[Ramsay-Hunt syndrome]. / Síndrome de Ramsay-Hunt.

Ramsay-Hunt syndrome is a peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear or in the mouth; it is caused by varicella zoster virus that affects the geniculate ganglion. The zoster oticus is the second most common cause of atraumatic peripheral facial paralysis. We present a review of zoster oticus identified in our hospital among 2001-2005. We show various atypical cases with multiple cranial nerve involvement; cerebellum and spinal cord was affected in one patient. 3/10 cases were complicated with pneumonia. So, we think that some grade of immunodeficiency may be present in these cases. Treatment with acyclovir and prednisone has been successfully to improve the outcome in the most of patients. Compared with Bell s palsy, patients with zoster oticus often have more severe paralysis at onset and are less likely to recover completely.

[Base tongue actinomycosis]. / Actinomicosis de base de lengua.

Actinomycosis is a bacterial, suppurative chronic infectious disease caused by Actinomyces israelii. Actinomycosis of the tongue is an uncommon form, and only 3% affect the base of the tongue. We report a case with dysphagia from an epiglottis, vallecula and tongue base mass. Diagnosis was made on histologic examination of a tissue biopsy. The disease completely resolved after chirurgical incision and drainage of the abscess and one month of oral amoxicillin therapy. The recurrence of the disease, five years later, made necessary a second surgical procedure and one year of penicillin therapy. We comment the possible causes of this recurrence.

[Unusual presentation forms of Wegener's disease]. / Formas de presentación infrecuente de la enfermedad de Wegener.

Wegener's granulomatosis may appear with the classic granulomatous necrotizing vasculitis affecting both high and low airway and renal glomerule, and rarely small vessels in any other location. In this way we may find generalized and localized forms of the disease. Three atypical cases of the disease are reported. The first one as a limited form with only airway affection. The second one as an unusual case of otitis with progressive affection of I, II, V, VI, VII and VIII cranial nerves. The third one was a generalized case with sinusitis and orbital pseudotumor. Both first and second cases have been controlled for a very long period of time of 22 and 14 years respectively, and none of them has presented any other location of the disease.

[Mortality in advanced stage laryngeal cancer]. / Mortalidad en el cáncer de laringe en estadios avanzados.

Patients with advanced laryngeal carcinoma present a high mortality rate due to locoregional recurrence, distant metastases and second cancer. We present a report about the most important prognostic factors in mortality in patients included in III and IV stages. The most important are the presence of metastatic lymph nodes (p = 0.001), extracapsular spread (p = 0.002) and N stage (p = 0.005).

[Distant metastases in patients with advance laryngeal carcinoma]. / Metástasis a distancia en pacientes con carcinoma de laringe avanzado.

Patients with advanced stage cancer larynx have a higher risk of development of distant metastases which means a bad prognosis. In our study we try to identify risk factors with the idea of involve to all of these patients in more aggressive systemic therapy protocols. Data of 57 patients surgically treated, with squamous pharyngolaryngeal carcinoma, stage III and IV, are evaluated. Advanced T stage or more extensive neck disease more often caused distant metastases (p < 0.05), and also the histological evidence of tumor invasion in three or more cervical nodes (p = 0.02), and poorly differentiated tumors (p < 0.05). Tumor site, surface area in cm, presence of ulceration, and loco-regional uncontrol were not associated with distant metastases.

[Melanoma of the hard palate]. / Melanoma de paladar duro.

Oral melanomas are extremely rare and occur most often on the palate and gingiva. Its prognosis is poor. Surgical management remains the preferred treatment, sometimes in combination with chemotherapy. We report the case of a 72 years old woman with a malignant melanoma of the hard palate who developed three years later a gingival nevi and 5 years later metastatic cervical lymph nodes. Our treatment has been only radical surgery all times.

[Pharyngoesophageal foreign bodies]. / Cuerpos extraños faringoesofágicos.

