Encuesta poblacional a usuarios de lavados nasales con agua de mar: seguimiento de la recomendación médica, hábitos de uso, percepción de beneficios y satisfacción global / Population survey to users of nasal washes with seawater: follow-up of medical recommendation, use habits, perception of benefits and global satisfaction

INTRODUCCIÓN: Existen pocos estudios sobre la recomendación de soluciones de aguas de mar y el grado de adherencia y satisfacción de los pacientes/usuarios. OBJETIVO: Analizar el perfil de recomendación del médico de los lavados nasales con solución isotónica de agua de mar, el seguimiento y la satisfacción del usuario. MATERIAL Y MÉTODOS: Estudio observacional, epidemiológico, transversal y multicéntrico basado en un registro médico y una encuesta telefónica estructurada a pacientes/usuarios de lavados nasales con agua de mar. RESULTADOS: Participaron 175 médicos (87 pediatras, 53 otorrinolaringólogos, 35 alergólogos) y se entrevistaron por teléfono 1.350 usuarios. Los principales motivos de recomendación: congestión nasal (65,2%), rinitis (34,6%) e higiene (30,6%). La pauta más recomendada es 3 lavados/día durante 3 semanas. El 95% de los usuarios siguió las instrucciones del médico. El principal beneficio es la mejora de la congestión nasal (85,2%), la mucosidad (77,7%) y la dificultad para respirar (72,2%). Un 66,4% refirió haber acortado los días de enfermedad y un 52,8% reducir el uso de medicamentos. La valoración global fue buena o muy buena en el 93,85% de los casos. CONCLUSIONES: El seguimiento del paciente/usuario de la recomendación médica sobre lavados nasales con soluciones de agua de mar es alto y no interfiere de manera importante con su rutina diaria. Sus principales beneficios son la reducción de la congestión nasal, la mucosidad y la dificultad para respirar, así como el acortamiento de los días de enfermedad y el menor consumo de medicamentos. Dos de cada tres lo consideran mejor que el suero fisiológico tradicional

INTRODUCTION: There are few studies on the criteria for recommending the physiological seawater solutions and the adherence and satisfaction of the patients/users. OBJECTIVE: Analyze the medical recommendation profile of nasal washes with isotonic solution of seawater, the follow-up of recommendation and overall satisfaction of the users. Materials and methodology: Observational, epidemiological, cross-sectional and multi-center study based on a medical record and a structured telephone survey of patients/users of nasal washes with isotonic microdiffusion of sea water. RESULTS: A total of 175 physicians participated (87 paediatricians, 53 otolaryngologists and 35 allergists) and 1350 users were interviewed by telephone. The main reasons for recommendation: nasal congestion (65.2%), rhinitis (34.6%) and hygiene (30.6%). The most recommended pattern was 3 washes daily for 3 weeks. 95% of users followed the doctor's instructions. The main benefits were improvement of nasal congestion (85.2%), mucus (77.7%), rhinorrhea (75.6%) and difficulty in breathing (72.2%). 66.4% reported having shortened sick days and 52.8% that had reduced the use of other medications. The overall assessment of the product was good or very good in 93.85% of the cases. CONCLUSIONS: The follow-up by the patient/user of medical recommendation on nasal washes with seawater solutions is high and does not interfere in an important way with the daily routine of patient. The main benefit is the reduction of nasal congestion, mucus and difficulty in breathing, as well as the shortening of sick days and the lower consumption of medications. Two out of three subjects consider their use better than traditional physiological saline

Position paper on nasal obstruction: evaluation and treatment.

Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary.

