[Middle ear adenoma: our casuistry and revision of the literature]. / Adenoma de oído medio: nuestra casuística y revisión de la literatura.

Tumours of the middle ear are rare. Among them glomus tympanicum is the most frequent, followed by adenoma of the middle ear (AME). This insidious pathology entity displays unspecific clinical and audiological features. Advances in histology and immunohistochemistry have greatly contributed to an accurate diagnosis. We report our experience with two patients, a middle-aged man and a woman, diagnosed in our hospital. Both patients underwent surgical treatment and have shown no signs of recurrence after a 27- and 28-month follow-up. In both cases an accurate diagnosis was confirmed by histological and immunohistochemical analysis.

Adenoma de oído medio: nuestra casuística y revisión de la literatura / Middle ear adenoma: our casuistry and revision of the literature

Los tumores del oído medio son poco habituales, siendo el de mayor frecuencia el glomus timpánico seguido en mucha menor frecuencia por el adenoma de oído medio (AOM). Es una entidad que se presenta de forma insidiosa, con unos hallazgos clínicos y audiológicos muy inespecíficos, a cuyo diagnóstico de certeza han contribuido de forma importante los avances en histología e inmunohistoquímica. Presentamos dos casos diagnosticados recientemente en nuestro centro, en un hombre y una mujer ambos de mediana edad. Los dos pacientes fueron tratados mediante cirugía y permanecen sin signos de recidiva después de 27 y 28 meses de seguimiento. En ambos casos se llegó al diagnóstico definitivo mediante el análisis histológico e inmunohistoquímico

Tumours of the middle ear are rare. Among them glomus tympanicum is the most frequent, followed by adenoma of the middle ear (AME). This insidious pathology entity displays unspecific clinical and audiological features. Advances in histology and immunohistochemistry have greatly contributed to an accurate diagnosis. We report our experience with two patients, a middle-aged man and a woman, diagnosed in our hospital. Both patients underwent surgical treatment and have shown no signs of recurrence after a 27- and 28-month follow-up. In both cases an accurate diagnosis was confirmed by histological and immunohistochemical analysis

[Toxic shock syndrome associated with nasal packing]. / Shock tóxico estafilocócico asociado a cirugía nasal.

Staphiloccocal Toxic Shock Syndrome is a potentially fatal multisystem disease associated to nasal packing, catheter insertion, retention of foreign materials and uneffective sterile techniques. It is usually developed in the immediate postoperative period (first 48 hours) with hypotension, skin rash, fever, multisystemic failure and shock. We report a case in a 24-year-old man secondary to nasal surgery.

Shock tóxico estafilocócico asociado a cirugía nasal / Toxic shock syndrome associated with nasal packing

El síndrome del shock tóxico estafilocócico es unaenfermedad multisistémica potencialmente letal que ha sidoasociada con diversos procedimientos quirúrgicos en relacióncon taponamientos nasales, inserción de catéteres, retenciónde cuerpos extraños y rupturas de la asepsia quirúrgica.Se suele desarrollar en las primeras 48 horas tras laintervención y cursa con hipotensión, rash cutáneo, síndromefebril y en algunos casos shock y fallo multiorgánico.Presentamos el caso de un paciente varón de 24 años deedad que desarrolla el cuadro en el postoperatorio de unaseptoplastia

Staphiloccocal Toxic Shock Syndrome is a potentiallyfatal multisystem disease associated to nasal packing,catheter insertion, retention of foreign materials and uneffectivesterile techniques. It is usually developed in the immediatepostoperative period (first 48 hours) with hypotension,skin rash, fever, multisystemic failure and shock. Wereport a case in a 24-year-old man secondary to nasal surgery

[Fibrous displasia of the temporal bone. Presentation of one case]. / Displasia fibrosa del hueso temporal. Presentación de un caso.

We present one case of a 14 years old girl, diagnosed of fibrous displasia of the temporal bone, who developed a conductive hearing loss of progressive character. We analyse the clinic manifestations, radiologic and histopathologic study, and therapeutic indications of this disease.

Displasia fibrosa del hueso temporal. Presentación de un caso / Fibrous diaplasia of the temporal bone. Presentation of one case

Se presenta el caso de una niña de 14 años diagnosticada de displasia fibrosa del hueso temporal que cursa con hipoacusia conductiva de carácter progresivo.Se realiza un análisis de las manifestaciones clínicas, estudio radiológico e histopatológico, así como de las indicaciones terapéuticas de dicha enfermedad

We present one case of a 14 years old girl, diagnosed of fibrous displasia of the temporal bone, who developed a conductive hearing loss of progressive character. We analyse the clinic manifestations, radiologic and histopathologic study, and therapeutic indications ofthis disease

[Assessment of quality of life in patients treated by supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP)]. / Calidad de vida en pacientes tratados mediante laringectomía parcial supracricoidea con cricohioidoepiglotopexia (CHEP).

