[The physiopathology of vertigo]. / Physiopathologie des vertiges.

Vertigo is the predominant symptom in labyrinthine dysfunction, and is characterized by an unpleasant modification of the sense of static or dynamic orientation. In order to arrive at a correct clinical interpretation of this symptom and to administer the appropriate treatment, both its etiology and the underlying physiopathological mechanisms need be specified. In the present paper, we shall review a few qualitative concepts, which seem interesting to us and namely concern, on the one hand, the physiopathological mechanisms of vertigo and, on the other hand, the basic principles of the function of peripheral receptors bearing some etiological significance.

[Temporal bone fracture: review of 40 cases (44 traumatic injuries)]. / Fracturas del hueso temporal. Revisión de 40 casos (44 traumatismos).

Temporal bone fractures are common injuries in patients suffering cranio-encephalic traumatisms. They call for a precociuos diagnosis, including a careful oto-neurologic examination as well a computerized tomography (CT), in order to asses sequelae and complications arrised from traumata. Here are reported a review of 40 patients with 44 temporal fractures attended in our Hospital, from January 1993 until March 1996. The injured were clinically evaluated in the ENT-Department by computer radiography and the classic audiovestibular battery tests. Particularly emphasized were luxations of the ossicular chain, lesion of the labyrinthine capsula and peripheral facial palsies. Our basic concern is to evaluate the incidence of petrosal involvement in our environment, owing to the scarcity of the national literature, and to analyze the after maths and the management of postraumatic facial paralyses.

[Pott's puffy tumor]. / Tumor blando de Pott.

Between the complications of frontal sinusitis orbital or intracranial are the most frequent encountered (meningitis, abscesses and empyemas). All are secondary to thrombophlebitis of veins communicating the intracranial cavity with the frontal sinus. Frontal osteomyelitis secondary to sinusitis, the so-called Pott's puffy tumor, is a much more rare aftermath in the antibiotic epoch. Pott's puffy tumor must be suspected in patients with frontal headache followed by frontal oedema. Concerning the diagnosis clinical suspicion is essential and must be settled throughout computerized tomography and/or magnetic resonance or even bone scintiscan. The paper report 2 cases, one an orbital periostitis, at the beginning of the disease, which was recovered with medical antibiotic treatment and another one, an osteomyelitis somewhat evolved requiring surgery through frontal osteoplasty. Perusal of etiology, pathogenesis, diagnosis and treatment of this complication.

[Nasopharyngeal cysts. Report of four cases and literature review]. / Quistes nasofaríngeos: descripción de cuatro casos y revisión de la literatura.

Nasopharyngeal cysts although common are not completely understood. They are classified according to their localization and pathogenesis in congenital or acquired and medial or lateral. We report 4 cases: a branchiogenic causing serious otitis, a Tornwaldt's cyst also producing otitis serosa, another asymptomatic Tornwaldt's cyst and a retention cyst which produce an obstructive apnea syndrome. All but the asymptomatic one were operated on transoral, by grasping the cyst and its implantation site. They all remain till now asymptomatic. We review the chapter of nasopharyngeal cysts, discussing their clinicopathological classification, their diagnosis and treatment.

[Subdural empyema as a complication of sinusitis. Association with Streptococcus milleri]. / Empiema subdural como complicación de sinusitis. Asociación a Streptococcus milleri.

Intracranial complications of sinusitis now are unusual and subdural empyema is even more infrequent. Furthermore, subdural empyema usually is related to sinus infections, particularly those caused by Streptococcus milleri, an anaerobic organism. Although clinical suspicion is fundamental, computed tomography and magnetic resonance imaging are essential for discovering these complications. These studies enable early diagnosis and prompt treatment, thus reducing the high mortality of this disease. We report two cases of subdural empyema secondary to sinusitis in persons without impaired immunity. Streptococcus milleri was isolated in one of them. A review of the literature disclosed that this is the most frequently involved organism, so the empirical selection of antibiotics targeted this organism.

[Primary laryngeal lymphoma]. / Linfoma laríngeo primario.

We report a new case of supraglottic primary laryngeal lymphoma. The tumor was a B-cell, non-Hodgkin lymphoma with good response to polychemotherapy and radiotherapy. Although the head and neck region is a frequent site of origin of extranodal non-Hodgkin lymphomas, laryngeal involvement is exceptional. Including this case, 88 primary laryngeal lymphomas have been reported in the literature.