Linfangiomas de cavidad oral en edad pediátrica / Lymphangiomas of the oral cavity in childhood

Los linfangiomas son tumores raros y benignos producidos por el desarrollo anómalo de los vasos linfáticos. Presentamos un caso de linfangioma quístico asintomático localizado en paladar duro; se trata de una localización atípica, puesto que la mayoría de esas lesiones se localizan en la lengua a nivel de cavidad oral. Se realizó una resección con láser de CO2, sin que se evidenciase recidiva tras dos años de seguimiento. Actualmente se acepta adoptar una actitud expectante o el tratamiento con agentes esclerosantes que reduzcan su tamaño o los eliminen (AU)

Lymphangiomas are rare, benign tumors produced by the abnormal development of the lymphatic vessels. We present a case of asymptomatic cystic lymphangioma localized in the hard palate. This is an uncommon location since most of these lesions are found in the tongue at the level of the oral cavity. Resection was performed with CO laser, and there was no evidence of recurrence after two years of follow-up. At the present time, the approaches most widely accepted are expectant treatment or administration of sclerosing agents that reduce the size of the lesions or eliminate them (AU)

Malformaciones arteriovenosas durales en el ámbito de la ORL / Arterioveinous dural malformation in ENT

La Malformación Arteriovenosa Dural (MAVD) es una entidad rara dentro de las anomalías vasculares intracraneales, con etiología nobien conocida y variabilidad en sus tratamientos. Presentamos once casos de MAVDs de entre los cuales 5 presentaban el acúfeno como síntoma de aparición. La importancia de esta patología hace necesario descartarla ante un paciente que consulta por un acúfeno pulsátil con otoscopia normal

The arterioveinous dural malformation (MAVD) is a rare entity between the vascular craneal anomalies with a not well nown ethiology and variability in treatments. We present eleven cases of MAVDs, between them five presented tinnitus as symptom of aparition. The importance of this pathology makes necessary to discard it before a patient consulting because of pulsaltil tinnitus with normal otoscopy

[Fistula of the first branchial arch]. / Fístula de primer arco branquial.

The complexity of the embriologic development of the neck and the possible abnomarlies in this process, with the consequent posterior manifestations make necessary the knowledge of the embriologic anatomy of the neck. In the possible manifestations that can be of the anomalies of the development of the branchial archs are the abnomarlies of the first branchial archs. They are, in the anomalies of the development of the branchial archs infrequent and are intimately related with the facial nerve. We present a clinic case of a seven years old boy affected by this pathology and revise its more important aspects.

Fístula del primer arco branquial / Fistula of the first branchial arch

La complejidad del desarrollo embriológico del cuello y las posibles del cuello y las posibles anomalías en este proceso, con las consiguientes manifestaciones posteriores hacen necesario el conocimiento de la anatomía embriológica del cuello. Dentro de las posibles manifestaciones que pueden darse de las anomlías del desarrollo de los arcos branquiales se encuentran las anomalías del primer arco branquial. Son dentro de las anomalías del desarrollo de los arcos branquiales, infrecuentes y están íntimamente relacionadas con el nervio facial. Presentamos el caso clínico correspondiente a un niño de 7 años con esta patología y repasamos los aspectos más importantes de la misma

The complexity of the embryologic development of the neck and the possible abnormalies in thi process, with the consequent posterior manifestations make necessary the knowledge of the embryologic anatomy of the neck. In the possible manifestations that can be of the abnormalies of the development of the branchial archs are the abnormalies of the first branchial archs. The are, in the anomalies of the development of the branchial archs infrequent and are intimately related with the facial nerve. We present a clinic case of a seven years old boy affected by this pathology and revise its more important aspects

[Arterioveinous dural malformation in ENT]. / Malformaciones arteriovenosas durales en el ambito de la ORL.

The arterioveinous dural malformation (MAVD) is a rare entity between the vascular craneal anomalies with a not well nown ethiology and variability in treatments. We present eleven cases of MAVDs, between them five presented tinnitus as symptom of aparition. The importance of this pathology makes necessary to discard it before a patient consulting because of pulsaltil tinnitus with normal otoscopy.

[Persistence of the third branchial arch]. / Persistencia de tercer arco branquial.

The third branquial arch anomalies represent less than 1% of this deformites. The clinical manifestation can be varied althouth the formation of cysts is the commonest one and may appear at any time in life. We report the clinical case of a 7 year old boy with an neck mass. This mass was diagnosed as a branquial cyst. The patologist found a "timic reminescences". We carry out a review of the literature for this pathology.

