ABSTRACT
Hypoglossal-facial anastomosis was performed in four patients with total peripheral facial palsy after removal of cerebellopontine tumors (three patients with neurinoma) and pontine aneurysm (one patient). The anastomosis was performed after a period of 3 months to one year from surgery. The results obtained, concerning the facial activity, were clinically valued according to the tests used (questionnary, and the House-Brackmann paralysis index); the EnOG was used for its electrophysiological assessment. The follow-up period was 4 years with a good facial recovery in three patients and poor in one (class V, 27% in ENoG). We observe that the improvement in function greatly depends on the early surgical process performance.
Subject(s)
Facial Nerve/surgery , Facial Paralysis/surgery , Hypoglossal Nerve/surgery , Adult , Anastomosis, Surgical , Female , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
Realizamos anastomosis hipogloso-facial en cuatro pacientes que presentaban una parálisis facial completa aparecida, en tres casos, tras la exéresis quirúrgica de un neurinoma del acústico y en uno tras la presencia de un proceso expansivo hemorrágico protuberancial. El tiempo transcurrido entre la intervención quirúrgica y la anastomosis hipogloso-facial estaba entre 3 y 12 meses. Los resultados obtenidos fueron valorados en la clínica siguiendo un cuestionario estandarizado y la clasificación de House- Brackmann y electrofisiológicamente mediante la electroneuronografía (ENoG). El seguimiento de los pacientes se realizó durante 4 años obteniendo buenos resultados en el movimiento facial en tres pacientes (2 pacientes grado II y 38-40% en la ENoG y un paciente grado III y 35% en la ENoG) y en un paciente fue pobre (grado V y 27% en la ENoG). Concluimos que la anastomosis hipogloso-facial da resultados satisfactorios en la recuperación de la motilidad facial fundamentalmente cuando es realizada de manera temprana a la presencia de la parálisis facial
Hypoglossal-facial anastomosis was performed in four patients with total peripheral facial palsy after removal of cerebellopontine tumors (three patients with neurinoma) and pontine aneurysm (one patient). The anastomosis was performed after a period of 3 months to one year from surgery. The results obtained, concerning the facial activity, were clinically valued according to the tests used (questionnary, and the House-Brackmann paralysis index); the EnOG was used for its electrophysiological assessment. The follow-up period was 4 years with a good facial recovery in three patients and poor in one (class V, 27% in ENoG). We observe that the improvement in function greatly depends on the early surgical process performance
Subject(s)
Male , Female , Middle Aged , Adult , Humans , Facial Paralysis/surgery , Hypoglossal Nerve/surgery , Facial Nerve/surgery , Anastomosis, Surgical , Follow-Up StudiesABSTRACT
Se realiza un estudio con potenciales evocados auditivos de tronco cerebral en 50 recién nacidos que no han pasado el examen con otoemisiones acústicas transitorias evocadas. 27 neonatos (54 por ciento) no refieren antecedentes familiares de hipoacusia neurosensorial ni están incluidos en los grupos de riesgo. Verificamos ausencia de registro de PETC en 35 (70 por ciento) de los 50 bebés examinados. Durante su seguimiento confirmamos normoaudición en 21 (60 por ciento) y distinto grado de disfunción auditiva en 14 (40 por ciento). Necesitamos un intervalo de tiempo comprendido entre uno y nueve meses para llevar a cabo un diagnóstico definitivo (AU)
Auditory Brainstem Response (ABR) of 50 newborn with negative transient evoked acoustic emissions (OEAT) was performed. 54% of them had no family history of sensorineural hearing loss (SHNL) and no risk factors were found. In 70% of cases ABR recording was negative. Follow up did show that 60% of them had normal recordings of hearing and in a 40% different stages of hearing loss were seen. To establish a definitive diagnosis a 1 to 9 month period is necessary (AU)
Subject(s)
Infant, Newborn , Humans , Female , Male , Otoacoustic Emissions, Spontaneous , Evoked Potentials, Auditory, Brain Stem , Deafness/congenital , Hearing Loss, Sensorineural/congenital , Neonatal Screening/methods , Hearing Loss, Bilateral , Spain/epidemiologyABSTRACT
La electroneurografía (EnoG) es una herramienta utilizada como método de valoración pronóstica en la parálisis facial periférica. Creemos que cuando se realiza en condiciones estandarizadas y se asocia al enjuiciamiento clínico evolutivo del paciente es adecuada para indicarnos el momento crítico en el que se debe plantear utilizar una modalidad de tratamiento más radical. Nuestro estudio se realiza en 44 pacientes de los que 13 presentaban denervación fibrilar superior al 90 por ciento. Una mala recuperación clínica nos lleva a realizar descompresión quirúrgica del nervio facial en 5 pacientes con restitución a la normalidad en tres de ellos (AU)