OBJECTIVES: To assess quality of life in patients diagnosed with epidermoid carcinoma of the larynx, after supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). To examine how quality-of-life may be associated to the treatment received: neck dissection, decannulation and radiotherapy. PATIENTS AND METHOD: A descriptive, observational, cross-sectional study was conducted involving 26 patients out of a group of 51. They were all males with an average age of 61.7 years at the time of the interview. We used the disease-specific quality of life questionnaire devised by the University of Michigan: the Head and Neck Cancer-specific Quality of life instrument (HNQOL). RESULTS: During an average follow-up period of 83.65 months, 2 patients (3.92%) suffered a recurrence. Estimated survival after 3, 5 and 10 years was 95.83%. Communication and overall disturbances caused by treatment were found to be the two quality-of-life domains mainly affected. Generally speaking, patients who had received radiotherapy, those who had not had their tracheal cannula removed or those that had undergone neck dissection were the most affected. CONCLUSIONS: SCPL with CHEP as a surgical technique allows good control of the condition and has a low impact on the patient's quality of life.

Mucormicosis rinocerebral: diagnóstico diferencial de las sinusitis fúngicas invasivas / Rhinocerebral mucormycosis: differential diagnosis of invasive fungal sinusitis

La mucormicosis es una infección oportunista causada por hongos Mucoraceae pertenecientes a la familia de los Phycomycetes. Suele afectar a pacientes debilitados e immunodeprimidos con neoplasias malignas, grandes quemados o diabéticos existiendo diferentes formas entre las que se incluyen rinocerebrales, pulmonares o diseminadas. Describimos un caso de mucormicosis rinocerebral con complicación intracraneal, visto en nuestro hospital que fue tratado mediante cirugía radical y tratamiento médico (AU)

Sinusitis fúngicas no invasivas: micetoma y sinusitis fúngica alérgica / Non invasive fungal sinusitis: mycetoma and alergical fungal sinusitis

Hemos realizado un estudio de diferentes casos de sinusitis fúngicas (SF) no invasivas vistas en nuestro hospital y tratadas mediante cirugía endoscópìca nasosinusal (CENS) y tratamiento médico. Presentamos 2 casos de SF no invasivas: Aspergiloma y sinusitis fúngica alérgica y realizamos el diagnóstico diferencial entre los diferentes tipos según la nueva clasificación. Por último resaltamos los aspectos más relevantes de cada tipo con una amplia revisión bibliográfica (AU)

[Endoscopic surgery of nasopharyngeal angiofibroma]. / Cirugía endoscópica del angiofibroma nasofaríngeo.

Juvinile nasopharyngeal angiofibromas are highly vascular benign tumors but with an agressive behaviour with invasion of skull base and vital structures. Our study includes 11 male patients that underwent surgery for angiofibromas between 1992-2002 with an endoscopic surgical approach and embolization before surgery. The average age was 14.7 years old. Using Fisch staging, 8 patients were stage II. All cases achieved symptomatic remission, with no complications but the recurrence was 36.3%. The endoscopic excision is a safe and effective minimally invasive surgical treatment in patients in stage I and II. It should be considered as a first-choice option for these cases.

Calidad de vida en pacientes tratados mediante laringectomía parcial supracricoidea con cricohioidoepiglotopexia (CHEP) / Assessment of quality of life in patients treated by supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP)

Objetivos: Cuantificar el grado de calidad de vida en los pacientes con carcinoma epidermoide laríngeo tratados mediante laringectomía parcial supracricoidea (LPSC) con cricohioidoepiglotopexia (CHEP) y detectar las posibles relaciones con algunos aspectos referentes al tratamiento como la realización de vaciamientos cervicales, la decanulación y la radioterapia. Pacientes y método: Estudio descriptivo observacional de tipo transversal llevado a cabo sobre 26 pacientes seleccionados de un grupo de 51; todos ellos varones y con una edad media en el momento de la entrevista de 61,7 años. Para cuantificar la calidad de vida se empleó un cuestionario específico de la Universidad de Michigan para tumores de cabeza y cuello, el Head and Neck Cancer-Specific Quality of Life (HNQOL). Resultados: En un período medio de seguimiento de 83,65 meses se produjeron 2 recidivas (3,92 por ciento). La supervivencia estimada a 3, 5 y 10 años fue de 95,83 por ciento. Los dominios de calidad de vida más afectados fueron la comunicación y las molestias globales ocasionadas por el tratamiento. En líneas generales los pacientes más afectados fueron los que recibieron radioterapia, los no decanulados y aquellos a los que se le hizo vaciamiento cervical. Conclusiones: La LPSC con CHEP es una técnica que aporta un excelente control de la enfermedad con escaso impacto en la calidad de vida del paciente (AU)

