[Efficacy and safety of fexofenadine and cetirizine in the treatment of allergic rhinitis]. / Eficacia y seguridad de la fexofenadina y la cetirizina en el tratamiento de la rinitis alérgica.

BACKGROUND: Allergic rhinitis affects 20 million of people in United States and a higher figure all around the world. OBJECTIVE: To evaluate the efficacy and safety of fexofenadine compared with certirizine in the treatment of allergic rhinitis. MATERIAL AND METHOD: It was carried out a prospective, double blind, comparative, randomized and multicentric study in patients with allergic rhinitis, with ages between 12 and 65 years. In the first phase, placebo was administered during three days to all the patients; and then, they were randomly allocated to receive fexofenadine 120 mg or cetirizine 10 mg in one dose a day during 14 days. Laboratory and cabinet tests at the beginning and at the end were performed to value security, as well as a global evaluation of the researcher to estimate effectiveness. RESULTS: 176 patients were included, 63.6% were women, average age was 27 years (+/- 12), 47.7% received fexofenadine and 52.2%, cetirizine. There was not significant difference in parameters of effectiveness nor of security in the studied group. CONCLUSION: The results of the present study confirm the efficacy and safety of the antihistaminic fexofenadine in the treatment of allergic rhinitis.

Surgical treatment of labyrinthine fistula caused by cholesteatoma.

In a 144-month period, 27 cases of labyrinthine fistula (LF) were seen, and 360 mastoid operations were performed; the LF prevalence was 7.5%. Primary symptoms were hypoacusis, otorrhea, vertigo, tinnitus, and otalgia. All patients underwent preoperative CT scans and preoperative audiometry. LF diagnosis was made before surgery for 93% of patients on the basis of symptoms, signs, and imaging studies. With respect to surgical technique, the canal-wall-down procedure was performed in 92%, and the canal-wall-up procedure was performed in 8%. In 88% of patients the fistula was located in the horizontal semicircular canal. In 96% of patients the cholesteatoma matrix was removed, and the fistula was sealed; in 4% of patients the matrix was left. With a follow-up of 13 years, vertigo disappeared in 96% of patients, and hearing remained unchanged in 70% of patients. Further complications of chronic otitis media existed in approximately half of the patients with LF. Open surgery with removal of the cholesteatoma matrix and sealing of the fistula with temporalis fascia in a canal-wall-down manner is a safe procedure that can make vertigo disappear and helps to preserve cochlear function.