Electroneurography (EnoG) is a prognostic test used in the assessment of the peripheral facial nerve paralysis. We believe that when performed in standard conditions and together with the clinical evolutive parameters, it is very useful to reveal the critical time for a more radical treatment. We studied 44 patients; 13 patients had greater than 90% neural degeneration on EnoG. 5 of them underwent facial nerve surgical decompression due to a poor clinical outcome and up to three of these patients had a normal facial function after this (AU)
Subject(s)
Male , Female , Humans , Aged , Adult , Adolescent , Middle Aged , Aged, 80 and over , Child , Neural Conduction , Facial Paralysis/diagnosis , Electrodiagnosis/methods , Reproducibility of Results , Treatment Outcome , Disease Progression , Decompression, Surgical , Prognosis , Recurrence , PrognosisABSTRACT
240 patients with chronic otitis media (COM) were studied: 166 ears termed as non cholesteatomatous otitis media and 74 with cholesteatoma. In 38 ears an aural polyp was found with no evidence of cholesteatoma in 19 ears (11.4%) whereas a cholesteatoma was present in the remaining 19 ears. The histology of the polyp and the characteristics of the chronic process were matched: a) The aural polyp is an infrequent complication in COM. b) After histological analysis was found to present two different pictures: The inflammatory reaction polyp, present in non cholesteatomatous COM; and the polyp with granulation tissue and foreign body reaction (keratina) usually found in cholesteatomatous COM. c) The finding of granulation tissue reaction and keratina in an aural polyp is a good predictor for the presence of a cholesteatoma.
Subject(s)
Ear, Middle , Otitis Media/complications , Polyps/complications , Cholesteatoma, Middle Ear/pathology , Chronic Disease , Diagnosis, Differential , Ear, Middle/surgery , Granulation Tissue/pathology , Humans , Polyps/pathology , Polyps/surgeryABSTRACT
Se estudian 240 pacientes que presentaron una otitis media crónica, de los cuales 166 fueron diagnosticados como "no colesteatomatosa" y 74 como "colesteatomatosa". En 38 casos (15,8 por ciento) existía un pólipo aural, de los cuales en 19 casos (11,4 por ciento) coincidía con una OMC no colesteatomatosa y en 19 casos (25,7 por ciento), con una OMC colesteatomatosa. Se realiza el estudio histopatológico del pólipo y su relación con la patología inflamatoria de oído medio, llegándose a las conclusiones siguientes: a) el pólipo aural es una complicación poco frecuente (15,8 por ciento) de la otitis media crónica; b) el pólipo aural diagnosticado histopatológicamente como "inflamatorio" se presenta predominantemente en la OMC no colesteatomatosa (72,3 por ciento); c) el pólipo aural diagnosticado histopatológicamente como "tejido de granulación y reacción a cuerpo extraño (material queratínico)" se presenta predominantemente en la OMC colesteatomarosa (68,4 por ciento); d) la presencia de un pólipo diagnosticado histopatológicamente como " tejido de granulación y reacción a cuerpo extraño (material queratínico)" es predictivo de una OMC colesteatomatosa aunque no patognomónico de ella. (AU)
240 patients with chronic otitis media (COM) were studied: 166 ears termed as non cholesteatomatous otitis media and 74 with cholesteatoma. In 38 ears an aural polyp was found with no evidence of cholesteatoma in 19 ears (11.4%) whereas a cholesteatoma was present in the remaining 19 ears. The histology of the polyp and the characteristics of the chronic process were matched: a) The aural polyp is an infrequent complication in COM. b) After histological analysis was found to present two different pictures: The inflammatory reaction polyp, present in non cholesteatomatous COM; and the polyp with granulation tissue and foreign body reaction (keratina) usually found in cholesteatomatous COM. c) The finding of granulation tissue reaction and keratina in an aural polyp is a good predictor for the presence of a cholesteatoma (AU)
Subject(s)
Humans , Ear, Middle/surgery , Otitis Media/complications , Polyps/complications , Cholesteatoma, Middle Ear/pathology , Chronic Disease , Diagnosis, Differential , Granulation Tissue/pathologyABSTRACT
Auditory Brainstem Response (ABR) of 50 newborn with negative transient evoked acoustic emissions (OEAT) was performed. 54% of them had no family history of sensorineural hearing loss (SHNL) and no risk factors were found. In 70% of cases ABR recording was negative. Follow up did show that 60% of them had normal recordings of hearing and in a 40% different stages of hearing loss were seen. To establish a definitive diagnosis a 1 to 9 month period is necessary.
