Study of the influence of psychological factors in the etiology of vocal nodules in women.

OBJECTIVE: The role placed by certain psychological factors such as stress and personality on the development of vocal nodules has not yet been established. The aim of this case-control type study is to analyze the relationship between these psychological factors and the presence of vocal nodules while also considering the professional and social aspects of the subjects suffering from this pathology. METHODS: The case group is made up of 50 patients diagnosed with vocal nodules and with at least 6 months of evolution. The control group is made up of 50 patients diagnosed with nasal respiratory insufficiency. All the patients were examined by laryngeal stroboscopy. For the personality study, the perceived stress, and the voice use, the Minnesota Multiphasic Personality Inventory-2, Levenstein Perceived Stress Questionnaire, and Goldman Voice Use Survey were used, respectively. RESULTS: The subjects with vocal nodules presented a mean perceived stress score of 0.41±0.09, which was higher than that of the control group (0.35±0.06), the differences observed being statistically significant (P<0.001). In the personality study (MMPI-2), the only scale that was associated with the presence of the vocal nodules was that of psychomotor acceleration. The mean score obtained for the scale was 51.64±8.25 in the vocal nodule group and 45.02±0.06 in the control group (P<0.001). In the analysis of voice use, the subjects with vocal nodules scored 9.31±1.36, which was significantly higher than the score of the control group (8.07±1.24; P<0.001). In addition, other variables were associated with the presence of vocal nodules, such as being young and working in professions considered to be of vocal risk. CONCLUSIONS: Perceived stress and personality features of hyperactivity and impulsivity are independent factors related to vocal nodules.

Cirugía mayor ambulatoria. Estudio de 1.028 operaciones de otorrinolaringología / No disponible

Introducción: Los servicios de otorrinolaringología (ORL) se han implicado desde el inicio de la cirugía mayor ambulatoria(CMA) en esta modalidad asistencial que permite una mejor utilización de los recursos disponibles con total satisfacción de los pacientes. Material y método: Se revisa un total de 1.028 pacientes programados por patología otorrinolaringológica en la unidad de CMA de nuestro hospital. El 30,6% correspondieron a patología laríngea; el 30,1% a patología otológica, y 39,2% a patología nasal y de tejidos blandos. Se trata de un estudio observacional obtenido de las bases de datos clínicas de la unidad, manejadas mediante el programa informático Stat View 5.1.0.Resultados: De las 1.028 intervenciones previstas, 20 fueron suspendidas (1,9%). El 74,5% de los pacientes fueron intervenidos bajo anestesia general; un 1,39% sufrieron complicaciones (..) (AU)

Background: Otolaryngology or ENT departments become involved since the beginning of day surgery in this health care modality that allows a better use of available resources with overall patient satisfaction. Materials and method: A total of 1028 patients, registered for ENT pathology in the day surgery unit of our hospital, have been studied. A 30.6% corresponded to laryngeal pathology,30.1% to ear pathology, and 39.2% to nasal pathology and soft tissues. It is an observational study obtained from the databases clinical unit, managed by the programme Stat View 5.1.0.Results: From 1,028 planned interventions, 20 were cancelled,1.9%. A 74,5% patients were operated on under general anaesthesia. A 1.39% suffered intraoperative complications, a 3.9% postoperative complications and a 1.78% needed unexpected hospitalisation. There was no mortality. Conclusions: Day surgery in ENT pathology confirms the success of day surgery, because with this modality of surgery is possible to obtain a correct treatment of patients with maximum safety and good acceptance both of patients and professionals (AU)

Implantación coclear con bisturí armónico Ultracision® / Cochlear implants using the Ultracision® harmonic scalpel

