Ligadura de la arteria esfenopalatina en la epistaxis recidivante posterior. Estudio retrospectivo de 50 pacientes / Ligation of the sphenopalatine artery in posterior epistaxis. Retrospective study of 50 patients

Objetivos: Queremos estudiar la efectividad y las ventajas de la ligadura de la arteria esfenopalatina en el tratamiento de la epistaxis recurrente posterior. Métodos: Hemos realizado un estudio retrospectivo sobre un total de 50 pacientes ingresados en nuestro servicio por epistaxis recidivante posterior en los que el taponamiento nasal posterior resultó ineficaz. A todos ellos se les realizó la ligadura endoscópica de la arteria esfenopalatina para controlar dicha hemorragia. Resultados: De todos los pacientes intervenidos, sólo 7 presentaron recidiva de la epistaxis. Uno de ellos fue resuelto ligando la arteria etmoidal anterior; otro ligando, asimismo, la arteria esfenopalatina contralateral; otro se encuentra en estudio por una alteración de la coagulación no filiada, ya que se le han ligado las arterias esfenopalatina, etmoidal anterior y etmoidal posterior homolaterales, y las epistaxis persisten; y los 4 restantes se controlaron con un taponamiento nasal anteroposterior. El resto de pacientes fue dado de alta a los 2 días de la intervención, sin recidiva ni otras complicaciones relacionadas con la intervención. Conclusiones: Creemos que la ligadura endoscópica de la arteria esfenopalatina es una técnica segura, con escasos efectos secundarios, que minimiza las molestias y complicaciones de otros métodos como el taponamiento nasal o la embolización arterial (AU)

Objectives: The aim of this study was to evaluate the efficacy of endoscopic ligation of the sphenopalatine artery in the treatment of severe posterior epistaxis. Methods: We have carried out a retrospective study on 50 patients hospitalised with posterior recurrent epistaxis, in whom posterior nasal packing was not effective. All of them underwent surgical treatment, with endoscopic ligation of the sphenopalatine artery to control the epistaxis. Results: Only seven patients had a new epistaxis after surgery. One of them is being studied for some kind of coagulopathy, another patient was controlled by ligation of the anterior ethmoidal artery and it was necessary to ligate the contralateral sphenopalatine artery in a third patient. The other four patients were controlled with posterior nasal packing and discharged two days after surgery, without any complications. Conclusions: We believe that endoscopic ligation of the sphenopalatine artery is a safe technique, with fewer complications than other methods such as posterior packing or embolisation (AU)

[Ligation of the sphenopalatine artery in posterior epistaxis. Retrospective study of 50 patients]. / Ligadura de la arteria esfenopalatina en la epistaxis recidivante posterior. Estudio retrospectivo de 50 pacientes.

OBJECTIVES: The aim of this study was to evaluate the efficacy of endoscopic ligation of the sphenopalatine artery in the treatment of severe posterior epistaxis. METHODS: We have carried out a retrospective study on 50 patients hospitalised with posterior recurrent epistaxis, in whom posterior nasal packing was not effective. All of them underwent surgical treatment, with endoscopic ligation of the sphenopalatine artery to control the epistaxis. RESULTS: Only seven patients had a new epistaxis after surgery. One of them is being studied for some kind of coagulopathy, another patient was controlled by ligation of the anterior ethmoidal artery and it was necessary to ligate the contralateral sphenopalatine artery in a third patient. The other four patients were controlled with posterior nasal packing and discharged two days after surgery, without any complications. CONCLUSIONS: We believe that endoscopic ligation of the sphenopalatine artery is a safe technique, with fewer complications than other methods such as posterior packing or embolisation.

Mucormicosis rinocerebral: a propósito de ocho casos / Rhinocerebral mucormycosis: Report on eight cases

La mucormicosis es una afección grave, por lo general de curso agudo y frecuentemente mortal, que se presenta en su versión más agresiva en huéspedes debilitados, generalmente por inmunosupresión o con cetoacidosis diabética. Como otorrinolaringólogos, debemos diagnosticarla lo más temprano posible, instaurar tratamiento precózmente con anfotericina B y efectuar una maniobra quirúrgica, con la finalidad de obtener márgenes libres de infección. Es poco frecuente y conocida, lo que contribuye a un retraso en su diagnóstico, aunque debemos tenerla presente debido al gran aumento de población con factores de riesgo. Presentamos ocho casos vistos en nuestro hospital en los últimos años (1997–2007). Cuatro eran del sexo femenino y otros cuatro del masculino, con edades comprendidas entre 36–86 años. La edad media de presentación era de 57 años y todos presentaban algún factor predisponente. El tratamiento llevado a cabo fue el de la enfermedad de base, la terapia antifúngica sistémica y la cirugía (AU)

Mucormycosis is a serious condition, usually acute and often fatal, It presents in its most aggressive form in debilitated hosts, usually with diabetic ketoacidosis or immunosuppression. As otolaryngologists, we must diagnose it as early as possible, establish early treatment with amphotericin B and perform a surgical manoeuvre to obtain infection-free margins. It is rare and largely unknown, contributing to delayed diagnosis. It should be borne in mind due to the great increase of population with risk factors. We report eight cases seen in our hospital in recent years (1997–2007). Four were female and four male, aged between 36 and 86 years. The mean age at diagnosis was 57 and all had a predisposing factor. The treatment carried out was that of the underlying disease, systemic antifungal therapy and surgery (AU)

[Rhinocerebral mucormycosis: report on eight cases]. / Mucormicosis rinocerebral: a propósito de ocho casos.

Mucormycosis is a serious condition, usually acute and often fatal, It presents in its most aggressive form in debilitated hosts, usually with diabetic ketoacidosis or immunosuppression. As otolaryngologists, we must diagnose it as early as possible, establish early treatment with amphotericin B and perform a surgical manoeuvre to obtain infection-free margins. It is rare and largely unknown, contributing to delayed diagnosis. It should be borne in mind due to the great increase of population with risk factors. We report eight cases seen in our hospital in recent years (1997-2007). Four were female and four male, aged between 36 and 86 years. The mean age at diagnosis was 57 and all had a predisposing factor. The treatment carried out was that of the underlying disease, systemic antifungal therapy and surgery.