Bleeding control in endoscopic sinus surgery: a systematic review of the literature.

In the literature various methods are described to reduce bleeding in endoscopic sinus surgery. Scientific evidence and results were gathered and analysed to determine the effectiveness of the various methods used. A total of 20 articles fulfilled the inclusion criteria. Two retrospective articles studied the differences between local and general anaesthesia. Three articles analysed the use of local methods to control bleeding. The majority of the articles analysed the use of different systemic drugs to control intraoperative bleeding. Certain procedures, such as the reverse Trendelenburg position, the use of high doses of epinephrine, the infiltration of phenylephrine and lidocaine into the pterygopalatine fossa, the preoperative use of prednisone, and the control of the heart rate (with dexmedetomidine or remifentanil), appear to reduce the intraoperative blood loss and/or improve the visualisation of the surgical field. However, the evidence supporting these conclusions is poor. The benefits of other procedures, such as the preoperative use of ß-blockers, antihypertensive agents, and surgical pledgets with oxymetazoline, phenylephrine, or cocaine, for bleeding control are not evidenced in the literature. In addition, the literature does not present any evidence on the benefits of local anaesthesia compared with general anaesthesia or the use of propofol compared to inhaled analgesics in terms of intraoperative bleeding or complication rates.

[Cochlear hemorrhage. Unusual cause of sudden sensorineural deafness]. / Hemorragia coclear. Causa excepcional de sordera súbita sensorineural.

Sudden sensorineural hearing loss (SNHL) caused by intralabyrinthine hemorrhage is a rare entity usually associated to patients with previous pathological factors, such as blood dyscrasias, anticoagulant therapy and local hemorrhagic pathologies. We report the first-published case of sudden-onset deafness due to cochlear hemorrhage in a patient with no previous pathologies. We describe the history, diagnosis and follow-up of this patient in comparison to others previously published.

Hemorragia coclear. Causa excepcional de sordera súbita sensorineural / Cochlear hemorrhage. An exceptional cause of sudden sensorineural mearing loss

La sordera súbita sensorineural producida por una hemorragia laberíntica es una rara entidad que clásicamente ha sido descrita en pacientes con factores patológicos previos, tales como discrasias sanguíneas, tratamientos anticoagulantes y lesiones hemorrágicas de vecindad. Presentamos un caso de sordera súbita producida por una hemorragia limitada a la porción coclear del laberinto en una paciente sin patología previa. Describimos la clínica, método diagnóstico y evolución de este caso en comparación con los publicados con anterioridad (AU)

Sudden sensorineural hearing loss (SNHL) caused by intralabyrinthine hemorrhage is a rare entity usually associated to patients with previous pathological factors, such as blood dyscrasias, anticoagulant therapy and local hemorrhagic pathologies. We report the first-published case of sudden-onset deafness due to cochlear hemorrhage in a patient with no previous pathologies. We describe the history, diagnosis and follow-up of this patient in comparison to others previously published (AU)

Plasmocitoma solitario de seno esfenoidal / Solitary plasmacytoma of sphenoid sinus

Propósito: Presentar un caso de plasmocitoma solitario extramedular (PSE) en una rara localización de cabeza y cuello, y evaluar el procedimiento diagnóstico y terapéutico más adecuado de estos tumores. Contamos con el único caso publicado con imágenes clínicas y de RM antes y después del tratamiento. Casos clínicos: Varón de 42 años con una masa en seno esfenoidal. La RM reveló extensión intracraneal. Resultados: Tras la biopsia y un estudio de extensión sistémico negativo se diagnosticó al paciente de PSE. El paciente fue tratado con radioterapia, con remisión clínica total hasta la actualidad. Conclusiones: El diagnóstico de PSE sólo puede realizarse tras un estudio de extensión sistémica negativo. Existe controversia sobre el tipo adecuado de tratamiento. La radioterapia consigue remisiones locales en el 80-95 por ciento de los casos. El pronóstico después del tratamiento es bueno (AU)