Position paper on nasal obstruction: evaluation and treatment / No disponible

Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary

La obstrucción nasal (ON) se define como la percepción subjetiva de disconfort o dificultad en el paso del aire a través de las fosas nasales. Es un motivo de consulta frecuente en atención primaria y especializada, que puede afectar hasta un 30-40% de la población. Repercute en la calidad de vida (especialmente con alteración del sueño) y disminuye la eficiencia laboral. El objetivo de este documento es consensuar el manejo de la ON, estableciendo una metodología para su evaluación y diagnóstico y un abordaje individualizado para el tratamiento. La ON puede ser uni o bilateral, intermitente o persistente y debida a factores locales o sistémicos, ya sean anatómicos, inflamatorios, neurológicos, hormonales, funcionales, ambientales o medicamentosos. La anamnesis dirigida y la exploración física son claves para el diagnóstico diferencial. La evaluación de la ON puede realizarse con herramientas de valoración subjetiva (escala visual analógica, puntuación de síntomas, cuestionarios estandarizados) o por estimación objetiva (rinomanometría anterior activa, rinometría acústica, flujo máximo nasal inspiratorio). Aunque existe poca correlación entre ellas, sus resultados pueden considerarse complementarios y no excluyentes. También es aconsejable valorar el impacto en la calidad de vida mediante cuestionarios estandarizados. El tratamiento de la ON se establece en función de la causa. Es fundamentalmente farmacológico (tópico y/o sistémico) cuando la etiología es inflamatoria o funcional. El tratamiento quirúrgico estará indicado tras el fracaso del tratamiento médico, para complementarlo o mejorarlo. Puede ser necesaria la combinación de varias técnicas quirúrgicas y/o la asociación de un tratamiento médico pre/post cirugía

Vértigo posicional paroxístico benigno del canal horizontal / Benign paroxysmal positional vertigo of the horizontal semicircular canal

Objetivo: Aportación de 8 nuevos casos de vértigo posicional paroxístico benigno del canal horizontal (VPPBCH), dada la presentación poco común de esta variante de vértigo posicional. Realización del estudio oculográfico de la respuesta nistágmica mediante Electrooculografía (EOG), técnica que permite estudiar con detalle las características de los nistagmos. Material y método: Estudio retrospectivo de 8 pacientes con VPPB-CH y con maniobra diagnóstica de rotación de la cabeza objetivada mediante Electrooculografía (EOG). Se analizó mediante esta técnica las características de la respuesta nistágmica. Se investigó también la existencia de posibles alteraciones en otras pruebas de EOG. Resultados: La respuesta nistágmica observada con mayor frecuencia fue un nistagmo horizontal bilateral de dirección cambiante geotrópico que lo presentaron 7 de los 8 pacientes del estudio. Hubo 1 paciente en el que el nistagmo fue horizontal ageotrópico. Hubo 5/8 pacientes con alteración de la prueba calórica. Conclusiones: Se constata que el VPPB-CH es una entidad poco frecuente. En la mayoría de los casos al realizar la maniobra de provocación se procude un nistagmo horizontal bilateral de dirección cambiante geotrópico que tendría su explicación en la canalitiasis del canal semicircular horizontal. Existe un pequeño número de casos en los cuales la respuesta nistágmica sería horizontal ageotrópica que implicaría cupulolitiasis o localización de las partículas en la parte anterior del canal. La prueba calórica, que aparece alterada en muchos de los casos, puede ayudar a determinar el oído afectado

Objective: Assesment of 8 new cases of benign paroxysmal positional vertigo of the horizontal semicircular canal (BPPV-HC), since this variant of benign positional vertigo occurs rarely. An oculographic study of features in the positional response was carried out. Electrooculograpy (EOG) allows an exhaustive study of positional nystagmus. Material and methods: We have studied retrospectively 8 patients with BPPV-HC and positive head rotation manoeuvre registered by EOG techniques. Possible alterations in other EOG tests in the group of patients were analyzed. Results: Most of the patients (7/8) expressed bilateral horizontal geotropic changing-direction nystagmus. One patient exhibited apogeotropic horizontal nystagmus. 5/8 cases showed caloric hypofunction. Conclusions: We have proven that BPPVHC is an uncommon disorder. In most of the cases, provocative manoeuver generates bilateral horizontal geotropic changing-direction nystagmus that probably is due to canalitiasis of the horizontal semicircular canal. The rest, a few cases, exhibit apogeotropic horizontal response that can be secondary to cupulolitiasis or location particles in the anterior portion of the horizontal canal. A caloric test showed abnormal in many and can help to locatize the affected ear