Persistencia de tercer arco branquial / Persistence of the third branchial arch

Las anomalías derivadas del desarrollo del tercer arco y bolsa branquiales representan menos del 1% del total de estas malformaciones. Su forma de manifestación puede ser variada, aunque la más frecuente es la forma quística y pueden aparecer en cualquier etapa de la vida. Presentamos el caso clínico correspondiente a un paciente de 7 años con una tumoración laterocervical derecha de un año de evolución, diagnosticado de quiste branquial y con un estudio anatomopatológico tras la extirpación de restos tímicos. De igual modo realizamos una revisión de la literatura de estos casos

The third branquial arch anomalies represent less than 1% of this deformites. The clinical manifestation can be varied althouth the formation of cysts is the commonest one and may appear at any time in life. We report the clinical case of a 7 year old boy with an neck mass. This mass was diagnosed as a branquial cyst. The patologist found a "timic reminescences". We carry out a review of the literature for this pathology

[Non Hodgkin's lymphoma in the ENT field]. / Linfomas no Hodgkin en patología cérvico-facial.

OBJECTIVES: Non Hodgkin's lymphoma (NHL) is a frecuent tumor in the ENT field althougt there are not too many publications with a large number of patients. PATIENTS AND METHODS: We have studied 300 patiens with NHL and analysed the head and neck affectation, the presence in Waldeyer's ring, the first symptoms and the stage of the disease. RESULTS: Over 50% had head and neck manifestation. Of them, the most frequent one were adenopathies. In the Waldeyer's ring, the tonsil was the most frecuently affected structure. CONCLUSION: There is an evident relationship between NHL and the Oto-Rhino-laringology area and it is necessary consider it in the differential diagnosis of head and neck adenopathies.

[Internal carotid artery loop: an uncommon cause of parapharyngeal tumor]. / Bucle de arteria carótida interna: una causa infrecuente de tumoración parafaríngea.

The parapharyngeal space-occupying lessions may develop from any of the structures located inside it. Uncommon although possible ethiologies for them are anatomic variations of the course of the internal carotid artery. These anatomic variants mainly arise from degenerative, mostly age-amplified, causes and lead to elongations, angulations, kinking and tortuosities in the course of the vessel that appear as impressions or protusions of the pharyngeal wall. Utherly unfrecuently lead to loops that may show as large parapharyngeal tumors. This fact should be noticed previously to any invasive procedure to be performed on the patient specially when evidenced in concommitance with an infectious process at the moment of diagnosis. A case of an impressive internal carotid artery loop that conditioned an important parapharyngeal mass in a patient with an associated pharyngeal infection is reported to warn about this rare parapharyngeal space-occupying condition and its potential danger.

Linfomas no Hodgkin en patología cérvico-facial / Non Hodgkin’s lymphoma in the ENT field

Objetivo: El linfoma no Hodgkin (LNH) es una tumoración frecuente que afecta con asiduidad al área ORL aunque no existen muchos trabajos con series grandes sobre el tema. Pacientes y metodología: Hemos estudiado 300 pacientes con LNH y hemos analizado su afectación cérvicofacial, del anillo de Waldeyer, sus síntomas de aparición y el estadio de la enfermedad. Resultados: Más del 50% tenían afectación cérvico-facial. De ellos, la manifestación clínica más frecuente era la presencia de adenopatías. Dentro de la afectación del anillo de Waldeyer, lo más frecuente es la afectación de la amígdala palatina. La mayoría de los paciente se encontraba en un estadio IV de su enfermedad. Conclusiones: Existe una relación clara entre el LNH y el área ORL por lo que es necesario tenerlo en cuenta en la aparición de adenopatías cérvico-faciales

Objetives: Non Hodgkin´s lymphoma (NHL) is a frecuent tumor in the ENT field althougt there are not too many publications with a large number of patiens. Patients and methods: We have studied 300 patiens with NHL and analysed the head and neck affectation, the presence in Waldeyer ´s ring, the first symptoms and the stage of the disease. Results: Over 50% had head and neck manifestation. Of them, the most frequent one were adenopathies. In the Waldeyer ´s ring, the tonsil was the most frecuently affected structure. Conclusion: There is an evident relationship between NHL and the Oto-Rhino-laringology area and it is necessary consider it in the differential diagnosis of head and neck adenopathies

Bucle de arteria carótica interna. Una causa infrecuente de tumoración parafaríngea / Internal carotid artery loop: an uncommon ethiology for a parapharyngeal tumor

