[Inverted nasosinusal papilloma. 11 cases and bibliographic revision]. / Papilomas invertidos nasosinusales. A propósito de 11 casos y revisión de la bibliografía.

INTRODUCTION: We present the cases registred from 1998 to 2003 and a revision of the bibliography. MATERIAL AND METHOD: In the section of Rhinology of a second level Hospital 11 patients affected by inverted papilloma type 1 of the OMS classification were diagnosed aged between 40 and 79, 9 men and 2 women. They were explored through endoscopy and biopsy and the exeresis of the lesion was done by endoscopic polipectomy with microdebrider (PEM). RESULTS: All the cases at stage I, II and III of the Krouse classification. Treated by CEN, 6 by mixed endonasal approach and through the canine fossa 4 by nasal approach only and 1 by Caldwell-Luc approach. The follow-up was done between 9 to 64 months and there was a recidive who was operated by open surgery and no one malignant transformation was seen. DISCUSSION: We coment the aspects related to etiology, the symptons and the surgical technics. CONCLUSIONS: We propose to stage the tumor and the realisation of a PEM with topic anesthesia with deep biopsies in all unilateral poly formations to avoid a retarded diagnosis and to be able to apply endoscopic technics.

[An immunohistochemistry study of p53 protein in squamous cell carcinoma of the larynx]. / Proteína P53 mediante inmunohistoquímica en el carcinoma epidermoide de laringe.

P53 protein detects damages in DNA, stopping the cellular cycle to repair it and stimulates "apoptosis" or programmed death cell when it cannot do it. We present an immunohistochemistry study of 58 squamous cell carcinomas of larynx operated between 1991 and 1996 and in which we detected the overexpression of P53 in 31 cases (53.44%). We did not find a statistic relationship between survival and the detection of P53 protein using Log Rank statistic analysis; the survival media for the wild-type protein cases was 64 months (very similar to native cases).

[Myringoplasty: our results]. / Miringoplastias: nuestros resultados.

Tympanoplasty is the surgical technique used to restore the anatomy and function of the middle ear. The tympanoplasty type I or myringoplasty is performed when the ear only has a perforation of the tympanic membrane without any ossicular damage. We present a retrospective study started in 1997 and finished in 2000 with a total of 118 cases who had undergone a myringoplasty along this period of time. The percentage of closure was 85.59% (n = 101). The techniques used were underlay in a 60.16% of the patients (n = 71), overlay in 34.74% (n = 41) and sandwich in 5.08% (n = 6). In the paediatric patients (under 14 years of age) the percentage of a successful graft following surgery was 88% and in the adults 83.87%. More than fifty years have passed. Since Zöllner and Wullstein described for the first time this type of surgery important because of its good results.

Papilomas invertidos nasosinusales. A propósito de 11 casos y revisión de la bibliografía / Inverted nasosinusal papilloma. 11 cases and bibliographic revision

Introducción. Presentamos los casos registrados durante los años 1998 al 2003, haciendo una revisión de la bibliografía. Material y Método. Se diagnosticaron, en la sección de Rinología de un Hospital de 2° nivel, 11 pacientes de Papiloma invertido tipo 1 de la clasificación de OMS, con edades comprendidas entre 40 y 79 años, 9 varones y 2 mujeres. Fueron explorados mediante endoscopia y biopsia, y/o exéresis de la lesión mediante polipectomía endoscópica con microdesbridador (PEM). Resultados. Todos los casos en estadio I, II y III de la clasificación de Krouse. Tratados mediante CEN: 6 con abordaje mixto endonasal y a través de fosa canina, 4 con abordaje sólo endonasal y 1 con abordaje CadlweIl-Luc. Con un seguimiento entre 9 y 64 meses, hubo una recidiva que fue intervenida por cirugía abierta, y ninguna transformación maligna. Discusión. Comentamos los aspectos relacionados con la etiología, los síntomas y las técnicas quirúrgicas. Conclusiones. Proponemos el estadiaje del tumor y la realización de una PEM con anestesia tópica con biopsias profundas en todas las formaciones poliposas unilaterales para evitar el diagnóstico tardío y poder aplicar técnicas endoscópicas

