Acute neck infections: prospective comparison between CT and MRI in 47 patients.

PURPOSE: The purpose of this work was to assess the advantages and disadvantages of MRI versus CT in the initial evaluation of acute infections involving the neck. METHOD: We prospectively evaluated 47 patients with neck infections. All patients underwent CT and MRI with contrast of the area of interest using similar slice thickness. Final diagnosis was achieved by percutaneous aspiration, surgical exploration and drainage, or follow-up after successful antibiotic therapy in all patients. Two radiologists reviewed all imaging studies with special attention to lesion conspicuity, location, extension, bone involvement, source of infection (odontogenic versus nonodontogenic), and presence of gas and/or calcium in the lesions. A 3 point scale was used to grade these parameters, and statistical comparison was done using paired t test. RESULTS: As used in our population, MRI was superior to CT in regard to lesion conspicuity, number of anatomic spaces involved, extension, and source. Additionally, although not statistically significantly, MRI detected a greater number of abscess collections. CT was superior to MRI in the detection of intralesional gas and calcium and showed fewer motion artifacts. These advantages of CT were, however, not significantly better than those of MRI. CONCLUSION: As used in our study, MRI was considered superior to CT in the initial evaluation of neck infections. Our findings suggest that MRI may be used as the first and perhaps the only modality to initially evaluate patients with neck infections when clinically feasible.

[Acute suppurative thyroiditis secondary to fistula of the pyriform sinus]. / Tiroiditis aguda supurada secundaria a fístula del seno piriforme.

Acute suppurative thyroiditis is very rare and often related to congenital abnormalities of the branchial pouches or immunodeficiency. A case of acute thyroiditis due to fistula of the left pyriform sinus in a young man with no relevant history is reported. We review the embryology, diagnosis, and treatment of this rare entity.

[Parapharyngeal carcinoma of the larynx: current clinical and pathological aspects and reports of a clinical case]. / Schwanoma parafaríngeo: aspectos clinicopatológicos actuales y exposición de un caso clínico.

Schwannomas (neurilemmomas) are benign tumors of the nerve sheath arising from the Schwann cells in the neural sheath of cranial and spinal nerves. The most frequent sites are the peripheral nerves of the head and neck and the flexor surfaces of the upper extremities. Parapharyngeal schwannomas are rare, which makes them interesting for ear, nose and throat specialists. A new case of schwannoma of the parapharyngeal space is reported. Our experience with the clinical management and surgical treatment of cervical schwannomas is discussed and the literature is reviewed.

[Adenosquamous carcinoma of minor salivary glands. Reporting a case in the tongue]. / Carcinoma adenoescamoso de glándulas salivares menores. Exposición de un caso de localización lingual.

Adenosquamous carcinoma of the salivary glands is an unusual neoplasm not unanimously included in many classifications of salivary gland malignancies. A case sited in the oral cavity, within the tongue is reported. Clinical and histopathologic features are described together with a discussion about treatment and behaviour. We also include an updated of literature relating to this entity.

[Postoperative pain in tonsillectomy in general anesthesia and local infiltration]. / Dolor postoperatorio en amigdalectomía bajo anestesia general e infiltración local.

UNLABELLED: The aim of this study is to demonstrate that blockade by bupivacaine of nociceptors located at the same level than the anterior tonsillar pillar, can reduce the pain in the postoperative period following tonsillectomy, thus, making easier the recovery of these patients at home. For this purpose, fifty children aged 2 to 13 years old, are studied. A double blind study is performed distributing the children randomly in two groups. One group is infiltrated prior to surgery with 1 cm3 of bupivacaine 0.25% + epinephrine 1:200,000 in three points of the anterior tonsillar pilla, while the other group is infiltrated with normal saline. The pain in the immediate postoperative period (60 minutes) is classified in five categories by a visual pain scale (scored 1-10). Short term postoperative (7 days) is also classified in five categories by a scale (scored 1-10) based in the information provided by the mother. Statistical analyses of the data is performed considering the statistical significance of the correlations obtained from the Chi2 and Student's tests. CONCLUSION: pre-incisional infiltration in the anterior tonsillar pillar with bupivacaine in the tonsillectomy will cause a remarkable reduction in the intensity of the postoperative pain.