Hemos valorado la utilidad, indicaciones e inconvenientes del bisturí armónico Ultracision®, en la implantación coclear, así como sus ventajas respecto de otros sistemas de electrocoagulación. Estos aspectos se analizaron en 50 implantes cocleares realizados a lo largo de estos últimos años. Como conclusión, hay que establecer que el bisturí armónico Ultracision ® encuentra sus indicaciones más importantes en el campo de la otología, en aquellos casos en los que el implante coclear está insertado en la cóclea y es necesario utilizar un sistema de electrocoagulación o incisión, con fines diversos. En la mencionada situación, el bisturí armónico Ultracision® se mostró rápido, eficaz y seguro y con evidentes ventajas respecto del corte frío o de la electrocoagulación bipolar

We have evaluated the utility, indications and disadvantages of the Ultracision® harmonic scalpel, in the cochlear implants, and his advantages compare to other electrocoagulation´s systems. These aspects were evaluated in 50 cases of cochlear implants, made along the last years. We concluded that the Ultracision® harmonic scalpel is indicated, mainly, in the otology field, in these situations in wich the cochlear implant is in the cochlea, and is mandatory the use of an electrocoagulation system. In this situation, the Ultracision® harmonic scalpel was quick, safe and sure, and with many advantages, over the traditional scalpel and the bipolar diathermy

[Goya, his deafness and his time]. / Goya, su sordera y su tiempo.

We have made a bibliographyc review of the most important otology books from the end of the XVIII to the begining of the XIX century. We propose several hipothesis of the diagnoses and treatment of Goya's deafness in relation to the contemporary otological advances.

Goya, su sordera y su tiempo / Goya, his deafness and his time

Hemos realizado una revisión bibliográfica de las sobras más representativas de la otología del final del siglo XVIII y principios del siglo XIX. Se plantean diferentes hipótesis sobre el diagnóstico y el tratamiento de la sordera de Francisco de Goya en base a los avances otológicos de su época

We have made a bibliographyc review of the most important otology books from the end of the XVIII to the begining of the XIX century. We propose several hypothesis of the diagnoses and treatment of Goya´s deafness inrelation to the contemporary otological advances

[Cochlear implants using the Ultracision harmonic scalpel]. / Implantación coclear con bisturí armónico Ultracision.

We have evaluated the utility, indications and disadvantages of the Ultracision harmonic scalpel, in the cochlear implants, and his advantages compare to other electrocoagulation's systems. These aspects were evaluated in 50 cases of cochlear implants, made along the last years. We concluded that the Ultracision harmonic scalpel is indicated, mainly, in the otology field, in these situations in wich the cochlear implant is in the cochlea, and is mandatory the use of an electrocoagulation system. In this situation, the Ultracision harmonic scalpel was quick, safe and sure, and with many advantages, over the traditional scalpel and the bipolar diathermy.

Pólipo antrocoanal gigante / Giant antrochoanal polyp

No disponible

[Selective therapeutic embolization in intractable epistaxis]. / Embolización selectiva terapéutica en epistaxis incoercibles.

Epistaxis is a common otolaryngologic emergency that is controlled frequently with conservative measures. On the other hand, more aggressive treatments are required in refractory or severe epistaxis, which may have systematical impact. About intractable posterior epistaxis, selective embolization of external carotid territory is an effective option for managing. Three patients with severe epistaxis successfully treated with selective embolization and a review of literature are exposed.

[Auditory training with wide-band white noise: effects on the verbal discrimination]. / Entrenamiento auditivo con ruido blanco de banda ancha: efectos sobre la discriminación verbal (II).

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the verbal reception threshold URV), the maximum discrimination (Dmax), and the discrimination coefficient (Kd) in a sample of 48 patients, who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvements of the verbal discrimination variables expressed in percentage are 4.23% for the URV, a 9.04% for the kd, a 17.87% for the Dmax, and 4.32%, 10.05%, 13.04% for the binaural URV, Kd and Dmax respectively. From our results, it can be deduced that the auditory training with wide-band white noise improves the verbal discrimination measures. Not only it allows to reach the verbal reception threshold at a lower intensity, but also it moves the discrimination line towards the left. Furthermore, it increases the maximum discrimination both in binaural measurements and in those which consider all the ears.

[Auditory training with wide-band white noise: effects on the recruitment (III)]. / Entrenamiento auditivo con ruido blanco de banda ancha: efectos sobre el reclutamiento (III).

