Open Tracheostomy for Critically Ill Patients with COVID-19.

BACKGROUND: COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy can shorten ICU length of stay and help weaning. Aims/Objectives. To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy. Material and Methods. A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10th March to 30th April 2020. Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum follow-up were recorded. The Otolaryngology team was tested for COVID-19 before and after the procedures. RESULTS: Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT. Twenty-seven patients (29%) underwent a tracheostomy. After three months, within the group of tracheotomized patients, 29.6% died and 48.15% were extubated in a mean time of 28.53 days. In the nontracheostomized patients, the mortality was 42.4%. CONCLUSIONS: Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI. Mortality after tracheostomy was less common than in nontracheostomized patients.

Wildervanck's syndrome with severe inner ear dysplasia and agenesis of the right internal carotid artery.

We describe a case with Wildervanck syndrome (cervico-oculo-acoustic syndrome) comprising Klippel-Feil anomaly, retractio bulbi (Duane syndrome), and congenital sensorineural deafness. An 18-month male baby had a severe inner ear dysplasia, and MRI also showed a complex vascular carotid malformation associated.

[Surgical management of salivary gland tumours]. / Tratamiento quirúrgico de los tumores de glándulas salivales.

INTRODUCTION AND OBJECTIVES: Salivary gland tumours account for 3% of head and neck tumours. The aim of this study is to analyze our series of tumours of the salivary glands requiring surgical treatment at our centre from 2004 to 2007. MATERIAL AND METHODS: This study is a retrospective review of 49 patients diagnosed as having tumours of the major and minor salivary glands or ectopic salivary tumours, and surgically treated at our hospital between 2004 and 2007. We reviewed their clinical characteristics, imaging findings, fine-needle cytology results, surgical charts (sub-maxillectomies, parotidectomies, palatal tumour excisions and cervicotomies), final pathology findings, and course with at least one year follow-up. RESULTS: Forty-nine salivary tumours were treated, including 43 parotid tumours (87%), 3 sub-mandibular tumours (6%), 1 palatal tumour (2%) and 2 ectopic tumours (4%). Sixteen percent of the tumours were malignant. Fine-needle cytology sensitivity was 40%, whereas specificity was 100%. Out of 43 parotidectomies, 40 (93%) were primary parotidectomies, and 3 were revision parotidectomies. Most parotidectomies (81%) were superficial or partial and 8 (19%) were total. Parotidectomy complications are similar to those described previously in the literature: permanent facial palsy in superficial or partial parotidectomy (5%), wound dehiscence or necrosis (13%), post-operative bleeding (4%), fever or wound infection (7%), sialoceles (44%) and Frey's syndrome (2%). CONCLUSIONS: Parotid tumours are the most common salivary gland tumours. Most of them are benign, but Warthin's tumour is more frequent than usual in our series. Early and late complications from parotidectomy are uncommon, although sialocele is a common transitory complication in our series.

Tratamiento quirúrgico de los tumores de glándulas salivales / Surgical management of salivary gland tumours

Introducción y objetivos: Los tumores derivados del tejido salival son el 3% de los tumores de cabeza y cuello. El objetivo de este estudio es analizar una serie de tumores derivados de tejido salival que han requerido tratamiento quirúrgico en nuestro hospital en el periodo 2004–2007. Material y método: Revisión retrospectiva de 49 tumores derivados de glándulas salivales mayores o menores o de estirpe salival de localización ectópica. Se analizan datos relativos a la historia clínica, pruebas complementarias, datos quirúrgicos (submaxilectomías, parotidectomías y otras intervenciones), anatomopatológicos y de evolución del paciente, con un seguimiento mínimo de 1 año. Resultados: De los 49 tumores salivales, 43 (87%) eran parotídeos; 3 (6%), submaxilares; uno en mucosa oral palatina, y 2 ectópicos cervicales. El 16% de los tumores fueron malignos. La punción aspirativa con aguja fina tuvo una sensibilidad del 40% y una especificidad del 100%. De las parotidectomías, 40 (93%) fueron parotidectomías primarias, y 3 (7%), revisiones de parotidectomías; en 35 (81%) casos fueron parotidectomías superficiales o parciales, y en 8 (19%) fueron totales. Las complicaciones posquirúrgicas en las parotidectomías fueron similares a las descritas en la literatura: parálisis facial permanente tras parotidectomía superficial (5%), necrosis o dehiscencia de herida quirúrgica (13%), hemorragia postoperatoria (4%), fiebre o sobreinfección de la herida (7%), sialoceles transitorios (44%) y síndrome de Frey (2%). Conclusiones: Los tumores parotídeos son los más frecuentes, siendo en su mayoría benignos. En nuestra serie el tumor de Whartin es más frecuente que en otras series. Las complicaciones precoces y tardías de las parotidectomías son poco habituales, aunque en nuestra serie el sialocele es una complicación transitoria frecuente (AU)

Introduction and objectives: Salivary gland tumours account for 3% of head and neck tumours. The aim of this study is to analyze our series of tumours of the salivary glands requiring surgical treatment at our centre from 2004 to 2007. Material and methods: This study is a retrospective review of 49 patients diagnosed as having tumours of the major and minor salivary glands or ectopic salivary tumours, and surgically treated at our hospital between 2004 and 2007. We reviewed their clinical characteristics, imaging findings, fine-needle cytology results, surgical charts (sub-maxillectomies, parotidectomies, palatal tumour excisions and cervicotomies), final pathology findings, and course with at least one year follow-up. Results: Forty-nine salivary tumours were treated, including 43 parotid tumours (87%), 3 sub-mandibular tumours (6%), 1 palatal tumour (2%) and 2 ectopic tumours (4%). Sixteen percent of the tumours were malignant. Fine-needle cytology sensitivity was 40%, whereas specificity was 100%. Out of 43 parotidectomies, 40 (93%) were primary parotidectomies, and 3 were revision parotidectomies. Most parotidectomies (81%) were superficial or partial and 8 (19%) were total. Parotidectomy complications are similar to those described previously in the literature: permanent facial palsy in superficial or partial parotidectomy (5%), wound dehiscence or necrosis (13%), post-operative bleeding (4%), fever or wound infection (7%), sialoceles (44%) and Frey's syndrome (2%). Conclusions: Parotid tumours are the most common salivary gland tumours. Most of them are benign, but Warthin's tumour is more frequent than usual in our series. Early and late complications from parotidectomy are uncommon, although sialocele is a common transitory complication in our series (AU)