Subject(s)
Deafness/congenital , Evoked Potentials, Auditory, Brain Stem , Hearing Loss, Sensorineural/congenital , Neonatal Screening/methods , Otoacoustic Emissions, Spontaneous , Deafness/diagnosis , Deafness/epidemiology , Female , Hearing Loss, Bilateral/congenital , Hearing Loss, Bilateral/diagnosis , Hearing Loss, Bilateral/epidemiology , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/epidemiology , Humans , Infant, Newborn , Male , Spain/epidemiologyABSTRACT
Electroneurography (EnoG) is a prognostic test used in the assessment of the peripheral facial nerve paralysis. We believe that when performed in standard conditions and together with the clinical evolutive parameters, it is very useful to reveal the critical time for a more radical treatment. We studied 44 patients; 13 patients had greater than 90% neural degeneration on EnoG. 5 of them underwent facial nerve surgical decompression due to a poor clinical outcome and up to three of these patients had a normal facial function after this.
Subject(s)
Electrodiagnosis/methods , Facial Paralysis/diagnosis , Neural Conduction , Adolescent , Adult , Aged , Aged, 80 and over , Child , Decompression, Surgical , Disease Progression , Facial Paralysis/surgery , Female , Humans , Male , Middle Aged , Prognosis , Recurrence , Reproducibility of Results , Treatment OutcomeABSTRACT
Diffuse idiopathic skeletal hyperostosis (DISH) with cervical involvement which cause dysphagia is a rare disease. The otolaryngologist usually can make its diagnostic with a barium swallowing esophagogram. Two patients with DISH are reported.
Subject(s)
Esophagus/diagnostic imaging , Esophagus/physiopathology , Hyperostosis, Diffuse Idiopathic Skeletal/diagnosis , Hyperostosis, Diffuse Idiopathic Skeletal/physiopathology , Aged , Female , Humans , Male , Middle Aged , RadiographyABSTRACT
La enfermedad de Forestier (DISH) es una entidad que puede ser la culpable de la disfagia que presenta el paciente que acude a la consulta del especialista en ORL.No obstante, debido a la rareza de la misma dentro del área Otorrinolaringológica su diagnóstico ha de ser hecho siempre por exclusión. Un esofagograma con contraste baritado suele ser, la mayoría de las veces, una prueba suficientemente objetiva para verificar la presencia de osteofitos a nivel cervical. En este trabajo presentamos dos casos de DISH que causan disfagia (AU)
Diffuse idiopathic skeletal hyperostosis (DISH) with cervical involvement which cause dysphagia is a rare disease. The otolaryngologist usually can make its diagnostic with a barium swallowing esophagogram. Two patients with DISH are reported (AU)
Subject(s)
Middle Aged , Aged , Male , Female , Humans , Hyperostosis, Diffuse Idiopathic Skeletal/diagnosis , Esophagus/pathology , Hyperostosis, Diffuse Idiopathic Skeletal/physiopathology , RadiographyABSTRACT
La intubación difícil es una entidad poco frecuente, pero no rara, que debe ser investigada sistemáticamente en el preoperatorio por un examen clínico riguroso. Se estudian las diferentes etapas del examen clínico y las etiologías responsables haciendo especial referencia a las del área otorrinolaringológica (AU)
Subject(s)
Female , Male , Humans , Intubation, Gastrointestinal/adverse effects , Intubation, Gastrointestinal/methods , Intubation, Gastrointestinal , Intubation, Gastrointestinal , Intubation/classification , Intubation/adverse effects , Intubation/methods , Intubation , Glottis/surgery , Glottis , Glottis/physiopathology , Respiratory Tract Diseases/complications , Respiratory Tract Diseases/surgery , Anesthesia , Anesthesia/adverse effects , Anesthesia/methods , Tooth Mobility/complications , Head Movements/physiology , Obesity/complications , Acromegaly/complications , Intraoperative Complications/diagnosis , Intraoperative Complications/epidemiology , Intraoperative Complications/surgery , Intubation, Intratracheal , Intubation, Intratracheal/instrumentation , Intubation, Intratracheal/methods , Anesthesia, Endotracheal , Anesthesia, Endotracheal/methods , Anesthesia, Endotracheal/instrumentation , Laryngoscopy/methods , Airway Obstruction/surgery , Airway Obstruction/complications , Airway Obstruction/diagnosis , Neck Muscles/abnormalities , Neck Muscles/physiopathology , Hypertrophy/complications , Foreign Bodies/complications , Respiratory System/pathology , Pharyngeal Neoplasms/complicationsABSTRACT