[Oculographic findings in 145 patients with benign paroxysmal positional vertigo]. / Hallazgos oculográificos en 145 pacientes con vértigo posicional paroxístico benigno.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) can be produced by specific manoeuvres and be studied by electrooculography (EOG). It allows an exhaustive study of features in the positional nystagmus. Although most of the patients with BPPV express typical nystagmus, there exists a group of them that exhibit a non typical form. In this work, a comparative study was carried out between two groups of patients. MATERIAL AND METHODS: We have studied retrospectively 145 patients with BPPV and Dix-Hallpicke (D-H) positive manoeuvre registered by EOG techniques. All patients were explored in a complete EOG tests. Two groups were identified: typical response/atypical response according to the features of nystagmus response. Possible alterations in other EOG tests in each group were investigated and differences between both types of response were analyzed. RESULTS: 83.5% of cases showed typical nystagmus and atypical in the rest. Other EOG alterations observed in these patients, were (group typical response/atypical response): caloric hypofunction (17.3%/23%), positional nystagmus (12.4%/62.5%), alterations in visual-oculomotor function tests (10%/50%). CONCLUSIONS: Frequent alterations were observed in the classic manoeuvres and also in the rest of EOG tests. Probably atypical response in the first is due to or can explain the existence of the second.

Hallazgos oculográficos en 145 pacientes con vértigo posicional paroxístico benigno / Oculographic findings in 145 patients with benign paroxysmal positional vertigo

Objetivo: En los pacientes afectados por vértigo posicional paroxístico benigno (VPPB), el nistagmo provocado por las maniobras posicionales clásicas puede ser recogido mediante electrooculografía (EOG), que permite estudiar con detalle sus características. Aunque la respuesta nistágmica suele tener unas características típicas, existe un grupo de pacientes que presentarán una respuesta atípica. En este trabajo se realizó un estudio comparativo entre ambos grupos de pacientes. Material y método: Estudio retrospectivo de 145 pacientes con VPPB y con maniobra de Dix-Hallpike (D-H) positiva objetivada mediante EOG. Se hizo una clasificación en dos grupos: respuesta típica/respuesta atípica, según la secuencia nistágmica obtenida. Se investigó la existencia de alteraciones en otras pruebas de EOG en uno y otro grupo y se analizaron las diferencias entre ambos tipos de respuesta. Resultados: El nistagmo típico se dio en el 83,4% de casos, apareciendo en el resto de los casos con algún rasgo atípico. Se asociaron alteraciones en otras pruebas de EOG: (grupo de pacientes con respuesta típica/atípica): hipofunción calórica: (17,3%/50%), nistagmo de posición: (12,4%/62,4%), alteración de pruebas de función visuo-oculomotora: (10%/50%). Conclusiones: Existencia de frecuentes alteraciones tanto en las maniobras posicionales clásicas como en el resto de pruebas de EOG practicadas. La respuesta atípica en las primeras es probablemente debida o explica la existencia de las segundas

Objective: Benign paroxysmal positional vertigo (BPPV) can be produced by specific manoeuvres and be studied by electrooculography (EOG). It allows an exhaustive study of features in the positional nystagmus. Although most of the patients with BPPV express typical nystagmus, there exists a group of them that exhibit a non typical form. In this work, a comparative study was carried out between two groups of patients. Material and methods: We have studied retrospectively 145 patients with BPPV and Dix-Hallpicke (D-H) positive manoeuvre registered by EOG techniques. All patients were explored in a complete EOG tests. Two groups were identified: typical response/atypical response according to the features of nystagmus response. Possible alterations in other EOG tests in each group were investigated and differences between both types of response were analyzed. Results: 83.5% of cases showed typical nystagmus and atypical in the rest. Other EOG alterations observed in these patients, were (group typical response/atypical response): caloric hypofunction (17.3%/23%), positional nystagmus (12.4%/62.5%), alterations in visual-oculomotor function tests (10%/50%). Conclusions: Frequent alterations were observed in the classic manoeuvres and also in the rest of EOG tests. Probably atypical response in the first is due to or can explain the existence of the second

[Eosinophils in nasal polyposis pathogenia. Bibliographic revision]. / Los eosinofilos en la patogenia de la poliposis nasal. Una revisión bibliográfica.

