[Bogorad syndrome or crocodile tears after Ramsay-Hunt]. / Síndrome de Bogorad o lágrimas de cocodrilo tras Ramsay-Hunt.

Crocodile tears or Bogorad Syndrome describes a complication or sequel after facial palsy with incomplete recovery characterized by an excessive hyperlacrimation during the food ingestion. We report the case of a 50 years old female with that pathology associated to facial syncinesias secondary to suffer a right Ramsay-Hunt syndrome. Its pathogenesis and different treatment modalities are analysed.

[Laryngeal chondrosarcoma of low grade of malignancy. Report of a case located on thyroid cartilage]. / Condrosarcoma laríngeo de bajo grado de malignidad. A propósito de un caso localizado en cartílago tiroides.

Cartilaginous tumors of the larynx are rare. Only a 2-5% of all chondrosarcomas arise on head and neck area while the laryngeal forms represent less than 1% of the malignant neoplasms in that location. Laryngeal chondrosarcoma is three times more frequent in men than in women with average age of presentation about the 6th - 7th decades. Most of them are originated on cricoid (70-75%) followed by the thyroid cartilage (10-20%) as in the case that we are reporting. Its growth often is very slow with delayed clinic being hoarseness, dyspnea and dysphagia the most common symptoms. Laryngeal chondrosarcomas use to be tumors with low-grade of malignancy and their elective treatment is surgery preserving the laryngeal function. Local and late recurrences are frequent and the definitive diagnosis is the anatomopathological exam.

Condrosarcoma laríngeo de bajo grado de malignidad. A propósito de un caso localizado en cartílago tiroides / Laryngeal chondrosarcoma of low grade of malignancy. Report of a case located on thyroid cartilage

Los tumores cartilaginosos de la laringe son raros. Sólo el 2-5% de todos los condrosarcomas se originan en el área de cabeza y cuello mientras que las formas laríngeas representan menos del 1 % de las neoplasias malignas de esta localización. El condrosarcoma laríngeo es tres veces más frecuente en hombres que en mujeres con edad media de presentación alrededor de la 6a-7 a décadas de la vida. La mayoría se localizan en cricoides (70-75%) seguido por el cartílago tiroides (10-20%) como en el caso que presentamos. El crecimiento por lo general es muy lento con clínica tardía siendo la disfonía, disnea y disfagia los síntomas más comunes. Los condrosarcomas de laringe suelen ser tumores de bajo grado de malignidad y su tratamiento de elección es la cirugía con conservación de la función laríngea. Las recidivas locales tardías son frecuentes y el diagnóstico definitivo es anatomopatológico

Cartilaginous tumors of the larynx are rafe. Only a 2-5% of all chondrosarcomas arise on head and neck afea while the laryngeal forms represent less than 1 % of the malignant neoplasms in that location. Laryngeal chondrosarcoma is three times more frequent in men than in women with average age of presentation about the 6th -7th decades. Most of them are originated on cricoid (70-75%) followed by the thyroid cartilage (10-20%) as in the case that we are reporting. Its growth often is very slow with delayed clinic being hoarseness, dyspnea and dysphagia the most common symptoms. Laryngeal chondrosarcomas use to be tumors with low- grade of malignancy and their elective treatment is surgery preserving the laryngeal function. Local and late recurrences are frequent and the definitive diagnosis is the anatomopathological exam

[Paraganglioma of the jugular foramen presenting with initial isolated vertigo]. / Paraganglioma del agujero rasgado posterior o foramen yugular presentándose con vértigo aislado inicial.

The more common symptoms of the jugulotympanic paragangliomas are hearing loss, tinnitus and palsy of cranial nerves. Diagnosis is often delayed due to the slow growth of the tumour. We report one case with affectation of jugular foramen which clinically debuted as a peripheral vertigo and the diagnosis was made by CT, IRM and angiography. The patient was treated by Neurosurgery using Gamma Knife (radiosurgery) with good result.

