[Postural control related to age in patients with benign positional paroxysmal vertigo]. / Control postural según la edad en pacientes con vértigo posicional paroxístico benigno.

OBJECTIVE: To study the relationship between age and posturography in patients with benign positional paroxysmal vertigo. MATERIAL AND METHODS: Prospective study performed in 65 patients with benign positional paroxysmal vertigo (BPPV) in any variant. Sensory Organization Test outcomes were recorded and compared with their equivalents in a control group by means of scatter-plot diagrams and regression line. For statistical study, Mann-Whitney's U-test was used. RESULTS: Slope for regression lines in composite was -0.0934 in group NORMAL; in group BPPV it was -0.4284. This difference is due to conditions 5 and 6. Results were statistically significative. CONCLUSIONS: BPPV patients have a worse postural control than control group. The difference is bigger the older the patient is. It is due to a failure in conditions 5 and 6, so it should be from a vestibular origin.

Control postural según la edad en pacientes con vértigo posicional paroxístico benigno / Postural control related to age in patients with benign positional paroxysmal vertigo

Objetivo: Estudiar la relación entre la edad y el control postural en pacientes con vértigo posicional paroxístico benigno. Material y método: Estudio prospectivo realizado en 65 pacientes diagnosticados de vértigo posicional paroxístico benigno (VPPB) en cualquiera de sus variantes. Se miden los resultados del Test de Organización Sensorial, comparándolas con sus equivalentes en un grupo control mediante nube de puntos y recta de regresión. Para el estudio estadístico se usó el test U de Mann-Whitney. Resultados: En el grupo NORMAL, la recta de regresión del resultado global tiene una pendiente de –0,0934; en el grupo VPPB, de –0,4284. Esta diferencia se debe fundamentalmente a las condiciones 5 y 6, siendo los resultados estadísticamente significativos. Conclusiones: Los pacientes con VPPB tienen un peor control postural que el grupo control. Esta diferencia es mucho más acusada cuanto mayor es la edad del paciente, y es de origen vestibular

Objective: To study the relationship between age and posturography in patients with benign positional paroxysmal vertigo. Material and methods: Prospective study performed in 65 patients with benign positional paroxysmal vertigo (BPPV) in any variant. Sensory Organization Test outcomes were recorded and compared with their equivalents in a control group by means of scatter-plot diagrams and regression line. For statistical study, Mann-Whitney’s U-test was used. Results: Slope for regression lines in composite was –0.0934 in group NORMAL; in group BPPV it was –0.4284. This difference is due to conditions 5 and 6. Results were statistically significative. Conclusions: BPPV patients have a worse postural control than control group. The difference is bigger the older the patient is. It is due to a failure in conditions 5 and 6, so it should be from a vestibular origin

Postural control according to the age in patients with benign paroxysmal positional vertigo.

OBJECTIVES: To study the relationship between age and postural control in patients with benign paroxysmal positional vertigo. MATERIAL AND METHODS: Prospective study performed in 65 diagnosed patients with benign paroxysmal positional vertigo (BPPV) in any of its variants. The results of the Sensory Organization Test are compared with their equivalent in a control group by means of scatterplot and regression lines. For the statistical study the Mann-Whitney's U test was used. RESULTS: In the NORMAL group, the regression line for composite has a 0.0934 slope; in the BPPV group, 0.4284. This difference is due to conditions 5 and 6 fundamentally, the results being statistically significant. CONCLUSIONS: The patients with BPPV have a worse postural control than the group control. This difference is much more pronounced the older the patient, and is of vestibular origin.

Resultados del tratamiento del cáncer laríngeosupraglótico mediante cirugía endoscópica con láser CO2 / Treatment of supraglottic cancer by means of CO2 laser endoscopic surgery: results

Hemos estudiado una serie de 253 pacientes con cáncer de laringe, tratados mediante cirugía endoscópica con láser CO2.Cincuenta pacientes presentaban una localización supraglótica. Tras analizar diversos parámetros, se concluye que la cirugía endoscópica láser en los carcinomas supraglóticos tiene una tasa de supervivencia y un tiempo libre de enfermedad muy similares a la cirugía por vía externa. El tiempo de ingreso es mucho más reducido, el riesgo de complicaciones menor y el coste por proceso más bajo que con la cirugía convencional. Se evitó la traqueotomía en la mayor parte de los pacientes. Las recidivas pueden tratarse de nuevo por vía endoscópica, pero, la necesidad de realizar una laringectomía total tras una recidiva, se considera un factor de mal pronóstico (AU)

A group of 253 patients with laryngeal carcinoma was treated by endoscopic laser-CO2 surgery, 50 of them presented a supraglottic localization. The follow up period ranged from 1 to 10 years. From the analysis of different parameters (age, site, stage, histopathology, etc) it could be concluded that survival and free-symptoms-time rates in patients treated with laser endoscopy were similar to those obtained in patients treated with conventional external surgery. However, the endoscopic laser-CO2 surgery reported several advantages such as: no pharyngostoma, less complications, shorter stay in hospital and, consequently, lower health costs. In addition, tracheotomy was almost never necessary. Recurrencies can be also treated endoscopically, but, when total laryngectomy is needed following recurrency, this is considered to be a bad prognostic factor (AU)

[Results of supraglottic laryngeal cancer treatment with endoscopic surgery using CO2 laser]. / Resultados del tratamiento del cáncer laríngeo supraglótico mediante cirugía endoscópica con láser CO2.

