ABSTRACT
Objetivos: Queremos estudiar la efectividad y las ventajas de la ligadura de la arteria esfenopalatina en el tratamiento de la epistaxis recurrente posterior. Métodos: Hemos realizado un estudio retrospectivo sobre un total de 50 pacientes ingresados en nuestro servicio por epistaxis recidivante posterior en los que el taponamiento nasal posterior resultó ineficaz. A todos ellos se les realizó la ligadura endoscópica de la arteria esfenopalatina para controlar dicha hemorragia. Resultados: De todos los pacientes intervenidos, sólo 7 presentaron recidiva de la epistaxis. Uno de ellos fue resuelto ligando la arteria etmoidal anterior; otro ligando, asimismo, la arteria esfenopalatina contralateral; otro se encuentra en estudio por una alteración de la coagulación no filiada, ya que se le han ligado las arterias esfenopalatina, etmoidal anterior y etmoidal posterior homolaterales, y las epistaxis persisten; y los 4 restantes se controlaron con un taponamiento nasal anteroposterior. El resto de pacientes fue dado de alta a los 2 días de la intervención, sin recidiva ni otras complicaciones relacionadas con la intervención. Conclusiones: Creemos que la ligadura endoscópica de la arteria esfenopalatina es una técnica segura, con escasos efectos secundarios, que minimiza las molestias y complicaciones de otros métodos como el taponamiento nasal o la embolización arterial (AU)
Objectives: The aim of this study was to evaluate the efficacy of endoscopic ligation of the sphenopalatine artery in the treatment of severe posterior epistaxis. Methods: We have carried out a retrospective study on 50 patients hospitalised with posterior recurrent epistaxis, in whom posterior nasal packing was not effective. All of them underwent surgical treatment, with endoscopic ligation of the sphenopalatine artery to control the epistaxis. Results: Only seven patients had a new epistaxis after surgery. One of them is being studied for some kind of coagulopathy, another patient was controlled by ligation of the anterior ethmoidal artery and it was necessary to ligate the contralateral sphenopalatine artery in a third patient. The other four patients were controlled with posterior nasal packing and discharged two days after surgery, without any complications. Conclusions: We believe that endoscopic ligation of the sphenopalatine artery is a safe technique, with fewer complications than other methods such as posterior packing or embolisation (AU)
Subject(s)
Humans , Male , Female , Epistaxis/etiology , Epistaxis/surgery , Epistaxis/therapy , Maxillary Artery/anatomy & histology , Nasal Cavity/blood supply , Epistaxis/epidemiology , Natural Orifice Endoscopic Surgery/methods , Retrospective StudiesABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Adult , Fibrous Dysplasia, Monostotic/complications , Pneumocephalus/etiology , Frontal Bone/pathology , Fibrous Dysplasia, Polyostotic , Craniotomy , Frontal Sinus/pathology , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: The aim of this study was to evaluate the efficacy of endoscopic ligation of the sphenopalatine artery in the treatment of severe posterior epistaxis. METHODS: We have carried out a retrospective study on 50 patients hospitalised with posterior recurrent epistaxis, in whom posterior nasal packing was not effective. All of them underwent surgical treatment, with endoscopic ligation of the sphenopalatine artery to control the epistaxis. RESULTS: Only seven patients had a new epistaxis after surgery. One of them is being studied for some kind of coagulopathy, another patient was controlled by ligation of the anterior ethmoidal artery and it was necessary to ligate the contralateral sphenopalatine artery in a third patient. The other four patients were controlled with posterior nasal packing and discharged two days after surgery, without any complications. CONCLUSIONS: We believe that endoscopic ligation of the sphenopalatine artery is a safe technique, with fewer complications than other methods such as posterior packing or embolisation.
Subject(s)
Arteries/surgery , Epistaxis/surgery , Hemostasis, Endoscopic/methods , Adult , Aged , Anticoagulants/adverse effects , Cardiovascular Diseases/epidemiology , Comorbidity , Diabetes Mellitus, Type 2/epidemiology , Emergencies , Female , Hematologic Diseases/epidemiology , Hemorrhagic Disorders/chemically induced , Hemorrhagic Disorders/epidemiology , Humans , Ligation , Male , Middle Aged , Nasal Septum/surgery , Recurrence , Retrospective StudiesSubject(s)
Fibrous Dysplasia, Monostotic/complications , Frontal Bone/pathology , Frontal Sinus/pathology , Pneumocephalus/etiology , Adult , Bone Substitutes , Cognition Disorders/etiology , Consciousness Disorders/etiology , Craniotomy , Fibrin Tissue Adhesive , Fibrous Dysplasia, Monostotic/diagnostic imaging , Fibrous Dysplasia, Monostotic/surgery , Frontal Bone/diagnostic imaging , Frontal Bone/surgery , Frontal Sinus/diagnostic imaging , Frontal Sinus/surgery , Headache/etiology , Humans , Male , Pneumocephalus/surgery , Plastic Surgery Procedures , Tomography, X-Ray ComputedABSTRACT
Los linfomas primarios a nivel laríngeo son una manifestación poco frecuente de linfoma. La mayoría corresponden a la estirpe celular B y sólo un 11 por ciento aproximadamente se diagnostican como linfomas T. El origen más común de estas neoplasias a nivel de cabeza y cuello es el anillo linfático de Waldeyer. Presentamos un caso clínico de linfoma T primario de laringe cuyo síntoma clínico principal fue una hemorragia súbita que precisó taponamiento laríngeo. Se discuten aspectos relacionados con el diagnóstico y tratamiento (AU)
Subject(s)
Female , Male , Middle Aged , Humans , Hemorrhage/complications , Larynx/physiopathology , Larynx/injuries , Larynx/pathology , Laryngoscopy , Antineoplastic Agents/therapeutic use , Vincristine/administration & dosage , Lymphoma, T-Cell, Peripheral/diagnosis , Laryngeal Neoplasms/complications , Laryngeal Neoplasms/diagnosis , Laryngeal Neoplasms/therapy , Doxorubicin/administration & dosage , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Immunohistochemistry/methods , Leukoplakia, Oral/complications , Leukoplakia, Oral/diagnosis , Laryngeal Neoplasms/drug therapy , Laryngeal Neoplasms/radiotherapyABSTRACT
AIMS AND BACKGROUND: To assess the efficacy of orgotein in the treatment of acute secondary effects of radiotherapy on head and neck tumors. MATERIAL AND METHODS: Data were collected on 41 patients who received radiotherapy for tumors of the head and neck. Radiotherapy was the exclusive treatment in 19.5% of cases, with surgery in 24.4%, chemotherapy in 48.8%, and with both in 7.3%. The toxicity requiring use of orgotein was: oropharynx mucositis (26.8%), dysphagia (34.2%), or both (39%), in grade 2 or more according to the RTOG scale. Orgotein (8 mg i.m.) was administered every 48 hrs until radiotherapy was finished. RESULTS: The overall response rate was 92.5%; a complete response was obtained in 12 patients (30%) and partial in 25 (62.5%). The reduction in toxicity at the end of radiotherapy was one grade in 18 patients (45%), 2 grades in 16 (40%), 3 in 2 patients (5%), and 4 grades in the only patient with grade 4 acute toxicity. A statistically significant influence was shown in obtaining complete response: laryngeal tumor location (P = 0.037), duration of radiotherapy of more than 53 days (P = 0.002), discontinuation for non-toxic reasons (P = 0.008). CONCLUSIONS: We consider that orgotein is highly effective in dealing with acute secondary effects of radiotherapy on the head and neck area.
