Revisión del tratamiento quirúrgico de la rinosinusitis / Revision of surgical treatment of rhinosinusitis

Este artículo de revisión tiene por objeto la actualización integral de los aspectos que permiten obtener el máximo rendimiento del tratamiento quirúrgico endoscópico de la rinosinusitis del adulto. El desconocimiento del origen y mecanismo de producción de la rinosinusitis hace que no exista aún un tratamiento curativo. Los más recientes hallazgos en la fisiopatología de los senos paranasales, junto con los avances endoscópicos y radiológicos, han revolucionado el tratamiento quirúrgico de la rinosinusitis. Existe un elevado número de pacientes a los que se realiza cirugía endoscópica nasosinusal funcional. El uso apropiado de la tomografía computarizada es fundamental para que el cirujano obtenga las referencias necesarias y pueda planificar el procedimiento con precisión y seguridad. La cirugía endoscópica nasosinusal es una técnica segura si se realiza con una técnica adecuada y el suficiente entrenamiento, pero deben tenerse en cuenta los recursos necesarios para la prevención y tratamiento de complicaciones (AU)

The aim of this revision paper is to provide an update of available resources to achieve the best endoscopic sinus surgery outcomes of adult rhinosinusitis. The cause and mechanisms of rhinosinusitis remain unknown, and curative treatment does not exist. Recent new insights into paranasal sinus pathophysiology, along with technical advances in imaging and endoscopy, have revolutionised surgical treatment of rhinosinusitis. Since an increasing number of patients undergo functional endoscopic sinus surgery as a therapeutic regimen for their disease, appropriate use of computed tomography is critical in providing a “roadmap” for the surgeon to delimit the surgical procedure, as well as to ensure safety and accuracy. With proper training and technique, endoscopic surgery is quite safe, but prevention and management of complications must be known (AU)

Acoustic analysis of voice in Huntington's disease patients.

BACKGROUND/OBJECTIVES: Alterations of voice and speech are frequently observed in Huntington's disease (HD). The aim of this study was to assess the degree of voice and speech abnormalities in a group of patients with HD and to analyze possible correlations with degree of disease severity. PATIENTS/METHODS: An observational study was carried out on diagnosed cases and controls. The voices of 20 patients were analyzed and compared with an age- and sex-matched control group. Variables analyzed included subjective voice exploration, analysis of aerodynamic efficiency, acoustic analysis measures, and laryngeal examination descriptions. Results obtained were correlated with degree of disease severity. RESULTS: Changes in the Voice Handicap Index and clinical characteristics of the voice were observed. Maximum phonation time was reduced. Acoustic analysis revealed changes that were analyzed. Uncontrolled adduction-abduction movements were observed by laryngeal examination. All results showed a positive correlation with degree of disease severity assessed by the Unified Huntington's Disease Rating Scale. CONCLUSIONS: HD causes alterations in subjective voice features, aerodynamic and acoustic analysis measures that are correlated with disease severity.