A group of 253 patients with laryngeal carcinoma was treated by endoscopic laser-CO2 surgery, 50 of them presented a supraglottic localization. The follow up period ranged from 1 to 10 years. From the analysis of different parameters (age, site, stage, histopathology, etc) it could be concluded that survival and free-symptoms-time rates in patients treated with laser endoscopy were similar to those obtained in patients treated with conventional external surgery. However, the endoscopic laser-CO2 surgery reported several advantages such as: no pharyngostoma, less complications, shorter stay in hospital and, consequently, lower health costs. In addition, tracheotomy was almost never necessary. Recurrencies can be also treated endoscopically, but, when total laryngectomy is needed following recurrency, this is considered to be a bad prognostic factor.

Benign paroxysmal vertigo: a comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley maneuver.

We performed a prospective study to evaluate the efficacy of three physical treatments for benign paroxysmal positional vertigo: Brandt & Daroff habituation exercises, the Semont manoevre (intended as a statoconia-detachment maneuver), and the Epley maneuver (intended as a statoconia-repositioning maneuver). A total of 106 BPPV patients were randomly assigned to one of the three treatment groups, and responses were evaluated one week, one month and three months after the initial treatment. At the one-week follow-up, similar cure rates were obtained with the Semont and Epley maneuver (74% and 71% respectively), both cure rates being significantly higher than that obtained with Brandt & Daroff exercises (24%). By the three-month follow-up, the cure rate obtained with the Epley maneuver was higher (93%) than that obtained with the Semont maneuver (77%), though both remained higher than that obtained with the Brandt & Daroff maneuver (62%). However, the proportion of initially responding patients showing subsequent relapse was lower among patients treated by the Semont maneuver than among patients treated by the Epley maneuver. In view of these findings, we propose a treatment algorithm for patients with BPPV.

Epistaxis: estudio prospectivo sobre la atención urgente a nivel hospitalario / Epistaxis: prospective study on hospital emergency care

Realizamos un estudio prospectivo sobre los 279 pacientes con epistaxis referidos al ORL por el servicio de urgencias de nuestro hospital a lo largo de un año. Nuestros pacientes han sido preferentemente varones (62 por ciento), de edad media o avanzada (mediana 56 años), y aquejados de otras enfermedades (HTA 22,9 por ciento, Tto. antiagregante/anticoagulante 11, 1 por ciento). Los factores etiológicos locales predominantes han sido los traumatismos (12,9 por ciento) y las inflamaciones (14 por ciento). Las epistaxis esenciales han supuesto un 36,9 por ciento de nuestra serie. La localización más frecuente en todas las edades fue la anterior, en su mayor parte localizada en el área de Kiesselbach, aunque a partir de la 4ª década la incidencia de las posteriores aumentó deforma característica, afectando más a los varones. La mayoría de la epistaxis (> 99 por ciento) han sido manejadas exclusivamente de manera conservadora y sólo en dos pacientes ha sido necesario tratamiento quirúrgico o intervencionista. El mayor índice de resangrado se presentó en las epistaxis de localización posterior y en los pacientes entre los 30 y los 59 años. Los pacientes que necesitaron ingreso hospitalario tuvieron más edad que los ambulatorios y padecían más enfermedades. Su estancia media hospitalaria fue de 9,2 días (AU)

We prospectively studied 279 patients with epistaxis referred to ENT specialist from emergency room in our hospital in one year. Masculine sex (62%), medium or old ages (median 56 year), and associated diseases (HBP 22.9%, anticoagulants or antiplatelet drugs 11.1%), were the most common. Predominant local etiologic factors were trauma (12.9%) and inflammation (14%). Epistaxis had been essential in 36.9%. The most frequent location in all ages was the anterior one, especially located in the Kiesselbach's area, although the incidence of the posterior epistaxis increases in characteristic way from fourth decade, affecting more to men. Most of epistaxis (> 99%) were treated successfully by conservative approach and only two patients required surgical or interventional therapy. Patients between 30-59 year and the posterior epistaxis was the most refractory to the treatment. Hospitalized patients were older than ambulatory ones and had more associated diseases. Their average hospital stay was 9.2 days (AU)

Neumatocele traqueal postraumático. Un caso de fístula traqueal y enquistamiento aéreo paratraqueal / Postraumatic tracheal pneumatocele. A case of aerialtracheal fistula and paratracheal encysted

Presentamos un caso de neumatocele traqueal postraumático tras una herida cervical abierta. Aportamos un tratamiento conservador a tener en cuenta como es la punción simple del quiste aéreo y el vendaje compresivo cervical (AU)

[Epistaxis: prospective study on emergency care at the hospital level]. / Epistaxis: estudio prospectivo sobre la atención urgente a nivel hospitalario.

We prospectively studied 279 patients with epistaxis referred to ENT specialist from emergency room in our hospital in one year. Masculine sex (62%), medium or old ages (median 56 year), and associated diseases (HBP 22.9%, anticoagulants or antiplatelet drugs 11.1%), were the most common. Predominant local etiologic factors were trauma (12.9%) and inflammation (14%). Epistaxis had been essential in 36.9%. The most frequent location in all ages was the anterior one, especially located in the Kiesselbach's area, although the incidence of the posterior epistaxis increases in characteristic way from fourth decade, affecting more to men. Most of epistaxis (> 99%) were treated successfully by conservative approach and only two patients required surgical or interventional therapy. Patients between 30-59 year and the posterior epistaxis was the most refractory to the treatment. Hospitalized patients were older than ambulatory ones and had more associated diseases. Their average hospital stay was 9.2 days.