The aim of this work is to do a review on relations between the eosinophils and nasosinusal polyps. The etiopathogenical action of eosinophils are reviewed, from bone narrow to nasal mucosa infiltration. The mechanism of tissue eosinophilic mediated inflammation, his regulation and the significance of the balance between positive (IL-5) and negative (TGFbeta and IL10) mediators are discussed. We conclude that the degree of eosinophilic infiltration and degranulation's patterns are important aspects conditioning the severity and prognosis of chronic rhinosinusitis and nasosinusal polyps.

[Pleomorphic adenoma of deep lobe of the parotid gland]. / Adenoma pleomorfo gigante de lóbulo profundo de la parótida: a propósito de un caso.

Parapharyngeal space tumors are rare. Salivary neoplasms being the most frequent ones. The important volume they can reach, their silent character, and the complex anatomic relationships of this area makes their surgical resection difficult. This report describes a case of a pleomorphic adenoma in the deep lobe of the parotid gland presented like a parapharyngeal mass, and its diagnosis and treatment.

Adenoma pleomerofo gigante de lóbulo profundo de la parótida: a propósito de un caso / Pleomorphic adenoma of deep lobeo f the parotid gland

Los tumores del espacio parafaríngeo son una rareza. Las neoplasias de glándulas salivales son los tumores más frecuentes. Debido al importante volumen que pueden alcanzar en el momento de su diagnóstico, por su carácter silente durante largo tiempo, y la complejidad anatómica de esta región, su extirpación puede plantear dificultades. Presentamos un caso clínico de adenoma pleomorfo del lóbulo profundo de la parótida manifestado como una masa parafaríngea. El interés radica en los problemas de diagnóstico y tratamiento que plantea por su tamaño y localización

Parapharyngeal space tumors are rare. Salivary neoplasms being the most frequent ones. The important volume they can reach, their silent character, and the complex anatomic relationships of this area makes their surgical resection difficult. This report describes a case of a pleomorphic adenoma in the deep lobe of the parotid gland presented like a parapharyngeal mass, and its diagnosis and treatment

[Benign paroxysmal positional vertigo of the horizontal semicircular canal]. / Vértigo posicional paroxístico benigno del canal horizontal.

OBJECTIVE: Assesment of 8 new cases of benign paroxysmal positional vertigo of the horizontal semicircular canal (BPPV-HC), since this variant of benign positional vertigo occurs rarely. An oculographic study of features in the positional response was carried out. Electrooculograpy (EOG) allows an exhaustive study of positional nystagmus. MATERIAL AND METHODS: We have studied retrospectively 8 patients with BPPV-HC and positive head rotation manoeuvre registered by EOG techniques. Possible alterations in other EOG tests in the group of patients were analyzed. RESULTS: Most of the patients (7/8) expressed bilateral horizontal geotropic changing-direction nystagmus. One patient exhibited apogeotropic horizontal nystagmus. 5/8 cases showed caloric hypofunction. CONCLUSIONS: We have proven that BPPV-HC is an uncommon disorder. In most of the cases, provocative manoeuver generates bilateral horizontal geotropic changing-direction nystagmus that probably is due to canalitiasis of the horizontal semicircular canal. The rest, a few cases, exhibit apogeotropic horizontal response that can be secondary to cupulolitiasis or location particles in the anterior portion of the horizontal canal. A caloric test showed abnormal in many and can help to locatize the affected ear.

[Cyst and pseudocyst lesions of the floor of the mouth with submental affectation]. / Lesiones quísticas y pseudoquísticas del suelo de la boca con afectación submentoniana. Diagnóstico diferencial y tratamiento.

