[The role of video-nystagmography in the diagnosis of acoustic neuroma]. / El papel de la videonistagmografía en el diagnóstico del neurinoma del acústico.

AIM: Schwannoma of the vestibular nerve represents 75% of all expansive processes affecting the pontocerebellosum angle. Hearing loss is the most frequent symptom at diagnosis (86%) with or without tinnitus, in the intracanalicular tumors. Vestibular symptoms are described in 60% of patients. MATERIAL AND METHOD: We study twenty cases of acoustic neuromas diagnosed between years 2000 and 2002 in both Otolaryngology and Neurosurgery Departments in our hospital. Videonystagmography (VNG) was performed in all of them. Videonystagmographic findings were analyzed statistically together with the tumoral size and hypoacusia level. DISCUSSION AND CONCLUSION: According to the medical literature reviewed for this paper, we conclude that caloric tests are the most frequently altered ones (77%), showing vestibular hyporreflexia or arreflexia.

[Non-benign paroxysmal positional vertigo]. / Vértigo posicional paroxístico no benigno.

Positional vertigo is a frequent clinical manifestation of vertigo of very different etiologies, being the benign paroxystic positional vertigo (BPPV) the most frequent one of them, representing in some series even the most found etiology of peripheral vertigo. Usually of severe entities, positional vertigo may appear in the context of severe entities and of difficult diagnosis. In these cases, the bearing of the symptoms in spite of the repositioning manoeuvers, the association with otological or neurological symptoms, and the atypical nystagmus evoked by Dix-Hallpike manoeuver, must take the otolaryngologist to suspect of a feasible non benign pathology. We report a case of positional paroxysmal vertigo caused by an intracranial tumour and we review the clinical signs that shoved help us to suspect of non benign pathologies that can mimic a positional vertigo.

[Cordectomy in the surgical treatment of tumors T1 of the vocal cords. Review of our cases (1974-1990)]. / La cordectomía en el tratamiento quirúrgico de los tumores T1 de cuerda vocal. Revisión de nuestra casuística (1974-1990).

We decided to review the results of cordectomy in our surroundings over the 22 years of existence of our Service. 631 clinic histories of patients undergoing surgery for laryngeal cancer in our Department, between 1974 and 1990, were reexamined, and from those selected 56 pertaining to T1 tumors treated with cordectomy. In this reduced group were studied epidemiology, clinical and pathologic data, complications, survival and death causes as well. The 58 considered were of male sex, middle aged (58-86) excepting 9 patients under 50. Their relation with tobacco eas clear, although less than in our general series (87.93% smokers). Of the 58 patients group 4 of then disappear during the 5 years follow-up term (8.62%). Three died: one from ganglion disease, other from local recurrence and the last one from other condition. In brief, global survival are accounted for 94.34% and the adjusted survival was 96.1%.

[Surgery of cancer of the larynx. Analysis of the results of our cases]. / Cirugía del cáncer de laringe. Análisis de resultados de nuestra casuística.

After 20 years of existence of this Department we decided to carry out a review of the characteristics of our series and also of the results of treatment, according to the protocol elaborated and followed in agreement with the Tumour Committee if the Hospital. 631 medical histories of patients diagnosed and operated for cancer of larynx between 1974 and 1990 were reviewed. 83 of which (13.154%) disappeared during the 5 year follow-up period. Epidemiological, clinical, location, extension and treatment fdata were considered as well as the survival results and a single descriptive statistical analysis performed. The mean age of our study was 59.02 years, showing a clear relation to exposure to tobacco (91.44% were smokers and 63.39% of more than 20 cigarettes per day). The predominant location of the growth was supraglottic (64.05% of cases) followed by glottic in 33.76%. The most frequently used surgical technique was the total laryngectomy and total and extended to either the pharynx or tongue basis in 76.28%, followed by supraglottic laryngectomy in 13m5%. The stages were rather advanced with predominance of stage III /40.60%) and stage IV (21.17%). Global survive rate of our series accounted for 68.61% while the adjusted survival rate was 71.4%.

[Benign positional paroxysmal vertigo in the general ear, nose, and throat clinic]. / El vértigo posicional paroxístico benigno en la consulta de ORL general.

Benign positional paroxysmal vertigo is a common disease which may be caused by abnormal movement of utricular debris in the posterior semicircular canal. It is diagnosed by the Dix-Hallpike positional maneuver eliciting vertigo and nystagmus. Treatment generally consists of physical exercises with the Epley or Semont maneuvers. We review 43 consecutive patients diagnosed as BPPV in the last year and treated with physical therapy (Epley maneuvers). Results were very good, with a cure rate of 88.37% (53.5% after a single maneuver). Physical therapy is an effective treatment for BPPV.

[Mortality in laryngeal cancer surgery]. / Mortalidad en la cirugía del cáncer de laringe.

UNLABELLED: The causes of death were studied in a series of 171 patients who died in a 5-year follow-up period, out of a total of 631 patients who underwent different surgical techniques for cancer of the larynx. MATERIAL AND METHODS: The case histories of 631 patients who had undergone surgery between 1974 and 1990 were reviewed; 83 did not have a 5-year follow-up and were excluded from the study. A descriptive and inferential statistical study was made of the remaining cases to determine the relation between cause of death and tumoral extension, primary location, degree of tumoral differentiation, surgical technique and other data. RESULTS: Ninety-one patients died from local or regional recurrence, 50 from distant metastases, 20 from diseases other than the tumor, and 10 from postoperative complications. These findings were studied with regard to factors such as tumor extension, location, surgical technique, etc. CONCLUSIONS: The main cause of death in surgery for cancer of the larynx was recurrence, either local, on the tumor bed (62 patients) or regional (29 patients). The mortality rate was higher in older patients, patients with lymph-node involvement in the postoperative histological study, and patients with less differentiated histological forms.

