Vascularization of the long process of the malleus: surgical implications.

Knowledge of the vascularization of the malleus may help to better understand some unwanted effects occurred in those surgical techniques using the handle as an attachment site of ossicle-replacement prostheses. Our hypothesis is that vascular damage occurred in the long process of the malleus during tympanic membrane detachment before fastening a malleovestibulopexy (MVP) prosthesis promotes the lysis of this ossicle at the attachment site. To confirm this premise, we carried out an evolutive and descriptive study of ten MVP procedures as well as a morphological analysis of ten cadaveric mallei using both light and scanning electron microscopies. The arterial supply of the manubrium comes from two main sources: vascular branches that reach this ossicle from the site of insertion of the tensor tympani tendon and small perforating branches which penetrate the bone from arteries of the tympanic membrane that, following the periosteum/perichondrium, they arrange parallel to the bone. The detachment of the tympanic membrane to fasten a MVP prosthesis causes a damage in the periosteal/perichondral vascular supply of the handle as well as micro-trauma on it, which can promote bone resorption at the point of anchorage by osteoclast stimulation. Respect periosteal vascularization of the manubrium may be important to prevent damage in this ossicle caused by some middle ear reconstruction prostheses.

[Neuroendocrine cervicofacial tumors. Revision and report of six cases]. / Tumores neuroendocrinos cervicofaciales. Revisión a propósito de seis casos.

The neuroendocrine cervicofacial tumors are proliferative infrequent process in head and neck but no exceptional. They possess a common origin from the cells derivided from the neural crest, that today gathered on the term of neuroendocrine diffuse system (SNED). Incidentally several associated tumors appear, synchronically or metachronically and some of them possess secretor character. We present the clinic cases of 6 patients, with 6 different types of tumor in head and neck, with the common link to belong to SNED. We analyse their clinical diagnostic characteristics, evolution and treatment.

[Presumption diagnosis: otomycosis. A 451 patients study]. / Diagnóstico de presunción: otomicosis. Estudio de 451 pacientes.

Otomycosis is a common disease. We try to analyze the causative factors for otomycosis in our environment. Our study includes 451 patients with a presumed diagnosis of otomycosis. The patients were included by ear, nose and throat specialist and general doctors; the diagnosis was confirmed in 24.43% and 16.16% respectively. The most common fungal pathogen found was Aspergillus spp. and Candida sp. The high frecuency of Aspergillus Niger may be because of the diferent ways of gathering samples. The abundance of Candida parapsilosis in the samples that came from general doctors may be because the inadequate treatment with topic antibiotics contributes fungal proliferation. We conclude that the causative factors for otomycosis could be avoided or treated. Treatment with antifungal agents is not enought to ensure complete cure, an furthermore the treatment should be aimed to restore the physiology of the external auditory cannal.

[Bilateral thrombosis of the internal jugular vein due to laryngeal surgery]. / Trombosis bilateral de la vena yugular interna tras cirugía laríngea.

Reporting one case of bilateral thrombosis of internal jugular vein in absence of neck's space handling or other systemic elements justifying the pathology. Clinical description, evolutive course and treatment performed. Review of corresponding literature what allowed us to classify the case between the idiopathic thrombosis jugularis after neck's surgery, surely brought about for the forced position of the neck for long time.

[Small-cell laryngeal neuroendocrine carcinoma. A case report and review of literature]. / Carcinoma neuroendocrino de células pequeñas localizadas en la laringe. Presentación de un caso clínico y revisión de la literatura.

A case of small-cell carcinoma of larynx was diagnosed in a 48-year-old man. This is an unusual laryngeal carcinoma (the incidence is lower than 1% of all carcinomata in this location). We analyzed some clinical and histopathological aspects of these carcinomata and some prognostic and therapeutic factors. A bibliographic review was made.

[Anatomical variation of the helix root (Radicis Helicis)]. / Variaciones anatómicas de la raíz del hélix (Radicis Helicis).

The root of the helix is not a smooth structure and morphologically constant but shows a series of irregularities, which are described in this article. 288 patients were aleatory studied and found some prominences, localized on the root of the helix. There are two tubercules--upper and lower--and one cleft or groove facing the lower branch of the antehelix. We report these variants as well as the prevalences dues to the age and sex.

[Otosclerosis and Van der Hoeven's syndrome: a contribution]. / Aportación al estudio de la otosclerosis y del síndrome de Van der Hoeve.

