Tumor de células gigantes tenosinovial condroide de articulación temporomandibular. Presentación de un caso / Chondroid tenosynovial giant cell tumour of the temporomandibular joint: A case report

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Acalasia cricofaríngea primaria / Primary cricopharyngeal acalasia

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Metástasis de adenocarcinoma de colédoco en laringe / Laryngeal metastasis from bile duct adenocarcinoma

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Gel nasal y hendidura olfatoria / Nasal gel and olfactory cleft

Objetivo: Identificar si un gel administrado mediante un inhalador de cabeza radial puede alcanzar la hendidura olfatoria y si su distribución intranasal se modifica según el método de aplicación. Material y método: Se estudiaron 16 voluntarios a los que se administró un gel teñido de modo diferente en cada fosa, realizándose una endoscopia tras 1 y 7 min. Resultados: No se identificó gel a nivel de la hendidura olfatoria, cornete medio o meato medio independientemente del método de administración utilizado. En el vestíbulo se identificó colorante en todos los casos. En el lado derecho la segunda localización más frecuente fue el cornete inferior con una incidencia del 87% al minuto y del 75% a los 7 min. Le siguieron el tabique, 75 y 62%, y el meato inferior, 6,2 y 12,5%. En el lado izquierdo la segunda localización más frecuente fue el tabique, 18,7 y 13,5%, seguida del meato inferior, 6,5 y 65%. Las diferencias en la presencia de colorante a nivel del septo (p < 0,01) y el cornete inferior fueron significativas. Conclusiones: No se ha identificado la presencia de gel a nivel de la hendidura olfatoria, cornete medio o meato medio. La distribución se localiza a nivel de la parte anterior e inferior de la fosa nasal, con diferencias significativas si se emplean métodos de administración diferentes (AU)

Objective: To evaluate whether a nasal gel, administrated using a radial-hole inhaler, reaches the olfactory cleft and if a different administration method influences distribution. Material and method: Sixteen healthy volunteers underwent a nasal endoscopy at 1 and 7 minutes after the administration of a intranasal gel, with a different method in each fossa. Results: No dye deposition was identified at the olfactory cleft, middle turbinate or middle meatus. In all cases the gel was identified at the nasal vestibule. On the right side, the second most frequent dye identification area was the inferior turbinate, with a rate of 87% at the first minute and 75% at 7 minutes. It was followed by the septum (75 and 62%) and the inferior meatus (6.2 and 12.5%). On the left side, the second most frequent stained area was the septum (18.7 and 13.5%), followed by the inferior meatus (6.5 and 65%). No inferior turbinate staining was found in the left side. There was a significant difference in the deposition rate at the septum (P<0.01) and inferior turbinate (P<0.001), when both administration methods were compared. Conclusions: No nasal gel, administrated using a radial-hole inhaler, was found at the olfactory cleft, middle turbinate or middle meatus. Gel distribution was located at the anterior and inferior portion of the nose, independent of the administration method used. Significantly different gel distribution rates were found at the septum and inferior turbinate when the 2 administration methods were compared (AU)

Nasal gel and olfactory cleft.

OBJECTIVE: To evaluate whether a nasal gel, administrated using a radial-hole inhaler, reaches the olfactory cleft and if a different administration method influences distribution. MATERIAL AND METHOD: Sixteen healthy volunteers underwent a nasal endoscopy at 1 and 7minutes after the administration of a intranasal gel, with a different method in each fossa. RESULTS: No dye deposition was identified at the olfactory cleft, middle turbinate or middle meatus. In all cases the gel was identified at the nasal vestibule. On the right side, the second most frequent dye identification area was the inferior turbinate, with a rate of 87% at the first minute and 75% at 7 minutes. It was followed by the septum (75 and 62%) and the inferior meatus (6.2 and 12.5%). On the left side, the second most frequent stained area was the septum (18.7 and 13.5%), followed by the inferior meatus (6.5 and 65%). No inferior turbinate staining was found in the left side. There was a significant difference in the deposition rate at the septum (P<.01) and inferior turbinate (P<.001), when both administration methods were compared. CONCLUSIONS: No nasal gel, administrated using a radial-hole inhaler, was found at the olfactory cleft, middle turbinate or middle meatus. Gel distribution was located at the anterior and inferior portion of the nose, independent of the administration method used. Significantly different gel distribution rates were found at the septum and inferior turbinate when the 2 administration methods were compared.

