[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.

Vestibular neuritis: etiopathogenesis.

Vestibular neuritis presents as sudden unilateral vertigo in the absence of hearing loss or neurologic involvement and is thought to be due to neurotropic viruses. Its morbidity is unknown and it affects both sexes equally, with the highest incidence at 40-50 years of age. The etiology of this condition has been ascribed to viral, bacterial and protozoan infections, as well as allergic and auto-immune causes. Inflammation of the vestibular nerve is followed by demyelination and loss of function, which is not always reversible. Higher plasma fibrinogen and CRP levels in the acute phase, longer BERA latency and I-III interval and increased gadolinium uptake in the vestibular nerve and Scarpa's ganglion on enhanced MRI confirm the inflammatory nature of the process. An animal model of vestibular neuritis using retroauricular inoculation of herpes simplex virus in mice, histologic findings in the temporal bone of individuals who had vestibular neuritis, and influenza A virus infection in cultured Schwann's cells suggest viral infection as the main aetiologic cause.

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.

[Heat and vestibular stimulation]. / Calor y estimulación vestibular.

In 1905 Barany analyzed the nystagmus that appears during the irrigation of the ear with cold and hot water, justifying the phenomenon due to convectives currents in the horizontal semicircular canal. This hypothesis has been widely accepted until doubt was casted on it by the experiences carried out in the Skylab. Of the various mechanisms that could be responsible for the vestibular stimulation in the caloric tests, those which entail convection currents or endolymph expansion would need--we think--thermal gradients very superior to those occurring during these tests, that according to our calculations--always pro such hypothesis--seem insufficient.

[Polymorphic reticulosis of the rhinopharynx]. / Reticulosis polimorfa de rinofaringe.

"Malignant centrofacial granulomatosis" is an unusual but devastating spectrum of lymphoproliferative disorders that is now thought to include several entitites, such as polymorphic reticulosis or peripheral T-cell lymphoma. Characteristically there are destructive centrofacial lesions which often produce difficulties for the diagnostic to the clinician and pathologist. The case of a 71-year-old man diagnosed in our Department as polymorphic reticulosis sitting on the rhinopharynx is reported.

[Reading test as a qualitative method for evaluating the vestibulo-ocular reflex]. / El test de lectura como método de valoración cualitativa del reflejo vestibuloocular.

In the reading test the patient reads a text while his or her head is passively moved from one side to another with a frequency over 2 Hz. The vestibulo-ocular reflex (VOR) should stabilize the patient's gaze if it is performing adequately, allowing him or her to read well. Reading becomes impossible if the VOR is defective. We tested this method by assessing VOR in a 30-patient series by means of VAT and a previous reading-test score, and we compared the results of both groups. Next, the test was clinically validated with the bithermal caloric test. There were significant differences in ocular asymmetry between normal and strongly positive groups. The sensitivity, specificity, and positive and negative predictive values validated the reading testing as clinically useful.

[Fibrous craniofacial dysplasia]. / Displasia fibrosa craneofacial.

A case report of fibrous dysplasia affecting only the craniofacial right side, in a 56-year-old woman, seen in our outpatients Department suffering from fronto-orbital headache and subjective hypoacusis of the right side, besides a syndrome of dizziness of 6 years development.

[Bimastoid leads and bilateral stimulation in the recording of auditory-evoked brain-stem potentials]. / La derivación bimastoidea y estimulación bilateral en el registro de potenciales evocados auditivos de tronco cerebral.

The recording of auditory brain stem potentials (ABR) with bimastoid leads and bilateral stimulation makes it possible to evaluate relative cochlear function and the type of hearing loss. The theoretical background for this technique and the results obtained in patients with disease of the internal-middle ear, cochlea, and auditory nerve are discussed.

[Ectopic primitive thyroid papillary carcinoma: report of a fatal case and review of literature]. / Carcinoma papilar primitivo de quiste tirogloso: aportación de un caso letal y revisión de la literatura.

One percent of excised thyroglossal duct remnants exhibit histologic malignancy, a thyroid papillary carcinoma in 80% of the cases. The prognosis is excellent except for anaplastic types. We report the case of a 44-year-old woman with primitive thyroid papillary carcinoma diagnosed histologically as thyroglossal cyst. Its unusual aggressiveness produced local and regional spread, metastases and the patient's death in spite of treatment: Sistrunk operation, local excision of a recurrence and laryngothyroidectomy. Thyroid histology revealed the absence of carcinomatous foci. We discuss the most noteworthy aspects of the case in relation to other reports.

[Comparative study of the effect of different chemical procedures on the antigenicity of allogenic transplants of the human trachea]. / Estudio comparativo del efecto de distintos procedimientos químicos sobre la antigenicidad de trasplantes alógenos de tráquea humana.

Replacement of long tracheal segments poses some unsolved problems, specially the undisponibility of an adequated substitution material. This study deals with some of the immunological aspects of the transplantation and preservation of human tracheal grafts. Since immunological rejection occurs in the first place as a consequence of incompatibility for class II antigens (HLA-DR, -DP and -DQ), their presence and distribution was studied using monoclonal antibodies and the immunoperoxidase method. Class II expressing cells were recognized in the mucosa and the mixed glandular tissue. Furthermore we investigated the influence of different preservation methods on the antigenicity of tracheal allografts. The results showed a total destruction of these antigens. We can conclude that chemically preserved human tracheal allografts are immunologically suitable for reconstructive surgery of the trachea.