[Cancer of the tonsillar region. Retrospective study and review of the literature]. / Cáncer de la región amigdalina. Estudio retrospectivo y revisión de la literatura.

It has been carried out a retrospective analysis of 34 patients suffering from carcinoma epidermoid of the tonsillar fossa being treated with two different therapies from 1989 to 1996. Twenty three of them were treated with surgery (transoral resection or bloc radical tonsillectomy with myocutaneous flap reconstruction and ipsilateral lymph node dissection). Eleven of them were treated with chemotherapy and radiotherapy. The rate of overall survival at 5 years were 41.2%. Actuarial survival rates were (71.4%) in stages I-II and 33.3% in stages III-IV (p = 0.08). On multivariate analysis, age (p = 0.28) and modality of treatment (p = 0.80) were not significant effect on survival. Advanced stages (III-IV) showed 3.4 times much more risk of death than early stages (I-II) (p = 0.11).

[Multi-dimensional analysis of vocal function. A case-control study]. / Análisis multidimensional de la función vocal. Estudio de casos y controles.

The aim of this study was to select the most appropriate methods for analyzing vocal function from an array of existing tests. A case-control study (64 patients and 64 controls) was made of teaching staff in Logroño, Spain. The 64 patients had 25 nodules, 7 polyps, 15 hyperfunctional dysphonia, 6 hypofunctional dysphonia, 6 submucosal suffusion and 5 chronic laryngitis. The study methods included anamnesis, ENT examination, videostrobolaryngoscopy, perceptual evaluation of hoarse voices, basic aerodynamic tests, the frequency range of phonation, physical analysis of the voice signal of the vowel /a/ and the sentence ìmi padre era castellanoî, and spectrographic analysis of Spanish vowels according to Yanagiharaís classification using Sound Scope 1.0 software. We found no single test that consistently differentiated between hoarse and normal voices; values always overlapped. In contrast the phonation quotient (PQ), maximum phonation time (MPT) of the vowel /a/, S/Z quotient (Eckel and Boone), frequency range of phonation, APQ (average perturbation quotient), HNR (harmonic-to-noise ratio), BR (breathiness, or the high-frequency content of the source wave), RAP (relative average perturbation), standard deviation (SD) of the fundamental frequency (F0) of the vowel /a/, intensity and SD of the sentence ìmi padre era castellanoî, and the sound spectrographic analysis of Spanish vowels disclosed statistically significant differences between hoarse and normal voices.

[Cordectomy. Review of cases treated in our department between 1984 and 1991]. / Cordectomías. Revisión de los casos tratados en nuestro Servicio entre los años 1984 y 1991.

Survey of the 49 glottic tumors, state T1, treated by the AA. at their Department between the years 1984 and 1991. Subperichondral cordectomy through the midsaggital plane and laryngotracheal dissection of middle area was the followed procedure. Description of outcomes and bibliographical review.

[Craniofacial development in secretory otitis]. / Desarrollo craneofacial en la otitis secretora.

The AA. consider in a population of 76 children, the connexion between bony palate, choanae and the M. tensor veli palatini and the occurrence of secretory otitis. They measured for this purpose several craniofacial structures "in vivo". Children suffering secretory otitis presented, contrary to children without aural pathology, a greater incidence of gothic palate (p < 0.001) and a significant decrease of both palatine (p < 0.05) and choanae (p < 0.001). All children showed going through puberty an palatinal and choanal growth as well a closure of the M. tensor veli palatini angle.

[Prevalence of voice disorders among educational professionals. Factors contributing to their appearance or their persistence]. / Estudio de la prevalencia de los trastornos de la voz en los profesionales de la enseñanza. Factores que intervienen en su aparición o en su mantenimiento.

A study was made of the prevalence of voice disorders and their risk factors in teaching professionals of Logroño, Spain. A prevalence and case-control study was made, including interviews, ENT examination, videostrobolaryngoscopy, perceptual evaluation of hoarseness, basic aerodynamic tests, the physical range of phonation, and a physical analysis of the acoustic signal. The prevalence of voice disorders among Logroño teachers was 17.7% (confidence interval: 12.1-25%). Nodular lesions (8.1%) were the most frequent pathology, followed by hyperfunctional dysphonia (4.1%), chronic laryngitis (2.7%), polyps (1.4%), hypofunctional dysphonia (0.7%), and submucous suffusion (0.7%). Voice disorders were more prevalent in women (19.3%) than in men (15.6%), and among teachers of the lowest grades: 36.4% in nursery schools, 25% in elementary school, and 20.8% in junior school. The width and depth of classrooms, larger number of students, longer classroom hours, and noise level were related with the frequency of voice disorders.

[Sudden deafness. Experience at our hospital]. / Sordera brusca. Experiencia en nuestro hospital.

A retrospective study was made of 60 patients (61 ears) who were hospitalized for the study and treatment of sudden hearing loss. Data were compiled on the hearing loss and hearing gain after treatment. Hearing loss was unrelated with age or the appearance of vestibular symptoms. After hemodilution, steroid, and vasodilator treatment, 47.6% showed a hearing gain of up to 20 dB. The gain was significantly less (p < 0.05) in patients suffering vertigo. It also was less in patients who delayed treatment and in those with severe hearing loss in the high-tone frequencies, but these differences did not reach significance. The recovery period ranged from 2 days to 2 months, with 48% showing improvement in the first week.

[The nasopharynx in secretory otitis media]. / La nasofaringe en la otitis media secretora.