Paraganglioma del agujero reagado posterior o foramen yugular presentándose con vértigo aislado inicial / Paragnaglioma of the jugular foramen presenting with initial isolated vertigo

Los síntomas más frecuentes de los paragangliomas yúgulotimpánicos son pérdida de audición, acúfenos y la parálisis de pares craneales. El diagnóstico a menudo se ve retrasado por el lento crecimiento del tumor. Presentamos un caso con afectación del foramen yugular que debutó clínicamente como un vértigo periférico y fue diagnosticado mediante TAC, RMN y angiografía. El paciente fue tratado por Neurocirugía mediante Gamma Knife (radiocirugía) con buena respuesta

The more common symptoms of the jugulo tympanic paragangliomas are hearing loss, tinnitus and palsy of cranial nerves. Diagnosis is often delayed due to the slow growth of the tumour. We report one case with affectation of jugular for a men which clinically debuted as a peripheral vertigo and the diagnosis was made by CT, IRM and angiography. The patient was treated by Neurosurgery using Gamma Knife (radiosurgery) with good result

[Chondrocalcinosis (pseudogout) after surgical treatment of primary hyperparathyroidism. Report of a case and review of the literature]. / Condrocalcinosis (pseudogota) despúes de tratamiento quirúrgico de hiperparatiroidismo primario. Presentación de un caso y revisión de la literatura.

We are reporting the case of a 61-year-old female who developed an acute arthritis following parathyroidectomy because a primary hyperparathyroidism. The diagnosis of chondrocalcinosis or pseudogout was made by the clinical presentation, radiologic findings and demonstration of synovial fluid crystals of calcium pyrophosphate dihydrate. Rapid drops in serum calcium levels after removal of the adenoma may precipitate these acute articular inflammatory attacks that are not so uncommon as we can recognize if a bibliographic review about that association is performed.

[Recidived medullary thyroid carcinoma with neck metastases and tracheal invasion]. / Carcinoma medular de tiroides recidivado con metástasis ganglionares e invasión traqueal.

Medullary carcinoma represents about 5% of all malignant tumors located in thyroid gland and it can appear as sporadic or hereditary form. We report the case of a 58-year-old female who was initially operated by General Surgery Department of an infiltrating medullary carcinoma with cervical metastasic nodes having its origin on left thyroid lobe (LTL). The patient did not want any kind of control and 5 years later she suffered dyspnea due to the tumoral recurrence with invasion of the trachea and recurrential left palsy. Our ENT Service only performed a tracheostomy on fourth tracheal ring because the woman did not accept another surgical intervention. For 6 years she has been followed and reviewed in our consults beeing on alive up to now.

[Hürthle cells carcinoma. Report of two operated cases and review of the literature]. / Carcinoma de células de hürthle. Descripción de dos casos intervenidos y revisión de la literatura.

Hürthle cells carcinomas are considered a variant of folicular carcinomas and represent about 2% of all malignant thyroid tumours. We report 2 cases of 2 women of 46 and 43 years old confirmed by histological exam after total thyroidectomy with good postoperative evolution. The presence of capsular and vascular invasion is the most important criteria to distinguish this entity from the Hürthle cells adenomas.

[Usefulness of computed tomography and magnetic resonance in the preoperative diagnosis for hyperparathyroidism]. / Utilidad de la tomografía axial computerizada y la resonancia magnética nuclear en el diagnóstico preoperatorio del hiperparatiroidismo.

Sonnography and Tc-99m sestamibi scintigraphy are the most requested preoperative imaging tests nowdays in the surgery of hyperparathyroidism. The aim of our article is to know if Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) are useful as a location study and in which cases it would be more justified to ask these radiologic techniques. For that we report our results with 29 patients at all diagnosed as hyperparathyroidism (26 primary forms and 3 secondary ones) and operated by our E.N.T. Department later. On 20 of them a cervical CT was asked before the parathyroidectomy and on the rest 9, a MRI with sensitivities of 65% and 88.9% respectively. We think both complementary explorations must not be solicited by routine but they can represent a help in the cases in that sonnography and scintigraphy are not able to show the possible adenoma or hiperplasia, particularly in recurrent hyperparathyroidisms, reinterventions or suspect of parathyroid glands in an atypical location.

