[Spider's bite that develop eyelid necrosis]. / Lesión necrótica palpebral por picadura de araña.

CASE REPORT: We report the case of a spider bite in a 7 years-old girl that develop a dermonecrosis and did not need surgical treatment. DISCUSSION: We analize the mechanisms of these kind of lesions review and update therapeutic management of these kind of lesions.

Lesión necrótica palpebral por picadura de araña / Spider´s bite that develop eyelid necrosis

Caso clínico: Se presenta el caso de un paciente de 7 años de edad que sufrió una picadura de araña común, desarrollando posteriormente una necrosis cutánea que no requirió tratamiento quirúrgico.Discusión: Se analizan los mecanismos implicados en este tipo de lesiones y realizamos una revisión y actualización del manejo terapéutico de las mismas

Case report: We report the case of a spider bite in a 7 years-old girl that develop a dermonecrosis and did not need surgical treatment.Discusión: We analize the mechanisms of these kind of lesions review and update therapeutic management of these kind of lesions

[Results of one year's application of a universal protocol for the early detection of hearing loss in neonates]. / Resultados de aplicar durante 1 año un protocolo universal de detección precoz de la hipoacusia en neonatos.

These are the results of the first year of the application of a universal programme for the early detection of neonatal deafness. Our objective is making a diagnosis of all the unilateral or bilateral cases of hearing loss above 35 dB HL, before the age of 6 months. The detection strategy has 2 screening phases with transient evoked otoacoustic emissions (TEOAE) and one diagnostic phase with auditory brain stem response (ABR). The ABR were carried out both on those patients that failed the TEOAE screening and on the neonates with hearing loss risk factors. Of the 1,277 living newborn babies (NB), we evaluated 94%. 3.3% of the NB showed hearing loss risk factors. 90% of the NB passed the first TEOAE in both ears and, after the second TEOAE, only 2.5% of the NB reached the diagnostic phase. We provided early detection and treatment of 0.58% of cases of bilateral severe-deep hearing loss. Finally, the results obtained are examined together with the importance of planning universal hearing screening.

[Results of the application of the protocol for the early detection of hearing loss in high-risk neonates]. / Resultados de la aplicación del protocolo de detección precoz de la hipoacusia en neonatos de alto riesgo.

In coordination with the Paediatrics Department, we drew up a protocol for the "Early Detection of Hearing Loss in High-Risk Neonates" based fundamentally on the sequential application of impedanciometry and the Auditory Brain Stem Response (ABR). These are the results obtained from October 1994 to March 2001. Of the 240 children examined, we found 36 cases (15%) of severe-to-profound bilateral sensorineural hearing loss (> 60 dBs HL). 55% was associated with risk factors. However, we diagnosed only 2 of these cases of hearing loss (5.5%) using the protocol (sent by the neonatology department due to the fact that they showed hearing loss risk factors), since the rest (94.5%) came as a result of suspected hearing loss, which resulted in an average age for diagnosis of 3 years. Although the procedure used is highly sensitive and is diagnostically specific, in the light of these results, we consider it necessary to extend hearing screening to all newborn infants in order to evaluate its effectiveness in the early detection of infant deafness.

[Mastoid osteoma]. / Osteoma de mastoides.

The osteomas of the mastoids are slow growing benign tumors, made predominantly of mature bone. Clinically these tumors are asymptomatic, except for cosmetic deformities, and they are usually casual radiological findings. Surgical treatment is indicated for symptomatic osteomas. In Spain only sixteen cases of extracanalicular osteoma have been described in the literature. Two new cases are reported and a review of the literature is presented.

[Asymptomatic bilateral pharyngocele]. / Faringocele bilateral asintomático.

The diverticula of the lateral wall of the pharynx are called pharyngoceles. We present a case of a 71-year old male in whom we discovered, by chance, a bilateral pharyngocele. Given their scarcity, we review the characteristics of the process, highlighting the relevance of the oesophagopharingeal barium swallow. Finally, we describe two possible anatomical locations of the herniated sac.

[Lingual abscess]. / Absceso lingual.

