The role of vegetable and fruit consumption and other habits on survival following the diagnosis of oral cancer: a prospective study in Spain.

The authors carried out a hospital-based prospective study to evaluate the role of behavioral and clinical risk factors, occurring before and after diagnosis, on the prognosis of 146 patients with newly diagnosed oral cancer using Cox models. High weekly intake of vegetables before and after diagnosis were both associated with lower recurrence rates, longer overall survival and longer oral cancer survival. Diagnostic delay was associated with an increased risk of recurrence and oral cancer mortality. Patients presenting with pharyngeal pain or a mucosal lesion had a longer oral cancer survival than patients presenting with other symptoms. Quitting tobacco and alcohol consumption before and after diagnosis were both associated with a lower recurrence and/or better survival, but the effects were not statistically significant. This study suggests that high consumption of vegetables before and after diagnosis of oral cancer may reduce the risk of recurrence, overall mortality and cancer mortality in oral cancer patients.

[Percutanous dilation tracheotomy: our experience]. / Traqueotomía percutánea por dilatación: nuestra experiencia.

UNLABELLED: Percutaneous dilation Tracheotomy (PDT) is becoming a popular alternative to surgical tracheotomy. In our hospital, we recently adopted the use of the PDT in intensive care unit patients. OBJECTIVE: The objective [corrected] of this investigation is to characterize and quantify the rate of complications for PDT. MATERIALS AND METHODS: A prospective study of 60 PDT performed at different intesive care units, betweem September 2002 to July 2003. RESULTS: The intraoperative time for PDT was 8 minutes. Complications included 6 cases of mild intraoperative hemorrhage, 1 case of moderate intraoperative hemorrhage, 4 cases of mild postoperative hemorrhage and 1 case of subcutaneous emphysema. CONCLUSIONS: PDT is a good alternative to surgical tracheotomy and should be added to the otolaryngologists armamentarium of surgical airway procedures.

Traqueotomía percutánea por dilatación: nuestra experiencia / Percutanous dilation tracheotomy: our experience

La traqueotomía percutánea por dilatación (TPD) viene siendo una popular alternativa a la traqueotomía quirúrgica. En nuestro hospital ha sido integrada recientemente en la Unidad de Cuidados Intesivos. Objetivo: El objetivo de nuestro estudio es el de analizar las complicaciones de la TPD. Material y métodos: Realizamos un estudio prospectivo de 60 TPD, realizadas en diferentes unidades de cuidados intensivos, entre septiembre de 2002 y julio de 2003. Resultados: El tiempo intraoperatorio parala TPD fue de unos 8 minutos. Hubo 7 casos de hemorragia intraoperatoria, 6 leves y uno moderado, 4 casos de hemorragia postoperatoria y un caso de enfisema subcutáneo. Conclusiones: La TPD es una buena alternativa a la traqueotomía quirúrgica que debería añadir el otorrinolaringólogo a su repertorio quirúrgico de vía aérea (AU)

Percutaneous dilation Tracheotomy (PDT) is becoming a popular alternative to surgical tracheotomy. In our hospital, we recently adopted the use of the PDT in intensive care unit patients. OBJECTIVE: The objective [corrected] of this investigation is to characterize and quantify the rate of complications for PDT. MATERIALS AND METHODS: A prospective study of 60 PDT performed at different intesive care units, betweem September 2002 to July 2003. RESULTS: The intraoperative time for PDT was 8 minutes. Complications included 6 cases of mild intraoperative hemorrhage, 1 case of moderate intraoperative hemorrhage, 4 cases of mild postoperative hemorrhage and 1 case of subcutaneous emphysema. CONCLUSIONS: PDT is a good alternative to surgical tracheotomy and should be added to the otolaryngologists armamentarium of surgical airway procedures (AU)

[Crico-tracheal chondrosarcoma]. / Condrosarcoma crico-traqueal.

Chondrosarcoma is the most frequent mesenchymal tumor (nonepithelial) of the larynx. Radiographic studies and collaboration of pathologists have allowed that the number of cases diagnosed has increased considerably in the last few years. His privileged site is the subglotics. The late apparition of the symptoms delay the diagnosis, which is guided by CT scan and will be confirmed by histological examination of the surgical piece. The histological distinction between the different degrees of malignancy constitutes one challenge for the pathologist, so far, various criteria have been described for that aim. This biological behaviour is characterized by locoregional recurrence, in direct correlation with the grade of dedifferentiation. The treatment of choice is conservative surgical resection, and a regular follow up is obliged for early detection of recurrences and metastases. A case treated in our Center is presented, and the conclusions obtained after a literature review of the subject.