A review was made of 77 rigid esophagoscopies to remove a foreign body from the upper digestive tract. Mean age of patients was 59 years. Meat bones were the most frequent impacted foreign body and the cervical esophagus was the most frequent site of impactation. No foreign body was found in 22% of esophagoscopies, a high rate that could have been due to our lack of confidence in radiographic studies, which yield false positive and false negative information. Esophagoscopy is performed whenever patient-referred symptoms are clear. The only complications were three cases of major esophageal erosions without perforation and one pneumothorax. A case of intramural esophageal pseudodiverticulosis was found.

Cuerpos extraños faringoesofágicos / Pharynogesopnageal foreign bodies

Hemos realizado una revisión de 77 esofagoscopias rígidas para extraer cuerpos extraños del tracto digestivo superior. La edad media de los pacientes fue de 59 años, el cuerpo extraño más frecuente los huesos de carne y el esófago cervical el lugar más común de impactación. Un 22 por ciento de las esofagoscopias fueron negativas, una alta tasa que nosotros atribuimos a nuestra falta de confianza en los estudios radiológicos dada la existencia de falsos positivos y negativos, lo que nos lleva a realizar la esofagoscopia siempre que la clínica del paciente es clara. Como complicaciones sólo encontramos tres casos de erosiones esofágicas importantes sin ninguna perforación y un neumotórax. También encontramos un caso de pseudodivertículo esofágico intramural (AU)

A review was made of 77 rigid esophagoscopies to remove a foreign body from the upper digestive tract. Mean age of patients was 59 years. Meat bones were the most frequent impacted foreign body and the cervical esophagus was the most frequent site of impactation. No foreign body was found in 22% of esophagoscopies, a high rate that could have been due to our lack of confidence in radiographic studies, which yield false positive and false negative information. Esophagoscopy is performed whenever patient-referred symptoms are clear. The only complications were three cases of major esophageal erosions without perforation and one pneumothorax. A case of intramural esophageal pseudodiverticulosis was found (AU)

[Neuroendocrine carcinoma of the larynx]. / Carcinoma neuroendocrino de laringe.

We report a case of moderately differentiated neuroendocrine carcinoma arising in the left pyriform sinus and arytenoid of a 68-year-old man. The tumor was diagnosed initially as a poorly differentiated squamous carcinoma, but after surgery it gave rise to multiple painful skin metastases and a paraneoplastic syndrome. Immunocytochemical staining yielded the correct diagnosis. The patient, who had microscopic cervical lymph node metastases at the initial resection, died 13 months later, thus confirming the poor prognosis of these tumors.

[Acute epiglottitis in the adult]. / Epiglotitis aguda en el adulto.

Epiglottitis is a well-defined syndrome caused by Haemophilus influenzae type B in children. It also may affect adults and has an unpredictable clinical course, sometimes complicated with airway obstruction. Two cases of adult epiglottitis are reported. The first responded favorably to medical treatment and the second required emergency airway surgery. Indicators of poor prognosis are described. Epiglottitis should be considered in the differential diagnosis as a potentially lethal cause of sore throat.

[Jugular vein thrombosis: a case report]. / Trombosis venosa yugular. A propósito de un caso.

Thrombosis of the internal jugular vein is now rare but was well-known in the pre-antibiotic era, when it was associated with fulminant infections of the head and neck. Now the two major causes of jugular thrombosis are central venous catheterization and intravenous drug use. The clinical findings are a non-specific, painful, poorly delimited mass in neck that often is confused with an abscess or metastasis. CAT is necessary for diagnosis. We report a case secondary to central venous catheterization in which the clinical manifestations appeared three days after removing the catheter. The differential diagnosis of regional inflammations is described.

[Wegener's disease: localized and generalized forms]. / Enfermedad de Wegener: formas localizadas y generalizadas.

Two new cases of Wegener's granulomatosis are reported. One of them with the classic sinusal, pulmonary and renal involvement, and the other one as a limited form of the disease, only with respiratory affection, sparing the characteristic renal entailment, although its prolonged survival. The AA, comment literature controversial about if the forms limited to the ENT-area represents a unique and separate entity or an early and modified state of the disease.