The unilateral abscess of the anterior portion of the tongue is an extremely rare occurrence. We report a case in which we have used the ultrasonography in the diagnosis, and discuss, as etiologic hypothesis the participation of Blandin-Nühn glands in the genesis of these abscess.

[Early diagnosis of childhood deafness: detection protocol in high-risk neonates]. / Diagnóstico precoz de hipoacusia infantil: protocolo de detección en neonatos de alto riesgo.

The protocol developed at our hospital for auditory assessment of children with risk factors for deafness is presented. The results obtained with tympanometry and auditory brainstem response (ABR) audiometry from October 1994 to March 1998 were analyzed. In 122 children, 17 cases (14%) of severe-to-profound bilateral deafness were found. Only 50% of these cases were associated with risk factors present at birth. The average age at time of diagnosis of deafness was over 3 years. In view of these results, we recommend auditory screening for all newborns as the only effective procedure for early detection of childhood deafness.

[Fibrous diaphragm of the nasopharynx]. / Diafragma fibroso de rinofaringe.

A case of nasopharyngeal fibrous diaphragm of unknown origin is reported. In view of the scarcity of publications about this disorder, this new case is interesting. A differential diagnosis is made with choanal atresia and nasopharyngeal stenosis. Aspects of the etiology, clinical manifestations, and treatment are discussed.

[Cholesterol granuloma of the temporal lobe]. / Granuloma colesterínico del peñasco del temporal.

Cholesterol granuloma is a histological term used to describe a non-specific inflammatory reaction produced by the presence of cholesterol crystals, which may originate a foreign-body reaction. Cholesterol granuloma of the temporal bone is silent for years and not preceded by a history of otitis media. The diagnosis is made by CT and MRI, which reveal an expansive, isodense lesion brain tissue and increased signal intensity on both T1 and T2-weighted images respectively. A case of cholesterol granuloma of the petrous apex is presented. The granuloma was excised completely using an infra-retrolabyrinthine approach.

[The descriptive study of primary care in otorhinolaryngology]. / Estudio descriptivo de la asistencia primaria en otorrinolaringología.

A descriptive study was made of medical and surgical activity over a six-month period in an outpatient ENT clinic of Valladolid, Spain, serving a health district of 142,779 persons. Age, sex, type of consultation, symptoms, complementary studies, diagnosis, check-up, and surgical treatment were analyzed and correlated in 1170 patients.

[Undifferentiated carcinoma, or lymphoepithelioma, of the base of the tongue]. / Carcinoma indiferenciado o linfoepitelioma de base de lengua.

The histologic features of undifferentiated carcinoma of the base of the tongue and lymphoepithelioma, or lymphoepithelial carcinoma, of the nasopharynx are identical and can be considered synonymous. The frequency of undifferentiated nasopharyngeal carcinoma (lymphoepithelioma) located on the base of the tongue is discussed because undifferentiated carcinoma of the base of the tongue is considered to be the same tumor.

[Spontaneous cervical and mediastinal emphysema]. / Enfisema cervical y mediastínico espontáneo.

Cervical emphysema may have its origin in multiple causes. The continuity of the fascial planes connecting the soft tissues of the neck to the mediatinum and retroperitoneum enables the "aberrant air" localized in one of these three areas to spread to the other ones. The otolaryngologist must know the differential diagnosis of the presence of air in the neck, since the ultimate treatment to be given will depend on the etiology involved. We present two clinical cases of cervical emphysema secondary to spontaneous pneumomediastinum. One of the cases is idiopathic while the other one is associated with diabetic ketoacidosis. We analyze this and other causes that can give rise to cervical emphysema.

[Acute compartment syndrome as a complication of a distal forearm fracture: apropos of a case of a child]. / Syndrome aigu de la loge antérieure de l'avant-bras après fracture distale des deux os: à propos d'un cas chez un enfant.