OBJECTIVES: To assess quality of life in patients diagnosed with epidermoid carcinoma of the larynx, after supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). To examine how quality-of-life may be associated to the treatment received: neck dissection, decannulation and radiotherapy. PATIENTS AND METHOD: A descriptive, observational, cross-sectional study was conducted involving 26 patients out of a group of 51. They were all males with an average age of 61.7 years at the time of the interview. We used the disease-specific quality of life questionnaire devised by the University of Michigan: the Head and Neck Cancer-specific Quality of life instrument (HNQOL). RESULTS: During an average follow-up period of 83.65 months, 2 patients (3.92%) suffered a recurrence. Estimated survival after 3, 5 and 10 years was 95.83%. Communication and overall disturbances caused by treatment were found to be the two quality-of-life domains mainly affected. Generally speaking, patients who had received radiotherapy, those who had not had their tracheal cannula removed or those that had undergone neck dissection were the most affected. CONCLUSIONS: SCPL with CHEP as a surgical technique allows good control of the condition and has a low impact on the patient's quality of life (AU)

[Burkitt's nasopharyngeal lymphoma in pediatric age]. / Linfoma de Burkitt nasofaríngeo en edad pediátrica.

The Burkitt's lymphoma is a haematological neoplasia typical of early ages. In our country, the lymphatic nodes affectation is the most usual. We present a case report with a 12 year-old boy who consults for a asymptomatic cervical mass. The ultimate diagnosic was a nasopharyngeal Burkitt's lymphoma with neck extension.

Endoscopic surgery of nasopharyngeal angiofibroma / Cirugía endoscópica del angiofibroma nasofaríngeo

Juvenile nasopharyngeal angiofibromas are highly vascular benign tumors but with an agressiv ebehaviour with invasion of skull base and vital structures. Our study includes 11 male patients that underwent surgery for angiofibromas between 1992-2002 with an endoscopic surgical approach and embolization before surgery. The average age was14,7 years old. Using Fisch staging, 8 patients were stage II. All cases achieved symptomatic remission, with no complications but the recurrence was 36,3%.The endoscopic excision is a safe and effective minimally invasive surgical treatment in patients in stage I and II. It should be considered as a first-choice option for these cases (AU)

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[Cordectomy by laryngofissure. Review of the period 1978-1998]. / Cordectomía por laringofisura. Revisión del periodo 1978-1998.

OBJECTIVE: The early glottic carcinoma can be approached by different therapeutic options. We analyze the results obtained by means of cordectomy opened up by laryngofissure. MATERIAL AND METHOD: We design a descriptive retrospective study including 75 patients with glottic carcinoma T1N0M0 handled by means of cordectomy by laryngofissure (72 males and 3 females). The anaesthetic technique was locoregional and sedation. Tumor T1a, 62 patients (82.66%); T1b, 13 patients (17.33%). RESULTS: The specific survival rate at three, five and ten years was 100, 96.8 and 85.2% respectively; the global survival was 98.66, 90.47 and 52.17% respectively to three, five and ten years. There were ten recurrences (13.3%). Following treatment, 50% of the relapsed patients died. The probability of survival free of illness to three, five and ten years was considered in 0.9322, 0.9172 and 0.7093 respectively. CONCLUSIONS: This technique means good control of the illness and technical easiness. When doing it without a tracheostomy it is tolerated better and it generates lower costs per patient.

Linfoma de Burkitt nasofaríngeo en edad pediátrica / Burkitt's nasopharyngeal lymphoma in pediatric age

El linfoma de Burkitt es una neoplasia hematológica propia de edades tempranas. En nuestro medio su forma de presentación más habitual es la enfermedad ganglionar. Presentamos el caso clínico de un varón de 12 años que consulta por una masa cervical asintomática, que se correspondía con un linfoma de Burkitt primario de cavum con extensión hacia el cuello (AU)

The Burkitt's lymphoma is a haematological neoplasia typical of early ages. In our country, the lymphatic nodes affectation is the most usual. We present a case report with a 12 year-old boy who consults for a asymptomatic cervical mass. The ultimate diagnosic was a nasopharyngeal Burkitt's lymphoma with neck extension (AU)

Cordectomía por laringofisura. Revisión del período 1978-1998 / Cordectomy by laryngofissure. Review of the period 1978-1998

