Schwannoma of tongue.

The schwannomas are nervous tissue tumors. We report a case of schwannoma of oral tongue. Because schwannomas are quite rare in the oral cavity, they are often not immediately included in the differential diagnosis of oropharyngeal masses, causing delay in identification and treatment. The definitive diagnosis requires histopathologic examination.

[Positional vertigo. Symptom, clinical sign, or disease?]. / Vértigo posicional. Síntoma, signo o enfermedad?

INTRODUCTION: We present a prospective study with the aim of assessing the differences found between position-triggered vertiginous syndromes, those diagnosed as benign paroxysmal positional vertigos (BPPV) in primary care and non-specific clinics, and those classified as BPPV at an otoneurology unit. PATIENTS AND METHOD: Over a 17 month period, 432 consecutive patients were included after evaluation at a otoneurology unit receiving all referrals for vestibular pathologies. The existence of trigger factors was investigated, as was the distribution of the diagnoses associated with a positional trigger. The characteristics of the patients with a final diagnosis of BPPV were also studied. RESULTS: Of this population, 217 patients (50.23%) reported a positional change as the trigger for their symptoms, 106 (24.53%) were referred from their initial care centres with a diagnosis of BPPV, and 128 (29.62%) were classified as truly BPPV. The coincidence between the preliminary diagnosis and the definitive one was 52.8%. A history of positional paroxysmal vertigo during seconds was linked to BPPV in 78% of cases. Only in 4.7% of the BPPV cases diagnosed at the otoneurology unit had provoking manoeuvres been performed. CONCLUSIONS: We have found that an adequate anamnesis is capable of providing accurate guidance for diagnostic purposes in most cases of BPPV, but the performance of provoking manoeuvres and the correct specific treatment for this pathology is of paramount importance when classifying a patient with suspected BPPV.

Vértigo posicional. ¿Síntoma, signo o enfermedad? / Positional vertigo. Symptom, clinical sign, or disease?

Introducción: Presentamos un estudio prospectivo para valorar las diferencias encontradas entre los síndromes vertiginosos de desencadenante posicional, los cuadros diagnosticados como vértigo posicional paroxístico benigno (VPPB) por médicos de atención primaria y consultas no específicas, y los diagnosticados de VPPB en una unidad de otoneurología. Pacientes y método: Se estudió a 432 pacientes atendidos de forma consecutiva durante 17 meses en una unidad de otoneurología que recibe a todos los pacientes derivados al servicio de otorrinolaringología por afección vestibular. Se investigó si había factores desencadenantes y se valoró la distribución de los diagnósticos relacionados con un desencadenante posicional. También se estudió las características de los pacientes con diagnóstico final de VPPB. Resultados: Referían síntomas desencadenados por los cambios de posición 217 (50,23 %) pacientes; 106 (24,53 %) fueron remitidos con diagnóstico de VPPB establecido en sus centros de referencia, y 128 (29,62 %) resultaron ser VPPB realmente. La coincidencia entre el diagnóstico de derivación y el definitivo fue del 52,8 %. La historia clínica de vértigo posicional paroxístico de segundos de duración coincidió con el diagnóstico de VPPB en el 78 % de los casos. Solamente en el 4,7 % de los VPPB diagnosticados en la unidad de otoneurología se habían realizado maniobras de provocación antes de la derivación. Conclusiones: El adecuado interrogatorio del paciente puede aportar una orientación diagnóstica precisa en la mayor parte de los casos de VPPB, aunque la realización de maniobras de provocación y tratamientos adecuados y específicos para esta afección es de vital importancia para la correcta clasificación de los pacientes con sospecha de este cuadro

Introduction: We present a prospective study with the aim of assessing the differences found between position-triggered vertiginous syndromes, those diagnosed as benign paroxysmal positional vertigos (BPPV) in primary care and non-specific clinics, and those classified as BPPV at an otoneurology unit. Patients and method: Over a 17 month period, 432 consecutive patients were included after evaluation at a otoneurology unit receiving all referrals for vestibular pathologies. The existence of trigger factors was investigated, as was the distribution of the diagnoses associated with a positional trigger. The characteristics of the patients with a final diagnosis of BPPV were also studied. Results: Of this population, 217 patients (50.23 %) reported a positional change as the trigger for their symptoms, 106 (24.53 %) were referred from their initial care centres with a diagnosis of BPPV, and 128 (29.62 %) were classified as truly BPPV. The coincidence between the preliminary diagnosis and the definitive one was 52.8 %. A history of positional paroxysmal vertigo during seconds was linked to BPPV in 78 % of cases. Only in 4.7 % of the BPPV cases diagnosed at the otoneurology unit had provoking manoeuvres been performed. Conclusions: We have found that an adequate anamnesis is capable of providing accurate guidance for diagnostic purposes in most cases of BPPV, but the performance of provoking manoeuvres and the correct specific treatment for this pathology is of paramount importance when classifying a patient with suspected BPPV