There are several lesions which can present as a cyst or pseudocyst of the floor of the mouth with submental repercussion. The aim of this paper is to review the diagnosis methods which can help us to differentiate these lesions such as the surgical peculiarities of every tumour. We are reporting two cases of cystic/pseudocystic lesions of the floor of the mouth with submental repercussion. Both of them were epidermoid cysts. Ranulas, lipomas and lymphangiomas should be considered in the differential diagnosis. Imaging diagnosis, fine needle aspiration and adequate treatment in all of the tumours are reviewed. Both cases were operated via intraoral. They are now free of disease after at least one year. Differential diagnosis of cystic lesions of the floor of the mouth is important because the recommended surgery technique is not exactly the same in all of them. The firmness of the wall of dermoid cysts let their exeresis via intraoral even when they are of a big size. Exeresis of sublingual gland is recommended by most authors to treat ranulas, although it is followed by an important percentage of morbidity.

Lesiones quísticas y pseudoquísticas del suelo de la boca con afectación submentoniana / Cyst and pseudocyst lesions of the floor of the mouth with submental affectation

Pretendemos revisar los métodos diagnósticos que pueden ayudamos a diferenciar las lesiones quísticas de suelo de boca con afectación submentoniana, así como las peculiaridades de la técnica quirúrgica indicada en cada una de ellas.Presentamos dos casos que fueron diagnosticados de quistes epidermopides. En el diagnóstico diferencial deben ser considerados las ránulas, los lipomas y los linfangiomas. Se revisan el diagnóstico por la imágen, la punción-aspiración con aguja fina y el tratamiento de cada tumor. Ambos casos fueron intervenidos mediante un abordaje intraoral. Actualmente se encuentran libres de enfermedad después de al menos un año. El diagnóstico diferencial de las lesiones quísticas del suelo de la boca es importante porque la técnica quirúrgica recomendada no es exactamente la misma en todas ellas. La firmeza de la pared de los quistes dermoides permite su exéresis vía intraoral aún cuando presenten un gran tamaño. Para el tratamiento de las ránulas la mayoría de autores recomienda la exéresis de la glándula sublingual, a pesar de la morbilidad de dicha técnica

There are several lesions which can present as a cyst or pseudocyst of the floor of the mouth with submental repercussion. The aim of this paper is to review the diagnosis methods which can help us to differentiate these lesions such as the surgical peculiarities of every tumour. We are reporting two cases of cystic/pseudocystic lesions ofthe floor of the mouth with submental repercussion. Both of them were epidermoid cysts. Ranulas, lipomas and lymphangiomas should be considered in the differential diagnosis. Imaging diagnosis, fine needle aspiration and adequate treatment in all of the tumours are reviewed. Both cases were operated via intraoral. They are now free of disease after at least one year. Differential diagnosis of cystic lesions of the floor of the mouth is important because the recommended surgery technique is not exactly the same in all of them. The firmness of the wall of dermoid cysts let their exeresis via intraoral even when they are of a big size. Exeresis of sublingual gland is recommended by most authors to treat ranulas, although it is followed by an important percentage of morbidity

Atelectasia crónica maxilar: causa infrecuente de opacidad radiológica persistente / Chronic maxillary atelectasis: an uncommon cause of persistent radiological opacification

La atelectasia crónica maxilar (ACM) es una enfermedad poco frecuente, que se caracteriza por una disminución de volumen del seno maxilar con retracción de una o más de sus paredes. El mecanismo causal parece ser una hipoventilación del seno maxilar por obstrucción del complejo ostiomeatal, que crea presión negativa y retracción de las paredes del seno. Se presenta el caso de una niña de 14 años asintomática, que presentaba una imagen radiológica de opacidad en seno maxilar persistente a tratamiento. En la TC coronal se apreciaba una opacificación parcial del seno maxilar derecho, con desplazamiento lateral de la pared infundibular medial y retracción de la mucosa del meato medio, por lo que la paciente fue diagnosticada de ACM. El interés del caso radica en que se trata de una enfermedad poco conocida, que no debe confundirse con la sinusitis maxilar

