ABSTRACT
Introducción y objetivos: La endoscopia intervencionista nos permite actuar sobre la patología del paciente con mínimas molestias, bajos costes y alta eficiencia. Evaluamos la validez de la biopsia por endoscopia flexible en nuestro hospital, en las lesiones sospechosas de malignidad en el espacio rinofaringolaríngeo. Material y método: Estudio retrospectivo de los pacientes con patología sospechosa de malignidad valorados en el periodo 2006-2016 en nuestro centro. Valoramos la eficacia, la tolerancia y número de complicaciones. Calculamos la reducción de costes frente a la laringoscopia directa en quirófano. Comparamos nuestra muestra con otras de características similares descritas en la bibliografía. Resultados: Treinta pacientes fueron estudiados mediante biopsia por endoscopia flexible en ese período. Diecinueve pacientes obtuvieron resultados positivos que permitieron iniciar el tratamiento de su patología. Siete casos, sin evidencia de malignidad, requirieron nueva biopsia bajo anestesia general que confirmó el diagnóstico de carcinoma. Dos muestras descartaron malignidad, dato que se confirmó tras microcirugía de laringe. Un caso mostró inflamación y la lesión se resolvió tras antibioterapia. En un caso la toma de muestra resultó imposible. Obtenemos de esta forma niveles de sensibilidad del 73% con una especificidad del 100%. No se produjeron complicaciones. La reducción de costes en nuestra muestra fue superior al 80%. Conclusiones: La biopsia por endoscopia flexible aporta ventajas sobre la laringoscopia directa que resultan de interés en el diagnóstico de patología oncológica en otorrinolaringología (AU)
Introduction and objectives: Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. Subjects and methods: Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications. We calculated the cost reduction in comparison with direct laryngoscopy in the operating room. We compared our sample with others of similar characteristics described in the literature. Results: Thirty patients were studied with a flexible endoscopic biopsy during that period. Nineteen patients obtained positive results which allowed them to start treatment for their pathology. Seven cases had no evidence of malignancy and required another biopsy under general anaesthesia, which confirmed the carcinoma diagnosis. Two samples ruled out malignancy which was confirmed by laryngeal microsurgery. One case showed inflammation and the lesion was cured after antibiotherapy. It was impossible to collect the sample in one case. Thus, we obtained sensitivity levels of 73% with a specificity of 100%. There were no complications. The cost reduction in our sample was above 80%. Conclusions: Flexible endoscopic biopsy has advantages over direct laryngoscopy that are relevant in the diagnosis of oncological pathology in otorhinolaryngology (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Otorhinolaryngologic Neoplasms/pathology , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Retrospective Studies , Laryngoscopy , Cost-Benefit Analysis , Deglutition Disorders/pathology , Dysphonia/pathology , Early Detection of Cancer/methodsABSTRACT
INTRODUCTION AND OBJECTIVES: Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. SUBJECTS AND METHODS: Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications. We calculated the cost reduction in comparison with direct laryngoscopy in the operating room. We compared our sample with others of similar characteristics described in the literature. RESULTS: Thirty patients were studied with a flexible endoscopic biopsy during that period. Nineteen patients obtained positive results which allowed them to start treatment for their pathology. Seven cases had no evidence of malignancy and required another biopsy under general anaesthesia, which confirmed the carcinoma diagnosis. Two samples ruled out malignancy which was confirmed by laryngeal microsurgery. One case showed inflammation and the lesion was cured after antibiotherapy. It was impossible to collect the sample in one case. Thus, we obtained sensitivity levels of 73% with a specificity of 100%. There were no complications. The cost reduction in our sample was above 80%. CONCLUSIONS: Flexible endoscopic biopsy has advantages over direct laryngoscopy that are relevant in the diagnosis of oncological pathology in otorhinolaryngology.