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the recruitment coefficient in a sample of 48 patients who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvement of the recruitment coefficient expressed in percentage is a 7.7498%, which comes up to 23.5249% in the case of a binaural recruitment coefficient. From our results, it can be deduced that the auditory training with wide-band white noise reduces the recruitment. That is to say, the decrease of the recruitment in high intensities both binaurally and in all ears.

[Auditory training with wide-band white noise: effects on the pain threshold and pure tone thresholds]. / Entrenamiento auditivo con ruido blanco de banda ancha: efectos sobre la algiacusia y los umbrales tonales (IV).

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the total auditory threshold (UAt), the conversational auditory threshold (UAc), and the pain threshold (Ud) in a sample of 48 patients, who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvements of the variables expressed in percentage are 0.78% for the UAt, 0.64% for the UAc, and 5.31% for the Ud. From our results, it can be deduced that the auditory training with wide-band white noise does not modify the pure tone thresholds, but it moves the pain threshold towards higher intensities, enlarging the dynamic auditory field.

Embolización selectiva terapéutica en epistaxis incoercibles / Therapeutic selective embolization in intractable epistaxis

La epistaxis es una patología frecuente dentro de la urgencia otorrinolaringológica y en muchos casos aparece como un problema menor que se solventa con tratamiento conservador. En los casos recurrentes o severos puede ocasionar importantes complicaciones sistémicas, que nos hacen evaluar terapéuticas más agresivas buscando una resolución más efectiva. La embolización selectiva en el territorio de la arteria carótida externa es un método terapéutico aceptado en las epistaxis posteriores incoercibles y refractarias a los habituales tratamientos conservadores. Exponemos tres casos de epistaxis controladas mediante esta técnica, así como una completa revisión de la bibliografía actual sobre el tema (AU)

Epistaxis is a common otolaryngologic emergency that is controlled frequently with conservative measures. On the other hand, more aggressive treatments are required in refractory or severe epistaxis, which may have systematical impact. About intractable posterior epistaxis, selective embolization of external carotid territory is an effective option for managing. Three patients with severe epistaxis successfully treated with selective embolization and a review of literature are exposed (AU)

[Auditory training with wide-band white noise]. / Entrenamiento auditivo con ruido blanco de banda ancha.

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band modified noise which we will call "K-noise". The auditory trainer GAES 100 KT is a voice amplifier device with earphone outlets. It incorporates a wide-band noise generator which produces a noise that is a mixture of all the audibles frequencies. Therefore, it stimulates all the sensory cells in the organ of Corti, but from 1000 Hz it has a progressive fall towards the high pitch of 6 db per octave. This device consists of a series of controls which make possible to apply both the noise and the phonetic materials--texts and words lists that the therapist's voice presents--to either one of the ears or to both of them, in different intensities and for different periods of time. In this first article of our study of the auditory training with wide-band white noise we will review the different methods of hearing training and present not only the basic concepts on auditory training, but also the systematic we have followed to apply it.

Entrenamiento auditivo con ruido blanco de banda ancha: efectos sobre la algiacusia y los umbrales tonales (IV) / Auditory training with wide-band white noise: effects on the pain threshold and pure tone thresholds (IV)

El entrenamiento auditivo con ruido blanco de banda ancha es una metodología para la recuperación cualitativa de la pérdida auditiva en personas con hipoacusia neurosensorial basado en la aplicación de un ruido blanco de banda ancha modificado. Hemos valorado en un estudio prospectivo las modificaciones del umbral auditivo total (UAt), el umbral auditivo conversacional (UAc) y el umbral de dolor o algiacusia (Ud) en una muestra de 48 pacientes que han seguido un programa de 15 sesiones de entrenamiento auditivo con ruido blanco de banda ancha. Las mejorías medias de las variables expresadas en porcentaje son 0,78 por ciento para el UAt, 0.64 por ciento para el UAc, y 5,31 por ciento para el Ud. De nuestros resultados se concluye que el entrenamiento auditivo con ruido blanco de banda ancha no modifica significativamente los umbrales para los tonos puros, pero desplaza los umbrales de algiacusia hacia intensidades mayores ampliando el campo dinámico auditivo (AU)