En un estudio prospectivo, se determinó la concentración plasmática de cortisol a las 9.00 horas y se realizó estudio histopatológico de especímenes biópsicos tomados en el comete inferior a 40 pacientes diagnosticados de rinitis alérgica perenne y que habían sido sometidos a tratamiento tópico con Budesonide durante meses o años. En. un solo paciente se observó elevación del nivel del cortisol plasmático y no cambios significativos fueron observados en el estudio histopatológico. Estos hallazgos sugieren que el uso tópico de Budesonide durante largo tiempo no afecta la morfología de la mucosa nasal ni tiene repercusión sistémica significativa (AU)
In a prospective study, measurement of a 9.00 a.m. basal serum cortisol and biopsies of the inferior turbinate mucosa were taken from 40 patients using topical nasal corticosteroid (Budesonide) continuously for month or years. No systemic adverse effects and no histopathological changes of significance were found. These findings do no suggest that topically corticosteroids are harmful to the nasal mucosa and no produce systemic effects (AU)
Subject(s)
Middle Aged , Adult , Adolescent , Male , Female , Humans , Nasal Mucosa , Rhinitis, Allergic, Perennial/drug therapy , Budesonide/pharmacology , Anti-Inflammatory Agents , Administration, Topical , Time Factors , Prospective Studies , Hydrocortisone/bloodABSTRACT
Laryngeal lymphoepithelioma is a rare tumor (16 cases in the literature). It is an association of undifferentiated, non-keratinizing cells and normal lymphocytes and plasma cells. The Epstein-Barr virus is rarely found. To determine the actual nature of the tumor, a complete histochemical workup and/or electron microscopy often are needed. Cervical lymph node involvement is common. We report the cases of two men. In one patient, the tumor was located in the glossoepiglottic fold and in the other it was located in the left ventricule and false vocal cord. EB virus was absent in both cases. Cervical lymph node metastases were found, but not distant metastases. One patient was treated by irradiation and the second underwent surgery (supraglottic laryngectomy and cervical dissection) and was referred to radiotherapy for further treatment.
Subject(s)
Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/pathology , Laryngeal Neoplasms/diagnostic imaging , Laryngeal Neoplasms/pathology , Aged , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Intranasal meningoencephaloceles are rare. The tumor's appearance may suggest the diagnosis of a nasal polyp or glioma. This may lead to an inappropriate surgical approach and serious neurological complications. We report the case of an intranasal meningoencephalocele initially treated as a nasal polyp and complicated by nasal leakage of cerebrospinal fluid. The differential diagnosis of the tumor using CT and MRI and surgical treatment are described.
Subject(s)
Encephalocele/surgery , Meningocele/surgery , Nasal Polyps/surgery , Adult , Diagnosis, Differential , Encephalocele/complications , Encephalocele/diagnosis , Female , Glioma/diagnosis , Humans , Magnetic Resonance Imaging , Meningocele/complications , Meningocele/diagnosis , Nasal Polyps/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinuses/diagnostic imaging , Paranasal Sinuses/pathology , Tomography, X-Ray ComputedABSTRACT
El meningoencefalocele, a nivel vasal nasal, es raro de encontrar en la clínica diaria fundamentalmente en la edad adulta, siendo su presencia confundida, en muchas ocasiones, con un pólipo nasal. Ello conduce a actitudes terapéuticas inapropiadas que originan complicaciones neurológicas generalmente graves. Se presenta un caso donde se dieron las circunstancias descritas apareciendo como complicación neurológica licuorea. Se exponen las medidas exploratorias que deben realizarse para su diagnóstico diferencial, haciendo hincapié en la importancia del TAC y RMN, así como el proceder quirúrgico realizado siendo su resultado satisfactorio (AU)
Intranasal meningoencephaloceles are rare. The tumor's appearance may suggest the diagnosis of a nasal polyp or glioma. This may lead to an inappropriate surgical approach and serious neurological complications. We report the case of an intranasal meningoencephalocele initially treated as a nasal polyp and complicated by nasal leakage of cerebrospinal fluid. The differential diagnosis of the tumor using CT and MRI and surgical treatment are described (AU)
Subject(s)
Adult , Female , Humans , Nasal Polyps/surgery , Paranasal Sinuses , Magnetic Resonance Imaging , Encephalocele/surgery , Paranasal Sinus Neoplasms , Tomography, X-Ray Computed , Meningocele/diagnosis , Diagnosis, Differential , Glioma/diagnosisABSTRACT