Introduction: We present the cases registred from 1998 to 2003 and a revision of the bibliography. Material and Method: In the section of Rhinology of a second level Hospital 11 patients affected by inverted papilloma type 1 of the OMS classification were diagnosed aged between 40 and 79, 9 men and 2 women. They were explored through endoscopy and biopsy and the exeresis of the lesion was done by endoscopic polipectomy with microdebrider (PEM). Results: All the cases at stage I, II and III of the Krouse classification. Treated by CEN, 6 by mixed endonasal approach and through the canine fossa 4 by nasal approach only and 1 by Caldwell-Luc approach. The follow-up was done between 9 to 64 months and there was a recidive who was operated by open surgery and no one malignant transformation was seen. Discussion: We coment the aspects related to etiology, the symptons and the surgical technics. Conclusions: We propose to stage the tumor and the realisation of a PEM with topic anesthesia with deep biopsies in all unilateral poly formations to avoid a retarded diagnosis and to be able to apply endoscopic technics

Proteína P53 mediante inmunohistoquímica en el carcinoma epidermoide de laringe / An inmunohistochemistry study of P53 protein in squamous cell carcinoma of the larynx

La proteína P53 actúa detectando el ADN celular dañado, deteniendo el ciclo celular para repararlo y estimulando la "apoptosis" o muerte celular programada cuando no lo consigue. Realizamos un estudio mediante inmunohistoquímica de 58 carcinomas epidermoides de laringe intervenidos de su patología entre 1991 y 1996 siendo la proteína mutada positiva en 31 casos (53,44 por ciento). No encontramos una relación estadísticamente significativa mediante el análisis estadístico de Log Rank entre la supervivencia y la positividad para la proteína P53, siendo la supervivencia media para los casos negativos para la proteína de 64 meses de media, muy similar a los casos que presentan la proteína mutada (AU)

P53 protein detects damages in DNA, stopping the cellular cycle to repair it and stimulates «apoptosis» or programmed death cell when it cannot do it. We present an immunohistochemistry study of 58 squamous cell carcinomas of larynx operated between 1991 and 1996 and in which we detected the over expression of P53 in 31 cases (53.44%). We did not find a statistic relationship between survival and the detection of P53 protein using Log Rank statistic analysis; the survival media for the wild-type protein cases was 64 months (very similar to native cases) (AU)

Miringoplastias: nuestros resultados / Myringoplasties: our results

Se denomina timpanoplastia a la técnica quirúrgica orientada a la reconstrucción anatómica y funcional del oído medio. La timpanoplastia tipo I o miringoplastia se realiza cuando la única lesión existente es una perforación timpánica y la cadena de huesecillos no está lesionada. Realizamos un estudio retrospectivo desde el año 1997 hasta el 2000 de un total de 118 casos intervenidos de miringoplastia en este período de tiempo. El porcentaje de cierres de la perforación fue de un 85,59 por ciento (n=101). Las técnicas utilizadas fueron infratimpánicas en un 60,16 por ciento de los casos (n=71), supratimpánicas en un 34,74 por ciento (n=41) y sandwich el 5,08 por ciento (n=6). En los pacientes de edad pediátrica intervenidos (menores de 14 años) el porcentaje de éxito tras la intervención fue del 88 por ciento y en adultos del 83,87 por ciento. Desde que Zöllner y Wullstein describieron por primera vez este tipo de cirugía han transcurrido casi 50 años, sin embargo, en la actualidad la técnica de miringoplastia sigue teniendo gran vigencia por su sencillez, utilidad y buenos resultados (AU)

Tympanoplasty is the surgical technique used to restore the anatomy and function of the middle ear. The tympanoplasty type I or myringoplasty is performed when the ear only has a perforation of the tympanic membrane without any ossicular damage. We present a retrospective study started in 1997 and finished in 2000 with a total of 118 cases who had undergone a myringoplasty along this period of time. The percentage of closure was 85.59% (n = 101). The techniques used were underlay in a 60.16% of the patients (n = 71), overlay in 34.74% (n = 41) and sandwich in 5.08% (n = 6). In the paediatric patients (under 14 years of age) the percentage of a successful graft following surgery was 88% and in the adults 83.87%. More than fifty years have passed. Since Zöllner and Wullstein described for the first time this type of surgery important because of its good results (AU)