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the total auditory threshold (UAt), the conversational auditory threshold (UAc), and the pain threshold (Ud) in a sample of 48 patients, who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvements of the variables expressed in percentage are 0.78% for the UAt, 0.64% for the UAc, and 5.31% for the Ud. From our results, it can be deduced that the auditory training with wide-band white noise does not modify the pure tone thresholds, but it moves the pain threshold towards higher intensities, enlarging the dynamic auditory field (AU)

Entrenamiento auditivo con ruido blanco de banda ancha: efectos sobre el reclutamiento (III) / Auditory training with wide-band white noise: effects on the recruitment (III)

El entrenamiento auditivo con ruido blanco de banda ancha es una metodología para la recuperación cualitativa de la pérdida auditiva en personas con hipoacusia neurosensorial basado en la aplicación de un ruido blanco de banda ancha modificado. Hemos valorado en un estudio prospectivo las modificaciones del coeficiente de reclutamiento (Kr) en una muestra de 48 pacientes que han seguido un programa de 15 sesiones de entrenamiento auditivo con ruido blanco de banda ancha. Las mejoría media del coeficiente de reclutamiento expresada en porcentaje es del 7.7948 por ciento y para el coeficiente de reclutamiento binaural del 23.5294 por ciento. De nuestros resultados se concluye que el entrenamiento auditivo con ruido blanco de banda ancha disminuye el reclutamiento, considerando como tal la caída de la discriminación en intensidades elevadas, tanto binauralmente como considerando todos los oídos (AU)

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the recruitment coefficient in a sample of 48 patients who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvement of the recruitment coefficient expressed in percentage is a 7.7498%, which comes up to 23.5249% in the case of a binaural recruitment coefficient. From our results, it can be deduced that the auditory training with wide-band white noise reduces the recruitment. That is to say, the decrease of the recruitment in high intensities both binaurally and in all ears (AU)

Entrenamiento auditivo con ruido blanco de banda ancha: efectos sobre la discriminación verbal (II) / Auditory training with wide-band white noise: effects on the verbal discrimination

El entrenamiento auditivo con ruido blanco de banda ancha es una metodología para la recuperación cualitativa de la pérdida auditiva en personas con hipoacusia neurosensorial, basado en la aplicación de un ruido blanco de banda ancha modificado. Hemos valorado en un estudio prospectivo las modificaciones del umbral de recepción verbal (URV), la discriminación máxima (Dmax), y el coeficiente de discriminación (Kd) en una muestra de 48 pacientes que han seguido un programa de 15 sesiones de entrenamiento auditivo con ruido blanco de banda ancha. Las mejorías medias de las variables de discriminación verbal expresadas en porcentaje son 4,23 por ciento para el URV, 9,04 por ciento para el Kd, 17,87 por ciento para la Dmax, y 4,32 por ciento, 10,05 por ciento, 13,04 por ciento para URV, Kd, y Dmax binaurales respectivamente. De nuestros resultados se concluye que el entrenamiento auditivo con ruido blanco de banda ancha mejora las medidas de discriminación verbal: permite que se alcance el umbral de recepción verbal a menor intensidad, desplaza hacia la izquierda la curva de discriminación, y aumenta la discriminación máxima, tanto en las mediciones binaurales como en las que consideran todos los oídos (AU)

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the verbal reception threshold URV), the maximum discrimination (Dmax), and the discrimination coefficient (Kd) in a sample of 48 patients, who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvements of the verbal discrimination variables expressed in percentage are 4.23% for the URV, a 9.04% for the kd, a 17.87% for the Dmax, and 4.32%, 10.05%, 13.04% for the binaural URV, Kd and Dmax respectively. From our results, it can be deduced that the auditory training with wide-band white noise improves the verbal discrimination measures. Not only it allows to reach the verbal reception threshold at a lower intensity, but also it moves the discrimination line towards the left. Furthermore, it increases the maximum discrimination both in binaural measurements and in those which consider all the ears (AU)

