[Report of a case: large tonsillolith in palatine tonsil]. / A propósito de un caso: gran tonsilolito en amígdala palatina.

A 69-year-old woman presented with a one-year history of dysphagia and a hard overgrowth of the right palatine tonsil visible in oral examination. Computerized Tomography scan showed a big calcified lesion inside the tonsil not seen in a pharyngoscopy. Tonsillectomy was performed and a giant tonsillolith was found inside the resected piece. The calculus was 3 x 2 x 2.3 cm and with an irregular-pyramidal shape. Normal tonsillar tissue with many colonies of Actionomyces inside the tonsillar crypts was the definitive pathological feature.

A propósito de un caso: gran tonsilolito en amígdala palatina / Giant tonsillolith in palatine tonsil: report of one case

Presentamos el caso de una paciente de 69 años con clínica de disfagia de un año de evolución. En la exploración se apreció crecimiento de amígdala palatina derecha, con consistencia dura. La tomografía computerizada mostró una imagen de gran calcificación ocupando el centro de la amígdala, no evidenciable por faringoscopia. Realizada la extracción quirúrgica de la amígdala, en su interior se halló un tonsilolito gigante, con forma de pirámide irregular de 3x2x2,3 cm. El análisis histopatológico de la pieza de amigdalectomía se informó como tejido amigdalar dentro de los límites normales con presencia de numerosas colonias de actinomices en las criptas (AU)

A 69-year-old woman presented with a one-year history of dysphagia and a hard overgrowth of the right palatine tonsil visible in oral examination. Computerized Tomography scan showed a big calcified lesion inside the tonsil not seen in a pharyngoscopy. Tonsillectomy was performed and a giant tonsillolith was found inside the resected piece. The calculus was 3 x 2 x 2.3 cm and with an irregular-pyramidal shape. Normal tonsillar tissue with many colonies of Actionomyces inside the tonsillar crypts was the definitive pathological feature (AU)

[Elective dissection in cancer of the larynx]. / Vaciamiento electivo en cáncer de laringe.

OBJECTIVE: 1) To determine if elective neck dissection (END) is more effective than surgery without END in patients with cancer and a clinically negative neck (N0). 2) To determine if selective posterolateral neck dissection is effective in these patients. PATIENTS AND METHODS: The study included 74 patients with laryngeal cancer and no palpable nodes who were treated surgically at the ENT Department of the Universidad Complutense de Madrid between 1994 and 1997. Thirty-seven patients underwent surgery alone (Group A) and 37 patients underwent laryngeal surgery and elective neck dissection (Group B). No patient underwent irradiation. Minimum follow-up was 24 months. RESULTS: Cervical recurrence was observed in 4 (11%) patients who underwent laryngeal surgery alone and in 2 (5%) patients who underwent laryngeal surgery and elective neck dissection. CONCLUSIONS: Laryngeal surgery with elective neck dissection was more effective than laryngeal surgery without END in patients with laryngeal cancer and a clinically negative neck. Selective lateral neck dissection was effective for the elective treatment of these patients.

Vaciamiento electivo en cancer de laringe / Elective dissection in cancer of the larynx

El objetivo de este trabajo será comparar la evolución oncológica de los pacientes con cáncer de laringe sin ganglios palpables (NO) en los que se haya realizado vacimiento cervical electivo frente a aquellos enfermos en los que no se haya realizado cirugía ganglionar y estudiar si el vaciamiento selectivo postero-lateral es eficaz en el tratamiento selectivo de estos pacientes. Pacientes y métodos: Se estudiaron 74 pacientes con cáncer de laringe sin ganglios palpables tratados mediante cirugía en el Departamento de ORL de la Universidad Complutense de Madrid entre 1994-97. En 37 pacientes se realizó únicamente cirugía laríngea (grupo A) y en 37pacientes se realizó cirugía laríngea y vacimiento cervical electivo simultáneamente (Grupo B). Ningún paciente se radió posteriormente. El seguimiento fue de al menos 24 meses. Resultados: identificamos 4 recidivas cervicales (11 por ciento) cuando se realizó sólo cirugía laríngea y 2 recidivas cervicales (5 por ciento) en pacientes sometidos a cirugía laríngea con vaciamientos cervicales. Conclusiones: el Vaciamiento Cervical Electivo es más eficaz que la abstención terapéutica en pacientes con cáncer de laringe sin adenopatías palpables. El vaciamiento Selectivo Postero-Lateral es apropiado para el tratamiento de estos pacientes (AU)

OBJECTIVE: 1) To determine if elective neck dissection (END) is more effective than surgery without END in patients with cancer and a clinically negative neck (N0). 2) To determine if selective posterolateral neck dissection is effective in these patients. PATIENTS AND METHODS: The study included 74 patients with laryngeal cancer and no palpable nodes who were treated surgically at the ENT Department of the Universidad Complutense de Madrid between 1994 and 1997. Thirty-seven patients underwent surgery alone (Group A) and 37 patients underwent laryngeal surgery and elective neck dissection (Group B). No patient underwent irradiation. Minimum follow-up was 24 months. RESULTS: Cervical recurrence was observed in 4 (11%) patients who underwent laryngeal surgery alone and in 2 (5%) patients who underwent laryngeal surgery and elective neck dissection. CONCLUSIONS: Laryngeal surgery with elective neck dissection was more effective than laryngeal surgery without END in patients with laryngeal cancer and a clinically negative neck. Selective lateral neck dissection was effective for the elective treatment of these patients (AU)

[Rhinoscleroma. A case report]. / Rinoescleroma. A propósito de un caso.

Rhinoscleroma is a chronic, specific, inflammatory granulomatous condition of the nose and other structures of the upper respiratory tract. It is caused by the bacterium Klebsiella rhinoscleromatis. We report a case in a 29-year-old black male emigrant who consulted for a 2-year history of hoarseness, cough, and nasal discharge. The diagnosis was scleroma with nasal, laryngeal, tracheal, and bronchial involvement and ulcerating and necrotizing lesions that caused respiratory obstruction. Bacterial over-infection responded to treatment with third-generation cephalosporins and clindamycin. The sclerotic lesions responded well to treatment with ciprofloxacin. We review the clinical findings at different stages, diagnostic options, and several treatments.

[Chondroma of the larynx. Apropos of a case]. / Consideraciones sobre el condroma de laringe. A propósito de un caso.

Tumours originating from the laryngeal skeleton are a rarity. We present a case report of an 82 year old male with chondroma in the larynx. 23 years before, the tumour was diagnosed when the patient was asymptomatic. 10 years later he was operated up on with conservative surgery when the tumour grew to a size that caused permanent dyspnoea and dysphonia. After regular examinations, 13 years later, there is no evidence of recurrence of the mass. Chondromas are rare. Surgical extirpation is the essential line of treatment for tumours of the cricoid cartilage.