Characterization of Hearing Loss in Adult Patients With Nondialysis Chronic Kidney Disease.

OBJECTIVE: To confirm the association between chronic kidney disease and sensorineural hearing loss in non-dialysis non-diabetic patients and to establish the audiological profile of these patients indicating the possible location of the auditory damage. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary referral center. PATIENTS: Patients between 18 and 60 years old with chronic kidney disease, without diabetes mellitus and without personal history of otology disease, were compared with a healthy control group pared by sex and age to establish differences between their audiological profile. INTERVENTIONS: Pure tone audiometry (PTA), transient evoked otoacoustic emissions (TEOAEs), distortion products otoacoustic emissions (DPOAEs), and auditory brainstem responses (ABR) were performed in both groups. MAIN OUTCOME MEASURES: Mean and standard deviation of PTA auditory thresholds, TEOAEs reproducibility, DPOAEs level/noise, and ABR absolute latency and interwave latency were measured, and compared using linear mixed models. RESULTS: Fifty one cases were included and compared with 51 healthy volunteers. The audiometric profile found in patients with chronic kidney disease was a sensorineural hearing loss in 4 to 8 kHz frequencies in the PTA, a decrease in the TEOAEs reproducibility and a decrease in the DPOAEs level. An enlargement in the V wave absolute latency and III to V and I to V interwave latency in the ABR were also found but within normal range. CONCLUSIONS: There is an association between chronic kidney disease in non-dialysis non diabetic adults patients and sensorineural hearing loss, affecting high frequencies and having the cochlea as the main site of auditory damage.

Evaluación de la obstrucción nasal mediante rinomanometría y escalas subjetivas y medición del éxito terapéutico médico y quirúrgico / Assessment of nasal obstruction with rhinomanometry and subjective scales and outcomes of surgical and medical treatment

Introducción y objetivos: Estudio prospectivo de pacientes con obstruccción nasal (ON) a fin de cuantificar el éxito terapéutico mediante una rinomanometría anterior activa (RAA), la escala de Evaluación de los Síntomas de Obstrucción Nasal (NOSE) y la Escala Visual Análoga (EVA), y determinar la correlación que existe entre las pruebas. Métodos: Realizamos RAA y valoración subjetiva mediante las escalas NOSE y EVA a pacientes con ON antes y después del tratamiento médico (corticoides tópicos) o quirúrgico (septoplastia, turbinoplastia o septoturbinoplastia). Comparamos y analizamos los resultados de las puntuaciones obtenidas en ambas escalas subjetivas (NOSE y VAS) con las mediciones en la RAA. Resultados: Un total de 102 pacientes cumplieron los criterios de selección. Los resultados muestran que la mejoría de la ON, tras tratamiento quirúrgico, es evaluada más positivamente si la herramienta de medición es la RAA. Por el contrario, el tratamiento médico mejora el flujo nasal medido con la RAA, pero sin significación estadística (p=0,1363). Medimos la correlación entre RAA, escalas NOSE y EVA y hallamos solo una correlación positiva entre las escalas NOSE y EVA (r=0,83327). Conclusiones: Los pacientes quirúrgicamente tratados por ON presentan mejores resultados cuando estos se evalúan mediante RAA o con escalas subjetivas. No existe una correlación significativa entre RAA y las escalas NOSE y EVA; esto se considera debido a que la RAA y las escalas subjetivas son complementarias y miden diferentes aspectos de ON. La RAA y las escalas subjetivas son instrumentos útiles para emplearlos de forma conjunta en el seguimiento de pacientes con ON (AU)

Introduction: Prospective study of patients with nasal obstruction (NO) in order to measure therapeutic success by anterior active rhinomanometry (AAR), Nasal Obstruction Symptom Evaluation (NOSE) scale and Visual Analogue Scale (VAS) and to establish the correlation between these tests. Methods: Patients with NO, on whom we performed an AAR, NOSE and VAS scales at baseline and after medical treatment (topical nasal steroid) or surgery (septoplasty, turbinoplasty or septoplasty and turbinoplasty). The nasal flow obtained by the AAR and the score of both subjective scales (NOSE and VAS) were compared and analyzed. Results: A total of 102 patients were included in the study. Surgical treatment resulted in statistically significant differences with the AAR and the subjective scales. While in patients with medical treatment there was an increase in the AAR nasal flow but without statistical significance (P=.1363). The correlation between the AAR, the NOSE and VAS scales was measured finding a strong correlation between the NOSE and VAS scales only (r=.83327). Conclusions: The patients with NO treated surgically have better results when these are evaluated by AAR or with subjective scales. There is no significant correlation between AAR, NOSE and VAS scales, this is considered to be because the AAR and subjective scales are complementary and measure different aspects of NO. The AAR and subjective scales are useful tools to be used together for the follow up of patients with NO (AU)

Assessment of nasal obstruction with rhinomanometry and subjective scales and outcomes of surgical and medical treatment. / Evaluación de la obstrucción nasal mediante rinomanometría y escalas subjetivas y medición del éxito terapéutico médico y quirúrgico.

