Performance of endoscopic repair with endonasal flaps for congenital choanal atresia. A systematic review.

Endoscopic repair of congenital choanal atresia is the gold standard surgical treatment today. Though several controversies on treatment have been reported, surgical techniques for better outcomes are still in discussion. The objective of this study is to evaluate the performance of endoscopic choanal atresia repair with endonasal flaps and no stents. Publications in English in the last 5 years were searched in the PUBMED database and were systematically reviewed. A total of 9 articles were included according to the inclusion criteria, obtaining a total of 266 patients managed for congenital choanal atresia with endoscopic surgery, endonasal flaps, and no stents. Surgical results, type of atresia, atresia laterality, associated pathologies and follow up were evaluated. Successful surgery was obtained in 237 (89%) patients while 29 (11%) patients required a new surgical intervention during the follow-up period. Fourteen percent of the patients were diagnosed with CHARGE syndrome and 5% of the patients had some associated heart disease. Bony-Membranous stenosis was observed in 74% of the patients, while a total bony obstruction was recognized in 26% of the patients. Unilateral atresia was observed in 37% of the cases and 63% of the cases had bilateral atresia. The mean follow-up period was 39.5 months (range 3-168 months). An important functional success rate can be accomplished by correcting congenital choanal atresia using functional endoscopic surgery, covering raw areas with endonasal vascularized flaps, avoiding postoperative endonasal stenting.

Transcanal endoscopic type 1 tympanoplasty in children: Cartilage butterfly and fascia temporalis graft.

INTRODUCTION: Endoscopic type 1 tympanoplasty is every day gaining numerous adepts for tympanic membrane repair. Due to the value of reducing postauricular approaches, decreasing postoperative morbidity and hospitalization time. The objective of this study is to present surgical results of endoscopic type 1 tympanoplasty in the pediatric population using fascia temporalis or cartilage butterfly graft. MATERIALS AND METHODS: Prospective study regarding the pediatric population, mean age of 10.7 years old. Patients diagnosed with chronic otitis media without cholesteatoma and intact ossicular chain. Tympanic membrane reconstruction using inlay cartilage butterfly graft or underlay fascia temporalis graft according to surgical needs. Audiograms were evaluated preoperatively and 6 months after surgery. No postauricular approaches were performed. RESULTS: A total of 54 ears were operated, 25 utilizing underlay fascia temporalis graft and 29 using inlay cartilage butterfly graft. Six months following surgery, dry and closed tympanic membranes were obtained in 54 cases (92.6%). Preoperative and postoperative air conduction (AC) thresholds, bone conduction (BC) thresholds and air-bone gaps (ABG) were assessed. Preoperative AC of 24.6 dB, BC of 8.9 dB and an ABG of 15.5 dB. Postoperative AC of 16.3 dB, BC of 8.9 and an ABG of 6.9 dB. A postoperative ABG reduction of 8.5 dB was reached. CONCLUSION: Transcanal endoscopic type 1 tympanoplasty can be achieved in every pediatric patient with chronic otitis media without cholesteatoma, and, is a safe and efficient procedure.

[Rhinolithiasis. Review of one case]. / Rinolitiasis. A propósito de un caso.

Rhinoliths are foreign bodies of the nose, which may be found during the course of a routine examination or whe the show, if undetected for a long time, symptoms of nasal obstruction, similar to the ones of sinusitis. They require a high level of suspicion to be diagnosed and surgical removal is the treatment of choice. We present the case of a woman diagnosed of rhinolithiasis and we carry out a literature review.

Rinolitiasis. A propósito de un caso / Rhinolithiasis. Review of one case

Los rinolitos son cuerpos extraños nasales que pueden ser encontrados durante un examen nasal rutinario o producir, en caso de no detectarse, síntomas de obstrucción nasal, simulando una rinosinusitis crónica. Requieren un alto nivel de sospecha para su diagnóstico y la extracción quirúrgica es su tratamiento de elección. Presentamos el caso de una mujer diagnosticada de rinolitiasis y revisamos la literatura

Rhinoliths are foreign bodies of the nose, which may be found during the course of a routine examination or whe the show, if undetected for a long time, symptoms of nasal obstruction, similar to the ones of sinusitis. They require a high level of suspicion to be diagnosed and surgical removal is the treatment of choice. We present the case of a woman diagnosed of rhinolithiasis and we carry out a literature review

[Monostotic fibrous dysplasia. Three cases and literature review]. / Displasia fibrosa monostótica. A propósito de tres casos y revisión de la literatura.

