[Papilar thyroid carcinoma. An unusual clinic]. / Carcinoma papilar de tiroides de localizacion inusual.

The Papillary carcinoma is the most frequent neoplasic tumour of the thyroid gland. It accounts for 70-75% of all malignant thyroid tumours. In 80-90% of cases it presents as a slow-growing single thyroid node. Nevertheless, in 10-26% of cases, the initial presentation is a lateral neck mass without palpable thyroid mass. We present the case of a 67 year- old patient who attended to the ENT out-patient clinic with a lateral neck mass which had been growing slowly over the course of number of years.

[Unifocal eosinophilic granuloma of the temporal bone]. / Granuloma eosinófilo unifocal de hueso temporal.

We present a case of a twelve year old child with a eosinophilic granuloma of the temporal bone. The eosinophilic granuloma is the most frecuent and most benign form of the histiocytosis of the Langerhans cells. The frecuency of the othological manifestations of this condition varies between 15-60 percent and radiologically, the images are characterized by litho-lesions with sharp edges. The diagnosis is histological and the treatment includes surgical intervention accompanied by inter-lesion corticoid-therapy and/or radiotherapy.

Carcinoma papilar de tiroides de localización inusual / Papilar thyroid carcinoma. An unusual clinic

El carcinoma papilar es el tumor más frecuente de la glándula tiroides, con una frecuencia del 70-75% de todos los cánceres tiroideos. En el 80-90% de los casos se manifesta como un nódulo tiroideo único de crecimiento lento. Sin embargo, en el 10-26%; la forma de presentación es de una tumoración laterocervical aislada en ausencia de una masa tiroidea palpable. Presentamos el caso de un paciente de 67 años de edad que acudió a consulta por tumoración laterocervical de varios años de evolución

The Papillary carcinoma is the most frequent neoplasic tumour of the thyroid gland. It accounts for 70-75% of all malignant thyroid tumours. In 80-90% of cases it presents as a slow-growing single thyroid node. Nevertheless, in 10-26% of cases, the initial presentation is a lateral neck mass without palpable thyroid mass. We present the case of a 67 year- old patient who attended to the ENT out-patient clinic with a lateral neck mass which had been growing slowly over the course of number of years

Granuloma eosinófilo unifocal de hueso temporal / Unifocal eosinophilic granuloma of the temporal bone

Presentamos el caso de un niño de 12 años de edad con un granuloma eosinófilo del hueso temporal. El granuloma eosinófilo es la forma más benigna y frecuente de la histiocitosis de células Langerhans. La frecuencia de manifestaciones otológicas varía entre un 15-60% y radiológicamente las imágenes se caracterizan por lesiones líticas de bordes cortantes. El diagnóstico es necesariamente histológico y el tratamiento incluye resección quirúrgica acompañado de corticoterapia intralesional y/o radioterapia

We present a case of a twelve year old child with a eosinophilic granuloma of the temporal bone. The eosinophilic granuloma is the most frecuent and most benign form of the histiocytosis of the Langerhans cells. The frecuency of the othological manifestations of this condition varies between 15-60 percent and radiologically, the images are characterized by litho-lesions with sharp edges. The diagnosis is histological and the treatment includes surgical intervention accompanied by inter-lesion corticoid-therapy and/or radiotherapy

[Child nasopharyngeal angiofibroma]. / Angiofibroma nasofaringeo infantil.

Angiofibromas are benign tumors, highly vascularized, that affect male adolescents and young men. We present a clinical case of an 11-year-old patient with an angiofibroma of the nasopharynx, reviewing the etiopathogenic theories and current surgical approaches.

[Esophageal foreign bodies. Our ten years of experience]. / Cuerpos extraños esofágicos: nuestra experiencia en diez años.