Resultados funcionales y estéticos tras rinoplastia de aumento / Functional and aesthetic results after augmentation rhinoplasty

Introducción y objetivos: La septorrinoplastia de aumento (SRA) podría definirse como aquella técnica cuya finalidad es conseguir un aumento de las dimensiones de la pirámide nasal, tanto del dorso como de la punta. A lo largo de los años, para conseguir este aumento se han utilizado múltiples materiales que han sido objeto de controversia. El objetivo del presente estudio es mostrar nuestra experiencia con la septorrinoplastia de aumento, resaltando el tipo y la naturaleza de los injertos utilizados y las complicaciones acaecidas. Material y método: Se ha realizado un estudio retrospectivo descriptivo mediante la revisión de historiales clínicos de 188 pacientes intervenidos de septorrinoplastia en nuestro servicio en un período de 12 años comprendido entre enero de 1998 y abril de 2009.Resultados: En 42 pacientes se realizó una septorrinoplastia de aumento, la cual constituye el objeto de nuestro estudio. En un 66% de casos (28/42) se utilizó un injerto onlay de cartílago cuadrangular, en 22 pacientes (85,7%) una lámina única de cartílago y en 6 pacientes (21%) un injerto doble de cartílago cuadrangular. En 14 pacientes fue necesario recurrir a los injertos de material sintético: en todos los casos se empleó el Gore-Tex®, en 12 (28,5%) pacientes como único material del injerto y en 2 (4,7%) pacientes conjuntamente con cartílago septal. Conclusiones: La reconstrucción del dorso nasal exige el conocimiento de diferentes técnicas y recursos quirúrgicos, así como la utilización de diferentes tipos de injertos en función de las necesidades de cada paciente. El injerto ideal, que existe sólo como concepto, sería aquel que aúna biocompatibilidad, baja tasa de complicaciones y resultados estables a largo plazo. En la actualidad, el cartílago autólogo, y más concretamente el cartílago septal, permanece como primera opción en la SRA. En caso de no disponer de cartílago septal, recurrimos siempre a los injertos de cartílago de concha, de uno o de ambos lados según la necesidad de material (AU)

Introduction: Augmentation rhinoplasty could be defined as the method whose goal is to increase the dimensions of the nasal pyramid, both the dorsum and the tip. For a long time, surgeons have used different kinds of materials that have often been the object of discussion. The aim of this study is to report our experience with augmentation septorhinoplasty, emphasizing the type and nature of the grafts employed and the ensuing complications. Material and method: This is a retrospective study describing the medical history of 188patients who underwent septorhinoplasty surgery in our Department over a period of 12 years, from January 1998 to April 2009. Of these patients, 42 underwent augmentation septorhinoplasty, which is the object of our study. Results: In 66% of the cases (28/42), quadrangular autologous cartilage was the ‘‘onlay’’ graft most widely employed; we used a single graft in 22 (85.7%) cases and a double one in the other6 (21%). In 14 patients, it was necessary to use grafts of synthetic material: in all the cases Gore-Tex® was chosen, in 12 (28.5%) patients as the only graft material and in 2 (4.7%) used together with septal cartilage. Conclusions: Nasal dorsum reconstruction requires the knowledge of different methods and surgical procedures, as well as the use of different types of grafts according to the needs of each patient. The ideal graft, which exists only as a concept, would be the one combining biocompatibility, a low complication rate and results that remained stable for a long time. At present, autologous cartilage, and more precisely septal cartilage, is still the first option for augmentation rhinoplasty. If septal cartilage is not available, we always turn to conchalcartilage grafts, from one or both sides depending on the amount of cartilage required (AU)

[Functional and aesthetic results after augmentation rhinoplasty]. / Resultados funcionales y estéticos tras rinoplastia de aumento.

INTRODUCTION: Augmentation rhinoplasty could be defined as the method whose goal is to increase the dimensions of the nasal pyramid, both the dorsum and the tip. For a long time, surgeons have used different kinds of materials that have often been the object of discussion. The aim of this study is to report our experience with augmentation septorhinoplasty, emphasising the type and nature of the grafts employed and the ensuing complications. MATERIAL AND METHOD: This is a retrospective study describing the medical history of 188 patients who underwent septorhinoplasty surgery in our Department over a period of 12 years, from January 1998 to April 2009. Of these patients, 42 underwent augmentation septorhinoplasty, which is the object of our study. RESULTS: In 66% of the cases (28/42), quadrangular autologous cartilage was the "onlay" graft most widely employed; we used a single graft in 22 (85.7%) cases and a double one in the other 6 (21%). In 14 patients, it was necessary to use grafts of synthetic material: in all the cases Gore-Tex was chosen, in 12 (28.5%) patients as the only graft material and in 2 (4.7%) used together with septal cartilage. CONCLUSIONS: Nasal dorsum reconstruction requires the knowledge of different methods and surgical procedures, as well as the use of different types of grafts according to the needs of each patient. The ideal graft, which exists only as a concept, would be the one combining biocompatibility, a low complication rate and results that remained stable for a long time. At present, autologous cartilage, and more precisely septal cartilage, is still the first option for augmentation rhinoplasty. If septal cartilage is not available, we always turn to conchal cartilage grafts, from one or both sides depending on the amount of cartilage required.