Morphological and microchemical changes that effect to the otosclerotic stape in the Van der Hoeve's syndrome were examined with a scanning electron microscope equipped with an energy dispersive X-ray fluorescence. Using the Ca/P ratio as criterion--measured by the characteristic x-ray fluorescence--it was shown that the Van der Hoeve stape had a higher Ca/P ratio (2.6:1) as compared to the normal stape (2:1). The Van der Hoeve's syndrome lesions as poorly mineralized, with low calcium salt and apparent increase of phosphates. This finding indicates a possible change from hydroxyapatite (or apatite) to brushite, which imply an acidification of bone.

Scanning electron microscopy images and energy-dispersive X-ray microanalysis of the stapes in otosclerosis and Van der Hoeve syndrome.

OBJECTIVE/HYPOTHESIS: The objective of this study was to evaluate the morphological and microchemical changes that affect sclerotic stapes in otospongiosis and van der Hoeve syndrome. METHODS: A scanning electron microscope equipped with an energy-dispersive x-ray analyzer was used in the experiments. RESULTS: In otosclerosis, focal lesions are poorly mineralized, with low calcium salt and reduced calcium-to-phosphorus (Ca/P) ratio (1.9:1). This finding correlates with a spongiotic type of lesion and indicates unstable mineralization with possible change from hydroxyapatite to calcium triphosphate. In van der Hoeve syndrome the presence of magnesium in stapes suggests osteoclastic function stimulation. The osteoclasts secrete many protons, causing an acidified microenvironment. Brushite is formed, and Ca/P ratio decreases in comparison with that of control patients (2.0:1 vs. 2.6:1).

[Prospective follow-up of 27 tumors of the oropharynx]. / Seguimiento prospectivo de 27 tumores de la orofaringe.

The diagnosis of an oropharyngeal tumor should be simple because the site is easily accessible. However, these tumors are not often diagnosed is early stages, even when lesions are visible. We followed-up 27 oropharyngeal tumors from 1 January 1996 to 31 December 1997. Etiological data, the characteristics of the problem leading to diagnosis, and time from symptoms to definitive diagnosis were studied. Histopathological differentiation and stage determination were analyzed. Therapeutic strategy and post-treatment evolution were studied, among other parameters. Our results suggest that the most important etiopathogenic factors in the development of oropharyngeal carcinoma were alcohol and tobacco use, to effects of which are potentiated at this site. The most frequent primary oropharyngeal site was the tonsils in 58% of patients. Treatment of each tumor should be individualized. The general prognosis is poor because 40% of patients are stage IV.

[Retropharyngeal abscess: report of 2 cases]. / Absceso retrofaríngeo: a propósito de dos casos.

Retropharyngeal abscesses are uncommon and their frequency has decreased since the development of antibiotics. It is important to recognize this serious condition in order to begin treatment promptly. The causes of these processes differ in children and adults, as do the symptoms of presentation. Lateral cervical radiography and CT are diagnostic in only a few cases. Treatment is abscess drainage. Two cases of retropharyngeal abscess are reported. The first case occurred in a child and was due to infection of Waldeyer's lymphatic ring. The second occurred in an adult as a result of foreign body trauma.

[Morphofunctional changes in olfactory bulb after elimination of smell stimuli (I). Morphologic study]. / Alteraciones morfofuncionales en el bulbo olfatorio tras privación de estímulos olorosos (I). Estudio morfológico.

We study the olfactory bulb plasticity by olfactory deprivation in the jerbil (Meriones Unguiculatus). We analyze what effects has the odorous stimuli privation in the first days after the birth on the olfactory bulb. We have found that this stimuli absence reduces the size of the bulb in the discussed side and alters the volumes of some of the bulbars layers. This indicates that the structural development of the nervous system specifies of an integrity of their sensorial afferencies.

[Morphofunctional changes in the olfactory bulb after odor stimuli deprivation (II). Histochemical study]. / Alteraciones morfofuncionales en el bulbo olfatorio tras privación de estímulos olorosos (II). Estudio histoquímico.

By histochemical and immunohistochemical methods we study the effects that has the odorous stimuli privation in the first day after the birth on the activity of the olfactory bulb of the gerbil (Meriones Unguiculatus). This sensory deprivation of stimuli causes drastic reductions in given activities (Tyrosine Hydroxylase) no altering other (DOPA-Decarboxylase). This indicates that the functional ripeness of given enzymatic systems specify of an integrity of their sensorial afferences, while it is not necessary for the normal activity of other enzymes even within the same cell.

[Carcinoma of the nasopharynx, radiotherapy, otitis, labyrinthitis, inflammation of the petrous bone, meningitis]. / Cáncer de cávum, radioterapia, otitis, laberintitis, petrositis, meningitis.