Condrosarcoma crico-traqueal / Crico-tracheal chondrosarcoma

El condrosarcoma es el tumor mesenquinal (no epidermoide) más frecuente de la laringe, a pesar de su rareza. Las técnicas de imagen, y la estrecha colaboración de los anatomopatólogos con los cirujanos, han permitido que el número de casos diagnosticados en los últimos años haya crecido de forma considerable. Su principal localización es la subglotis. La aparición tardía de los síntomas hace que el diagnóstico se retrase. Éste se orienta por medio de TC y se confirmará por el análisis anatomopatológico de la pieza quirúrgica. La distinción histológica del grado de malignidad constituye un reto para el patólogo, habiéndose descrito distintos criterios para ello. Su comportamiento biológico tiende hacia la recurrencia locorregional, en íntima relación con el grado de indiferenciación. El tratamiento de elección es la resección quirúrgica, conservadora en lo posible, siendo obligado el seguimiento de cerca para detectar las recurrencias. Se presenta un caso tratado en nuestro Centro, que nos llevó a realizar una revisión sobre el tema, y las conclusiones obtenidas (AU)

Chondrosarcoma is the most frequent mesenchymal tumor (nonepithelial) of the larynx. Radiographic studies and collaboration of pathologists have allowed that the number of cases diagnosed has increased considerably in the last few years. His privileged site is the subglotics. The late apparition of the symptoms delay the diagnosis, which is guided by CT scan and will be confirmed by histological examination of the surgical piece. The histological distinction between the different degrees of malignancy constitutes one challenge for the pathologist, so far, various criteria have been described for that aim. This biological behaviour is characterized by locoregional recurrence, in direct correlation with the grade of dedifferentiation. The treatment of choice is conservative surgical resection, and a regular follow up is obliged for early detection of recurrences and metastases. A case treated in our Center is presented, and the conclusions obtained after a literature review of the subject (AU)

[Neoplastic invasion of laryngeal cartilage: diagnosis by computed tomography]. / Invasión neoplásica del cartílago laríngeo, diagnóstico mediante tomografía computerizada.

The diagnostic of the laryngeal cartilage neoplastic invasion plays an important role in the accurate staging of the laryngeal carcinoma and its treatment. To evaluate the accuracy of the CT diagnosing cartilage involvement, the present study is reported. 127 patients with carcinoma of the larynx and hipopharynx T3-T4, surgical treated between 1993 and 1997 at Ciudad Sanitaria y Universitaria de Bellvitge, are retrospectively studied. TC presents an a accuracy of 78%, a specificity of 91% and a sensitivity of 54% in the diagnostic of laryngeal cartilage invasion of the laryngeal and hipopharyngeal carcinoma.

Invasión neoplásica del cartílago laríngeo, diagnóstico mediante tomografía computerizada / Neoplasic invasion of laryngeal cartilage: diagnosis by computed tomography

El diagnóstico de la invasión neoplásica del cartílago laríngeo es de gran importancia para el correcto estadiaje del carcinoma laríngeo y su posterior tratamiento. Para evaluar la precisión del TC en el diagnóstico de la afectación cartilaginosa, se realiza el presente estudio. Se estudian retrospectivamente 127 pacientes con carcinoma de laringe e hipofaringe T3-T4, tratados quirúrgicamente en la Ciudad Sanitaria y Universitaria de Bellvitge entre los años 1993 y 1997. Se determina que el TC presenta una exactitud del 78 por ciento, una especificidad del 91 por ciento y una sensibilidad del 54 por ciento, para el diagnóstico de la invasión de los cartílagos laríngeos en el carcinoma de laringe e hipofaringe (AU)

The diagnostic of the laryngeal cartilage neoplastic invasion plays an important role in the accurate staging of the laryngeal carcinoma and its treatment. To evaluate the accuracy of the CT diagnosing cartilage involvement, the present study is reported. 127 patients with carcinoma of the larynx and hipopharynx T3-T4, surgical treated between 1993 and 1997 at Ciudad Sanitaria y Universitaria de Bellvitge, are retrospectively studied. TC presents an a accuracy of 78%, a specificity of 91% and a sensitivity of 54% in the diagnostic of laryngeal cartilage invasion of the laryngeal and hipopharyngeal carcinoma (AU)

[Thyroglossal cyst associated with squamous cell carcinoma of the larynx]. / Quiste tirogloso asociado a carcinoma escamoso de laringe.

Cyst of the thyroglossal duct results from a developmental anomaly of the thyroid gland. There are many congenital neck masses only outnumbered by benign lymphadenopathies. The majority appear in children between 2 und 10 year-old, but nearly a third of cases does not manifest clinically until much later (20 year or so). In association to a carcinoma is an uncommon event, but there are published malignant cases. The AA. report the case of a 74-year-old patient with a neck cystic mass evolving during a 40-year-term associated to a laryngeal squamous carcinoma. The imagery shows the radiological and anatomopathological correlation of changes in the tissues interpreted as a cyst of thyroglossal duct and a squamous carcinoma of the larynx, independent of each other.

[Laryngeal leiomyoma]. / Leiomioma laríngeo.

A case of a 41-year-old man with a simple leiomyoma is reported. The pathological features of these tumors are described and also the therapeutic ones. A review of the literature confirmed that the laryngeal leiomyoma is a very infrequent neoplasm and only 36 cases have been reported previously.

Rhinosinusitis and atopy in patients infected with HIV.

