[Effect of irrigation sequence in vestibular paresis results of bithermal caloric tests]. / Efecto de la secuencia de irrigación en los resultados de la paresia canalicular en la prueba calórica bitérmica.

OBJECTIVE: Bithermal caloric tests are among those most commonly used in vestibular function studies and require a properly systematized approach. Irrigation sequence varies between laboratories. Our objective is to study the effect of irrigation sequence on the percentage of vestibular paresis. MATERIAL AND METHOD: We analysed 1214 records, 77.51% cold to hot sequences (C-H) and the rest hot to cold (H-C). We considered results above 24% of vestibular asymmetry to be pathological. RESULTS: In general, 33.36% of the records were pathological. Groups compared showed that H-C sequence had more significant (P <0.001) pathological results than C-H (46.52% vs 29.54%). CONCLUSION: Irrigation sequence has a significant influence on the outcome of caloric tests to for the detection of vestibular paresis. More studies are needed to confirm the best irrigation sequence.

Efecto de la secuencia de irrigación en los resultados de la paresia canalicular en la prueba calórica bitérmica / Effect of irrigation sequence in vestibular paresis results of bithermal caloric tests

Objetivo: La prueba calórica bitérmica es una de las pruebas más utilizadas para el estudio funcional vestibular. Su realización requiere una adecuada sistematización. La secuencia de realización de las irrigaciones varía de unos centros a otros. Nuestro objetivo es analizar el efecto de las variaciones de la secuencia de irrigación en el porcentaje de paresias canaliculares (%PC). Material y método: Analizamos un total de 1.214 registros; en el 77,51 % practicamos secuencias frías-calientes (F-C) y en el resto, calientes-frías (C-F). Consideramos patológicas respuestas por encima del 24 % de asimetría entre ambos oídos. Resultados: En total, el 33,36 % de los registros resultaron patológicos. Al comparar entre secuencias, las C-F mostraban un %PC significativamente (p < 0,001) superior a las F-C (el 46,52 y el 29,54 %). Conclusiones: La secuencia de irrigación condiciona la capacidad de la prueba para detectar paresias canaliculares. Consideramos necesarios más estudios para establecer cuál es en nuestro medio el método más adecuado

Objective: Bithermal caloric tests are among those most commonly used in vestibular function studies and require a properly systematized approach. Irrigation sequence varies between laboratories. Our objective is to study the effect of irrigation sequence on the percentage of vestibular paresis. Material and method: We analysed 1214 records, 77.51 % cold to hot sequences (C-H) and the rest hot to cold (H-C). We considered results above 24 % of vestibular asymmetry to be pathological. Results: In general, 33.36 % of the records were pathological. Groups compared showed that H-C sequence had more significant (P< .001) pathological results than C-H (46.52 % vs 29.54 %). Conclusion: Irrigation sequence has a significant influence on the outcome of caloric tests to for the detection of vestibular paresis. More studies are needed to confirm the best irrigation sequence

Avoiding misdiagnosis in ceruminous gland tumours.

Ceruminous gland tumours are infrequent lesions of the external auditory canal (EAC). Controversy still exists about nomenclature, classification, tissue of origin, and accurate diagnosis of these tumours. We present three cases of ceruminous gland tumours, including benign eccrine cylindroma, ceruminous adenoma, and adenoid cystic carcinoma. Superficial biopsy led to an initial erroneous diagnosis of adenocarcinoma in the latter. All cases were positive for cytokeratin and S-100 protein, supporting a ceruminous gland origin. The benign eccrine cylindroma should be included in the ceruminous gland tumour classification. A wide excisional biopsy should be performed in every EAC lesion. The terms 'ceruminoma' and 'cylindroma' should be avoided.