Objetivo: El carcinoma glótico precoz se puede abordar con diferentes opciones terapéuticas. Analizamos los resultados obtenidos mediante cordectomía abierta por laringofisura. Material y métodos: Estudio descriptivo, retrospectivo, incluyendo 75 pacientes con carcinoma glótico T1N0M0 tratados mediante cordectomía por laringofisura (72 varones y 3 mujeres). La técnica anestésica habitual fue locorregional más sedación de base. Tumor T1a, 62 pacientes (82,66 por ciento); T1b, 13 pacientes (17,33 por ciento). Resultados: La supervivencia causa específica a tres, cinco y diez años fue del 100 por ciento, 96,8 por ciento y 85,2 por ciento respectivamente; la supervivencia global del 98,66 por ciento, 90,47 por ciento y 52,17 por ciento a tres, cinco y diez años respectivamente. Ocurrieron diez recidivas (13,3 por ciento). Tras la repesca murieron el 50 por ciento de los pacientes recidivados. La probabilidad de supervivencia libre de enfermedad a tres, cinco y diez años se estimó en 0,9322, 0,9172 y 0,7093 respectivamente. Conclusiones: Esta técnica aporta buen control de la enfermedad y facilidad técnica. Al prescindir del traqueostoma es mejor tolerada y genera menor coste por paciente (AU)

OBJECTIVE: The early glottic carcinoma can be approached by different therapeutic options. We analyze the results obtained by means of cordectomy opened up by laryngofissure. MATERIAL AND METHOD: We design a descriptive retrospective study including 75 patients with glottic carcinoma T1N0M0 handled by means of cordectomy by laryngofissure (72 males and 3 females). The anaesthetic technique was locoregional and sedation. Tumor T1a, 62 patients (82.66%); T1b, 13 patients (17.33%). RESULTS: The specific survival rate at three, five and ten years was 100, 96.8 and 85.2% respectively; the global survival was 98.66, 90.47 and 52.17% respectively to three, five and ten years. There were ten recurrences (13.3%). Following treatment, 50% of the relapsed patients died. The probability of survival free of illness to three, five and ten years was considered in 0.9322, 0.9172 and 0.7093 respectively. CONCLUSIONS: This technique means good control of the illness and technical easiness. When doing it without a tracheostomy it is tolerated better and it generates lower costs per patient (AU)

[Rhinocerebral mucormycosis: differential diagnosis of invasive fungal sinusitis]. / Mucormicosis rinocerebral: diagnóstico diferencial de las sinusitis fúngicas invasivas.

Mucormycosis is an opportunistic infection caused by molds Mucoraceae of the family Phycomycetes. This invasive FS is found in debilitated hosts, most frequently in patients with hematologic malignancies, burn patients and diabetes mellitus. There are several differents forms: rhino-cerebral, pulmonary or disseminated. We describe a case of invasive fungal sinusitis (FS): Rhino-orbital-cerebral mucormycosis, treated at our hospital with radical surgery and medical treatmen We reviewed the clinical presentation of the different types.

[Non invasive fungal sinusitis: mycetoma and alergical fungal sinusitis]. / Sinusitis fúngicas no invasivas: micetoma y sinusitis fúngica alérgica.

We have made a study about different cases of non-invasive fungal sinusitis (FS) treated at our hospital with surgery (endoscopic sinus approach) and medical treatment. We review two cases: Mycetoma and allergic fungal sinusitis, following the recent classification based on physiopathology, treatment and prognosis. We review the clinical presentation of the different types.

[Metastatic neck adenopathies without known primary tumor. Incidence study 1996-2001]. / Adenopatías metastásicas cervicales sin tumor previo conocido. Estudio de incidencia 1996-2001.

We made a retrospective descriptive study reviewing 92 patients with cervical lymph node metastases from unknown primary tumour. The study was accomplished during 6 years. (January 1996 to December 2001) in the Department of Otorhinolaryngology of the Hospital Reina Sofia, Córdoba. The median age was 61.7 years old, male 96.7% and heavy smoker (89.1%) and drinkers most of them. According to TNM categories, 72.2% patients were in phase N2a and half of them were localized Level II. Squamous cell carcinoma was the predominant histologic type. The patients were treated with surgery in 70.6% of the cases with or without radiation therapy and/or chemotherapy.

[Forestier-Rotes Querol syndrome]. / Síndrome de Forestier-Rotes Querol.

The diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is characterized by an hyperostosis of the anterolateral margin of the vertebral bodies. It is an uncommon cause of dysphagia in old patients. In the differential diagnosis of mechanical dysphagia we must have present this disease. Cervico-dorsal spine radiographies reveal large anterior osteophytes creating pharyngeal encroachment.