Chronic maxillary atelectasis (CMA) is an infrequent entity characterized by a persistent decrease in maxillary sinus volume due to inward bowing of one or more antral walls. The cause of CMA is probably maxillary sinus hypoventilation secondary to ostiomeatal complex obstruction. This creates negative pressure, leading to thinning of the sinus walls. We report the case of a 14-year-old asymptomatic girl with an opacified maxillary sinus on radiology following unsuccessful antibiotic treatment. A coronal computed tomography scan showed partial right antral opacification, with a laterally malpositioned medial infundibular wall and fontanel retraction, and consequently CMA was diagnosed. The interest of this case lies in the infrequency of CMA and the need to distinguish it from maxillary sinusitis

[Chronic maxillary atelectasis: an uncommon cause of persistent radiological opacification]. / Atelectasia crónica maxilar: causa infrecuente de opacidad radiológica persistente.

Chronic maxillary atelectasis (CMA) is an infrequent entity characterized by a persistent decrease in maxillary sinus volume due to inward bowing of one or more antral walls. The cause of CMA is probably maxillary sinus hypoventilation secondary to ostiomeatal complex obstruction. This creates negative pressure, leading to thinning of the sinus walls. We report the case of a 14-year-old asymptomatic girl with an opacified maxillary sinus on radiology following unsuccessful antibiotic treatment. A coronal computed tomography scan showed partial right antral opacification, with a laterally malpositioned medial infundibular wall and fontanel retraction, and consequently CMA was diagnosed. The interest of this case lies in the infrequency of CMA and the need to distinguish it from maxillary sinusitis.

[Electrooculography. Its value in the diagnosis of the patient with a balance disorder]. / Electrooculografía: aportación al diagnóstico del paciente con alteraciones del equilibrio.

INTRODUCTION: Controversy persists on the value of electrooculography (EOG) in the diagnosis of the unbalanced patient. The aim of this study has been to know the utility of EOG in the diagnosis of patients with equilibrium disorders. MATERIAL AND METHODS: We have examined 1000 patients in whom EOG test has been performed for unbalance symptoms. Results have been classified in peripheric or central pattern. Those patients included in the central pattern group have been compared with the results of imaging techniques. RESULTS: 45.7% of EOG performed showed pathological signs, 29.2% were of peripheral characteristics and 16.5% of central ones, of whom 6% showed different pathologies in the imaging test. DISCUSSIONS AND CONCLUSIONS: EOG in now a days of high value in the diagnosis of unbalanced patient, specially in those cases in which other clinical explorations were normal.

[Study of mucociliary transport and nasal ciliary ultrastructure in patients with Kartagener's syndrome]. / Estudio del transporte mucociliar y de la ultraestructura ciliar nasales en pacientes con síndrome de Kartagener.

OBJECTIVE: Kartagener's syndrome (KS) is a clinical variant of primary ciliary dyskinesia involving situs inversus associated with chronic airway infections. The ciliary defect associated with this syndrome is the absence of dynein arms. The aim of this study was to evaluate mucociliary transport and ciliary ultrastructure in 14 patients with KS. PATIENTS AND METHODS: We studied nasal mucociliary transport using a radioisotopic technique and ciliary ultrastructure in 14 patients with KS. RESULTS: Thirteen patients had mucociliary stasis and 1 had severely slowed transport (1.3 mm/min). Four patients (29%) had cilia with normal dynein arms, 2 patients (14%) had short inner dynein arms, and 8 patients (57.1%) had total absence of inner and outer dynein arms. CONCLUSIONS: We conclude that the typical clinical presentation, together with altered mucociliary transport as identified by an isotopic technique, is diagnostic of KS, even when the ciliary ultrastructure is normal. KS is clinically homogenous and morphologically heterogenous.

