Disección carotídea secundaria a herida cervical por arma de fuego / Carotid dissection secondary to cervical wound by a firearm

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Pediatric myringoplasty: Prognostic factors in surgical outcome and hearing threshold recovery.

CONCLUSIONS: This study shows as decisive factors the history of tympanostomy tube insertion and surgical approach. The closure of the perforation observed at the 6th post-operative month is almost definitive, without finding significant differences ahead. The myringoplasty can be performed simultaneously in bilateral perforations and in a day-case basis with same success rates. Astatistically significant audiometric improvement area is described, after myringoplasty, undescribed previously in literature. OBJECTIVES: The aim of this study was to evaluate prognostic factors in surgical outcome and hearing threshold after myringoplasty, in pediatric age. METHODS: A 10-year retrospective review of 142 myringoplasties performed by a single surgeon of the Pediatric ENT Department of 12 de Octubre University Hospital. Multiple prognostic factors were investigated, such as those related to perforation and surgery, contralateral ear status, and pre- and post-operative hearing threshold. RESULTS: The overall rate of closure of the perforation was 74.64%. The re-perforation rate was directly proportional to the number of tympanostomy tube insertion (OR = 1.64). Other determining factors were the surgical approach, the graft position and side. There was a post-operative significant improvement (p < 0.001) insuring that the more affected frequencies, low (125-500 Hz) and high frequencies (4000-8000 Hz), were the more improved after the procedure.

[Parotid tumours: correlation between fine needle aspiration biopsy and histological findings]. / Tumores parotideos: correlación entre la punción aspiración con aguja fina y los hallazgos histopatológicos.

OBJECTIVE: To evaluate the role of the fine needle aspiration biopsy (FNAB) in the study of parotid masses. METHODS: Retrospective review of FNAB results compared with final histological diagnosis in 148 patients with a parotid mass from 1993 to 2003. RESULTS: FNAB was performed in 93.92% of parotid masses. Eleven of these were not conclusive. The FNAB diagnosis of malignant o suspicious lesion had 81.25% of sensibility, 96.87% of specificity and positive and negative predictive values of 89.65% and 93.94%, respectively. The FNAB specific histopathologic diagnosis in the benign parotid masses were 92%, and 57.69% in the malignant masses. CONCLUSIONS: FNAB is a diagnostic tool with a high negative predictive value, very usotul in the study of suspicious malignant parotid masses and whenever surgery is not possible.

Tumores parotideos: correlación entre la punción aspiración con aguja fina y los hallazgos histopatológicos / Parotid tumours: correlation between fine needle aspiration biopsy and histological findings

Objetivo: Establecer la rentabilidad diagnóstica de la punción aspiración con aguja fina (PAAF) en el diagnóstico de las masas parotídeas. Material y métodos: Estudio retrospectivo en el que comparamos los resultados de la PAAF con los hallazgos anatomopatológicos de la pieza quirúrgica, en 148 pacientes diagnosticados de masa parotídea durante el período de 1993 al 2003. Resultados: Se realizó PAAF al 93,92% de las masas parotídeas, 11 fueron no concluyentes. Diagnosticando malignidad, la PAAF presentó una sensibilidad del 81,25%, una especificidad de 96,87% y unos valores predictivos positivo y negativo de 89,65% y 93,94%, respectivamente. Al evaluar la precisión en el diagnóstico exacto de la lesión, encontramos una concordancia del 92% en los tumores benignos y del 57,69% en los tumores malignos. Conclusiones: La PAAF es una prueba diagnóstica con un alto valor predictivo negativo, muy útil en el estudio de las masas parotídeas sospechosas de malignidad o en aquellos casos en los que no se vaya a realizar cirugía

Objetive: To evaluate the role of the fine needle aspiration biopsy (FNAB) in the study of parotid masses. Methods: Retrospective review of FNAB results compared with final histological diagnosis in 148 patients with a parotid mass from 1993 to 2003. Results: FNAB was performed in 93.92% of parotid masses. Eleven of these were not conclusive. The FNAB diagnosis of malignant o suspicious lesion had 81.25% of sensibility, 96.87% of specificity and positive and negative predictive values of 89.65% and 93.94%, respectively. The FNAB specific histopathologic diagnosis in the benign parotid masses were 92%, and 57.69% in the malign masses. Conclusions: FNAB is a diagnostic tool with a high negative predictive value, very usotul in the study of suspicious malignant parotid masses and whenever surgery is not possible

Réplica. Reflejo del parpadeo (R3) y parálisis facial / Reply. Blink reflex (R3) and facial palsy

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[Peripheral facial paralysis. The value of clinical neurophysiology]. / Parálisis facial periférica. Utilidad de la neurofisiología clínica.

AIMS: The aim of this study was to review the value of neurophysiological exploration in peripheral facial paralysis in the literature and in our own experience. METHOD: Peripheral facial paralysis is a frequently occurring cranial neuropathy with an acute presentation. Its striking clinical expression is usually in strong contrast to its benign prognosis, except for a small percentage of cases in which the existence of acute injury to the nerve (axonotmesis) will cause it to progress unfavourably, either due to the absence of nerve regeneration or because this is inadequate or insufficient. A neurophysiological study aids diagnosis and the functional and prognostic assessment. CONCLUSIONS: We recommend the utilisation of standardised studies involving a comprehensive electromyographic and electroneurographic evaluation of the facial territory, including reflexology (blink reflex). Use of a suitable methodology in the neurophysiological study of this neuropathy will allow us to complete the diagnosis and to evaluate progress, even from very early days (early surgical approach prior to the onset of nerve degeneration), all of which is decisive in the prognosis of injury throughout the process.

Parálisis facial periférica. Utilidad de la neurofisiología clínica / Peripheral facial paralysis. The value of clinical neurophysiology

Objetivo. Revisar la utilidad de la exploración neurofisiológica en la parálisis facial periférica en la bibliografía y en nuestra experiencia. Desarrollo. La parálisis facial periférica es una neuropatía craneal de aparición frecuente y presentación aguda. Su llamativa expresión clínica contrasta la mayor parte de las veces con un pronóstico benigno, a excepción de un pequeño porcentaje de casos en los que la existencia de una lesión aguda del nervio (axonotmesis) determina una evolución desfavorable, bien por la ausencia de regeneración nerviosa o por ser ésta inadecuada o insuficiente. El estudio neurofisiológico ayuda en el diagnóstico y en la valoración funcional y el pronóstico. Conclusiones. Recomendamos la realización de estudios estandarizados en los que se incluya una evaluación amplia electromiográfica y electroneurográfica del territorio facial, incluida la reflexología (reflejo de parpadeo). Una adecuada metodología en el estudio neurofisiológico de esta neuropatía va a permitir completar el diagnóstico y valorar la evolución, incluso desde los primeros días (puede indicar un abordaje quirúrgico precoz previo al inicio de la degeneración nerviosa), todo lo cual resulta determinante de cara al pronóstico lesional del proceso (AU)

[Primary laryngeal tuberculosis caused by Mycobacterium bovis]. / Tuberculosis laríngea primaria por Mycobacterium bovis.

It is suggested that laryngeal tuberculosis is a common complication of pulmonary tuberculosis. The most frequent germ is Mycobacterium tuberculosis. We present a case in which a infrequent bacillus, Mycobacterium bovis, was isolated without lung afectation. Considerations about morphologic and microbiologic findings are discussed.