INTRODUCTION: Prospective study of patients with nasal obstruction (NO) in order to measure therapeutic success by anterior active rhinomanometry (AAR), Nasal Obstruction Symptom Evaluation (NOSE) scale and Visual Analogue Scale (VAS) and to establish the correlation between these tests. METHODS: Patients with NO, on whom we performed an AAR, NOSE and VAS scales at baseline and after medical treatment (topical nasal steroid) or surgery (septoplasty, turbinoplasty or septoplasty and turbinoplasty). The nasal flow obtained by the AAR and the score of both subjective scales (NOSE and VAS) were compared and analyzed. RESULTS: A total of 102 patients were included in the study. Surgical treatment resulted in statistically significant differences with the AAR and the subjective scales. While in patients with medical treatment there was an increase in the AAR nasal flow but without statistical significance (P=.1363). The correlation between the AAR, the NOSE and VAS scales was measured finding a strong correlation between the NOSE and VAS scales only (r=.83327). CONCLUSIONS: The patients with NO treated surgically have better results when these are evaluated by AAR or with subjective scales. There is no significant correlation between AAR, NOSE and VAS scales, this is considered to be because the AAR and subjective scales are complementary and measure different aspects of NO. The AAR and subjective scales are useful tools to be used together for the follow up of patients with NO.

Sclerosing polycystic adenosis of the parotid gland / Adenosis Poliquística Esclerosante de la Glándula Parótida: un tumor raro aparentemente benigno

Objective. To present a case of sclerosing polycystic adenosis (SPA) of the parotid gland, highlighting the probable etiology and the benign behavior of these cases. Case report. A woman of 22 years old had a right parotid mass with a slowly progressive growth associated with a chronic infection due to Epstein–Barr virus. Initially, it was asymptomatic and subsequently the patient developed light dysesthesias in the region. A superficial parotidectomy was done and the microscopic study informed SPA. Conclusion. The SPA is similar to the fibrocystic changes, sclerosing adenosis and adenoid tumors of the mammary gland. The main location of the SPA is the parotid gland and it is considered a disease due to a pseudotumoral inflammatory reaction with a possible association with the Epstein–Barr virus. There is evidence that monoclonal cell populations exist. The treatment consists in excision of the tumor with a superficial parotidectomy, which has demonstrated high cure rates (AU)

Objetivo. Presentar un caso de adenosis poliquística esclerosante (APE) de la glándula parótida, destacando la etiología probable y el comportamiento benigno de estos casos. Caso clínico. Mujer de 22 años con una masa parotídea derecha de crecimiento lentamente progresivo asociada con una infección crónica por el virus de Epstein–Barr. Inicialmente, era asintomática y posteriormente desarrolló disestesias ligeras en la región. Se realiza una parotidectomía superficial y el resultado histopatológico es de APE. Conclusión. La APE muestra cambios histopatológicos similares a los hallados en la enfermedad fibroquística, adenosis esclerosante y los tumores adenoideos de la glándula mamaria. La ubicación salivar principal de la APE es la glándula parótida y se trata de una enfermedad causada por una reacción inflamatoria pseudotumoral con una posible asociación con el virus de Epstein–Barr. Hay pruebas de que existen poblaciones celulares monoclonales. El tratamiento de elección es quirúrgico, siendo la parotidectomía superficial la técnica de elección al haber demostrado tasas de curación elevadas (AU)

Neuromas mucosos de localización laríngea en una neoplasia endocrina múltiple 2B / Multiple mucosal neuromas in the larynx as part of a multiple endocrine neoplasia type 2B

No disponible

Síndrome inflamatorio de reconstitución inmune manifiesto como sarcoma de Kaposi en lengua / Immune reconstitution inflammatory syndrome manifested as a Kaposi's sarcoma in the tongue

No disponible

Cavernous hemangioma of the parotid gland in adults.

Hemangiomas account for 0.4-0.6% of all tumors of the parotid gland and most of them occur in children, nevertheless in adults hemangiomas are very rare. We report the case of a 62 year old woman with a mass in the parotid right tail associated with fluctuating swelling episodes unrelated to meals and with a slowly progressive growth. The provisional diagnosis was a pleomorphic adenoma, so a right superficial parotidectomy was performed. During surgery, the macroscopic appearance makes suspect a vascular lesion. The histopathological result was a cavernous hemangioma. The classic clinical presentation of a parotid hemangioma is an intraglandular mass associated or not with skin lesions characterized by reddish macules and/or papules, and a vibration or pulsation when palpating the parotid region. In imaging tests, phleboliths could be observed which are very suggestive of a hemangioma or a vascular malformation. In the absence of these signs, the diagnosis could be difficult, particularly in an adult due to its low prevalence, with about 50 cases reported worldwide. However a hemangioma should be considered in the differential diagnosis of parotid tumors in adults. Key words:Cavernous hemangioma, parotid gland, superficial parotidectomy, pleomorphic adenoma.

Extramedullary plasmacytoma of the larynx: a case report of subglottic localization.

Extramedullary plasmacytoma (EMP) is a rare neoplasm of plasma cells, described in soft tissue outside the bone marrow. EMP of the larynx represents 0.04 to 0.45% of malignant tumors of the larynx. A male of 57 years old presented with hoarseness, dyspnea, and biphasic stridor of 2 months. The indirect laryngoscopy (IL) revealed severe edema of the posterior commissure and a polypoid mass in the right posterior lateral subglottic wall. A biopsy of the subglottic mass was performed by a direct laryngoscopy (DL). The histopathologic diagnosis was EMP CD138+, therefore radiotherapy was given at 54 Gy in 30 sessions. The patient had an adequate postoperative clinical course and a new biopsy was performed having tumor-free margins. All laryngeal lesions should be biopsied prior to treatment to determine an accurate diagnosis to guide a proper management of the condition. Radiation therapy to the EMP is considered the treatment of choice, having local control rates of 80% to 100%. The subglottis is the least accessible area of view and the least frequent location of a laryngeal mass, nevertheless the otolaryngologist should always do a complete and systematic exam of the larynx when a tumor is suspected, to detect diagnoses such as a subglottic plasmacytoma.