), endoscopic CO2 laser with 8.21 % (91)and tympanoplasty with 7.85 % (87). The total cost for each surgical procedure was 1301.02, 11422.09, 1315.57, 11245.29, and 11454.04, respectively. Conclusions: The analysis of costs shows a direct relationship between the complexity of the procedure and its cost ,in terms of human resources, equipment and hospitalization. The use of ambulatory surgery units positively influenced by reducing costs (AU)

[Phonation fistulas today]. / Fístulas fonatorias hoy.

OBJECTIVE: To describe our experience with the use of trachea-oesophageal puncture (TEP) after total laryngectomy. MATERIAL AND METHOD: We have studied retrospectively 96 patients who received a voice prosthesis through tracheoesophageal puncture between October 2000 and December 2005. RESULTS: The punctures effected were 86 primary (89.6 %) and 10 secondary (10.4 %); of the prostheses, 81 (84.4 %) were Provox(R) type and 74 % of patients used it as their normal means of communication. Reasons for withdrawal included insufficiency and aspiration in 66.7 % (14/21), lack of use in 23.8 % (2/21), granulation tissue, and inflammation in 4.7 % (1/21). CONCLUSIONS: Voice rehabilitation by TEP and prosthesis was successful in 74 % of our patients with acceptable complications and better results than those obtained by tracheaoesophageal speech. We recommend the use of TEP in those patients who have the motivation and a good oncological and physical assessment.

Fístulas fonatorias hoy / Phonation fistulas today

Objetivo: Analizar nuestra experiencia con el uso de prótesis fonatorias (PF) tras la realización de laringectomía total. Material y método: Estudio retrospectivo de 96 pacientes a quienes se colocó una PF mediante punción traqueoesofágica entre octubre de 2000 y diciembre de 2005. Resultados: Se realizaron 86 (89,6 %) punciones primarias y 10 (10,4 %) secundarias; el 84,4 % (81/96) de las prótesis eran del tipo Provox® y el 74 % de los pacientes la utilizaban como medio habitual de comunicación. Las causas de retirada fueron: insuficiencia y aspiración, 66 % (14/21); no emplearla, 23,8 % (2/21), y granulaciones e inflamación, 4,7 % (1/21). Conclusiones: El empleo de PF mediante punción traqueoesofágica ha sido útil en el 74 % de nuestros pacientes, con una tasa de complicaciones asumible y resultados fonatorios superiores a los obtenidos mediante erigmofonía, por lo que recomendamos su uso en pacientes que, por motivación y valoración física y oncológica, sean candidatos

Objective: To describe our experience with the use of trachea-oesophageal puncture (TEP) after total laryngectomy. Material and method: We have studied retrospectively 96 patients who received a voice prosthesis through tracheoesophageal puncture between October 2000 and December 2005. Results: The punctures effected were 86 primary (89.6 %) and 10 secondary (10.4 %); of the prostheses, 81 (84.4 %) were Provox® type and 74 % of patients used it as their normal means of communication. Reasons for withdrawal included insufficiency and aspiration in 66.7 % (14/21), lack of use in 23.8 % (2/21), granulation tissue, and inflammation in 4.7 % (1/21). Conclusions: Voice rehabilitation by TEP and prosthesis was successful in 74 % of our patients with acceptable complications and better results than those obtained by tracheaoesophageal speech. We recommend the use of TEP in those patients who have the motivation and a good oncological and physical assessment