Endocranial complications of otitis show new etiopathogenic possibilities. We have accomplished an analysis of this issue after one of these cases. A female patient with a nasopharyngeal carcinoma developed an otogenous meningitis. Radiotherapeutic management was followed by osteoradionecrosis of cranial basis, local hypoimmunity favorized the reported course: middle otitis, labyrinthitis, petrositis and meningitis. Comments on pathogenetic, clinic and therapeutical peculiarities of this case.

[Anatomic considerations in relation to the importance of the external branch of the spinal nerve in surgery on the posterior cervical triangle]. / Consideraciones anatómicas sobre la importancia de la rama externa del nervio espinal en la cirugía del triángulo posterior del cuello.

The integrity of the spinal accessory nerve plays an important role in cervicofacial surgery since the majority of surgical approaches involve this structure. The resection of the spinal accessory nerve leads to the so-called <> mainly due to the denervation of the trapezius. This syndrome is characterised by the onset of regional pain, functional deficit and deformation of the shoulder joint. The anatomy of the accessory nerve is defined in the light of 93 functional neck dissections with particular regard to the following aspects: its relation with the internal jugular vein, its relation with the sternocleidomastoid muscle (ECM) and mastoid tip and its anastomoses with the cervical plexus.

[Hypoacusis and diabetes type II]. / Hipoacusia en diabetes mellitus tipo II.

The relation between diabetes mellitus and hypoacusis is discussed since Jordao, who firstly pointed out to this association in 1854. The disparity of results according several studies are due, after other AA., to the heterogeneous of groups considered. Our study was done resorting to a patients selection and their classification in 2 homogeneous groups following different parameters: age; sex; years of course; verified angiopathic complications: peripheric vasculopathy, microalbuminuria, altered creatinine clearance; malady control: glycosylated hemoglobin. The task consisted in the study of audiometric tracings in 40 patients in order to verify statistic differences of auditive thresholds between the established groups. These courses corresponding to a sensorineural hearing loss with a deep in high tones. But no significatively worse thresholds in patients suffering other angiopathic disorders were detected.

[Morphological and morphometric study of sphenoidal sinus]. / Estudio morfológico y morfométrico del seno esfenoidal.

Thanks to the help of anatomical dissections and imaging techniques we way present this paper in which are described the morphologic characteristics of the sinus, its pneumatization types more frequently encountered, the traits more noteworthy related to the intersinusal partition and bone crests inside the sinus as well the distances detaching the sinus from the anterior wall of the sella turcica and clivus, through which wall the sinus cavity keeps in touch with noble cranial structures as the hypophysis and the brain stem. Ultimately our outcomes are compared with those given by other researchers.

[Chronological development of the sphenoidal sinus]. / Desarrollo cronológico del seno esfenoidal.

In this paper are exposed the main characteristics of the sphenoidal sinus rise, through a follow-up of its growth during the life-span of the first 20 years of life. For so doing the AA. studied the antero-posterior diameters, the vertical greatest diameter and the several distances detaching this sinus from other important anatomical references, as well the various degrees of pneumatization that the cavity may reach according as the years go over.

[Upper aerodigestive infections and their effect on sphenoidal sinus development]. / Influencia de las infecciones de las vías aerodigestivas altas sobre el desarrollo del seno esfenoidal.

Paranasal sinuses development and its ultimate mode of happening as well, has been the purpose of numerous hypotheses, that can be synthetized in this two: One which sees the pneumatization as mechanical event resulting from muscular tractions exerted on the sphenoidal sinus walls and another one supposing the pneumatization as an active phenomenon due to the osteoclastic potential of the same respiratory mucous membrane. In this work were employed 200 radiogramms belonging both to patients suffering chronic ENT infections and subjects without antecedents. The conclusion drawn out are that chronic infections do not modify the percentage of pneumatization types, but reduce the anteroposterior maximal diameter.

[Mucocele of maxillary sinus]. / Mucocele del seno maxilar.

The term mucocele designates a cyst developing from a sinus mucosa, generally the frontal and/or ethmoidal sinuses. Maxillary sinus localization is exceptional however and raises numerous diagnostic problems in daily practice. The antral mucoceles are potentially destructive lesions, often secondary to Caldwell-Luc procedure. In this article are described in some detail the clinical, radiological and histopathological features of true antral mucoceles.

[Mucoepidermoid carcinoma of the larynx. A case report and review of literature]. / Carcinoma mucoepidermoide de laringe. Aportación de un caso y revisión de la literatura.

A new case of mucoepidermoid carcinoma of the larynx is presented. The microscopic differential diagnosis of mucoepidermoid carcinoma, the several cells stem with its malignancy degrees and its repercussion on prognostic and possible treatments of this rare growth are stressed. A review of the literature is set aside.