Electrooculografía: aportación al diagnóstico del paciente con alteraciones del equilibrio / Electrooculography. Its value in the diagnosis of the patient with a balance disorder

Introducción: El papel que debe jugar la electrooculografía (EOG) en el diagnóstico del paciente con trastornos del equilibrio sigue siendo controvertido. El objetivo de este estudio ha sido determinar la utilidad de la EOG en el diagnóstico del paciente con trastornos del equilibrio. Material y métodos: Hemos llevado a cabo un estudio retrospectivo de 1.000 pacientes que habían sido estudiados mediante EOG por padecer vértigo o desequilibrio. Se hizo una clasificación topográfica (central/periférico) de los resultados obtenidos. En el grupo de pacientes con resultado de características centrales en la EOG se compararon con los resultados obtenidos en la técnica de imagen. Resultados: En el 45,7% la exploración mostraba alteraciones, 29,2% de características periféricas y 16,5% con algún signo de centralidad, de los que el 6% tenían una prueba de imagen patológica. Discusión y conclusiones: La EOG es en la actualidad útil y rentable en el diagnóstico de los trastornos del equilibrio, sobre todo en aquellos pacientes en los cuales otras exploraciones complementarias son negativas

Introduction: Controversy persists on the value of electrooculography (EOG) in the diagnosis of the unbalanced patient. The aim of this study has been to know the utility of EOG in the diagnosis of patients with equilibrium disorders. Material and methods: We have examined 1000 patients in whom EOG test has been performed for unbalance symptoms. Results have been classified in peripheric or central pattern. Those patients included in the central pattern group have been compared with the results of imaging techniques. Results: 45.7% of EOG performed showed pathological signs, 29.2% were of peripheral characteristics and 16.5% of central ones, of whom 6% showed different pathologies in the imaging test. Discusions and conclusions: EOG in now a days of high value in the diagnosis of unbalanced patient, specially in those cases in which other clinical explorations were normal

Estudio del transporte mucociliar y de la ultraestructura ciliar nasales en pacientes con síndrome de Kartagener / Study of mucociliary transport and nasal ciliary ultrastructure in patients with Kartagener's syndrome

OBJETIVO: El síndrome de Kartagener (SK) es una variante clínica de la discinesia ciliar primaria que asocia a las infecciones crónicas de las vías respiratorias un situs inversus. La ausencia de brazos de dineína ha sido el defecto ciliar asociado a este síndrome. El objeto de este trabajo es el estudio del transporte mucociliar y de la ultraestructura ciliar en 14 pacientes con SK. PACIENTES Y MÉTODOS: Hemos estudiado el transporte mucociliar nasal, mediante una técnica radioisotópica, y la ultraestructura ciliar en 14 pacientes con SK. RESULTADOS: En 13 pacientes había estasis mucociliar y en uno, un transporte muy enlentecido (1,3 mm/min). Mostraban cilios con brazos de dineína normales 4 pacientes (29%); brazos internos de dineína cortos, 2 pacientes (14%), y ausencia completa de brazos internos y externos de dineína, 8 casos (57,1%). CONCLUSIONES: Concluimos que la presentación clínica típica junto con un transporte mucociliar alterado, objetivado con una técnica isotópica, es diagnóstica del SK, aunque la ultraestructura ciliar sea normal. El SK es clínicamente homogéneo y morfológicamente heterogéneo

OBJECTIVE: Kartagener’s syndrome (KS) is a clinical variant of primary ciliary dyskinesia involving situs inversus associated with chronic airway infections. The ciliary defect associated with this syndrome is the absence of dynein arms. The aim of this study was to evaluate mucociliary transport and ciliary ultrastructure in 14 patients with KS. PATIENTS AND METHODS: We studied nasal mucociliary transport using a radioisotopic technique and ciliary ultrastructure in 14 patients with KS. RESULTS: Thirteen patients had mucociliary stasis and 1 had severely slowed transport (1.3 mm/min). Four patients (29%) had cilia with normal dynein arms, 2 patients (14%) had short inner dynein arms, and 8 patients (57.1%) had total absence of inner and outer dynein arms. CONCLUSIONS: We conclude that the typical clinical presentation, together with altered mucociliary transport as identified by an isotopic technique, is diagnostic of KS, even when the ciliary ultrastructure is normal. KS is clinically homogenous and morphologically heterogenous