Membrana laríngea congénita / Congenital laryngeal membrane

La membrana laríngea congénita es una malformación infrecuente de las vías aéreas. La clínica que produce depende del grado de obstrucción que produzca en dichas vías. Debe tenerse en consideración al realizar el diagnóstico diferencial de la dificultad respiratoria del recién nacido. El tratamiento dependerá asimismo del grado de obstrucción de la vía respiratoria. Se describe el caso de una lactante de dos semanas de vida que presenta afonía desde el nacimiento y dificultad respiratoria en el curso de infecciones de las vías aéreas superiores. Mediante laringoscopia directa, se realiza el diagnóstico de membrana laríngea congénita. El tratamiento realizado consiste en varias intervenciones de vaporización con láser de dióxido de carbono (AU)

Congenital laryngeal membrane is a rare malformation of the airways. The symptoms depend on the degree of obstruction that triggers in these pathways. It must be taken into consideration in the differential diagnosis of the newborn respiratory distress. The treatment depends on the degree of airway obstruction. We report the case of an infant 2 weeks old with aphonia from birth and respiratory distress with upper airways infections. She is diagnosed of congenital laryngeal membrane by direct laryngoscopy. The treatment is performed with lasser (AU)

[Neonatal hearing loss screening: our results three years after starting the program]. / Despistaje de la hipoacusia neonatal: resultados después de 3 años de iniciar nuestro programa.

Since the 90s there increasing interest in early detection of neonatal hearing loss due to the feasibility of universal neonatal screening as well as to the possibility of early intervention. This has led to set up neonatal screening programs based upon otoacoustic emissions and to a great increase in the number of publications in the field. Our hospital started a neonatal hearing loss screening program using otoacoustic emission in March 2000. We used a Capella Cochlear Emissions (MADSEN electronics) equipment. Until May 2003 we have performed the test in 6372 children with a median age of 71 days. In our study, the sensibility of the test was 90.9% and the specificity 99.7%. Our results are similar to those reported in the literature although the age of the children was higher and we have found an incidence of hearing loss lower than other studies.

[Spectrographic study of voice disorders: subharmonics]. / Estudio espectrográfico de la disfonía: subarmónicos.

The presence of subharmonics in abnormal adult voices (polyps, polypoid degeneration, plicae ventricularis) was investigated. Subharmonics are low-frequency modulations located between two consecutive harmonics in the spectrum. Spectrum analysis was performed on 115 abnormal voices, of which 36 (31%) had subharmonics. Thirteen of the 36 voices with subharmonics had normal jitter and shimmer, so the rough voice was characterized acoustically not only by jitter and shimmer but by the presence of subharmonics in the spectrum. Subharmonics may correspond to a qualitative change in the behavior of the vibratory system.

[Thyroid cancer with extension to the upper respiratory-digestive tract: therapeutic approach]. / Cáncer de tiroides con extensión al tracto aerodigestivo superior: actitud terapéutica.

Thyroid carcinomas usually have a good prognosis, particularly well-differentiated tumors confined to the gland. An analysis was made of the treatment and prognosis of thyroid neoplasms with invasion of the upper respiratory and digestive tract. Of 211 patients treated at our institution from 1975 to 1994, only 18 had invasion of the upper respiratory and digestive system. All patients were treated surgically. The procedures included total thyroidectomy, laryngectomy, partial esophagectomy, and tracheal resection. The neoplasm recurred locally after complete resection in 33%. Cervical lymph node metastases occurred in 17% and distant metastases in 33%. The 5-year survival rate was 46% for well-differentiated carcinomas. Invasion of the respiratory and digestive tract had negative prognostic significance in the statistical analysis. Locally advanced thyroid neoplasms had a poorer prognosis than those limited to the thyroid gland. However, complete surgical resection of the malignancy was achieved in most patients without functionally mutilating procedures and with satisfactory survival results.

[Paragangliomas of the head and neck. Our experience]. / Paragangliomas de cabeza y cuello. Nuestra experiencia.

Paragangliomas of the head and neck are rare tumors of neuroectodermal origin. However, jugulotympanic paragangliomas are the second most common tumor of the temporal bone. Paragangliomas are recognized as benign tumors, but some show a biological behavior similar to that of malignant lesions, such as the development of recurrence or invasive growth patterns. We report 31 patients with a total of 35 paragangliomas who were seen in our department. Multiple paragangliomas were found in 2 patients. Twenty-two patients had jugulotympanic paragangliomas, 11 carotid and 2 vagal paragangliomas. None of the patients had prior treatment and the minimum follow-up was 1 year. Surgery was performed in 28 (90%), primary irradiation in 1 (3%), and 2 (7%) refused treatment. We describe our results, the clinical course, diagnostic methods and treatment options.

[Thyroid cancer. Epidemiological, diagnostic and therapeutic features]. / Cáncer de tiroides. Aspectos epidemiológicos, diagnósticos y terapéuticos.

A retrospective clinical study was made of 189 cases of thyroid cancer seen in our service between 1974 and 1994. Epidemiological, clinical, diagnostic, and therapeutic variables were analyzed for each histological type of thyroid carcinoma. Total thyroidectomy is the treatment of choice at our institution, followed by radioiodine treatment for differentiated carcinomas and external radiation and chemotherapy for anaplastic carcinomas. The 5-year survival rate after surgical treatment was 72% for all histological types of thyroid carcinoma. Permanent postoperative complications occurred in 2% of patients.