Condrocalcinosis (pseudogota) después de tratamiento quirúrgico de hiperparatiroidismo. Presentación de un caso y revisión de la literatura / Chondrocalcinosis (pseudogout) after surgical treatment of primary hyperparathyroidism. Report of a case and review of the literature

Se presenta el caso de una paciente de 61 años que desarrolló una artritis aguda después de la realización de una paratiroidectomía por hiperparatiroidismo primario. El diagnóstico de condrocalcinosis o pseudogota se estableció por la presentación clínica, hallazgos radiológicos y la demostración de los cristales de pirofosfato cálcico dihidratado en líquido sinovial. El brusco descenso de los niveles de calcio tras la extirpación del adenoma puede precipitar estos episodios agudos inflamatorio s articulares no tan infrecuente s como constatamos tras realizar una revisión bibliográfica sobre esta asociación

We are reporting the case of a 61 years-old female who developed an acute arthritis following parathyroidectomy because a primary hyperparathyroidism. The diagnosis of chondrocalcinosis or pseudogout was made by the clínical presentation, radiologic findings and demonstration of synovial fluid crystals of calcium pyrophosphate dihydrate. Rapid drops in serum calcium levels after removal of the adenoma may precipitate these acute articular inflammatory attacks that are not so uncommon as we can recognize if a biblíographic review about that association is performed

Carcinoma medular de tiroides recidivado con metástasis ganglionares e invasión traqueal / Recodoved medullary thyroid carcinoma with neck metastases and tracheal invasion

El carcinoma medular representa alrededor del 5% de todos los tumores malignos de la glándula tiroides y puede presentarse de forma esporádica o hereditaria. Presentamos el caso de una mujer de 58 años intervenida inicialmente por el Servicio de Cirugía General de un carcinoma medular infiltrante con metástasis ganglionares cervicales que afectaba al lóbulo tiroideo izquierdo (LTI). La paciente no siguió ningún tipo de control y 5 años después presentó disnea por recidiva tumoral con invasión de la luz traqueal y parálisis recurrencial izquierda. Nuestro Servicio de ORL practicó sólo una traqueotomía a nivel del cuarto anillo ya que la enferma no aceptó ninguna otra intervención. Durante 6 años ha seguido posteriormente revisiones en nuestras consultas continuando viva tras este período de tiempo y hasta la actualidad

Medullary carcinoma represents about 5% of all malignant tumors located in thyroid gland and it can appear as sporadic or hereditary formo We report the case of a 58 year-old female who was initially operated by General Surgery Department of an infiltrating medullary carcinoma with cervical metastasic nodes having its origin on left thyroid lobe (LTL). The patient did not want any kind of control and 5 years later she suffered dyspnea due to the turnaral recurrence with invasion of the trachea and recurrentialleft palsy. Our ENT Service only performed a tracheostorny on fourth tracheal ring because the wornan did not accept another surgical intervention. For 6 years she has been followed and reviewed in our consults beeing on alive up to now

Carcinoma de células de Hürthle. Descripción de dos casos intervenidos y revisión de la literatura / Hürthle cells carcinoma. Report of two operated cases and review of the literature

Los carcinoma s de células de Hürthle están considerados como variantes de los carcinomas foliculares y representan alrededor del 2% de todos los tumores malignos de la glándula tiroides. Presentamos 2 casos clínicos correspondientes a dos mujeres de 46 y 43 años confirmados mediante estudio histológico tras tiroidectomía total con buena evolución postoperatoria. La presencia de invasión capsular y vascular es el criterio más importante para diferenciar esta entidad de los adenomas de células de Hürthle

Hürthle cells carcinomas are considered as a variant of folicular carcinomas and represent about 2% of all malignant thyroid tumours. We report 2 cases of 2 women of 46 and 43 years old confirmed by histological exam after total thyroidectomy with good postoperative evolution. The presence of capsular and vascular invasion is the most important criteria to distinguish this entity from the Hürthle cells adenomas

Utilidad de la tomografía axial computerizada y la resonancia mágnetica nuclear en el diagnóstico preoperatorio del hiperparatiroidismo / Usefulness of computed tomography and magnetic resonance in the preoperative diagnosis for hyperparathyroidism