HYPOTHESIS: Rhinosinusitis is common during HIV infection; its prevalence is uncertain and could probably be related to clinical features, immunoallergological status, and diagnostic criteria METHODS: Seventy-four patients hospitalized with HIV infection were prospectively evaluated for the presence of rhinosinusitis based on clinical findings, nasal endoscopy, or paranasal sinus computed tomography (CT). Immune status, nasal smear, features of atopy (based on the prick test), and its contribution to sinusal inflammatory pathology were also evaluated. RESULTS: Most patients were severely immunosuppressed: CD4+ 155+/-201 cells/mL and 12+/-11% (mean +/- SD). Thirty-five percent of the patients presented at least two criteria of rhinosinusitis (clinical findings, nasal endoscopy, and CT: 35%; clinical findings and CT: 50%; nasal endoscopy and CT: 15%). CT scan showed multiple sinus involvement, opacification over 25% of the total volume of the maxillary sinus in 50% of patients, and opacification of the sphenoidal sinus in 40% of cases. Atopy was present in 18% of patients, a figure which reflects the expected prevalence in our geographic area. Two independent predictors were associated with a higher probability of rhinosinusitis: bilateral absence of maxillary infundibular patency (odds ratio, 7.5; 95% CI = 2.03-27.9) and low total count (odds ratio, 0.99; 95% CI = 0.99-1.00) or percentage of CD4+ (odds ratio, 0.93; 95% CI = 0.88-1.00). CONCLUSIONS: There is a high prevalence of rhinosinusitis in HIV-infected individuals. This finding is related to a decreased cellular immunity, but it does not appear to be related to IgE-related immediate hypersensitivity. Nasal endoscopy should be the first-step diagnostic test. However, when clinical suspicion exists and endoscopy fails to explain symptoms, CT scan is a valuable adjunct to establish this diagnosis.

[Oncocytoma of submaxillary gland]. / Oncocitoma de glándula submaxilar.

Oncocytoma of the salivary submaxillary gland is a well-known growth, but more frequently sitting on the parotid gland. Benign tumor which histological features are well-defined, but needing a thoroughly anatomo-pathological study in order to attaint a correct diagnosis. The AA. report one case of submaxillary oncocytoma and comment about its clinical, histological and therapeutical peculiarities.

[Malignant peripheral nerve sheath tumor. Vagus nerve sarcoma]. / Tumor maligno de vaina de nervio periférico. Sarcoma de nervio vago.

A young man was seen for a mass on the left side of the neck. Computed tomography revealed a round mass suggesting a lymph node metastasis with a necrotic center. Fine needle aspiration found mesenchymal cells. The tumor excised from its location on the Xth left cranial nerve was found to be a malignant peripheral nerve sheath tumor. Treatment was complemented by regional irradiation. After concluding complementary treatment in April 1996, the patient currently is disease-free. This type of soft-tissue sarcoma is reviewed. Survival depends on tumoral size and cellular differentiation.

Bilateral facial nerve palsy: four case reports.

Bilateral facial nerve palsy is relatively uncommon and may occur in association with a variety of neurological, infectious, neoplastic or degenerative disorders. Presentation is made of 4 cases of bilateral facial diplegia due to a refractory anemia with excess of blasts, a Lyme disease and a tuberculoid leprosy. In one of these patients the cause of bilateral seventh-nerve palsy was unknown (Bell's palsy). Facial palsy returned to normal after treatment with steroids in 3 patients. The patient with myelodysplastic syndrome did not show any improvement and died 6 months after diagnosis.

[Minor salivary gland tumor in nasopharynx]. / Tumor de glándulas salivares menores en rinofaringe.

Pleomorphic adenoma, or mixed tumor, is the most common tumor of the salivary glands, being responsible for 47% of minor salivary-gland neoplasms. The palate is the most frequent location, but the nasopharynx is a rare site. The case of a 64-year-old man diagnosed as pleomorphic adenoma of the nasopharynx is reported. The recent literature was reviewed and the anatomopathological and clinical features were analyzed, as well as the differential diagnosis.

[Multicenter study comparing the efficacy and tolerance of topical ciprofloxacin (0.3%) versus topical gentamicin (0.3%) in the treatment of simple, non-cholesteatomaous chronic otitis media in the suppurative phase]. / Estudio multicéntrico comparativo de la eficacia y tolerancia de ciprofloxacino tópico (0.3%) versus gentamicina tópica (0.3%) en el tratamiento de la otitis media crónica simple no colesteatomatosa en fase supurativa.

A multicentre double-blind randomized study was carried out to compare topical ciprofloxacin and topical gentamicin in the treatment of simple non-cholesteatomatous purulent chronic otitis media. Three hundred and eight patients were included in the study, 159 treated with ciprofloxacin and 149 treated with gentamicin. The percentage of clinical success (elimination of otorrhoea) was 95% with ciprofloxacin and 94% with gentamicin (ns). Likewise, the percentage of bacteriological erradication was 96% with ciprofloxacin and 93% with gentamicin. Both drugs were well tolerated, without changes in the audiometric values. In these patients, topical ciprofloxacin shows the same efficacy as topical gentamicin without any potential ototoxic effect.