[Peritonsillar infection. Out-patient management]. / Infecciones del espacio periamigdalar. Manejo ambulatorio.

INTRODUCTION: Peritonsillar infections are the most frequent deep infections in head and neck. The estimated annual incidence is 30 cases per 100.000 inhabitants. PATIENTS AND METHODS: A retrospective study was undertaken in 132 patients with peritonsillar infection. A diagnostic and therapeutic protocol was used consisting on diagnostic needle aspiration, incision and drainage and intravenous antibiotic and steroids. RESULTS: 35,6% were peritonsillar phlegmons and 64,4% were abscesses. The median of hospital monitoring was 9,2 hours. Only 25,8% were admitted to the hospital. Six patients had recurrences of the symptoms during the study. DISCUSSION: The needle aspiration is useful in differential diagnosis between phlegmons and abscesses. Bacteriologic studies are not necessary in the routine management of peritonsillitis. Surgical treatment of these patients is controversial. Incision and drainage seems to be appropiated in the management of this pathology. Admission to the hospital is not always necessary if a correct outpatient control is possible.

[Parotid gland myoepitheliomas. Differential diagnosis with pleomorphic adenoma]. / Mioepiteliomas de glándula parótida. Diagnóstico diferencial con el adenoma pleomorfo.

Myoepitheliomas are rare benign tumours of head and neck. The parotid gland is the most common site of origin. It consists on proliferation of myoepithelial cells and it shows some features similar to preomorphic adenoma although the ductal elements are very low. Diagnosis requires histology and immunohistochemistry because fine needle aspiration often shows erroneous results. Limited parotidectomy is the choice treatment. We report two cases of parotid gland myoepithelioma confirmed by immunohistochemistry.

Infecciones del espacio periamigdalar. Manejo ambulatorio / tittle

Introducción: las infecciones periamigdalares son las infecciones profundas más frecuentes de cabeza y cuello. Se estima una incidencia anual de 30 casos por 100.000 habitantes. Material y Métodos: realizamos un estudio retrospectivo de 132 casos de infección periamigdalar. Se aplicó un protocolo diagnóstico y terapéutico mediante punción aspirativa, incisión y drenaje y tratamiento con antibiótico y glucocorticoide. Resultados: el 35,6% son flemones y el 64,4% son abscesos periamigdalares. La mediana de estancia hospitalaria de los pacientes fue de 9,2 horas. Únicamente un 25,8% requirieron ingreso hospitalario. En 6 pacientes se produjo más de un episodi. Discusión: para diferencial si se trata de un flemón o absceso se puede hacer una punción aspirativa. Los estudios microbiológicos no se consideran necesarios de forma rutinaria. El tratamiento de estos pacientes es controvertido. La incisión y drenaje parece ser una buena opción para el manejo de la patología. El ingreso hospitalario no es necesario si es posible realizar un correcto control ambulatorio

Introduction: Peritonsillar infections are the most frequent deep infections head and neck. The estimated annual incidence is 30 cases per 100.000 inhabitants. Patients and methods: A retrospective study was undertaken in 132 patients with peritonsillar infection. A diagnostic and therapeutic protocol was used consisting on diagnostic neddle aspiration, incision and drainage and intravenous antibiotic and steroids. Results: 35,6% were peritonsillar phlegmons and 64,4% were abscesses. The median of hospital monitoring was 9,2 hours. Only 25,8% were admitted to the hospital. Six patients had recurrences of the symptoms during the study. Discussion: The needle aspiration is useful in differential diagnosis between phlegmons and abscesses. Bacteriologic studies are not necessary in the routine management of peritonsillitis. Surgical treatment of these patients is controversial. Incision and drainage seems to be appropiated in the management of this pathology. Admission to the hospital is not always necessary if a correct outpatient control is possible

Mioepiteliomas de glándula parótida. Diagnóstico diferencial con el adenoma pleomorfo / Parotid gland myoepitheliomas. Differential diagnosis with pleomorphic adenoma

Los mioepiteliomas son tumores benignos poco frecuentes de cabeza y cuello. El lugar de aparición más frecuente es la glándula parótida. Están formados por la proliferación de células mioepiteliales. Presentan algunas características que los asemejan a los adenomas pleomorfos, pero el componente ductal es muy inferior. El diagnóstico requiere el estudio, histológico e inmunohistoquímico porque a menudo la PAAF arroja resultados erróneos. El tratamiento de elección es la parotidectomía limitada. Presentamos 2 casos clínicos de mioepitelioma de glándula parótida confirmados mediante estudio inmunohistoquímico

Myoepithelioma are rare benign tumours of head and neck. The parotid gland is the most common site of origin. It consists on proliferation of myoepithelial cells and it shows some features similar to pleomorphic adenoma although the ductal elements are very low. Diagnosis requires histology and immunohistochemistry because fine ceedle aspiration often shows erroneous results. Limited parotidectomy is the choice treatment. We report two cases of parotid gland myoepithelioma confirmed by immunohistochemistry

[Extramedullary plasmacytoma of the nasopharynx. Typical versus atypical presentation]. / Plasmocitoma extramedular de nasofaringe. Presentación tipica versus presentación atípica.

Extramedullary plasmacytoma are rare plasma cell neoplasias. Eighty percent of these tumours grow in the ENT region. We report a typical case of a woman with a single tumour in the nasopharynx. Actually she is in complete remission after surgical and radiotherapic treatment. We also report an atypical case of a woman with a tumour in the nasopharynx associated with a cervical metastatic adenopathy and a plasmacytoma of bone. The treatment of this widespread disease was systemic chemotherapy. An update on this subject is done.

Plasmocitoma extramedular de nasofainge / Extramedullary plasmacytoma of the nasopharinx. Typical versus atypical presentation

Los plasmocitomas extramedulares son neoplasias de células plasmáticas poco frecuentes. El 80% de estos tumores se originan en el territorio ORL. Presentamos un caso típico de una mujer con un tumor único en nasofaringe. Actualmente está en remisión completa tras cirugía y radioterapia. También presentamos un caso muy atípico de una mujer con un tumor en nasofaringe asociado a una adenopatía metastásica cervical y un foco de plasmocitoma óseo. En este caso debió realizarse tratamiento sistémico con quimioterapia. Realizamos una actualización sobre el tema

Extramedullary plasmacytoma are rafe plasma cell neoplasias. Eighty percent of these tumours grow in the ENT region. We report a typical case of a woman with a single tumour in the nasopharynx. Actually she is in complete remission after surgical and radiotherapic treatment. We algo report an atypical case of a woman with a tumour in the nasopharynx associated with a cervical metastatic adenopathy and a plasmacytoma of bone. the treatment of this wide spread disease was systemic chemotherapy. An update on this subject is done