Las pruebas de imagen preoperatorias más solicitadas actualmente en la cirugía del hiperparatiroidismo son la ecografia y la gammagrafia con Tc-99m sestamibi. El objetivo de nuestro trabajo es conocer si la Tomografia Axial Computerizada (TAC) y la Resonancia Magnética Nuclear (RMN) son útiles como estudio de localización y en qué casos estaría más justificado solicitar estas técnicas radiológicas. Para ello presentamos nuestros resultados con un total de 29 pacientes diagnosticados de hiperparatiroidimo (26 primarios y 3 secundarios) que posteriormente fueron intervenidos por nuestro Servicio de ORL. En 20 de ellos se pidió un TAC cervical antes de la paratiroidectomía y en los 9 restantes una RMN con sensibilidades respectivas del 65% y 88,9%. Creemos que ambas pruebas no deben solicitarse de rutina, pero sí pueden suponer una ayuda en los casos en los que la eco y gammagrafía no son capaces de mostrar el posible adenoma o hiperplasia, particularmente en hiperparatiroidismos recurrentes, reintervenciones o sospecha de paratiroides en localización atípica

Sonnography and Tc-99m sestamibi scintigraphy are the most requested preoperative imaging tests nowdays in the surgery ofhyperparathyroidism. The aim of OUT article is to know ifComputerized Tomography (CT) and Magnetic Resonance Imaging (MRI) are useful as a location study and in which cases it would be more justified to ask these radiologic techniques. For that we report OUT results with 29 patients at all diagnosed as hyperparathyroidism (26 primary forms and 3 secondary ones) and operated by our E.N.T. Department later. On 20 ofthem a cervical CT was asked before the parathyroidectomy and on the rest 9, a MRI with sensitivities of 65% and 88,9% respectively. We think both complementary explorations must not be solicited by routine but they can represent a help in the cases in that sonnography and scintigraphy are not able to show the possible adenoma or hiperplasia, particularly in recurrent hyperparathyroidisms, reinterventions or suspect of parathyroid glands in an atypical location

[Thyroglossal duct cysts and fistulae. Review of 30 consecutive operated patients]. / Quistes y fístulas del conducto tirogloso Revisión de 30 pacientes consecutivos intervenidos.

Thyroglossal duct cysts represent a very common pathology among the benign neck masses. An own review of 30 consecutive operated patients between 1994-2003 by our ENT Department is reported. There have been analysed different parameters like age, sex, personal antecedents, clinical symptoms, complementary explorations, surgical treatment, evolution and anatomopathologic result (AP). We think the Sistrunk procedure is the best operatory technique or strategy to perform to avoid recurrences.

[Multiple brown tumours in a patient with tertiary hyperparathyroidism]. / Múltiples tumores pardos en paciente con hiperparatiroidismo terciario.

We describe the case of a 49-year-old female with chronic renal failure and secondary hyperparathyroidism that not dissapeared after kidney transplant and turned into an autonomous form (tertiary hyperparathyroidism). The xRays and CT showed the presence of multiple brown tumors in iliac bones and tibia. We performed a parathyroidectomy removing a lower left adenoma confirmed in the histological exam the renal. After the surgery the osteoarticular manifestations improved and lithiasis dissapeared. There were not any postoperative complications such as hypocalcemia or recurrential palsy although Nephrology Department had to control her renal function.

[Association between primary hyperparathyroidism and Paget's disease. Report of a case]. / Asociación entre hiperparatiroidismo primario y enfermedad de paget Presentación de un caso.

Although the association between hyperparathyroidism and Paget's disease is known, in the clinical practice occurs very rarely. We report the case of a 68 years old female who was diagnosed as such disease more than 5 years ago and later she got an increment of PTH levels and hypercalcemiajoint to other biochemical disorders that made to suspect a primary hyperparathyroidism. Besides the osteoarticular manifestations, clinically the patient suffered recurrent kidney lithiasis. She was operated by removal of one adenoma (1,5 cm) located in lower right parathyroid gland and her evolution was satisfactory without complications.