PURPOSE OF THE STUDY: We describe a case of acute volar compartment syndrome of the forearm occurred after fracture of the diaphyseal-metaphyseal junction of the distal radius and ulna. MATERIAL: A 7-year-old child fell down steps and injured his left forearm. METHODS: After reduction, the patient developed clinical signs of volar forearm compartment syndrome. Measurement of intramuscular pressure by the saline injection technique confirmed the diagnosis. RESULTS: Early decompressive fasciotomy led to uneventful healing with no residual symptoms. DISCUSSION: We discuss the mechanism, diagnosis and treatment of this injury. CONCLUSION: The development of suspicious clinical signs should be supplemented by compartment pressure measurements to determine the need of surgical decompression.

[Adenocarcinoma of the nasal cavities and paranasal sinuses. On low-grade adenocarcinoma]. / Adenocarcinoma de fosas nasales y senos paranasales. A propósito de un adenocarcinoma de "bajo grado".

The AA. having had the opportunity to diagnose and treat one of those cases, of low degree, sitting in the nasal cavity, discuss about its classification either in the nose or in the sinuses. Their opinion is coincidental with that of other reporters regarding to the complexity and varieties of a grouping system. They propose an other one, not original at all, but having perhaps the advantage that could make easier the comprehension and the clinical orientation when dealing with these growths.

[Morphological evaluation of the organ of Corti of guinea pigs submitted to acoustic trauma. II. Correlations of depth and surface lesions]. / Valoración morfológica del órgano de Corti del cobaya sometido a traumatismo acústico. II. Correlación en profundidad de las lesiones referidas en superficie.

Adult guinea pigs (250-500 g) were exposed to a chronic wide-band noise, at intensities ranging from 117 to 133 dB(A) at different times. While the first part of this paper concentrated on the surface study of the lesions produced by noise, this second part describes to correlating deep structural damage, based on the study of semi-thin and ultra-thin sections in the same specimen. Finally, a general discussion is presented with respect to the lesions described, both in so far as their specific characteristics as well as the possible mechanisms of damage which determine their formation.

[Morphological evaluation of the organ of Corti in the guinea pig subjected to acoustic trauma. I. Surface preparation study]. / Valoración morfológica del órgano de Corti del cobaya sometido a traumatismo acústico. I. Estudio en superficie.

Adult guinea pigs (250-500 g) were exposed to a chronic wide-band noise, at intensities ranging from 117 and 133 dB(A) at different times. The objective of this first part of the study is, after the lesions are established, to classify and put into order the structural damage produced by noise, using surface preparations observed with the light microscope and specimens prepared for scanning electron microscopy, from the organ of Corti.

[Surgical approach to the middle ear of the guinea pig]. / Abordaje quirúrgico del oído medio del cobaya.

A total of 40 guinea pigs have been used: in 5 a general anatomical dissection of the temporal bone was utilized; in another 5 guinea pigs a submandibular approach was performed; and in the remaining 30 a superior approach was employed. The submandibular approach begins with an incision of 30 mm inside of and parallel to the inferior border of the mandible , identifying the masseter muscle, the salivary gland, the thymus and posterior belly of the digastric muscle and, finally, the tympanic bulla. In the superior approach a horizontal supra-auricular incision of 15 mm is used which, after dissecting the temporal muscle, permits the access to the external wall of the epitympanum.

[Deep lobe parotid tumors]. / Tumores del lóbulo profundo de la parótida.

Tumours of the deep lobe, the section of the parotid located within the plane of the facial nerve, are not very frequent. Their diagnosis is difficult and seldom early, and their treatment involves complex technical problems. They evolve in one of two forms: as a tumour of the parapharyngeal space, or as a "dumb-bell" tumour with protrusion in the preauricular zone. Typical cases of both topographical possibilities are presented in this paper.

[A new system for the induction of experimental acoustic trauma by the application of recorded noise]. / Un nuevo sistema para la inducción de trauma acústico experimental mediante aplicación de ruido grabado.

This is a new method devised by the AA. in order to produce a laboratory experimental acoustic trauma, using a recorded noise. So it is possible to produce at will a noise strong enough to provoke a cochlear damage with the rythm, the frequency spectrum and duration chosen.