[Hypernephroma metastasis in frontal sinus]. / Metástasis de hipernefroma en seno frontal.

PURPOSE: We present a case of metastatic neoplasia in the right frontal sinus derived from and hypernephroma, with a clinical picture that initially was interpreted as a mucocele. PATIENTS AND METHODS: Sixty years old male. Personal history: prostatectomy and left nephrectomy because of hypernephroma three years before. In december 92 the patient reported a protrusion in the right frontal sinus. CT scans and NMR revealed a breakage of the external and internal walls of the right frontal sinus and the right orbital roof. In february 93 a surgical exploration of the frontal sinus revealed the metastatic nature of the lesion. DISCUSSION: Metastatic tumors in paranasal sinuses are infrequent since most of the tumors in this localization are primary. Metastatic affectation of the frontal sinus is extremely rare. We recommend the systematic exploration of paranasal sinuses in patients affected by hypernephroma.

[Pleomorphic adenoma of the nasal wall. Revision]. / Adenoma pleomorfo de tabique nasal. Revisión.

The pleomorphic adenoma is the most common neoplasm of the salivary glands, especially the parotid. It can also be originated from minor salivary glands and may appear in nasal cavities and paranasal cavities. We showed a case of pleomorphic adenoma of nasal septum and, at the same time, we reviewed all related bibliography.

[Solitary extramedullary plasmocytoma of the nasal cavity]. / Plasmocitoma extramedular solitario de cávum.

A case of Extramedullary Plasmacytoma of nasopharynx is reported in a 41 years old man. The presenting symptom was bilateral nasal obstruction. Multiple Myeloma was excluded. The treatment was surgical excision and postsurgical radiotherapy. At present the patient is well.

[Juvenile nasopharyngeal angiofibroma. Apropos of a case]. / Angiofibroma nasofaríngeo juvenil. A propósito de un caso.

We present the case of a 14 years old male with juvenile nasopharyngeal angiofibroma, treated in our Department with radiotherapy due to the patient having declined surgery. In the control carried out 2 years after finishing radiotherapy the tumour had disappeared. Up to now, we have not found important secondary effects of the treatment. We go over what has been published during the last few years about this disease.

[Cancer of the nasopharynx: our experience with 34 cases]. / Cáncer de nasofaringe: nuestra experiencia con 34 casos.

Thirty four cases of patients with nasopharyngeal cancer, all white people, are reviewed. The more frequent clinical signs are, in order of frequency: nasal obstruction, which is presented in 65% of patients, transmission deafness, in 59%; adenomegalies in 44%; epistaxis in 26% and migraine in 21% of cases. The mean time evolution between the first clinical symptom and the treatment was four and a half months. The pathologic study was: epidermoid carcinoma in 31 cases (91.9% and non-Hodgkin lymphoma in 3 cases 8.9%). The 31 cases of epidermoid carcinoma were treated with radiotherapy and the 5 years survival was 38%. In 62% of cases, the tumor recurred locally, in lymph nodes or were distant metastasis.

[Intracranial invasion of a tumor of the ear]. / Invasión intracraneal de un tumor ótico.

A 55 years old woman with a neoplasm originating in ceruminous glands of the external auditory canal, with temporal bone and intracranial invasion, mimicking a glomus jugulare tumor. This group of neoplasms, rare in man, are best treated by and aggressive wide "en bloc" temporal bone and contiguos structures resection. In our review few similar cases are found.

[Malignant tumor of the external auditory canal]. / Tumoración maligna de conducto auditivo externo.

The neoplasms from the modified apocrine glands of the external auditory canal are usually included under the term ceruminoma without any reference to their histology, clinical course or prognosis. It seems better to classify them according to their histologic pattern in the following types: 1.--Ceruminous adenoma, 2.--Adenoid-cystic carcinoma, 3.--Adenocarcinoma, and 4.--Pleomorphic adenoma (mixed tumour). We describe a case of adenoid-cystic carcinoma originated at postero-superior wall of the external auditory canal which presented as an otitis of long duration, and was treated surgically and received post-operative radiotherapy. The patient is at present free of disease. We review the literature on this group of tumours of the EAC.

[Ethmoido-frontal mucocele. Apropos of a clinical case]. / Mucocele etmoido-frontal. A propósito de un caso clínico.

We presented a case of a 60 years old woman, with a previous history of an intervention upon the frontal sinus 35 years ago, who was diagnosed and operated at our service from mucocele of frontal sinus. We profit this occasion to carry through a revision of bibliography, to contribute at better knowledge of mucoceles about their clinic, pathogenic, diagnostic and therapeutic aspects.

[Malignant oncocytoma of the parotid gland. Study with the optical and the electron microscope]. / Oncocitoma maligno de glándula parótida. Estudio con microscopio óptico y electrónico.

Salivary gland oncocytomas are very rare tumors with very few malignant cases reported in the literature. We present in this work a malignant oncocytoma of the parotid gland, and make a summary of all the accepted criteria in the reviewed publications as definitive of oncocytoma and malignant oncocytoma of the salivary gland, and furthermore we make a differential diagnosis with other neoplasms.