[Thyroid nodules: factors suggestive of malignancy]. / Nódulos tiroideos: factores sugerentes de malignidad.

The evaluation and management of thyroid nodules is a common problem in medicine. In a review of 250 cases of thyroid disease seen at the 12 de Octubre Hospital (Madrid, Spain), 191 cases of solitary nodules and multinodular goiter were analyzed. The clinical findings, complementary studies, and postoperative histology were analyzed to determine the parameters most closely related to malignant thyroid processes. The overall rate of malignancy was 22.5%. Major clinical factors associated with malignancy were fixation to deep structures, cervical lymph node enlargement, and paralysis of the vocal cords. None of the complementary tests was absolutely reliable in excluding malignancy, but fine needle aspiration biopsy, in spite of its limitations, was the best diagnostic tool. Surgery is indicated if the benignity of a nodule cannot be confirmed.

[Juvenile giant nasopharyngeal fibroma: the hinge maxillotomy approach]. / Fibroma nasofaríngeo juvenil gigante: maxilotomía en bisagra, una vía de abordaje.

A giant juvenile nasopharyngeal fibroma in a 29-year-old male was removed by hinge maxillotomy. The diagnosis and treatment of these tumors is discussed.

[Radiological criteria for laryngeal tumors and cervical metastases]. / Criterios radiológicos en los tumores de laringe y sus metástasis cervicales.

Radiological techniques are important for studying the extension of laryngeal tumors. CT and MRI yield high-quality images with few artifacts that can be studied quickly. We reviewed the fundamental criteria for radiologic study of these tumors by ear, nose, and throat specialists on the basis of our personal experience and the literature.

[Differential diagnosis of neurinomas of the jugular foramen and glomus jugulare: a clinical case]. / Diagnóstico diferencial entre neurinomas de agujero rasgado posterior y glomus yugular: Caso clínco.

Neurinomas or schwannomas of the jugular foramen are rare tumors whose differentiation from tumors of the jugular body may be difficult because they share common symptoms. Since schwannomas at this site are less aggressive than tumors of the jugular body and certain elements of their treatment differ, it is important to make a correct diagnosis promptly. A well-documented case of schwannoma of the jugular foramen is reported and its differential diagnosis is discussed in the light of the literature.

[Orbital cellulitis and permanent amaurosis: clinical case]. / Celulitis orbitaria y amaurosis permanente: caso clínico.

Orbital cellulitis is a rare, potentially serious but complication of acute sinusitis. It is more frequent and benign in children, but in adults usually requieres surgical drainage of the affected sinus. We report a case of aggressive evolution with permanent blindness in an adult without general or local risk factors, in spite of adequate treatment. The literature is reviewed.

[Subdural empyema induced by frontal sinusitis]. / Empiema subdural inducido por sinusitis frontal.

Nowadays the complications arising from sinusitis are rare. However its seriousness can even cause death. Intracranial complications are much more uncommon than the orbital ones. However, slight symptoms can appear, which may disjunct the correlation between clinical-radiology and the severity of the infection. The diagnosis is fundamentally based on the TAC, and early treatment with intravenous anti-biotherapy should be implemented, being followed by drainage surgery of the sinus and empyema. We have presented a case which evolved favourably and revised all the literature pertaining to it.

[The mastoid surgery in children at the Doce de Octubre Hospital. Review of the years 1988-1991]. / Cirugía de la mastoides en niños en el Hospital Doce de Octubre. Revisión de los años 1988-1991.

A study was made of 21 children with cholesteatoma and chronic otitis media between 1989 and 1991. We reviewed diagnostic tools, presurgical data, surgical procedures and results. Certain aspects of special relevance such as congenital anomalies and presurgical complications, are emphasized. The procedure of choice was mastoid tympanoplasty with the canal wall down, which is preferred in children. Hearing results were poor, partially caused by the process of bone resorption and by the surgical technique used. The incidence of persistent disease and recurrent cholesteatoma was high but we achieved a good control of the disease development because the canal wall down procedure allowed visualization and cleaning of the mastoid cavity.

[Congenital medially invasive cholesteatoma of the temporal bone: supralabyrinthine dissemination and possible origin in the area of the geniculate ganglion]. / Colesteatoma congénito medialmente invasivo de hueso temporal: vía de diseminación supralaberíntica y posible origen en área de ganglio geniculado.

Congenital cholesteatoma appears in about 2% of all cholesteatomas. The possibility of deep extension producing a medially invasive petrous bone cholesteatoma is very uncommon because congenital cholesteatomas are not as aggressive as acquired ones. The onset of facial palsy in a patient with a history of several years of hearing loss must suggest this possibility. We reviewed in this report the main concepts on this subject after bibliographic review and a case report.

[Tuberculous retropharyngeal abscess in an HIV patient. Report of a case]. / Absceso retrofaríngeo tuberculoso en paciente HIV. A propósito de un caso.

The tubercular retropharyngeal abscess is a rare manifestation of this infection, even in the presence of an extensive pulmonary involvement. We present the case of a patient HIV positive with an important compromise of the airway, and a review of the literature.