The fibrous dysplagia is a rare benign osseous pathology of unknown aetiology. It presents an incidence of craniofacial affectation of a 10% in its monostotic variety and a 100% in the poliostotic. The temporal bone implication is very rare, being usually referred in the monostotic variety. The diagnosis is based on radiology (CT) and histology. The majority of the authors agree in a conservative treatment. We present three clinical cases of monostotic fibrous dysplagia with craniofacial affectation, two of them in the temporal bone and another one in the frontal bone.

Displasia fibrosa monostótica. A propósito de tres casos y revisión de la literatura / Monostotic fibrous displasia. Three cases and litterature revision

La displasia fibrosa es una enfermedad benigna ósea infrecuente, de etiología desconocida. Presenta una incidencia de afectación craneofacial del 10 por ciento en su variedad monostótica y del 100 por ciento en la poliostótica. La implicación del hueso temporal resulta poco frecuente, siendo principalmente documentada en la forma monostótica. El diagnóstico se basa en la radiología (TC) y la histología. La mayoría de autores están de acuerdo en seguir un tratamiento conservador. Nosotros presentamos tres casos clínicos de displasia fibrosa monostótica con afectación craneofacial, dos de ellos a nivel del hueso temporal y otro a nivel frontal (AU)

No disponible

[Retropharyngeal phlegmon in the adult. Presentation of a case]. / Flemón retrofaríngeo en el adulto. A propósito de 1 caso.

Nowadays retropharyngeal phlegmon and abscesses are uncommon. Advances in medical care have changed the morbidity and mortality of this processes. The advance of computed tomography (CT) has made possible a more exact diagnosis of these infections. If CT suggests a cellulitis medical treatment is used, but abscesses need surgical drainnage.

Flemón retrofaríngeo en el adulto. a propósito de un caso / Retropharyngeal pflegmon in the adult. Presentation of one case

Los flemones y abcesos retrofaríngeos son actualmente una entidad poco frecuente. Los avances médicos han cambiado la morbimortalidad de estas infecciones y la tomografía computerizada ha permitido un diagnóstico más exacto. Si el proceso se encuentra en fase de celulitis, el tratamiento es médico, pero si existe abceso se necesita drenaje quirúrgico (AU)

No disponible

Characterization of peripheral-compartment kinetics of antibiotics by in vivo microdialysis in humans.

The calculation of pharmacokinetic/pharmacodynamic surrogates from concentrations in serum has been shown to yield important information for the evaluation of antibiotic regimens. Calculations based on concentrations in serum, however, may not necessarily be appropriate for peripheral-compartment infections. The aim of the present study was to apply the microdialysis technique for the study of the peripheral-compartment pharmacokinetics of select antibiotics in humans. Microdialysis probes were inserted into the skeletal muscle and adipose tissue of healthy volunteers and into inflamed and noninflamed dermis of patients with cellulitis. Thereafter, volunteers received either cefodizime (2,000 mg as an intravenous bolus; n = 6), cefpirome (2,000 mg as an intravenous bolus; n = 6), fleroxacin (400 mg orally n = 6), or dirithromycin (250 mg orally; n = 4); the patients received phenoxymethylpenicillin (4.5 x 10(6) U orally; n = 3). Complete concentration-versus-time profiles for serum and tissues could be obtained for all compounds. Major pharmacokinetic parameters (elimination half-life, peak concentration in serum, time to peak concentration, area under the concentration-time curve [AUC], and AUC/MIC ratio) were calculated for tissues. For cefodizime and cefpirome, the AUCtissue/AUCserum ratios were 0.12 to 0.35 and 1.20 to 1.79, respectively. The AUCtissue/AUCserum ratios were 0.34 to 0.38 for fleroxacin and 0.42 to 0.49 for dirithromycin. There was no visible difference in the time course of phenoxymethylpenicillin in inflamed and noninflamed dermis. We demonstrated, by means of microdialysis, that the concept of pharmacokinetic/pharmacodynamic surrogate markers for evaluation of antibiotic regimens originally developed for serum pharmacokinetics can be extended to peripheral-tissue pharmacokinetics. This novel information may be useful for the rational development of dosage schedules and may improve predictions regarding therapeutic outcome.