INTRODUCTION: Nasopharyngeal airway obstruction by adenoidal tissue was studied in children with otitis media with effusion compared with children with healthy ears. Adenoidal and nasopharyngeal development with age also were studied. PATIENTS AND METHODS: The study included 44 children with bilateral effusive otitis media and 32 children without ear disease, all of whom were scheduled for adenoidectomy. In a preoperative lateral radiograph of the nasopharyngeal cavity, adenoidal tissue and the nasopharynx were measured. Adenoidal volume and weight were measured after surgery. RESULTS: The group with effusive otitis media had a larger adenoidal volume, smaller nasopharyngeal cavity, and greater nasopharyngeal airway obstruction (all significant differences) than children without ear disease. All the children had an increase in the nasopharyngeal cavity with age and a decrease in adenoidal volume and nasopharyngeal obstruction after the age of seven years.

[Functional surgery of cholesteatoma. I. Closed techniques]. / Consideraciones sobre la cirugía funcional del colesteatoma. I. Técnicas cerradas.

A review was made of 138 ears treated with walled-up canal tympanoplasty for chronic otitis media with cholesteatoma. In 66.7% of the ears, two-stage operations were performed. Cholesteatomas were located in the attic (72.5%), mesotympanum (42.8%), antrum (39.1%), and mastoid (11.6%). The most common lesion of the ossicular chain was incus necrosis (61.6%). Total ossicular replacement prosthesis (TORP) (56.5%), partial ossicular replacement prosthesis (PORP) (21.7%), mastoid cortical bone autograft (13%), and incus autograft (8.7%) were used to reconstruct the ossicular chain. After three years, 56.5% of the operated cars were free of complications. The rest had the following complications: recurrence of cholesteatoma (17.4%), perforation of the neotympanum (12.5%), prosthesis extrusion (9.4%), and episodes of otorrhea (4.2%). The best functional results were obtained with autografts (cortical and incus) and TORP.

[Calcitonin and otosclerosis: a preliminary clinical note]. / Calcitonina y otosclerosis: nota clínica preliminar.

Otosclerosis is a disorder characterized by alternating periods of bone resorption and formation as a result of a disturbance in the enzymatic balance of the otic capsule and stapedial footplate. In some cases, calcitonin administration improved the metabolic abnormalities associated with the disease. This hormone inhibits bone resorption produced by osteoclasts and facilitates osteoblastic accretion. The authors describe the results obtained in a patient with aggressive otosclerosis who experienced an improvement in hearing and tinnitus after treatment with salmon calcitonin.

[Surgical pathology of parotid gland tumors]. / Patología quirúrgica tumoral de la parótida.

The records of 27 patients operated for parotid tumors were reviewed retrospectively. Pleomorphic adenoma was the most frequent tumor (37.1%) and required subtotal parotidectomy in all cases. Twenty percent presented permanent facial paralysis of the marginal mandibular branch. No recurrence has been observed in five years of follow-up. Warthin's tumor, found in 11.1% of patients, was removed by either superficial or subtotal parotidectomy. Parotidean cysts were observed in 7.4% and were excised by superficial parotidectomy. The malignant tumors included squamous cell carcinoma (22.2%), adenoid cystic carcinoma (14.8%), melanoma (3.7%), and renal-cell metastasis (3.7%). All were treated by total parotidectomy with conservation of the facial nerve in 67%. Twenty-five percent had postoperative facial paralysis and 33% developed Frey's syndrome. Thirty-three percent died in the next 5 years from locoregional metastases.

[Considerations regarding functional cholesteatoma surgery. II. Open techniques]. / Consideraciones sobre la cirugía funcional del colesteatoma. II. Técnicas abiertas.

A review was made of 128 canal wall-down tympanoplasties for chronic otitis media with cholesteatoma. The cholesteatoma was found in the attic (82.4%), antrum (71.7%), mastoid (45.8%), and mesotympanum (35.8%). In 89.1% of cases there was ossicular chain injury. In 39%, the ossicular chain was partially reconstructed (modified canal wall-down tympanoplasty). After one year, 84.4% of the operated ears were safe, dry and self-cleaning. The others (15.6%) had postoperative otorrhea. Canal wall-down modified mastoidectomy achieved closure of the air-bone gap from 40 to 24 dB (p < 0.001).

[Study of the nasopharyngeal microflora obtained by a cotton swab]. / Estudio de la flora microbiana nasofaríngea mediante up hisopo nasal.

Whether or not a representative sample of the nasopharyngeal microflora can be obtained by introducing a cotton swab through the nasal cavity has been evaluated. Also, a correlation between these results and those achieved from the middle ear effusions, has been searched. Ninety adenoidectomy-pending children, fifty of whom also presented otitis media with effusion, were included in the study. The research showed that there were a coincidence (p < 0.001) among the results obtained from the nasal cotton swab, those obtained from cultures of adenoid biopsies and the middle ear effusions.

[The microbiology of secretory otitis]. / Microbiología de la otitis seromucosa

The AA. realize a comparative study on the differences between the nasopharyngeal microbial flora of 50 children suffering a secretory otitis and other 40 children without middle ear disease. In nasopharyngeal cultures the pathogenic flora (Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, Streptococcus beta hemoliticus group A, Staphilococcus aureus) amounted for 96 percent in children with secretory otitis, which figure was reduced to 80 percent in healthy infants (p < 0.05). Haemophilus influenzae was the most identified microorganism in a both nasopharyngeal and otic flora. We have found a significative association (p < 0.001) among nasopharyngeal and otic flora of each individual.