Quistes y fístulas del conducto tirogloso. Revisión de 30 pacientes consecutivos intervenidos / Thyroglossal duct cysts and fistulae. Review of 30 consecutive operated patients

Los quistes del conducto tirogloso representan una patología muy frecuente entre las masas benignas cervicales. Presentamos una revisión propia de 30 pacientes consecutivos operados en el período 1994-2003 por nuestro Servicio de ORL. Analizamos diferentes variables como la edad, sexo, antecedentes personales, sintomatología clínica, exploraciones complementarias, tratamiento quirúrgico, evolución y resultado anatomopatológico (AP). Defendemos el procedimiento de Sistrunk como la mejor técnica o estrategia operatoria a realizar para evitar recurrencias

Thyroglossal duct cysts represent a very common pathology among the benign neck masses. An own review of 30 consecutive operated patients between 1994-2003 by our ENT Department is reported. There have been analysed different parameters like age, sex, personal antecedents, clinical symptoms, complementary explorations, surgical treatment, evolution and anatomopathologic result (AP). We think the Sistrunk procedure is the best operatory technique or strategy to perform to avoid recurrences

Asociación entre hiperparatiroidismo primario y enfermedad de Paget / Association between primary hyperparathyroidism and Paget´s disease- Report of a case

Aunque la asociación entre el hiperparatiroidismo y la enfermedad de Paget es conocida, en la práctica clínica ocurre muy raramente. Presentamos el caso de una mujer de 68 años que estaba diagnosticada de dicha enfermedad hacía más de 5 años y que posteriormente experimentó un aumento de la PTH e hiperca1cemia junto con otras alteraciones bioquímicas que hicieron sospechar un hiperparatiroidismo primario. Además de manifestaciones osteoarticulares, clínicamente la paciente sufría litiasis renal de repetición. Fue sometida a resección de un adenoma de 1,5 cm localizado en la glándula paratiroides inferior derecha y la evolución fue satisfactoria sin complicaciones

Although the association between hyperparathyroidism and Paget' s disease is known, in the clinical practice occurs very rarely. We report the case of a 68 years old female who was diagnosed as such disease more than 5 years ago and later she got an increment of PTH levels and hypercalcemia joint to other biochemical disorders that made to suspect a primary hyperparathyroidism. Besides the osteoarticular manifestations, clinically the patient suffered recurrent kidney lithiasis. She was operated by remo val of one adenoma (1,5 cm) located in lower right parathyroid gland and her evolution was satisfactory without complications

Múltiple tumores pardos en paciente con hiperparatiroidismo terciario / Múltiple brown tumours in a patient with tertiary hyperparathiroidism

Describimos el caso de una mujer de 49 años con insuficiencia renal crónica e hiperparatiroidismo secundario que no cedió tras transplante y se convirtió en una forma autónoma (hiperparatiroidismo terciario). Las pruebas de imagen revelaron la presencia de múltiples tumores pardos en huesos pélvicos y tibia. La paciente fue intervenida mediante paratiroidectomía resecando un adenoma inferior izquierdo confirmado posteriormente en el estudio histológico. Tras la cirugía mejoraron las manifestaciones osteoarticulares y desapareció la litiasis renal. No se registraron complicaciones posoperatorias como hipocalcemia o parálisis recurrencial aunque el Servicio de Nefrología tuvo que controlar la función renal

We describe the case of a 49-year-old female with chronic renal failure and secondary hyperparathyroidism that not dissapeared after kidney transplant and turned into an autonomous form (tertiary hyperparathyroidism). The xRays and CT showed the presence of multiple brown tumors in iliac bones and tibia. We performed a parathyroidectomy removing a lower left adenoma confirmed in the histological exam the renal. After the surgery the osteoarticular manifestations improved and lithiasis dissapeared. There were not any postoperative complications such as hypocalcemia or recurrential palsy although Nephrology Department had to control her renal function

[External severe laryngeal trauma with multiple fractures and airway compromise]. / Traumatismo laríngeo externo severo con fracturas mújltiples y compromiso de la vía aérea.

External laryngeal traumas are rare but clinically can cause important life-threatening injuries. We report the case of a 33 yeras old male who suffered a severe traffic accident: TCE, facial trauma with multiple fractures and laryngeal trauma with fracture of the thyroid cartilage and the hyoid bone. Because an important edema in the airway, it was not possible an orotracheal intubation and he required urgent coniotomy with later reconstruction surgery and tracheostomy. Actually our patient has been decanulated and the fibroscopic image of the larynx and its functionality is correct.