[The influence of hypercholesterolemia and noise on human auditory function]. / Influencia de la hipercolesterolemia y el ruido en la audición humana.

A cross-sectional study on occupational noise exposure and hypercholesterolemia was conducted in a group of 1.209 workers exposed to industrial noise. Clinical examinations and audiograms were compared in exposed and not exposed subjects to noise. There was a strong relationship between severe noise induced hearing loss and hypercholesterolemia in all de workers. But the relationship was not convincing when the workers were considered stratified in groups of age, because the number of hard of hearing labourers with high levels of cholesterol, increases as they get older. The AA, support the point of view that the age is an important confounding factor, and in their study there is no relation between noise induced hearing loss and hypercholesterolemia.

[Interaction of arterial blood pressure and industrial noise on human hearing]. / Interacción de la tensión arterial y el ruido industrial sobre la audición humana.

A cross-sectional study of occupational noise exposure and high blood pressure was conducted in a group of 1584 workers. Clinical examination, audiograms, and body mass index were compared in exposed and not to noise finding a strong relationship between severe noise induced hearing loss and high blood pressure in all the staff, as it has been marked by different authors. But when we stratify the population in groups of age, we can't find any influence between noise exposure and hypertension, or between the appearing of high blood pressure and noise induced hearing loss.

[Interaction between hypertriglyceridemia and noise in human hearing]. / Interacción de la hipertrigliceridemia y el ruido en la audición humana.

We carry out a cross-sectional study on 1205 workers exposed to industrial noise. After the clinical, analytical and audiological examination, we can't demonstrate any influence of hypertriglyceridemia on noise induced hearing loss. We get a statistically significant relationship between noise and hearing loss only in the group of workers with normotriglyceridemia.

[Cavernous hemangioma of the maxillary sinus]. / Hemangioma cavernoso de seno maxilar.

We describe a case of maxillary sinus hemangioma which originated in sinusal mucosa and which extended into the nasal cavity. Clinical and radiologic findings are presented and the literature reviewed. Surgery appears curative in most cases.

[Granular cell tumor of the larynx]. / Tumor de células granulosas de laringe.

Granular cell tumors are unusual tumors that can affect any site of the body, with most cases affecting the head and neck region. First described by Abrikossoff, considerable debate has surrounded the histogenesis of this neoplasm. We report a case of granular cell myoblastoma of the larynx. Histological features are described. The treatment was surgical removal, endoscopically.

[Rare benign tumors in otorhinolaryngology: plasma cell granuloma and histiocytoma]. / Tumores benignos raros en O.R.L.: granuloma de células plasmáticas e histiocitoma.

Two benign tumors in the face are reported. Plasma cell granuloma is a rare benign tumor that affects people at all ages and most frequently involves the lung. It is dominated by mature plasma cell proliferation. The AA. report a case appearing as a painless nontender mass in the right cheek, with purplish discoloration of the overlying skin. Differential diagnosis with Plasmocytoma was considered. Histiocytoma are most common seen on the lower extremities of young adults. Reporting a case localized on the skin of the root of the nose. Differential diagnosis with osteoma is made.

[Open wound of the larynx caused by the horn of a bull]. / Traumatismo abierto de laringe por asta de toro.

Open laryngeal traumas are seldom seen in E.N.T., specially those ones secondary to horn bull goring. We do a synthetized study with regard to report this original case treated in our Service. We justify the paper because of the intensity, the seriousness and the originality of the picture.

[Neurofibroma of the tongue]. / Neurofibroma de lengua.

Neural sheath tumors are rarely encountered in the oral cavity. The most common location is the tongue and thereafter, the sites in order of frequency are the buccal mucosa, the floor of the mouth, palate, lips and gingiva. The need to differentiate between Neurofibroma and Schwannoma is imperative in as much as the first one shows a much greater propensity for malignant transformation when associated with von Recklinghausen's neurofibromatosis. We present a case of Neurofibroma localized in the tongue which appeared as a sessile nodule of 0.3 X 0.4 cm. After extensive surgical ablation there was no further recurrence in 5 years follow-up.