OBJECTIVE: To study the management of esophageal foreign bodies. MATERIAL AND METHODS: A retrospective study was made of all rigid esophagoscopies performed for suspected foreign bodies in the esophagus by an otolaryngology department for ten years. RESULTS: Rigid esophagoscopy was performed for suspected foreign bodies in 46 patients (27 females, 19 males); age range 22 months to 88 years. In 40 cases an impacted foreign body was found. The most frequent location was the upper third of the esophagus (33/82.5%). The most common type of foreign body was chicken bones in adults (17/42) and coins in children (2/4). Nine patients (all adults) had complications. CONCLUSIONS: Due to its low cost and morbility, flexible endoscopy is the first choice for managing esophageal foreign bodies. Rigid esophagoscopy is still an appropriate technique when flexible endoscopy fails or it is not possible.

Cuerpos extraños esofágicos: nuestra experiencia en diez años / Esophageal foreing bodies. Our ten years experience

Objetivo: Estudiar el manejo actual de los cuerpos extraños enclavados en el esófago. Material y métodos: Se realizó un estudio de todas las esofagoscopias rígidas realizadas ante la sospecha de cuerpo extraño esofágico en un Servicio de Otorrinolaringología durante diez años. Resultados: A 46 pacientes (27 mujeres y 19 varones), con edades comprendidas entre 88 años y 22 meses, se les realizó una esofagoscopia rígida por sospecha de cuerpo extraño esofágico. En 40 casos se objetivó un cuerpo extraño enclavado. La localización más frecuente del mismo fue el tercio superior (33/82,5 por ciento), siendo los huesos de ave el tipo de cuerpo extraño más frecuentemente encontrado en adultos (17/42) y las monedas en niños (2/4). Nueve pacientes (todos ellos adultos) presentaron complicaciones. Conclusiones: Por su bajo coste y morbilidad, la endoscopia flexible es la técnica de elección en el manejo de los cuerpos extraños esofágicos. La esofagoscopia rígida sigue siendo una técnica de gran utilidad cuando la técnica anterior fracasa, o no es posible de realizar (AU)

OBJECTIVE: To study the management of esophageal foreign bodies. MATERIAL AND METHODS: A retrospective study was made of all rigid esophagoscopies performed for suspected foreign bodies in the esophagus by an otolaryngology department for ten years. RESULTS: Rigid esophagoscopy was performed for suspected foreign bodies in 46 patients (27 females, 19 males); age range 22 months to 88 years. In 40 cases an impacted foreign body was found. The most frequent location was the upper third of the esophagus (33/82.5%). The most common type of foreign body was chicken bones in adults (17/42) and coins in children (2/4). Nine patients (all adults) had complications. CONCLUSIONS: Due to its low cost and morbility, flexible endoscopy is the first choice for managing esophageal foreign bodies. Rigid esophagoscopy is still an appropriate technique when flexible endoscopy fails or it is not possible (AU)

Laryngeal tuberculosis.

Laryngeal tuberculosis is the most frequent granulomatous disease of the larynx. The disease has changed its behaviour with regard to average age of onset site and type of lesion. Laryngeal tuberculosis is usually secondary to, or at least contemporary with, pulmonary tuberculosis. Other recents studies, however, conclude by accepting a frequency of up to 20% for primary laryngeal tuberculosis. The age of presentation is between 41-50 years. Among the risk factors identified are the consumption of tobacco, alcohol, malnutrition and immunodeficiency. The predominant symptom was dysphonia (90%) either in isolation or accompanied by odynophagia (45%). Today, the ulcero-infiltrative lesions which predominantly affected the posterior larynx are not observed. At the present time the macroscopic appearance corresponds to a diffuse oedema or to a pseudo-tumoral image located in any zone. Any non-specific chronic laryngitis of poor evolution should lead us to suspect a laryngeal tuberculosis.

[Usefulness of brain stem auditory evoked potentials]. / Utilidad de potenciales evocados auditivos del tronco cerebral.

The neonates, children under 4 years and patients with central nervous system pathology are a population that need a screening test to estimate the hearing threshold. ABR-test (auditory brainstem response) is a viable and effective tool for identification a hearing impairment.