Subject(s)
Endoscopy , Otorhinolaryngologic Neoplasms/pathology , Aged , Aged, 80 and over , Endoscopy/instrumentation , Female , Humans , Image-Guided Biopsy/methods , Male , Middle Aged , Retrospective StudiesABSTRACT
INTRODUCTION AND OBJECTIVES: We address the efficacy of aerosol therapy in the treatment of otitis media with effusion during childhood. We study audiometric recovery in comparison with other classic treatments. MATERIAL AND METHODS: This is a retrospective analysis of 37 patients suffering from otitis media with effusion treated with aerosols. We analyze the pure tone audiometry gap results for the whole sample of patients. We also evaluate the characteristics of the group of patients that had previously required surgery and the group withdrawn from aerosol therapy for not responding. RESULTS: Thirty seven patients with a mean age of 6.8 years met the inclusion criteria. Audiometric tests were performed at the beginning of the treatment and after one month, 3 months and finally 6-12 months. In audiometric terms, 76% of the patients achieved results similar to those obtained after surgery. Seven patients were withdrawn from treatment due to poor or no response to aerosol therapy or due to a lack of collaboration. Two patients developed complications not related to aerosol therapy (tympanic perforation and cholesteatoma pearl). CONCLUSION: The efficacy of aerosol therapy is comparable to that obtained with classic treatments. We have found no differences in the outcomes obtained in the group previously treated with surgery. We found no indicators of poor response in those patients where the treatment failed.
Subject(s)
Otitis Media with Effusion/drug therapy , Adolescent , Aerosols , Child , Child, Preschool , Equipment Design , Female , Humans , Male , Retrospective StudiesABSTRACT
Introducción y objetivos: Comprobamos la eficacia de la aerosolterapia en el tratamiento de la otitis serosa infantil. Valoramos el nivel de recuperación auditiva en comparación con los tratamientos clásicos. Material y método: Realizamos un estudio retrospectivo de 37 pacientes pediátricos tratados con aerosolterapia por otitis media serosa. Valoramos los resultados del umbral audiométrico diferencial obtenidos en la muestra general. Valoramos asimismo las características del grupo de los pacientes que previamente habían requerido cirugía y del grupo de pacientes que abandonaron el protocolo de aerosolterapia por mala evolución. Resultados: Treinta y siete pacientes cumplieron los criterios de inclusión con una edad media de 6,8 años. Se realizaron controles audiométricos al inicio, al mes, a los 3 meses y a los 6 o 12 meses. El 76% de los pacientes obtuvo resultados audiométricos al año de seguimiento equiparables a los obtenidos con cirugía. Siete pacientes interrumpieron la aerosolterapia por mala evolución o falta de colaboración y en dos casos la necesidad de la cirugía se produjo por recurrencias de la patología tras resolución inicial al año. Dos pacientes presentaron complicaciones no directamente atribuibles a la aerosolterapia (perforación, perla de colesteatoma). Conclusión: La eficacia de la aerosolterapia es comparable a la obtenida con los tratamientos clásicos. No observamos diferencias en los resultados en el grupo que previamente había requerido cirugía. No detectamos factores indicadores de mala respuesta en el grupo en el que la aerosolterapia fracasó (AU)
Introduction and Objectives: We address the efficacy of aerosol therapy in the treatment of otitis media with effusion during childhood. We study audiometric recovery in comparison with other classic treatments. Material and Methods: This is a retrospective analysis of 37 patients suffering from otitis media with effusion treated with aerosols. We analyze the pure tone audiometry gap results for the whole sample of patients. We also evaluate the characteristics of the group of patients that had previously required surgery and the group withdrawn from aerosol therapy for not responding. Results: Thirty seven patients with a mean age of 6.8 years met the inclusion criteria. Audiometric tests were performed at the beginning of the treatment and after one month, 3 months and finally 6, 12 months. In audiometric terms, 76% of the patients achieved results similar to those obtained after surgery. Seven patients were withdrawn from treatment due to poor or no response to aerosol therapy or due to a lack of collaboration. Two patients developed complications not related to aerosol therapy (tympanic perforation and cholesteatoma pearl). Conclusion: The efficacy of aerosol therapy is comparable to that obtained with classic treatments. We have found no differences in the outcomes obtained in the group previously treated with surgery. We found no indicators of poor response in those patients where the treatment failed (AU)
