[Evaluation of efficacy and clinical impact of positron emission tomography with 18F fluoro-deoxyglucose (FDG) in patients with suspicion of recurrent laryngeal carcinoma]. / Evaluación de la eficacia y el impacto clínico de la tomografía de emisión de positrones (PET) con 18F fluoro-desoxiglucosa (FDG) en pacientes con sospecha de recurrencia de carcinoma de laringe.

AIMS: To evaluate the efficacy and clinical impact of FDG-PET in patients with suspected recurrent laryngeal carcinoma. MATERIALS AND METHODS: 15 patients, with suspicion of recurrent laryngeal carcinoma and ambiguous conventional imaging modalities. In all patients a whole body scan was performed with FDG-PET in fasting patients following i.v. administration of 370-444 MBq FDG. The results were confirmed by histology and clinical evolution (follow-up period > 12 months). RESULTS: Prevalence of recurrence was 86.6%. FDG-PET was positive in 13 patients, with confirmation in all cases, and 2 were true negative (TN). Overall sensitivity, specificity, PPV, NPV and accuracy were 100%. FDG-PET changed the modality of treatment in 10 patients (clinical impact 63.3%). CONCLUSIONS: FDG-PET has high clinical impact in patients with a suspicion of recurrent laryngeal carcinoma, and should be incorporated to the diagnostic protocols before making a therapy decision.

[Levels of the pineal hormone melatonin and its circadian variations in the cochlea of Wistar rats]. / Niveles de la hormona pineal melatonina y sus variaciones con el ritmo circadiano en cóclea de rata Wistar.

The normal inner ear contains different elements belonging to the immune system. Some pathology of the inner ear has been attributed to autoimmune mechanisms, both humoral and cellular. Melatonin, the principal hormone of the pineal gland, modulates the immune system, is involved in autoimmune processes, and mediates free-radical and interleukine production. In a study of the presence of melatonin in rat cochlea, a day-night rhythm of melatonin in cochlea was observed. Melatonin levels are high during dark periods and low during light periods. This rhythm is synchronic with peripheral melatonin circulation. More work, both experimental and clinical, is needed to determine the role of melatonin in the inner ear and its therapeutic usefulness.

[Melatonin in palate tonsils with recurrent acute tonsillitis and tonsillar hypertrophy]. / Melatonina en amígdalas palatinas de amigdalitis aguda recurrente e hipertrofia amigdalar.

Tonsils are a point of contact between the environment and the immune system. The pineal hormone melatonin is influenced by environmental dark-light variations and modulates the immune system. We measured the amount of melatonin present in pediatric tonsillar infectious and obstructive processes. The highest levels of tonsillar melatonin were found in tonsillar hypertrophy and the lowest levels in recurrent acute tonsillitis, with or without hypertrophy. Melatonin has an immunostimulative function and an antiapoptotic effect. The relationship between low tonsillar melatonin concentrations and infection, as well as high melatonin levels and increased tonsillar size is discussed.

[Unusual congenital laryngeal anomalies: a review of 13 cases]. / Anomalías congénitas laríngeas raras: una revisión de 13 casos.

In this study we presents: 6 subglottic stenosis, 2 subglottic hemangiomas, 2 laryngeal webs, 2 laryngeal cysts and 1 laryngoesophageal cleft. Were diagnosed during laryngotracheobronchoscopies performed to 220 newborns and small children that showed as main finding: stridor, voice change or aspiration syndrome. The stenosis, hemangiomas and cleft were resolved spontaneously. In the webs and cysts surgical correction was required. Here we will expound upon clinical, diagnostical and therapeutic aspects of these rare congenital laryngeal anomalies.

[Histiocytosis X: problems of differential diagnosis in otorhinolaryngology]. / Histiocitosis X: problemas de diagnóstico diferencial en ORL.

Four cases of Histiocytosis X are presented here, with symptoms otorhinolaryngologic. The evolution has been good, so they have been without disease for three of four years. We are presenting the problem of differential diagnosis of this disease for ENT specialists and the delay in the diagnosis. All our cases were diagnosed after one year of the beginning of symptoms.

[Relapsing polychondritis. Apropos of a case]. / Policondritis recidivante. A propósito de un caso.

Relapsing polychondritis is not a very frequent systemic disease. Nevertheless, it has to be borne in mind since very often the first symptoms appear in the sphere of otorhinolaryngology. We are faced with the problem of differential diagnosis in a case which in the beginning seemed to be a neurological pattern. The definitive diagnosis was not established until 15 months after the appearance of the symptoms when, after several outbreaks, the clinical pattern was clearer. As we have to deal with a recurrent and systemic pathology whose diagnosis is eminently clinical, long-term pursuit and valuation are necessary to allow us to know the natural history of the disease as well as the reaction to the treatment.