Las tumoraciones del espacio parafaríngeo pueden originarse a partir de cualquiera de las estructuras que por él discurren. Una infrecuente aunque posible etiología de las mismas son las variantes anatómicas del trayecto de la arteria carótida interna. Dichas variantes anatómicas surgen generalmente de causas degenerativas y conducen a elongamientos, tortuosidades o suaves rizos que originan improntas en la pared faríngea. Muy raramente, se producen bucles que pueden originar importantes tumoraciones faríngeas. Este hecho debería ser reconocido previamente a cualquier tipo de procedimiento invasivo en el paciente, especialmente cuando concurre en su diagnóstico un proceso infeccioso. Presentamos un caso de gran bucle de arteria carótida interna que condicionó una importante tumoración parafaríngea en un paciente con infección faríngea asociada para llamar la atención sobre esta rara entidad como causa de tumoración parafaríngea y su potencial peligro

The parapharyngeal space-occupying lessions may develop from any of the structures located inside it. Uncommon although possible ethiologies for them are anatomic variations of the course of the internal carotid artery. These anatomic variants mainly arise from degenerative, mostly age-amplified, causes and lead to elongations, angulations, kinking and tortuosities in the course of the vessel that appear as impressions or protusions of the pharyngeal wall. Utherly unfrecuently lead to loops that may show as large parapharyngeal tumors. This fact should be noticed previously to any invasive procedure to be performed on the patient specially when evidenced in concommitance with an infectious process at the moment of diagnosis .A case of an impressive internal carotid artery loop that conditioned an important parapharyngeal mass in a patient with an associated pharyngeal infection is reported to warn about this rare parapharyngeal space-occupying condition and its potential danger

[Cervicothoracic angiomyolipoma: an unusual tumor located at a site difficult to reach for surgery]. / Angiomiolipoma cervicotorácico: una tumoración inusual en una localización de difícil abordaje quirúrgico.

Angiomyolipoma is an uncommon hamartomatous renal tumor very prone to spontaneous bleeding. However it is possible to find it in extrarenal sites, being the liver the most frequent one. The rest of sites recorded in literature are exceptional. In fact, to our knowledge, this is the first case reported of cervicothoracic settlement of an angiomyolipoma. This rare location, together with its marked tendency to bleed bleeding determinate a complicated diagnoses a difficult surgical approach.

Angiomiolipoma cervicotorácico: una tumoración inusual en una localización de difícil abordaje quirúrgico / Cervicothoracic angiomyolipoma: an unusual tumor in a site with difficult surgical approach

El angiomiolipoma es un raro tumor hamartomatoso con asiento predominantemente en el riñón, con marcada tendencia al sangrado espontáneo. Sin embargo, es posible encontrarlo con localización extrarrenal, siendo en este caso el hígado su principal lugar de asiento. El resto de localizaciones descritas son excepcionales. De hecho, hasta dónde conocemos, éste es el primer caso descrito en la literatura médica de angiomiolipoma cervicotorácico. Esta peculiar localización, unida a su marcada tendencia al sangrado, determinan un complicado diagnóstico y un difícil abordaje quirúrgico (AU)

Angiomyolipoma is an uncommon hamartomatous renal tumor very prone to spontaneous bleeding. However it is possible to find it in extrarenal sites, being the liver the most frequent one. The rest of sites recorded in literature are exceptional. In fact, to our knowledge, this is the first case reported of cervicothoracic settlement of an angiomyolipoma. This rare location, together with its marked tendency to bleed bleeding determinate a complicated diagnoses a difficult surgical approach (AU)

[Epidermoid cyst of the parapharyngeal space]. / Quiste epidermoide de espacio parafaríngeo.

Epidermal cysts of parapharyngeal location are very unusual tumors, with a benign character, though when they reach a great size, adjacent zones and vascular and nervous structures of great importance can be affected. We are going to describe the clinical aspects of this case, the instructions and the surgical approach used: the Fabre inferior and internal jaw approach of the lateropharingeal space and infrasphenotemporal fossa, which avoids the aesthetics and functional aftereffects of other more common approaches.

Quiste epidermoide de espacio parafaríngeo / Epidermal cyst of the parapharyngeal space

Los quistes epidermoides de localización parafaríngea son tumores muy infrecuentes, de carácter benigno, aunque cuando alcanzan un gran tamaño, pueden afectar a zonas vecinas y comprometer a estructuras vasculares y nerviosas de gran importancia. Presentamos las características clínicas de un caso, así como las indicaciones y la técnica quirúrgica empleada: abordaje inferior y mandibular interno de Fabre de la región laterofaríngea y fosa infraesfenotemporal, que evita las secuelas estéticas y funcionales de otras vías más utilizadas (AU)

Epidermal cysts of parapharyngeal location are very unusual tumors, with a benign character, though when they reach a great size, adjacent zones and vascular and nervous structures of great importance can be affected. We are going to describe the clinical aspects of this case, the instructions and the surgical approach used: the Fabre inferior and internal jaw approach of the lateropharingeal space and infrasphenotemporal fossa, which avoids the aesthetics and functional aftereffects of other more common approaches (AU)

[Survival rate in epidermoid carcinoma of the oral cavity]. / Supervivencia en el carcinoma epidermoide de cavidad oral.