Entrenamiento auditivo con ruido blanco de banda ancha / Auditory training with wide-band white noise

El entrenamiento auditivo con ruido blanco de banda ancha es una metodología para la recuperación cualitativa de la pérdida auditiva en personas con hipoacusia neurosensorial basado en la aplicación de un ruido de banda ancha modificado que denominaremos ruido K. El entrenador auditivo GAES 100 KT es un equipo de amplificación de la voz con salida por auriculares, que incorpora un generador de ruido de banda ancha que produce un ruido que es la mezcla de todas las frecuencias audibles y que, por tanto, estimula todas las células sensoriales del órgano de Corti, pero que a partir de 1000 Hz tiene una caída progresiva hacia los agudos de 6 dB por octava. El aparato consta de una serie de controles que permiten aplicar tanto el ruido K como el material fonético (textos y listas de palabras que pre- senta la voz del rehabilitador), a uno u otro oído o a ambos, a diferentes intensidades durante más o menos tiempo. En este primer artículo de nuestro estudio del entrenamiento auditivo con ruido blanco de banda ancha, revisamos los diversos métodos de entrenamiento de la audición, presentamos los conceptos básicos sobre entrenamiento auditivo, así como la sistemática que hemos seguido para aplicarlo (AU)

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band modified noise which we will call "K-noise". The auditory trainer GAES 100 KT is a voice amplifier device with earphone outlets. It incorporates a wide-band noise generator which produces a noise that is a mixture of all the audibles frequencies. Therefore, it stimulates all the sensory cells in the organ of Corti, but from 1000 Hz it has a progressive fall towards the high pitch of 6 db per octave. This device consists of a series of controls which make possible to apply both the noise and the phonetic materials--texts and words lists that the therapist's voice presents--to either one of the ears or to both of them, in different intensities and for different periods of time. In this first article of our study of the auditory training with wide-band white noise we will review the different methods of hearing training and present not only the basic concepts on auditory training, but also the systematic we have followed to apply it (AU)

[Immunohistochemical markers of cell proliferation in laryngeal carcinoma]. / Marcadores inmunohistoquímicos de proliferación celular en el carcinoma de laringe.

Although several clinicopathological factors may contribute to the prognosis of laryngeal carcinoma, these factors are still uncertain because the carcinogenesis process and malignant behavior are not well known. Immunohistochemical methods using two important markers, PCNA and Ki67 antigen, were used to assess proliferative activity in malignant laryngeal lesions. We studied the correlation between expression of these markers and clinical factors in 72 patients with carcinoma of the larynx: age, sex, occupation, smoking, alcohol consumption, marital status, etc. We also analyzed other known biological and histopathological prognostic factors (tumor stage, histological grade, lymph node metastases, and local invasion). PCNA and Ki-67 expression differed significantly in relation to histological grade and lymph node involvement. No associations were seen between the expression of PCNA and Ki-67 antigens and other study parameters.

[Study of bcl-2 oncogene in squamous-cell carcinoma of the larynx]. / Estudio del oncogén Bcl-2 en el carcinoma escamoso de laringe.

Apoptosis is a special type of programmed cell death that occurs in the embryonic period, in normal adult tissues, and in several pathological situations. The Bcl-2 gene (B-cell leukemia/lymphoma) is the first member of an oncogene family whose main function is to increase cell survival and inhibit apoptosis, thus participating in the carcinogenic process. This relationship motivated our study of antiapoptosis through the immunohistochemical expression of Bcl-2 oncogene in 72 patients with cancer of the larynx who underwent surgery in our department. The correlation between immunohistochemical expression and clinical factors was analyzed: age, sex, work, smoking and drinking history, marital status, etc., as well as other known biological and histopathological prognostic factors (tumoral stage, histological grade, neck metastases, and local invasion). Bcl-2 expression showed a statistically significant correlation with histological grade and regional lymph node involvement, but no correlation with the other parameters studied.