El carcinoma linfoepitelial de laringe es una tumoración rara (16 casos encontrados en la bibliografía consultada), formada por células no queratinizadas pobremente diferenciadas, entremezcladas con linfocitos y células plasmáticas de aspecto normal, donde la presencia del virus de Epstein-Barr es excepcional. Su diagnóstico histopatológico generalmente requiere estudio histoquímico, e incluso examen con microscopia electrónica. Es muy frecuente la presencia de metástasis a nivel ganglionar cervical. Se presentan dos casos, de sexo masculino, que padecían tumoración uno a nivel de hemilaringe izquierda y otro en espacio glosoepiglótico. En ambos casos el diagnóstico histopatológico fue de linfoepitelioma de laringe, el estudio serológico del virus de Epstein-Barr fue negativo, y presentaban metástasis en ambas cadenas ganglionares cervicales, siendo el estudio de extensión negativo. Un paciente fue sometido a tratamiento quirúrgico tanto de su lesión como de la extensión ganglionar (laringuectomía horizontal supraglótica y vaciamiento ganglionar cervical bilateral) y radioterapia posquirúrgica, mientras que al otro se le sometió únicamente a radioterapia (AU)
Laryngeal lymphoepithelioma is a rare tumor (16 cases in the literature). It is an association of undifferentiated, non-keratinizing cells and normal lymphocytes and plasma cells. The Epstein-Barr virus is rarely found. To determine the actual nature of the tumor, a complete histochemical workup and/or electron microscopy often are needed. Cervical lymph node involvement is common. We report the cases of two men. In one patient, the tumor was located in the glossoepiglottic fold and in the other it was located in the left ventricule and false vocal cord. EB virus was absent in both cases. Cervical lymph node metastases were found, but not distant metastases. One patient was treated by irradiation and the second underwent surgery (supraglottic laryngectomy and cervical dissection) and was referred to radiotherapy for further treatment (AU)
Subject(s)
Middle Aged , Aged , Male , Humans , Carcinoma, Squamous Cell/pathology , Laryngeal Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
In a prospective study, measurement of a 9.00 a.m. basal serum cortisol and biopsies of the inferior turbinate mucosa were taken from 40 patients using topical nasal corticosteroid (Budesonide) continuously for month or years. No systemic adverse effects and no histopathological changes of significance were found. These findings do no suggest that topically corticosteroids are harmful to the nasal mucosa and no produce systemic effects.
Subject(s)
Anti-Inflammatory Agents/pharmacology , Budesonide/pharmacology , Nasal Mucosa/drug effects , Rhinitis, Allergic, Perennial/drug therapy , Administration, Topical , Adolescent , Adult , Female , Humans , Hydrocortisone/blood , Male , Middle Aged , Nasal Mucosa/pathology , Prospective Studies , Rhinitis, Allergic, Perennial/pathology , Time FactorsABSTRACT
A retrospective epidemiological and histopathological review was made of 258 patients. Forty had laryngeal polyps, 35 vocal fold nodules, and 41 Reinke edema. One hundred forty-two records were excluded for lack of epidemiological or histopathological data. No dysplastic changes were observed in nodules or polyps. One patient with edema had mild dysplasia. The epidemiological data showed that voice abuse or misuse was the main factor in patients with vocal fold nodules; smoking was the main factor in polyps and edema.
Subject(s)
Laryngeal Diseases/epidemiology , Laryngeal Edema/epidemiology , Laryngeal Neoplasms/epidemiology , Polyps/epidemiology , Vocal Cords , Adult , Age Distribution , Aged , Chi-Square Distribution , Female , Humans , Laryngeal Diseases/pathology , Laryngeal Edema/pathology , Laryngeal Neoplasms/pathology , Male , Middle Aged , Polyps/pathology , Risk Factors , Sex Distribution , Spain/epidemiology , SyndromeABSTRACT
A malformation of the facial nerve in the temporal bone of an otherwise normal adult is reported. The abnormality consisted in the facial nerve obstructing the oval window in the second part of its intrapetrosal section.
Subject(s)
Facial Nerve/abnormalities , Adult , Facial Nerve/pathology , Histological Techniques , Humans , Temporal Bone/pathologyABSTRACT
Fibrous dysplasia is an uncommon condition, which most obvious expression is the disorder of the osseous tissue setting up. Craniofacial bones are preferential sitting targets. We report a new case, in a 14-year-old boy, whose cytogenetic study neither in peripheral blood nor in tumor cells showed significantly differences.