The present study aims to analyse the survival of 94 patients with squamous cell carcinoma of the oral cavity. They were 86 men and 8 women with a mean age of 61. Seventy four percent were smokers and 70% consumed alcohol regularly. Eighty three percent had unhealthy teeth. A great majority of patients (76) were in the advanced stages (III-IV) and 61% showed neck nodules. The overall survival at 5 years was the following: 70% for patients in stage I, 85% in stage II, 58% stage III and only 17% for the patients in stage IV. The most significant prognostic factor that affected the survival was the N stage. For the patients in N0 and N1 we only found significant differences when the lymph nodes were histologically affected by the tumor.

Supervivencia en el carcinoma epidermoide de cavidad oral / Survival in epidermoid carcinoma oral cavity

Presentamos un estudio sobre 94 casos de carcinoma epidermoide de cavidad oral. La muestra consta de 86 varones, con una edad media de 61 años, siendo fumadores el 74 por ciento y bebedores regulares de alcohol el 70 por ciento. El 83 por ciento presentaba un estado buco-dental malo. La mayoría de los casos eran estadios avanzados III-IV (76 por ciento), con un 61 por ciento de adenopatías clínicamente significativas. La supervivencia a 5 años en estadio I fue del 70 por ciento, estadio II 85 por ciento, estadio III 58 por ciento y estadio IV 17 por ciento. Encontramos que la clasificación que tiene mayor valor pronóstico es la evaluación del estado ganglionar, pero en el caso de N0 y N1 la evaluación clínica es insuficiente, siendo necesario el estudio histológico tras la realización del vaciamiento ganglionar oportuno (AU)

The present study aims to analyse the survival of 94 patients with squamous cell carcinoma of the oral cavity. They were 86 men and 8 women with a mean age of 61. Seventy four percent were smokers and 70% consumed alcohol regularly. Eighty three percent had unhealthy teeth. A great majority of patients (76) were in the advanced stages (III-IV) and 61% showed neck nodules. The overall survival at 5 years was the following: 70% for patients in stage I, 85% in stage II, 58% stage III and only 17% for the patients in stage IV. The most significant prognostic factor that affected the survival was the N stage. For the patients in N0 and N1 we only found significant differences when the lymph nodes were histologically affected by the tumor (AU)

[First year of experience in laryngectomy and pharyngolaryngectomy with Pearson type laryngotracheal myomucosal shunt]. / Primer año de experiencia en laringectomías y faringolaringectomías con shunt miomucoso laringotraqueal tipo Pearson.

In this essay we deal with different aspects of the techniques described by Pearson and cols. in 1980, carrying out an analysis of objectives, indications and contraindications, physiological fundamentals, description of the surgical technique, aftercare and exposition of the results achieved in patients operated from September 1996-97.

[Vagal chemodectoma with atypical cells. Case report]. / Quemodectoma vagal con atipias celulares. Presentación de un caso.

We report a clinical case of vagal chemodectoma with cell atypies, which was presented as slowly growing neck mass without any other symptoms. At the beginning and due to the histologic report of the needle biopsy, which morphologic study based on cellular atypia was misinterpreted as a malignant tumor and with the images obtained by computed tomography (CT) suggesting a malignant neoplasia, we proceeded to approach the case as a metastatic tumor of unknown origin. We made a revision of the epidemiologic factors, and diagnostic and therapeutic management of this type of growths.

[Maxillary sinusitis caused by Aspergillus]. / TI: sinusitis maxilar por Aspergillus.

Naso-sinusal aspergillosis is an infrequent ailment which true incidence is not correctly assumed and furthermore the cases are increasing because of the progression of immunodeficiency problems. Suspicious become accentuated when repeated antibiotic treatments fail or in patients with previous dental pathology or radiologically show inside of sinus images of forcing bodies. Despite of which the diagnosis should be histological thanks to the examination of the surgical piece gained following the classic approaches through the canine fossa or endoscopic surgery. The only real treatment is surgery. We report one clinical case of an acute naso-sinusal aspergillosis with ineffectiveness of all used treatments and whose diagnose was achieved only through the anatomopathological study of the piece supplied by the Caldwell-Luc procedure.