[Adaptable radial flap for oropharynx reconstructive microsurgery after oncologic resection]. / Versatilidad del colgajo radial en la reconstrucción microquirúrgica de orofaringe-hipofaringe tras resección oncológica.

The free radial forearm flap has become the most common used flap in recreative head and neck. The tolerable complications rate and also the achievements rate offers one of the best choices in pharynx repair.

[Multiple primaries of the upper aerodigestive tract, esophagus, and lung]. / Múltiples primarios en vías aerodigestivas superiores, esófago y pulmón.

The existence of multiple primary tumors of the upper aerodigestive tract, esophagus, and lung (UADT-E-L) is related with a common etiopathogenic factor (alcohol-tobacco association). In a review of 43 patients, 6.75% with a UADT-E-L tumor developed another neoplasm, 3.25% at the same site. Nine percent (8.59%) of the tumors were synchronic and 10.85% were metachronic. The most frequent association was larynx-lung. Another neoplasm was detected by physical examination and/or radiology in 44.18% of cases, with a time lapse of less than 3 years in 50%. The most frequent treatment was surgery with/without complementary radiotherapy. The most common stage was T1-T2 (62.06%) and N0-N1 (68.96%). The survival rate was 31% at 2 years and 25% at 3 years.

Múltiples primarios en vías aerodigestivas superiores, esófago y pulmón / Multiple primaries of the upper aerodigestive tract, esophagus, and lung

La existencia de múltiples primarios en vías aerodigestivas superiores, esófago y pulmón (VADS-E-P) se relaciona con un factor etiopatogénico, común (asociación alcohol-tabaco). Revisamos 43 pacientes, el 6,75 por ciento con un tumor de VADS-E-P desarrollan otra neoplasia, en un 3,23 por ciento en estas mismas localizaciones. El 8,59 por ciento de los tumores fueron sincrónicos y el 10,85 por ciento metacrónicos. La asociación más frecuente fue laringe-pulmón. La detección de otra neoplasia fue un hallazgo exploratorio y/o radiológico en un 44,18 por ciento de los casos, siendo el intervalo de tiempo entre las mismas menor de 3 años en un 50 por ciento. El tratamiento más utilizado fue cirugía con/sin radioterapia complementaria. El estadio más frecuente fue TI - T2 (62,06 por ciento) y NO-NI (68,96 por ciento). La supervivencia fue del 31 por ciento a 2 años y del 25 por ciento a 3 años (AU)

The existence of multiple primary tumors of the upper aerodigestive tract, esophagus, and lung (UADT-E-L) is related with a common etiopathogenic factor (alcohol-tobacco association). In a review of 43 patients, 6.75% with a UADT-E-L tumor developed another neoplasm, 3.25% at the same site. Nine percent (8.59%) of the tumors were synchronic and 10.85% were metachronic. The most frequent association was larynx-lung. Another neoplasm was detected by physical examination and/or radiology in 44.18% of cases, with a time lapse of less than 3 years in 50%. The most frequent treatment was surgery with/without complementary radiotherapy. The most common stage was T1-T2 (62.06%) and N0-N1 (68.96%). The survival rate was 31% at 2 years and 25% at 3 years (AU)

[Vertigo in the elderly: otorhinolaryngologic approach]. / Vértigo en la tercera edad: enfoque otorrinolaringológico.

Dizziness is a common but little understood ailment of old people. Its presence is the origin of an important incapacity associated with lack of personal autonomy. Clinical and electronystagmographic findings of aging individuals enduring imbalance and coming to our Department allowed us to accept that those cases in which the cause could be identified it was on clinic data, being of scarce utility the other exams done.

[Auditory brain stem response and child attention deficit hyperactivity disorder]. / PTC y déficit de atención e hiperactividad infantil.

Diagnostic audiological test performed in two children showed remarkable differences between the results of behavioral audiometry and those of auditory evoked response audiometry. The results of neuropsychological evaluation showed attention disorders. It is possible that a response desynchronisation in the auditory pathway may exist in these disorders. Interpretation of ABR findings can be problematic in children with learning disabilities or minimal cerebral dysfunction.